Racism and Discrimination in Health Care
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Where there is structural violence or cultural violence in the larger society, so will there be evidence of systematic inequities in the institutions of these societies. The healthcare system in Australia is one example—from a plethora of similarly situated healthcare systems—in which the color of a patient’s skin or the race of his parents may determine the quality of medical received. Life expectancy and infant mortality rates are vastly different for non-Aboriginal, Aboriginal, and Torres Strait Islanders residing in Australia. The life expectancy of Aboriginal men is 21 years shorter than for non-Aboriginal men in Australia.
We need to be open to identifying and controlling our own implicit biases. We need to be able to manage overt bigotry safely, learn from it, and educate others. These themes need to be a part of medical education, as well as institutional policy. We need to practice and model tolerance, respect, open-mindedness, and peace for each other. It is important to link all of these goals and actions together, as they are layers of the same huge problem. The insidious structural racism, subconscious implicit bias, and overt, external discrimination come from the same place. Dr. Saadi’s words hold very true: “We — as physicians and society more generally — must realize that the struggles of one marginalized community are struggles of all of us. My fight as a Muslim-American doctor to serve my patients without fear of racism, and the fight of an African-American patient to be treated with dignity and respect, should also be your fights.” To that end, the call to action to address racism and discrimination in medicine is for all of us, providers and patients (Rachel R. Hardeman, 2016).
Over 15% of the medical practitioners have experienced racism and discrimination. Their suggestions to reduce racism includes setting task forces to recommend institutional strategies and policies that can reduce racism. Other recommendations include taking patients to courts for subjecting healthcare practitioners to disciplinary measures.
National Center for Health Statistics (US). Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities. Hyattsville, MD:
National Center for Health Statistics (US); 2016 May. Report No.: 2016-1232.
The Department of Health and Human Services, United States (HHS). National partnership for action to end health disparities: Offices of Minority Health. Washington, DC, 2011.
Rachel R. Hardeman, Ph.D., M.P.H., Eduardo M. Medina, M.D., M.P.H., and Katy B. Kozhimannil, Ph.D., M.P.A. Structural Racism and Supporting Black Lives — The Role of Health Professionals. New England Journal of Medicine, October 12, 2016.
King CJ, Redwood Y. The Health Care Institution, Population Health and Black Lives. Journal of the National Medical Association, May 2016.
Sreshta, Nina, et al. The Social Justice Coalition of the Cambridge Health Alliance: An open letter to our patients in the Trump era.