Summary Racism in Healthcare: Its Relationship to Shared Decision-Making and Health Disparities

In their article, “Racism in Healthcare: Its Relationship to Shared Decision-Making and Health Disparities: a response to Bradby,” Monica E. Peek, Angela Odoms-Young, PhD, Michael T Quinn conducted a study to point out the important questions about racism, patient/provider communication is U.S. health disparities. According to “Racism in Healthcare,” “There are three levels of racism: institutionalized racism, personally-mediated racism and internalized racism. Institutionalized racism, defined as differential access to goods, services, and opportunities by race, includes differential access to health insurance, which study participants described as a contributing factor to communication disparities between African-Americans and their physicians. It is imperative to note that institutional racism does not require personal bias commonly associated with term ‘racism.’ This type of racism, termed personally-mediated racism, is defined as prejudice. After going through the study, there were significant developments in these areas, with Prejudice and discrimination that may manifest as disrespect, poor service and failure to communicate options, all of which our study participants described in their experiences within the U.S. healthcare system. They attributed differential physician assumptions and behaviors (“they just talk right at the patient because they are black”) specifically to being African-American, indicating participants’ perceived influence of race on patient/physician encounters. There were studies that indicated the Healthcare providers may harbor racial biases personally mediated racism, and may be at increased risk of using stereotypes as cognitive short-cuts because of clinical encounter characteristics time pressure, high cognitive demand, limited resources and uncertainty. There is evidence that physicians hold stereotypes based on patient characteristics (race), which may influence their interpretation of patient behaviors and symptoms, and consequently their clinical decisions. For example, one study found that physicians were more likely, after controlling for confounding variables, to rate their African-American patients as less educated, less intelligent, more likely to abuse drugs and alcohol, and less likely to adhere to treatment documented the association between implicit physician bias and racial disparities in treatment.