Healthcare is the organized system of services aimed at improving the health of an individual, treating the sick, and supporting recovery. Sounds important, right? It sounds like something that everyone should have access to, right? Yet the reality of healthcare in the United States is a different story. Access to healthcare is a common struggle for millions of Americans, particularly those of communities of color. This unequal access is known as a disparity, an unfair difference in treatment/access to a resource.
Health disparities include differences in health outcomes between distinct groups, access to healthcare, and the quality of healthcare. In short, health disparities lead to some groups being less healthy or having shorter life expectancies, not because of chance, but because of unequal opportunities. Unfortunately, health disparities drastically impact people of color compared to their white counterparts. However, this is not due to individual shortcomings. Health disparities have been ingrained in the American healthcare system over generations of systemic inequality and racist ideologies. Racism, discrimination and discriminatory legislation, poverty, and the neglect of communities with higher populations of people of color have created barriers that are virtually indestructible and impossible to overcome.
For hundreds of years, healthcare in the United States has discriminated against its citizens on the basis of race. Newly emancipated black citizens in the post-Civil War era were dying at disproportionate rates as compared to white citizens as the smallpox virus ran through the country. This is not due to biological disadvantages, but rather the mistreatment of blackAmericans. As doctors recognized the ways in which poor sanitation and poor nutrition made people more susceptible to illness, they neglected to help black communities that were suffering from smallpox outbreaks and left them to experience excessive rates of infection (Interlandi, 2019). This is just one of the many instances throughout the history of the country where black people suffered through racial disparities in the healthcare system.
As the American healthcare system was constructed, federal health care plans were put forth to improve public health outcomes. However, this federal system was designed to exclude black Americans. Black Americans were often denied jobs that offered healthcare coverage and were unable to afford it. Even if they were able to afford it, health care facilities were segregated, leading them to suffer shorter and sicker lives than white citizens. These white facilities were well funded and rich in resources, while any black health facilities had to provide fund-raising of their own, leading to less successful facilities, thus perpetuating health disparities.
In 2010, the Affordable Care Act sought to provide health insurance to disadvantaged groups through an expansion of Medicaid, a system that worked to provide healthcare coverage. Despite the proposed expansions in 2010, many states, particularly those from the former Confederacy, refused to expand. Some states who accepted the expansion enforced work requirements in order to be eligible for coverage, thus continuing to discriminate against black citizens who are oftentimes disfavored in the workforce. A never-ending cycle of disparities built on top of disparities.
Racial disparities in the healthcare system are not the fault of the deprived individuals, but rather fall on the systems, institutions, and historical injustices that continue to define people’s health opportunities. Unequal housing, education, employment, and racism plague the country that has been built off of the backs of the marginalized groups that have systemically struggled. Healthcare must be reimagined and reframed as a right, not a privilege. But how do we do this when those in power are not the ones suffering? How do we get them to hear our call to action? Will those leading the country continue to laugh all the way to the bank, or will they finally begin to find a solution to a problem that never should have formed. If healthcare ought to be reframed as a right, not a privilege, how may we begin to reshape the very system that has failed so many?