The Lingering Shadow: Is US Healthcare Still Using Racist Medical Practices?

For centuries, the promise of healing in the United States has been overshadowed by a darker reality for many: the pervasive, insidious presence of racism within its healthcare system. While the overt segregation and brutal experimentation of the past may seem like distant history, a closer look reveals that systemic biases and discriminatory practices continue to cast a long, damaging shadow over contemporary American medicine.

The question isn't whether racism was present, but whether it truly ever left.

The roots of this disparity run deep, intertwining with the very fabric of American history. From the forced medical exploitation of enslaved people, such as J. Marion Sims's gynecological experiments on Black women without anesthesia, to the Tuskegee syphilis study, where Black men were deliberately left untreated, medicine has often been a tool of oppression rather than liberation for Black and Indigenous communities.

These historical traumas aren't just footnotes; they've shaped medical education, research, and the inherent biases that seep into clinical practice today, fostering deep-seated mistrust that persists across generations.

Today, the manifestations are often more subtle, yet equally harmful. Consider the widely documented racial bias in pain management, where healthcare providers, influenced by debunked myths about biological differences, consistently undertreat pain in Black patients.

Studies have shown that some medical students still hold false beliefs, such as Black people having thicker skin or feeling less pain. This leads to a tragic reality where legitimate suffering is dismissed, and patients of color are often labeled as drug-seeking, resulting in inadequate care and prolonged agony.

Beyond individual biases, racism is embedded in the very tools and algorithms used in modern medicine.

Race-adjusted calculations, designed to account for supposed biological differences, can inadvertently exacerbate disparities. For instance, algorithms used to assess kidney function often assume lower baseline function for Black individuals, potentially delaying critical diagnoses and access to life-saving treatments like transplants.

Similarly, pulse oximeters have been shown to be less accurate on darker skin tones, leading to underestimation of hypoxemia in Black patients, particularly critical during the COVID-19 pandemic.

The cumulative impact of these practices is starkly evident in persistent health disparities. Black women in the US face alarmingly higher rates of maternal mortality compared to white women, a crisis that cannot be explained by socio-economic factors alone, pointing instead to systemic biases in care.

Chronic conditions like hypertension, diabetes, and heart disease are often diagnosed later and managed less effectively in communities of color, contributing to shorter life expectancies and a diminished quality of life.

Addressing this deeply entrenched problem requires more than just acknowledging its existence; it demands a radical reimagining of healthcare.

This includes dismantling racist algorithms, instituting comprehensive anti-racism training for all medical professionals, diversifying the healthcare workforce, and centering the voices and experiences of marginalized communities in policy-making. Only by confronting these uncomfortable truths and actively working to dismantle systemic barriers can the US healthcare system truly begin to heal itself and, in turn, heal all its people, irrespective of their race.