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Introduction:

It is clear that race and racism both play a strong role in the social determinants of health.

Minorities are facing health disparities on a regular basis and it is affecting them severely.

Discrimination is the healthcare industry causes tremendous amounts of mistreatment, permanent

health effects and deaths. Multiple studies have shown that race plays a large role in how one is

treated within healthcare, which essentially determines the outcomes of their health. But is race

or racism the problem? While your race plays a role in your medical treatment, the real problem

within healthcare is racism. Racism has a stronger effect on health due to the fact it is the key

factor in many social determinants of health, causes negative treatments from physicians due to

skin color or appearance and prevents access to education and healthcare is lesser for those in

areas with higher racial prejudice.

The Social Determinants of Health and Racism

There are multiple social determinants of health that play some of the biggest impacts on

minorities and how they are treated within the healthcare industry. One of the social determinants

that plays the biggest role in how racism affects health is education. Those who are properly

educated in health and other subjects tend to live longer and healthier lives. For instance, those

with an education trying to understand their symptoms may be able to find more accurate and

reliable data to learn about their condition, while someone who is not as educated may rely on

inaccurate data, causing them to face difficult health problems (Tulane, 2021). Literacy coming

from education also contributes to health. Systematic racism in education is the root problem that

paves the way for so many other issues, especially within medicine.

A social determinant that also plays a large role in how racism affects health is the

environment in which one grows up in and lives in. Millions of people do not have access to
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clean water, proper sanitation. People in these areas have a bigger environmental health risk.

Unfortunately, many of these poorer areas where these risks fall, consist of mainly minorities.

The combination of environmental risks with health risks creates a large problem for the people

living in these areas. Racism creates underemployment, economic disadvantage and more that

sets many of these minorities in such a situation (Prochaska et al., 2014). There are greater

chances of premature mortality, decreased quality of life and more that comes along with

environmental exposures. These environmental factors create a baseline for more possible

illnesses than people who were to live in richer and safer areas would face.

Another social determinant of health that has a great effect is economic issues. Poverty is

seen across many communities in which minorities and people of color dominante.

Unemployment is high amongst this group as well. The economic issues play heavily into the

roles that environmental and educational factors have. Areas in which poverty is high, have

lesser access to education, lesser access to proper water and sanitation. These all are important

for a healthy lifestyle, but unfortunately, they are scarce for minority groups. Racism plays its

role in this because many employers, insurance companies, landlords and more discriminate

against minorities, which all eventually plays into their health.

Limited Access Due to Racism

As mentioned previously, many of the social determinants of health are a result of limited

access to things like education, healthcare, insurances, employment and more. Throughout the

class, there was one article in particular that really tied into this subject. “County Level Racial

Prejudice and the Black-White Gap in Infant Health Outcomes” by Jacob Orchard revealed data

that showed how African Americans had significantly lower birth rates than Caucasian women,
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especially in areas with higher racial prejudice (Orchard & Price, 2017). This proves that one's

race is not the issue, it is the amount of racism they face in healthcare.

Many African Americans were also found to have higher rates of heart disease, cancer,

obesity than white people. This was linked to the fact that African Americans have a limited

access to healthcare, in addition to less economic resources and delays in treatment (St.Kate,

2021). One example of this is Medicaid. The south eastern area of the United States has a large

population of African Americans. The south eastern area also consists of states that have not

expanded Medicaid under the Affordable Care Act. Given this, many African Americans, as well

as other minorities, make too much money in order to be considered for Medicaid, but not

enough to afford other insurance and medical treatment plans (Taylor, 2022).

Some of these areas have great educations, highly ranked hospitals and more, but

minorities will still find themselves in situations where they are receiving worse care than

Caucasians. This is simply due to high levels of racism, proving that racism being taught is the

problem, not actually just one's race.

Minorities are dying sooner due to a simple border caused by severe racism. Their actual

race has nothing to do with their diseases and deaths, but it is rather their lack of access to

healthcare due to systematic racism that makes the rates of people of color increase for

mortalities.

Physician Mistreatment

Race is one of the main factors in how you are treated by physicians, but the reasons

physicians are providing mistreatment is because of racism. As we learned throughout this

semester, race is a social construct. This means it is essentially used as a way to categorize and

separate us based on appearance and background. Access and treatment with medical care has
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played a large role in the means of separating us, as many minorities are seen to face a range of

disparities that white people do not face in healthcare.

Over the years, for both African American and Caucasian people, health rates have

increased significantly. However, for African Americans, rates of morbidity and mortality are

still significantly higher than Caucasians (Williams, 2000). There are a large number of reasons

for such poor rates for African Americans and other minorities within the healthcare system.

Physicians do not provide the same treatment to many patients of color as they do to white

patients. This is seen in many different aspects. For instance, hispanic patients were less likely to

receive sufficient and equal painkillers for procedures and illnesses as white patients were

(Williams, 2000). Over fifty percent of the physicians in the United States are white (AAMC,

2018). According to the NIH, a large majority of this country still believes in negative

stereotypes around people of color, including welfare dependence, violence assumptions, lesser

intelligence and more (Williams, 2000). This is an aspect of racism that once again has a large

effect on healthcare for minorities, especially given that the large majority that assumes the

negative stereotypes includes many physicians.

There is a large history of abuse and neglect in healthcare directed towards minorities.

There are many stories showing the neglect physicians have towards African American patients,

as a PBS mini documentary highlighted. One patient was accused of having tertiary syphillis,

and when she told the doctor she was not having sex at age 12, the doctor did not believe her and

dismissed her. Eventually, she ended up having stroke like symptoms, in which they determined

she was having complex migraines (Alcindor et al., 2021). There are many other examples of

such within this video, that show many minorities were having different experiences than their

white peers with doctors. They were not given pain medications due to assumptions of addiction
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and misuse, many were dismissed of their severe symptoms, and many of the interviewees said

they think they wouldn't have been treated as such if they were white. This goes to show that no

matter your race or the type of person you are, your medical treatment will come down to the

racism you face from your doctor.

Personal Reflection

I have lived in one of the most diverse counties in the United States my whole life. As a

white woman, I have witnessed my friends and peers of different backgrounds face issues I

would never have to face. I have seen them receive different treatment from my teachers,

violence from the security guards in schools and public places, harsher punishments and overall

mistreatment. All of them were some of the most intelligent, kind and peaceful people I have

ever known, but yet they were treated like criminals. This goes to show that race has nothing to

do with treatment, but it is rather the racism they receive from others that causes the issues they

face daily. While I have not had any direct experience with disparities in medical care, based on

what I have learned in this class and in research, it is clear that this same discrimination I saw my

peers face in school and in public can be applied to healthcare.

Conclusion

Race and racism both have large impacts on health. Racism is the key factor in the

determination of one's medical treatment. Race is simply used in showing the statistics in which

minorities face disparities. It is also used as an excuse from the people who create the racism as

to why minorities often face more health problems then white patients. The racism that creates a

lack of education, insurance policies, gaps and more has a bigger effect on health than race does.

This created a lack of access to essentials that also create disparities in healthcare. And lastly, the

mistreatment from physicians that minorities face is due to the racist tendencies of the doctors,
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not the race of the person. Racism drives these factors that create social disparities of health for

minorities and people of color. Racism itself is not just a social determinant of health, but it is the

baseline for all of the determinants that make up the inequalities that many face. Therefore,

racism has a greater effect on health than race does.

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References

Alcindor, Y., Wellford, R., Lloyd, B., & Bolaji, L. (2021, February 24). With a history of

abuse in American medicine, Black Patients Struggle for Equal Access. PBS.

https://www.pbs.org/newshour/show/with-a-history-of-abuse-in-american-medicine-black-

patients-struggle-for-equal-access

AAMC. percentage of all active physicians by Race/ethnicity, 2018. AAMC. (n.d.).

https://www.aamc.org/data-reports/workforce/interactive-data/figure-18-percentage-all-acti

ve-physicians-race/ethnicity-2018

J, O. J. P. (n.d.). County-level racial prejudice and the black-white gap in infant health

outcomes. Social science & medicine (2017). https://pubmed.ncbi.nlm.nih.gov/28404321/

Prochaska, J. D., Nolen, A. B., Kelley, H., Sexton, K., Linder, S. H., & Sullivan, J. (2014).

Social Determinants of Health in environmental justice communities: Examining

cumulative risk in terms of environmental exposures and Social Determinants of Health.

Human and ecological risk assessment : HERA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995452/

Racial discrimination in Healthcare. How Structural Racism Affects Healthcare. (2021,

June 15). https://www.stkate.edu/academics/healthcare-degrees/racism-in-healthcare

Social determinant of health: Education is crucial. Social Determinant of Health:

Education Is Crucial. (2021).

https://publichealth.tulane.edu/blog/social-determinant-of-health-education-is-crucial/
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Taylor, — J., Jamila TaylorDirector of Health Care Reform and Senior Fellow, Taylor, J.,

Director of Health Care Reform and Senior Fellow, — By Rebecca Vallas and Vilissa

Thompson, Taylor, — B. J., & Vallas, — B. R. (2022, April 26). Racism, inequality, and

health care for African Americans. The Century Foundation.

https://tcf.org/content/report/racism-inequality-health-care-african-americans/?agreed=1

Williams, D. R., & Rucker, T. D. (2000). Understanding and addressing racial disparities

in health care. Health care financing review.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194634/