Disproportionate Outcomes: Disparities in healthcare

We are all currently living through both a pandemic and a cultural revolution. During this time, there has been no shortage of headlines that share similar threads of information. The world has watched our healthcare workers struggle and our system fail under the weight of uncertainty and contagion. But for many people in this country, this was simply not a surprise.

Currently, the US population identified as non-white is about 40% which is roughly 131 million people. BIPOC make up nearly half of the US population, yet they experience immense disparities in our healthcare system. Communities that are wholly under served by our healthcare system were not surprised when the system began failing everyone, including its own employees. The population of the United States is projected to be a majority-minority by 2045. Healthcare providers have to begin looking at what we can do to offer more inclusive, equal patient care.

Healthcare Statistics

Black women are four times more likely to die from pregnancy related causes than white women. Black people are more likely to die from heart disease and cancer than white people. The black community sees higher rates of diagnosis of diabetes, asthma and many other chronic illnesses. The CDC lists this community at higher risk for obesity, hypertension and liver disease.

Why is this?

Our healthcare system is plagued by implicit bias and healthcare deserts which lead to racial disparities in black and brown communities.

Implicit Bias

The simplest explanation for implicit bias in healthcare is that BIPOC are not experiencing the same quality of care as white people. This has been proven in a study produced by the National Academy of Medicine. Although there are likely racist providers in every healthcare field, this study was looking into people who believed themselves to be free of racial bias. The results of this study described the “uncomfortable reality” that minority groups are less likely to be given appropriate care across many fields of health including cardiac and cancer care. NAM’s study went further to show that BIPOC were more likely to receive older, cheaper and more conservative treatment options. They are even discharged from hospitals earlier, often before the standard length of stay.

Black women are less likely to be offered radiation after mastectomies. Black and brown people are more likely to have savable limbs amputated. All of this data is based on people who believed they were not making racially motivated decisions, yet we still see an immense deficit in care. These statistics do not even account for people making blatant racially motivated choices for the patients.

Healthcare providers have to begin considering whether the choices they are making for black and brown patients would be the same for their white patients. Are you providing each patient first-rate care? If the answer is no, what can you do to change that? Our healthcare providers and system as a whole have to begin a process of education and reform to better the quality of care BIPOC experience..

Healthcare Deserts

Healthcare desert is a term used to describe a densely populated area that does not have easy access to quality healthcare, if any access at all. The frame of accessibility is usually within a 5 mile radius, but when you account for the availability of travel options and child care the window may shrink. More than 25% of black and brown Americans live in zip codes that would be considered healthcare deserts.

Due to our largely privatized healthcare system, a solution to healthcare deserts is not so simple. Private hospitals systems have their choice in location. Private practice doctors of all specializations have the right to choose the location for their business. So, how do we get quality healthcare to neighborhoods in need?

That answer may take legislation, decades of action and changes to the way these zip codes are perceived. We, as a system, have to begin considering ways to get quality care into healthcare deserts. This is a vital step in the process to bringing quality healthcare to underserved communities all across the nation.

Changing The Future

In order to change the future of healthcare in a way that addresses the disparities in its service of black and brown patients, we have to understand history. Well into the 20th century, medical schools perpetuated stereotypes that BIPOC were more unhealthy because of their skin color. During this time science and medicine experimented on black people without their consent. Segregation left black communities with inferior hospitals, supplies and service. Even as recent as 2008, the American Medical Association was apologizing for the exclusion of black physicians.

With all of that in mind, it would be logical to assume that for decades the healthcare system could not be trusted by the black communities they were supposed to care for. Distrust of a system can become rooted into a person's stress response which can then be passed down as generational trauma. Most of that history is only 2 generations old considering that segregation of hospitals only legally ended around 60 years ago. There are some places in the South that still held segregated events until as recent as 2013.

Our healthcare system is rooted in a history of inequality of care for black and brown patients. We have to accept that as a society in order to move forward and change the way this system works. Our healthcare system has to begin serving every patient with first-rate, quality care going forward. Providers can no longer allow the system to function from of a place of discrimination.

Chiropractic Care Equality

Currently, chiropractic care is considered a source of Complementary and Alternative Medicine (CAM). According to research, around 96% of the population that is using CAM’s as their primary healthcare choice is white. That figure is staggering, but brings up another key point: not only are black and brown people facing disparities in healthcare, holistic approaches are not reaching all communities.

Chiropractic care has endless possibilities for preventative and wellness care. We are not excluded from the rampant implicit biases plaguing healthcare. Chiropractors must also look within our system and recognize what we can do to better serve black and brown communities going forward. Our system has to begin a journey of inclusivity in patient care and use community outreach to better educate and serve communities that may not know what Chiropractic can do for them.

Wellness and preventative healthcare should not be commodified by white populations. Black and brown people need access to quality care and access to holistic, vitalistic health approaches. Chiropractic care should be made accessible and affordable to all patients who seek to better their overall health. We must do our part to make the healthcare system more inclusive and equal for all patients, regardless of race or income status.