Despite be uninsured, even though eight of 10 are

Despite remarkable
improvements in the overall health of our nation during the past two decades,
compelling evidence suggests that our nations racial and ethnic minority
Americans suffer increasing disparities in the incidence, prevalence, mortality
and burden of diseases and adverse health outcomes compared with white
Americans. (Copeland, V. C. 2005)

Racism in Health Care

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Approximately 12 percent, (34.7 million) of the U.S.
population are African American. Compared with white Americans, they are less
likely to have private employment-based health insurance, more likely to be
covered by Medicaid or other publicly funded insurance, and twice as likely to
be uninsured, even though eight of 10 are in working families. (Copeland,
V. C. 2005) A disproportionate percentage of African Americans work in jobs
that do not provide health insurance thus they are less likely than white
Americans to have a usual source of health care. There have been great changes
in civil rights, housing, education, and income but the inequalities in health
care continue to persist. Not only do the disparities show up in medical care
but in mental health care as well.

The correlation of experienced
violence and racism or the perceived threat of either on mental illness and
overall health has been well documented in health disparities research. Public
health statistics reveal that African American men have some of the poorest
life expectancy and quality of life outcomes of any other racial or ethnic
group. (Staggers-Hakim, R. 2016)
Whether the racism is experienced or perceived, it still has been associated
with adverse health outcomes in racial minorities. According to the Centers for
Disease and prevention (CDC), the age adjusted death rates for Black
non-Hispanic males is 1,052.8 Out of 100,000 population compared to 639.8 in
Hispanic males and 876 in white males. Throughout the life course, the death
rates for Black males are higher than all combined racial/ethnic and gender
groups.  The death rate of young African
American males is 1.5 times the rate of their White and Hispanic counterparts.
As the overall death rate declines in all men between the ages of 25-29 years,
rates increase among African American men. (Staggers-Hakim, R. 2016) Racism violence and health all seem
to go hand in hand. I brought up these disparities to show that exactly.
Although there are no single answers to why the disparities exist with the
lives of African American men being so short but research on health disparities
suggests that communities of color, African Americans are the most vulnerable
to the effects of social inequalities in overall health. The higher rates of
stress associated with racism, racial profiling, police brutality, and social
inequalities in general like unemployment, poor quality housing, neighborhood,
and community underdevelopment, crowding, poverty, and violence all lead to the
sequelae of disparate health outcomes in African Americans such as obesity, hypertension,
physical inactivity, mental health outcomes and overall premature mortality.
(Staggers-Hakim, R. 2016)
Depression has also been established to have a direct correlation with
discrimination and physical health outcomes including cardiovascular disease,
diabetes, cancer.


 The first thing that
comes to my mind when I think of social values is that all people should be
valued equally. Equal rights for all people is a constitutional right and a
value that this country was founded on. I think of the social structures and
economic positioning that encompass resource and prestige based measures. The
prestige based measures say the more you have, the better you deserve to be
treated.  If one does not have good
health, it makes it very difficult if not impossible to participate fully in
the workforce which leads all different kinds of suffering. Ill health
threatens one’s ability to live a long and prosperous life. You must have good
health to fully function in society. Society has an ethical obligation to
maximize the wellbeing of those worst off. History has shown that African
Americans made great contributions to the building of this country. This
country needs everyone to contribute to maintain the nations prosperity. Added
to that is the idea that healthy workers produce more and generate lower annual
Medicare costs. For people, just in the Cleveland area alone, if you have no
insurance or come from low economics, chances are that you will be sent to
Metro Hospital, or St. Vincent Charity Hospital where the quality of care is
not quite up to par.


The 1998 Presidential Initiative on Race and Health was
the first was the first national commitment to eliminate health disparities
between majority and minority population groups. (Copeland, V. C. 2005)
The Affordable Care Act, 2010, (Obama Care) was the latest and offers
the promise of reducing disparities in health and medicine by promoting access
to equitable and more efficient health care. There has not been much policy to
address the disparities because the majority population still views the
minority population as less than equal. The policies that care providers hold
usually support the discrimination.


Advocacy on this issue past and current has been led by the
Black Church. Since its inception, the black church has been a spiritual,
social, and political resource for the African American community.  (Adepoju,
O. E., Preston, M. A., & Gonzales, G. 2015). Booker T Washington founded
the National Negro Health Week/Movement and it ran from 1915 to 1951. It was
funded by Andrew Carnegie, a wealthy businessman. In 1921, The United States
Public Health Service made it a national black health initiative and began to
publish the National Negro Health Week Bulletin and had the U.S. Surgeon
General appear at the first NNHW conference. With all that the NNHW was able to
accomplish, the grassroots advocacy was the black church.

trend of advocating for equal rights and healthcare continued into the civil
rights era and the black church again, is out in the forefront with The Rev. Dr.
Martin Luther King, who at The Convention of the Medical Committee for Human
Rights, proclaimed that, “Of all the forms of inequality, injustice in
healthcare is the most shocking and most inhumane.” (Adepoju, O. E., Preston,
M. A., & Gonzales, G. 2015 p. 1108)

the early twenty-first century, the Black Church is still advocating for health
and human rights for minorities and it was the Rev. Jesse Jackson leading the
way. The Reverend Jackson liked to use slogans and catch phrases to garner
attention. Churches United to Stop HIV (CUSH) was established in 1999 to
include training faith-based leaders and congregations to develop HIV
educational programs, outreach and referral services, and support programs for
infected individuals and others affected by the epidemic. The Reverend also
partnered with other community organizations and churches to fight the crack
cocaine epidemic and coined the slogan “Down with Dope! Up with Hope!” (Adepoju,
O. E., Preston, M. A., & Gonzales, G. 2015 p. 1109)




I do not truly know that many of the circumstances were
intended or could be foreseen. To the point that discrimination and racism is
so real, I do not think that there is a conscious thought of consequences of
some discriminatory practices. To make a person of color wait in the lobby of
an emergency room longer than a white person with the same symptoms, only to
find that the black person died during the wait, I think is more ignorant than
intentional. I do not believe that it was understood, although done, the trauma
that years of discrimination and racism would have the mental or physical
health consequences that it has, thus a practitioner attempting to understand
someone from a place of poverty and mental health, and misdiagnosing because he
simply has no clue as to who he is dealing with. I bet no one counted on racism
in health care costing as much as it does monetarily speaking. Because we want
to discriminate instead of allowing adequate healthcare to all, the cost is


So as social workers, how do we help to eliminate health
disparities? I think we first need to recognize our own biases and understand
how these biases affect us. We cannot be afraid to accept who we are and our
limitations when it comes to race and discrimination, when it comes to how we
feel about poverty and the people living in it, when it comes to how we feel
about politics and those participating, when it comes down to how we feel about
education and those who can and cannot afford it. We must know ourselves! We
must advocate for system change and help create policy to get the system
changed. There needs to be research done on and within these target groups of
people. There needs to be treatments that reflect the whole of society and not
just the dominant culture. I think we need to understand that in dealing with
Historical Trauma, African Americans come from a different perspective and I
think treatments should reflect that much like military is treated. Because of
these unique issues, policies should address them.