Health Disparities and Race 101: Breaking Down Common Terminologies

Addressing implicit bias, especially in healthcare, can seem like a daunting task. As an organization dedicated to providing improved access to healthcare for children and families around the world, we are committed to addressing issues of health disparities head-on with our staff, volunteers, and supporters.

Health equity is at the core of our mission at FIMRC. Through health education programs, community outreach initiatives, and clinical improvements, we work every day to achieve our goals. However, we know we must also work with our communities to gain a better understanding of how and why health disparities occur in the first place to help combat serious health issues such as chronic disease management, HIV/AIDS, and maternal and child health.

To wrap our heads around such a large, complex issue, we are breaking down some of the most common terminologies about health disparities and implicit biases as they relate to healthcare so that we can begin to recognize, understand, and ultimately make progress toward health equity. While these terms are likely to evolve and many are currently being re-evaluated, gaining an understanding of these words and how we use them to describe current health equity barriers is the first step on the long road to change.  

Health Disparities:  When a health outcome is seen to a greater or lesser extent between populations, there is disparity. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health. For example, higher rates of obesity typically occur among Black populations in the United States. At FIMRC Project Alajuelita, Costa Rica, the majority of our patient population is comprised of Nicaraguan refugees, who face significant challenges when it comes to accessing healthcare. Because of their refugee status, these patients don’t have access to Costa Rica’s healthcare system and must rely on organizations like FIMRC in order to access essential healthcare services.

Health Equity:  Achieving health equity means that no person or group of people is prevented from reaching a high level of health and healthcare due to their social position or identity. 

Social Determinants of Health:  The conditions in which people are born, grow, live, work, and age. They include factors like socioeconomic status, education, neighborhood, physical environment, employment, and social support networks, as well as access to health care. In Chicago,  where residents of the predominantly Black neighborhood of Englewood live an average 30 years less than residents of the predominantly white neighborhood, Streeterville, just 10 miles away. This can be attributed to a lack of access to grocery stores, pharmacies, and other health resources simply based on where a person lives. 

Implicit Biases in Healthcare:  Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. For example, a healthcare provider might assume a Black patient has a higher pain tolerance simply because of his or her race and not offer the same pain management treatment that would be offered to a white patient. 

Healthcare Access:  Access to healthcare means having the timely use of personal health services to achieve the best health outcomes. Barriers to access can include the cost of care, lack of health insurance or lack of enough coverage, or lack of access to services -- for example if a patient lives in a rural community or lives far away from transportation to healthcare.

Race:  Race is a social and political construct, not a biological trait, although it can have biological consequences such as a higher prevalence of diabetes among Blacks in the United States. Often race can be used as a medical shortcut to diagnose or explain the high prevalence of a condition among a population without taking into account the socio-economic factors.

Prejudice: A preconceived notion about another person or group of people, not based on reason or direct experience with that person or group. Prejudices can be positive or negative, but most often associated with judgments based on a person’s race or appearance. 

Racism:  Racism is the belief that a person’s race is equated with particular traits or characteristics, including believing one race is superior to others, resulting in the unequal distribution of power based on race, including unequal access to healthcare, employment, and housing. 

Systematic Oppression/Racism:  Oppressive actions or behaviors that occur methodically or in an organized manner. This type of oppression can also be referred to as structural or institutional racism, generally pointing to the large scale nature of oppression. An example would be hiring managers not considering a resume based on the applicant’s name or if they received their education from a historically black college or university. 

Systemic Oppression/Racism:  Oppression that occurs throughout societies based on institutionalized laws, processes, and procedures. Racism becomes part of the system, for example, if all the hiring managers for an organization are white they might be more likely to hire people with similar backgrounds and appearances. In relation to healthcare, this would mean not hiring as many care providers of color and therefore patients of color not having access to providers who look like them, perpetuating the cycle. 

These are just a few of the most common phrases to help describe and demystify the challenges providers and patients face when seeking healthcare, both in the United States and worldwide. As these terms and definitions evolve,  we look forward to incorporating clear and inclusive language into our mission to improve health equity worldwide.

 A few additional resources to provide context around these phrases include:

Just Medicine:  A Cure for Racial Inequality in American Health Care

Black and Blue:  The Origins and Consequences of Medical Racism 

The Immortal Life of Henrietta Lacks

Podcast: Racism as a Public Health Issue

Podcast: Racial Health Disparities: How COVID-19 Magnified a Public Health Emergency

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