10 Reports to Learn About Systemic Racism in Health Care

Numerous medical studies have proven that Black people and people of color are at higher risk of developing diabetes, hypertension, heart disease and other life-shortening conditions than their white counterparts. While these disparities have long been attributed to socioeconomic disadvantages or even biology, there’s no longer a question that systemic racism plays a role in the health care inequities Blacks and people of color often experience.

Research has shown that BIPOC (Black, Indigenous, People of Color) experience discrimination in the health care industry that directly affects their health outcomes. And of course, many of the social and economic issues that contribute to poor health -- like housing, education, and income -- are strongly shaped by inequality.

It’s important for everyone to stay informed about systemic racism in the health care industry so we can understand the problem and help advocate for change. Here are some resources to get started:

In Focus: Reducing Racial Disparities in Health Care by Confronting Racism

This 2018 report from The Commonwealth Fund looks at case studies from several health care systems that worked proactively to address issues of systemic health inequality. In one example, a hospital system successfully closed a racial gap in colorectal cancer screening by soliciting feedback from African American patients and addressing their concerns, and offering screening that would be easier for these patients to access. The report includes a list of lessons other health care providers can use to address inequality in their own systems.

Implicit Bias and Racial Disparities in Health Care

“Black people simply are not receiving the same quality of health care that their white counterparts receive, and this second-rate health care is shortening their lives,” concludes this human rights report from the American Bar Association.

Socioeconomic factors alone are not enough to explain this disparity. Black patients are less likely to receive kidney dialysis or transplants than their white counterparts, are less likely to receive coronary bypass operations or appropriate cancer treatment, and are discharged earlier from the hospital than white patients. Disturbingly, they’re also more likely to receive less desirable treatment, like having their limbs amputated.

Time for Justice: Tackling Race Inequalities in Health and Housing

This report from the Brookings Institution breaks down several causes of racial health disparities, including implicit bias, socioeconomic differences, housing disparities and discrimination, health behaviors, and discriminatory law enforcement practices. It also proposes policy solutions, including government leadership that actively promotes equity in health care, enforcement of civil rights rules that prohibit discrimination in health programs, and implementation of an executive order for environmental justice.

The Health Care System and Racial Disparities in Maternal Mortality

Black mothers are three to four times more likely to die in childbirth than their white counterparts, a disparity that can’t be explained by socioeconomic factors or comorbidities like obesity, diabetes and hypertension. This 2018 report from the Center for American Progress examines contributing factors, including access to health insurance and appropriate OB/GYN care, as well as training for health care providers. “Many of the instances where women have experienced complications or died during pregnancy or birth include aspects where medical professionals have not been fully attentive to African American women’s experiences or medical needs,” the report notes.

Inequality and the health-care system in the USA (2017)

“The life expectancy of the wealthiest Americans now exceeds that of the poorest by 10-15 years,” note the authors of a 2017 report on the links between economic inequality and health. Lack of access to insurance, or inadequate insurance, are major drivers of poor health outcomes, and the prohibitive cost of health care causes many people to postpone or avoid treatment. Structural racism and policies that deny care to immigrants cause the health concerns of people of color to go ignored at both the community and individual levels.

How Systemic Racism Impacts Coronavirus Racial Disparities

In many cities, COVID-19 is sickening and killing African Americans, Latinx, and Native Americans at much higher rates than their white counterparts. This report by the Anti-Defamation League looks at how systemic inequality and structural racism in housing, employment, education, and health care settings contribute to these disparities, and highlights how stereotypes and bias can make it difficult for Black and Latinx men to protect themselves by wearing a mask, because it increases their risk of being harassed or attacked.

How Structural Racism Can Kill Cancer Patients

Black patients are more likely to die from breast cancer, melanoma, stomach chance, colorectal cancer, and more. Until recently, scientists attributed these disparities to biological differences. But research increasingly supports the conclusion that social inequality and racism are to blame. This report by the American Cancer Society highlights current research on the role of implicit bias and structural racism in cancer outcomes, and provides examples of organizations working to close the gap.

Covid-19 lays bare how discrimination drives health disparities among Black people

This overview in Stat looks at racism as a public health crisis, from how structural racism impacts health through poverty, nutrition, and housing disparities, to the barriers that deny Black patients access to quality health care. It also covers the historical context of medical discrimination, from well-known examples like the Tuskegee syphilis experiments, to the racist roots of medical devices like the spirometer, a tool that measures lung capacity, and which still uses a different setting for Black patients -- based on a rubric originally designed to justify using slaves for field labor.

Racism and discrimination in health care: Providers and patients

Patients aren’t the only people who experience discrimination in health care. Doctors and health care providers who are people of color or from a religious minority routinely contend with patients who question their credentials, use abusive language, or even attack them physically. This 2017 article from the Harvard Health Blog looks at racism in medical care from both the patient’s and the provider’s perspective.

The historical roots of racial disparities in the mental health system

Research shows that people who are Black, indigenous, and people of color (BIPOC) are not only less likely to have access to mental health services or to receive needed care, they’re also more likely to receive poor quality mental health care or be misdiagnosed. Black men, for example, are four times more likely than white men to be diagnosed with schizophrenia, while they are underdiagnosed for PTSD and mood disorders. This report in the publication Counseling Today looks at the current factors and historical context for racial disparities in mental health care.

What We Can Do To End Systemic Racism

We all need to do our part to end systemic racism in health care. Breaking down the structures that perpetuate health inequality will not just make things fairer, it will also improve the health of millions of Americans, and save lives. Learning about the issues and staying informed is the first step to addressing this national conversation.