The American healthcare system has been shaped by as well as complicit in the long standing history of racism, oppression, and social injustice in the U.S. The impacts of our history are still felt by many communities today: those that identify as LGBTQ+, women, people with disabilities, those who live in under-resourced areas, and those with low socioeconomic status (SES). While “health disparity” is a relatively new term, unequal access to quality care is not a novel phenomenon and is one which we must actively work to overcome. However, even when access is addressed, disparities continue to exist. Often, this is the result of unconscious or implicit bias by healthcare workers.
To ensure that communities which have been historically disenfranchised have access to high quality healthcare, healthcare professionals and those interested in the healthcare field must begin the work of uncovering these biases and unlearning them. Unconscious or implicit biases can have a devastating impact on health outcomes resulting in increased mortality, incorrect or inappropriate medical treatment, and betrayal of trust. We must commit to resocializing ourselves, examining our biases, and serving as role models for others. For information on implicit bias, check out Harvard's Implicit Association Test, where you can take a test to help you become more aware of hidden biases.
Learning about what preconceived notions we bring to the table is important, but we must also be aware of and sensitive to the present and historical injustices faced by marginalized populations. In the context of healthcare, consider the Public Health Service’s Syphilis Experiment at Tuskegee, the treatment of people with disabilities during the eugenics movement in the 20th century, and the AIDS crisis. By acknowledging the past and its current manifestations, we can begin taking the steps needed to make healthcare work for all.
The practice of cultural humility unlike cultural competence goes a step further and asks us to engage in sustained effort and reflection where we listen, reflect and work in partnership with others rather than play the role of expert. It recognizes that people are complex beings and that learning from an individual’s lived experience rather than solely on book learning is of upmost importance.
In addition to the lifelong learning that cultural humility asks of each of us, increased recruitment of diverse healthcare professionals is essential part of moving toward health equity. While African Americans make up 13% of the population, they only represent 4% of the physician workforce. Furthermore, studies have shown that health disparities decrease with a more diverse healthcare workforce and that there is an increase in preventive services received.
It is past time that healthcare professionals reflect the diversity of the communities they serve. By recognizing the failures of the past and increasing and valuing diversity in healthcare, we can all contribute to building a better future by ending the health disparities that continue today.
To learn more about diverse populations, consider taking courses in African American Studies, Latin American and Caribbean Studies, Native American Studies, Women's Studies or Disability Studies while at UGA.
Learn more about racism and structural inequity in healthcare:
- Prioritizing Equity video series from the American Medical Association
- Epidemics and the African American Community video series from the Hutchins Center Project on Race and Gender in Science and Medicine
- What the Racial Data Show: The pandemic seems to be hitting people of color the hardest. The Atlantic, April 2020
- Duke University School of Medicine Antiracism Resources
- Harvard University Countway Library Antiracism and Health Reading List
- Yale School of Medicine’s Race and Racism in Medicine
- Peggy McIntosh TEDTalk: How to recognize your white privilege — and use it to fight inequality
- Vox’s video “The US Medical System Is Still Haunted by Slavery”
UGA events of interest to further your understanding:
- LGBT Resource Center's Connect Conference
- The College of Education Diversity, Equity, and Inclusion Conference
- Social Justice Symposium
- Disability History Symposium
- Women and Girls in Georgia Conference
- Working in the Public Interest Law Conference
- Conference on James Baldwin for Academics, Artists, and Activists