Racism In Medicine

Racism In Medicine

Evie Plumb ·
dr sesay

“Talks with Dr. Sesay” is driven by the desire to promote healthier lifestyles and provide a better understanding of common medical conditions within the community. Our health talks were created to educate, enlighten, empower and hopefully save lives.”

Lets Process The Facts 

Cancer and ethnicity:

o   Black ethnic group have higher rates of myeloma and stomach cancer. Black males have higher rates of prostate cancer than their White counterparts.

o   Liver cancer is higher amongst people from the Asian ethnic group compared with the White ethnic group, as are mouth and cervical cancer in women.

o   Black women were more likely to be diagnosed at a late stage of breast cancer compared with White women.

o   Those in Black ethnic group were also more likely to be diagnosed with colorectal and lung cancer at late stage compared with other ethnic groups.

Infant mortality and ethnicity:

o   In 2014, the Pakistani, Black African and Black Caribbean ethnic groups, and those whose ethnic group was not stated, had significantly higher rates of infant mortality than England as a whole while White Other and White British had lower rates.

Maternal mortality and ethnicity:

o   MMBRACE report Maternal death rates were almost four times higher for women from Black ethnic backgrounds (a slight improvement from five times based on the previous report) and almost two times higher for women from Asian ethnic backgrounds, compared to white women.

o   A common theme reported by Black women is that they often feel as though they are not taken seriously/often not believed/dismissed when they report concerns about symptoms:

o   An example of this occurred to Serena Williams one day after giving birth to her daughter via Caesarean section, she developed worsening shortness of breath and because she was aware of her previous history of pulmonary embolism (blood clot in her lung), she immediately asked to have a CT scan performed and to have treatment right away but she explained that she wasn’t listened to initially as “the nurse thought her pain medicine might be making her confused”. Despite her requests, the doctors performed a doppler scan on her legs first which was normal and eventually after much insistence, they finally performed a CT scan which revealed several small blood clots in her lungs. If someone like her who is renowned and famous wasn’t initially listened to, what luck does your everyday Jo have?

Covid 19 deaths and ethnicity:

o   According to Office of National Statistics: males and females of Black and South Asian ethnic background were shown to have increased risks of death involving COVID-19 compared with those of White ethnic background.

o   Males of Black African background had the highest rate of death involving COVID-19: 2.7 times higher than males of White background

o   Females of Black Caribbean ethnic background had the highest rate of death involving COVID-19, 2.0 times higher than females of White ethnic background

In response to these disparities initially highlighted around Covid-19 deaths in minority ethnics, a paper released by ‘The Health Foundation’ in May 2020 called “Emerging findings on the impact of COVID-19 on black and minority ethnic people” states:

Experts in the field point to racism as a ‘fundamental cause’, affecting health in multiple ways. A strong evidence base has demonstrated that racial discrimination affects people’s life chances through, for example, restricting access to education and employment opportunities. Black and minority ethnic groups tend to have poorer socioeconomic circumstances, which lead to poorer health outcomes. In addition, the stress associated with being discriminated against based on race/ethnicity directly affects mental and physical health through physiological pathways.”

Breaking down this statement:

o   When talking about employment opportunities:

o   A study by experts based at the Centre for Social Investigation at Nuffield College, University of Oxford, stated that applicants from minority ethnic backgrounds had to apply 80% more times to get a positive response from an employer compared to a white person of British origin.

o   According to the Trades Union Congress, Black, Asian and minority ethnic workers were much more likely (2x) than white workers to be in insecure jobs such as zero-hours contracts.

o   When talking about stress: It is known to be associated with mental health disorders – depression, anxiety; raised blood pressure, cardiovascular problems etc. So repetitive stress from exposure to racism can have an impact in this way 

It’s also been said that racial discrimination is recognised as a key social determinant of health and driver of racial/ethnic health inequities. There have been studies, which show that people exposed to racism have poorer health outcomes (particularly for mental health), alongside both reduced access to health care and poorer patient experiences.

What Can We Do With This Info?

o  Recognise and acknowledge the existence of this very real issue.
o  Raise awareness about the matter so we can hopefully:
o  Reduce the prevalence of its occurrence
o  Arrange further investigations and assessments to ascertain how we can tackle this
o  Set up systems in place and further training for staff and health care providers.
o  It all starts with us – we can make a change if we all worked together to stop the disparities.

References

  1. Public Health England: “Local action on health inequalities Understanding and reducing ethnic inequalities in health” published August 2018
  2. Office of National Statistics: “Updating ethnic contrasts in deaths involving the coronavirus (COVID-19), England and Wales: deaths occurring 2 March to 28 July 2020”
  3. MBRRACE-UK: Saving Lives, Improving Mothers’ Care 2020: Lessons to inform maternity care from the UK and Ireland Confidential Enquiries in Maternal Death and Morbidity 2016-18
  4. The Health Foundation: “Emerging findings on the impact of COVID-19 on black and minority ethnic people” May 2020 
  5. Trades union congress: “BME workers far more likely to be trapped in insecure work” Apr 2019
  6. The impact of racism on the future health of adults: protocol for a prospective cohort study. March 2019
  7. The Guardian article “Minority ethnic Britons face ‘shocking’ job discrimination” 2018

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