#BLM, Science

Racism in the healthcare setting

Racial biases within medicine have been rampant and prominent across history. With many doctors and scientists throughout history, reinforcing racial stereotypes and hierarchical systems within the quality of health care they provide. History shows decades of biased education, the exploitation of racial minorities as subjects for medical teaching and training, and unethical scientific experimentation such as the Tuskegee and Guatemala experiments. Ultimately, this has resulted in those of minority descent being deeply wary of the care provided to them. Within the modern era this has manifested into many significant cases. For example, white women have a higher incidence rate of breast cancer yet African American women have a higher mortality rate. Similarly, Black women are 71% more likely to undergo cervical cancer-related death than their white counterparts. This is perhaps due to delayed detection as well poor support in terms of diagnosis, treatment options and after-care within black patients.

The Black Lives Matter movement has highlighted these issues with health care students, scientists and professionals specifying gaps in their education as the cause of failure to offer efficient care to black patients. The Proceedings of the National Academy of Sciences showed that 40% of first- and second-year medical students in a study believed the notion that “black people’s skin is thicker than white people’s”. These unsettling beliefs echo the attitudes of previous eras where false claims of biological differences were utilised to reinforce racial prejudices and social constructs.

The conscious and subconscious biases reinforced through the medical system and its students and staff have served to perpetuate racial disparity within medicine. A 2016 report found a substantial amount of white medical staff and students believed in false claims of biological difference relating to pain assessment and treatment. Widespread misunderstanding within pain management has resulted in African American patients being 22% less likely to obtain pain medication than white patients. These biases have also manifested within childbirth across the UK. A study carried out between 2014-2016 found that Black mothers were five times more likely to die than white mothers. Many have pinpointed this to a lack of concern or attentiveness towards those of minority ethnicity. Racial disparities are also apparent within dermatological care with only 3% of the industry being composed of black physicians and diseases such as melanoma having a survival rate of 65% within black patients compared with 90% for white patients. This is especially dangerous when some symptoms may not be observed in darker skin as in white skin, for example, Kawasaki syndrome.

Most recently, the coronavirus pandemic has highlighted the racial biases upheld in our medical system. Research concluded that both infection and death rates amongst patients from Black and Minority Ethnic (BAME) backgrounds were substantial, with Black people being 1.9 times more likely to die than white people. BAME key workers or patients were less likely to speak about their concerns with Personal Protective Equipment (PPE) or quality of care they’ve received due to historic or personal experiences of racial discrimination. The global pandemic has emphasised the racial disparities within our medical institutions and revealed a system built on historic racism, biased medical education and consistent biological misbeliefs.

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Emily Hawkes

February 2021
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