The Health Divide: Survey offers fresh look at widespread racism in health care


by CHJ Fellow Amber Dance

For many people of color, preparing for a doctor’s appointment includes dressing up to boost the chances they’ll be taken seriously and treated with respect, according to a new survey by the Kaiser Family Foundation.

Survey respondents described donning clothing with university logos prominently displayed, getting their hair done, and adding makeup and jewelry in advance of medical appointments. 

“Como te miro, te trato — You’re treated how you look,” Jeymie Luna Roldán, a Florida woman who is Latina, told Devi Shastri at AP News

The survey of nearly 6,300 people, conducted over the telephone during the summer of 2023, revealed that 55% of Black people, 49% of American Indian/Alaska Native people, 47% of Hispanic people, and 39% of Asian people say they take care with their looks to receive fair treatment at least some of the time. That’s compared to 29% of white people who said the same. 

It’s just one of many biases and indignities included in the report. People of color were less likely than whites to say their health care providers spent enough time with them, involved them in care decisions, respected their culture, or explained concepts clearly. 

Of adults who’d been pregnant or gave birth in the past decade, 22% of Black people reported they were denied pain medication, compared to 10% of white adults. 

This kind of discrimination can lead to worse health overall, reports Colleen DeGuzman at KFF Health News.

Even the anticipation of maltreatment can make patients tense and unable to communicate well, Dr. Alison Bryant, an obstetrician at Massachusetts General Hospital, told AP. 

The survey also documented racism and discrimination in everyday activities, which contributes to stress, and structural inequities that impact safety and social and economic circumstances.  

For example, only 4% of white respondents reported being threatened or mistreated by the police over the past year, compared to 11% of Black people.

But the discrimination in health care is particularly dangerous, Bryant said. 

“Racial bias in health care is as damaging as any disease,” Burgess Harrison, executive director of the National Minority Health Association, told KFF Health News.

 Studies show that Black patients get better treatment and tend to feel better heard and cared for with Black doctors, as Dr. Lisa Cooper of Johns Hopkins University explained while discussing her seminal research on the topic in a recent Center for Health Journalism webinar.

In the KFF survey, people of color reported better treatment when their health care providers matched their ethnicities. 

“A renewed emphasis on recruiting more people of color into the health care field is vital,” said Harrison. 

But that prescription faces added headwinds from the recent Supreme Court decision that restricts the use of race in medical school admissions.

Suicide rates rose among women in 2022

The latest data on suicides shows the highest rate of deaths among American Indians and Alaska Natives. 

The group had nearly 27 deaths per 100,000 in 2022, a slight dip from the previous year. 

The data from the Centers for Disease Control and Prevention, covering nearly 50,000 deaths in 2022, has not yet been finalized and will likely incorporate more deaths in total, reports Mary Kekatos at ABC News. 

Another concerning trend is a rise in suicide among women, writes Mariel Padilla at The 19th. While more men commit suicide overall, the rate for women increased 4% from 2021 to 2022, compared to only a 2% increase for men.

And the rate for women may be an undercount, the CDC said, because women often use methods such as poison that take longer to be deemed a suicide.

Mental health experts told The 19th that the pandemic, which eliminated many forms of social support and added financial strain and caretaking obligations, may underlie the rise in suicide among women. Domestic violence may also be a contributor. 

Among young adults, education costs and living expenses are also stressors, said Hyeouk Chris Hahm, associate dean for research at the Boston University School of Social Work. 

The increase in suicide rates in women might also be due simply to better tracking of the problem, said Jessica Provines, assistant vice president of wellness at Wichita State University.

Continued support, treatment and interventions, such as the 988 suicide crisis line launched in 2022, can help, Provines said.

Black people need fertility treatment, too

Stereotypes and stigma suggest infertility isn’t a common problem for Black people, a belief that is untrue, reports Anissa Durham at Word in Black.  

Durham draws on a new report from CCRM Fertility, a clinic in Newport Beach, pointing to barriers to fertility care in the Black community. 

Of the 1,000 Black men and women who answered the survey, 57% believed Black people are less likely to seek fertility treatment, and 26% reported experiencing bias when doing so. 

Black individuals suffer from long-held misconceptions, rooted in slavery, that Black women are highly fertile, that Black men are especially virile, and that Black people have many babies, writes Durham. 

Yet some research indicates Black women have higher infertility rates than white women.

High rates of chronic illness among the Black community can also make it harder to get pregnant, Dr. Stephanie Marshall Thompson, who led the survey, told Word in Black.

Cost is also a barrier: A single cycle of in-vitro fertilization can run $10,000 or more, shutting out many people of color.

Nearly half of survey respondents said they were more comfortable with fertility providers who are also Black, but a similar number felt there was not enough Black representation in the field.

The Food and Drug Administration just cleared an over-the-counter artificial insemination kit, which retails for $129.99 and could allow some people to conceive at home. 

“The bottom line is as health care providers we must do better,” Thompson said in a release

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