A Third of Americans Say Racism Is a Major Problem in Healthcare

Although nearly a third of the American public thinks racism in medicine is a major problem, that proportion is actually much lower than the public perception of other sectors, potentially signaling a healthy level of patient trust across racial and ethnic groups, according to new KFF polling.

Still, the researchers said trust levels, and consequently positive perceptions, are lower among racial and ethnic minorities who are more likely to report a recent experience of racism in healthcare.

Racism in healthcare has become a key talking point as industry experts continue to work toward health equity. While many racial health disparities have been carved out at the hands of institutional racism, there’s growing evidence that implicit and explicit bias in the medical setting has also created inequities.

This most recent KFF survey showed that 32 percent of all Americans agree that is the case, but that public perception could be much worse. While a third of respondents agreed racism is a major problem in healthcare, more than half said the same of policing (51 percent), the criminal justice system (54 percent), and politics (56 percent).

But those perceptions aren’t the same across racial and ethnic minorities.

Indeed, healthcare is the most-trusted sector across the three polling areas regardless of race or ethnicity, but the data showed that White people are less likely to think racism is a major problem in medicine than Hispanic people (34 percent), Black people (52 percent), Asian people (35 percent), and American Indian/Alaska Native people (35 percent).

These differences are likely the result of vastly different healthcare experiences, the data indicated.

For example, Black people are significantly more likely to have experienced at least one form of discrimination in a healthcare setting at least a few times in the past year compared to their White counterparts. While 33 percent of White respondents said they’d recently experienced discrimination in healthcare, 60 percent of Black folks said the same.

For Hispanic respondents, that figure was 43 percent, and for Asian respondents, it was 45 percent.

Distilled further, the researchers said an unfair or discriminatory healthcare experience is a key predictor of poor patient trust. Overall, 49 percent of those reporting disrespect in healthcare said racism is a major problem in the industry; only 28 percent without a poor experience said the same.

For Black patients, those figures are 74 and 46 percent, respectively, and for Hispanic patients, it was 58 and 30 percent.

As expected, White people were generally less likely to report that racism is a major problem in US healthcare, but bad prior experiences were also a weaker predictor for this population, the data showed. Around four in 10 (39 percent) White people reporting unfair or disrespectful treatment from a healthcare worker said racism is a big problem in healthcare; 25 percent with no bad healthcare experiences said the same.

Despite these concerning figures, the researchers said patients of all races and ethnicities largely trust their doctors and clinicians providing direct care to them.

Nearly three-quarters (72 percent) said they trust their providers to do what is right for them most of the time. This was mostly consistent across race and ethnicity, although Black adults with self-reported very dark/dark skin tone were slightly less likely to trust their providers.

That said, Black patients did become more likely to say they trusted their doctors when they had more visits with doctors who were also Black. In fact, racial concordance improved trust levels among Black patients (74 percent), Asian patients (83 percent), and White patients (78 percent).

These findings corroborate what other analyses have found to be true: racial concordance is good for the patient-provider relationship. However, data has indicated that patient-provider racial concordance is elusive, mostly due to poor healthcare workforce diversity.

Healthcare needs to reexamine the medical education pipeline in order to cultivate greater workforce diversity. This includes encouraging more students of color to pursue medicine and making changes to the medical education environment to ensure less attrition of students of color. At the same time, efforts to promote cultural competency could help improve patient perceptions of healthcare.