Black communities face profound inequities in healthcare access, treatment, and outcomes—a reality rooted in systemic racism that has persisted for generations. Although deeply complex and entrenched, we cannot afford to accept these disparities as inevitable. Through intentional practice, innovative solutions, and collective action, the healthcare sector can dismantle these inequities and build a system that uplifts individuals of all races.
This blog will explore the challenges systemic racism poses to Black communities in healthcare, shed light on courageous progress being made, and propose actionable pathways to ensure equitable health outcomes. Whether you’re a healthcare professional, social activist, or public health advocate, this discussion provides valuable insights and strategies for driving meaningful change.
What Is Anti-Black Racism in Healthcare?
Systemic racism in healthcare refers to the cumulative and consistent racial inequities perpetuated through policies, practices, and prejudices. Anti-Black racism specifically describes the oppression and marginalization targeting Black individuals and communities, leading to stark disparities in health outcomes.
Black patients often experience discrimination at multiple points along their healthcare journeys, from scheduling appointments to receiving appropriate diagnoses and treatments. Studies show that Black people encounter implicit bias among healthcare providers, substandard care, and misdiagnosed or ignored symptoms (Hall et al., 2015; Maina et al., 2017; Fitzgerald & Hurst, 2017). These inequities are not rooted in isolated incidents but rather structural issues embedded within the healthcare system itself.
The Consequences of Systemic Racism in Healthcare
Inequitable Access to Care
Black communities often face geographic and economic barriers to accessing healthcare (Mullins et al., 2005). A lack of culturally competent providers, clinics in underserved areas, and affordable options widens the gap between Black patients and the timely, quality care they deserve (Richard-Davis, 2021; Davidson, 2012; Nadeem & Kaiser, 2022).
Disparities in Health Outcomes
Systemic racism directly contributes to disparities in chronic disease prevalence, maternal mortality, and mortality rates among Black populations (Mullins et al., 2005; Balan et al., 2022).
For example:
- Maternal Mortality: Black women in Canada are significantly more likely to die during pregnancy or childbirth than their white counterparts, a statistic linked to systemic neglect of Black women’s pain and concerns (Alphonsus et al., 2024; Tucker et al., 2007; Boakye & Prendergast, 2024; Boakye et al., 2023).
- Chronic Illness: Black Canadians experience disproportionately high rates of hypertension and diabetes, exacerbated by socioeconomic inequities and reduced access to preventative care (Mullins et al., 2005; Balan et al., 2022).
Loss of Trust in Medical Institutions
Historical injustices, such as unethical medical experiments targeting Black individuals and present-day discrimination, have eroded trust in healthcare systems. Many Black patients delay seeking care due to fears of bias or mistreatment, which can exacerbate health conditions (Hall et al., 2015; Penner et al., 2014).
Stories of Resilience and Progress
Despite these long-standing challenges, Black communities and allies have made strides toward healthcare equity.
- Representation in Healthcare Professions: Organizations like Black Physicians of Canada are working to increase racial diversity among healthcare professionals. Representation ensures more inclusive, empathetic care while inspiring future generations to pursue medical careers.
- Community-Based Interventions: Programs like Black-led mental health initiatives prioritize culturally competent care and destigmatize seeking help within Black communities.
- Anti-Racism Training: Public and private health institutions increasingly implement mandatory training aimed at identifying and reducing bias in clinical settings. This promotes more equitable and compassionate patient interactions.
How to Foster Equity in Healthcare
Achieving equity in healthcare requires tackling systemic issues while enhancing providers, patients, and communities alike. These six steps outline actionable pathways to change.
1. Advocate for Culturally Competent Training
Healthcare professionals must engage in ongoing anti-racism education to understand the impact of implicit bias and institutional discrimination. Virtual reality simulations (Fronk, 2024) and participatory workshops provide effective, interactive ways to foster empathy and reduce prejudice.
2. Increase Accessibility to Clinics
Closing the geographic gap involves bringing healthcare services to historically underserved Black communities. This includes opening clinics in marginalized neighbourhoods and incentivizing telemedicine services to overcome transportation obstacles.
3. Diversify Hiring Practices
Representation matters. Increasing the number of Black professionals in healthcare—from nurses to policymakers—creates a more inclusive and responsive environment for Black patients.
4. Support Community-Based Research
Community-based participatory research (CBPR) ensures that Black voices are central to developing health interventions designed to meet their unique needs. Building trust and fostering collaboration with community leaders is a key strategy for long-term impact.
5. Address Social Determinants of Health
Healthcare equity cannot be separated from broader social inequities. Policies that support affordable housing, access to nutritious food, and education are critical to improving health outcomes within Black communities.
6. Build Trust Through Transparency
To rebuild relationships with Black communities, healthcare organizations must acknowledge historical injustices, engage openly about efforts to address inequities and ensure accountability for measurable progress.
Black History Month and the Urgency of Year-Round Commitment
Black History Month offers a moment to reflect on the immense contributions of Black communities to our society—while also confronting the systemic inequities that persist. Within healthcare, it serves as a valuable opportunity to amplify the voices of Black patients, providers, and advocates. However, committing to healthcare equity cannot be relegated to February alone. Progress demands ongoing attention and action, 365 days a year.
Driving Change, Together
The fight against anti-Black racism in healthcare is not a sprint; it is a marathon that requires every individual within the system to step up. Whether you’re a frontline provider, public health leader, or advocate for equity, know that your efforts matter.
Through education, policy reform, and unwavering commitment, we can transform power in healthcare into a system truly rooted in justice and compassion.
Start with Us
At DiversityTalk, we’re dedicated to advancing healthcare equity through education, innovation, and community collaboration. Explore our free resources or join our community of change-makers taking action for a more equitable future.
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References
- Hall, W.J., Chapman, M.V., Lee, K.M., Merino, Y., Thomas, T.W., Payne, B.K., Eng, E., Day, S., & Coyne-Beasley, T. (2015). Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review. American journal of public health, 105 12, 2588.
- Maina, I., Belton, T.D., Ginzberg, S.P., Singh, A., & Johnson, T.J. (2017). A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. Social science & medicine, 199, 219-229 .
- FitzGerald, C., Hurst, S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics 18, 19 (2017). https://doi.org/10.1186/s12910-017-0179-8
- Davidson, C.M. (2012). My Aging Minority Rural Grandparents: Disparities in the Health and Health Care of the Rural Elderly Minority Population and the Need for Culturally Competent Health Care Providers. Elder Law Studies eJournal.
- Nadeem, M.F., & Kaiser, L.R. (2022). Disparities in Health Care Delivery Systems. Thoracic surgery clinics, 32 1, 13-21 .
- Penner, L. A., Blair, I. V., Albrecht, T. L., & Dovidio, J. F. (2014). Reducing Racial Health Care Disparities: A Social Psychological Analysis. Policy insights from the behavioral and brain sciences, 1(1), 204–212. https://doi.org/10.1177/2372732214548430
- Fronk, A.E. (2024). The Looking Glass Framework: Using Virtual Reality and Video Game Simulations to Improve Clinical Decision-Making and Reduce Healthcare Disparities in African Americans. Journal of Health and Human Services Administration.
