Race Relations in the Healthcare System
What is Racism?
Racism is the discrimination of one ethnic group by another ethnic group or an individual based particularly on race and other factors such as culture, religion, skin color, and physical appearance. Racism results from avoidable and unfair differences in power, resources and opportunities between ethnic groups. In general, the perception of racialism is that one race is inferior or superior to another ethnic group.
Types of Racism
‘Internalized racism’ is the perception that the dominant society perpetuates negative attitudes, values, philosophies and prejudices as factual about the race. This perpetuates negative self-images and recognition through despair, impoverishment, poverty and embracing perceived and increased insufficiency.
‘Interpersonal racism’ refers to the contact between people who maintain and propagate racial inequality, including the use of name and insult. The systemic racism includes criteria, circumstances, procedures, policies and processes that sustain and reproducing avoidable and unequal inequalities between racial or ethnic groups and increases their vulnerability to prejudice and discrimination, devaluation and contempt, and distrust and indifference.
‘Systemic (or institutionalized) racism’ limits access to housing, training, jobs, revenue and living conditions as well as information, money, power, medical services and representations. Systematic racism in the healthcare system explicitly and severely impairs the efficiency and access of proper medical assistance. When racism is rife in the healthcare system, it can cause unfair and limited access to the means that are necessary in conducting a healthy lifestyle (education, housing, employment, healthcare, etc.) and it can exposed patients to risky factors related to an unhealthy life (dangerous goods, toxic substances, and junk food). Other negative effects that racism can have on patients are stressful cognitive/emotional responses that have negative influences on cardiovascular, endocrine, immune, and other biological systems; patients can also end up stop practicing healthy routines such as going for their routine check-ups.
Racism in Healthcare
These are some of the stories captured by the media in Australia about racism in the healthcare sector:
Systematic racism article: Patrick Cumaiyi was the victim of police brutality in Australia, including a cover-up, as medical records obtained by The New York Times show. Mr. Cumaiyi`s treatment, which left him with a fractured skull, provides a disturbing insight into Australia – it shows that the nation has not completely lost the legacy that was left to them by colonizers. Another troubling aspect of Cumaiyi's case is that medical records and other documents that The New York Times verified, confirmed that Cumaiyi was not just a victim of police brutality, but also that health and police officials covered up what caused his wounds and the extent of injury. The courts did not question anything.
Interpersonal racism article: In 2017, nurses in Australia were against a change in policies that required them to “acknowledge white privilege” before medically assisting patients who are Indigenous Australians. Midwives and nurses around Australia had to abide by a newly written code of conduct with a part of it stipulating that is explicitly dedicated to “culture” and that it gives detail on how non-indigenous Australians/White Australians ‘inherent privilege’ compared to Torres Straight Islanders and Indigenous Australians.
Internalized racism cases: A specialist at the ‘Menzies School of Health Research’, Dr Paul Lawton, said kidney specialists in Australian meant well when they chose non-indigenous Australians over indigenous Australians when it came to kidney transplants. It was evident that internalized racism had led to unsatisfactorily low rates of kidney transplants among patients who are Indigenous Australians. Dr. Lawton said that the Australian healthcare system favored patients who are non-indigenous Australians over Torres Strait Islander people and Aboriginal Australians.
Transforming Institutionalized Racism
Health providers with better cultural skills and sensitivity can reduce health disparities. In order to provide solutions to build cultural skills, healthcare providers and institutions have to work together to develop innovative solutions. Cultural competence appraisal approaches to provide self-assessments are another method that can help in transforming institutionalized racism. Healthcare facility leaders should also play their part in combating racism within the organizations that they lead.
The lack of clarity on what institutional racism is and how it should be managed can create additional friction and increase change resistance. Overcoming culturally sensitive and developing non-judgmental communication skills is the best way that healthcare providers can provide proper healthcare to patients from different ethnic groups.