Apr 21, 2022 - Health

A quarter of Black, Latino seniors report health care discrimination

Reproduced from Commonwealth Fund 2021 International Health Policy Survey; Chart: Axios Visuals

Roughly one in four Black and Latino adults ages 60 and older say health care professionals treated them unfairly or ignored their health concerns because of race or ethnicity, according to a survey out today from the Commonwealth Fund.

  • More than a quarter of those who reported experiencing discrimination said it prevented them from getting the care they felt they needed as a result.

Why it matters: The COVID-19 pandemic has surfaced disparities in health care and outcomes along racial lines in America.

  • But this survey zeroed in on individuals' interactions with the health care system — a factor that has a major bearing on outcomes, the report's authors say.

"This study shows the health care system is not working for people of color, especially older adults," Michelle Doty, one of the authors of the paper, told Axios.

  • "When you have over a quarter of Black and Latino/Hispanic older adults reporting that they have been treated unfairly or felt their health concerns weren't taken seriously because of their race and ethnicity, that's a problem," she said.

Between the lines: The findings add to a growing body of research documenting systemic racial bias that cuts across age groups in U.S. health care delivery.

  • A systemic review published in January in Critical Care Medicine found "significant differences in the care and outcomes among ICU patients of different races." Another study, published in the April issue of the Maternal and Child Health Journal, found implicit bias can lead medical professionals in NICU to disregard mothers who are Black and economically disadvantaged as they advocate for their infants' health.
  • Black patients were more than two-and-a-half times as likely as white patients to have negative descriptors about them in their electronic health records, according to a study published in January in Health Affairs.
  • A study published last August in JAMA, found health care spending was higher on white patients, even after adjusting for age and health condition. It provided evidence of inequities "from how physicians respond to patients to bias that exists in the algorithms that assess health needs and determine the appropriate intervention," the researchers wrote.

Between the lines: In the summer of 2021, the American Medical Association adopted guidelines to tackle structural racism in health care and the American Hospital Association issued a statement addressing racism as a public health issue.

Yes, but: The public may be tuning out accounts of disparities and bias in the medical system.

  • A study published in Social Science & Medicine in March suggested that white Americans were less likely to support health policies like masking or show empathy after reading about the disparate impacts of COVID-19 on other races.
  • Healthcare may be getting drawn into culture wars over race, gender and identity that are playing out in other arenas, such as public schools. On Monday, Stanley Goldfarb, a former associate dean of curriculum at the University of Pennsylvania’s Perelman School of Medicine, wrote an op-ed in the Wall Street Journal touting a new nonprofit he helped form to fight the "radical ideology" infecting health care.
  • The group is offering legal help to fight "critical race theory-inspired policies" that are affecting providers.

The bottom line: It may be valuable to refocus the disparities conversation on fixes, such as improved reporting systems for patients or enhanced training for medical students, said Morenike Ayo-Vaughan, another author of the Commonwealth Fund report.

  • "I see how people can be tired of hearing about it because it becomes normalized. 'Yes, we know this is happening.'" she told Axios. "But the hope with this work is we can inspire people to come together to think about the solutions."
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