Prejudice and Discrimination in Healthcare

“People fail to get along because they fear each other; they fear each other because they don’t know each other; they don’t know each other because they have not communicated with each other.”

— Martin Luther King, Jr.

Prejudice is one of the principles of social psychology and has been prevalent throughout human history. Society continues to make distinctions among people on various grounds, such as race, ethnicity, religion, gender, socioeconomic status, and many more. This human conflict is a complex problem that affects everyone and has led to abuse, wars, murder, and suffering. In fact, the report on the World Social Situation 2016 argued that discrimination is one of the key drivers of social exclusion (United Nations, 2016).

Prejudice is theoretically defined as the unjustified prejudgment held over certain people or groups of people due to inadequate knowledge. Prejudice can be both negative and positive, so long as it is preconceived and relies on stereotypes. Stereotyping is the view of the entire group as identical or the belief that because one person is a certain way, all people in that group are the same. Moreover, discrimination takes place when people allow their internal prejudice to take over their actions. It is essentially the translation of thoughts into actions.

Some common forms of prejudice are racism, sexism, classism, casteism, homophobia, and nationalism, and discrimination can extend to institutions or social and political systems. Institutional discrimination refers to the discrimination embedded in the functional and social structures of any institution, such as workplaces, schools, and universities, as well as healthcare centers such as hospitals.

One of the main reasons for such discrimination is elitism among the educated and wealthy. As a matter of fact, discrimination in the healthcare sector is extremely prevalent. Despite medical practitioners’ oath to “dedicate themselves to providing care to those in need”, it is very common to observe social inequalities committed by these providers. The Robert Wood Johnson Foundation (RWJF) describes health equity as “the ethical and human rights principle that motivates us to eliminate health disparities, which are differences in health or its key determinants (such as education, safe housing, and freedom from discrimination) that adversely affect marginalized or excluded groups. Disparities in health and in the key determinants of health are the metric for assessing progress toward health equity.” This mistreatment of patients from minority groups limits their access to quality care and treatment.

Discrimination against patients can range from their health concerns being dismissed unjustifiably, misinformation, a lack of privacy, a variance in treatment on the basis of their insurance or financial status, or not providing care in the patient’s preferred language. Thus, patients who experience discrimination in the medical setting may lose trust in their providers, not communicate openly, or opt out of seeking healthcare altogether.

In a study published in JAMA Network Open, Nong, Jodyn Platt, Ph.D., of the Medical School’s Department of Learning Health Sciences, and their colleagues surveyed over 2,000 respondents in a study examining their lifetime experiences of discrimination within the healthcare system. 21% of respondents reported experiencing some type of discrimination during a health care encounter. Those who were younger, identified as female, had a lower annual household income, and had poor or fair health were more likely to say they were discriminated against. Moreover, racial discrimination was the leading type reported, followed by discrimination based on education or income, weight, sex, and age.

Consequently, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization’s Global Health Workforce Alliance launched the ‘Agenda for Zero Discrimination in Health Care’ on March 1, 2016. This program aims to increase commitment, collaboration, and accountability among countries, the United Nations and development partners, civil society, professional health-care associations, academics, and other key stakeholders for the following objectives:

1. Remove legal and policy barriers that promote discrimination in health care.
2. Set the standards for discrimination-free health care.
3. Build and share the evidence base and best practices to eliminate discrimination in health-care settings.
4. Empower clients and civil society to demand discrimination-free health care.
5. Increase funding support for a discrimination-free health workforce.
6. Secure the leadership of professional health-care associations in actions to shape a discrimination-free health workforce.
7. Strengthen mechanisms and frameworks for monitoring, evaluation, and accountability for discrimination-free health care.

Thus, in order to provide prime healthcare, it is necessary to rid the system of any discrimination and ensure a healthy and flourishing environment for patients who already deal with the difficulties of poor health.