How Racism and Other “Ism’s” Play a Role in Medical Disputes
Race, class, and gender all impact health. However, race is health’s greatest determinant. Public health practitioners recognize that race, class, and gender produce different health outcomes. Several of these phenomena have been examined, but when it boils down to it, race best determines an individual’s health and overall medical treatment.
Race is a social construction, rather than a biological category. As stated in House and Williams, biologically, there is a 75% difference within racial groups and a 95% similarity between racial groups. Still, knowing about the 95% variance between racial groups, it is evident that a social construction has been systematically designed for race to determine our life outcomes, thereby hindering the quality of health care. Take the case of the Tuskegee Syphilis Study in Tuskegee, Alabama. A group of impoverished sharecroppers contracted syphilis. Instead of the doctors treating the disease, the men were given free healthcare, meals, and other amenities. Conducting the same experiment on whites was an unquestionable thought. As noted above, race does affect the quality of treatment received.
Race is important to consider when examining health inequities. Geiger (2007) describes two studies that were orchestrated to identify “racism.” In the first study, researchers interviewed physicians on their “biased” treatment plans given to African Americans with coronary artery disease. The physicians’ reasons were documented as “classic negative racial stereotypes.” These judgments enabled the doctor to deny proper care for bypass grafting, which are often urgent. By contrast, the second study used the same experiment, coronary artery disease, but did not include patients’ race. In the last study, race was not the determining variable for health equity. Since physicians’ were unaware of their patients’ racial background, the physicians did not deny proper care to the patients. While this is just one example, race is pertinent to health equity. As public health advocates though, we must look at socioeconomic status and gender as well. Policies are based on socioeconomic status (hereinafter “SES”). These policies involve a variety of areas and include infrastructures, practices by banks, voting, health care, etc.
Socioeconomic status is an economic and social measurement of a person’s combined interactions relative to others. SES is measured based on income, education, and occupation. SES is categorized on three levels: high socioeconomic status, middle socioeconomic status, and low socioeconomic status. By having a higher SES, health care will be less of an obstacle. In the United States, most Americans are in the lower level of SES, thereby receiving bad health care and suffering illness more frequently compared to people who have a higher SES, who can afford quality health care. “Regardless of specific diseases, those with socioeconomic disadvantage are more susceptible to early death and preventable disease” (Hofrichter, 2010 p.9). Additionally, racial minority groups are suffering more from these socioeconomic disadvantages. Disadvantaged people are dying earlier because of the lack of health care and apathetic attitudes from decision-makers.
Likewise, gender is significant and is a relevant factor when examining health disparities. Turning to an examination of gender, women are generally perceived as inferior. This misconceived female incapability has created systematic gender discrimination for decades. Women are underrepresented in politics and the division of labor is unequal; moreover, women have a limited access to health care. Systematic gender discrimination leaves women without the resources needed for their well-being (Horfrichter, 2010 pp.16). While women are clearly limited by gender discrimination, women who are also a racial minority have a particularly difficult time obtaining resources for their well-being. Inequality crosses gender lines; nevertheless, race is the core principle for determinants of health.
Society gives the racial construction power. Race affects everything: education, income, healthcare, voting rights, etc. Moreover, there is no significant difference between people of difference races, yet society still has been conditioned to think that racial groups are different. Race is a powerful construction. Society wants race to be powerful, not because race must to be powerful. Race clearly impacts one’s health and well-being. In the 2008 movie, “Unnatural Causes…is inequality making us sick?” the narrator demonstrates how inequality stems from race, even with prestige and power. While history has proven that racial discrimination is prominent and still exists, racism has manifested in determining who gets quality health care. Race, class, and gender all impact our lives yet race remains the main component of health determinants because of the power society gives to race.
Because race is likely to play a part in health care and medical treatment, an ADR practitioner engaged in dispute resolution must be aware of these subtle nuances while sitting at the mediation table. Medical malpractice cases or personal injury claims are subtly influenced by the care given to a soon-to-be Plaintiff. A soon-to-be Defendant Doctor’s choices and conscious or unconscious steps in selecting treatment are going to become relevant. A mediator who is skilled at cross-cultural mediation can help parties not only reach resolution, but perhaps address some of the underlying bias and prejudice that might have led to the dispute in the first place.