Aversive Racism and Inequality in Health Care

Aversive Racism and Inequality in Health Care

Racial or Ethnic Inequality in Health Care in the United States

The United States has been and is still making a lot of notable societal progress as far as racial equality is concerned. Furthermore, the US has the most advanced systems and resources for disease diagnosis and treatment for most of the known existing and emergent diseases. However, despite these societal developments and advances made in healthcare systems, there is widespread evidence of healthcare inequalities among minority ethnic and racial groups. According to Rosenblum and Travis (2016), the current health inequalities in the United States in terms of the differences in the quality of healthcare from the views of race and ethnicity are no longer related to access to healthcare, healthcare preferences, or appropriateness of health interventions. Such health inequalities are a result of racial and ethnic prejudices and overt biases that exist in healthcare systems in the United States.

The most notable examples of racial and ethnic inequalities in health care in the United States are health insurance and the quality of care delivered. Non-minority racial and ethnic groups across the US, including Black or African Americans, Asian Americans, Hispanics or Latinos, Native Hawaiians, and other Pacific Islanders, American Indians, and Alaska Natives, are evidently underinsured and are more likely to receive health services of poor quality than the majority white populations. The differences between the health outcomes of minority racial and ethnic groups, especially Black Americans and Hispanic racial groups, and the majority of whites are reflective of the racial inequalities in health care.

Roles of Aversive Racism in Health Insurance and Quality of Care Inequalities

Despite the developments the US is making socially in an attempt to root out systematic racism in healthcare and other social services, the hierarchy of racism has been maintained in societal myths propagated in cultures of poverty and classism (Rosenblum & Travis, 2016). The culture of classism seeks to cancel the existence of these societal myths of the culture of poverty. Although traditional racism has largely been tackled, these societal myths are the reason for aversive racism today and the legitimization of inequalities that exist within the systems of healthcare. Race and ethnicity play a role in providing institutional services, especially within financial and educational institutions. Due to the existence of societal myths, the job market, financial institutions, health care, and coverage providers legitimately deny the effects of structural racism on opportunities, education, and income among minority racial and ethnic groups. The result is the existence of a large socioeconomic gap between the non-minority racial groups and the minority groups. This translates to greater income inequality and the inability to afford health insurance. According to Rosenblum and Travis (2016), lower income is directly related to poorer health outcomes. Furthermore, healthcare insurance companies tend to profile individuals racially in relation to chronic diseases during the provision of insurance services.

Based on the very evident segregation of residences in most regions, especially in the Southern states and in major urban centers, regions dominantly inhabited by African-Americans and Hispanic communities are more likely to lack major and equipped hospitals and essential skilled healthcare workers. Aversive racism defines the nature of medical interactions and trust among white medical officers and racial minorities, especially Black American and Hispanic groups. This defines the quality of care delivered within such interactions for minority groups. Societal myths that Black Americans and Hispanic racial groups are more likely to use drugs, be violent, or be linguistically deficient (Rosenblum & Travis, 2016), may define how non-minority health professionals interact and relate with minority group patients with an impact on the quality of care. Besides these, low-income adults are less likely to be seen by doctors for a health problem as compared to higher social class adults.

Reducing Aversive Racism in Health Insurance and Quality of Care

In order for the United States to achieve its national health goals and meet its population’s health needs, it needs to re-examine the existing structures and policies of racism that are contributing to the existing racial and ethnic health inequalities. To achieve equity in healthcare, healthcare delivery systems need to first deal with aversive racism in health insurance and the quality of care delivered to minority racial and ethnic groups. The greatest reason behind the existence of aversive racism is the denial of care providers bearing preconceptions of such minority groups. In reducing aversive racism in the provision of quality care, Mallinger and Lamberti (2010) argued that physicians needed to accept that racial and ethnic inequalities exist in the provision of quality health care and accept their own contributions to such disparities. Health coverage institutions and care providers need to change their long-held attitudes and beliefs towards minority ethnic groups. There is also a need to eliminate racial and ethnic stereotyping across the entire healthcare delivery system for minority racial and ethnic groups.

Impact of Implicit Bias on Health Care in the United States

Implicit bias is a result of in-group favoritism. It involves an individual or a service provider preferring to offer or provide services to members of their own group more than those they refer to as outsiders. Discrimination still exists in the provision of services, especially between members of non-minority racial groups against the members of minority groups (Zestcott et al., 2016). The current inequitable state of healthcare systems and health outcomes of ethnic and racial minority groups across the United States are a reflection of the effects of implicit bias within the healthcare systems and in healthcare delivery. Ethnic and racial minority populations are at a higher risk of experiencing implicit bias when obtaining health care services due to demographics. A majority of health providers across the US are mostly from non-minority racial groups. Due to this, minority racial-ethnic groups experience limited healthcare access to healthcare services or receive low-quality care services. The impact of this implicit bias in health care services delivery can be summarized based on the health outcomes of minority groups. Patients of minority racial and ethnic backgrounds are more ethnicity have higher reported morbidity and mortality rates due to treatable chronic diseases than non-minorities due to implicit bias. Implicit bias in healthcare can be directly linked to the higher levels of psychological distress among African-American and Hispanic racial groups (Rosenblum & Travis, 2016).

References

Mallinger, J. B., & Lamberti, J. S. (2010). Psychiatrists’ attitudes toward and awareness about racial disparities in mental health care. Psychiatric services, 61(2), 173-179.

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

Zestcott, C. A., Blair, I. V., & Stone, J. (2016). Examining the presence, consequences, and reduction of implicit bias in health care: a narrative review. Group Processes & Intergroup Relations, 19(4), 528-542.

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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/or 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.