Today, we commemorate World Health Day in the midst of a public health crisis that will grip the public psyche for years, if not decades, to come. To fend off the worst outcomes among the vulnerable populations among us, we have implemented protocols that present their own challenges in communities of color where health care disparities have existed for generations.
In time, we will find a need to address the fall out from the trauma of COVID-19, the anxiety caused by prolonged isolation, deal with the psychological burden of fearing human contact all the while working feverishly to build our way out of the economic hole this pandemic has created. In no uncertain terms, these are extremely troubling times applying unprecedented pressures on our civil society that we have never faced before. Unfortunately, the societal and institutional shortcomings highlighted by this crisis are not unique to this situation.
The pain felt by the wrath of COVID-19 has had a disproportionate impact on black and brown communities. The source of this disparity has long since been identified, yet left woefully and inadequately addressed. For the 27 million uninsured Americans, our system remains in a state of perpetual crisis without any reasonable timeline for improvement. People of color and working-class Americans disproportionately hold jobs that are part of the essential workforce and do not easily allow for teleworking. Further, they do provide these workers with employer-based access to comprehensive, affordable health insurance. This alone does not begin to describe the full extent of the systemic inequities.
Women of color, especially black women, have suffered some of the worst outcomes that our broken healthcare system has produced. Unfortunately, this has been the case for generations. Though we might assume that the scientific and medical community would rely more on data, the American medical profession has proven itself as susceptible to racial bias and stereotyping as anyone else.
These misplaced beliefs do not simply cause misunderstandings in the doctor-patient relationship — they continue to be a matter of life and death. This is evidenced by the fact that Black women are 3–4 times more likely to die from pregnancy-related causes nationwide, than their white peers, indicating that this problem is far more than a series of unfortunate misunderstandings. Clearly, COVID-19 has not caused these disparate outcomes. Unfortunately, the immediate steps necessary to slow the spread will not deliver black women from the wrath of the larger failings in our healthcare system.
Put plainly, our healthcare system has always categorically failed marginalized populations. Even as healthcare delivery evolves through advances in technology, there continues to be pervasive bias which expands the probability of poor outcomes for communities of color. Racial bias has even managed to undermine the allegedly race-neutral decision-making of algorithms that have become commonly used in all manner of human analysis and decision-making.
It is becoming increasingly evident through the use of this technology that algorithms carry the implicit biases of their programmers. This means that an algorithm and a biased medical practitioner may both ignore a black pregnant mother’s pain and the human elements of an accurate diagnosis and treatment without justification. In this light, it is clear that institutionalized bias pervades every aspect of the healthcare experience that involves medical professionals with internalized implicit biases.
For far too long, we have responded to crises by presuming that the challenges presented in that moment are unique. We do this to not only improve our shared healthcare outcomes, but rather as a means of assuaging our fears about the longstanding underlying injustice that remains so pervasive in our civil society. Instead of jumping to comforting conclusions, we must confront this crisis that is compounded by the inequities of the pervasive racial discrimination in healthcare and make clear that the public health crisis that COVID-19 has presented.
It has also shed a light on exposing the gaping wounds and inequities of a healthcare delivery system that has been permitted to fester, rot and neglect the health and well being of black, brown and immigrant communities for far too long. Simply put, our health care system is one that provides disparate treatment to its citizens. The longer we fail to address these inequities, the more black women and girls will continue to live their lives with their health and well being at risk.
I applaud the healthcare professionals who put their lives on the line each day to support our community. That said, I would be remiss to not acknowledge the systemic failures of our healthcare system. It doesn’t have to be this way.
U.S. Rep. Yvette Diane Clarke represents New York’s 9th congressional district including the neighborhoods of Brownsville, Crown Heights, East Flatbush, Flatbush, Kensington, Park Slope, Prospect Heights, Midwood, Sheepshead Bay, Marine Park, Gerritsen Beach, and Prospect Lefferts Gardens.
