The Effects of Discriminatory Practice in Health Care Services

Speaking at a 1966 national human rights convention, Martin Luther King, Jr. once declared, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane." Following years of health care inequality, Title VI of the 1964 Civil Rights Act barred discrimination in the use of all federal funds, including health care facilities. Despite legal advances, in practice, discrimination in the health care industry at both institutional and individual levels continues to negatively affect patients.

Lack of Physical Access

• One effect of discriminatory practices in health care services is the lack of physical access to healthy care services that minority and poor populations face. Largely minority communities tend to be medically under-served, as disproportionately few white physicians choose to have their practices in these areas. The shortage of minority physicians, who are most likely to practice in minority communities, further limits minority access to health treatment. As a result of these limitations, minorities may be left with substandard health institutions or with no treatment facilities at all.

Treatment Inequality

• Barriers to proper health treatment are not always a matter of physical distance from treatment facilities. When minorities are physically able to access treatment, inequities in the quality of treatment and preventive care abound. For example, University of Dayton law professor Vernellia R. Randall found that though African-Americans are more likely to require health services than other groups, they are less likely to receive them. Similarly, language and cultural barriers may affect the care received by Hispanic and Asian patients. This inequality in treatment has been documented in a variety of studies done on pain treatment, cardiology, organ transportation and a host of other diseases. Similar studies have found inequities between the treatment of White and minority patients, even when controlling for insurance, education and income. Doctors tend to be less aggressive when treating minority patients and marked differences exist between quality and quantity of care.

Reduced Use of Health Services

• Feelings of discrimination may make patients less likely to seek needed treatment, with possibly grave consequences. Black patients, for example, experience excess mortality rates for common health conditions. A study of the RAND research organization found that, when compared to Whites, minorities were significantly more likely to report being looked down upon or treated with disrespect. As a result, they were much less likely to receive optimal chronic disease screening and follow their doctor's advice and were more likely to delay care.

Lack of Economic Access to Health Care

• According to the Kaiser Commission, more than 46 million Americans are uninsured with no economic access to health care. Poor populations tend to be unemployed or employed in jobs that do not provide health insurance. With typically high stress levels, long hours of physical labor and infrequent consumption of healthy food, these groups face increased health issues, yet are financially unable to afford necessary treatments. With welfare reforms enacted in 1996, those who qualify for Medicaid may not even be aware of their eligibility.

  Economic and racial discrimination may overlap to prevent treatment access. A study on medical transfers to Cook County Hospital found that 89 percent of transfer patients were of African-American and Hispanic descent. These transfers were typically done for economic reasons and without the patient's consent.