The United States healthcare system is omnipresent on the discussion blocks of what does and does not work well in this country. In some aspects, the United States healthcare system is considered one of the best in the world, but in other areas it pales in comparison to many other developed countries. Most of the issues within the U.S. healthcare system revolve around money, and social issues and inequalities are no exceptions.
Though overt racism in healthcare is fairly non-existent, and punished heavily when it is found, comparative statistics suggest that covert racism is one of the greatest hurdles that the healthcare system must overcome. One positive thing that came out of the COVID changes was that healthcare disparities unrelated to the virus were put into the spotlight after many reports of racially disproportionate cases and care related to COVID were publicized.
Here is a closer look at some of the social issues that the U.S. healthcare system is facing.
Health equity means every single person in the country has the same opportunities to be as healthy as they possibly can. While many Americans are able to get the best possible care, not everyone in the country has that opportunity, and the treatment of COVID is a prime example of failures in health equity.
The depth of socioeconomic issues that lead to these disparities, is unfortunately book-worthy, but in short, all of these disparities are bi-products of many other areas failings within the U.S. government that have yet to reach equity either (locations, food options, population density, etc.).
According to the Kaiser Family Foundation and the Epic Health Research Network, COVID hospitalization rates per 10,000 people in a given racial demographic were as follows: (all per 10,000) White – 7.4; Asian – 15.9; Hispanic – 30.4; Black – 24.6. Death rates per 10,000 were proportionately similar: White – 2.3; Asian – 4.3; Hispanic and Black both 5.6.
This means that COVID, with no understanding of what race or money is, was 3 times more likely to affect black and Hispanic Americans, and 2.5 times more likely to kill them than it was for white Americans. Asian Americans fell somewhere in the middle. Anti-Asian rhetoric that was frequent in the Trump Administration following discoveries that COVID originated in China (often referred publicly by the administration as the “China Virus” or “Kung Flu”) led to a rise in hate crime against Asian Americans. The fact that COVID disparities relative to the Asian community are higher than other healthcare disparities suggests that racist rhetoric caused some of the disproportionate care.
Where the anti-Asian rhetoric mentioned above was a result of modern vocalizations of feelings, implicit biases are passed down from generation to generation. These biases are more likely the reasons for the number of black and Hispanic COVID cases being higher for that demographic, as similar disparities existed in other parts of healthcare for this demographic before the pandemic, and will most likely exist after COVID is eradicated as well. Health policies in America are starting to put a heavy focus on cultural awareness and an understanding of implicit biases, and the statistics that those biases cause.
Implicit biases are those feelings ingrained in us by any and all influences we are exposed to in our youth. A non-abrasive example would be East Coasters referring to interstates as “Route 10” and West Coasters calling it “The 10.” No one is wrong, but both think they’re right because that’s what they were taught. Racism is generational in America, and even those with families devoid of hate feel societal influences, and these influences can cause individuals to view groups of people as less, or at least different than their own.
These biases are the reasons that disparities exists, such as black women being four times as likely to die during childbirth. Though many people are able to overcome these biases in healthcare, some providers still do not give equal effort and care to demographics other than their own.
The availability of quality care in a given locale is also determined heavily by money in that area. Generally speaking, minority communities aren’t as affluent as their white counterparts due to systemic racism. These systemic issues make it more difficult for minorities to be hired for jobs than their white counterparts are competing for and, ultimately, to afford to move to areas with better healthcare. Thus, finances may also lead to the disparities mentioned above, as well as many other conditions.
Though extremely long, the path to healthcare equity does exist, and it begins with awareness. Some hospitals keep their disparities related to demographics (often race, but ageism and sexism also exist) hidden for whatever reason, and encouraging healthcare teams to be honest and transparent about any disparities they find is the only way to correct them and move forward. In the same sense that it takes admitting and conscious effort to overcome implicit biases, it also takes the same admittance and conscious efforts to reverse disparities in a given healthcare system.
Guest Author Bio
With a Bachelor’s in Health Science along with an MBA, Sarah Daren has a wealth of knowledge within both the health and business sectors. Her expertise in scaling and identifying ways tech can improve the lives of others has led Sarah to be a consultant for a number of startup businesses, most prominently in the wellness industry, wearable technology and health education. She implements her health knowledge into every aspect of her life with a focus on making America a healthier and safer place for future generations to come.