How Healthcare Inequality Affects Young Minorities
January 20, 2022
"Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane." Martin Luther King made these remarks in 1966 at a Chicago Press Conference for the meeting of the Medical Committee for Human Rights. Fifty-five years later, this statement still holds true. It’s no secret that the healthcare system in America is unjust, and most of the system's flaws can be traced back to health disparities. Health disparities are the differences in physical and mental health and the accessibility of affordable, quality healthcare due to social, economic, or environmental factors. These disparities mainly target minorities and can have profound impacts on adolescents, yet these groups are often denied the treatment and care they deserve. Drawing on data from the Journal of Latinx Psychology, Hispanic youth are often affected by obesity at an early age. Rates are twice as high for Hispanic youth aged six to eleven when compared to non-Hispanic white children of the same age. Those aged two to five years old carry an obesity rate that is four times higher. These figures are cause for concern since adolescent obesity tends to persist into adulthood, causing problems like heart disease, type two diabetes, sleep apnea, certain types of cancer, and osteoarthritis. Unfortunately, these issues often go untreated and worsen with time, as 2021 statistics reveal that Hispanics are more likely to be without health insurance than any other ethnic group at 23.6%. In fact, heart disease and cancer are some of the leading causes of Hispanic deaths. Due to these statistics, it’s vital that Hispanic youth affected by obesity have access to the care they need, yet it’s proven that most weight loss studies among youth have been conducted in non-Hispanic white populations. The Hispanic community currently has poorer health care access and a lack of utilization and preventive care when compared with their counterparts. Sadly, black adolescents feel the effects of healthcare inequality in a similar fashion. According to a report by Psychiatric Annals, they commonly face inequality in the psychiatric care system, where they are more likely to be referred to the juvenile justice system for disciplinary services while their white counterparts are referred to treatment-oriented programs. The inclination to refer black youth to juvenile justice systems rather than treatment facilities points to biases. Unfortunately, bias and stereotyping are inevitable due to the lack of representation in psychiatric services; Approximately 86% of psychologists are white, and less than 2% of American Psychological Association members are African American. Despite efforts to develop cultural competency and awareness, a lack of people of color representing mental health systems inevitably fuels the bias and stereotyping that leads to health disparities. As a result, black youth referred to the juvenile justice system with psychiatric health struggles are failed. They aren't treated in fit environments if they are helped at all. In fact, these issues often worsen in the juvenile justice system due to the overcrowding, lack of available support systems (family, friends), lack of treatment options, solitary confinement, and restrictive housing. Black parents are aware of the biases of mental health providers, and due to a fear of involvement from social services, many are unwilling to have their children psychologically assessed. But health inequalities don't just affect racial minorities; they are also seen in sexual and gender minorities. Per the CDC, LGBT youth are more likely to experience bullying, discrimination, and violence than their heterosexual counterparts, and this translates into increased health risks related to substance abuse, eating disorders, risky sexual behaviors, mood disorders, and can even result in suicide. In fact, attempted suicide rates for LGBT teenagers are two to seven times higher than their heterosexual peers. However, despite this alarming information, the LGBT community is often overlooked in the healthcare system. They are less likely to have health insurance and are more likely to report low quality of care and unjust treatment due to bias and stigma. There is also a lack of understanding of LGBT health risks and concerns, evidenced by the fact that lesbians are less likely to get preventive services for cancer. So, why is this happening? As mentioned previously, some issues derive from biases and stereotypes; however other concerns stem from a lack of clinical studies for minorities. Many professionals falsely believe that black people have nerve endings that are less sensitive than white peoples’, that they have thicker skin, or that their blood coagulates more quickly, and so they feel pain to a lesser extent. A study in 2016 published in the Proceedings of the National Academies of Science revealed that half of the medical students surveyed believed these statements. These false assumptions contribute to health disparities by miscalculating and/or downright overlooking black patients’ pain, and they can even lead to misdiagnoses. That results in setbacks in treatment and recovery. Another cause of health disparities is the affordability of healthcare. Some may point to the Affordable Care Act, or Obamacare, fixing this by increasing healthcare coverage for people who are uninsured and making reforms to the health insurance market. The number of Americans without health insurance fell considerably between 2010 and 2015 but rose again after 2016. One of the major issues is that health insurance premiums have gone up in the five years since the law's passing. That, and the increase in deductibles- the amount you pay before the insurance comes into play- has resulted in millions of families losing their insurance because of the costs. Unfortunately, this was the case for a dad in Fredericksburg, Virginia. His health insurance premiums cost $4,000 a month- more than his mortgage. He doesn’t get subsidies and is doubtful that he can continue to afford insurance. However, even with Medicaid, providers accept it less than any other insurance. According to a brief from Healthcare Dive, 71% of providers accept Medicaid compared to 85% who take Medicare and 90% that accept private insurance. This further demonstrates the inequalities people on the lower end of the economic spectrum face. Beyond the affordability and acceptance of healthcare, other factors of health disparities can include lower socioeconomic status, which could affect one's access to healthy foods and the violence in their community. For example, black adolescents are more likely to be exposed to violence. Exposure to violence is associated with an increased risk of mental health problems, risky health-related behaviors (alcohol abuse, sexual risk-taking), chronic disease (coronary heart disease, diabetes), and premature mortality. Environmental factors can affect one's air quality and the pollution around them. For some minority groups, language barriers may also be an issue, making communication between them and their providers difficult and health literacy more of a challenge. Healthcare inequality often creates a sense of distrust between the affected groups and the healthcare system. Because these affected groups are often minorities, this creates another barrier for them in America. This is likely to have a profound impact on young minorities who are already struggling with acceptance from their peers and society as a whole, as they come to realize they can't always trust the health care that they're receiving if they have access to it at all. Increased feelings of alienation and frustration are likely, contributing to disparities linked to mental health. It's a vicious cycle that needs to be broken. To erase these disparities, it is important to be educated and accepting of people from all groups and backgrounds. Health professionals need to be aware of the existence of biases to change them, and more research and clinical studies need to be conducted for minority groups to dispel false assumptions about their health and increase awareness for common health issues they face. Young minorities can take an active role in their health by learning more about biases and policies in the healthcare system. This can help them recognize when they are being taken advantage of or aren't receiving quality care. Health literacy also leads to awareness of health benefits or treatments one may be entitled to or eligible for and help affected groups regulate aspects of their health they have control over, like substance abuse, sexual behaviors, and leading an active lifestyle. Resources to aid and inform minority groups affected by health disparities: The Gay and Lesbian Medical Association National Black Leadership Commission on Health (NBLCH) U.S. Department of Health and Human Services Office of Minority Health (OMH) National Institute on Minority Health and Health Disparities (NIMHD) NCI Center to Reduce Cancer Health Disparities (CRCHD) Association of Clinicians for the Underserved (ACU) National Alliance for Hispanic Health (NAHH)
Behavioral Health | Youth.gov. (2021). Retrieved 5 December 2021, from https://youth.gov/youth-topics/lgbtq-youth/health-depression-and-suicide
Breland-Noble A. M. (2004). Mental Healthcare Disparities Affect Treatment of Black Adolescents. Psychiatric Annals, 34(7), 534–538.
Centers for Disease Control and Prevention. (2021). FastStats- health of the Hispanic or Latino population. Retrieved 2 December 2021, from https://www.cdc.gov/nchs/fastats/hispanic-health.htm
Isasi, C. R., Rastogi, D., & Molina, K. (2016). Health Issues in Hispanic/Latino Youth. Journal of Latina/o psychology, 4(2), 67–82. https://doi.org/10.1037/lat0000054
LGBTQ+ Health Disparities | Cigna. (2021). Retrieved 4 December 2021, from https://www.cigna.com/individuals-families/health-wellness/lgbt-disparities
Masterson, L. (2019). Doctors Are Less Likely to Accept Medicaid Than Other Insurance. Retrieved 2 December 2021, from https://www.healthcaredive.com/news/doctors-less-likely-to-accept-medicaid-than-other-insurance/546941/
Opportunities for Prevention. American journal of preventive medicine, 55(4), 462–469. https://doi.org/10.1016/j.amepre.2018.05.017
Perez, V. H., Fang, H., Inkelas, M., Kuo, A. A., & Ortega, A. N. (2009). Access to and utilization of health care by subgroups of Latino children. Medical care, 47(6), 695–699. https://doi.org/10.1097/MLR.0b013e318190d9e4
Perzichilli, Tahmi. (2020). “The Historical Roots of Racial Disparities in the Mental Health System.” Counseling Today, ct.counseling.org/2020/05/the-historical-roots-of-racial-disparities-in-the-mental-health-system/.
Sheats, K. J., Irving, S. M., Mercy, J. A., Simon, T. R., Crosby, A. E., Ford, D. C., Merrick, M. T., Annor, F. B., & Morgan, R. E. (2018). Violence-Related Disparities Experienced by Black Youth and Young Adults:
Turner, G. (2020). Top Reasons Why Obamacare is Wrong for America. Retrieved 2 December 2021, from https://www.forbes.com/sites/gracemarieturner/2020/01/17/top-reasons-why-obamacare-is-wrong-for-america/?sh=3c286d2b3c84
Yang, J. (2021). Percentage of Uninsured Americans by Ethnicity | Statista. Retrieved 2 December 2021, from https://www.statista.com/statistics/200970/percentage-of-americans-without-health-insurance-by-race-ethnicity/