Racism in Healthcare: Examining Patient-Provider Communication and Health Disparities

Introduction

Over years racism has been a constant in societal issues. This literature review highlights important questions about racism, patient/provider communications, and health disparities. What is the best way to understand racism in healthcare, is there evidence to support these claims in the U.S. healthcare system, and how can we disentangle racism discrimination from discrimination based on other factors. Injustice perception has emerged as a risk factor as well as higher pain, and related disability. This brought attention to the problem of racism in healthcare and more specifically racist acts toward healthcare workers and a call to action. Racial discrimination will be associated with perceived barriers to health care. Institutional racism is a structural and legalized system that results in differential access to health services. The cultural refers to the negative racial stereotypes often reinforced by medical results in poorer psychological and physiological well being of minorities. The arguments presented in this essay unfold and dive into the complex theme of racism in healthcare.

Racism in Healthcare

Injustice in healthcare forms a risk for minorities with musculoskeletal pain outcomes. There has been no study conducted to address the injustice actions with CLBP. The current study dealt with associations of injustice and pain, and depression in a diverse community. Variables were used to mediate the results, controlling the demographic and pain-related variables shows injustice evidence in racial disparities. Black participants received higher levels of injustice related to CLBP, as well as pain-related disability. Current findings give information regarding the part of injustice perception especially in the context of CLBP and in a racially diverse community sample. The finished results touch over the need for greater diversity in injustice and CLBP research and antecedents of injustice appraisals.

In the United States, lower back pain is the leading cause of pain, disability, affecting 52 million of all health care visits(Trost et. al). Although lower back pain resolves quickly most patients develop a chronic and disabling condition. Individuals who identify as Black or African American have more frequent and disabling pain across a wide variety of conditions compared to other racial groups. Literature in the area of Worker’s Compensation discovers that African Americans show far worse long-term outcomes after a back injury in the working field. The scholarly article recognize systematic racial disparities in evaluation, treatment, and legislative outcomes, highlighting the potential relevance of injustice appraisals

Ethics

Ethical disputes surround the healthcare environment in all aspects. 71% of black techinicans have reported racial discrimination in a work related enviroment (Rasmussen & Garran). Workers in healthcare are being discriminated against. Research gives little attention to racism in this profession. The effects of racism in healthcare includes addressing the problem of power imbalances. Race in healthcare workers creates ethical problems that prevents others from confronting the issue and challenge. For example a patient declines medical treatment based on a doctor’s racial identity. That raises challenging ethical, legal, and professional predicaments by experiencing this, physicians may be offended and skewed their psychological status while attending another minority who is non-racist. Kimani Pual-Emile argued that patients frequently refused treatment based on racial identity (Rasmussen & Garran). Racism in this matter has a variety of forms, Overt racism would result in a health care worker received denial to service a patient. Less overt racism can be perceived in the form of microaggressions.

Microaggressions

Massive amounts of microaggression is experienced in healthcare within all aspects of it. Counselors report a higher experience of racist than whites, healthcare workers are treated unfairly within the work environment. Professionals are neglected in racism by research, practice, and policy. Micoragression can incorporate questioning of where the doctors received the degree, what country were they born in, and if they are being supervised to access an individual. Nursing reported that little research attention has been given to the issue of racism despite the constant racist experiences on the job and the fear of bringing the constant issue to light. Counselors reported more occurrences of racism in cross-racial treatment than white counselors did (Gelsomino). In healthcare industry, Aymer recgonizes the complex undergoings facing black workers who have a history of racism along side of them as they provide therapy to a range of clients.

Barriers

All across America inequities in healthcare persist across racial and ethnic groups according to recent U.S. Health and Human Services Initiative to reduce racial and ethnic disparities in health. Barriers effects of racial discrimination will be particular severe for women, sexual minorities, and low socio-eco staus. 2 out of 3 of the groups named recieve some form of discrmination. These group of individuals are more likely to get discriminated against and create barriers in healthcare. Racial discrimnation is significantly associated with perceived health care barriers to predict healthcare. Patients are analyzed to predict barriers to healthcare across all models. Racism is limited by an exclusive focus on a patients or workers race in an area. In communities lacking high-quality facilities it forms a patterned to barriers from high quality care. Hispanics are reporting a problem with obtaining care, going without needed care, and not being assured that a family member could get needed care. Almost one third of hispanics are reporting not having a type of care in America.

Class, Age, and Gender

Individuals with a lower class, higher age, and certain sexualities are expected to be discriminated against. Racism has shown to negatively affect the healthcare industry quality but little is known to the extent through gender, class, and sexuality is affected. In 2014 Australian General Social Survey, a national representative survey of individuals aged 15 and older living in private dwellings. (Bastos, João L., et al) The gained knowkledeg of the survey helps associated the effects of perceived racial discrimination against women, sexual minorities, and low socio-economic status citizens. The connections between racism and healthcare at a social level are linked between lacking high-quality healthcare facilities and occupational instances that are concentrated in low-paying jobs with less flexible work-schedules.

Conclusion

Racial tension has always been an occurrence in healthcare and in more industries than that. Class, age, and gender create a problem for minorities because they undergo a system that continues to keep them under. Reports have shown the unfair treatment and government issued resolution to problems of racism. American policies are important to racist ties because the legislative branch helps develop a community overtime to benefit the minority. Barriers in racial discrepancies consistent of cause prevention of a race pursuing in healthcare and in the workers themselves. The racist actions prevent a patient from feeling comfortable unless it is a skin color the doctor and patient both share. In communities of low income areas are filled with barriers of receiving an inefficient healthcare industry to “aide” the community. This leads to microaggressions in minorities towards healthcare patients who would question where the doctor was authorized to be reviewing them or pester the worker about where they have received their degree. All factors of racial injustice in healthcare brings up the question of ethics in the industry. Research neglects the effects of ethical questioning and racism in minorities. A non-minority may feel uncomfortable and request a new doctor if they do not appear to have the same race and background of one another. This also messes with the doctors psychological ethic opinions of other minorities. Future research should pertain to distribution of powers, resources if available, opportunities, benefits, and capacities. These subjects coniside to interpersonal interactions that keep a constant reinforced power difference.

Works Cited

1. Brian M. Rasmussen, Ann Marie Garran, In the Line of Duty: Racism in Health Care, Social Work, Volume 61, Issue 2, April 2016, Pages 175–177, https://doi-org.liblink.uncw.edu/10.1093/sw/sww006
2. Paul-Emile K. (2012). Patients' racial preferences and the medical culture of accommodation. UCLA Law Review , 60, 462–504. https://www.uclalawreview.org/pdf/60-2-3.pdf
3. Davis L. E.Gelsomino J. (1994). An assessment of practitioner cross-racial treatment experiences. Social Work , 39, 116–123. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1022.5989&rep=rep1&type=pdf
4. Dossey, Larry. “The Shock of Charlottesville: Unmasking Racism in Healthcare.” https://www-sciencedirect-com.liblink.uncw.edu/science/article/pii/S1550830717303701#bib16
5. Phillips, Kathryn. “Barriers To Care Among Racial/Ethnic Groups Under Managed Care.” Health Affairs, 2000, https://www.healthaffairs.org/doi/full/10.1377/hlthaff.19.4.65
6. Bastos, João L., et al. “Health Care Barriers, Racism, and Intersectionality in Australia.” https://www-sciencedirect-com.liblink.uncw.edu/science/article/pii/S0277953617303040#!