Systemic Racism in Healthcare Page 1

Systemic Racism in Healthcare

Jasmine Avalos Barajas

California State University, Channel Islands

HLTH 499-02: Senior Capstone Project

Professor Winans

Spring 2021
Systemic Racism in Healthcare Page 2

Systemic Racism in Healthcare

The issue of racism interconnected within the structural institutions of the United States

has been highlighted by many scholars over the years, and the public has become more alert

regarding this issue. Racism is a public health issue, to address this issue there needs to be major

structural changes in how we view healthcare, policies and equity. Black, Indigenous and People

of Color (BIPOC), face discrimination by medical professionals as patients and as colleagues

within institutions. There is no short-term approach to fixing the problems caused by structural

(systemic) racism, institutions need to revisit policies and training to begin to restore disparities

that targeted BIPOC.

Social Determinants of Health

To begin to only scratch the surface of this issue, we must review what structural

elements are disproportionately affecting BIPOC. These areas include lack of access to health

resources, inaccessible treatment processes, underrepresentation as stakeholders,

microaggressions and overt discrimination. Most medical doctors do not take into consideration

the social determinants of health when suggesting a treatment plan to people of color. Healthy

People 2030 definiens Social Determinants of Health as: "conditions in the environments in

which people are born, live, learn, work, play, worship, and age that affect a wide range of

health, functioning, and quality of life outcomes and risks." (Arya, et al., 2020) Due to this lack

of consideration on these factors that affect health, treatments for BIPOC may not be as effective

as they are for their white counterparts even if they are treating the same illness or ailment. These

issues regarding systemic racism are extremely prevalent on today’s society, we are witnessing

this in our current Covid-19 Pandemic. There is a clear disproportion of People of Color who are

being affected by this virus because of lack of resources in their community, pre-existing
Systemic Racism in Healthcare Page 3

conditions (influenced by environment) and overrepresentation among in low-wage jobs

regarded as “essential workers”. (Johnson, 2020)

Racism

Racism is correlated with poorer mental and physical health outcomes and damaging

experiences in the health care system by Black, Indigenous and People of color. (Sexton, et al.,

2021) These discrepancies create mistrust between the BIPOC Community and physicians as

well as with the entire healthcare system. The effects of structural racism in health care are not

limited to only patients, physicians and other supporting health care staff can experience racism

from patients or less obvious microaggressions from their colleagues. Although, diversity and

cultural competency training is a start to creating a more empathetic healthcare environment, it

does not fix or alter the structural factors relating to this issue. The majority of decisionmakers in

healthcare are white, areas including public health researchers, policymakers, medical educators,

hospital administrators, insurance and pharmaceutical executives, along with important medical

personnel. (Feagin & Bennefield, 2014) This creates issues with the efficacy of these policies

because those in charge of enacting polies do not have any direct connection to the communities

in which their policies will affect. Thus, policymakers will not inherently see of feel the

implications policies enacted in communities of Black, Indigenous or People of color.

Conclusion

In conclusion, systemic racism has been intertwined in the field of healthcare and

requires reframing of institutions and policies. Black, Indigenous and Persons of Color

communities often lack resources, access to fresh nutritious food and are more likely to be

affected by environmental hazards such as heavy pollution, and contaminated water. Physicians

should be taking these environmental health issues and access to resources into consideration
Systemic Racism in Healthcare Page 4

when planning a course of action for patients of color in marginalized communities.

Furthermore, there needs to shift in power from predominantly white policy makers enacting

policies that affect communities of color to a more racially diverse representation that have direct

connections to the community. All in all, there are major barriers to tackling the issue of

systemic racism in the field of health care, there are current measures put in place like cultural

competency but there are still numerous obstacles to overcome.

Systemic Racism in Healthcare Page 5

References

Arya, V., Butler, L., Leal, S., Maine, L., Alvarez, N., Jackson, N., & Varkey, A. C. (2020).

Systemic Racism: Pharmacists' Role and Responsibility. American Journal of

Pharmaceutical Education, 84(11), 1453+.

https://link.gale.com/apps/doc/A648187785/AONE?u=csuci&sid=AONE&xid=aa11c69c

Feagin, Joe, & Bennefield, Zinobia. (2014). Systemic racism and U.S. health care. Social

Science & Medicine (1982), 103, 7–14. https://doi.org/10.1016/j.socscimed.2013.09.006

Johnson, S. S. (2020). Equity, Justice, and the Role of the Health Promotion Profession in

Dismantling Systemic Racism. American Journal of Health Promotion, 34(7), 703–708.

https://doi.org/10.1177/0890117120943736

Sexton, S. M., Richardson, C. R., Schrager, S. B., Bowman, M. A., Hickner, J., Morley, C. P.,

Mott, T. F., Pimlott, N., Saultz, J. W., & Weiss, B. D. (2021). Systemic Racism and

Health Disparities: A Statement from Editors of Family Medicine Journals. Family

Practice Management, 28(1), 5+. https://link.gale.com/apps/doc/A647997272/AONE?

u=csuci&sid=AONE&xid=d8826ab7

Systemic racism persists in the sciences. (2020). Science (American Association for the

Advancement of Science), 369(6502), 351–351. https://doi.org/10.1126/science.abd8825