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To begin pushing for anti-racist healthcare, we must first understand that BIPOC individuals often face disproportionately higher chronic and debilitating health burdens due to inadequate healthcare research and practices that have stemmed from a long history of systemic racial and ethnic inequalities and disparities. A combination of non-diverse healthcare practitioners, lower access to specialists, and conscious or unconscious racial bias can result in worse overall health outcomes, with these disparities also disproportionately widening during outbreaks such as the current COVID-19 pandemic. According to McKinsey, the COVID-19 mortality rate is 3.8 times higher for Black Americans and 3.2 times higher for Latinx Americans compared to white Americans. Out of all racial groups, Indigenous populations have also had the highest crude and age-adjusted COVID-19 mortality rates per 100,000 population.
Health insurance coverage is one important determinant for measuring access to healthcare. According to the U.S. Department of Health and Human Services, only 55.5% of Black Americans had private health insurance, compared to 75.4% of white Americans. Additionally, many minimum wage and part-time jobs don’t cover healthcare. Fourteen states still haven't expanded Medicaid coverage under the Affordable Care Act (ACA), meaning that “30 million people remain uninsured. About half of those 30 million are people of color.” Having affordable health insurance is vital for encouraging BIPOC patients to visit their providers for regular check-ups or early detection of chronic illness and other ailments, but some people of color have distrust for doctors and only visit when they are seriously ill. In addition, if the high cost of healthcare remains a deterrent, BIPOC's medical issues may not be caught until much later, therefore being more financially devastating for BIPOC patients when they have to pay for hospitalization or specialized operations. Sometimes, these medical issues are not caught until much later due to racism within medical diagnosis and treatment — healthcare practitioners' implicit bias and false beliefs about biologic differences between Black and white people, such as how Black people have thicker skin or that their blood can coagulate more quickly, are detrimental to equitable healthcare.
Finally, one key consideration in all clinical research and experimentation is that many from Black, Latinx, and Indigenous communities are inherently distrustful of medical systems, due to instances of medical apartheid such as the Tuskegee Syphilis "Study," James Marion Sims (father of gynecology)'s forced experimentation on Black female slaves, and countless more. We recommend Harriet A. Washington's book, "Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present," as a starting point.
Helping health professionals serve patients from all backgrounds with quality care, attention, and communication at all touch points of the healthcare system. Strong cultural competence will lead to stronger patient-physician relationships, greater patient participation and consent in medical decisions, greater trust in the medical system, and higher satisfaction with care.
Decrease bias through wearables: Neurotech wearables could help eliminate bias, in addition to training more BIPOC hospital staff members. Neuroscience has been able to detect bias in decision making through fluctuations in alpha waves. A wearable could inform practitioners when bias plays a role in their decision making with patients of color. However, due to the high unit cost of such tech, this solution cannot be widespread and will be accessible to some populations, especially lower-income BIPOC.
New smart devices in hospitals: We can reduce biased decision-making by removing human judgement and having tech make data-based decisions. For example, IOT beds and collection plates are unbiased when they have scales built in that continually measure blood and fluid loss. These tools trigger alarms based on metrics, not doctors.
Many minority populations lack ****primary care physicians due to medical distrust, residential segregation, and other factors, and therefore can’t get access to specialists for treatment without a referral, which leads to higher rates of emergency room visits from BIPOC patients. Additionally, HSA and Benefits systems are complex and difficult to understand — these barriers are further amplified for those who are low literacy or do not have English as their primary language.