INTRODUCTION

Racial inequality within the healthcare system is a prevalent issue that permeates various aspects of medical practice, leading to disparities in access to care, treatment outcomes, and overall health outcomes among different racial and ethnic groups. 

RACIAL INEQUALITY IN THE HEALTHCARE SYSTEM

A concerning factor contributing to racial inequality in healthcare is the persistence of false beliefs and misconceptions regarding the biological variances between racial groups. Studies conducted among medical students, notably highlighted in a 2016 research study, have exposed a disconcerting trend where a significant proportion of white medical students harbour erroneous beliefs about racial disparities in biology (Rees, 2020). These misconceptions range from antiquated notions such as the notion that Black individuals possess thicker skin, less sensitive nerves, or stronger immune systems, to beliefs that harken back to historical justifications used to rationalise the exploitation of slaves in the 19th century (Rees, 2020). Such false beliefs not only perpetuate racial stereotypes but also significantly influence medical decision-making processes and patient care outcomes.

Racial inequality within the healthcare system is worsened by disparities observed in emergency care settings, encompassing discrepancies in access to care, pricing structures, and diagnostic procedures. Research findings have consistently highlighted the presence of implicit biases among healthcare providers operating within emergency departments, manifesting in differential treatment patterns based on race and ethnicity. Analyses of longitudinal data spanning from 2005 to 2016 have revealed alarming trends regarding the differential admission rates of patients based on their racial background. Specifically, Black patients were found to be 10% less likely to be admitted to hospitals compared to their white counterparts, a disparity that underscores systemic biases in healthcare delivery (Rees, 2020). This discrepancy in admission rates is particularly concerning given the associated increase in mortality rates among Black patients within emergency department and hospital settings, highlighting the grave consequences of racial bias on patient outcomes (Rees, 2020).

STORY OF BRIAN SINCLAIR

The tragic narrative of Brian Sinclair, a First Nations individual, serves as an unforgettable example of the devastating consequences of racial inequality within the healthcare system. Despite visibly displaying symptoms indicative of severe illness, including persistent vomiting and physical deterioration, Sinclair was callously ignored by hospital staff who attributed his distress to either intoxication or sleeping, thereby neglecting his urgent medical needs (Boyer, 2017). After 34 hours of being neglected in the waiting room, Sinclair passed away of an easily treatable bladder infection. This harrowing story presses the urgent need to address systemic biases and discriminatory practices within healthcare settings to ensure equitable access to care and prevent avoidable tragedies like that of Brian Sinclair.

THE IMPACT OF RACISM IN THE HEALTHCARE SYSTEM

• Higher Mortality Rates in People of Color

• Disparities in Mental Health Diagnoses and Outcomes

• Differential Reporting of Mental and Physical Health Issues

Racism permeates the healthcare system, exacting a heavy toll on the health outcomes and experiences of people of colour. This impact is evident in the higher mortality rates, disparities in mental health diagnoses and outcomes, and differential reporting of mental and physical health issues.

People of colour face disproportionately higher mortality rates compared to their white counterparts, reflecting systemic disparities in healthcare access and quality. Research findings reveal that Black patients are 1.26 times more likely to die in the Emergency Department or hospital compared to white patients (Rees, 2020). This disparity underscores the profound consequences of racial bias on patient outcomes, transcending age groups and medical conditions.

While all races have an equal likelihood of receiving mental illness diagnoses, the experiences and outcomes of individuals vary significantly across racial and ethnic groups. Despite this equal likelihood, Black people experience a disproportionate burden of disability from mental health issues. For instance, Black men are four times more likely to receive a schizophrenia diagnosis, often due to clinicians overlooking symptoms of depression and focusing solely on psychotic symptoms. This disparity in diagnoses translates into disparities in treatment access and outcomes, exacerbating existing mental health inequities. Additionally, Indigenous peoples face a disproportionately high prevalence of substance abuse and addiction issues, reflecting systemic disparities in access to mental health services and culturally competent care (Rees, 2020).

People of colour are more likely to report mental and physical health issues compared to their white counterparts, highlighting disparities in healthcare experiences and outcomes. For instance, 14.2% of Black Canadian adults report their health as poor, compared to 11.3% of White Canadian adults (Abdillahi & Shaw, 2020). Moreover, Black and Hispanic individuals report higher rates of persistent, long-term depression compared to their white counterparts (Rees, 2020). These disparities underscore the urgent need for equitable mental health services to address our diverse communities' needs.

SOLUTION

• Acknowledging and Confronting Racism

• Policy and System Changes

Addressing systemic racism within the healthcare system requires a multifaceted approach, encompassing individual interventions as well as policy and system changes. This section outlines comprehensive strategies aimed at acknowledging and confronting racism, as well as implementing policy reforms and system-wide initiatives to promote equity, diversity, and inclusion (EDI) in healthcare.

To effectively address racism within healthcare, it is crucial to acknowledge and confront both conscious and unconscious biases among healthcare providers. This entails fostering an environment that supports individual reflection and intervention to counteract biases. Providers must be assisted in recognizing their biases and understanding the consequences of their actions on patient care. Moreover, incorporating patient perspectives on racism into healthcare practices can offer valuable insights and inform strategies for addressing racial disparities. Implementing accountability measures for resistance to anti-racism efforts ensures that all stakeholders are held accountable for promoting equity and combating racism within the healthcare system.

In addition to individual interventions, policy and system changes are essential to dismantle systemic racism within healthcare. This involves reviewing and revising existing policies to ensure equity in healthcare delivery and outcomes. Establishing accountability systems with reporting initiatives enables the tracking and addressing of instances of racism within healthcare settings. Furthermore, updating medical school curricula to include comprehensive education on racial disparities in healthcare and increasing opportunities for diverse healthcare providers through scholarships and recruitment initiatives are crucial steps toward fostering an inclusive healthcare workforce. Providing equity, diversity, and inclusion (EDI) training for healthcare personnel and involving marginalised communities in policy development ensures that healthcare practices are informed by diverse perspectives and promote culturally competent care.

FINAL WORDS

Addressing racism within the healthcare system requires a holistic approach that encompasses individual interventions and policy and system changes. By acknowledging and confronting biases, implementing policy reforms, and promoting EDI in healthcare, strides can be made toward achieving equity and inclusivity in healthcare delivery and outcomes.

REFERENCES

Abdillahi, I., & Shaw, A. (2020, September 08). Social determinants and inequities in health for Black Canadians: A Snapshot. Retrieved from Government of Canada: https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health/social-determinants-inequities-black-canadians-snapshot.html 

Boyer, Y. (2017, November 20). Healing racism in Canadian health care. Canadian Medical Association Journal, 1408-1409: https://doi.org/10.1503/cmaj.171234 

Rees, M. (2020, September 17). Racism in healthcare: What you need to know. (A. Biggers, Editor) Retrieved February 23, 2024, from Medical News Today: https://www.medicalnewstoday.com/articles/racism-in-healthcare