As the COVID-19 pandemic rages, putting Black and Hispanic patients at an outsized risk of hospitalization and death, new research suggests just how fraught the doctor-patient relationship can be in minority communities.
Nearly one-third (30%) of Black patients in California and 13% of Hispanic patients feel their health care provider has viewed and treated them differently because of the color of their skin, or their ethnicity. Only 3% percent of white patients felt the same way.
Nineteen percent of Black patients believed they couldn’t get the treatment they needed because of their race, while nine percent of Hispanic patients felt the same way. One percent of white patients agreed with that.
Black and Hispanic patients said, at greater rates than white patients, that they were treated differently because of their income and their insurance carrier.
That’s according to a study released this week by the American Academy of Family Physicians, which delved into the barriers preventing strong patient-doctor relationships — bonds that can enable frank talk and patients’ trust about treatment on sensitive medical matters.
Patients who didn’t have one primary-care provider had far more mistrust than those who did, according to the researchers at the Charles R. Drew University of Medicine and Science.
Such perceptions do not appear to be unfounded.
In November, members of the American Medical Association, a professional organization, acknowledged that while differing health outcomes might happen because of structural racism in the health-care system, “racism and unconscious bias within medical research and health care delivery have caused and continue to cause harm to marginalized communities and society as a whole.”
It’s crucial to find ways to end the perception, the authors of the latest report said. “Perceived discrimination is correlated with medical mistrust,” they wrote. If the perception actually causes mistrust “then decreasing such discrimination may improve trust in medical clinicians and reduce disparities in health outcomes.”
The researchers polled more than 2,300 patients in 2019, long before the pandemic’s start. But the stakes in building a better bond are higher than ever.
In the first half of 2020 alone, Black and Hispanic patients constituted 58% of all people hospitalized with coronavirus and 53% of the people who died from the virus, according to researchers at Stanford University School of Medicine and Duke University School of Medicine.
As of Wednesday, the United States has 22.86 million cases and 381,130 deaths, according to data aggregated by Johns Hopkins University.
Furthermore, surveys suggest many people in Black and Hispanic communities are wary of a COVID-19 vaccine, mirroring broader hesitancy.
In one autumn poll of Black Americans, 14% said the vaccine would be safe and 18% said it would work. In the same study, 34% of Hispanic Americans polled said the vaccine would be safe and 40% said it would be effective.
While the researchers at Charles R. Drew University of Medicine and Science focused on the patient-doctor relationship, ongoing research from the RAND Corporation and Robert Wood Johnson Foundation have been looking at people’s broader attitudes about race and public health during the pandemic.
After releasing a first round of survey results in October, the second round came out Wednesday. The survey sample of more than 4,000 people is overrepresented with Black, Hispanic and Asian Americans.
From the first wave of results to the latest, attitudes about race and public health are largely unchanged. In both waves of results, essentially 50% of the survey participants agreed with the statement that “racism is a public health crisis.”
Slightly more people agreed with the statement that more people of color dying from COVID-19 was “just another example of racial injustice in this country.” Those in agreement edged up to 38%, from almost 36%.