Healthcare Should Not Be for a Selected Few!
Healthcare Inequality and YOU.
Sadly, many today feel that when it comes to high-quality healthcare, and even lifesaving medical assistance, they are viewed as second-class citizens who will not receive the best treatment and quickest response based on their race, ethnicity, or socioeconomic status. Are YOU among those who feel this way? Have YOU been impacted by such neglect or discrimination?
The United States has some of the most advanced health care and mental health provisions in the world. One would expect that everyone is thriving under this multibillion-dollar system, yet far be that from the truth. Health disparities due to “having no health insurance; stereotypes that health-care professionals hold about racial/ethnic minorities, lesbian, gay, bisexual and transgender patients, or people of different ages, gender, or socioeconomic groups; language barriers; and barriers to access for some disabled individuals (American Psychological Association, 2012).
Disparities in Healthcare.
For quite some time there have been discussions and concerns about health disparities. Gaps in the quality and level of health and healthcare “across racial, ethnic, and socio-economic groups (Riley, 2012). Yet, these are not the only reason for inequalities of healthcare as age, sexual orientation, location, and lack of access all are factors to be considered in this issue (Riley, 2012). There are many who would like to believe that inequalities in providing needed help to patients do not exist (Sue, 2004). Yet, research shows that something as insignificant as replying to an email is impacted by a bias, we have to how we perceive the race or ethnicity of the individual who sent it in connection to how their name sounds to us and what we believe their racial background could be (Betrand & Mullainathan, 2004).
Healthcare disparities related to race and ethnicity “pose significant moral and ethical dilemmas for the US healthcare system” (Riley, 2012). The United States has “an abundance of healthcare facilities, cutting edge technologies, and pharmacotherapeutics and other assets that are the envy of the world, but which are not accessible for a myriad of reasons to all segments of the population” (Riley, 2012). Psychologists and the services that they provide are not excluded in this disparity. “Racial/ethnic, gender, and sexual minorities often suffer from poor mental health outcomes due to multiple factors including inaccessibility of high-quality care services, cultural stigma surrounding mental health care, discrimination, and overall lack of awareness” (American Psychological Association, 2023).
Racial and ethnic minorities are less likely than Whites to receive mental health care. In part this is due to a lack of cultural awareness by medical professionals, including psychologist who underdiagnose and/or misdiagnose mental illness in people from racially/ethnically diverse populations (APA, 2023).
Covid-19 Pandemic Presented Shocking Healthcare Inequities!
Covid-19 Pandemic Magnified Existing Health Care Gaps for Minorities.
The Covid-19 pandemic has had a devastating effect on the lives of millions across the world, and yet statistics show that minorities in various domains have been hit even harder by this virus. The pandemic brought restrictions to mobility, interpersonal contact, employment, and health (Martinez-Bravo & Sanz, 2021). Social distancing, travel bans, and an inability to perform our daily activities brought great distress to many, but data shows that minorities were impacted even more so.
Yet, inequality of financial assistance, treatment and healthcare attention exacerbated these issues for minorities (Martinez-Bravo & Sanz, 2021). Martinez-Bravo and Sanz (2021) showed that the poorest households experienced much greater financial loses than did the richer households. The disparities were seen across gender as well. Women’s income dropped more so than did those of men during the pandemic. Furthermore, income recovery was slower for women than it was for men. The levels of well-being and health of individuals was reported to be lower among those of low socio-economic status during the pandemic than it was for those of high socio-economic status (Martinez-Bravo & Sanz, 2021).
Psychologists Can Treat More Than Just Individual Patients.
Psychologists have been very much involved with fighting the apparent inequities of Covid-19, combating the systemic disparities that have “led the virus to disproportionately affect people of color and other groups” (APA, 2020). Psychologists noted that the Covid-19 virus has magnified an already existing gap and health disparity in the United Stated, impacting many physically and psychologically, calling it a “magnification” (APA, 2020). Research findings show that the virus infected and killed Black and Hispanic communities disproportionately, as well as Native American communities (APA, 2020). Additionally, people with disabilities and elderly ones reported struggles to have access to healthcare and a shortage of necessary medications (APA, 2020).
It is important to note that individuals with disabilities and economic inequalities are disproportionately represented in neighborhoods of color and being a part of any of these groups is further compounded by age especially in connection with the effects of Covid-19 (APA, 2020). Psychologists can bring attention to these disparities, being outspoken that socioeconomic factors and racism are contributing to unequal health care in the midst of such critical times as the Covid-19 pandemic.
Psychologists raising questions, studying the issues at hand when it comes to these disparities, and adding to evidence in the literature can raise awareness and reduce prejudice and discrimination. Kathleen Bogart Ph.D., (APA, 2020) stated: “The most important thing I think I can do as a psychology researcher is identify the challenges and the points of resilience and be sure these challenges are addressed in future policy and these resiliencies are capitalized.” I agree with such statements, as it is important for us not to shy away from problems, but rather be willing to speak up.
Does it Matter if You Are Black or White?
Colorblindness Is Not a Good Thing!
We might think that in the years from 2020 to 2023 issues of racial and ethnic inequalities would be little to nonexistent. However, we would be wrong in this assumption. Research findings show that even a name that is indicative of a different race or ethnicity is cause for discrimination (Betrand & Mullainathan, 2004). Betrand and Mullainathan (2004) found that the gap between Whites and African Americans receiving employment application call backs is significant and widens with high-quality resumes. They compared such names as Emily and Greg to Lakisha and Jamal. White-sounding names were 50 percent more likely to receive an interview opportunity via callbacks. This sort of discrimination occurred across occupation, industry, and employer size (Betrand & Mullainathan, 2004).
How would this affect a physician who is overbooked and who has to decide which patient to make time for? Would a White doctor show this sort of bias when looking at only the patient’s name of Amber versus Shevaun? Would it affect an insurance agent or assessor who is trying to review health insurance coverage for Zack versus Leroy? It is difficult to assume that such prejudices would not and have not occurred in providing health care to minorities and low-income housing areas during the Covid-19 pandemic that cost millions their lives.
Sue (2004) explained her experience with workmates who although well-intentioned were quite unaware of discrimination and the existence of inequalities in society. Sue (2004) stated that “they are trapped in a Euro American worldview that only allows them to see the world from one perspective” (Sue, 2004). Perhaps some of the health care professionals or case workers during the pandemic were also well-intentioned but imprisoned in a narrow view of their own culture while deciding about the lives and futures of minorities that they could not relate to or struggled to empathize with?
Does it matter if racial and ethnic differences are found in higher education, extensive training, or with impeccable references? Betrand and Mullainathan (2004) showed that even when African Americans had high-quality resumes, they were no more likely to receive call backs than African Americans with low-quality resumes, yet Whites were 50 percent more likely to receive call backs for employment than African American, and Whites with high-quality resumes were 30 percent more likely to receive call backs than Whites with low-quality resumes.
Therefore, Whites with high-quality resumes further elevated the gap of disparity and discrimination against African Americans (Betrand & Mullainathan, 2004). If we apply this to the health care setting, does that imply that when it is time for providing crucial health care to Covid-19 patients, that Whites from high socioeconomic status are even more likely to receive high-quality health care than Whites from low socioeconomic status, and that the disparity and discrimination against African Americans widens when we include high socioeconomic status for Whites? We cannot directly make such an inference, but the notion isn’t too farfetched, is it?
Chao et al. (2011) in their study findings showed that colorblindness and multicultural knowledge and awareness are negatively related. This is a worrisome finding because it shows that perhaps those who think that they are the least prejudice because they think that they are blind to racial and ethnic diversity, end up being the most biased individuals. Furthermore, a so-called colorblind perspective minimizes racial inequalities and comes from a racially biased attitude (Chao et al., 2011). This means that if an individual who has such a colorblind worldview is making decisions in providing health care during the Covid-19 pandemic, they would completely ignore their own potential bias due to their background, race, and ethnicity.
When it comes to such public health issues as Covid-19, cancer, and dementia it is expected to look to medical, biomedical, and technological advances for progress and a reduction in prevalence and incidence (Brown & Fee, 2014). However, social movements in the health care settings have also proven to be valuable tools for significant improvements.
History Speaks for Itself.
Learn from the Past.
When we consider some of the health concerns of the past that included poor housing areas due to dampness, darkness, lack of ventilation, and dilapidation, which resulted in the spread of contagious diseases, including tuberculosis. It is easy to understand why there was an outrage during the Covid-19 pandemic over housing, medical and public health response time in low income and minority neighborhoods (Mackenzie, 2022). The Covid-19 pandemic “has seen a rapid growth of collective organizing on the part of patient groups to address the pandemic, both in-person and online, highlighting strategic actions and expressions to frame and advance policy goals that address healthcare and vaccine access, and inequities in who is surviving the pandemic” (Mackenzie, 2022).
There also has been a great increase in the scale and scope of cancer activism (Klawiter, 2005). Today there are many cancer organizations, cancer groups, and developments that offer support, guidance, and funding to cancer patients. The very existence of these groups and the media attention that they demand has caused medical research to become more concerned with providing aid to cancer patients, has allowed cancer patients to have a less traumatic experience during some of the most difficult times of their lives, and has allowed supportive family members and friends to be more educated and less stressed in providing care (Klawiter, 2005).
Functional or Conflict Theory?
I think that viewing this movement through both the conflict and functional theory is appropriate and necessary. The functionalist theory highlights that society and its parts function similar to the human body, as a unit in which its parts complement each other (Omerod, 2020), when there’s instability then attention from other parts can contribute to stabilization. However, it cannot be ignored that this theory does not address the constant inequality and strive that exists in society, and that there is a tendency towards elitism. The conflict theory focuses on these very unequal and competitive parts of society (Kretchmar, 2021). This theory is especially applicable to the social movement in health care when it comes to such issues as the Covid-19 pandemic not being adequately address in low-income, minority neighborhoods and groups. Karl Marx who supported the conflict theory stated that the rich and powerful control society by exploiting vulnerable groups (Kretchmar, 2021).
Stok et al. (2021) noted that the recent Covid-19 pandemic place an enormous public health burden on our society. The infection of Covid-19 goes beyond the individual symptoms of fever, cough, respiratory distress, and lack of energy, it exposed a sociological illness of inequalities due to socio-economic and socio-cultural disparities (Stok et al., 2021). In their research, Stok et al. (2021) highlight who was and is affected by the virus and who was and is included in Covid-19 prevention measures, emphasizing the inequalities posed to solidarity and social justice. Their findings showed that the pandemic impacted socioeconomically disadvantaged populations groups and countries more than others (Stok et al., 2021). This conflict and dominance of the elite over those with little means is in line with the conflict theory of social change movements. The social movement for health care equality and justice is aimed to combat such problems.
Once of the largest social movements in the United States, which is quite significant in size and intensity was the demand for universal health care. The demand for health care reform and the fervor behind this movement is largely linked to the same reasons, those of inequality (Hoffman, 2003). Much of the policy, structure, and design of the health care system has always been done and run by “elite organizations and individuals with little connection to the average person” (Hoffman, 2003).
Cancer continues to be the second leading cause of death in the United States (American Cancer Society, 2023), with about 1.9 million new cancer cases in 2022 and 605,213 deaths due to cancer (Center for Disease Control and Prevention, 2022). It is a major public health problem worldwide responsible for 10 million deaths in 2020 (World Health Organization, 2022). Zhang et al. (2022) assessed the socioeconomic-related inequalities in health care use among cancer patients to analyze factors connected with this disparity. How would it impact you if your mother or father, your wife or husband, even your daughter or son were diagnosed with cancer but because of their race, ethnicity, or socioeconomic status they would receive lower-quality health care or would not receive care as early as others who are of a different race, ethnicity, or socioeconomic status?
Disparities across multiple healthcare settings are a concern and your voice matters.
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