this post was submitted on 18 Jan 2024
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From neonatal and primary care to emergency medicine, kids got lower-quality care than their white peers, researchers found. Disparities include longer waits and less pain medication after surgery.

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[–] Enk1@lemmy.world 4 points 10 months ago (2 children)

I'm not sure if you're being genuine or not; your last sentence makes me lean towards racist, but I'll give you the benefit of the doubt.

The issue is not doctors giving lesser quality healthcare to children of color, it's that healthcare in America is the most expensive in the world, and people of color are extremely disproportionately impoverished in the US compared to white people. They get poorer healthcare because they literally cannot afford decent healthcare.

The US government spent the century after the Civil War preventing free men and women of color from voting and creating generational wealth. Regressive tax laws, and private school vouchers that serve no other purpose than to defund public schools people of color rely on for education are just a couple of the litany of things that keep poor people in a cycle of generational poverty. Does this also affect poor white people? Absolutely. But Black Americans are more than twice as likely to be below the poverty line in the US.

The system is broken for all of us that aren't shareholders and CEOs, it just happens to disproportionately affect people of color. We're all on the same team and we're not part of the 1%. But politicians and media have convinced 49.5% of us that the other 49.5% are our enemies so we'll be distracted while the 1% picks our pockets.

[–] dexa_scantron@lemmy.world 5 points 10 months ago (1 children)

It's also implicit bias, though. Health care providers have to make assessments of their patients constantly: does this person need more pain meds? Can we discharge them? Do they need surgery or just physical therapy? And implicit bias (for example the very well-known bias that Black women can 'handle' more physical pain than white women because they're 'tougher') will be one factor in these thousands of constant little decisions. If you looked at any one decision you probably couldn't find fault with it, but they add up over time and if you look at the data you'll find statistical trends. Black women are more commonly recommended to have C-sections than white women, all other factors being equal. That's not because individual doctors hate Black women, but it's because unconscious biases affect their decision making, and because race is considered as a risk factor for certain treatment decisions.

[–] MSgtRedFox@infosec.pub -1 points 10 months ago* (last edited 10 months ago) (1 children)

I'm having a hard time imagining that someone would withhold pain management assuming the patient can just handle more pain or because they're tough. To me, that would be insane. I'm not saying it's not happening, I just can't understand.

[–] dexa_scantron@lemmy.world 5 points 10 months ago

Let's say it's normal to keep someone on pain meds for 4 to 8 days after surgery. Each day, you assess the patient and check a number of factors to determine when to stop pain meds, like: how much pain do they say they're in? How much do they wince when they walk? How comfortable do they seem? Do they seem distracted when talking to you? Etc. Each of those assessments is subjective, and therefore can be influenced by biases you don't even realize you have. Over a year, maybe that means you stop pain meds on the 5th day, on average, for Black patients, and on the 6th day for white patients. You're not really withholding pain meds from any one patient. Each patient probably doesn't really notice the difference. But over time, that slight difference compounds and adds up to poorer quality of care for one group.

This is why it's so important to measure things like this subjectively, and look for and fix the reasons they're happening. It's very hard, probably impossible, to fix these issues by just assuming that well-meaning people will be able to be completely unaffected by bias. And sometimes people overcorrect: managers in tech are less likely to give Black employees critical feedback, for example, because they don't want to be racist, and that behavior harms Black employees by not giving them opportunities to correct behavior that's holding them back from advancement. Again, tiny behaviors that compound at scale.

[–] MSgtRedFox@infosec.pub 1 points 10 months ago (1 children)

I’m not sure if you’re being genuine or not; your last sentence makes me lean towards racist, but I’ll give you the benefit of the doubt.

Ha, that's mighty big of you? 🤔. The necessary? into to your comment says "I read something you said and assume you're a racist, but I'm not sure based on four short sentences." I'm guessing you inferred the people I was talking about treating medical staff like shit were all non-whites "like me"?

It's not that I don't understand how easy it is to assume or infer things from internet conversations, but would you consider questions help more than statements?

Yes, I was genuinely asking.

It's very hard to trust any "studies" anymore since with enough money, I feel like you could fund a study to say anything, and get other institutions to back it for the greater good/bad. Does that mean I don't believe in discrimination or bias, no. That's why I'd like to get first hand accounts also, knowing there's less credibility of random lemmy users, it's still something.

One of comments I read pointed out the study only included patients with insurance. If a significant contributor to quality of care has to do with income, I would want to believe that insurance would reduce that, since the organization is getting paid. I don't know the back end details of different carriers and what they pay, and whether that would effect the actual care providers. I wouldn't think a nurse gives a crap how much the patient's insurance would or wouldn't cover.

I've had pain meds withheld, and I'm the perfect white male that should get everything. I might have assumed care providers tend to think addiction issues with other people more than others.

My profession has come a long way. Someone with fucked up points of view on race joined my team a while ago. They got sorted out real fast. I saw and experienced that those ideas wouldn't be tolerated at all. Instantly shutdown.

I suppose that's not the case everywhere.

[–] Enk1@lemmy.world 1 points 10 months ago (1 children)

Everyone is required to have insurance in the US or they face a tax penalty. The ACA was so hamstrung by GOP pols that all it actually did was force Americans to buy insurance with low premiums but absurdly high deductibles, copays, and out-of-pocket costs. For many Americans, their health insurance exists only for catastrophic things, because being in debt for a $5000 deductible is a lot better than having $100,000 in medical debt, despite the fact they can't afford the deductible either. Many can't afford preventative healthcare that many of us take for granted, because for them the choice is the $50 copay for a checkup or buying food for their family. Healthcare outcomes for them are abysmally low.

[–] MSgtRedFox@infosec.pub 1 points 10 months ago

This is frustrating. The person that cuts my hair is self employed. They don't have insurance, so medical care other than emergency is basically just toughing it out or calling in favors from their medpro clients.

I'd think most of us are favor of catastrophic dept prevention due to medical emergency, so that was a good start. Still not offording regular visits or getting a prescription for something easily treated is frustrating in a first world nation economy.

As long as you stay super poor and make no effort to fix your situation, you can get Medicaid/care. So we have that going for us...