Health disparities in America are an unnatural creation because they are preventable differences in the burden of disease, injury, exposure or violence borne by socially disadvantaged racial and ethnic minority populations. Moreover, they are missed opportunities to achieve optimal health instead of the usually worse outcomes that are experienced by these populations.
The passage and enforcement of the Civil Rights Act of 1964 helped end Jim Crow practices in America by prohibiting discrimination in public accommodations, facilities, and schools. It also outlawed discrimination in federally funded projects. This should have meant the end of disparities in healthcare— at least in federally financed health programs but sadly, it did not. Subtle forms of segregation and the failure to assure nondiscriminatory treatment persisted in medical settings due to bias, stereotyping, prejudice and clinical uncertainty by the health systems, providers, managers and other personnel entrusted to provide care. Moreover, other external factors in the context of broader inequalities experienced by socially disadvantaged racial and ethnic minorities, like unstable housing, food deserts, education, income, comorbid illnesses and health insurance (type or lack of) also help contribute to health disparities. Black Americans as a group tend to mistrust healthcare professionals more than other racial groups due to negative personal experiences with physicians and other medical providers. They also remember America’s history of using Black people for unethical medical experiments, as well as its history of denying everyone universal medical insurance in hopes that Black people would die off because they were too poor to get treatment.
