Racial Discrimination in the Healthcare System

Introduction

The issue of racial disparities is still relevant in modern society, despite several special protection laws and the ongoing fight for racial equality. The disparities could be identified in workplaces as well as healthcare systems and services. This paper will discuss the history behind racial discrimination, identify federal laws related to racial protection in the workplace and discuss how issues and the laws can manifest themselves within the healthcare system.

Main body

Historically, the need for special protection of racial groups occurred due to racism issues. Racism motivated several practices in the US, like slavery, segregation, and job discrimination. According to Carter et al. (2018), racism caused both social and physical isolation of people of Color. Many of the current issues in racially diverse communities like poverty, hunger, and high crime rates are an outcome of systematic racism. Racial discrimination limited earning opportunities for non-white people and significantly deteriorated their living conditions, separating the population from economic benefits and healthcare services. Moreover, as pointed out by Carter et al. (2018), racial discrimination is proved to be closely connected to mental health problems and unhealthy behavioral outcomes. To prevent further racial discrimination, eliminate racism, and provide equal opportunities for representatives of all races, several affirmative actions were introduced to the US. Affirmative actions are separate from law and present a set of policies and practices encouraged by the government designed to increase the representation of protected groups.

The protection of racial groups in the workplace is regulated by the Title VII of the Civil Rights Act of 1964. According to the Title, employers’ discrimination of an individual ‘based on race, color, religion, sex or national origin’ is prohibited if the employer has 15 or more employees (Civil Rights Act, 1964). The Equal Employment Opportunity Act (1972) expanded the non-discrimination policy to employers with 25 employees. According to Hahn et al. (2018), previous to the Civil Rights Act of 1964, most states already have adopted their own version of anti-discrimination regulations, except for eight southern states. The proportion of black women in household service work declined from 50% to 25% after 1964, and the proportion of white-collar employment of black women increased twice (Hahn et al., 2018). Additional reports showed that average wages for black women, which comprised 64% of white women’s wages before the Civil Rights Act, became equal by the 1980s (Hahn et al., 2018). The Civil Rights Act significantly improved the situation with racial discrimination in employment and the workplace.

As for the healthcare aspect of racial discrimination, the issue was covered multiple in research and studies but remains unsolved. In the article on perspectives of social discrimination, Small and Pager (2020) noted that although discrimination in employment is important, it is episodic. Cumulative discrimination, on the other hand, in the everyday context, presents a bigger threat to the population due to its health outcomes (Small & Pager, 2020). The authors emphasize that episodic cases of racial discrimination only matter if they took place, but for mental health, the pressure of racial discrimination is continuous in character (Small & Pager, 2020). In their article on how discrimination can affect health, Williams et al. (2019) stated that discrimination is proved to relate to depression, anxiety, and psychological distress and increases the risks of psychiatric disorders. According to Cook et al. (2017), access to mental healthcare services is limited due to financial barriers, but the issue could potentially be solved through the expansion of health insurance or policy interventions. Thus, there is a strong need for the manifestation of laws and policies that allow equal access to mental healthcare.

In addition, the federal government should develop future laws and policies designed to allow equal access to any field of healthcare services with an emphasis on racial discrimination. The emphasis is sourced from the outcome of previous healthcare practices, like the Affordable Care Act. According to the study conducted by Manuel (2017), the documentation of racial differences in health services use, and access after the Affordable Care Act revealed that non-Hispanic whites benefitted the most from the program. Among Hispanic and Black respondents of the study, the healthcare reform did not impact the number of visits. The study suggests that despite the progress in access to healthcare services, the health care reform needs to focus more on solving the racial disparities through insurance coverage, provider training, and other initiatives (Manuel, 2017). Therefore, the government needs to address the racial disparities in the healthcare system and develop laws and policies that provide access to healthcare services to people of color.

Aside from the central issue of the availability of healthcare services, the healthcare system is deeply fused with an implicit bias towards racial minorities. Although the healthcare providers and physicians themselves are not explicitly racist, they operate in a racist system that does not treat all patients equally. According to Bridges (2018), studies show that pain medications are prescribed to white patients more often than black patients. Moreover, the author draws evidence that aggressive yet more effective medications are more likely to be prescribed to white patients than white patients (Bridges, 2018). Although implicit biases include both structural and individual factors, the widespread occurrence of this problem across the healthcare system presents a potential danger to the health of people of color.

Conclusion

In conclusion, this paper addressed the issues of history behind racial discrimination, identified federal laws related to racial protection in the workplace, and uncovered how issues and laws could manifest themselves within the healthcare system. The results show that racial discrimination and implicit biases significantly impact the population’s health. Although there is some progress in improving access to healthcare services, addressing racial disparities in the healthcare system requires the development of additional laws and policies.

References

Bridges, K.M. (2018). Implicit bias and racial disparities in health care. Human Rights Magazine.

Carter, R. T., Johnson, V. E., Kirkinis, K., Roberson, K., Muchow, C., & Galgay, C. (2018). A meta-analytic review of racial discrimination: Relationships to health and culture. Race and Social Problems, 11, 15–32.

Civil Rights Act of 1964, Pub.L. 88-352, 78 Stat. 241 (1964).

Cook, B. L., Trinh, N. H., Li, Z., Hou, S. S., & Progovac, A. M. (2017). Trends in racial-ethnic disparities in access to mental health care, 2004-2012. Psychiatric services, 68(1), 9–16.

Equal Employment Opportunity Act of 1972, Pub.L. 92-261, 86 Stat. 103 (1972).

Hahn, R.A., Truman, B.I., & Williams, D.R. (2018). Civil rights as determinants of public health and racial and ethnic health equity: Health care, education, employment, and housing in the United States. SSM – Population Health, 4, 17-24.

Manuel J. I. (2018). Racial/ethnic and gender disparities in health care use and access. Health services research, 53(3), 1407–1429.

Small, M. L., & Pager, D. (2020). Sociological perspectives on racial discrimination. Journal of Economic Perspectives, 34(2), 49–67.

Williams, D. R., Lawrence, J. A., Davis, B. A., & Vu, C. (2019). Understanding how discrimination can affect health. Health services research, 54 (2), 1374–1388.