A brief history of racism in healthcare – World Economic Forum

If youre Black or Latino in the US, youre almost twice as likely to die from COVID-19.

Thats according to The New York Times analysis of data from Americas Centers for Disease Control and Prevention (CDC). The numbers also reveal that Native Americans are more likely to be hospitalized with the condition than other ethnic groups.

In the UK, its a similar story. Official figures show that Black people are 1.9 times more likely to die from COVID-19 than white people. In France, infection rate data is not collected by ethnicity but the trends are believed by some medical experts to be similar.

These patterns are drawing attention to long-standing health inequalities faced by ethnic minority groups. From HIV/AIDS and cancer to prenatal care, and even amputations, research shows Black, indigenous and people of colour (BIPOC) in America and elsewhere are more likely to be affected, and less likely to receive the right treatment.

Implicit bias when people are unconsciously influenced by prejudices or stereotypes can play a part in these inequalities. In the US, for example, only 4% of doctors are Black, compared to 13% of the population. Several studies show that doctors can hold negative stereotypes of BIPOC patients without realizing, which can make interactions unpleasant and affect the treatment given.

And in some cases, these inequalities stem from structural or overt racism that goes back decades, or centuries. Heres how its developed.

Spirometers measure lung capacity. In the past their readings were used to justify discrimination based on racial difference.

Image: REUTERS/Rick Wilking

Throughout history, medical racism has often been based on the myth that Black people have different and inferior bodies.

Tales of experiments that were done to show it make for grim reading.

Phrenology was one example of this the belief popular in 19th-century Europe and America that character traits could be read through differently shaped skulls. The idea that Black people were naturally submissive was used by some slave owners to justify their trade.

In America, black and Latino communities have suffered from higher coronavirus death rates than white groups.

Image: NY Times

The spirometer, a common medical device in use around the world today, also tells a story of racial difference. It measures lung capacity, and was used during the American Civil War to study the bodies of Union soldiers. Doctors incorrectly concluded Black soldiers had inferior bodies because white soldiers had a higher lung capacity.

Even today, spirometers are usually race corrected. Researchers say that history shows this practice could represent an implicit bias, discrimination, and racism, and masks economic and environmental factors.

The 'Tuskegee Study of Untreated Syphilis in the Negro Male' used 600 Black men.

Image: CDC

Deception and misinformation

Black people were used unwittingly in early 20th-century medical experiments. One of the worst examples is the Tuskegee study.

In 1932, US government researchers recruited 600 poor Black men in Alabama for a syphilis study. Free Blood Test; Free Treatment said the advert. Except the 399 in the group who had syphilis were never treated they were just observed until they died. But neither they, nor their families, were ever told about this.

The COVID-19 pandemic and recent social and political unrest have created a profound sense of urgency for companies to actively work to tackle racial injustice and inequality. In response, the Forum's Platform for Shaping the Future of the New Economy and Society has established a high-level community of Chief Diversity and Inclusion Officers. The community will develop a vision, strategies and tools to proactively embed equity into the post-pandemic recovery and shape long-term inclusive change in our economies and societies.

As businesses emerge from the COVID-19 crisis, they have a unique opportunity to ensure that equity, inclusion and justice define the "new normal" and tackle exclusion, bias and discrimination related to race, gender, ability, sexual orientation and all other forms of human diversity. It is increasingly clear that new workplace technologies and practices can be leveraged to significantly improve diversity, equity and inclusion outcomes.

The World Economic Forum has developed a Diversity, Equity and Inclusion Toolkit, to outline the practical opportunities that this new technology represents for diversity, equity and inclusion efforts, while describing the challenges that come with it.

The toolkit explores how technology can help reduce bias from recruitment processes, diversify talent pools and benchmark diversity and inclusion across organisations. The toolkit also cites research that suggests well-managed diverse teams significantly outperform homogenous ones over time, across profitability, innovation, decision-making and employee engagement.

The Diversity, Equity, and Inclusion Toolkit is available here.

The injustice had a long history: it wasnt until 1972, when the study was exposed, that it was finally shut down.

American history provides another famous example of experimentation without consent.

In 1951, Henrietta Lacks, a 30-year-old African American woman, was diagnosed in hospital with an aggressive form of cervical cancer. She was killed by the disease, but the cancer cells lived on.

They were cultured on a mass scale, becoming known as the HeLa cell line. These immortal cells were critical to medical breakthroughs, including the polio vaccine, cancer treatments and IVF. They have even been into space and you can still buy them today.

But they were taken without her, or her familys, knowledge or consent. So was this medical racism?

On one hand, the 1950s was a time when it was common not to ask family members for their consent, whatever their race. But that wasnt the only occasion. In the 1970s, when scientists went back to her children to do research on them that's the moment I think race played a significant role, Lacks biographer, Rebecca Skloot, tells National Geographic.

In 20th-century history, one of the big trends in medicine globally has been the use of computers to manage healthcare. But medical software can be racist.

In 2019, an algorithm that helps manage healthcare for 200 million people in the US was found to systematically discriminate against Black people. According to research published in the journal Science, people who self-identified as Black were given lower risk scores by the computer than white counterparts, leading to fewer referrals for medical care.

The computer appeared to give fewer referrals to Black people because their care costs on average were less over a year than for white patients (despite the Black patients being sicker).

That might be because Black people have lower levels of trust in health-care systems, an example of systemic racism where whole systems are loaded against particular groups, unknowingly or not. The researchers also suggested that direct racial discrimination by healthcare providers could play a part.

In recent years, systematic discrimination has become better understood as a powerful force around the world that traps people on lower incomes in unhealthier places - for example, in more polluted neighbourhoods, breathing dirtier air.

Yet clearly, as COVID-19 shows, systemic racism and other forms of discrimination continue to be powerful, and deadly.

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A brief history of racism in healthcare - World Economic Forum

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