Racial disparity in health care

Recognizing problem is Rx for change

12/1/2017, 7:01 p.m.
The headlines about health problems plaguing the African-American community are frequent and alarming. From diabetes to hypertension and heart disease, ...

To diagnose conditions, and to treat them, doctors and health care professionals must examine a patient’s symptoms. From there, they may question, “How authentic do I believe these symptoms are? Do I need to run more tests on this person to diagnose them?” Dr. Hunter said. A doctor’s bias may influence how he or she reacts, he said.

In the 2015 book, “Just Medicine: A Cure for Racial Inequality in American Health Care,” author Dayna Bowen Matthew stated that a doctor’s implicit bias may support his or her decision not to refer a black patient with coronary heart disease symptoms to a specialist. Instead, the physician may recommend “only a conservative course of medical treatment, though a white patient in the same condition would have been referred for an interventional procedure.”

Although the doctor isn’t engaged in overt racism, “the covert disparity in treatment may ultimately decrease the quality of (the patient’s) health and longevity of life just as if the doctor had hung a “Whites Only” sign on his door and refused (the patient) admission in his examination room,” wrote Ms. Matthew, a law professor at the University of Virginia.

The potential for bias looms even larger when determining the resources — and even bricks and mortar — for health care within communities of color. Are funding and resources allocated to provide quality health care centers in areas of largely minority populations? Are there enough doctors available to work in underserved areas?

The answer, according to research, is no.

Virginia lawmakers have responded in part by requiring the state Board of Health to analyze the “health status and conditions of minority populations in the Commonwealth by age, gender, and locality,” and to report on these statistics annually.

Additionally, agencies such as the Virginia Department of Health’s division of Multicultural Heath and Community Engagement work to eradicate health disparities “through a focus on social determinants of health,” which include “socioeconomic status, race/ethnicity, geography, gender, immigrant status and other social classifications,” according to its website.

Recognizing these disparities is important and critical to maintaining good health. But what can individuals do to improve and preserve their health?

Talking openly about health care disparities and maintaining an active lifestyle and exercise routines are just a start, said Alice Freeman, an urban nutritionist, and the CEO of Healthy Heart Plus in South Side.

Additionally, “we need to make community connections that provide access to fresh, healthy foods,” said Ms. Freeman.

In a city plagued with food deserts, Ms. Freeman’s organization engages in food advocacy and food justice efforts, and its programs educate and empower African-Americans in Metro Richmond “to eat in a way that contributes to good health.”

Although African-Americans are adversely impacted by various conditions and may face challenges when seeking quality health care, the first steps to combating these problems are awareness of the issues. Establishing a secure relationship with your doctor also goes a long way toward maintaining good health.

“The most important thing a patient can do, and a primary care physician can do, (is) establish a good relationship where the two trust each other,” said Dr. Hunter. “The physician will have adequate compassion and care for the patient because of that relationship.”

And don’t be afraid to speak up, he advised. “At any time that you doubt (the care) you are receiving, it’s important to validate what you are receiving.”

For more information on statewide efforts to understand and combat health disparities impacting ethnic communities, visit the Virginia Department of Health’s website, www.vdh.gov. To learn more about how food impacts overall health and healthy food access efforts in Richmond, contact Heart Healthy Plus at (804) 320-1220 or www.healthyheartplus.com.