On December 20, 2020, Susan Moore passed away from complications of COVID-19. Susan Moore, who is actually Dr. Susan Moore, is a Black female physician who despite her medical degree and knowledge, reportedly fell victim to the bias and racism that affects so many Black people and people of color in our healthcare systems.
Racism in Healthcare
The words “racial bias” and “racism” are words that make people uncomfortable. As doctors and healthcare professionals, we shudder at such terminology because our oath is to do no harm and to act to the highest good for the patient. However, in 2020 alone, a study of selected states and cities with data on COVID-19 deaths by race and ethnicity showed 34% of deaths were among non-Hispanic, Black people. This group accounts for only 12% of the population[i]. This is but one statistic in one domain in which Black, Hispanic, Indigenous and other people of color are being disproportionately affected by inequities in healthcare.
“But what does racism have to do with it?” one might ask.
Let’s take Dr. Susan Moore as an example. During her hospital stay she was treated by a White male doctor and nurse who, when she complained of shortness of breath, reportedly did not believe her. In fact, in the last video she recorded before she died, Dr. Moore stated the physician told her she could not be feeling shortness of breath even though her oxygen saturations indicated that she was in distress. She also reported being denied pain medication during her stay when she complained of chest pain from the pneumonia she experienced. Subsequently, she was sent home, and was later re-admitted. Dr. Moore chose a different location, and although she received the proper care, the damage had already been done. She succumbed to the complications of her illness.
Unfortunately, this is not an uncommon scenario in the treatment of Black patients. Black and Hispanic people have experienced this type of mistreatment for decades. The number of deaths per 100,000 live births is three times higher in Black women than White women[iii].
My experiences are common for clinicians of color who are routinely exposed to instances of racism and discrimination at work. In a recent study[v], 23% of participants (who were clinicians of color) reported that a patient had directly refused their care specifically due to their race. Microaggressions experienced at work and symptoms of secondary traumatic stress were significantly correlated. The qualitative data revealed the majority of participants had experienced significant racism from their patients, colleagues and institutions.
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[i] Holmes L, Enwere M, Williams J, et al. Black-White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges. Int J Environ Res Public Health. 2020;17(2):4322. DOI: https://doi.org/10.3390/ijerph17124322.
[ii] Zestcott CA, Blair IV, Stone J. Examining the presence, consequences, and reduction of implicit bias in health care: A narrative review. Group Process Intergroup Relat. 2016;19:528–542.
[iv] Sukhera, Javeed MD, PhD, FRCPC; Watling, Christopher J. MD, PhD; Gonzalez, Cristina M. MD, MEd Implicit Bias in Health Professions: From Recognition to Transformation, Academic Medicine: May 2020 - Volume 95 - Issue 5 - p 717-723 doi: 10.1097/ACM.0000000000003173.