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Racial Bias Against Black Patients in Healthcare

“Had I’ve not been black... I would've gotten better treatment way earlier.”

- Matthew John “John River” Derrick-Huie, 2019


Health care, like many other industries, is not immune to racial bias. Black patients of white doctors have reported mistreatment and negligence time and again; lack of proper sedation, cruel and apathetic attitude, snarky comments between staff, and sloppy procedures. This malpractice dates back too far too long and unless we act sooner than later, progress will slow to a halt.


Myths and Origins


The particular stereotype that is prevalent is healthcare is the superhumanization of Black people. This means that people believe that Black people are able to endure more pain than others. This myth stems from  slavery, when white people [slave owners] thought that black people were dulled from the pain of working on plantations, and were strong enough to experience excruciating pain.  Due to this stereotype however, black people are undertreated for their pain, and being thought of as more physically advanced  in this context has led to numerous consequences. Patients not receiving half as much pain medication leads to doctors not prescribing the right medication, resulting in more deaths and undiagnosed illnesses. 


Image courtesy of National Stereotype.com


Examples


In 2017, Toronto rapper John River was unable to get the proper treatment for the side effects of a spinal tap test. As a result of the staff not giving the correct attention needed, he endured an immense amount of pain in the back of his head. He claimed that he was not being treated because the doctors thought he was faking his pain in order to receive drugs for recreational usage. While his original doctor was away, he visited five hospitals in the GTA, however was unable to get proper treatment. “According to the Missagua Native, he was told he was imagining his pain, and he was admitted to the psych ward for two days.” When asked for details regarding his mistreatment, River mentioned that stereotypes such as wearing certain clothing played a role in how he would be perceived. “He was told by...members of his community that he should avoid dressing a certain way.” It had gotten to the extent that his mother had to put on a buttoned down shirt the next time he visited the ER while he was unconscious.


A University of Washington study found that those with a “pro-white bias” were more likely to give less concentrated medicine after surgical procedures to Black patients. Ibuprofen, which is typically used to treat minor injury such as headaches, toothaches and reduces fever, has often been refused to Black patients by white doctors on the basis of predetermined false stereotypes.


Black women, while giving birth, have a higher risk of dying than white women. The main reason for this is racial bias. Lack of resources and access to care do play a vital role, however the main issue is not being monitored nor taken seriously enough.  While star tennis player Serena Williams was giving birth to her daughter, she experienced a  pulmonary embolism- which is blood clotting in veins mainly in the legs. She was at a great risk of death, but staff neglected her. Due to this negligence, Black  women “are three out of four times as likely to die from pregnancy related causes” according to the Centers for Disease Control and Prevention”.


Image courtesy of Bing


Prevention


In 2015, the University of Princeton published a study pertaining to this topic and found that many white caregivers held beliefs including a myth that there are biological differences towards and black and white patients-- such as black people having  “thicker skin”.Subsequently, holding such beliefs resulted in the white participants giving higher pain ratings to white patients versus Black patients. 


A possible way to prevent this type of discrimination is to include more diversity training for medical schools.  Our future doctors must be well-versed in intersectional health care; not only do many medical conditions show up differently on dark skin, but the frequent misdiagnosis of people of colour due to rampant stereotypes and lack of mental health awareness. Including the history of racism in medicine within the curriculum would further prevent unconscious biases stopping doctors from under-treating their patients and educating students on how not to treat their patients.


In August of this year, the University of Toronto was reported to conduct research on the impact on COVID-19 in racialized communities. One way that Roberta Timothy, assistant professor, could help understand the effect the virus had on these communities is to collect race based data. The Ontario government has mandated collecting data centered around race among other factors with those who have been infected. The purpose of this data collection was to see how Black and Indigenous communities interact with the healthcare system, as her team stated that racism played a factor in the many deaths of racialized groups. 


Image courtesy of University-College.com


It’s important that during these trying times healthcare equity is prioritized. In the midst of the Black Lives Matter protests and uprisings, as non-Black folk, we must seek out justice and lift up our Black friends when they are in need of support.



References:


American Heart Association News. (2020). Why are black women at such high risk of dying from pregnancy complications? Retrieved October 04, 2020, from https://www.heart.org/en/news/2019/02/20/why-are-black-women-at-such-high-risk-of-dying-from-pregnancy-complications


Durbin, K. (2020). Ibuprofen Uses, Dosage & Side Effects. Retrieved October 04, 2020, from https://www.drugs.com/ibuprofen.html


Farooqui, S. (2020, August 25). University of Toronto research to explore racism in health care during pandemic. Retrieved October 04, 2020, from https://toronto.ctvnews.ca/university-of-toronto-research-to-explore-racism-in-health-care-during-pandemic-1.5078884


Hoffman, K. M., Trawalter, S., Axt, J. R., & Oliver, M. N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences, 113(16), 4296-4301. doi:10.1073/pnas.1516047113

Mayo Clinic. (2020, June 13). Pulmonary embolism. Retrieved October 04, 2020, from https://www.mayoclinic.org/diseases-conditions/pulmonary-embolism/symptoms-causes/syc-20354647


Monique Tello, M. (2020, July 09). Racism and discrimination in health care: Providers and patients. Retrieved October 04, 2020, from https://www.health.harvard.edu/blog/racism-discrimination-health-care-providers-patients-2017011611015


Nittle, N. (2019). 4 Ways Racism in Health Care Is Still a Problem Today. Retrieved October 04, 2020, from https://www.thoughtco.com/racism-in-health-care-still-a-problem-2834530

Toronto, C. (Director). (2019). Racial bias in Canadian healthcare [Video file]. CityNews. Retrieved 2019, from https://www.youtube.com/watch?v=40V43Iz0QCM


Why black women face a high risk of pregnancy complications. (2019, February 25). Retrieved October 04, 2020, from https://www.hsph.harvard.edu/news/hsph-in-the-news/black-women-pregnancy-complications/


Featured image courtesy of Wix



Article Author: Idil Mohamed Gure

Article Editors: Maria Giroux, Victoria Huang