Race and health in the United States
[26] According to the American Journal of Preventive Medicine, a data analysis was performed using The Behavioral Risk Factor System survey to examining the perceptions of racial privilege in healthcare among different races.
The report identified six areas of health concern: cancer, cardiovascular disease and stroke, chemical dependency related to cirrhosis of the liver, diabetes, homicides and accidents, and infant mortality.
[69] Residence in poor neighborhoods, racial bias in medical care, the stress of experiences of discrimination and the acceptance of the societal stigma of inferiority can have deleterious consequences for health.
[76] Two local governments in the US have issued declarations stating that racism constitutes a public health emergency: the Milwaukee County, Wisconsin executive in May 2019, and the Cleveland City Council, in June 2020.
In 2003, the Institute of Medicine released a report showing that race and ethnicity were significantly associated with the quality of healthcare received, even after controlling for socioeconomic factors such as access to care.
Raj Bhopal writes that the history of racism in science and medicine shows that people and institutions behave according to the ethos of their times and warns of dangers to avoid in the future.
Krieger writes that this suggestion ignores a growing body of evidence on how noneconomic as well as economic aspects of racial discrimination are embodied and harm health across the lifecourse.
[101] These differences can be commonly linked to correction factors in medical calculators, algorithms that are unable to account for variables rooted in social disparities, and drugs designed for specific racial populations.
[102] The Food and Drug Administration initially rejected applications of the medication since their clinical trials did not demonstrate any efficacy for a general racial population within the United States, except for African Americans.
Vyas makes a rebuttal to this idea, stating, "Explanations that have been given for this finding include the notion that black people release more creatinine into their blood at baseline, in part because they are reportedly more muscular."
For some patients, judgments about the initial encounter seem to have less to do with clinical expertise or experience of the provider and more with perceptions of empathy and the quality of the interpersonal connection between the two individuals (Earl, Alegría, Mendieta, & Diaz Linhart, 2011[112]).
[118] According to the U.S. Department of Health and Human Services Office of Minority, African American women have the highest rates of obesity or being overweight compared to any other groups in the United States.
Research done by the Journal of General Internal Medicine has determined that persevering funding disparities have led to less quality resources for hospitals that predominantly serve black patients.
RD Bullard writes that a growing body of evidence reveals that people of color and low-income persons have borne greater environmental and health risks than the society at large in their neighbourhoods, workplaces and playgrounds.
[141] Although impoverished or underdeveloped communities are at greater risk of contracting illnesses from public areas and disposal sites, they are also less likely to be located near a distinguished hospital or treatment center.
Whether it be at a hospital, a walk-in clinic, or a family doctor's office, people are hit with bias-based comments concerning "general bias, ethnicity / national origin, race, age, gender, accent, religion, political views, weight, medical education from outside the US, sexual orientation, and more".
A greater initiative from healthcare organizations surrounding policy that protects not only black doctors, but other professionals that deliver unsurpassed care retains the much needed diversity and leadership in medicine.
[158] David Williams writes that higher disease rates for blacks (or African Americans) compared to whites are pervasive and persistent over time, with the racial gap in mortality widening in recent years for multiple causes of death.
Research suggests that improving quality of the lowest-performing hospitals could benefit both non-Hispanic white and Hispanic women while reducing ethnic disparities in serve maternal morbidity rates.
Latino and Hispanic communities have a hard time communicating with health professionals due to a language or cultural barrier; as a result, they turn to outside sources for help and medication.
[166] A 2000 study found that between 1973 and 1976, physicians at four IHS facilities – those in Albuquerque, Oklahoma City, Phoenix, and Aberdeen, South Dakota – sterilized 3,406 women, 3,001 of whom were of childbearing age at the time.
American Indian and Alaska Native identifying people are more likely to have unmet mental health needs, and to experience major depressive episodes than the non-Hispanic white population.
In 2016, 6.7% of American Indian and Alaska Native adults reported having needs for mental health services that had been unmet in the last twelve months, compared to 5.4% of the non-Hispanic white population.
Dr. Maria Yellow Horse Brave Heart first described historical trauma for Native Americans in the 1980s as, "cumulative emotional and psychological wounding", which in turn affects both physical and mental health.
[24] The opioid epidemic in the United States is overwhelmingly white, sparing African-American and Latino communities because doctors unconsciously prescribe narcotics more cautiously to their non-white patients.
[201][202] A government representative cited "historical abuse", "present racial injustices and health care disparities", and "recent social unrest (and) the faltering economy" as factors impeding recruitment of blacks.
A study conducted at Planned Parenthood health centers in Louisiana and Kentucky highlights how insurance instability and lack of regular sources of care exacerbate these challenges, particularly in states that do not have expanded medicaid under the ACA.
The study underscores the critical role of health centers in bridging these gaps, but also point out the need for more robust governmental support to enhance Medicaid access and strengthen safety-net services.
These barriers compound existing disparities, limiting their ability to access continuous coverage and essential services, and therefore, demonstrating the need for CHCs to develop tailored solutions that address women of color in healthcare.
Children in immigrant families (CIF) are more likely to experience adverse social determinants of health, suboptimal health service utilization, and increased rates of chronic illness compared to children in non-immigrant families due to disproportionate rates of parental unemployment and underemployment, limited English proficiency (LEP), and limited access and participation in public safety net programs that exist among immigrant communities.
