Why Health Equity is the Best Medicine
As we celebrate black history month and shine a light on all the notable achievements of African Americans, imagine a world where everyone has equal access to good quality health care regardless of their race or ethnicity. I use the word “imagine” because the harsh reality is that subliminal systemic racism embedded in our health care model is literally killing thousands of Americans of color every year.
In her book Just Medicine: A Cure for Racial Inequality in American Health Care, Dayna Bowen Matthew unveils how implicit bias is rife among the medical establishment in the US and negatively impacts how health care is delivered to people of color. Even when isolating for socio-economic factors, the author cites a multitude of interdisciplinary studies which show that health equity disparities are stubbornly entrenched in our health care system. Case in point is the Covid-19 pandemic which has disproportionately affected people of color and has intensified the existing inequities in health care access and indeed access to vaccines.
For people of color, conscious and unconscious socio-cultural biases among health care professionals not only influences their access to care, but also impacts their quality of care and health care outcomes. This is commonly manifested in less accurate diagnoses, less aggressive pain management, curtailed treatment options and less optimal management of chronic diseases. While health care providers are prone to the same bias and prejudices as the general population, the power and influence of their judgements are especially potent because of their pivotal role in healthcare delivery, exacting a heavy toll on people of color which is entirely preventable.
To effect change and move toward a more just healthcare system, we need to take ownership of our individual and collective contributions to the problem. Institutional change around bias training, diversifying the medical pipeline and using performance metrics with incentives and consequences can drive the impetus for positive change. As our population continues to diversify, we need to constantly work on educating ourselves around cross-cultural influences in health care. In this way, knowledge and science can fuel advocacy for policies that support a more equitable health care delivery system for all – this is not just good medicine, but the best medicine.