By Stacy M. Brown
The Urban Institute’s Coronavirus Tracking Survey, a nationally representative survey of adults ages 18 to 64, found that Black adults were more likely than White or Hispanic/Latinx to report being discriminated against or unfairly judged by a doctor or health care provider.
“These patterns are concerning given that health care disruptions and suboptimal quality that result from unfair treatment can lead people to delay or forgo care, to search for a new provider, and to experience adverse health consequences,” authors of the study wrote.
The report comes as Covid deaths and hospitalizations continue to soar, with people of color disproportionately affected.
It also comes as many advocates and activists call more attention to the dire maternal health crisis facing Black women.
CNN reported that Black women in the United States are more likely to die in pregnancy or childbirth than any other demographic – and the Covid-19 pandemic may be exacerbating one of the starkest disparities in American health care.
The network reported that health care practitioners and advocacy groups had raised the alarm that the pandemic may further increase barriers to care for pregnant women.
“Even before the pandemic, the United States was considered the most dangerous developed nation to be pregnant,” Stacey Stewart, CEO, and President of the March of Dimes, a nonprofit that advocates for better health care outcomes for mothers and babies, told CNN.
“Black women and women of color are far more likely to die — and that was the case even before the pandemic.”
Earlier this year, Congress introduced the Black Maternal Momnibus Act, providing pre-and post-natal support for Black mothers.
However, the bill has lingered since its February introduction.
The Urban Institute’s study, part of an ongoing body of work exploring patients’ reported experiences of discrimination and unfair treatment in health care, found:
- Roughly 5 percent of all nonelderly adults reported having been discriminated against or judged unfairly by a doctor, other health care provider, or their staff in the previous 12 months.
- Black adults (10.6 percent) were more likely than Hispanic/Latinx adults (4.5 percent) and White adults (3.6 percent) to report having experienced this type of discrimination or unfair judgment.
- Just over half of respondents reporting this type of discrimination or unfair judgment in the past 12 months indicated there were multiple reasons for it.
- Race or ethnicity (cited by 3.0 percent of adults) was the most common reason reported for perceived discrimination or unfair judgment by a health care provider or their staff, and 7.9 percent of Black adults reported having experienced this type of discrimination or unfair treatment.
- Black women (13.1 percent) and Black adults with low incomes (14.6 percent) reported having experienced discrimination or unfair judgment by a health care provider or their staff in the prior year at, exceptionally high rates.
- Although researchers found less prevalence of discrimination or unfair judgment than comparable surveys due to differences in survey wording and question reference period, the disparities in these experiences by race and ethnicity were similar across surveys.
Given the well-documented pattern, researchers asserted that it’s imperative to identify and implement needed changes in policy and practice to eliminate the systematically worse treatment that Black patients and other people who frequently experience discrimination receive.
They determined that immediate steps include educating and training providers and other health care staff to acknowledge and recognize racism and the implicit, unconscious, and explicit biases ingrained in the health care system – including how such biases harm patients.
The Urban Institute researchers added that it’s vital that institutions acknowledge other forms of discrimination based on gender identity, language spoken, or health insurance coverage.
Researchers wrote that institutions should implement practices to disrupt these patterns to ensure that health care providers and their staff provide consistent, evidence-based, and culturally effective care.
They also should hold providers, their staff, and health care education institutions accountable for racist and other discriminatory policies and practices.
The authors continued that reducing inequities in the health care system will also likely require diversifying the racial, economic, linguistic, and educational backgrounds of physicians and other health professionals to more closely resemble the communities they serve.
Policies that would make the health care workforce more diverse and culturally competent include expanding and targeting scholarship and loan repayment programs for medical school.
Urban Institute researchers said that policies should include expanding training opportunities in other health professions for underrepresented communities and providing mentoring and tutoring programs to support a pipeline into these programs.
Further, the intentional implementation of antiracist medical school programming will also be essential.
At the same time, health policy and health services researchers should prioritize building the evidence base on what public and private investments and interventions reduce unequal treatment and contribute to equitable outcomes in the health sector.
“To fully ameliorate racial and ethnic inequities in health outcomes, policymakers and the health care system will need to confront and address the adverse experiences patients have when seeking health care and hold payers, providers, and their staff accountable for discriminatory practices and unfair treatment,” the authors wrote.