Introduction
Unfortunately, African Americans face health problems very often. From poverty to structural racism, many issues require government attention and immediate resolution as human life is at stake. This paper will focus on structural racism – its history, causes, consequences, and possible solutions to this problem. Finding structural racism and inequalities in physical ability is essential to ensure that health care is accessible to all. To achieve equality in health, everyone must have an equal opportunity to reach their full physical potential. Racial equality in health care means that no one is hindered from achieving any health care service and fulfilling their physical potential.
It is worth noting that structural racism extends not only to patients who cannot receive medical care for unfair reasons but also to doctors within the health care system. The topic does not leave anyone indifferent and causes quite violent reactions in society. In addition, the problem undermines the fundamental values of the health system, human rights, and cultural diversity.
History
Understanding the reasons that led to structural racism today will help better understand the problem to tackle it at the root. Many researchers are now focusing on finding solutions to problems and building systems that mainly deal with the symptoms of the problem rather than its source (Hicken et al., 2021). Frequently, people may not be aware of or reflect on deeply rooted values, the beliefs they hold, and how they affect behavior and decision-making. People in power have always tended to limit the possibilities of the weaker. In this regard, critical thinking is a necessary component of understanding the essence and roots of the problem.
With the help of critical thinking, first, it is necessary to identify in each situation the victim of structural racism and who benefits from the event. A deep study of the motives of the specified person will allow understanding the reasons that led him to such behavior. In addition, many scientists propose an approach based primarily on non-empirical and empirical studies of environmental inequality (Hicken et al., 2021). This method involves changing views on the concepts of cultural and structural racism, linking with historical events, and identifying the implicit use of economic violence against victims of racism.
In addition, there is a basis for studying the historical aspects of the problem. Socioecological psychology does not pay enough attention to the problem of structural racism (Trawalter, 2020). The historical background can help to examine individual psychological biases in the use of force in government structures – police and health care. In addition, trauma resulting from racial injustice has been shown to profoundly affect the mental health of African Americans (Shim, 2021).
Receiving highly qualified assistance in this area is also complicated by various issues. First, there is still a misconception in many healthcare settings that racial groups are biologically and genetically different, and therefore drug use is uneven. This biological determinism is a false belief, just like cultural determinism. In the second case, it is assumed that differences in racial groups result from purely cultural factors. The consequences of social injustice and structural racism are misunderstood by these approaches, while social and economic factors are not considered.
Finally, older history shows that racism has been a perverse feature of America for quite some time. Structural racism does not have a universally accepted concept and a single definition. Historically, racism has grown into one of the most critical social problems of the state. A critical assessment concludes that racism is not a private prejudice of a group of unfriendly people. Racism has also historically originated and reproduced in laws, regulations, and practices, is sanctioned and even implemented at various levels of government, and is embedded in the economic system as well as cultural and social norms (Bailey, 2021).
Therefore, the fight against it should be carried out at all levels, not only where symptoms appear. Increasingly, US citizens begin to engage in active social activities to draw the attention of the authorities to this problem, but only with consent and cooperation is it possible to take significant steps.
Reasons and Determinants
Structural racism in health care is usually attributed to social and economic factors. The vicious circle of inability to obtain solid social status for African Americans has consequences in the form of discrimination in education and medicine (Churchwell et al., 2020). Although most health care providers have a record in their code of conduct for equality in admission, regardless of race, gender, social status, age, and cultural differences, the problem persists.
Unfortunately, a certain percentage of African Americans live in poverty, making it impossible for them to receive qualified medical care. However, even if such an opportunity arises, its quality does not always correspond to high qualifications. Discrimination based on financial opportunities is another area of racism, but it is precisely in this combination of areas of disrespect (based on race, culture, and more) that is the reason for the formation of a general problem of federal scope (Churchwell et al., 2020). Structural racism takes place in health care and education, housing, and other areas, but it is in medicine that the cost of such discrimination is exceptionally high.
Social determinants of health are considered significant drivers of health inequities and inequities in society, and racism is firmly established as a social determinant of health. Research consistently highlights the poor health performance of blacks and other communities of color compared to whites in different settings (Shim, 2020). This type of structural racism extends to education in medicine and is one of the key ones in this problem.
Education before medical practice forms a person not only in her professional plan. Education also lays down culture, allows a person to develop his civic position, to look critically at many values. Since structural racism can manifest itself at this stage, it affects the behavior of graduating students. Such cases, without visual indication, can be perceived as the norm and then extrapolated to practice already in natural conditions. As stated in the section above, it is necessary to find the root of the problem and not just solve symptomatic problems.
Finally, the above social and economic problems have been exacerbated by the COVID-19 pandemic, which has revealed all the weaknesses in the health care structure. First, difficulties in the economy increased, there were not enough places in hospitals for all those in need, which required action on the part of the authorities. Second, a shortage of specialists has exposed severe gaps in the healthcare system, even though the United States spends vast amounts of money on it every year.
This situation required the authorities to make bold and financial decisions, which only in the future will turn out to be either correct or not. Because of this legacy, public health emergencies such as the COVID-19 pandemic disproportionately affect communities of color, exacerbated by high rates of pre-existing chronic diseases such as obesity (Bleich & Ard, 2021). While short-term measures in the form of certain payments to those in need are necessary, the authorities need to seize the moment to make long-term decisions. A policy change is urgently needed because of this problem, but adjusting to eradicate the factors leading to structural racism will also be an essential step towards an equal society.
This policy may include removing barriers for the poor, providing them with more opportunities to find work, and clarifying the root causes of unemployment. In addition, special attention should be paid to education in medicine, where, as mentioned above, incorrect approaches and understandings to this problem can be formed. Otherwise, the consequences can lead to an implicit racial bias that even children can suffer from it.
This bias is another source of inequality in health care. Research shows that African American patients suffer from inappropriate prescription drugs that they cannot get without a doctor’s prescription. Moreover, even in the basics of patient care, expressions of concern and concern were significantly less racial (Johnson, 2020). Similar behavior is observed among pediatricians about children, as evidenced by statistics: even healthy colored children have a higher mortality rate than whites (Johnson, 2020). These problems require strengthening measures to control such behavior, as well as creating alternatives for African Americans, which often do not exist for various economic reasons.
Possible Solutions
As stated above, the authorities need to seize the opportunity for radical change due to the COVID-19 pandemic. First of all, quick symptomatic solutions were required to provide hospital beds to those in need and develop a vaccine. However, a field has also emerged for solving long-standing problems in the health care system. Changing policies that have long supported structural racism would be an essential first step on the part of the authorities to meet their people. Naturally, this process must be accompanied by various control systems and constant assessments, especially civil ones.
Moreover, there is a need to develop cross-sectoral partnerships. Collaboration between sectors, especially critical sectors, allows industries to participate at the federal level, allowing for clearer funding and development planning. The general idea of tolerance and the elimination of discrimination will allow not only to learn from the experience of other sectors but also to carry out standard programs under a single auspice, capture a large part of society and unite them by their example. Finding the obstacles and roots of the problem of structural racism together is more likely to succeed than working alone.
The next possible solution is also a policy change but aimed at taking advantage of new economic opportunities. The pandemic has shocked supply and demand across many industries. Many people lost their jobs, were at a high risk of infection due to the inappropriate measures introduced. All these determinants do not favor economic growth, but now the state needs its people more than ever. This situation provides an opportunity to remove barriers for the poor, providing them with jobs and, as a result, education and medicine. Urban areas and more remote areas will be able to find a vocation right on their territory. Such actions by the authorities will not only able to improve the economic situation in the country in the future but also suppress various moods in society, leading to demonstrations, riots, and a large crowd of people during a pandemic.
Moreover, public programs, as a result of the activities of the most active citizens of society, will also contribute to the common cause. These programs are designed to provide regions with access to food, health care, safety, and well-being services. Funding for community-based programs should support structural interventions that build resilience and change the structural context of health rather than reduce social risk (Johnson, 2020). Only recently have states mustered the courage to develop a statement and admit that racism is indeed a health crisis (Krieger, 2020). Recognition is only the first step towards an equal society, and community programs funded at more local levels will help combat structural racism in a more targeted way.
However, point wrestling already has a more symptomatic character, which is also necessary for conditions of a neglected problem. There are so-called vulnerable communities in which the activities of the state should be aimed at building trusting relationships. Mistrust in the health care system is not limited to people of color. Unethical experiments, stories of abuse, however, are much more often used in the context of structural racism.
Expanding resources and providing access to such medical services at the federal level should be considered ongoing since giving the opportunity only during the national crisis of the COVID-19 pandemic is not a manifestation of trust. The health system must not only meet halfway in a problematic situation but allow speaking out to everyone, without exception, with particular attention to communities of color.
Finally, some social risk factors require immediate intervention and are already a complete fight against the symptoms of the problem. Combining individual-level interventions with community-based efforts can build resilience and mitigate worsening behavior over time (Johnson, 2020). Although it will be economically challenging for the state to build such a system, the continuation of the injustice looks even more inhuman outcome. In times of crisis, the situation is difficult for everyone without exception, especially given the global nature of the problems, therefore only agreement and cooperation can lead to positive changes in the dynamics of this problem.
Conclusion
Structural racism in health care is a problem with historical roots and extends far beyond the health sector. Social and economic factors are the determinants of this problem, which the COVID-19 pandemic has exacerbated. One of the most critical areas where it is necessary to deal with this ailment is medical education, which contributes to forming the personality of the future nurse or medical practitioner. Poverty is also a significant problem in this regard.
Its solutions lie in the plane of cooperation between state authorities and citizens of society. Consensus between authorities and people and their constant communication will identify the root causes of the problem and provide a platform to tackle it. The pandemic has created the need for radical policy changes, which must be used to restore order in health care structures. The human approach must be translated not only by the active civic position of citizens and victims of structural racism but also by amending laws, standards, and legally binding codes.
References
Bailey, Z. D., Feldman, J. M., & Bassett, M. T. (2021). How structural racism works—racist policies as a root cause of US racial health inequities. The New England Journal of Medicine, 384, 768-773.
Bleich, S. N., & Ard, J. D. (2021). COVID-19, obesity, and structural racism: Understanding the past and identifying solutions for the future. Cell Metabolism, 33(2), 234-241.
Churchwell, K., Elkind, M. S., Benjamin, R. M., Carson, A. P., Chang, E. K., Lawrence, W. & American Heart Association. (2020). Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association. Circulation, 142(24), e454-e468.
Hicken, M. T., Miles, L., Haile, S., & Esposito, M. (2021). Linking History to Contemporary State-Sanctioned Slow Violence through Cultural and Structural Racism. The ANNALS of the American Academy of Political and Social Science, 694(1), 48-58.
Johnson, T. J. (2020). Intersection of bias, structural racism, and social determinants with health care inequities. Pediatrics, 146(2).
Krieger, N. (2020). Enough: COVID-19, structural racism, police brutality, plutocracy, climate change—and time for health justice, democratic governance, and an equitable, sustainable future. American Journal of Public Health, 110(11), 1620-1623.
Shim, R. S. (2020). Dismantling structural racism in academic medicine: a skeptical optimism. Academic Medicine, 95(12), 1793-1795.
Shim, R. S. (2021). Dismantling structural racism in psychiatry: a path to mental health equity. American Journal of Psychiatry, 178(7), 592-598.
Trawalter, S., Bart-Plange, D. J., & Hoffman, K. M. (2020). A socioecological psychology of racism: making structures and history more visible. Current Opinion in Psychology, 32, 47-51.