Access to affordable, quality healthcare is a core aspect of workplace benefits packages and of wellbeing overall. As with many things in American life, however, race often factors into how accurate and high-quality that care truly is. For Black Americans, navigating the medical world can be a fraught experience, and companies need to be aware of these challenges so they can offer their employees adequate support.
Historical Sources of Inequities
Racial disparities in healthcare are not a new phenomenon. In fact, many of the inequities we see today are rooted in centuries of racist beliefs and practices.
One of the most persistent and damaging is the “pain” myth: old ideas about Black patients naturally feeling less pain.
“There’s the persistent, tacit idea that Black patients are somehow biologically different. Medicine as an institution grew up alongside slavery. In order to commodify another human being, you have to dehumanize them. So there’s this idea that people with Black skin are somehow biologically different from people with white skin, which is simply not true scientifically,” Neel Shah, an assistant professor in obstetrics and gynecology at Harvard Medical School and chief medical officer of Maven Clinic, told Smithsonian. Although this myth is not necessarily taught in explicit ways anymore, it still rears its head in implicit bias or care professionals mistrusting reported symptoms in Black patients.
In general, Black patients face worse medical outcomes due to bias in medical training. Common symptoms may not present the same way on darker skin, but the “standards” taught in medical training often use white (and, often, male) patients as the “normal” or sample cases, leading to less knowledge and worse outcomes for Black and other darker-skinned patients. One recent study even found that pulse oximeters, a common medical device used to measure oxygen saturation, are less accurate on darker-skinned individuals.
History has also led to other issues affecting the quality of healthcare for Black patients. For instance, a 1910 “report” ostensibly meant to improve the quality of medical training actually led to the shutdown of most institutions that trained women and Black doctors due to their comparably fewer resources, putting those groups behind, discarding their perspectives, and leading to them being underrepresented even today. Add to that shortage of Black physicians what the CDC calls “social determinants of health”: historic and present racial inequities in housing, education, available resources, employment, wealth, and more, all of which trickle down to impact health directly and indirectly in communities of color. This is especially visible in intersectional areas, such as Black maternal healthcare, where Black women suffer much higher maternal mortality rates than other racial groups.
The Effects Aren’t Just Physical
When it comes to the long-term effects of racial disparities in health care, it’s not just about physical health. Black Americans also face bigger hurdles in getting access to the mental health care they need, due to a confluence of factors including social determinants, cultural norms surrounding mental health, and both conscious and unconscious biases among healthcare providers.
The American Psychiatric Association reports that only one in three Black Americans who needs mental health care actually receives it. The same report also notes other serious disparities, including:
- Black Americans are less likely to receive guideline-consistent care, less frequently included in research, and more likely to use emergency rooms or primary care (rather than mental health specialists) than white Americans.
- Differences in how Black patients express their symptoms, or how those expressions are perceived, may contribute to misdiagnoses.
- In one study, researchers found that physicians were 23% more verbally dominant, and engaged in 33% less patient-centered communication with Black patients than with white patients.
- Black people with mental health conditions (particularly schizophrenia, bipolar disorders, and other psychoses) are more likely to be incarcerated than patients of other races with the same conditions.
How HR Can Help
While HR teams can’t remedy the biases in the medical community, they can take actions to help their employees access the care and support they need. It all starts with a robust commitment to DEI&B, ensuring that work is a place where Black employees can feel safe, comfortable, and supported, rather than a place where microaggressions and biases exacerbate the disparities they encounter elsewhere.
Developing an overall culture of work-life balance can help to support both physical and mental health among Black employees as well as among the entire workforce. A negative or high-pressure culture tends to have a negative impact on health, causing stress and exacerbating symptoms. HR can lead the way in building a company culture where people aren’t expected to just “power through” health problems, but are instead encouraged and supported in finding long-term solutions.
This also connects to the Total Rewards function of HR, where compensation and benefits are determined. Companies can work to ensure that health care benefits are strong and comprehensive, with coverage for both physical and mental health care. It’s also important to look into avenues for providing resources so that Black employees who face healthcare discrimination or dismissals have options to get a second opinion without paying exorbitant amounts.
Supporting employees and committing to DEI&B means understanding the unique challenges that employees of color go through and trying to find ways to assist them. With medical inequities still having a serious impact on Black communities, it’s more important than ever for companies to provide resources and support to ensure that their employees can access what they need to be healthy, productive, and happy.
By Ruben Moreno
About the Author
After a 25-year career in Corporate Human Resources and HR Executive Search, Ruben Moreno and his two partners co-founded Blue Rock Search based on a simple but ambitious vision of creating a firm that would “Change Lives and Organizations One Relationship at a Time.” Ruben leads the Blue Rock HR and Diversity Executive Search practice specializing in the identification, assessment, recruitment, and onboarding of Chief HR Officers and Chief Diversity Officers and their respective teams — inclusive of leaders in Talent Acquisition, Total Rewards, HRBP’s, Learning & OD, HR Technology, HR Operations, and HR Analytics. Ruben has helped place hundreds of HR Executives and built deep relationships within the CHRO community across multiple industry verticals. His clients consider him a trusted partner who takes the time to understand their business and add value beyond executive search.