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26 comments
  • USA is the only developed country where your right to health care depends on your job.

    Makes sense that children in poorer families would get worse care.

  • Can someone share personal experiences?

    Insert my physical appearance here, but I've met any health care professionals who cared about a person's race. I don't mean that cared for me, I know a bunch of providers personally.

    They did however have plenty of stories of people treating them like shit or like a waitress at a restaurant.

    • A fair question, but fwiw, racism is typically inherent in the system rather than the individuals. i.e., for one thing it correlates with poverty, while for another there tend to be aspects of race that transcend that. Admittedly, I did not chase down reading the underlying study - it wanted payment for individual access to this article - but even if it did not go so far as to adjust for correlations of underlying factors like income level (which, notably, it should have been rejected from any even halfway respectable peer-reviewed journal if it did not), hospitals in primarily-black areas tend to be those that can offer poorer quality of care, and even at the same care facilities, black people often report differences in how they are treated (not all you understand, but many - and yes, sometimes it happens literally only when people are not around to verify it, as in some people are highly friendly when watched but FAR less so when not; plus there is a marked difference b/t "politeness" vs. "friendliness"). In short, just bc you do not see it as a non-POC does not mean that it does not exist. Kudos for asking for a dialog though to broaden your perspectives - I upvoted to in case that helps someone see it who can respond with a more personal story. Indeed, Truth is often quite complex and difficult to pin down correctly - e.g. what if hospitals in primarily city areas were busier and offered lower quality-of-care than those in rural areas, regardless of race? But if you keep an open mind, you will most definitely see it happen, I guarantee it (not that you should trust me, just that if you are really open to seeking, then you will eventually find what you are looking for).

      • Is it a fair question? Does a perceived lack of personal anecdotes have any bearing whatsoever on:

        The review found children of color are less likely to get diagnostic imaging and more likely to experience complications during and after some surgical procedures.

        "I'm just asking questions here!" Bullshit.

        I understand you're making the same point. Just...reiterating, I guess.

    • I don’t think people would necessarily know that they’re experiencing discrimination. And people might not realize that they are treating folks unequally.

      You can know you’re in pain and that the medication that you’ve been given isn’t eliminating all of the pain. But you don’t know why. Are you being given the maximum reasonable dose or is it because the doctor doesn’t believe you when you say you’re in pain? Or is it because the neighborhood you’re in (which is still influenced by decades of systemic racism) has had a history of more patients with drug seeking behavior? Maybe the ER in your neighborhood has longer wait times due to some unknown corporate policies or accounting that impacts staffing? How would you know? It’s not like you’re checking out all the ERs all the time and leaving Yelp reviews. Or maybe the person doing triage makes a split second judgment that you seem to be in less pain than someone else and are therefore lower priority?

      All that said, I did actually have a racist dentist once. IDK if it had any real impact on the quality of my care (it’s not like I’m a dentist and can assess whether a filling should have been a crown or something).

      How did I know? Well,ll I didn’t know at 1st. The receptionist was the dentist’s mother and she was super old. She would always be checking and double checking that I understood that I would be billed if the insurance didn’t pay and that I understood how much things could cost. And this wasn’t just once in a while, it was every damn time I came in. As a fairly well paid engineer with good insurance, this seemed really weird. My white husband had the same dentist and when I told him about this he was like “What? Dr X’s mom is just as sweet as pie.” She never asked him how he would pay for things even though he was on MY damn insurance! So we went on with me thinking the dentist’s mother was racist and my husband thinking that I was imagining things. And then one day, my husband was in the chair with a sports magazine from the waiting room. The cover had some large athlete, looking intimidating. It may have been someone who got physical with someone? I don’t remember, I’m not sporty. Anyway Dr. X says to my husband “Can you imagine having that gorilla coming at you”?. This was decades ago but my husband learned a valuable lesson that day.

    • I'm not sure if you're being genuine or not; your last sentence makes me lean towards racist, but I'll give you the benefit of the doubt.

      The issue is not doctors giving lesser quality healthcare to children of color, it's that healthcare in America is the most expensive in the world, and people of color are extremely disproportionately impoverished in the US compared to white people. They get poorer healthcare because they literally cannot afford decent healthcare.

      The US government spent the century after the Civil War preventing free men and women of color from voting and creating generational wealth. Regressive tax laws, and private school vouchers that serve no other purpose than to defund public schools people of color rely on for education are just a couple of the litany of things that keep poor people in a cycle of generational poverty. Does this also affect poor white people? Absolutely. But Black Americans are more than twice as likely to be below the poverty line in the US.

      The system is broken for all of us that aren't shareholders and CEOs, it just happens to disproportionately affect people of color. We're all on the same team and we're not part of the 1%. But politicians and media have convinced 49.5% of us that the other 49.5% are our enemies so we'll be distracted while the 1% picks our pockets.

      • It's also implicit bias, though. Health care providers have to make assessments of their patients constantly: does this person need more pain meds? Can we discharge them? Do they need surgery or just physical therapy? And implicit bias (for example the very well-known bias that Black women can 'handle' more physical pain than white women because they're 'tougher') will be one factor in these thousands of constant little decisions. If you looked at any one decision you probably couldn't find fault with it, but they add up over time and if you look at the data you'll find statistical trends. Black women are more commonly recommended to have C-sections than white women, all other factors being equal. That's not because individual doctors hate Black women, but it's because unconscious biases affect their decision making, and because race is considered as a risk factor for certain treatment decisions.

      • I’m not sure if you’re being genuine or not; your last sentence makes me lean towards racist, but I’ll give you the benefit of the doubt.

        Ha, that's mighty big of you? 🤔. The necessary? into to your comment says "I read something you said and assume you're a racist, but I'm not sure based on four short sentences." I'm guessing you inferred the people I was talking about treating medical staff like shit were all non-whites "like me"?

        It's not that I don't understand how easy it is to assume or infer things from internet conversations, but would you consider questions help more than statements?

        Yes, I was genuinely asking.

        It's very hard to trust any "studies" anymore since with enough money, I feel like you could fund a study to say anything, and get other institutions to back it for the greater good/bad. Does that mean I don't believe in discrimination or bias, no. That's why I'd like to get first hand accounts also, knowing there's less credibility of random lemmy users, it's still something.

        One of comments I read pointed out the study only included patients with insurance. If a significant contributor to quality of care has to do with income, I would want to believe that insurance would reduce that, since the organization is getting paid. I don't know the back end details of different carriers and what they pay, and whether that would effect the actual care providers. I wouldn't think a nurse gives a crap how much the patient's insurance would or wouldn't cover.

        I've had pain meds withheld, and I'm the perfect white male that should get everything. I might have assumed care providers tend to think addiction issues with other people more than others.

        My profession has come a long way. Someone with fucked up points of view on race joined my team a while ago. They got sorted out real fast. I saw and experienced that those ideas wouldn't be tolerated at all. Instantly shutdown.

        I suppose that's not the case everywhere.

    • There have been studies that indicate that people who are not exposed to varieties of people constantly tend to not recognize faces and/or facial expressions on other races.

      There are also studies that indicate that white patients are more likely to be prescribed painkillers when they're in pain, whereas black patients are more likely to be thought of as exaggerating.

      I've had instances where I, as a white person, got immediate access to great medications. My black coworker, same illness around the same time, was told to take Sudafed and other OTCs.

      The numbers also don't lie. Maternity mortality is higher for non-white patients. Surgical outcomes tend to be poorer. Follow care tends to be less stringent. It's across the board.

      On one hand, there are some systemic things that can explain this. Drug interactions are kind of presumed to be identical for all races when you control for race, but that may not be the case - we may just be averaging out to a measure that is no longer useful. So biological differences, ability of the doctor to identify pain/issues, willingness to believe the patient, and all sorts of other things play in just as much if not more than overt racism.

  • In other breaking news: Racism is still a thing in America.

  • Big surprise here.

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