Free Essay - The Role of Racial Bias in Black Individuals' Interactions With Medical Professionals

While ethical principles demand that justice and fairness should be upheld in healthcare, the existence of disparities in the sector is well-documented. Other than lower access to health services, minority communities such as African Americans receive an inferior quality of care when they access them, and ultimately have poorer health outcomes (Ashton et al. 146). Resultantly, the mortality and morbidity rates are higher in the African American population, and their general health status is poorer compared to the rest of the population. For example, the highest number of deaths resulting from stroke and heart disease is among African Americans (Hall et al. e62). Several factors are responsible for these disparities. Notably, beliefs held during slavery, such as the argument that African Americans are biologically more tolerant to pain, have survived over the decades and influence the quality of care given to this population even today. Such beliefs, coupled with other societal factors, shape the behaviors and attitudes of healthcare providers leading to these disparities. Though the advancement of technology has dramatically improved the quality of care given to patients over the last century, the disparities in healthcare resulting from racial bias continue to affect African Americans negatively and lead to poor health outcomes. In this light, this paper seeks to discuss the role that racial bias plays in interactions between African Americans and medical professionals, as well as its effect on their health outcomes. Particularly, the detrimental effects of harmful stereotypes and false medical narratives on issues such as maternal mortality and pain management will be explored.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

The detrimental effect of Harmful Stereotypes

Stereotypes refer to over-generalized notions or beliefs about a specific group of people. A decline in overt discriminatory behavior has been witnessed in the United States over the last decades. However, subtle and implicit attitudes that influence the behavior of healthcare providers, as well as their treatment options, sustain both institutional bias and covert discrimination. Though disparities in access to healthcare are well documented, Aston et al. (2003) established that even when the access to care and severity of illness is similar, African Americans and other minority groups are less likely to use services requiring doctor's orders, such as invasive procedures, operations, and hospitalization. As such, it is clear that doctor-patient interactions are also a primary cause of the disparities. Harmful stereotypes are among the major causes of this challenge.

Implicit Bias

Bias refers to the negative evaluation of a certain group, and its members, in relation to others. While explicit bias is often conscious, implicit bias is usually unintentional and unconscious (Blair et al. 71). Implicit attitudes can be defined as feelings and thoughts that one harbors outside their conscious awareness. As such, these attitudes are difficult to acknowledge and control consciously. This notwithstanding, attitudes have been shown to affect human behavior significantly. Negative implicit attitudes regarding black people are one of the biggest contributors to health disparities (FitzGerald and Hurst 19). As a result of both conscious and unconscious racial bias, African Americans receive poorer healthcare services as compared to whites. For instance, studies have shown that black patients may wait longer for assessment and treatment as compared to their white counterparts. Also, healthcare professionals frequently spend less time with black patients, and their collaboration is usually poorer (Hall et al. e70). Also, owing to implicit bias, black patients are more likely to be labeled as unruly and uncooperative, as compared to white patients (Blair et al. 71).

Such biases have been shown to affect the judgment and decision-making of healthcare professionals, and hence cause differential medical outcomes. This is in direct violation of ethical principles that require healthcare providers to observe justice and fairness and hence eliminate differential outcomes (Puddifoot 69). Particularly, studies have shown that some diseases are stereotypically associated with African Americans. As mentioned earlier, a larger percentage of African Americans live in poverty as compared to the white population. Therefore, they are often associated with conditions found in people from low socioeconomic backgrounds (Puddifoot 69). As such, healthcare providers may intentionally or unintentionally associate those diseases with this population. Such attitudes and behaviors have the potential of hurting the patient's outcome. Therefore, there is a need to reduce the negative influence of stereotypes on clinical judgment. This goal can be achieved through strategies such as counterstereotypical measures and societal interventions meant to enhance the integration of different social groups in society (Puddifoot 69). Increasing awareness of medical, societal, and personal implicit biases also helps address the issue (Sabin).

Inadequacy

Some healthcare providers view black patients as less intelligent. As such, they believe that the patients cannot adhere to the given treatment regimens, and also associate them with various risky behaviors (Hall et al. e70). Also, healthcare providers feel that black patients cannot maintain treatments that require consistency or close observation. As such, they are given weaker alternatives, which further hurt the outcomes.

False Medical Narratives

There exist various false medical narratives that lead to disparity in healthcare between the white and black populations. While these narratives have no scientific basis, they are believed by some healthcare professionals. Ultimately, they affect the quality of care given to black patients.

Power Dynamic and Absence of Effective Communication

Communication is an essential element of quality interactions between the patient and the healthcare professional. Unfortunately, owing to the unequal power dynamic between black patients and healthcare providers, communication is often ineffective. Owing to racial bias, communication between healthcare providers is affected, and hence the patient outcomes are poorer. Studies have shown that implicit bias significantly affects the interpersonal interactions between healthcare providers and minority patients (Blair et al. 71). For instance, studies have shown that healthcare providers may express subtle biases through the use of condescending and dominant tones. When approached in such a manner, patients feel less valued, and the likelihood that they will feel heard decreases. In instances where a language barrier exists, healthcare providers may also fail to provide interpreters, hence affecting the interactions (Hall et al., e67). As compared to the rest of the population, African Americans are also less satisfied with the quality of interactions between them and healthcare providers (Hall et al. e60).

Generally, it has been shown that healthcare providers often have poorer communication when dealing with minority patients, such as African Americans (Ashton et al. 146). For instance, a 2015 study established that interactions between black people and healthcare providers are characterized by the demonstration of less positive emotions, dominant communication styles, fewer requests for patient input, and less patient-centered care (Hall et al. e60). In turn, inefficient communication may affect trust and commitment on the patient's side, resulting in poor adherence (Blair et al. 71). Besides, the interactions between the patient and the healthcare provider yield critical information that guides the diagnosis and treatment decisions. As such, when the interaction is poor, the decisions are also bound to be affected (Puddifoot 69). The effect of implicit bias on diagnosis and treatment choices is confirmed by a study that showed that thrombolytic drugs are less likely to be recommended for black patients (Puddifoot 69). Unconscious bias has also been blamed for discrepancies in cervical cancer screening rates, as well as follow-up care among black women (Puddifoot 69). According to the study, some of the women indicated that some physicians did not want to touch them, hence contributing to inadequate care (Puddifoot 69).

Super Human Qualities from Slavery

African Americans are wrongly associated with various superhuman qualities that lead to bias in pain management, as well as other spheres of critical care health. According to studies, they are often undertreated for pain as compared to whites. This disparity can be attributed to false narratives about blacks that have been propagated over the years. For instance, the belief that black people have thicker skin than whites directly contributes to this bias (Hoffman et al. 4296). Such beliefs are more prevalent among white medical trainees. They also believe that black people's nerve endings are less sensitive than those of white people. A 2016 study established that approximately 40% of medical trainees believe in such myths and stereotypes (Sabin).

Another study carried out among both the general white population and white medical students also revealed that beliefs regarding blacks' higher tolerance to pain exist. Their beliefs also pointed to the notion that African Americans are biologically stronger than whites (Hoffman et al. 4297). Such beliefs have been historically propagated by slave owners and rogue scientists to justify slavery and the maltreatment of blacks in research, respectively. For example, some physicians believed and wrote that African Americans could persevere in surgical operations without the use of anesthesia. Similarly, mustard gas, as well as other chemicals, were tested on black soldiers during the Second World War (Hoffman et al. 42980). The Tuskegee Experiment also stands as an ugly reminder of the false narratives that have been held regarding black people and their biological constitutions over the years (Hoffman et al. 4298). Unfortunately, some of these beliefs persist today.

If not addressed, such biases can lead to wrong medical judgment, which, in turn, contributes to health disparities. For instance, as will be shown below, trainees who hold such beliefs are less likely to treat African Americans' pain appropriately. According to experts, the disparities seen in pain treatment may not be intentional. Rather, they are a result of implicit biases.

Maternal Mortality

As mentioned earlier, the morbidity and mortality rates in the United States are higher among African Americans. Particularly, maternal mortality is disproportionately higher among black women. According to statistics, black women are 243% more likely to succumb to pregnancy and childbirth-related causes as compared to white women (Martin and Montagne). While various socioeconomic factors such as inadequate access to healthy food, unsafe neighborhoods, lack of insurance, and pre-existing medical conditions may explain the disparity, studies have shown that implicit biases also play a significant role. This explains why even black women who are more educated and well-off than their white counterparts are more likely to die during pregnancy and childbirth (Martin and Montagne). These biases lead to insufficient management of pain and even neglect in some instances.