Systemic Racism in Healthcare
June 26 | Written By Sophia Mai
The narrative of the Immortal Life of Henrietta Lacks by Rebecca Skloot introduces the woman who changed the course of medicine. Henrietta Lacks developed cervical cancer and contributed to the HeLa cell line, the first immortal human cell line, but she went unrecognized for her contributions for decades. This issue could be because she was a poor African American farmer in the 1900s when ethical and medical practices were underdeveloped and beneficial to the white population. However, her cells were influential and were used to develop medicines because they were cheap, easy to use, and a reliable population of growing cells. Medical professionals exploited, took advantage of, and profited off of Henrietta’s cells, creating a multi-million dollar industry, while she and her family were uninformed of the procedures on Henrietta and the use of her cells. Systemic racism refers to the institutional and structural barriers within a society, perpetuating discriminatory and unjust practices and outcomes for individuals based on their racial identity. It is characterized by the systemic policies, procedures, and structures inherent in society, resulting in unequal access to opportunities, resources, and privileges, such as education, employment, housing, and healthcare. Although the medical field strives to provide equal care to all individuals, systemic racism continues to persist due to issues with informed consent, equitable access to medical care, and historically ingrained stereotypes. Addressing these issues will allow society to circumvent racial barriers and improve patient care overall.
INFORMED CONSENT
One problem regarding the persistence of racism in the medical field is the problem with giving informed consent. In the context of Henrietta Lacks, access to medical facilities was very limited for African Americans. Professionals from Johns Hopkins, one of the few medical facilities that allowed black patients, “often used patients from the public wards for research, usually without their knowledge” (Skloot 29). Many scientists during the 1950s believed that “since patients were treated for free… it was fair to use them as research subjects as a form of payment” (Skloot 30). While doctors were not compensated for their work, it is immoral for doctors and professionals to perform procedures without informed consent and to take advantage of a patient without compensation or knowledge of the procedure. Black Americans during the 1950s were targets of discrimination and racism and had lower standards of living in virtually every aspect compared to White Americans. Regardless of a patient's identity and race, it was wrong for the doctors to exploit Henrietta to further innovations in the scientific community. Henrietta's case raises concerns about the morality and necessity of using individuals for the betterment of society without their consent. While ethics and thinking at the time may be different from the modern day, protecting the rights and privacy of patients was crucial, even if taking risks that could harm them held the potential to save millions. The scientific community has made efforts to improve medical practices and ensure some rights for patients, but there is still a long way to go in terms of equal rights, access to opportunities, and informed consent for minority groups. The medical industry, professionals, and society must make an effort to address these issues. However, the medical industry, professionals, and society still have a long way to go concerning equal rights, access to opportunity, and informed consent for minority groups.
An example of the persistent and ongoing problem of informed consent in the medical field is seen in the article "The Long History of Medical Violence Against People of Color." The text highlights the case of forced sterilizations that occurred in 2020 at an immigrant jail in Georgia. The text exposes medical abuses, including state-sanctioned eugenics and forced sterilizations of individuals who did not have U.S. citizenship or were considered criminals. A black nurse at the jail reported that "incarcerated people would be sent to the doctor for medical procedures, including hysterectomies, and 'they don't know why they went or why they're going'"(Jackson). Women were not fully informed about the medical procedures in their native language and were subjected to intimidation from nurses to undergo forced sterilizations that stripped them of their reproductive rights. In addition to these medical abuses, migrants in the jail were also denied human rights, such as access to water and food. Medical abuses in the United States are not a recent development. "In 1914, the U.S. States Public Health Service (USPHS) allied itself with the eugenics movement" (Ordaz), supporting eugenics and restricting immigration to regulate the reproduction of people seen as "mentally defective, undesireable and harmful to society." People labeled as such were those of color, immigrants, poor, and disabled. While there are more measures and attempts to give more rights, such as consent to minority groups, there are continuous recurrences of racism and violence rooted in white supremacy.
ACCESS TO HEALTHCARE
Systemic racism has had a profound impact on access to healthcare in the United States, leading to unequal and unfair outcomes for people of color. Racism has shaped the social, economic, and political structures that determine who has access to health care and who does not. For example, many communities of color are disproportionately affected by poverty and lack of access to quality education, which limits their ability to secure good-paying jobs and access to health insurance. According to Jabali, a writer for The Guardian News, "early data indicates that black Americans comprise a disproportionate number of the victims" during the COVID pandemic (Jabali), and the death rate for African Americans was more than twice the rate of whites. The article also argues that the COVID pandemic has resurfaced the harsh reality that the country "is still separate and still unequal." Black Americans lack access to the same opportunities that whites have concerning access to health care. Racism has also contributed to the underfunding of healthcare in minority communities, leading to a shortage of medical facilities and a lack of healthcare providers. However, the Trump administration has placed much of the responsibility for these disparities on the victims themselves by speculating their lifestyle choices, such as smoking and drinking habits, instead of acknowledging and addressing the underlying conditions of the racial caste system that is rooted in America's history of white supremacy. This approach fails to address the core causes of disparities and perpetuates the cycle of inequality in access to medical care. Additionally, discrimination and implicit biases in the healthcare system also contribute to unequal access to care, with people of color often experiencing discrimination and a lack of trust in the healthcare system, leading to a reluctance to seek care and engage in preventive health behaviors. Steps must be taken to break down these racial barriers and promote equality in patient care to improve health outcomes for all individuals, regardless of race.
STEREOTYPES
The issue of systemic racism in medicine is brought to the forefront by movements like Black Lives Matter. Discrimination still exists in medicine partly due to racial backgrounds, and many surgery algorithms take into account a patient's ethnicity when calculating their risk for certain illnesses, which frequently leads to colored patients having lower-quality treatments as a result of racial health disparities. "Black patients' pain were also often underestimated and undertreated by residents who held false beliefs that Black patients have higher pain tolerance than other patients" (Sim). This method minimizes the severity of several ailments in people of color, delaying treatment and resulting in hesitation to receive medical attention because of distrust in the healthcare system. Comparatively, Rebecca Skloot addresses the systematic racism experienced by African American patients. Because they believed Henrietta to be of lesser social standing, her white doctors neglected to follow "normal procedure" and warn her about "fertility loss before [she] took part in the cancer therapy" (Skloot 47). Throughout Henrietta's treatment, there was a lack of communication, which led to lower-quality medical care. Studies have shown that the implicit racial biases and negative experiences caused by racism create distrust in the healthcare system and continue a cycle of poor health among minority groups.
CONCLUSION
Systemic racism in healthcare exists due to issues such as lack of informed consent, unequal access to medical care, and harmful stereotypes. By addressing these issues, society can better patient care and break down racial barriers to healthcare. Despite the progress made through rights movements, systemic racism continues to permeate not only healthcare but also society as a whole. The unequal treatment of marginalized groups is a result of issues such as lack of informed consent, unequal access to medical care, and harmful stereotypes. We must come together to address these injustices and promote equality in patient care for all.
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Works Cited
Jabali, Malaika. "The coronavirus has laid bare the reality of America's racial caste system; Generations after Brown v Board of Education, the US is still separate and unequal." Guardian [London, England], 27 May 2020, p. NA. Gale In Context: Opposing Viewpoints, link.gale.com/apps/doc/A625035302/OVIC?u=j101914&sid=bookmark-OVIC&xid=d9d02637. Accessed 30 Jan. 2023.
Jackson, Jenn M. "The Long History of Medical Violence Against People of Color." Gale Opposing Viewpoints Online Collection, Gale, 2023. Gale In Context: Opposing Viewpoints, link.gale.com/apps/doc/YLOSHN414370524/OVIC?u=j101914&sid=bookmark-OVIC&xid=55b0c57f. Accessed 30 Jan. 2023.
Ordaz, Jessica. "Migrant detention centers have a long history of medical neglect and abuse." Washingtonpost.com, 18 Sept. 2020, p. NA. Gale In Context: Opposing Viewpoints, link.gale.com/apps/doc/A635834497/OVIC?u=j101914&sid=bookmark-OVIC&xid=8e717c7c. Accessed 2 Feb. 2023.
Sim, Wilson, et al. "The perspectives of health professionals and patients on racism in healthcare: A qualitative systematic review." PLoS ONE, vol. 16, no. 8, 31 Aug. 2021, p. e0255936. Gale In Context: Opposing Viewpoints, link.gale.com/apps/doc/A673834707/OVIC?u=j101914&sid=bookmark-OVIC&xid=c34ceed0. Accessed 27 Jan. 2023.
Skloot, Rebecca. The Immortal Life of Henrietta Lacks. Crown Publishers, 2010.