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Health Care for All. Social Equity.

Dismantling Systemic Racism in Healthcare

Category:
  • Social Justice

The issue of systemic racism in health care is very real, urgent, and dire. The disparities in care, access, and treatment options are significantly impacting communities of color. We must immediately address this health care crisis—health care is a fundamental human right.

So why are we facing this disparity in health care? The truth is it’s always existed, and though we may want to believe it’s getting better, the truth is, systemic racism in health care is prevalent.

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.

Change is Possible

How do we change that alarming statistic? We must recognize and prioritize overcoming systemic racism, not only in health care but throughout this country. It’s a crisis that leads to death by everything from police brutality to HIV disease. Health has got to be central to the conversation as a basic human right. We’ve got to demand change from our government leaders and replace jails and correctional officers with treatment centers and counselors. We must get away from this idea that a health diagnosis can be a crime, whether that’s a mental health issue, addiction, or one’s HIV status.

5th

HIV disease is currently the leading cause of death among African Americans.

At Vivent Health, we’ve proven a different approach can work. All people with HIV who come through our doors get access to health care, regardless of their ability to pay. We’ve created some of the best clinical outcomes known, including eliminating the gap between Black and white patients in our Denver operation; we are close to achieving that across the country.

But we need to provide more than access to quality health care; we have to provide for our patients’ human needs holistically. If someone is hungry or homeless, their health is not their top priority. Social determinants of health are every bit as important as lab results. That’s why we’ve put food pantries in medical clinics and provide housing vouchers to our patients who need them.

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.

Author(s):
Mike Gifford
President and Chief Executive Officer

Michael J. Gifford has been a leading force in the fight against AIDS in the United States for three decades. He currently serves as the President and Chief Executive Officer of Vivent Health. During…