Generally, when we think of healthcare, we think of an ever-progressing field that is often one of the first sectors to utilize new technologies and other means of improving patient care, ultimately improving every part of our health-related lives. With this in mind, it comes as a large surprise to many that mortality rates during pregnancy increased 25% between 2000 and 2014 in the United States. By 2017, over 295,000 women died from preventable causes related to pregnancy and childbirth.
Furthermore, black mothers were 3 times more likely to die during childbirth than their white mother counterparts during this time. Taken over a 14-year period, it’s very safe to say those statistics were not flukes, and the systemic racism that affects much of our nation has not spared black mothers at the hospital, either.
A common misperception is that people have to be consciously or overtly racist to make decisions that wind up causing disparities like the ones black mothers face, but that is simply not true. Implicit biases exist in all of us, simply based on the things we see as we grow up. These exist in everyone and are not things that we should be ashamed of, but are things that should be recognized and overcome, especially when these biases affect the work someone does, and doubly especially when that work involves saving people’s lives.
Overt bias is saying something like “I prefer to hang out with white people,” and that is certainly much more of a rarity today than it was fifty years ago, but implicit bias would be walking into a room with five people of five different races and automatically thinking that you have a better chance of being friends with the one who looks the most like you. Though that feeling is normal, it is, when really thought about, pretty ridiculous to assume someone’s appearance will affect the way you interact with them.
In hospitals, this same feeling is what causes disparities like the ones seen in black women giving birth. White doctors talk longer to white patients and even that extra bit of conversation can make a difference in how much care is given to a patient, based on the short-yet-relevant “personal” relationship. It’s no different with black women and the disparities that exist when they give birth.
One way to correct this issue is by adding more focus on cultural competence in nursing, and throughout the healthcare space. Cultural competence is a broad term for acceptance and understanding of all races, ethnicities, genders, religions, etc. that one may come in contact with during the course of a given work week. For healthcare professionals, being able to communicate with the same levels of efficiency to every patient is, in and of itself, a step in the direction needed to end racial disparities in healthcare.
A deeper issue is, bluntly put, is that conscious racism still exists as well. Generally, healthcare professionals are intelligent enough to be above this, but certainly not always, just as in the cases with other occupations that involve disproportionate advantages to Caucasians. As fellow healthcare professionals, the only way to combat this is by being vocal when it is seen. Vetting processes for bigotry now exist across a very wide breadth of occupations, and in some areas healthcare is following suit. Recommend that your locale does the same to further help minimize these glaring disparities.
The third large-scale issue related to racial disparities is locational “fairness” in healthcare. Places with high densities of black and Latino individuals also tend to have less funding in their public health options, meaning the care is simply not as good. This is not a case of conscious racism, either, and though technically it is a financial issue, the reasons behind those communities having less funding are, indeed, racially motivated. Fixing these disparities starts at the local voting booth, and fighting for legislation to make affordable care also be quality care is important in the overall battle.
Correcting these disparities will not be something that happens overnight, even if everyone magically jumped on board. They are deeply rooted, and only generational education can ensure that individuals who are responsible for the gaps in care today don’t exist tomorrow.
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