Not only have each of us probably been to the doctor, taken our children to wellness checks, or needed emergency care, we are all keenly aware of the medical field right now as we battle COVID-19 around the world. It has revealed to us how critical good medical care is to be able to function individually and as a society.
However, as with all systems in our country, the medical field is not free from racism. Black women are far less likely to have breast cancer yet are 40% more likely to die from it. The life expectancy of Black people across the board is about 6 years less than their white counterparts. The infant mortality rate is 2.3 times higher for Black children than that of other races. Black Americans with COVID-19 have been dying at about 2.4 times the rate of white Americans. Black patients receive less pain medication than white patients for anything from broken bones to cancer. Black teenagers are 50 percent more likely than their white peers to show signs of bulimia, but get diagnosed significantly less, even if they have identical symptoms. Black mothers are at a greater risk for postpartum depression, but are less likely to receive treatment.
So where do these disparities come from? They are rooted in the structural racism that pervades our society, much of it is in the implicit bias people carry around with them. During slavery, Black people were dehumanized as a justification for their enslavement. In dehumanizing a person, you have to make assumptions that they don’t feel or think in a humanistic manner. This is where the assumption that Black people somehow feel less pain than white people came from. A prime example of this is the use of women who were enslaved for experimental surgeries with no pain medication. J Marion Sims was a white doctor who was hailed as a hero for a medical breakthrough in gynecology during the 1800s yet it was at the expense of 11 Black women whom he operated on without anesthesia.
Another example would be the Tuskegee Syphilis Experiment. Between 1932 and 1972 – 40 years! – 600 Black men took part in this study which was conducted without the patients’ informed consent. The researchers misled them by telling the men they were being treated for “bad blood,” a local term used to describe several ailments like anemia and fatigue. In truth, they did not receive the proper treatment needed to cure their illness even when penicillin became well known as treating syphilis in 1947.
There is another common racist stereotype that Black people are more likely to be trying to game the system, possibly seeking out drugs or pills. This means doctors and nurses are implicitly biased to be more skeptical of Black patients’ claims that they are in pain or experiencing certain symptoms which leads to diminished levels of care and attentiveness to their needs.
Black people are also stereotyped as dramatic, especially Black women, which leads to distrust in their pain scale estimates and can cause Black patients to be ignored or placed behind other patients who are perceived to have “real” or more urgent medical issues. For instance, Serena Williams almost died after giving birth to her daughter. She had to advocate heavily to the medical professionals to trust her word that she knew her body, knew something was wrong, and they had to act immediately. She could have died and faced a really tough recovery after all of that, not to mention the lasting trauma and mistrust that can come from such an experience.
Another issue is misdiagnosis or under-diagnosis in Black people. Recently, a young Black man who is in medical school created a handbook called “Mind the Gap” which shows clinical signs of disease on Black and Brown skin. He realized that he was learning how to diagnosis these things but only ever on white skin. This lack of diversity can have fatal consequences when practitioners are unable to adequately diagnose their patients. This stems from an entire system built by white people for white people, the dominant culture lays the ground work and tries to squeeze in people of color without acknowledging that they are different. Without this recognition people can potentially receive subpar medical care that may ultimately result in death.
To overcome these disparities we have to start with recognition and understanding of the problem. But we also have to get creative in challenging the system as it stands today. Using your skills (such as the young man who created the handbook described above) is a really good step. We challenge you to start thinking about what resources you have, what areas you feel called to, and how you could tangibly step into interrupting these systems of injustice to create change moving forward.
Resources
Medical Apartheid by Harriet A. Washington
Killing the Black Body: Race, Reproduction, and the Meaning of Liberty By Dorothy Roberts
The Immortal Life of Henrietta Lacks by Rebecca Skloot
Racism and discrimination in health care: Providers and patients by Monique Tello
How Structural Racism Affects Healthcare by Niran S. Al-Agba
Why a Statue of the 'Father of Gynecology' Had to Come Down by Adam Serwer
U.S. Public Health Service Syphilis Study at Tuskegee at CDC.gov
Guided Prayer
Lord, please intercede on our behalf in the Church’s heart towards racial justice, open all believers’ eyes and take away anything inhibiting them from hearing, seeing, and responding to the pain of their brothers and sisters in Christ. Send Your comfort, peace, protection, and strength to those touched by racial injustice in all aspects of its insidious existence. Protect those working in all ways against racial injustice: make their goals clear and well-received and guard their hearts against corruption, distraction, and fatigue. Lord, open healthcare providers’ hearts, minds, and eyes to the racial injustice within the medical field and place an urgency in them to learn about and then act to eliminate systemic racism. Give our Black and Brown brothers and sisters strength to advocate for themselves and their loved ones in doctor’s offices, emergency rooms, hospitals, and more as they seek care for their health needs. Please allow their concerns to be heard, received, and acted upon equitably by medical caregivers. Place courage and fresh ideas in peoples' minds to allow a restructuring of medical education programs to include comprehensive curriculum on systemic injustice within the profession as well as within individuals. Please provide tangible ways to combat and end this structural inequity as new generations enter the medical field. Let the healthcare system reflect your justice in this world. Amen.