The article, 'Still Closing the Gap' by Fitzhugh Mullan highlights several aspects of disparities in the United States. It focuses on racism as a critical factor in enhancing disparities in different dimensions. For example, the article explores racism in medicine, the civil rights movement and its impacts and racism in social contexts. The author of the article Fitzhugh Mullan is a professor with a wide knowledge base in healthcare practise. He is a professor at the Milken Institute School of Public Health at George Washington University, a Co-Director of the George Washington University Health Workforce Institute and a professor of paediatrics in the school of Medicine and Health Sciences. The article presents both the contemporary and the past contexts of racial discrimination practises in the healthcare system of the United States. That makes the article a present day article hence validated for use in the understanding of the subject topic. If the article would have been written during the early years before the revolution of the medical care practises, it would have addressed different aspects of racism. Most probably, it would have presented the challenges of racial discrimination in healthcare systems or rather focused on enhancing racial discrimination as it were during the earlier days.
Mullan has conducted several researches including research on HIV/AIDS in Africa, health workforce policy and community health delivery. Such attributes makes his contributions in the article relevant and credible in understanding the racial issues in healthcare system of the United States. The purpose of this paper therefore is to explore racism in the United States from the early days before formation of the Civil Rights Movement, the process of reducing disparities between the whites and the non-whites and provide suitable examples related to the literature provided by the article.
Healthcare System Before
Racism largely played a divisive role in the American society. It defined all the relations between whites and blacks. Americans citizens received favours in job opportunities, healthcare, income and voting rights based on their colour. According to Mullan, the health sector was largely discriminative. The blacks were secluded from attaining quality healthcare services. For example, from the article the blacks in Durant had specific hospitals that they could attend. The segregated hospitals meant for the blacks were in dilapidated conditions. They had no adequate facilities, which could be used to provide adequate medical care. For example, children in the hospitals could be put in the diarrhoea room is they suffered from diarrhoea. Additionally, the hospitals lacked competent medical practitioners who could provide the needed health services unlike in white-dominated hospitals. Lincoln had many cases involving traumatic conditions. Most people became victims of falls and consistent fire cases that caused trauma among the population. However, despite the high number of trauma cases, the blacks lacked neurosurgeons, who could address their mental needs (Mullan Par. 6-8).
The article by Brandt (21-23) further exhibits the prevalence of racism before the civil rights movement. According to the article, the research conducted among syphilis patients showed that most blacks were syphilitic compared to the whites. The Tuskegee study showed that black men were primitive and could not be assimilated into the whites' civilization. That, therefore, exposed most blacks to risk factors of syphilis. Even the most educated blacks could not maintain healthy practices, which could least expose them to syphilis. The study was discriminative since it majorly focused on blacks more than the whites. Additionally, some of the medical practitioners advocated for strict punitive measures against blacks for sexual crimes. For example, some could undergo castration and seclusion due to their health conditions.
Malebranche (par.7-9) Provides several examples of discrimination based on race. His parents were white and black. The parents tried to raise him without racial bias, but he always became a victim of racism. During his career, he often saw black patients being mistreated. They were misjudged based on their illnesses. For example, the medical practitioners at the hospital underestimated Mr. X based on his unusual behavior. The doctors had not seen such characteristics among their patients. Therefore, they quickly sought to subject him to psychiatric analysis.
The struggle to eradicate inequities in the United States dates back to the 1960s. Several programs have been initiated to ensure equality among American citizens. More emphasis has been on the blacks, who are victims of racial discrimination in most cases. Safety Net is an example of programs that were put in place to elevate the living standards of the vulnerable people in society. The safety net programs aimed at covering the vulnerable sections of the society through improved standards in the medical fields. The programs, therefore, established health centers such as public hospitals and policies, which could address the needs of different people (Malebranche par. 10).
Besides, the civil rights movement came into place to advocate for equal rights among American citizens. The movement advocated for the rights of the blacks since they were victims of a violation of human rights. They championed for reforms in the healthcare system of the United States. The system by then was largely marred with discriminatory practices. The whites were favored more than the blacks were. The preferential treatment among the whites stirred revolutionary actions that aimed at advocating for equality in all aspects of social life. The Civil Rights Movement, therefore, encouraged people through rallies to change their perceptions and racial attitudes they held against the blacks. The civil rights movement, therefore, ensured that policies were in place to eradicate some of the racial practices that were in existence (Malebranche par. 13).
The United States has made efforts to narrow the gap between the blacks and the whites in accessing health services. Despite the several attempts, it has not attained its full potential in reducing the inequities. The contemporary healthcare system in the United States still faces issues of racism perpetuated against blacks. Many blacks are still uninsured. That makes it hard for them to access public medical services at cheaper rates. The whites, on the other hand, are insured more than the blacks, and they are able to access free healthcare services. Lack of insurance covers also bars blacks from accessing diagnostic tests or hospitalization. Besides, the current medical coverage among blacks is irregular. In most cases, the blacks have to undergo several processes of documentation for them to attain the medical covers. Such aspects, therefore, make it hard for blacks to follow the channels for documentation (Mullan).
Malebranche asserts that there is a need to expand the cultural competence programs, which would help to teach medical students the existing differences between pathological diseases and the cultural experiences of illnesses associated with the blacks. The programs would be suitable to identify personal and cultural biases that exist hence increasing chances of providing objective medical care to patients regardless of race and skin color.
Brandt, Allan . "Racism and Research: The Case of the Tuskegee Syphilis Study." The Hastings Center Report. Vol. 8, no. 6, 1978. https://dash.harvard.edu/bitstream/handle/1/3372911/Brandt_Racism.pdf?sequence=1
Malebranche, David. ''Learning about Medicine and Race.'' Health affairs. Vol. 23, no. 2. March/April, 2004. https://www.healthaffairs.org/doi/10.1377/hlthaff.23.2.220
Mullan, Fitzhugh. ''Still Closing the Gap.'' Health Affairs. Vol. 28, no. 4. July/August 2009. https://www.healthaffairs.org/doi/10.1377/hlthaff.28.4.1183
Reverby, Susan. ''Listening to Narratives from the Tuskegee Syphilis Study.'' The Lancet. Vol. 377, no. 9778. May 14, 2011. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60663-6/fulltext
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