By Kate Prell, Program Specialist, Recruitment and Placement, NIMAA

What Is Medical Racism?

Medical racism is the idea that black and other people of color have experienced care inequities due to unconscious bias and larger institutional policies. That is not to say that every provider or healthcare professional is explicitly racist but that the same implicit bias that exists within every aspect of our lives also impacts the quality and access to care in communities of color. This is particularly evident when healthcare professionals are not representative of the patients that they serve. Health trends reported by the Centers for Disease Control and Prevention (CDC) show that Black and other marginalized communities have higher rates of illness, infant mortality, and premature death when compared to their white counterparts. These trends can be attributed to multiple causes including unequal access to affordable housing, healthy food, jobs with health insurance, and education. All of these factors can predetermine health and well-being, and are aspects of institutional racism.

These structural inequities combine with the individual’s care experience. At the further detriment of their health, patients of color often experience bias from their providers and healthcare team. Their symptoms are often not believed or viewed as less serious compared to those of white patients, which is explored in the article “Racism and Discrimination in Health Care: Providers and Patients.” In the article, a doctor recounts a Black patient’s experience with their symptoms not being taken seriously because of her race. Despite pain that brought the patient to the emergency room, the patient was denied pain medication and a proper diagnosis. The patient claimed that the emergency room staff assumed she was faking her symptoms in order to get pain medication. These biases and assumptions, combined with less access to care, often lead to worse health outcomes for patients of color compared to white patients.

The recent COVID-19 pandemic has highlighted health inequities for people of color. According to the CDC, non-Hispanic American Indians or Alaskan Natives and non-Hispanic Black persons have an infection rate 5 times higher than non-Hispanic white persons. Several factors contribute to this disparity in COVID-19 infection rates, but we will focus on a few. Black, Indigenous, and people of color (BIPOC) are more likely to work essential jobs that put them at higher risk of infection. These jobs might not have sick pay or health insurance coverage, leaving employees unable to receive the care they need when sick or experiencing symptoms. Furthermore, there are fewer testing sites in majority-Black and Hispanic neighborhoods, as seen in cities across the United States, including Philadelphia, Dallas, Miami, and Los Angeles. Less access to testing sites despite higher infection rates for BIPOC reflects larger trends in healthcare, and show that we have a long way to go towards equal quality of care and access to care.

Addressing Medical Racism Through a Diverse Healthcare Workforce

Creating a diverse healthcare workforce that is representative of all patients and their experiences is essential to addressing medical racism and bias. By focusing on growing the talent within the communities that our health center partners serve, the National Institute for Medical Assistant Advancement (NIMAA) is working towards training a more diverse healthcare workforce that is representative of patients. Many NIMAA students have chosen to train for a career in safety net clinics because they saw a need for more diversity and representation in their own healthcare experience. NIMAA provides that opportunity by providing a high-quality education at a more affordable cost in underserved areas.

NIMAA was founded by two community health centers, Community Health Center, Inc. in Connecticut and Salud Family Health Centers in Colorado, in order to provide educational opportunities in the communities they serve. This grassroots approach to healthcare and education is an important step towards addressing the inequities that exist in healthcare. NIMAA focuses on building relationships with safety net providers in traditionally underserved areas, both rural and urban, in order to better understand and address the needs of students and the community. In rural areas with fewer higher educational opportunities. Additionally, the cost of education can often be a barrier to entering a health career. As a non-profit, private institution, NIMAA is able to provide a more financially accessible option to residents of underserved communities.

NIMAA is providing one part of the solution for creating a diverse healthcare workforce. A more diverse workforce representative of the patient population is an important step toward better patient outcomes for BIPOC and addressing medical racism.

Resources for further learning

https://www.nejm.org/doi/full/10.1056/NEJMp1609535#t=article

https://www.justhealthcollective.com/home

https://www.npr.org/sections/health-shots/2020/05/27/862215848/across-texas-black-and-hispanic-neighborhoods-have-fewer-coronavirus-testing-sit

https://naacp.org/coronavirus/coronavirus-resources/

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