USA is the only developed country where your right to health care depends on your job.
Makes sense that children in poorer families would get worse care.
this post was submitted on 18 Jan 2024
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While income is part of it, racism is also a contributor. From the article:
The researchers looked only at studies that included children who had health insurance, "so we cannot blame the lack of insurance for causing these disparities," Heard-Garris says.
Important point.
Also Important to note that most racism is either systemic or acted out subconsciously. It's not that the providers are being deliberately racist. They don't consciously treat these kids differently; it's a subconscious act. We can say "I'm not racist" all day long, but that's not going to change things. Racism is the default in our system, and it takes a deliberate act not to be racist.
I know all this, and I'm from Bumfuck, Nowhere. Some people in these threads need to go to their local community college and enroll in a human relations class asap.
…why are you assuming that all non-white kids are poor? It said across the board, non-white kids of every race had worse health care.
I didn’t say that, but you can’t deny linking health care with employment disproportionately hurts minorities.
And to account for that, all the children they studied had insurance.
How comparable are US health insurances? Like does everyone offer the same deals or would say white tech bros be getting a more comprehensive plan than a black factory worker?
More and more workers are being pushed onto high-deductible plans that are cheaper for the employer but pushes risk onto the employee.
Most US bankruptcies over medical debt are from people who had health insurance.
And there's a million reasons why no other developed country is interested in imitating the US healthcare insurance system. Awful system.
Can someone share personal experiences?
Insert my physical appearance here, but I've met any health care professionals who cared about a person's race. I don't mean that cared for me, I know a bunch of providers personally.
They did however have plenty of stories of people treating them like shit or like a waitress at a restaurant.
A fair question, but fwiw, racism is typically inherent in the system rather than the individuals. i.e., for one thing it correlates with poverty, while for another there tend to be aspects of race that transcend that. Admittedly, I did not chase down reading the underlying study - it wanted payment for individual access to this article - but even if it did not go so far as to adjust for correlations of underlying factors like income level (which, notably, it should have been rejected from any even halfway respectable peer-reviewed journal if it did not), hospitals in primarily-black areas tend to be those that can offer poorer quality of care, and even at the same care facilities, black people often report differences in how they are treated (not all you understand, but many - and yes, sometimes it happens literally only when people are not around to verify it, as in some people are highly friendly when watched but FAR less so when not; plus there is a marked difference b/t "politeness" vs. "friendliness"). In short, just bc you do not see it as a non-POC does not mean that it does not exist. Kudos for asking for a dialog though to broaden your perspectives - I upvoted to in case that helps someone see it who can respond with a more personal story. Indeed, Truth is often quite complex and difficult to pin down correctly - e.g. what if hospitals in primarily city areas were busier and offered lower quality-of-care than those in rural areas, regardless of race? But if you keep an open mind, you will most definitely see it happen, I guarantee it (not that you should trust me, just that if you are really open to seeking, then you will eventually find what you are looking for).
Is it a fair question? Does a perceived lack of personal anecdotes have any bearing whatsoever on:
The review found children of color are less likely to get diagnostic imaging and more likely to experience complications during and after some surgical procedures.
"I'm just asking questions here!" Bullshit.
I understand you're making the same point. Just...reiterating, I guess.
Honestly I have no idea - it depends on the user, and I cannot see inside their head. Even they themselves have limited knowledge of their own conscious thought processes, and might not be able to answer that fully. I am far from the only respondent who cannot fully tell whether they are being genuine or not - and again even they might not know. Also, does it matter, really?
But let me bump the question back to you: why is it wrong to ask questions? No, I do not mean bowtie-wearing-freak style - I am 100% with you there - but if they had legitimately meant to ask, why would that be wrong? Did you mean to suggest that perhaps this is not the right forum for that - a news community rather than a ELI5 or AskLemmy one? Yeah sure they should do their research, but one means of doing that is to ask so... this might legitimately BE that process happening?
And as for the study, I myself legit clicked through to try to read it, but could not, being stymied by a paywall. Because of that, arguably this OP was more of an "advertisement" than a fact-bearing post, b/c while the clickbait title got me to click it, I got very little in terms of full-on "factual information" from trying to read it. Admittedly it did read in the style of "these researchers are trust-worthy", but that could be part of the scam, to get more clicks? Anyway, I am not outright accusing them of anything, just saying that the answer is less of a "firm yes" nor a "firm no" as you seem to be suggesting, it is much more gray, especially to someone not used to reading primary research materials (as I imagine the person I responded to might be?).
As for the claim of "Bullshit"... maybe, I cannot deny that. It did read like a sea-lioning comment... but anyway I am explaining that I chose to give it the benefit of the doubt. And you explained clearly that you were not willing to. That is your right, I suppose. So be the change that you want to see in the world... and block them? :-P
Well said, I appreciate your wisdom. And yes, was legit asking for perspective.
It's pretty cool when we can get ideas and perspectives from all over the world from people in these Internet services, it's just hard to interpret people's intent sometimes.
I've done that from one site to another - before Lemmy, Reddit, and before that FaceBook - and yeah Lemmy is by far the best one that I have seen.
You brought an excellent counter-point too, that severely complicates the issues. It is something that e.g. black police officers struggle with on a daily basis as they police mostly black neighborhoods: should they NOT do this or that action, b/c of fear of "profiling" someone, even/especially if they are literally acting suspiciously? And sadly, much of the "tough guy/gal" culture brings things upon itself. So is the demeanor of the person asking a contributing factor? Then again, white people (especially older ones) can say the absolute meanist shit imaginable, yet they often get a free pass?
In this case, not so much health care professionals but rather the pencil-pushing administrators may be the ones doing the actual denying of care, likely due to financial reasons - poorer health care facilities, in poorer neighborhoods, just treat poor people like they are... I dunno, poor? And sometimes they happen to be black, go figure, it's almost like those two things are sometimes related, and therefore show up in any study that does not properly distinguish between the varying factors. Any such correlation-based study will have such issues with it. And while actual attempts at causation studies can be done in other areas - e.g. swap resumes and switch a man's name to a woman's, or a white-sounding one with a black-sounding one, and see if that change impacts the decision (you might be surprised at how often it does, I've literally sat in on phone calls where someone "axed" for a particular person by name, only to be told that there is no such person at that office, then rather than ask for clarification in case of a pronunciation issue we were hung up on instantly, so we called back mere seconds later and this time I was the one who "asked" - notice my own pronunciation there? - and we were put through immediately), with healthcare you can't (ethically) fake an illness, diagnosis, or treatment plan, so we are back to correlation studies as the only things that can illuminate the situation.
And supposedly there is something more to it than merely poverty, where black people report being "believed" less often when they say that they are in great pain - particularly women. Whatever the complex set of underlying reasons entails, I have no idea, but it strains credulity to think that racism is not somewhere in the heart of it all. I liken it to the "me too" movement, where women report being groped and sexually abused in all manner of ways (sometimes literally raped) but men who have not seen it happen first-hand do not wish to believe those horror stories, especially about their buddies who even if they engage in "locker talk", SURELY would not do something like THAT!? So until you see it happen with your own eyes, or else just choose to believe those who you know well and are relating their stories to you, you won't know, not REALLY. Those buddies don't show that side of their personality with you, which is probably a good thing, b/c they realize that you do not share that aspect with them.
Anyway, based on everything else that I have seen and heard over the years, I have no trouble at all believing these claims, though in this particular type of scenario I have no direct or even indirect experiences, only stories I have heard from people I do not know first-hand. Though there are a LOT of such stories, some conducted by the utmost authority sources including the DOJ, and they tell a pretty damning trend that racism is alive and well in certain parts of the country. I used to question that too but... yeah, it's real.
Here's a fun video covering a related topic, in case you are interested: https://www.youtube.com/watch?v=-v0XiUQlRLw
I don’t think people would necessarily know that they’re experiencing discrimination. And people might not realize that they are treating folks unequally.
You can know you’re in pain and that the medication that you’ve been given isn’t eliminating all of the pain. But you don’t know why. Are you being given the maximum reasonable dose or is it because the doctor doesn’t believe you when you say you’re in pain? Or is it because the neighborhood you’re in (which is still influenced by decades of systemic racism) has had a history of more patients with drug seeking behavior? Maybe the ER in your neighborhood has longer wait times due to some unknown corporate policies or accounting that impacts staffing? How would you know? It’s not like you’re checking out all the ERs all the time and leaving Yelp reviews. Or maybe the person doing triage makes a split second judgment that you seem to be in less pain than someone else and are therefore lower priority?
All that said, I did actually have a racist dentist once. IDK if it had any real impact on the quality of my care (it’s not like I’m a dentist and can assess whether a filling should have been a crown or something).
How did I know? Well,ll I didn’t know at 1st. The receptionist was the dentist’s mother and she was super old. She would always be checking and double checking that I understood that I would be billed if the insurance didn’t pay and that I understood how much things could cost. And this wasn’t just once in a while, it was every damn time I came in. As a fairly well paid engineer with good insurance, this seemed really weird. My white husband had the same dentist and when I told him about this he was like “What? Dr X’s mom is just as sweet as pie.” She never asked him how he would pay for things even though he was on MY damn insurance! So we went on with me thinking the dentist’s mother was racist and my husband thinking that I was imagining things. And then one day, my husband was in the chair with a sports magazine from the waiting room. The cover had some large athlete, looking intimidating. It may have been someone who got physical with someone? I don’t remember, I’m not sporty. Anyway Dr. X says to my husband “Can you imagine having that gorilla coming at you”?. This was decades ago but my husband learned a valuable lesson that day.
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.
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.
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.
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.
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.
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.
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...
There have been studies that indicate that people who are not exposed to varieties of people constantly tend to not recognize faces and/or facial expressions on other races.
There are also studies that indicate that white patients are more likely to be prescribed painkillers when they're in pain, whereas black patients are more likely to be thought of as exaggerating.
I've had instances where I, as a white person, got immediate access to great medications. My black coworker, same illness around the same time, was told to take Sudafed and other OTCs.
The numbers also don't lie. Maternity mortality is higher for non-white patients. Surgical outcomes tend to be poorer. Follow care tends to be less stringent. It's across the board.
On one hand, there are some systemic things that can explain this. Drug interactions are kind of presumed to be identical for all races when you control for race, but that may not be the case - we may just be averaging out to a measure that is no longer useful. So biological differences, ability of the doctor to identify pain/issues, willingness to believe the patient, and all sorts of other things play in just as much if not more than overt racism.
Big surprise here.
In other breaking news: Racism is still a thing in America.