PHOTO: SEAN GARCIA
It’s tempting to think of medicine and health care as objective and neutral, driven solely by scientific principles and free inquiry. Indeed, scientists go through extensive measures to make their research bias-free. However, recent developments show that despite the best efforts, racial disparities persist in the health care system even when they are unintentional.
The disproportionate impact of coronavirus disease 2019 (COVID-19) on Black and Latinx communities in the United States has demonstrated that although illnesses may not discriminate, varying access to treatment, preventive measures, and other resources can still lead to imbalances in health care. Racial differences persist in scientific research as well: Algorithms designed to make decisions about health care incorporate biases that limit care for Black patients. Another recent study showed that Black applicants to granting programs at the U.S. National Institutes of Health got less money than their White colleagues. This was not a result of intentional discrimination, but because Black researchers worked in areas (fertility, health disparities, and adolescent health) that tend to be underfunded.
Why do racial disparities persist despite the safeguards scientists have put into place to keep their work bias-free?
Much of the problem is that racial biases not only occur in individuals, but are also embedded in our institutions—what sociologists refer to as “structural” or “systemic” racism. Once primarily heard among social scientists, these terms have, in the past few months, become more mainstream. Systemic racism refers to the well documented fact that most of our institutions—in politics, law, education, and health care, to name a few—are fundamentally organized according to assumptions and policies that work to the disadvantage of communities of color, and Blacks in particular.
In health care, for instance, this can mean pay policies that discourage practitioners from treating patients who are affected by poverty, discrimination, and other factors that can impair health—factors that disproportionately affect Black patients and the Black practitioners who are more likely to treat them. In technology, this means facial recognition systems that frequently misidentify Black people. And in the legal system, these structural barriers are present in the oft-cited racial disparities in mandatory minimum sentencing rules for drug use, and in targeting predominantly Black, low-income communities for nonviolent drug crimes whose punishment can escalate into a loss of voting rights and other freedoms.
None of these policies is necessarily a result of individual intent, overt bias, or malice. But ultimately, individuals are the ones who create social institutions. When most of these people are White, it is all too likely that they will fail to recognize the particular realities of life for Black citizens.
The first step toward addressing these issues is to recognize that despite the pride scientists take in being analytical thinkers, these problems persist. Most people don’t set out to maintain racial disparities, but do so inadvertently, and the scientific community is not exempt. After acknowledging the issue, the second step would be to establish policies that encourage more racial diversity in all sectors of the scientific community—among researchers, educators, and policy-makers across the board.
What is badly needed is a wider range of perspectives. This suggestion may not sit well with scientists who are committed to the belief that theirs is a completely meritocratic field. But bringing together a broader variety of voices to the scientific community will help all scientists as they continue to make discoveries that advance society. The crisis that the COVID-19 pandemic has brought to Black and Latinx communities adds to the urgency.