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Does racism hinder how medical treatment is given to minorities ?

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Sherryl Brown

MSW Student, School of Social Work

Hawaii Pacific University

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Research Question

Methods

Background

Results

Implications

Outline

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Discussion

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Background

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Health care providers hold negative explicit and implicit biases against marginalized groups of people.

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Black Americans, Hispanic Americans, and American Indians have higher infant mortality rates than White and Asian Americans.

Inequalities contribute to uneven access to services, and poorer health outcomes among certain populations specifically African Americans.

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Research Question

  • Does one’s race, ethnicity or gender effects how one is medically treated in American society.
  • This systematic literature review aims to examine existing publications focusing on the research question “Does racism hinder how medical treatment is given to minorities?”

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Methods

Data collection came from online research using specific peer reviewed articles from HPU bases focusing on the research question “Does racism hinder how medical treatment is given to minorities?”

Research articles that reported results of racial/ethnic discrimination, patient or provider perceptions of race or ethnicity-based discrimination within health care settings.

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  • (KW “Medical gaslighting”) and (minorities)
  • (KW “Gaslighting”)
  • (KW “Medical”) and (gaslighting)
  • (KW “Medical” and (oppression)
  • (KW “Medical”) and (oppression) and (minorities)
  • (KW “Health equality)
  • (KW “Health”) and (inequality)
  • (KW “Health inequality”) and (minorities)
  • (KW “Medical”) and (gaslighting) and (women)

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  • (KW “Marginalized”) and (women)
  • (KW “Health care disparities”) and (America)
  • (KW “Medical biases”)
  • (KW “Medical biases”) and (minorities)
  • (KW “Medical biases”) and (women)
  • (KW “Medical biases”) and (racial)

Keywords used

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Results

Duplicate records removed

N=1,664

N=2,835

Articles located from Hawaii Pacific University

N=80,804

Articles located EBSCO, GALE and Taylor and Francis

N= 81,975

Articles eligible

 

N=14

Articles included in Systematic Literature Review

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Discussion

The research implied that racial assumptions are not just limited to personal beliefs.

Providers frequently used implicit and explicit biases when treating minority patients.

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Providers also used false beliefs about women in their medical decision making process.

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The impacts of these decisions creates gaps in medical knowledge for minority communities.

Healthcare providers cannot improve the quality of their care without also identifying and reducing disparities in the care that their minority patients receive.

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Implications

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Conclusion

  • Health disparities are particularly prominent among minorities.

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  • Patients of different ethnicities and gender frequently received different levels of medical care

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References

Additional informationNotes on contributorsGaile PohlhausGaile Pohlhaus, & ReferencesAlcoff. (n.d.). Discerning the primary epistemic harm in cases of testimonial injustice. Taylor & Francis. Retrieved March 1, 2023, from https://www.tandfonline.com/doi/full/10.1080/02691728.2013.782581#:~:text=Defining%20the%20primary%20epistemic%20harm,of%20credibility%20in%20these%20cases.

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Elias, A. (2023). Racism as neglect and denial. Ethnic and Racial Studies, 1–23. https://doi.org/10.1080/01419870.2023.2181668

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FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics, 18(1). https://doi.org/10.1186/s12910-017-0179-8

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Frank Harris III, J. L. W. (2021, February 22). Racelighting: A prevalent version of gaslighting facing people of color. Diverse. Retrieved March 7, 2023, from https://www.diverseeducation.com/opinion/article/15108651/racelighting-a-prevalent-version-of-gaslighting-facing-people-of-color

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Heggen, K. M., & Berg, H. (2021, October 15). Epistemic injustice in the age of evidence-based practice: The case of fibromyalgia. Nature News. Retrieved March 10, 2023, from https://www.nature.com/articles/s41599-021-00918-3#:~:text=Epistemic%20injustice%20is%20wrong%20done,of%20their%20own%20illness%

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Maina, I. W., Belton, T. D., Ginzberg, S., Singh, A., & Johnson, T. J. (2018). A decade of studying implicit racial/ethnic bias in healthcare providers using the Implicit Association Test. Social Science & Medicine, 199, 219–229. https://doi.org/10.1016/j.socscimed.2017.05.009

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Riggs, D. W., & Bartholomaeus, C. (2018). Gaslighting in the context of clinical interactions with parents of transgender children. Sexual and Relationship Therapy, 33(4), 382–394. https://doi.org/10.1080/14681994.2018.1444274

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References

Ross, P. T., Lypson, M. L., & Kumagai, A. K. (2012). Using illness narratives to explore African American perspectives of Racial Discrimination in health care. Journal of Black Studies, 43(5), 520–544. https://doi.org/10.1177/0021934711436129

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Ruíz, E. (2020). Cultural Gaslighting. Hypatia, 35(4), 687-713. doi:10.1017/hyp.2020.33

TD;, W. D. R. R. (n.d.). Understanding and addressing racial disparities in health care. Health care financing review. Retrieved March 10, 2023, from https://pubmed.ncbi.nlm.nih.gov/11481746/

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Thompson, C. M., Babu, S., & Makos, S. (2022). Women’s experiences of health-related communicative disenfranchisement. Health Communication, 1–12. https://doi.org/10.1080/10410236.2022.2137772

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Tobias, H., & Joseph, A. (2018). Sustaining systemic racism through psychological gaslighting: Denials of racial profiling and justifications of carding by police utilizing local news media. Race and Justice, 10(4), 424–455. https://doi.org/10.1177/2153368718760969

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Watson-Creed G. Gaslighting in academic medicine: where anti-Black racism lives. CMAJ. 2022 Oct 31;194(42):E1451-E1454. doi: 10.1503/cmaj.212145. PMID: 36316019; PMCID: PMC9828884.

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Vela MB, Erondu AI, Smith NA, Peek ME, Woodruff JN, Chin MH. Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs. Annu Rev Public Health. 2022 Apr 5;43:477-501. doi: 10.1146/annurev-publhealth-052620-103528. Epub 2022 Jan 12. PMID: 35020445; PMCID: PMC9172268.