The Mistreatment of Black People in Healthcare

This article is an excerpt from the Shortform book guide to "The 1619 Project" by Nikole Hannah-Jones. Shortform has the world's best summaries and analyses of books you should be reading.

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How are Black people mistreated in the healthcare industry? How does racism manifest in healthcare?

The American healthcare industry fails to provide adequate care and treatment to Blacks. Nikole Hannah-Jones, the author of The 1619 Project, links mistreatment of Black people in healthcare to medical practitioners’ racist beliefs that cause them to underestimate Black illness and not provide necessary treatments.

Here’s how the effects of slavery echo across the American healthcare industry.

The Mistreatment of Black Americans

In the American healthcare industry, Blacks are mistreated due to slavery-era beliefs—particularly that Black bodies are biologically and physiologically different than white bodies.

(Shortform note: In Biased, Jennifer Eberhardt calls this scientific racism—the false theory that different racial groups have fundamentally different physical and mental traits. She explains that this is a centuries-old phenomenon that was developed to prove the racial superiority of whites and that it’s been so deeply ingrained into Western culture that some beliefs persist today.)

The authors explain that academic articles claimed that Black people have thicker skin, a higher pain tolerance, and different emotional and intellectual capabilities. In 2016, a study on medical students found that half of white participants believed at least one of these claims—the most common belief was that Black people felt less pain. The authors say that this belief would make the students less likely to prescribe appropriate treatment to Black patients.

(Shortform note: The 2016 article referenced by the authors also uncovers that only the white participants showed a correlation between false beliefs and their perception of pain and treatment recommendations for Black patients. False beliefs held by non-white participants didn’t impact their perception of Black patients’ pain nor the treatments they recommended. So while both white and non-white practitioners may hold false beliefs, misdiagnosis and lack of adequate treatment is a much bigger risk for Black people when the practitioner is white.)

Statistics show that these racist beliefs still impact the treatment of Black people in healthcare. For example, Black Americans are 2.8 times more likely to die of Covid-19 than white Americans and are less likely to be treated for pain.

The Dangers of Stereotypes in Modern Medicine

Experts add that these stereotypes have not only lived on in the minds of medical students but also in medical equipment like spirometers. As the authors point out, this can lead to dangerous misdiagnoses and a lack of adequate treatment, especially for Black people who contract Covid-19.

The first spirometer, a tool to measure lung capacity, was developed in 1851 by a physician intent on proving that Blacks have inferior lung capacity which could be improved through hard labor. He determined that the “lung deficiency” of Black people was at about 20%. And even today, modern spirometers assume a 10-15% smaller lung capacity for Blacks and a 4-6% smaller lung capacity for Asians compared to the lung capacity of whites.

Experts add that this race-correction software could cause physicians to miss important diagnoses during the Covid-19 pandemic. For example, they could fail to diagnose restrictive ventilatory dysfunction, an emerging problem in Covid-19 patients, if they read a lower lung capacity in Blacks to be normal. Further, they could be led to misdiagnose the severity of respiratory issues like pulmonary fibrosis, letting the issues linger by not prescribing an aggressive enough treatment.

The Mistreatment of Black People in Healthcare