Nearly half of health care workers nationwide have witnessed discrimination against patients, and more than half say
this racism is a "crisis" or "serious problem
," according to a study published Thursday.
The report, published by the Commonwealth Fund and the African American Research Collaborative (
AARC
), reveals that Latino, Black and Asian doctors, nurses, laboratory technicians and other workers were more likely to than their white counterparts to claim that they had witnessed discrimination.
All health care workers agreed that discrimination, whether based on race, ethnicity or language, was a "serious problem," but Latinos, Blacks, Asians and Native Americans were much more likely to notice and report it, and young people even more so. than their older counterparts.
[Racism and discrimination undermine the mental health of young adults]
The report, titled
Inequalities Uncovered: Healthcare Workers' Observations of Discrimination Against Patients
,
is based on the results of a national survey of more than 3,000 healthcare workers.
St. Joseph's Community Campus uses interpreters to help staff speak with Latino patients, like this mother, Giselle Colón, and her daughter, Shaureiddys Reyes-Colon.
MediaNews Group/Reading Eagle vi / MediaNews Group via Getty Images
“This study sheds light on the discrimination and racism observed by health workers and its implications for negative health outcomes in patients in many communities,” said Henry Fernández, general director of the AARC and Telemundo News, in an interview with Noticias Telemundo. lead author of the report.
"Racism is more serious here because it can be lethal,"
Fernández explained.
This study stands out for its low margin of error (1.8%) and the large number of people surveyed throughout the country: different types of healthcare workers, such as doctors, surgeons, nurses, laboratory technicians and assistants, among others.
[Racism can be conscious or unconscious when we “internalize it”]
Where there are more Latinos, there is more discrimination
The study showed that where discrimination is most reported is in centers that receive more Hispanic or black patients.
70% of workers at centers with predominantly black patients and 61% of workers at centers with predominantly Latino patients witnessed discrimination, compared to only 43% of workers at centers with majority patients. whites.
Latino or black workers were also more likely to report discrimination.
"They are more aware," explains Fernández, and have cultural knowledge and life experience that helps them detect attacks that other groups may not perceive.
Health workers also feel discriminated against
While the report focuses on the effects of discrimination on patients, it also examined discrimination felt by healthcare professionals, as well as the role employers play in addressing these issues.
Most Black healthcare workers (58%) and nearly five in 10 Latinos (49%) indicate they have been discriminated against in the workplace because of their race or ethnicity.
44% of health workers say they have observed their colleagues being subjected to racism, but when given examples of possible discrimination that number jumps to 68%, two-thirds.
[23% of older Latinos report discrimination in healthcare]
These examples included negative comments, different employment opportunities, not being given equal time off, not being promoted, being disciplined more harshly, or a patient asking to change doctors based on race or ethnicity.
This applies to the rest of the respondents: when they were given concrete examples of discrimination, they were more able to recognize and report it.
These examples include a patient being given fewer treatment options, being perceived as having less knowledge, not being allowed to ask questions, or, in the case of dark-skinned people, not being given treatment. for the right pain.
"There is a prejudice that black people are more resistant to pain,"
says Fernández.
That, ironically, in past years shielded the African-American population from receiving pain medicine such as opioids, which are more freely prescribed to white people, the main victims of that epidemic for many years.
Discriminated against for not speaking English
Language was also a reason
for Latinos and immigrants to be discriminated against.
More than half of healthcare workers (57%) witnessed discrimination against patients whose first language is not English.
This complicates things for Latino patients, since it is always important to be able to advocate for fair treatment, communicate if there is pain, allergies, or if you are not comfortable with a suggested treatment.
But nearly half (48%) said medical providers are more tolerant when white patients advocate for themselves compared to dark-skinned patients.
"When a darker-skinned patient advocates for themselves, it is perceived as aggressive,"
lamented a black doctor cited in the report.
"Some doctors don't take the time to explain things to the Spanish-speaking population as they should."
latin nurse
"Some doctors don't take the time to explain things to the Spanish-speaking population like they should," one Latina nurse was quoted as saying.
All of this is also, in an ironic and cruel twist, harmful to health: the study also found that discrimination causes stress for just under half (47%) of healthcare workers.
Up to
27% of Latino workers say they are very stressed about discrimination,
and 36% reported some stress.
This is particularly concerning as health centers seek to recruit and retain doctors and other workers at a time of staffing shortages in all fields of health care.
The U.S. Bureau of Labor Statistics projects a nationwide shortfall of about 275,000 nurses by 2030.
For
Afro-Latinos, discrimination can occur on several fronts,
discriminated against because of the color of their skin, their immigration status or for not being fluent in English.
In some regions, such as New York or Philadelphia, they represent a large part of health workers.
Young people offer a ray of hope amid these dismal results.
Only 8% of respondents over 60 said health discrimination was “a crisis,” but that number jumped to 31% for those under 30.
Why the gap?
Fernández believes that it is because younger people have more access to information, "they are more aware," they are receiving more and better training on discrimination, and they grew up with movements like 'Black Lives Matter'
and
the protests against disproportionate police brutality against black and brown communities.
How to solve it?
And while most healthcare workers see positive efforts from employers, most Black, Latino and Asian healthcare professionals
are concerned about retaliation if they report discrimination issues.
When asked about possible solutions, more than two-thirds of healthcare workers mentioned the following measures:
Offer an easy option to report anonymously.
Create opportunities to listen to both professionals and patients.
Investigate the treatment that non-English speaking patients receive.
Provide training in medical schools or to health care personnel to learn how to detect discrimination.
[Racism and discrimination undermine the mental health of young adults]
How did you arrive at these solutions?
Six focus groups worked on them along with an advisory panel, which included experts from hospitals, universities and groups such as the American Medical Association and the National Hispanic Medical Association, among others.
Solutions such as installing an anonymous reporting system were supported by 7 out of 10 people in the focus groups.
"If we want to build health systems with equity, we have to start by listening to those on the front lines providing care," Dr. Laurie C. Zephyrin, executive vice president of the Advancing Health Equity program, said in a news release. (
Advancing Health Equity)
of the Commonwealth Fund and co-author of the report. “Understanding what health workers experience, and what they want and need from their employers and colleagues to take action against discrimination, is essential for successful change and sustainable".