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Overview
Equal access to quality health care is a crucial issue facing the
United States. For too long, too many Americans have been denied equal
access to quality health care on the basis of race, ethnicity, and
gender. Cultural incompetence of health care providers, socioeconomic
inequities, disparate impact of facially neutral practices and policies,
misunderstanding of civil rights laws, and intentional discrimination
contribute to disparities in health status, access to health care
services, participation in health research, and receipt of health care
financing.
The need to focus specific attention on the racism inherent in the
institutions and structures of health care is overwhelming. Minorities
are sicker than White Americans; they are dying at a significantly
higher rate. These are undisputed facts. There are many examples of
disparities in health status between racial/ethnic groups and between
men and women: infant mortality rates are 2½ times higher for blacks,
and 1½ times higher for American Indians, than for Whites; the death
rate for heart disease for blacks is higher than for Whites; individuals
from racial and ethnic minority groups account for more than 50 percent
of all AIDS cases although they only account for 25 percent of the U.S.
population; the prevalence of diabetes is 70 percent higher among blacks
and twice as high among Hispanics as among Whites; Asian Americans and
Pacific Islanders have the highest rate of tuberculosis of any
racial/ethnic group; cervical cancer is nearly five times more likely
among Vietnamese American women than White women; women are less likely
than men to receive life-saving drugs for heart attacks; more women than
men require bypass surgery or suffer a heart attack after angioplasty.
Yet, despite these significant health care status disparities, many
Americans have been denied equal access to quality health care on the
basis of race, ethnicity, and gender. Cultural incompetence of health
care providers, socioeconomic inequities, disparate impact of facially
neutral practices and policies, misunderstanding of civil rights laws,
and intentional discrimination contribute to disparities in health
status, access to health care services, participation in health
research, and receipt of health care financing.
Drs. Micahel Byrd and Linda Clayton lay out clear the long history of
racism and medicine in their seminal work: An American Dilemma: A
Medical History of African Americans and the Problem of Race, Beginnings
to 1900". In their work, Drs. Byrd and Clayton clear show that the
problem of minority health status and minority health care access is a
part of a long continuum of racism and racial discrimination dating back
almost 400 year. Since colonial times, the racial dilemma that affected
America also distorted medical relationships and institutions. There are
has been active assignment of racial minorities to underfunded,
overcrowded, inferior, public health-care sector. Furthermore, medical
leadership has helped to establish the slaveocracy, create the racial
inferiority myths, build a segregated health subsystem, and maintain
racial bias in the diagnosis and treatment of patients. Only after 350
years of active discrimination and neglect, were efforts made to admit
minorities into the "mainstream" health system. However, these
efforts were flawed and since 1975 minority health status has steadily
eroded and continue to experience racial discrimination in access to
health care and quality of health care received.
Yet, the current health disparity issues are not isolated health
system problems. In fact, the current health disparity is the cumulative
result of both past and current racism throughout the American culture.
For instance, because of institutional racism, minorities have less
education and fewer educational opportunities; minorities are
disproportionately homeless and have significantly poorer housing
options; and minorities disproportionately work in low pay, high health
risk occupations (i.e., migrant farm workers, fast food workers, garment
industry workers). |
