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4 for Now
Jahi McMath bled for hours after a routine tonsil-removal surgery in 2013 while nurses dismissed her. Her grandmother, a nurse herself, called for help after midnight. While intubating Jahi, one doctor said, “Oh, shit, her heart stopped.” Doctors declared Jahi “brain-dead” two days later. For five years, her family continued their fight for doctors to treat her.
“Jahi McMath was not brain dead or any other kind of dead,” her mother said in a statement after Jahi’s death. “She was a little girl who deserved to be cared for and protected not called a dead body.”
This is far from an isolated incident. The US “healthcare” system is built on racial bias [PDF] that results in anyone who isn’t white receiving worse care than if they had been white.
Data Illustrating Racism in US Healthcare
- African-American women are three times more likely to die of pregnancy-related causes than white women and the African-American infant mortality rate is more than double that of white infants.
- Adults of Hispanic origin had the highest rates of being uninsured from 1999 to the first half of 2015 [PDF, data on page 30], at almost twice the rate of Black folks and over twice the rate of white folks.
- In 2016, Congress gave the Indian Health Service a $4.8 billion dollar budget, which works out to $1,297 per person. Compare that to $6,973 per inmate in the federal prison system.
- Asian Americans are even more under-represented in this data than Natives. The information I found mostly related to racism and its affects on health (which has been studied for Black folks). This article from NPR posits several reasons, including the pernicious “model minority” myth and the fact we take people from dozens of different ethnicities and lump them into one racial group. The former means Asian Americans are often overlooked; the latter makes it hard to parse meaningful data when they aren’t.
Not to mention the racism doctors of color experience, or that medical education is mainly about the white experience of health and disease [PDF]. There are countless studies, observations, and personal tales showing us it’s all true. But we white folks still accept it as if there’s nothing we can do.
How the Healthcare Industry Can Reduce Racism
The 2003 study “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” made several recommendations on how to improve equity within the healthcare industry, including:
- Increase awareness of racial and ethnic disparities in healthcare among the public, key stakeholders, and healthcare providers.
- Increase the proportion of underrepresented U.S. racial and ethnic minorities among health professionals.
- Limit provider incentives that may promote disparities while providing incentives for practices that reduce barriers and encourage evidence-based practice.
- Integrate cross-cultural education into the training of all current and future health professionals.
The AMA has proposed a strategic plan for 2021-2023 [PDF. Strategy starts on page 45, specific actions on page 60] that calls on the industry to address inequity issues, and a group of doctors have recommended their antiracist approach.
But what can those of us outside of healthcare do to help? See my suggestions in 4 for Later below.
4 for Later
- Learn more about racial health inequity in healthcare via Coursera courses. You can access the material for free: History of Racial Inequity in Healthcare, Causes of Racial Inequity in Healthcare, and Achieving Health Equity in Healthcare. (To access the assignments for certification, you have to subscribe or purchase the certification for that course.)
- When you see racist behavior from a medical practitioner, call it out. If you see a racist representation of healthcare or disease, call it out. The less acceptable we make racism in healthcare, the more motivated the industry is to stop it. (See this PDF on when and how to call someone out or call someone in.)
- Support your local community health center. Donate, volunteer, sing their praises … ask what they need and give what you can! (The community health center model addresses social needs that contribute to health inequities.)
- Towards the bottom of this page is a list of things folks in different industries can do to take action on healthcare equity (there’s a box to the side with steps for everyone).