Illustration of a woman, a ladder, a medical kit, a microscope, a man, a heart

If our families can afford healthcare to take us to a doctor as children for regular check-ups, we assume everyone has access to doctors who are focused on our growth, diet, exercise, and overall well being. As children, we hope to have a positive experience when we seek medical care. This assumption is not something to take for granted. Not everyone is afforded equal access to quality doctors and medical care.

Imagine this: You wake up with severe stomach pains. You decide you need medical attention and when you arrive at the doctor's office they ask you to rate your pain on a scale of 1-10; you rate your pain a 7.

Do you expect your doctor to trust your judgement and treat your pain as you describe it?

Bias in the healthcare system can contribute to unequal care for many minority patients. For example, research shows that black people and other minority groups in the United States experience higher rates of illness, worse outcomes, and premature death.  A few of the other ways healthcare experiences can differ in the U.S. include access to quality doctors, location of facilities, doctor awareness of diagnosing illnesses on darker skin tones, and a lack of funding to establish care centers in higher minority population communities.

Population in South Africa Without Access to Healthcare in 2020

Bar graph showing people without access to healthcare in 2020

Percentages of people of different ethnicities going without medical care. In South Africa, the word "coloured" is an official term used to refer to a person who has one Black parent.

In South Africa, research found that 40.8% of Black people and 22.9% of Coloured people reported going without medical care at some point in the last year, compared with 10.9% of White people and 6.9% of Asian people.

*In South Africa, the word "coloured" is an official term used to refer to a person who has one Black parent. Under South African law, Black people include Africans, Coloureds, and Indians with South African citizenship. 

A Tale of Two Patients

Two patients of the same age visit the same doctor, but their experiences are dramatically different.

Emily is pregnant at the age of 30. She dropped out of high school to support her family. Presently, she works a 9-5 job, 5 days a week. She is excited to meet her baby boy, Jacob! She starts her maternity leave and a week later Emily starts feeling contractions. She calls her friend to take her to the hospital and 16 hours later Jacob is born. Emily continues to feel pain in her abdomen after delivery; in an abundance of caution, the doctors decide to keep Emily at the hospital a few more days to monitor her pain and keep her on close watch. A few days later Emily is pain free and goes home with Jacob and begins a new chapter in her life as a mom.

Grace is pregnant at the age of 30. She earned her legal degree from a well acclaimed University and runs a successful practice. She owns her own home in a great neighborhood. She is excited about her baby girl, Elizabeth! Two days before her due date she starts to feel contractions and her family takes her to the hospital.  She delivers a healthy baby girl. The next day she notices some swelling in her right leg which she mentions to her doctor. Her doctor dismisses her pain and says that it's likely related to swelling she had before delivery and will probably go down in a few days. She is released to go home with Elizabeth the same day as her delivery. One week later, Grace is rushed back into the hospital due to excruciating pain in her leg resulting from an untreated, life-threatening condition.

Why did these two women have different experiences ?

Even with all of the emotional, physical, and monetary support, Grace's health was still threatened due to faults in the healthcare system that show bias in the treatment of patients based on race. It was discovered that Grace developed a blood clot after giving birth which would have been identified and treated if only further evaluation was done at the time she pointed out the swelling in her leg. 

Grace's story is unfortunately not unique. While there are many drivers of maternal mortality according to the CDC, data suggest the majority of deaths, 60% or more, could have been prevented. Identifying and addressing implicit bias in health care would likely improve health outcomes.

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