Influence of race and class as underlying dimensions of health disparities

Black Studies

Heath Disparities and Race

Many readings show that there is bias in medical treatment between blacks and whites, as much as the health profession might not care to admit it. The four articles discussed here look at this disparity and why it exists.

In one study, 80% of black Medicare patient visits were handled by only 22% of available physicians, and these physicians rarely saw white patients. These physicians were also less likely to be board certified than the physicians treating white patients (Bach et. al. 575). Thus, because of less training, the black patients received a lower-quality care experience than similar white patients did. This has been the case with many other studies, but this one indicated that blacks are often treated by physicians with less training than those treating white patients.

The study found that a "typical" physician for this study was about 50 years-old, non-Hispanic, male, and worked in a small one- or two-person practice in an urban area. White patients were far less likely to visit the physician if he was black. In addition, 27.8% of the physicians responding felt they could not give high-quality health care to all their patients, because of a variety of factors.

The physicians treating black patients also reported it was harder for them to access additional services for their patients, such as non-emergency hospital admission, sub-specialists, and x-rays. This is another reason their health care is often substandard. Thus, the fact that black patients do not seek out secondary or other additional services may be because it is more difficult for them to get these services.

As more health care professionals begin to understand the disparity of health care between the races, more studies have been conducted to discover these racial differences. In the 1980s, only 20 publications on the topic appeared, while over 700 were completed during 2000 to 2004. These studies indicate many racial disparities throughout the health care profession, and most of these studies are compared to white individuals.

Many critics do not agree with the racial classifications between other races and whites in health care studies, because there is no central definition of "whiteness" in the studies. In fact, as late as 1989, infants' race was determined by the race of the father, no matter what the race of the mother was, unless the man was white and the woman was any other race, then the mother's race was used. Thus, traditional definitions of "white" and "black" could be skewed in some studies.

Many studies also fail to make a connection between biological and behavioral factors in certain health issues under study, and so the final outcome of the studies can be questioned. For example, Hispanics tend to suffer from obesity and high blood pressure, but it is not known whether this is cultural or behavioral. More study needs to go into minority health issues, rather than simply comparing their health experiences with the white community.

There can also be negative connotations held toward some ailments, such as AIDS, which has been called the "gay" disease, which stigmatizes all those who contract the disease. Biases such as these can often affect the outcome of a study or even bias the researchers, even if they do not realize it. Thus, truly defining "whiteness" and who is actually white can affect the outcomes of studies in the future, and can help keep bias from entering into health care studies.

Another interesting statistic is that the United States is the only nation in the West who does not report health information by class. This indicates that many Americans do not feel there are distinct classes in American society, but most sociologists believe there are, and so, health data reported simply by race is skewed. We know that there is a disparity between black and white life expectancy, for example, but do not know what class (such as income, work, or education) have to do with this disparity.

There is a tendency to treat race and class as the same thing, and attribute racial differences in health care to biological differences between blacks and whites. In the 1850s, for example, many people believed blacks were inferior to whites in just about all areas. This idea is antiquated now. The ideas many of these studies about black and white medical differences, and how they were conducted, may seem antiquated one hundred years from now, too, due to the exclusion of class in the studies.