“Our nation’s legacy of racism is embedded in our health care system. For many people of color, this legacy has meant less access to quality care and poorer health outcomes.”
https://www.commonwealthfund.org/publications/2021/oct/confronting-racism-health-care
Race as a social rather than a biological construct has only recently been recognized by the American Medical Association (new-ama-policies-recognize-race-social-not-biological-construct). The effect of reduced access is pervasive across health research and care in America. Inclusion and diversity is a goal rather than a mandate in clinical studies, trials, drug development and product release, whether in the selection of patients within the trial, in funding researchers to perform the studies, or in assuring equity of access to new developments.
Think how many times you have heard about the differences between races, how many times genetic differences, or even superior or inferior characteristics have been used as identifying factors. How many times I heard in school that I would be good with money (I’m not) because I’m Jewish. Then think about the statistic from the CDC that Black women are 3 times more likely to die of pregnancy complications (https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/e-stat-maternal-mortality-rates-2022.pdf).
Black men and women have insurmountable obstacles when it comes to cancer prevention, detection, treatment, and survival. Quoting the American Cancer Society on equity in cancer care: “In fact, Black people have the highest death rate and shortest survival of any racial/ethnic group for most cancers in the U.S.” (cancer-disparities-in-the-black-community.html. There are racial disparities apparent in every aspect of the medical research, from a lack of disparity among researchers, funding for research, participation in research, and information or awareness about research.
In addition to racial inequality, there are social and economic disparities which impact health care and health research. The World Health Organization defines “social determinants as the circumstances in which people are born, grow up, live, work, and age and the systems put into place to deal with illness.” (https://www.cancer.org/latest-news/report-social-determinants-must-be-addressed-to-advance-health-equity.html).
Access to care, the ability to pay for that care, finding out about prevention and care, much less the latest research about your condition are all determined by your social and economic status, and sometimes the luck of living near a research hospital or qualifying for Medicare so that you can pay for that care.
Awareness of the racial and social/economic disparities seems to be the first step in combating these problems, but luck appears to be the only mitigating factor currently available. Luck has factored into my care and treatment much too often for my own comfort. I have talked to too many people who just happened to question a diagnostic result or just happened to move near a medical center conducting research and just happened to have a doctor mention a study for which they qualify. In my own case, I was lucky enough to be born Caucasian, lucky enough to afford college and graduate school, lucky enough to have a wonderful career and live in a safe, beautiful town, lucky enough to live near a research hospital and have a doctor encourage my participation in a research study. Luck is a horrifyingly poor defense against disease, a horrifying reality of health care in America, but luck seems to be the one defense I have. That, and a lot of anger at what i am learning about health care in the USA.
Susan, ‘Luck is a horrifyingly poor defense against disease’ wow! Such a powerful sound bite!! ❤️
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