Do the right thing: Address racial bias in healthcare

August 21st, 2015

“You’ll never go anywhere in this organization.”

Those words were spoken to my father when, as a young minister, he stepped down from speaking at his annual church conference. He had gripped the edges of the podium and argued that the separate black and white church organizations should be united as one. The person who spoke that threat was wrong. After the conferences were united, my dad went on to serve some of the largest churches in the conference, as well as a rotating stint as a district superintendent. He also was elected as a delegate to the denomination’s regional, national, and world conferences. Sometimes doing the right thing earns you the respect of your peers and opens doors for you to make a difference.

Two leaders in the healthcare field are putting out a call for healthcare providers to do the right thing. In a Viewpoint published in JAMA, Ronald Wyatt, MD, MHA, The Joint Commission’s medical director, and David R. Williams, PhD, MPH, professor of public health and other subjects at Harvard, call for action to address racial bias throughout the U.S. healthcare system.

Even when providers don’t realize that bias is there, it’s been tied to several negative outcomes, including biased treatment recommendations, poorer communication, and lower patient ratings on how the encounter went, they say. The authors point out that at the same time, black people and other minorities report serious health issues such as becoming ill earlier, having more severe and more rapid progression of diseases, and higher level of comorbidity and impairment throughout their lives. Also, mortality rates differ by races; 260 black people die prematurely every day, they report.

“Medical schools, health care organizations, and credentialing bodies should pay greater attention to disparities in health and health care as a national priority,” the authors wrote. “These organizations should redouble their efforts to increase awareness of disparities, enhance diversity in the health professions, and work toward eliminating discrimination and its adverse effects on health and health care. Considerable evidence is available to guide in the implementation of interventions to reduce racial/ethnic differences in health and health care.”

So where can you start? One place is to look at the impact that policies have on other areas of society. The authors say that segregation limits access to quality education and jobs, which leads to stress and poor health. They say it also leads to worse housing in neighborhoods where blacks and other minorities are exposed to psychological stressors and toxic chemicals, and where they have less access to medical care.

“Much of the contemporary disease burden can be linked to behaviors that are potentially modifiable with access to timely information and the necessary resources and opportunities to facilitate the challenge of behavioral change,” they wrote. “Many individuals live, learn, work and play in disadvantaged contexts where it is nearly impossible to pursue healthy choices. Multilevel policies and interventions in homes, schools, neighborhoods, workplaces and religious organizations can help remove barriers to healthy living and create opportunities to usher in a new culture of health in which the healthy choice is the easy choice.”

Racism among providers isn’t the only issue you are facing. Sometimes patients show bias by asking for providers of certain races (or genders or religions). We tackle the liability concerns surrounding that subject in our upcoming September issue of Healthcare Risk Management. (Editor’s note: Obtain hospital-related breaking news as it happens on Twitter @HospitalReport.)