Two pediatricians, two allergists, one dermatologist and three hospitals. Anna Akins, 32, sat in waiting rooms in Louisiana for over nine months trying to get her newborn son’s condition diagnosed while he spent his days coughing and wheezing with undiagnosed allergies and no answers.
For Akins, it took hours of exhausting conversations with doctors. She said she was not taken seriously by medical professionals as a Black mother. Doctors questioned her mental state, asked her if she was on drugs and yelled at her when she became more persistent in pushing for her son’s diagnosis, she told USA TODAY.
At a time when the Centers for Disease Control and Prevention says communities of color are at a higher risk of COVID-19, medical professionals say complaints of medical discrimination are on the rise and they are pushing to change it.
“I don’t think they took me seriously as a mom,” said Akins. “I think that we don’t say anything because we are not taken seriously. Even if we say we feel like we’ve been discriminated against medically, we are not taken seriously.”
Her son’s diagnosis ended up being asthma and dairy, wheat and egg allergies. Akins said the diagnosis shouldn’t have taken so long.
While discrimination in health care has been a longstanding issue, the pandemic has shown numbers highlighting the racial disparity in the industry.
Racial and ethnic minority groups are listed as people who need extra precautions throughout the pandemic in the CDC’s information page on the coronavirus.
According to a report published this month by the National Urban League, Black people and Latinos are four times more likely than white people to be hospitalized for COVID-19.
“This is a crisis,” said Marc Morial, CEO of the National Urban League. “Those with underlying conditions are more likely to get sick. Those that have less access to doctors and hospitals are going to be diagnosed much later. when they’re diagnosed much later, they are more likely to be hospitalized, they’re more likely to die.”
COVID-19 is devastating Black, brown and Indigenous communities with mortality rates for Black Americans being about 2.4 times higher than for white Americans.
Higher mortality rates come at a time when national attention is being drawn toward the issue of discrimination and racism. Systemic health and social inequities have put members of racial and ethnic minority groups at increased risk of getting COVID-19 or experiencing severe illness, according to the Centers for Disease Control and Prevention.
Meanwhile, lawmakers across the nation have declared racism as a public health emergency. As numbers reveal the need for equity in the medical field, discrimination at a doctors office or a hospital are not isolated incidents.
A recent poll by the Kaiser Family Foundation, a non-profit organization that focuses on national health issues, showed that one in six Black adults said they have experienced unfair treatment while getting health care.
A very small share of white adults say they have experienced this type of unfair treatment due to their racial or ethnic background, according to the poll.
A recent editorial in the New England Journal of Medicine pushes the need for addressing racism in the health care industry and acknowledging the disparities.
“By looking through a racially impervious lens, clinicians neglect the life experiences and historical inequities that shape patients and disease processes,” read the editorial. “They may inadvertently feed the robust structural racism that influences access to care, quality of care, and resultant health disparities.”
Dr. Monique Aurora Tello, a primary care physician at Massachusetts General Hospital, is pushing for representation and inclusion in medicine. She has been in practice since 2005 and has heard many stories of patients who suffered through substandard medical care because of their race.
Tello is a part of the Center for Diversity and Inclusion at her hospital where she’s helping to develop a plan for addressing inequities. She said she did not receive any training to ensure racial equity in the medical field.
“Believe it or not, teaching things like health inequities, systemic and structural racism as it impacts health outcomes in medical school is still controversial,” she said.
Just because implicit bias teachings are not integrated does not mean they do not exist. The Implicit Association Test (IAT) developed by Harvard researches for a non-profit called Project Implicit tests equity, diversity and inclusion training.
The health care industry is beginning to speak up on the importance of acknowledging racial disparities. According to The American Medical Association’s policy statement, integrating social determinants of health into medical education are essential in ensuring that “graduating medical students are well prepared to provide their patients safe, high quality and patient-centered care.”
Tello has seen how the pandemic has affected communities of color and how those teachings could be helpful in avoiding misdiagnoses or further discrimination in medical practices.
“In April, I was redeployed by my institution, plucked from the outpatient side to work on the inpatient COVID-19 surge wards,” said Tello. “We all saw that the majority of patients who were sick and very sick and dying from COVID-19 was overwhelmingly Latino and Black, and our other Boston hospitals had a similar experience. Per the data, there is no doubt that COVID-19 is impacting communities of color to a much greater degree than whites.”
Complaints of discrimination in healthcare are not always physician-to-patient. A lawsuit that began in November accuses St. Luke’s Physician Group and St. Luke’s Health System of race, color and sex discrimination, harassment and retaliation.
The discrimination continued even after the staff went through a bias training. According to The Kansas City Star, the staff was told to “get over it” afterwards.
Italo M. Brown, an Emergency Medicine physician and Clinical Instructor in Social Emergency Medicine at Stanford Hospital, told USA Today that education about health disparities are not fully integrated but that there has been a push to have implicit bias training as a part of the curriculum.
Brown said he constantly hears stories about patients experiencing discrimination and that this is one way to prevent it.
“It would be interesting to see how you could capture the presence of bias earlier on in medical training and potentially design a curriculum or learning to help correct some of these biases,” said Brown.
Black, Native American and Alaska Native women remain at the top of the list for the highest risks when it comes to racial medical disparities, according to a study by the CDC. Maternal mortality rates are about three times higher than those of white women.
The study showed that systemic issues and lack of resources contribute to the persistent racial disparities when it comes to health care.
Unstable housing, limited access to transportation, missed or delayed diagnosis and inadequate access to care are some of the most significant contributing factors.
Maternal mortality review committees (MMRC) provided prevention strategies alongside the contributing factors. According to MMRC, systemic solutions include expanding clinical office hours and the number of providers who accept Medicaid, prioritizing pregnant and postpartum women for temporary housing programs, and improving access to transportation.
Dr. Myra Jones-Taylor is the Chief Policy Officer at Zero to Three, a national nonprofit organization that “informs, trains and supports professionals, policymakers and parents in their efforts to improve the lives of infants and toddlers.”
The organization released a “State of Babies Yearbook” which provides a national look at how certain inequities affect Black and brown communities even before birth. Jones-Taylor said that because evidence is shown from birth that there are inequities in healthcare, the entire industry needs to be reexamined.
Jones-Taylor expressed the importance of advocating for yourself in discriminatory health care instances. She said that healthcare providers need to take the initiative to further educate themselves on how to provide equitable care.
“We have to be tireless in our laser focus in tracking data that is aggregated by race so we really understand the full picture,” said Jones-Taylor. “Then we need to target our resources and our efforts to make sure that we are addressing those very specific concerns that we’re seeing in Black and brown communities.”