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Dismantling Systemic Racism in Healthcare
Historical Amnesia and Systemic Racism in Health care
Renowned activist, author, and scholar Professor Angela Davis once shared with me the concept of historical amnesia and the disastrous consequences it can have. By historical amnesia, I mean people—even whole countries—tend to omit, forget or ignore aspects of history that are inconvenient or uncomfortable in the present. One danger of America’s historical amnesia is that it dooms us to continuously reinforce and repeat the very patterns that perpetuate societal injustice in this country. This issue dominates our health care system. One of these historical patterns is redlining, the systematic denial of various services to residents of specific, often racially associated neighborhoods or communities. In real estate, redlining creates unnecessary obstacles for residents who want to purchase their homes and invest in their communities. Without owner-occupied homes, neighborhoods and home values deteriorate, and residents cannot create generational wealth. Redlining can also be found in finance, lending, insurance, and more. It’s nothing less than blatant discrimination. Today, we are in the midst of a health care redlining crisis. If you live on the wrong side of a state line, policy around Medicaid means you cannot access specialists or medications or even basic health care. If you live in a redlined zip code, you might well find yourself abandoned by a health care system seeking profits in more prosperous areas. Decisions being made by both the private and public sectors are creating health care deserts throughout the country that disproportionately affect Black and Brown communities. In cases involving HIV, for example, the health care system in America delivers worse outcomes for African Americans about 50% of the time. This is incredibly significant when one considers that HIV is currently the fifth leading cause of death among African Americans. As a society with our historical amnesia fully engaged, we find it easier to blame the patient. The problem is not the patient. The problem is systemic racism in health care.This is a crisis that needs us to change, demands that we change the health system.
The truth is that nobody in this country should have to die of HIV. Prevention messages should be available that curtail new infections. If you’re living with HIV, you should be able to have unfettered access to care that will save your life. If you are at risk for HIV, you should have access to PrEP, which is 95% effective in preventing HIV in the first place.
The problems with the U.S. health care system are multifaceted and complex, especially when it comes to inequities in access and treatment due to racial and socioeconomic factors. But if we can shake off the fog of our collective historical amnesia, then we can honestly confront the flawed policies that have led to and perpetuate social injustice and systematic racism in health care.
If we can reject the entire concept of redlining an individual’s health options based on their race, address, or sexual identity, we can change outcomes. We can save lives. As a society, we have the skill, knowledge, and resources to do that. The question is whether we have the courage and the political will.
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