discrimination in health care

1. DISCRIMINATION
IN
HEALTH CARE
PPT By:
Nayana shree Ramesh
24
E1

2. INDEX:
• Definition
• Types
• Discrimination in COVID situation
• Racism
• Discrimination towards LGBTQ community
• Gender bias
• Bibliography

3. Definition:
• Discrimination in the healthcare setting can be defined as negative actions or lack of
consideration given to an individual or group that occurs because of a preconceived
and unjustified opinion.
• Doctors take an oath to treat all patients equally, and yet not all patients are treated
equally well. The answer to why is complicated!!!!!!!!!!
• We now recognize that racism and discrimination are deeply ingrained in the social,
political, and economic structures of our society.
• For minorities, these differences result in unequal access to quality of healthcare
and education, healthy food, livable wages, and affordable housing.
• In the wake of multiple highly publicized events, the Black Lives Matter movement has
gained momentum, and with it have come more strident calls to address this ingrained,
or structural, racism, as well as implicit bias.

4. Types :
• The 4 types of Discrimination
• Direct discrimination: somebody has been treated differently or worse than
another employee due to age, race, religion or beliefs.
• Indirect discrimination: when a company puts a plan or rule in place, which isn’t
discriminatory but puts people with specific characteristics at a disadvantage
• Harassment: Harassment is when somebody is conveying negative behaviour
towards a fellow employee, which humiliates, intimidates or excludes them.
• Victimisation: Victimisation occurs when an employee suffers a ‘detriment’, A
‘detriment’ can include a loss, disadvantage, damage or harm

5. • Racism in COVID :
• The COVID-19 pandemic draws attention to this. A May 2020 study estimates that
in the U. S., Black people were 3.57 times more likely to die from COVID-19 than
white people. Similarly, the risk of death within the Latin-x population was nearly
twice that of the white population.
• Data from other countries reveal the same problem. A 2020 report from Public
Health England found that in England, COVID-19 death rates were higher
among Black and Asian people than white people.
• The report also found that healthcare workers from marginalized groups felt
unable to voice their concerns about the lack of personal protective
equipment and COVID-19 testing in the pandemic’s early stages

6. Conclusion of 2020 public Health England
report:
• The emerging evidence base suggests that individuals in black, Asian, and minority
ethnic groups are at increased risk of mortality due to COVID-19. Those of Black
African and Black Caribbean descent appear to be at greatest increased risk. Health
inequalities known to affect the BAME communities( black , Asian and minority ethnic)
in England may be increasing the risk of transmission (overcrowded housing,
reliance on transport, living in population centeres) and the risk of mortality (high
underlying risk of co-morbidities: CVD, diabetes, obesity). Furthermore, the measures
to control the spread of the COVID-19across the country may have led to further
economic or housing instability. Local and national policy initiatives will need to be
sensitive to BAME communities to ensure existing health and economic inequalities are
not widened due to the extraordinary measures taken during the pandemic

7. How racism impacts health
• Racism has a profound impact on mental and physical health, and can make it more
difficult for people to access healthcare services.
• In 2015, the U. S. Department of Health and Human Services (HHS)Trusted Source found
numerous examples of health inequity for POC in the U.S., including:
• Lower life expectancy: In 2014, Black males and females had lower average life
expectancies than white males and females.
• Higher blood pressure: Between 2013 and 2014, 42.4% of Black males had high blood
pressure, compared to 30.2% in white males. During the same period, 44% of Black
females also had this condition compared to 28% in white females.
• Lower rates of influenza (flu) vaccination: Flu vaccines can save lives. However, in
2014, only 60% of Black and Latinx people aged 65 or over got a vaccination, compared to
70% of white and Asian people of the same age.
• Strain on mental health: A 2015 reviewTrusted Source found that racism was strongly
associated with mental health difficulties, contributing to stress, anxiety, and depression.
This was especially true for Asian American and Latinx groups.

8. Pain treatment
• A 2016 study found many white medical students wrongly believe Black people have a
higher pain tolerance than white people. Of all the participants, 73% held at least one
false belief about the biological differences between races.
• Examples of these beliefs include Black people having thicker skin, less sensitive
nerve endings, or stronger immune systems. The researchers note these beliefs are
centuries old, and that some 19th-century doctors used them to justify the inhumane
treatment of slaves.
• These myths still have an impact today. In a study, Black children with appendicitis were
less likely to receive appropriate pain medication than white children. The same was
true in research on people with recurring cancer.

9. Group Infant mortality
Black 11 in 1,000
Indigenous 8 in 1,000
White and Latinx 5 in 1,000
Asian or Pacific Islander 4 in 1,000
Pregnancy
Racial disparities also affect the medical care of pregnant people and newborn babies.
The term “infant mortality” refers to the proportion of babies who die below the age of one
compared to those that live. Organizations often use infant mortality to measure the success
of postnatal healthcare.
Between 1999–2013, infant mortality tended to decrease in the U.S. However, there were
still disparities between racial groups. The following 2013 data comes from the HHSTrusted
Source( health and human services):
Black people also face higher risks during pregnancy. According to a 2019 studyTrusted
Source, they are 3–4 times more likely to die from pregnancy-related causes than white
people in the U.S.

10. Summary
• Many studies reveal racial disparities in how marginalized groups access and
receive healthcare . Sometimes, these disparities are related to socioeconomic
inequality.
• However, biases and stereotypes also have a serious impact on how doctors
treat POC. This can lead to over- or under-diagnosis of certain conditions, a
lack of proper pain management, and increased health risks, even when
economic status is not a factor.

11. Discrimination towards LGBTQ:
• All people who need medical care should be able to see
their doctor without worrying about being mistreated,
harassed, or denied service outright. The Affordable Care
Act (ACA) helped address this issue by prohibiting
health care providers and insurance companies from
engaging in discrimination. As a result of several court
rulings and an Obama administration rule, LGBTQ people
are explicitly protected against discrimination in health care
on the basis of gender identity and sex stereotypes.
• Despite existing protections, LGBTQ people face
disturbing rates of health care discrimination—from
harassment and humiliation by providers to being turned
away by hospitals, pharmacists, and doctors.
• Discrimination—and even the potential for
discrimination—can deter LGBTQ people from seeking
care in the first place.

12. CAP survey (College of American Pathologists survey):
• CAP survey data show that discrimination played a role in preventing a
significant number of LGBTQ people from seeking health care. In the year
prior to the survey, 8 percent of all LGBTQ people—and 14 percent of
those who had experienced discrimination on the basis of their sexual
orientation or gender identity in the past year—avoided or postponed needed
medical care because of disrespect or discrimination from health care staff.

13. How Discrimination Impacts LGBTQ Healthcare
• Discrimination against LGBTQ individuals has been associated with high rates of psychiatric disorders,
substance abuse, and suicide. LGBTQ populations have the highest rates of drug use, including the use of
tobacco and alcohol. Elderly LGBTQ people face additional barriers to health, especially because of isolation
and a lack of culturally competent providers. Examples of discrimination that negatively affects the health of
LGBTQ individuals include:
• Legal discrimination in access to health insurance, employment, housing, adoption, and retirement benefits
• Financial barriers
• Lack of social programs that are inclusive for LGBTQ people of all ages
• Shortage of healthcare providers who are knowledgeable and culturally competent in LGBTQ health (which can
discourage LGBTQ people from seeking care)
• Negative provider attitudes
• Furthermore, barriers to healthcare related to sexual and transgender stigma worsen when combined with
systemic racism and xenophobia. LGBTQ people who are immigrants or have limited English proficiency
are especially vulnerable in the healthcare system. Many individuals who need care forgo it out of fear and
distrust of the system.

14. Gender bias in healthcare
• Gender bias is present throughout the healthcare system, from the interactions between
patients and doctors to the medical research and policies that govern it. Some examples
include:
• Disbelief in symptoms
• Stereotypes about gender affect how doctors treat illnesses and approach their patients. For
example, a 2018 study found that doctors often view men with chronic pain as “brave”
or “stoic,” but view women with chronic pain as “emotional” or “hysterical.”
• Workplace harassment, bullying, and discrimination
• Gender bias also leads to discrimination against health workers. A 2020 study of older
women doctors found that age- and gender-based harassment, discrimination, and
salary inequity persisted throughout their careers.

15. • Gaps in medical research :In the past, many scientists believed that
males made the best test subjects because they do not have
menstrual cycles and cannot become pregnant. This meant that a
vast amount of research only involved male participants.
• Summary
Gender bias in healthcare is a critical, well-documented problem
that endangers people’s lives and well-being. It is a component
of sexism, which is a major cause of inequity worldwide, including
health inequity.
Gender bias affects diagnosis, treatment, and health outcomes,
reducing the quality and effectiveness of healthcare. In order to
stop it, organizations and institutions need to commit to changing
their policies and practices.

16. • OCR enforces nondiscrimination regulations
that apply to programs, services, and activities
receiving HHS( health and human survice )
Federal financial assistance
• Section 1908 of the Public Health Service
Act (42 USC § 300w)prohibits discrimination on
the basis of age, race, color, national origin,
disability, religion, or sex (including pregnancy,
sexual orientation, and gender identity) in
programs, services, and activities funded by
Preventative Health and Health Services Block
Grants
Office for Civil Rights

17. Bibliography:
• https://www.health.harvard.edu/blog/racism-discrimination-health-care-providers-
patients-2017011611015
• https://labblog.uofmhealth.org/rounds/1-5-have-been-discriminated-against-
healthcare-setting
• https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-8124-z
• https://www.hrsolutions-uk.com/4-types-of-discrimination/
• https://www.medicalnewstoday.com/articles/gender-bias-in-healthcare#summary
• https://www.stkate.edu/academics/healthcare-degrees/lgbtq-health-discrimination

18. • “People fail to get along because they fear each other; they fear each other because they don’t
know each other; they don’t know each other because they have not communicated with each
other.”
— Martin Luther King, Jr.