Overview: Essay on History of Black and White Binary and its Impacts on Systematic Healthcare

Experiences of Systematic Racism in Health Care in the 21st Century 

There have been large disparities within the health-care system concerning “people of color” and specifically, the Black community. Across the United States, Black men and women are being turned away, neglected, and misrepresented when attempting to secure good health care. In our exhibit, we will be demonstrating the many ways that this community is negatively affected by highlighting how deep-rooted racism runs this country, as well as its lasting effects. We learned in week four from Race Myths (Graves, 2005) that the idea of race is just a myth. When previous renowned scientists such as Charles Darwin began to investigate human origins, he came up with the claim that we all stem from one singular ancestry. Darwin then explained that he believed there to be a system in which the “best” most promising traits would be passed down from generation to generation which would later be known as Natural Selection. When proposing that each race may have stemmed from similar ancestors, he was rejected and advised to find another solution to questions pertaining to race. Even then, the idea that people could have multiple racial backgrounds caused people discomfort. To be accepted and respected, Darwin and many other scientists at the time rephrased their findings and separated races into binaries. This essay will focus on the evidence presented in our exhibit and how racism has influenced the way race is viewed in our health-care system. 

For our first exhibit, photographs of drawings from scientist Samuel Morton published in the 1800s show how he interpreted measurements of the cranial skull of different races. Many people think that the issues we have within our health-care system stem from recent years, but this image captures that the idea of cranial structure has influenced our systems for a long time. Samuel suggests that the smaller the cranial structure is, the less intelligent the race is. When certain “people of color” were compared to White people and found to have a smaller cranial measurement, it was because they were perceived as "less than” (Morton, 2023). This idea also was explored in our article from class, Phrenology-All that is Interesting (Fraga, 2023). In this article, they explore vintage phrenology drawings from 1902. In these drawings they depict different head and ear shapes, encouraging the idea that based on your head and ear shape, people could make assumptions about your level of intelligence. Our second image consists of a foundation that created a survey to capture the racial identification of Hispanic and Black people over a decade and its impact. Over time, fewer people answering the survey chose only one race and there was an increase in the multi-racial category from 3% in 2010 to 13% in 2021(Artiga and Phillia, 2023). Our last image consists of Montequsqui’s Racial Hierarchy which breaks down how races are ranked socially (Montesquieu, 2023). Through these first three images, we can demonstrate how racial ideas have influenced our system today. 

In our second slide of our exhibit, we focused on the Black and White binary within racism. For the first image we inserted a cartoon that had three hands with different skin tones (Miller, 2021). We included this to represent how people separate Black people and White people and not given a choice to identify anywhere in between Black and White. This can have negative side effects because people are multicultural and have many distinct parts of themselves that they may want to be represented, but feel as though that is not an option. People of color that are biracial, the Black and White binary often does more harm than good forcing them to choose an identity, or worse have society choose their identity for them. The second image we included was of a teacher in a classroom representing CRT (George, 2021). Critical Race Theory helps educate people on why the political, class, and social systems in the United States are racially separated and based on power and privilege. Our last picture has a picture of a Black doctor holding up a cardboard sign protesting the lack of health care during the pandemic (Keshavan, 2020). This protest was a response to the lack of care for communities of color who were disproportionately impacted by the pandemic. We included these three images because they represented how separating people by race has impacted communities at whole negatively. 

Disparities in health care are a direct result of structural barriers and systematic racism working to keep unwell people from becoming better. Disparities are any form of treatment that seems ill-motivated or unfair. An example of this is a health-care worker not giving pain medication to a Black woman because they believe she is exaggerating her pain because she is just wanting drugs to abuse. Not only is this untrue, but it is unfair to assume that a White person is more deserving of treatment than a Black person. However, it is not as simple as Black and White because there is marked culturally significant wording, such as advantage and disadvantage that hold weight based on the experiences and perceptions that help shape each person’s racial identity (Hartigan, 2010). The people who invented social determinants of health, Michael Marmot and Richard Wilkinson, thought that factors such as economic stability, physical environment, food, housing, social community, and the health care systems all contribute to outcomes based on how supported an individual was during a specific time (Artiga and Hinton, 2018).  

Individuals who are more knowledgeable of resources and are better supported are more likely to have more positive health outcomes such as less morbidity and mortality, greater life expectancy, and accurate health status. Racial bias in health care directly correlates to Black people being sick and dying sooner than White people. This is fueled by physicians having predetermined prejudice towards non-white patients due to their own personal beliefs, as well as a history of racialized medical care that purposely excluded and dismissed people of color in clinical trials and care. Also, marginalized communities have less access to essential resources that promote the health and well-being of the whole community. An example of this is COVID-19 in South Atlanta disproportionately killing Black Americans at a rate 2.3 times higher than White Americans due to lack of COVID testing and it being a medically underserved area (Wise, 2020). When determining the quality of care a patient will receive, looking at race and social determinants of health can provide a good prediction of how care should be expected to go. Unfortunately, non-white patients are predisposed to unfair and inaccurate medical treatment solely based on not being valued, prioritized, and cared for the same as White people. This is why breaking down the Black and White binary in health care would be a huge win: There would be less focus on categorizing someone and more focus on treating their symptoms.  

Not only are Black people treated differently from White people based on assumptions about their race, but many physicians believe that there are actual genetic differences distinguishing a Black from a White person (“Black Genocide,” 2018). This is inaccurate and non-scientific data that leads to distinct differences in how physicians treat their patients. For instance, an article on Black Genocide describes how government-funded birth control was given to Black women in the 1960s. People questioned the intent behind birth control and concluded that birth control was a means of controlling Black population and limiting Black political power, which ultimately led to a mistrust that Black people still hold towards physicians today.  

One story of mistrust is about a light-skinned Black woman who has held beliefs towards medical professionals told by Time magazine. She explains how she was taken from her mother at birth and given to another parent that was light-skinned in comparison to her mother who had a darker complexion than her. The mix-up was intentional and almost caused mother and child to be permanently separated. When that baby grew up and decided she was going to have her own child, fear of the same occurrence filled her mind even though it was a different hospital at a different point in time. When the mother checked into the hospital, she was asked to check a box that asked her race. Out of panic, she selected “White” even though she is an outspoken, proud Black woman. The generational fear and mistrust that Black women hold towards medical professionals is valid due to the experiences that continue to shape their health expectations. If a patient is not White, there is a great possibility that a person will be misdiagnosed, underserved, misrepresented, or mistreated due to cultural awareness that medical professionals lack. As a result of this lack of cultural sensitivity and this racial ignorance, Black women are three to four times more likely than White women to die from a pregnancy-related cause (Howell, 2018). The chances of adverse negative outcomes, such as morbidity and mortality, are increased in Black mothers due to systematic barriers that are harmful to anyone who is not White and receiving adequate prenatal care to ensure the best chance of a healthy pregnancy. White life is valued and seen as precious and irreplaceable, but Black lives are viewed as disposable, non-human, and in degrading ways. A change to move towards a health-care system where no one is categorized as more deserving of care is necessary to help remove binding characteristics that label and limit those impacted by disparities as a result of this categorization. 

Health-care systems and providers recognize race as an important classification necessary for delivering quality care. However, race is a socially constructed categorization tool used to place people in vague categorizations based on a select few phenotypic characteristics. Race is not real, but the implications of society using race as a casting system are very real. One implication of this is the idea that Black characteristics are inherently bad and White characteristics are deemed normal and standard. For instance, coiled localized hair on a Black person is considered normal, but on a White person this is considered an abnormality and must be due to an underlying medical condition. In this case, Woolly hair syndrome is the diagnosis for any White person with hair that possess qualities that are deemed undesirable and unacceptable for their race. A White person having characteristics a Black person possesses is viewed as not acceptable and therefore something must be wrong with that person. At the end of the day, this medical diagnosis of Woolly hair syndrome is absurd and a negative means of justifying why a White person possesses Black characteristics. 

Another rigid way of thinking about race is the differences of diagnosis and  treatment between White and Black Americans in relation to hypertension. Black Americans have a higher risk for high blood pressure and the onset of hypertension which directly impacts their rates of mortality and morbidity (Lackland, 2015). Often Black people with hypertension are criticized for their diagnosis and told that it could be prevented through healthy eating and exercise, but what is not talked about are the structural barriers that cause a lack of access to knowledge and resources, such as affordable healthy food or an affordable gym membership that caused them to be there in the first place. Not only are there structural barriers preventing Black people from getting the health care they need, but there is a lack of representation in clinical trials. One example of representation in a clinical trial was The Tuskegee Syphilis Study, but this study did not take place without harm. The trials ran from 1934-1972 where Black men were lied to and mistreated like not giving the participants the treatment of penicillin that was found to be effective for curing syphilis in 1943 (The Syphilis Study, 2007). This blatant disregard for Black lives is a reflection of what it means to be non-white in America. Action must be taken to help reduce the discriminatory and degrading medical practices used on Black people to save lives and reduce error.  

Through our research, we have found that the lack of security within the health-care system for the Black community is not a result of just present-day racism, but racism that goes back centuries. The ideas behind the Black and White binary were created under the pretense that White people could not handle the truth that they are genetically the same as everyone else, so therefore, the separation of the two was further enforced. Creating these binaries was not accurate or helpful, yet in the eyes of the powerful, creating these binaries was essential in creating The (racist) America known today. Through dissecting these harmful narratives, we can break down the binaries and create environments that will help repair our broken system.

References  

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