Hello. My name is Daniel Fulk, and the title of my presentation is “Getting to the Bottom of Racial Inequalities in Healthcare”. This topic interests me because it is something that I have witnessed in my own hometown, Winston Salem NC. Racial inequalities have always been prevalent in Southern states such as North Carolina and is an issue that is still alive today. This has negative impacts on all aspects of life, including health care. Research has shown that in North Carolina there is a disparity in the quality of healthcare received between white people and racial minorities, such as Black and Hispanic people. It was also found that these disparities are not held to emergency hospital visits and acute illness but also chronic diseases and use of hospitals in general. I have gathered secondary research to discover if there is a disparity in the quality of healthcare received in communities of racial minorities, and if so, what causes this. The goal of this research is to get to the bottom of systematic issues keeping these groups from the healthcare they deserve and also what may cause these groups to be less willing to seek out medical resources. This is important because these issues are causing groups of people to be underserved based on their race, which should never be a factor.
Although the difficulty of accessing healthcare in general for these groups of minorities is a big problem in itself, this is only half of the battle. Studies support that there are systematic inequalities in healthcare facilities themselves, as even when racial minorities overcome the obstacle of getting to healthcare, they are still more likely to receive less care than necessary in comparison to white patients. The Journal of Surgical Research speaks on this, stating “Severely injured Black and Hispanic trauma patients are more likely to be undertriaged than otherwise similar white patients” (Alber & Dalton, 2021, para. 4). This is a serious issue as it shows that even when other obstacles of getting to healthcare in the first place are overcame, there is still an underlying disadvantage of having a different skin tone that is entirely out of the people’s hands.
Not only were Hispanic and Black patients more likely to be underserved in healthcare for severe acute injuries, the same inequality is prevalent for chronic health issues and long-term programs. The American journal of physical medicine & rehabilitation explains that white patients were more likely to be referred for cardiac rehabilitation than were black patients. Some may argue that the difference in referral rates may have to do with other factors, but the journal continues to state that for the patients who were able to be considered for cardiac rehabilitation, race is independently correlated with the chances of being referred for the rehabilitation program(Gregory & LaVeist, 2006, p. 705). This is extremely discouraging for the groups at a disadvantage and overall acts as a setback for the fight against these inequalities as it eliminates trust between these patients and healthcare, making them less likely to utilize the facilities there for them when health issues arise.
All of the medical studies and statistics presented show that the inequalities in healthcare is a definite issue, but something that can be overlooked when researching this problem is what the groups of minorities have to say themselves about these inequalities. The Journal of the National Medical Association conducted a study of 277 African American men treated for prostate cancer, in which they gathered the opinions on the care they had received. The men in the study responded saying that health care providers were not sensitive to the concerns they had and did not show interests in the patients input. It was explained that the white healthcare providers did not answer questions about prostate cancer and how it would affect them (Moore & Hamilton, 2013, p. 94). These responses are very important because it gives direct insight into the untrusting and skeptical feelings many POC feel towards a healthcare system not built to treat them fairly. These opinions dictate whether or not these people are likely to seek out help from healthcare providers available to them, and if they are led to think negatively about those services this will only serve as a setback to the systematic issues we are already facing.
Over the past year the presence of the coronavirus has magnified the inequalities in healthcare racial minorities are experiencing. The Journal of Racial and Ethnic Health Disparities highlights these inequalities, stating that that African Americans are four times as likely to die from Covid19 related health issues than the national average (Louis-Jean & Cenat, 2020, p. 1039). The statistics related specifically to covid stem from multiple different issues whether it be lack of education about the disease, insufficient access to testing sites, or the inability to access healthcare facilities in general. These are all problems that are applicable to health problems other than Covid19 and have put these communities at a disadvantage far longer than covid has been around.
Overall, the research gathered proves there are definite inequalities in the quality of healthcare received by communities of racial minorities, regardless of the type of care needed. There are multiple causes for this, such as systematic racism in the healthcare system, under informing of communities, and lack of ability to access healthcare as a whole. This issue across the board is unacceptable and change must be made moving forward to ensure equality for all North Carolina citizens, no matter what race. This change can be started by creating an environment focused on racial literacy in healthcare by better teaching those working in the profession to be aware of the systematic racism that has occurred up until now and ensuring that the main goal at all times is to provide the necessary care to patients without any bias. These disparities can also be worked against by providing better education about health to the communities affected, because it is very difficult to get the care you need when you are under informed about health risks to begin with. Hopefully in the future more studies of similar nature can be conducted along with implemented changes in the healthcare system to document these issues and hopefully see an increase in equality for everyone.
Alber, D. A., Dalton, M. K., Uribe-Leitz, T., Ortega, G., Salim, A., Haider, A. H., & Jarman, M. P. (2021). A multistate study of race and ethnic disparities in access to trauma care. Journal of Surgical Research, 257, 486-492. https://www.sciencedirect.com/science/article/pii/S0022480420305758
Gregory, P. C., LaVeist, T. A., & Simpson, C. (2006). Racial disparities in access to cardiac rehabilitation. American journal of physical medicine & rehabilitation, 85(9), 705-710. https://journals.lww.com/ajpmr/Fulltext/2006/09000/Racial_Disparities_in_Access_to_Cardiac.1.aspx
Louis-Jean, J., Cenat, K., Njoku, C. V., Angelo, J., & Sanon, D. (2020). Coronavirus (COVID-19) and racial disparities: a perspective analysis. Journal of racial and ethnic health disparities, 7(6), 1039-1045. https://link.springer.com/article/10.1007/s40615-020-00879-4
Moore, A. D., Hamilton, J. B., Knafl, G. J., Godley, P. A., Carpenter, W. R., Bensen, J. T., … & Mishel, M. (2013). The influence of mistrust, racism religious participation, and access to care on patient satisfaction for African American men: the North Carolina-Louisiana Prostate Cancer Project. \, 105(1), 59-68. https://www.sciencedirect.com/science/article/abs/pii/S0027968415300869
Featured Image Source
Hoban, Rose. (2020). Sign at Rally to commemorate the death of George Floyd. [Digital photograph]. North Carolina Health News. Retrieved April 1, 2020 from https://www.northcarolinahealthnews.org/2020/06/08/racism-and-african-americans-health/