Racism is based on an ideology in which humanity is divided into social groups called "races". These groups are assigned different ranks so that a dominant race (the European, white race) is allowed to use its power to devalue and disempower people. It is an organized social system that uses social resources and opportunities to classify other defined groups (African, Asian, Native Americans) as inferior. Slavery and segregation may have been abolished, but racism still plagues people and institutions around the world, including healthcare systems and those who work in them.
When the topic of racism comes up, we usually think of discrimination or abuse in various fields, but we rarely address racism in medicine. Although it may be difficult to admit, the first step in eliminating or combating racial discrimination in medicine is to understand that it goes beyond personal bias or prejudice on the part of health care providers. Data from the National Center for Health Statistics (1998) indicate that over the past 50 years, the health status of both blacks and whites in the United States has improved, as evidenced by increased life expectancy and decreases in infant and adult mortality. However, blacks continue to have higher morbidity and mortality rates than whites on most physical health indicators. Hispanics and Native Americans also have higher rates of illness and mortality for several diseases.
Barriers to accessing healthcare are often long waiting times, complex bureaucratic procedures and undignified treatment of patients, which usually discourage those affected from using the healthcare system. Over the years, black people and other communities around the world have had poorer access to healthcare. Its poorer quality is also reflected in inequalities in morbidity, mortality and overall health.
Discrimination in medicine and science has been around for several years. In the 20th century, Africa was turned into a living laboratory by Western scientists during the sleeping sickness pandemic. When the disease began to spread in Africa, European colonial rulers feared that it would slow down the African labor force, which in turn would affect colonial projects and revenues.
In order to contain the spread, the German scientist Robert Koch conducted medical experiments on Africans that were considered too dangerous for Europeans. Many of the remedies Koch tested on Africans contained toxic substances such as arsenic. He set up numerous "concentration camps" to isolate the sick from the healthy. The methods used had devastating consequences for the colonized, but benefited the sovereignty of the German Empire and contributed to its industrial rise. The practice of colonial science exposed the colonized to an early death, and these deaths were of value to the colonial presence because these practices were based on violent conquest and a brutal political system.
The experiment deprived people of their existence, as the colonized people's bodies were reduced to their social and economic value. Atoxyl was administered to the test subjects in full doses, although it led to poisoning, blindness and even death. When these people returned to their villages and their health improved, they were arrested and sent back to concentration camps to continue the experiments. These colonized people were constantly dehumanized and treated like animals, their health was brutally attacked and their rights violated. Through medical experiments, people were tortured and treated in an inhumane way.
The data collected in these camps was eventually passed on to British officials who were also trying to combat sleeping sickness outbreaks in their colonies.
Robert Koch was a brilliant scientist, and it is likely that he really wanted to cure sleeping sickness in those who suffered from it. Others consider him a racist and a symbol of colonial suffering whose impulsive drive to achieve his own glory led to the humiliation and deprivation of the dignity of Africans. Whatever his intentions, his methods were extreme and led to imprisonment and murder. Not only did he poison thousands of people, but he also helped to establish the idea that different rules apply to Africa than to Europe in terms of medical ethics, with serious consequences that have influenced the way Western scientific communities have treated Africa to date.
Over the years, there has been some awareness that has led to a decrease in bias, but subtle forms of disparate treatment still exist. Most healthcare providers still seem to practice some form of discrimination in the form of a positive attitude towards whites and a negative attitude towards blacks. Healthcare providers may take more time and give more attention to White patients than to Black patients. Furthermore, the degree of cooperation may vary. It is common for them to address patients in a tone that makes them feel unheard and unappreciated by their providers. Often, interpreters are not provided when needed. In addition, doctors, nurses and therapists like to grant special privileges to White patients, such as allowing some families to visit for hours and restricting other families from visiting.
To effectively combat injustice and discrimination in healthcare, all other sectors of society must be involved, as some healthcare providers are not even aware of the fact that they are discriminating against patients. New initiatives need to be taken to adequately train and recruit more service providers from disadvantaged groups. If medical professionals want to actively reach out to patients and reach them where they are, they should come from all walks of life. This should be pursued and extended to communities. Job training and healthcare opportunities offered to community members, especially the youth, contribute greatly to development and economic security, which in turn promotes stability and health for people in Black communities. When these youth are trained, they are better able to provide valuable services to their communities in more accessible and affordable ways.
When community residents and institutions are equipped with the necessary knowledge and skills to follow or choose a healthier lifestyle, the long-term benefits are numerous, so it is necessary that people are empowered by these opportunities so they can thrive. A study using variations of the federal Earned Income Tax Credit (EITC) and the presence of state EITCs found that income from the EITC decreased the rate of low birth weight and increased average birth weight, with the associations being greater for blacks than whites.
Since a significant factor in these health inequalities is due to racism as a result of institutional policies, people, laws and practices, healthcare providers have a duty to eliminate racism by making a conscious effort to prevent racism, however it manifests itself.
Furthermore, an equitable distribution of health resources paves the way for equity in health services. This requires that the needs of society are thoroughly considered to ensure that every member of society has an equal opportunity to access medical services.
Patients should be offered supportive social services to help them improve their health. A study of 1059 low-income families at a pediatric clinic in the U.S. found that families most often had needs for employment (25 %), housing (14 %), child care (13 %), health insurance (11 %) and food assistance (10 %).
A recent study in the US found that an increase in the minimum wage in each of the 50 states between 1980 and 2011 led to an improvement in the birth rate per month. It was found that a one dollar increase in the minimum wage above the federal minimum wage was associated with a 1 to 2 % decrease in the low birth rate and a 4 % decrease in postpartum mortality. It was estimated that a $1 increase in the minimum wage in 2014 would result in a 2790 decrease in low birth weight births and a 518 decrease in postneonatal mortality. The living conditions of people in society should be improved to promote the quality of health, as a better living environment also leads to a healthy lifestyle, which has a positive impact on health.
Racism is a global evil that must be eradicated by all. If the quality of our health or our life expectancy depends on a factor like "race", that is a truly terrible way to live.
Author, Judith Adorsu