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Systemic Racism

Addressing Systemic Racism in the South Carolina Healthcare System

Help for victims of discrimination and bias in hospitals and medicine

America is currently in a public health crisis. As the coronavirus pandemic spread throughout the United States in 2020, tension, protests, and heightened emotions also highlighted the continued issue of racial inequality. With the pandemic disproportionately affecting African American communities across the country, it’s time to take a closer look at systemic racism in the healthcare system.

African American patients face the threat of both physician bias during healthcare as well as systemic prejudices built into the algorithms and software used by medical facilities to determine the care patients receive. The South Carolina injury attorneys at McGowan, Hood, Felder & Phillips, LLC have years of experience working with patients who’ve suffered injury and discrimination at the hands of the healthcare system.

What is systemic racism?

Many people believe that racism is simply hatred of people of a different race. However, when it comes to systemic racism, this is an oversimplification. According to Eduardo Bonilla-Silva, a Duke University sociologist, systemic racism refers to the systems in place that perpetuate racial injustice. He points out that systemic racism is a structural phenomenon, meaning it’s “built in” to the systems within which we work and operate every day. It also means that, regardless of intention, most people engage in these systems and biases all the time.

Our country is in the midst of addressing racism in all forms, and it’s time to start with systemic racism and how it affects every aspect of a person of color’s life – especially his/her health.

Physician bias, racial disparity, and why it hurts black patients

The color of someone’s skin should not play a role in the quality of medical care they receive. However, various studies and analyses show that this simply is not the case in many hospitals and medical facilities here in South Carolina and across the country. It is important to remember that this does not mean that the medical community is full of racists – much of this behavior is unconscious – but what it does mean is that the system is full of implicit biases that must be addressed.

For example, a 2019 New York Times article points out that the medical field has a long way to go regarding the way it treats minority patients. Analyzing several studies and research from the last few years, the Times article revealed that African American patients are treated differently than white patients when it comes to:

  • Cardiovascular procedures
  • Cancer diagnosis and treatment
  • Receiving appropriate care for HIV
  • Care for diabetes, kidney disease, mental health
  • Prenatal care and pregnancy

These patients are also more likely to die from these conditions or complications from these conditions, after adjusting for age, sex, insurance, education and the severity of the disease.

Even an algorithm commonly used in U.S. hospitals – a risk calculation program – was found to be less likely to refer black patients than white patients to programs providing more personalized and additional medical care. This algorithm, used to predict which patients would benefit from increased care or specialists, greatly underestimates the needs of black and minority patients.

In fact, in order to receive the same medical treatment as white patients, black patients had to be significantly sicker to be referred for additional care. The algorithm is still in use, although its developers are “tweaking” it to improve its performance.

In an experiment at Stanford University and the University of California at Berkeley, researchers recruited 1,300 African-American men and offered them $25 to complete a general health survey, and then offered them a free health screening. Some would receive care from black doctors, and some from non-black doctors. The results? Those who saw black doctors were 56% more likely to get a flu shot, 47% more likely to agree to diabetes screening, and 72% more likely to accept a cholesterol screening. [source]

Why do doctors approach black patients’ care differently than white patients’ care?

Although most physicians report treating all patients alike, studies show subtle forms of racism exhibited toward minority patients, whether unconsciously or consciously. There are a number of myths regarding physiological differences between black and white patients – myths rooted in slavery that still endure today. Some of these myths (debunked decades ago) include:

  • Black and Hispanic people have a higher tolerance for pain than white people
  • Black patients’ nerve endings are less sensitive than other patients
  • Black skin is thicker than white skin
  • Black people have less lung capacity than white people

The combination or belief in any of these myths can lead to tragedy for many African American patients when doctors do not take their complaints of pain seriously. Doctors may miss signs of a cardiac event or cause a patient unnecessary pain and suffering, or even cause wrongful death if they allow implicit bias to affect their decision-making. This is absolutely unacceptable.

Research also shows that black Americans are:

  • Less likely to receive proper diagnostic care
  • Less likely to receive proper emergency care
  • More likely to die at an earlier age
  • More likely to die from breast cancer
  • More likely to die within the first year of life
  • More likely to have high blood pressure
  • Three times more likely to die from pregnancy complications
  • Twice as likely to die from heart disease
  • Twice as likely to have underweight babies

These disparities are alarming, and can lead to correlations between chronic stress and chronic health conditions (also called “weathering”) as well. This is a preventable and vicious cycle that simply makes people sicker and sicker. Although many states have recently declared racism a public health crisis, South Carolina is not currently on that list.

We must acknowledge and eliminate disparities in healthcare

Healthcare professionals and officials agree racial bias exists, but they do not seem to agree on how to solve it. We do know that various factors play a part:

  • Communication and language. Language barriers can prevent minority patients from receiving proper care. Patients and their families must have access to language services as soon as possible in order to provide the best possible treatment from the start.
  • Patient engagement. Many people of color have a deep-seated distrust of the healthcare system, leading to low patient engagement. Because of the way African Americans have been historically abused by the medical system, black men especially are wary of health studies and treatment.
  • Diversity in the medical field. Studies show that black patients receive better care when treated by black doctors. Researchers believe black doctors provide a comfortable and more trusting setting for their black patients, likely due to shared backgrounds and experiences. However, there are simply not enough black medical professionals to go around.
  • Access to health insurance. Historically, African Americans have less access to health insurance than whites, at 6 percent of the black population uninsured as compared to 5.9 percent of whites. Inequities in health insurance leads to less comprehensive healthcare, or causes a patient to delay care because they cannot afford it.
  • Medicare. The Affordable Care Act expanded Medicare coverage for most low-income adults. However, this expansion decision was left up to the states, and currently South Carolina has not adopted the expansion, leaving yet another critical and unnecessary gap in level of care.

“Some patients don’t trust doctors because they haven’t had access to quality health care. They are also extremely vulnerable.” – Dr. Jen Tang

When physician bias becomes medical malpractice, it’s against the law

Some doctors are working to overcome implicit bias; however, when it is sewn into the fabric of the healthcare system, it will take some time. If a patient is injured due to a physician’s neglect or lack of treatment due to discrimination, our South Carolina medical malpractice attorneys can investigate to find out exactly what happened. Sometimes, by the time a patient has dealt with his/her injuries and discovers he/she may have been a victim of discrimination and malpractice, that patient may be feeling an incredible amount of stress, fear, and pain, and may be loathe to file a claim.

We can help.

At McGowan, Hood, Felder & Phillips, LLC, we refuse to accept this status quo. As civil justice advocates, we believe it is our duty to give a voice to those whose voices have been suppressed for so long. Medical discrimination can cause pain and suffering, misdiagnoses, and improper treatment, and lead to worsened conditions or even death. Any medical professional who discriminates against a patient due to race, gender, income level, or any other factor and causes injury must be brought to justice. You can count on us to fight for that justice by your side.

Help for victims of medical bias and discrimination in South Carolina

If you feel discrimination or bias was a factor in your improper medical care, the attorneys at McGowan, Hood, Felder & Phillips, LLC can help. We will not stand for any type of discrimination and will advocate for you. We have the resources and expertise to fight back against hospitals and insurance companies after you’ve suffered injury or harm at the hands of a medical practitioner. Contact us or call us today at 803-327-7800 for a free case review. Let us level the playing field.

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