The Death Toll of Racism in the Healthcare Industry
The Intersection: Healthcare
ROBIN HUANG: As coronavirus made its way throughout the country, the illusion of the disease as the “great equalizer” of American society quickly shattered.
Despite limited reporting, emerging statistics indicate that Black Americans face higher rates of infection and deaths by COVID-19 across the country. African Americans account for roughly a quarter of deaths from COVID-19, even though they only make up about 13 percent of the population. The death rate from the disease among African Americans is over three times higher than their white counterparts. The trend is evident nationwide. While Black Americans only make up a third of the state’s population in Louisiana, they account for over 70 percent of COVID-19 related deaths. Meanwhile, in Chicago, African Americans make up over half of all cases, though only 30 percent of the population is Black. Although the coronavirus cannot discriminate how it infects populations, the crisis has instead exposed the shortcomings of American institutions that have historically failed already disadvantaged groups, especially within the healthcare system.
Why has the pandemic disproportionately impacted Black Americans? The answer is not found in genetic or biological reasons, but rather in the social and economic circumstances Blacks face in the United States. African Americans are more likely to be employed in “essential work,” front-line jobs that cannot be conducted remotely and thus risk greater exposure to the disease. They are also more likely to live in high-density neighborhoods, reducing the efficacy of social-distancing efforts. Commuting daily to essential work, interacting with many customers at a front-line job, and returning home to cramped housing — these conditions naturally lead to elevated infection rates.
The increased rates of infection and death from COVID-19 among Black Americans reveal shortcomings of the broader healthcare system in ensuring equal access to quality resources for minorities. Ironically, the very system designed to preserve American lives has failed to do so for an entire community. The American healthcare system is guilty of longstanding institutional bias against Black Americans. Whether it be COVID-19 or other health conditions, Black Americans are less likely to receive treatment than their white counterparts who report the same symptoms. The toll of inequitable healthcare access has led to higher rates of underlying medical conditions such as diabetes and heart disease among the Black population, which create an increased risk of death from the coronavirus.
The dominant influence of race in health outcomes in the United States has been known to scientists and lawmakers alike long before the coronavirus arrived at America's borders. The phenomenon has been dubbed by researchers as the “weathering effect,” where the impact of economic disparity and systemic racism faced by Black Americans heighten stress levels and diminish health over time. A 2003 congressional report states: “Racial and ethnic minorities tend to receive a lower quality of healthcare…[which] are associated with greater mortality among African-American patients.” Even wealthier or more educated Blacks have shorter life expectancies compared to white Americans of similar standing. Across the board, Blacks face poorer quality of medical treatment, and therefore reduced lifespans. If the mortality rate were equal between Black and white Americans, 100,000 fewer Black lives would be lost annually. The interplay of socioeconomic disadvantages and racial bias in the healthcare system has produced a society where being Black in America means living a shorter life.
Within the frame of the pandemic, we must tailor public health responses to communities in crisis. Physical distancing, while crucial to fighting the disease, is a privilege. Low-income communities, especially among Black Americans, are disproportionately impacted by COVID-19. It is impossible to socially distance if one must continue commuting to front-line work to keep paying the bills. Providing food, wage relief, and housing during the pandemic are essential to public health response, allowing groups to exercise social distancing measures.
Also, past the coronavirus pandemic, the American healthcare system must eradicate its problem of institutional bias. Racism, particularly within healthcare, continues to cost countless lives. Healthcare is not exempt from the influence of structural racism in the United States. Research demonstrates that implicit bias among physicians can lead to less appropriate treatment of patients of color. Doctors must be trained against the effect of implicit racism in impacting their work. Already, the Centers of Disease Control and Prevention has warned healthcare professionals to be alert to the influence of racial bias in prescribing treatments.
Furthermore, healthcare is a necessarily personal profession, where doctor-patient trust is critical. While all doctors must be trained to form empathetic relationships with patients to provide the highest quality care, including doctors with whom a patient identifies can build an irreplicable bond. Studies show that a shared identity between caregiver and patient heightens quality of care: doctors are not only more likely to treat a patient more appropriately, but patients are more likely to follow given medical advice. However, only five percent of physicians in the United States are Black. By increasing the number of Black healthcare professionals—whether through initiatives in education, hiring, or outreach—healthcare becomes a more inclusive and resilient space for doctors and patients alike. While it is important to note that solutions to dismantle systemic racism in healthcare may take years before they are proved effective, the death toll from unequal healthcare is far too significant to be ignored.
The Black Lives Matter movement's current nationwide protests expose anger at not only police brutality, but also deep-seated frustrations at economic and health woes against American institutions tainted with racism. How can Black Lives Matter when systems meant to care for them too often fail? Racial justice is a public health matter, too. Whether it be short-term solutions such as providing resources for social distancing during the pandemic or long-term solutions such as combating racism, we must seek to protect the Black community's lives. The coronavirus pandemic may have only lasted several months so far, but racism — especially in healthcare — has killed Black people for generations. By fighting racism, we will also save lives.
Robin Huang is a sophomore in the Walsh School of Foreign Service studying International Politics and Public Health. She is originally from North Carolina.