Our healthcare system is inequitable. How can we fix it? — Eneida Roldan
It has become increasingly clear that inherent racism in our systems poses an impediment to good health and that many racial and ethnic minorities do not have access to adequate healthcare. As a practicing doctor and a medical administrator I have seen first-hand the negative results of this inequity. Never more so then during the past few years when the COVID-19 virus has been affecting these communities disproportionately.
Therefore, I was intrigued by the results of the study that McKinsey released in which they analyzed people of color’s perception of the healthcare system. Beyond looking at data, the McKinsey experts actually asked Black and Latino consumers to define the status of existing services, asking them to weigh in on how best to improve both access and quality.
It comes as absolutely no surprise that: “Black and Latino consumers are more likely to perceive that they receive lower quality of care due to their race.” Both in terms of physical and mental healthcare, people of color are more likely to not receive the treatment they need due to pre-conceived notions and not looking at the patient as a whole being. We know that gender, genetics, environment, and community stigmas can all play a role in deterring a positive outcome. A few of the statistics from the study underscore this:
· 23 percent of White adults reported receiving some form of mental-health treatment and 19 percent reported taking medication for mental health within the past year in 2019. Comparatively, 11 percent of Black adults and 10 percent of Hispanic adults reported taking medication.
· Intermediate diabetes outcomes, such as glycemic control, are poorer for Black patients than for their White counterparts.
· In maternal health and child health, Black women are 3.2 times more likely to die from pregnancy or childbirth-related causes than White women.
When you perceive that you will receive lesser care, it can have a direct impact on how and when you seek treatment. As the study indicates, people of color are more than twice as likely to wait:
· 19 percent of White adults delayed care. Fifty- two percent of Black and 49 percent of Hispanic workers said they postponed care because it would take too long. Other considerations in delaying care included lack of transportation, an expectation of not getting treatment, and uncertainty about what to do when feeling unwell.
Beyond receiving proper care, many Black and Latino patients reported that they have experienced disrespect due to their race or ethnicity. This extends beyond the medical staff to the insurance companies:
“Being a person of color may make me a second-class citizen in the eyes of the health insurance industry.”
There can be no doubt that our healthcare system is inequitable and needs to be corrected. We need to ensure that underserved communities get the services they need without them going into debt — or eschewing treatment because they can’t pay for it. At the same time, we must strive to improve Black and Latino patients’ perception of healthcare so that once they have adequate access at an affordable price, they make use of it. This study proposes several solutions from increased representation in care staff, to promoting culturally relevant care, to investing time and resources in assessing community health needs. My opinion is that we implement as many potential solutions as we can at the same time. We do not have the luxury of time to try one and then another.
To read the full McKinsey study, click here
About Eneida Roldan: Eneida is a dynamic physician leader, a vibrant teacher and mentor, and a dedicated board member with service on an array of for-profit and not-for-profit boards. She has held executive positions in a full range of health care settings, including private and public hospitals, academic medical centers, and entrepreneurial medicine in the field of wellness and health promotion. She is passionate about advocating for diverse women in leadership positions and providing strategic solutions to improve business efficiency and effectiveness, while ensuring inclusive healthcare to all. Her most recent accomplishment has been providing crisis management throughout the pandemic to the Miami community.
