When it comes to the health of Americans, racial discrimination and white privilege have a devastating impact on health care outcomes, resulting in an across-the-board advantage for whites in every aspect of the health care system.
According to a column on Vox.com by Julia Belluz and Steven Hoffman, from birth all the way through to old age, white Americans enjoy many more health advantages that result in them living much longer than African-Americans.
“By the end of a life, all these health disadvantages add up to a lifespan that’s cut short: black men can still expect to live five years fewer than white men, and black women can expect to live four years fewer than white women,” they write. “There are no biological or genetic explanations for this difference. Four and five years is a lot of life: it’s the length of time it takes to complete college or to see your child through to kindergarten.”
They say the gap starts at birth, where Black women have a 43 percent higher risk than white women to deliver their babies prematurely and are also between two and three times as likely to have babies dangerously early, in less than 32 weeks.
Once the babies are born, Black mothers are much less likely to breastfeed than white mothers, resulting in less healthy children.
“This gap has been explained by everything from preference to a lack of access and education about health benefits, to a dearth of support for new moms,” the authors write. “The latest data from the CDC (Centers for Disease Control and Prevention) showed that hospitals in predominantly black neighborhoods also do less to promote breastfeeding than mostly white hospitals.”
Black kids are more likely to suffer asthma and obesity and have poorer oral health than whites. Into adulthood, the prevalence of obesity in Black people was nearly twice that of white people, resulting in much higher rates of diabetes in African-Americans.
African-Americans suffer the most from HIV of all racial groups.
Not only do Black women have the highest breast cancer death rates, they’re 40 percent more likely to die of the disease than white women.
Even when Black and white people have the same rates of cancer screening, studies show Black people are more likely to die from the disease. A study in Maryland found that white women got surgery more, while Black women were more likely to get radiation or chemotherapy combined with radiation.
In older adults, the authors write, Black people have the highest death rates from stroke and hypertension, in addition to the largest incidence and highest death rates from colorectal cancer.
Black patients are much less likely to get life-saving organ transplants than white people. In a six-state study that measured the likelihood of being placed on a waiting list for a donor organ, “Black patients were much less likely than white patients to have been referred to a transplantation center for evaluation; they were also much less likely to have been placed on a waiting list or to have received a transplant within 18 months after the initiation of dialysis.”
Black women suffer the most because they are hit by the double whammy of race and gender disparities. The authors cite a classic study from the New England Journal of Medicine 15 years ago, showing that when 720 physicians from across America are shown eight random videos of an actor conveying symptoms and asked to make health care recommendations, Black women were the least likely group to be referred for cardiac catheterization.
Thomas LaVeist, director of the Hopkins Center for Health Disparities Solutions at the Johns Hopkins Bloomberg School of Public Health, who has been studying racial disparities for decades, told Vox.com one key cause is “everyday racism.”
“These little microaggressions include things like going to a reception and sipping a glass of wine, and no one talks to you; trying to go into an elevator and someone doesn’t hold the door for you; or walking into the elevator and someone moves farther away as if they’re concerned about you snatching their purse,” LaVeist said. “These things are happening at a subconscious level, and they have a physiological and psychological response. That degrades your health, and it has been shown to degrade the strength of the immune system.”
Even at a policy level, while the Affordable Care Act has expanded access to more than 30 million people, it isn’t working as well for African-Americans as other racial groups: their uninsured rates have only dropped from 21 percent to 20 percent since the legislation was introduced.
“Right now, in 2014, despite all the advances of medicine in the last 100 years, despite this groundbreaking health-care legislation, despite having a black president in the White House, the black-white health gap isn’t going away,” the authors write. “We often focus on medicine and the latest technology in health. Yet as the people of Ferguson, Missouri, know, what dictates how healthy you’ll be throughout life — and all the promise and opportunity that cascades from that — is something a lot more basic. In America, it’s still the color of your skin.”