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Running head: RACIAL DISPARITIES IN HEALTH CARE

Racial Disparities in Health Care: The Color of Health

Raqheal N.Payne

First Colonial High School

Legal Studies Academy


RACIAL DISPARITIES IN HEALTH CARE 2

Abstract

The topic I chose for my legal research and writing paper is Racial Disparities in Health Care, I Commented [1]: I know its suppose to be indented but
everytime I try to indent it it mess up the formatting of
the paper
chose this topic because this a current health issue that is become a huge topic in the health

system. I conducted this research paper with numerous studies and researches that provide

evidence that Racial Disparities in health care and in health is an issue that can not go unnoticed.

Racial Health Disparities has become a issue that has been killing African American women

during or after pregnancies. Racial DIsparities in health care and in health demand a better

quality and access to federally funded health care for lower income families especially those who

are minorities. This issue went from a general problem to something more specific and targeting

a certain group of people. From studies from numerous doctors such as, Dr. Kovesdy in which I

conducted a phone interview and we discussed how this issue of racial disparities first became a

thought that we ponder on today which results to the proper access and quality of healthcare. Dr.

Kovesdy starred out by saying the issue in which politicians are fighting about if citizens should

have the right to have basic health care is ludicrous. The issue of racial disparities starts with the

quality of health care.If we all had the same basic health care than maybe racial inequalities

might be different than finding that we see today. The final thought that we came on was that

skin color doesn't define biology. People who were born in poverty deserve the right to proper

health care.We talked about how Racial Disparities in health care is much more deeper than skin

color. It moves pass to how each of our bodies were constructed to a different environment. I

will also discuss what we talked about with how single cell anomia is found in higher quantity in

male African american than white males and it is because years ago while in Africa , African

Americans created a mutation to malaria that was found in Africa centuries ago that it carried

generations on and became this thing known as single cell anomia.As talking to Dr.Kovesdy I
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learned that there is a deeper problem than skin it comes back to accessory and I will be

discussing this in my legal research paper (K. Csaba Pal, Personal communication, October 19,

2017).
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Racial disparities in Health Care

Racial disparities in health care is defined as the quality of care a person receives due to their Commented [2]: I know its suppose to be indented but
everytime I try to indent it it mess up the formatting of
the paper
access to healthcare ,but racial disparities in health care is mainly seen through the color of one's

skin. Racial disparities in healthcare and racial health disparities are not the same thing but they

are a key barrier in improving the quality and research of the medical system. Those who are in

the lower economic status and no educational background don't receive the proper health care as

compared to someone who is in a higher economic status and has some sort educational

background. African Americans make up majority of the lower- income population. “African

Americans are more than likely than non- hispanics to be poor or closer to poor and less likely

to receive a high school diploma.Which leads to their social economical status to be in the lower

class in some instances leaving them not to qualify for health care period” (Beil, 1996 23 oct).

This having the lower class live in poorer conditions and government assisted living homes

which can be a key factor in their well-being.

Economic status can predict a person's future. Lower income families might not qualify for Commented [3]: I know its suppose to be indented but
everytime I try to indent it it mess up the formatting of
the paper
public health care. Therefore, they are less likely to report to the doctor because of their fear of a

high bill. This results in a lot of health issues being ignored which can cause more complications.

In some states to qualify for healthcare, it doesn't factor in the household size. Virginia is under a

policy where it's not based on family size , but it's based off income solely on your income

status. Income status below $28,780 “patients won't qualify based purely on income. Patients

also won't qualify for financial assistance on a health insurance plan because Virginia does not

participate in expanded medicaid” ("How Medicaid Health Care Expansion Affects You," n.d.).

Expanded health care doesn't factor in just income but it also factors the house size, disabilities,

and family
RACIAL DISPARITIES IN HEALTH CARE 5

status. The expanded health care can grant more lower income families to qualify for health

insurance coverage. It is up to the states discretion if they wanted to take part in expanding

healthcare. Most states are still solely based entirely on income and a handful have expanded.

For those individuals who do qualify for do not receive the day to day attention from a care

provider because medicaid simply does not cover it.

Some states have their own independent programs to help those minorities and lower

income families with a public health care that the community might provide. For example, in

Chicago they have adapted a minority managed health plans. Not many states participate in

minority managed programs in fact the number in the world is less than 15% . These programs

focus on day to day coverage by doctors who are well known throughout the community and

have worked with minorities before. It compares the quality of medicaid which is a government

funded program to a non-profit health care program the mostly focuses on health care for

minorities. Most states do not have these independent health care programs and minorities still

face disparities (Serb, 1997).

Comparing Health Insurance coverage in United States to Russia

The healthcare system that Russia has is completely different from The United States. In

Russia they has a system similar to most European countries. They believe every citizen has the

right to health care and provided them with a public health care which is free to all Russians.

There are two types of healthcare in Russia, ¨The compulsory insurance known as OMC, and

privately purchased medical insurance, or DMC. OMC is provided by the state and is provided to

Russian citizens¨("Health Insurance in Russia," n.d.). Compared to the United States where

government funded health acre is only provided if you fall in a certain income range rather than

it dependíng on citizenship as in Russia. Russia health care system is all peachy, it does have its
RACIAL DISPARITIES IN HEALTH CARE 6

downfalls. For instance, The OMC only applies to certain basic treatments and are only valid at

certain hospitals.Regardless of the minimum coverage, Most Russian citizens still chooses to use

the free policy that Russia provides and tend to find doctors who will agree in times of an

emergency they can pay the doctor directly for what is not covered by the insurance which seems

to work best for them.People of the lower class in Russia do have the basic health care coverage

that they need if any health issue that might occur throughout their life ("Health Insurance in

Russia," n.d.).So the idea of a disparity because of their socioeconomic status doesn't really

become a idea because almost everyone has the same health insurance coverage and is being

provided with the same basic treatment as the next person. The next issue of a disparity comes

into play when comparing privatized health insurance to publicized health insurance. This same

issue occurs within the borders of the United States. Private health care in the United States and

in Russia seek to have a better quality than the publicized one. This is a result of how much

money your willing to put into your health care to live longer, In result this health care disparity

becomes a key factor in the healthcare system. This disparity is what divided the lifespan. Those

who don't receive the proper care because of the lack of attention that they receive from the care

provider because something is not covered by their health insurance can be a cause of death to

the patient. Its ludicrous to think that he ones who took an oath to save lives can be those very

one killing it.

Comparing United States to Germany

Germany is known for having one of the best healthcare systems compared to any other

country. “Approximately 85% of the population are mandatory or voluntary members of the

public health scheme while the rest have private health insurance” (Matz-Townsend, 2017).
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Germany requires its citizen to have health care. If they cannot afford private health care, the

country will provide them with public healthcare which covers pregnancy and medical check-ups

regardless of social status or race. Germany’s healthcare system has its flaws too. Instead of

there inequalities being affected by race , it just involves Socioeconomic status. It is a divided

line between the rich and the poor. The inequalities that the lower income face in Germany are

“mortality, morbidity, and quality of life”(Reibling, 2016).As I said before 85% of Germany’s

population participates in its Public healthcare program compared to United States which 36.1%

participates in public health care known as medicaid or medicare (Jessica C. Barnett and Edward

R. Berchick, 2017).Instead of these citizens of Germany getting discriminated because of the

color of their skin or because of the type of health insurance that they have,but it's because of the

situation that they are living in. People in the lower socioeconomic status tend to live in poorer

conditions compared to those in the middle and higher status. These living environments leaves

the people of the community vulnerable to “many chronic health conditions, including

depression, heart attack, stroke, diabetes, high blood pressure, osteoporosis, arthritis, and various

cancers”(Reibling, 2016).

Republican views V. Democratic views

There has always been a huge debate between the government on funding government

healthcare programs for the lower class. It doesn't come to surprise that the Republican party

opposes the expansion and funding of medicaid:


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As the House Republicans’ health-care-reform bill, called the American Healthcare Act,

makes clear, the Party doesn’t merely want to roll back the Obamacare reforms; it wants

to shrink the entire program, transferring it to the states and imposing tight caps on the

payments they receive from the federal government. (Cassidy, 2017)

The party has tried numerous times to get Obamacare repealed; they feel as of its a waste

of money and time.The party doesn't want to cut government funding health care at all but to

simply put it on a tighter budget. Most of the loyal voters from the political party are under

Obamacare. This results in them not eliminating it altogether, but coming up with another health

care plan that is less costly(Cassidy, 2017).

For the Democratic party their political goal as a party is to grant everyone the proper

quality and an affordable health care. During President's Obama’s term he passed a controversial

Patient Protection and an Affordable Care Act that gave 16.4 million Americans health care

covered. This act that is referred to as Obamacare it allows students to stay on their parents

health care until the age of 26 if they are not able to keep an occupation at the time. There is a

part of this new law that benefits the lower class. “ Insurance companies cannot place annual or

lifetime limits on coverage, an act which puts individuals and families in compromising positions

should they be unable to pay out-of-pocket” ("Home," 2016). The Democratic party believes in

publicizing health care and not privatizing it. “Democrats believe that no American should have

to face financial destitution because they fall ill or get injured, stating that no one should have to

choose between taking their child to a doctor and paying the rent” ( Says, 2014).This is where

the thought of expanding insurance coverage rather than requiring Americans to have their own.

Expanding health care cover results in quality health care in an affordable way.
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The big debate of affordable health care results in a tax increases that puts a damper on

the upper class. Some insurance workers are being overloaded with work due to the pick up of

numerous clients which can result in the quality of care declining due to the work overload

(Says, 2014).

The debate between the Democratic party and the Republican party has been a huge

issue for years. They all come to common ground that getting rid of federal health care as a

whole would only hurt and not help the country and its people. The Republican party believes

that not all Americans need federal health as a basic need of life. The Democratic party believes

that healthcare should be an basic right to all American citizens. This issue will always be a topic

of interest until both parties come to a common ground on what is best for the greater good of the

country( Says, 2014; "Home," 2016).

Quality of healthcare & Quality of access

The disparities in the quality of healthcare have been increasing over the years due the

increase in need of federally funded health care:

Black and American Natives receive worse care for whites for about 40% of

measures, Asians received worse care than Whites for about 20% of

measures.Hispanics received worse care than non-Hispanic Whites for about 60%

of core measures.Poor people receive worse care than high-income people for

about 80% of core measures. (Casale, 2014)


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This shows how minorities receive quality that is nothing compared to the white

Americans. These disparities don't just affect the African American community, but also Asians,

Native Americans, and Hispanics. “In 2008, Hispanics under age 65 were less likely than non-

Hispanic Whites to have health insurance (66.7% compared with 87.5%)”(Casale, 2014). Other

minorities, such as Hispanics, have communication problems with their doctors and health care

providers. “35 percent of Latinos and low-income individual reported difficulties getting care

that they needed, compared to 25 percent of white Americans and 15 percent of high-income

earners” (Pearl, 2015). The fact that they can't verbally communicate with their doctor to tell

them their issue or illness characteris can result in a wrong diagnosis for that patient and getting

ill even more. “281 million people age 5 and over in 2007 , 55.4 million of those individuals

stated that they speak a language other than English at their home”(Casale, 2014).

These patients report poor communication with nurses and doctors and receive no language

assistance while attending the medical center (Casale, 2014).

It has become evident that the poor quality and access to care that these minorities

receive leads to them having a shorter life expectancy. Racial disparities in health care can

potentially lead to their death. African Americans face racial discrimination in health care, but

those who are a minority and in the lower socioeconomic status face more challenges. Minorities

in the lower socioeconomic status can be prone to a higher disease rate, a shorter life span and a

much more limited access to the proper health care that results in them receiving poorer

treatment and health (Pearl, 2015).

Dr. Ron Wyatt experienced racial discrimination in medicine first hand. After just

coming back from a volunteering mission, he became ill. The first encounter Dr. Wyatt was
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when his wife was denied the right to fill out his health insurance forms for her husband because

he wasn't feeling so well. The nurse stated, "No, he will have to come sit right here, Wyatt recalls

the nurse saying, ordering him to sit next to her, where she took his temperature“ (Schroeder,

n.d.). Once the doctor came in to see Dr.Wyatt, he insisted that he should just take some tylenol

and just go home without a thorough exam of the patient, who was Dr.Wyatt. After his

temperature rose above 100 degrees again with Dr.Wyatt catching chills , he was still told to go

home and just take some tylenol. Dr.Wyatt is an African American doctor that received poor

quality of care from this medical facility because they thought because he was African American

male, and they thought that he was a drug abuser. All other patients that Dr.Wyatt saw before

seeing the doctor were white patients. The only other African American he observed was a

staffer that told them “Don't let bother you.” Dr.Wyatt stated that he believes that a racist system

of health kills people. This type of treatment is something that the lower-income earners and

minorities face everytime they go to the doctor's office. This type of treatment is unacceptable to

a field that has the primary job of taking care of its patients no matter their race, or if they’re

uninsured or not (Schroeder, n.d.).

Racial disparities in Health Care v. Racial disparities in Health

Racial disparities in health care can be connected to racial disparities in health. Although

the two issues are not the same they can be to each other. A health disparity is defined as “a

higher burden of illness, injury, disability, or mortality experienced by one population group

relative to another”(Artiga, 2017). A health care disparity is defined as “differences between

groups in health insurance coverage, access to and use of care, and quality of care”(Artiga,

2017). Doctor’s have been conducting research to compare the two. Locally in the Hampton

Roads area Eastern Virginia Medical School just received a grant to conduct a study on racial
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disparities in health care and in health. Dr.Britt ,the leading surgeon on this study, states that

“healthcare disparities are a crucial concern for surgeons nationwide”("Surgeon Leads National

Effort to Address Surgical Disparities," 2017). Dr.Britt ,as an African American man, recalls as a

child dealing with health care disparities first hand. He remembers his family packing lunches

when attending the doctor's office because it would take hours before they would see the doctors

only which then the appointment lasted for a few minutes. It is a key factor in finding what the

real issue is regarding these disparities before being able to address it. The two issues describe

the difference that low-income minorities disadvantages that they face in the medical field

("Surgeon Leads National Effort to Address Surgical Disparities," 2017).

Researchers have came to the conclusion that regardless of health insurance status, race,

or income status these disparities can be routed back to the established by minorities having a

heavier burden on health issues in the geographical region of America. “Blacks are less likely to

undergo such common treatments as coronary bypass surgeries, kidney transplants,

appendectomies and hip replacements, studies have found. Blacks are more likely to have certain

other surgeries, such as hysterectomies and lower limb amputations” (Beil, 1996 23 Oct). These

studies show how minorities suffer from more complexed and server health issues compared to

others, which results in the minorities receiving care for an illness that is not commonly

performed.

Racial Health Disparities

The issue of racial disparities starts with the quality of health care.If we all had the same

basic health care than maybe racial inequalities might be different than finding that we see today.

The social and medical side of this issue is different . People try to approach this issue from both

sides at the same angle but the sides are completely different. As addressing questions that are
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being brought up about the quality of health care comes with what is a primary care provider

defined as. Dr.Kovesdy also discussed the experiments that he constructed in regard to these

finding. African American veterans are at higher risk in receiving a heart disease compared to

white veterans. As he stated of course it can be different for the population that are non veterans

because they have different qualifications but he has no control over the data but as researchers

they can only speculate to a degree. As the evidence shows people in the lower class who can't

afford health care tend to live a shorter lifespan than those who can. Unfortunately, Many

minorities in the lower income fall into that category of those who can't afford the proper

treatment that they need to live a substantial and long life (K. Csaba Pal, Personal

communication, October 19, 2017).

Health Disparities can be traced back to the established of America and Jamestown.

Before African Americans were brought to the new world, African Americans body structures

and mutations were created to the atmosphere of Africa, but once they were brought to North

America, their bodies weren't used to the environment and took time to adjust. Some of the

mutations that they developed in Africa became a genetic mutation or disease that majority of

their population is affected by, sickle cell anemia is on if those mutations.

Sickle cell anemia was first introduced in Africa to prevent a mutation of the malaria

disease that affected a huge population of the Africans. Once the Africans were brought into the

United States the mutations that they developed in Africa was no longer needed because it wasn't

a big health issue in America like it was in Africa.The mutation that Africans developed for

malaria slowly turned into what is known as sickle cell anemia. “Sickle cell anemia is a disease

that reforms the red blood cells making it hard to develop oxygen throughout the body, 60-80%

of African Americans are affected with Sickle cell Anemia” (Sayre, 2011). Sickle cell anemia
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has widely spreaded throughout the minority community. It is one of the leading diseases that

being diagnosed to minority babies. Sickle cell anemia does not necessarily mean that the person

will die from it with proper care and attention. A person diagnosed with sickle cell anemia can

live a healthy live. It all depends on the care the person receives once being diagnosed. So the

question then becomes what happens to those minorities who can't afford the proper care? Are

they denied the right to receive this treatment ? In Germany their government says everyone has

the right to the proper and efficient healthcare. All citizens in Germany are granted the right to

health care as one of their basic rights (K. Csaba Pal, Personal communication, October 19,

2017).

Black Women define health disparities

“In the United States African American women are four times more likely to die in or just

after childbirth than white women”(Martin & Montagne, 2017). The reasoning behind this,

African American women don't have the same access or quality of care during the pregnancy that

white women have. Therefore, “African American women are twice more likely to suffer from

late-pregnancy loss as to White women (Vega, 2017)” These results can be tied back to high

blood pressure and diabetes which are also health issues that are commonly found among

African Americans. African American women are four times more likely to die during or after

birth than white women. “Black women also had the highest rate of being hospitalized for

hemorrhaging and blood transfusions, which are commonly seen in maternal deaths in Texas”

(Simmons, 2017). Texas holds one of the highest rate of people who are uninsured in the united

states and has one of the highest maternal mortality rates in the country (Simmons, 2017). “Some

studies have shown that chronic stress triggered by racism and discrimination can lead to health
RACIAL DISPARITIES IN HEALTH CARE 15

problems”(Simmons, 2017). African American women are the visual proof that a health

disparities do exist.

The causes of these health disparities that might be affecting the mortality maternity rate

is still unclear, but some evidence can point at how majority of African American women has

been detected to have high blood pressure and stress. Discrimination can also be a cause of the

high mortality rate. A women recalls her daughters challenging pregnancy with carrying twins.

Her daughter became ill to the point where she could not hold any food or liquid in her system.

Perkins, who was the interviewers daughter, went to the doctor where they found that she had a

infection. The doctors induced perkins to deliver tow 2 pound babies. She was then discharged

from the hospital a few days later, but perkins was never fully recovered.Women of color seem

to enter pregnancy unhealthy which can be the cause of there death. African American women

do seek the health attention that they need for their well-being before a pregnancy which makes

them a higher risk during the pregnancy. This can be tied back to the women not having the

proper access to receive this care. Texas having the highest number of uninsured citizens and

mortality maternity rates also took huge cuts to most of their women health programs which

provide family planning and other services such as prenatal care to lower income women.

It is substantial that the women in the lower class especially minority be granted the

access to the proper health care that they need to have a health pregnancy and a healthy life after

pregnancy. If these women don't receive the proper care it needs mortality maternity rates will

continue to rise and more African American lower income women can be at a higher risk of

dying. The mortality maternity rate is just one example of the disparities that exist.

African American Women represents ¨32% of all breast cancer that have been diagnosed,

African Americans have the highest death rate and shortest survival of any racial and ethnic
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group in the US for most cancers¨("Cancer Facts & Figures for African Americans," 2016). All

of these health disparities connect to not having the proper quality and access to health care. A

type of health insurance a person has can dictate how long that person lives.

Legal Aspect

One experiment that first recognized health disparities that later turned into a legal ethical

issue that is very known is the Tuskegee Experiment. This experiment is a great example on how

health disparities can occur. Those African Americans who were not treated for the Syphilis that

they were giving while taking part in this study has been some of their cause of death.

The Tuskegee experiment was the first of what will turn to be many health disparities.

Many who were left untreated from the experiment were found dead years later. Their death can

be later traced back to the Tuskegee experiment. Although, the Tuskegee experiment was just a

civil lawsuit on behalf of all those affected by the study against the US Public Health Service.

This experiment set precedent in regarding to ethical practices that should be followed when

conducting certain experiments similar to the Tuskegee experiment. In result of this experiment

Congress signed into law the National Research Act. This Act established the basic principles

that should be followed when conducting any biomedical and behavioral human subjects

research (Kennedy, n.d.). This legal lawsuit relates to racial health disparities because some of

those participating in the study,after being affected with syphilis, could not afford or acces the

proper care that they needed to treat that disease. All of those people that participate in this study

were African American man. The men were told that they were being treated for a disease that

they thought that they had, but instead researchers injected the disease into 399 African
RACIAL DISPARITIES IN HEALTH CARE 17

American man to see if the effect of syphilis had the same results as in other races ("U.S. Public

Health Service Syphilis Study at Tuskegee," 2017).

Years after the men who participated in this experiment finally gained knowledge of what

was really goin on but was discouraged to seek Medical assistance. Many of those minority man

couldn't afford the proper care that they need resulting in their death. This same issue still exists

today, those minorities who can afford proper health care lives a shorter life which creates the

barrier of racial health disparities ("U.S. Public Health Service Syphilis Study at Tuskegee,"

2017).

On the other side, Florida v. Department of Health and Human Services can show of

affordable healthcare act violated state laws if they failed to comply to the Medicaid expansion

("Florida v. Department of Health and Human Services," n.d.). Expanding Medicaid can

potentially provide more minority lower income families with suitable health insurance that they

need to live a longer life. Expanding Medicaid in all 50 states of America can slowly but surely

began to close the racial healthcare disparities that we face today.

In the court case, Florida v. Department of Health and Human Services, the state of

Florida express that “the Medicaid expansion provision of the ACA violates the Constitution by

threatening states with the loss of their existing Medicaid funding if they decline to comply with

the expansion” ("Florida v. Department of Health and Human Services," n.d.).The state of

Florida felt as health care insurance policies powers should be up to that deciding state ("Florida

v. Department of Health and Human Services," n.d.). This same law governs this paper which is

Affordable Care Act. This debate became effective in President Barack Obama 2010 presidency

term("Affordable Care Act," n.d.). The Affordable Care Act has a primary goal of making

affordable health insurance available to more people. Once this law was first enacted in 2010, It
RACIAL DISPARITIES IN HEALTH CARE 18

became up to the states discretion if they wanted to expand health care or not ("Affordable Care

Act," n.d.). In the ruling of this case, Seen supreme court justices agree that medicaid expansion

violates the United States Constitution ("Florida v. Department of Health and Human Services,"

n.d.).

Conclusion

There is no true color that defines biology. Racial disparities in the medical system goes

beyond the color of skin as research shows. Racial disparities in health care and Racial

disparities in health are not the same ethical issue but are one can potentially affect the other.

Evidence has shown this issue is killing people of color. The question then becomes what can we

do as citizens to close this disparity gap? Lower income minorities have to be more aware of

their well-being and become informed citizens when it comes to health because if not these

disparities can become the leading cause of death in minorities. In the world of biology

everything is seen black and white. To some researchers racial disparities in health care is the

result in the color of their skin, to others it's something with a deeper meaning that dates back to

the establishment of the world and colony.


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