Healthcare has been one of the most hotly contested issues in the democratic primaries. Candidates are either backing Medicare for all or suggesting less “radical” reforms. However, one thing that’s not been subject to debate is how race and ethnicity factor in healthcare.
Almost 16 years ago, the Institute of Medicine published the Unequal Treatment report. It demonstrated how ethnic minorities are less likely to obtain preventive medical treatment than whites and often receive a lower quality of care. Little has improved since then.
The report explained that even after taking factors like income, comorbid illness, and health insurance type into account, health outcomes in the African American community were worse than the whites.
Similar research conducted in 2010 revealed that minorities such as blacks and Hispanics often miss out on crucial services such as diabetes monitoring and cancer screening, which sometimes proves to be the difference between life and death.
To make matters worse, minorities often get treatments that are unnecessary, economically inefficient, and, potentially harmful. A common example of this is improper imaging of low-back and the use of antibiotics. Hispanics and black beneficiaries of Medicare face a greater probability of improperly receiving feeding tubes. Moreover, 33% of black Medicare beneficiaries receive butalbital or opioid prescriptions for migraines, fewer than 25% of white patients receive similar prescriptions.
Among the Medicare patients -who already have low rates of preventive care visits -minorities have the lowest rate. Fewer Medicare annual visits by minorities are related to education and income, factors that are often associated with ethnic and racial inequality. As Joseph Castle of ClothingRIC points out, Americans generally spend 7.8% of their budget on healthcare. Marginalized communities generally spend a higher percentage since they’re more vulnerable to disease and worst of all; they have a more limited budget. It’s nothing short of a nightmarish scenario.
However, the healthcare woes of minorities exceed far beyond just money problems. Racism and discrimination in the healthcare industry are something that is rarely discussed. Black, Latino, and Muslim patients complain about facing apathy and ill-treatment from doctors and nursing staff. While doctors take an oath to treat all patients equally, sometimes their pledge takes a backseat to their subconscious prejudices.
This issue has multiple layers. Racism is deeply ingrained in the social, political, and economic structure of American society. For the people of color, this results in a lack of access to better education, affordable housing, and in this case, quality healthcare. Patients who face covert racism in hospitals feel like they are not welcome, which discourages them from ever going back.
Recently, the Democratic Presidential candidate, Bernie Sanders was asked about his plans to counter racism on the Trevor Noah show. While answering, Senator Sanders discussed how a black voter complained about feeling harassed at the hospital. The 2020 hopeful made a good point on how even Medicare for All will be of no use if patients feel disrespected at the hospital due to their racial identity.
This short exchange is a good start. Moving forward, more presidential candidates should discuss racial disparity in healthcare. Minorities need a health care system that addresses long-standing structural biases. The need of the hour is to take the racism head-on, whether it’s the disrespectful attitude of the healthcare professionals toward colored individuals, or income equality that leads to black and Latinos receiving a lesser quality of treatment.
Healthcare struggles of marginalized communities should take the center stage as we head into the election year. Candidates should be asked how they plan to make the best treatments available to minorities and most importantly, how they plan to inspire their trust in the country’s healthcare system.