Aversive Racism and Inequality in Health Care

Aversive Racism and Inequality in Health Care

Rosenblum and Travis (2016) define aversive racism as “the obliviousness to prejudice-especially when it is one’s own” (Rosenblum & Travis, 2016). Notably, in the United States, aversive racism coupled with racial inequality significantly affects the healthcare sector. This concept is contrary to the belief that the healthcare sector should have equal rights for its access. As a result, individuals are deprived of the opportunity to access proper and quality healthcare based on their income, insurance status, and racial identity. Health disparities are not an overly new phenomenon in the United States. As a result, racial and ethnic minorities tend to receive somewhat poorer quality care than other nonminority groups, even when there is control of income levels and insurance status.

Examples of Inequality and Their Impact on Health Care in the United States

A practical example of where inequality is presented in the healthcare system in the United States is the healthcare disparity characterized by the lack of healthcare of approximately one-sixth. Based on Rosenblum and Travis (2016), about 44% of individuals lack affordable healthcare insurance. Ideally, the Affordable Care Act is the most significant improvement in the United States since it assisted most individuals in accessing healthcare insurance, which was previously challenging to acquire. According to Bailey et al. (2019), most individuals who gained medical insurance coverage in 2019 under the Affordable Care Act included 2.8 million African Americans. However, even with the significant progress in providing affordable healthcare to individuals, there is still a considerable problem when it comes to accessing affordable healthcare services, especially for African Americans and other minority groups. Ideally, this racial group tends to have no insurance coverage. The resolution to this form of racism would be to extend the Medicaid program to assist vulnerable individuals effectively (National Academies of Sciences, Engineering, and Medicine, 2017).

It is important to note that some states have taken the duty to extend their Medicaid program. Still, some states are reluctant to offer similar services, especially the Southern States that primarily harbor African-American individuals. According to Bailey et al. (2021), “In states that have not expanded Medicaid under the ACA, African Americans and other people of color are most likely to fall within a coverage gap – meaning they earn too much to qualify for traditional Medicaid, yet not enough to be eligible for premium tax credits under marketplace insurance plans” (Bailey et al., 2021). Notably, if Medicaid could be extended to all states, the individuals who are not insured would be insured. Hence, low-income and African-American individuals would significantly benefit from this program.

Shortages characterize the second example of racial inequality. Bailey et al. (2021) suggest that “Due to residential segregation, majority African-American and Hispanic areas are more likely to lack hospitals and other health care providers.” From this perspective, it is evident that there are bound to be health disparities. In most cases, the lack of primary care forces individuals to seek other services, such as being admitted to emergency care. Ideally, the lack of primary care for African Americans compelled the minority groups to seek alternative standards of sustenance. Therefore, the possible solution would be to address the type of aversive racism to improve patient segregation. The United States statistics suggest that African Americans and other minority groups have a lower income than White Americans. Subsequently, this translates to difficulty acquiring affordable housing and other amenities (National Academies of Sciences, Engineering, and Medicine, 2017). From this perspective, the lower-income earners live in impoverished neighborhoods, which creates some form of stigma and hence makes it difficult for these individuals to access standard healthcare in their area.

Methods for Reducing Aversive Racism and the Impact of Implicit Bias on Health Care

One of the methods that can be used to reduce aversive bias is reducing implicit bias. Implicit bias is characterized by an unconscious association, belief, or attitude toward a particular group of people (DiBrito et al., 2019). According to DiBrito et al. (2019), physicians with high scores concerning implicit bias primarily dominated their interactions when dealing with minority groups. As such, the minority groups possessed less confidence, self-esteem, and confidence in the healthcare provider. Implicit bias can be as harmful as conscious discrimination. Although subconsciously, physicians can treat their patients differently depending on their background. Accordingly, this suggests that the patient may pick up the trait or response provided, which determines how the patient perceives the services rendered to them.

Conclusion

When a physician or nurse attends to a patient, they should ensure that the services rendered are holistic and complement the principles of patient-centered care. Aversive racism and inequality in healthcare in the United States has been a much-debated aspect and, therefore, prompting the discussion of the vice on the ground roots. Minority groups have been segregated based on their backgrounds, but this has been addressed through various avenues such as Medicaid. As such, it is essential to address the need for equality regarding healthcare access for individuals irrespective of race, religion, or socioeconomic status.

References

Bailey, Z. D., Feldman, J. M., & Bassett, M. T. (2021). How structural racism works—racist policies as a root cause of US racial health inequities. New England Journal of Medicine, 384(8), 768-773. DOI: 10.1056/NEJMms2025396

DiBrito, S. R., Lopez, C. M., Jones, C., & Mathur, A. (2019). Reducing Implicit Bias: Association of Women Surgeons# HeForShe Taskforce Best Practices Recommendations. Journal of the American College of Surgeons, 228(3), 303. doi: 10.1016/j.jamcollsurg.2018.12.011

Rosenblum, K. E., & Travis T. C. (2016). The Meaning of Difference: American Constructions of Race and Ethnicity, sex and gender, Social Class, sexuality, and disability (7th ed.). New York, NY: McGraw-Hill.

National Academies of Sciences, Engineering, and Medicine. (2017). Communities in action: Pathways to health equity.

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Aversive racism is a subtle and indirect type of racism that can contribute to unequal treatment in a variety of settings and situations, including, but not limited to, healthcare access for minority racial and ethnic groups. Individuals who engage in aversive racism say they support the principle of racial equality and do not believe they are prejudiced. However, they also possess subconscious negative feelings and beliefs about specific racial and ethnic groups. Aversive racism often results in a majority group’s failure to help a minority group, even though they do not intentionally cause harm. Aversive racism may be a contributing factor to poor quality health care for some minorities.

To prepare for this Assignment:

Review the Section III, “Framework Essay,” and Reading 31 in the course text. Pay particular attention to aversive racism and health care access.
Review the article “Psychiatrists’ Attitudes Toward and Awareness About Racial Disparities in Mental Health Care” and focus on methods for reducing aversive racism.
Take the Race Implicit Bias test at the Project Implicit website.
Identify two examples of racial or ethnic inequality in health care in the United States.
Think about how aversive racism contributes to the examples that you identified.
Consider methods for reducing aversive racism in your examples.
The Assignment (3–4 pages):

Describe two examples of racial or ethnic inequality in health care in the United States.
Explain how aversive racism contributes to the inequality illustrated in the examples (and thus in health care) you described.
Explain methods for reducing aversive racism in your examples. Be specific and provide examples to support your explanation.
Discuss how implicit bias might impact health care in the United States.

References:

Rosenblum, K. E., & Travis T. C. (2016). The meaning of difference: American constructions of race and ethnicity, sex and gender, social class, sexuality, and disability (7th ed.). New York, NY: McGraw-Hill.

For review: Section III, “Framework Essay”

Section II, Reading 31, “Cause of Death: Inequality”

Section II, Reading 32, “Why Are Droves of Unqualified, Unprepared Kids Getting Into Our Top Colleges? Because Their Dads Are Alumni”

Section III, Reading 37, “Fourteen Key Supreme Court Cases and the Civil War Amendments”