The United States of America has often been touted as one of the greatest nations in the world, the land of freedom and opportunity. It’s history however, shows a violent and discriminatory attitude towards racial and other minorities, especially African-Americans. The racism of the past has not been without effect, and it definitely has not gone away. In the present day we see the damage inflicted on healthcare access for African-Americans. Historical experiences with racism in medicine has scared many African-Americans from utilizing healthcare resources when necessary, to the detriment of their wellbeing. And even when they do use healthcare, a combination perceived racism and lower quality of care continues to harm African-Americans, and consolidate their fear of healthcare.

First, I will delve into the background of African-American history. “Racial Disparities in Health Status and Access to Healthcare: The Continuation of Inequality in the United States Due to Structural Racism.” mentions multiple contributing factors to African- American access to healthcare and the racism present in the USA historically which contributes to present day racial tensions. I will also cite “Systemic Racism and U.S. Health Care.” which delves into the same topic.

Second, I will set up the history of racial discrimination in healthcare, specifically citing the Tuskegee study, mentioned in “The Harm That Comes From Racism”. This study caused a lot of distrust between the African-American community and the health system. Very harmful experiences like this one have caused fear and hatred of our healthcare system for minorities. I will make a connection to refusal to access healthcare. Possibly include here more sources of different historical topics that could cause this mistrust or even recent ones.

Third, I will describe the racism in present day healthcare. Starting with “Racism and Discrimination in Health Care: Providers and Patients.” to give incites of personal experiences of perceived racism. “Racism in Healthcare: Its Relationship to Shared Decision-Making and Health Disparities: a Response to Bradby.” mentions racial bias that many workers may have. “The Strangest of All Encounters: Racial and Ethnic Discrimination in US Health Care.” also finds racial bias within healthcare workers. Set up next paragraph.

Finally I will discuss the effects of the aforementioned racism. . “Effects of perceived racism, cultural mistrust and trust in providers on satisfaction with care.” will show patient care dissatisfaction because of perceived racism against minorities.“Impact of Perceived Racism on Healthcare Access Among Older Minority Adults.” shows African-American unwillingness to seek healthcare because of racist experiences. “The Influence of Mistrust, Racism, Religious Participation, and Access to Care on Patient Satisfaction for African American Men: The North Carolina-Louisiana Prostate Cancer Project.” will show a combination of low patient satisfaction and not wanting to utilize healthcare resources due to racism.

Solutions

Podcast of minority experiences in healthcare.

The United States of America has often been touted as one of the greatest nations in the world, the land of freedom and opportunity. It’s history however, shows a violent and discriminatory attitude towards racial and other minorities, especially African-Americans. The racism of the past has not been without effect, and it definitely has not gone away. In the present day we see the damage inflicted on healthcare access for African-Americans. Historical experiences with racism in medicine has scared many African-Americans from utilizing healthcare resources when necessary, to the detriment of their wellbeing. And even when they do use healthcare, a combination perceived racism and lower quality of care continues to harm African-Americans, and consolidate their fear of healthcare.

There is a historical basis for the institutionalized racism that African Americans faced and are continuing to face. “Racial Disparities in Health Status and Access to Healthcare: The Continuation of Inequality in the United States Due to Structural Racism.” delves further into the history of African healthcare issues. It is mentioned that “As a result of their lack of employer‐sponsored healthcare insurance and their poverty, these minority families are disproportionately unable to afford to pay for healthcare.” This lower quality of healthcare and lack of healthcare negatively impacts minorities perceptions of medicine. “... 32 percent [of African Americans], say they have personally been discriminated against when going to a physician or health clinic (NPR et al. 2018: 13).”

Moreover, a history of discrimination and prejeduce against african americans, as well as a majority white USA has created a more than unwecoming healthcare system for minorities. In “Systemic racism and U.S. health care” it is mentioned that, “The majority-white decisionmakers include public health researchers and policymakers, medical educators and officials, hospital administrators, and insurance and pharmaceutical executives, as well as important medical personnel. A substantial majority are white.” The existing stereotypes of African-Americans have led to a poor quality of healthcare. There is also a history of damaging medical events for the African American community. Events such as Henrietta Lack’s blood being stolen from her and “Her cells have been used to help develop a polio vaccine and research cancer.”

Another example would be the Tuskegee study, mentioned in “Bad Medicine: The Harm That Comes From Racism”. Frakt discusses the extent of this “study” and the damage it has caused. He mentions that “To do so [understand syphilis], the [African American] men were lied to about the study and provided sham treatments. Many needlessly passed the disease on to family members, suffered and died.” This caused a huge issue between African Americans and the healthcare system. Citing economists Marcella Alsan and Marianne Wanamaker, Frakt states that, “Their analysis suggests that one-third of the black-white gap in male life expectancy in the immediate aftermath of the study could be attributed to the legacy of distrust connected to the Tuskegee study.” This is evidence of the historical systematic racism that has impacted the present day.

Racism is usually not outright stated, it is usually the perception of the person being discriminated against that believes that a racial motivation is harming them. For example, in “Racism and Discrimination in Health Care: Providers and Patients.” Monique Tello shares the experience of one of her patients, quoting them saying the following; “They treated me like I was trying to play them, like I was just trying to get pain meds out of them. They didn’t try to make any diagnosis or help me at all. They couldn’t get rid of me fast enough.” Experiences like this show the divide between minorities and healthcare workers. In “The Strangest of All Encounters: Racial and Ethnic Discrimination in US Health Care.”, states that “According to the committee, the last of these, negative stereotypes that many healthcare providers hold toward racial and ethnic minorities, are among the most challenging barriers to overcome.” Racial bias present within providers leads to the negative experiences minorities share.

This bias against minorities, especially African Americans causes the mistrust of healthcare from the community and is reaffirmed by their experiences in the past and present. In “Effects of perceived racism, cultural mistrust and trust in providers on satisfaction with care.” the connection between bad experiences with a provider and broken trust causes minorities to not want to seek out healthcare providers anymore.“Impact of Perceived Racism on Healthcare Access Among Older Minority Adults.” also shows this, seeing how older minorities have an unwillingness to access healthcare because of a combination of badhistory and personal experiences. In “The Influence of Mistrust, Racism, Religious Participation, and Access to Care on Patient Satisfaction for African American Men: The North Carolina-Louisiana Prostate Cancer Project.” We see that African American men reported lower rates of patient satisfaction than caucasian males and that these experiences also lead to refusal of healthcare.

All these factors show exactly how racism is ingrained in our healthcare system and why it is such a large issue. There is no one solution, but the most important one to have racial bias training for healthcare professionals. “To fight racism and discrimination, we all need to recognize, name, and understand these attitudes and actions. We need to be open to identifying and controlling our own implicit biases. We need to be able to manage overt bigotry safely, learn from it, and educate others. In “Racism and Discrimination in Health Care: Providers and Patients.” Tello offers this solution: “These themes need to be a part of medical education, as well as institutional policy. We need to practice and model tolerance, respect, open-mindedness, and peace for each other.” If these sort of education programs are implemented then the patient care satisfaction should be similar for everyone. Another way to improve this is to do more research on minorities' health, to replace the white-centric view of patients and health. When we can understand the differences between different groups, medical professionals will be better able to provide satisfactory care to minorities. And most importantly, we must foster trust between medicine and African Americans, there must be a long standing history of positive experiences to combat the negative ones to help bridge the gap for everyone.