The Compounding Cost of Systemic Racism in Access to Healthcare 

Anushka Roy

Financial inaccessibility to healthcare stretches beyond differences in salary and reveals an intimate connection between healthcare and the cracks in society, extending the discussion to that of systemic racism. In a report, published December 13th in 2017, the WHO reveals that 800 million people spend 10% or more of their household budgets on healthcare, and almost 100 million of them cannot afford these expenses without being pushed into "extreme poverty" (World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses). In PayScale’s 2020 investigation into the racial wage gap in the United States, the uncontrolled group showed that black and Hispanic women, both, earned approximately 80 cents for every $1 earned by a white man (Racial and Gender Pay Gap Statistics for 2021). Similarly, Black women and Hispanic women from the controlled group earn 97 and 98 cents, respectively, for every $1 earned by a white man with similar qualifications (2020 Racial Wage Gap - Compensation Research from PayScale). 

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It becomes evident that disparity in the earnings of different communities can be traced back to race and further to systemic racism in employment and wages. These statistics reflect that people of colour face amplified hardship when trying to pay the high costs of quality healthcare. "African-American, Hispanic and some Asian populations" in the U.S. often have "lower levels of health insurance coverage" in comparison to that of the white population (Bulatao Health Care). This cost to racial minorities compounds into compromises which evolve across time, creating a long- lasting impact spanning generations. In the abstract of her article, "Racial wage differentials in developed countries", which focuses on data from the UK, Simonetta Longhi (University of Reading, UK and IZA, Germany) discusses that while these differences in wages are "partly the result of immigration", they often "persist" in the second and third generations of racial minorities. 

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If this parasitical relationship that healthcare has with racial minorities is seen and sustained from generation to generation, it becomes something of a folk tale entrenched in the history of a culture. When a second-generation, child of an immigrant grows up in an environment where healthcare is seen as an expense which takes from the quality of their lifestyle and that of their family, the idea of trading-off quality healthcare for survival due to financial reasons is passed down and becomes a familiar situation. And often familiarity grows into normalisation. This is reflected in a 2019 survey, which compares the 15.1% of Hispanic. adults and 13% of Black adults who forego or delay medical healthcare due to costs, to the 9.3% of white adults who do the same (Amin, Krutika). 

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While these issues of the healthcare system are birthed at the intersection of financial inequity and racial inequity, the humanity at the centre of an institution which caters to something as personal as healthcare is also birthing solutions. The story of Ms. Eaddy-Onque, reported by the New York Times, sets a grim context at first, revealing that Black mothers in the U.S. are "four times" more likely to die from "maternity-related complications" than white women (Proujansky) and often reject hospital births due to financial and racial disparities- opting for birthing centres instead. Birthing centres do not have the capacity to deal with a high-risk birth, and complications can arise when a low-risk birth escalates to a high-risk situation, as explained by Dr. Timothy Fisher (medical director of the Northern New England Perinatal Quality Improvement Network). In any other situation, this scenario would elucidate the graveness of financial inaccessibility to quality healthcare due to racial disparities, but The Birth Centre of New Jersey provided Eaddy-Onque with a safe and well-supported birth. Founded by "Dr. Nicola Pemberton, a Black obstetrician- gynecologist", the birthing centre differs in that it is run by a medical doctor with "admitting privileges at a nearby hospital and that it primarily serves people of colour". 

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A growing awareness of these issues leads to a growing compassion in people who connect with racial minorities, and, if these people happen to have the professional knowledge and means to do something, The Birth Centre and Dr. Nicola Pemberton are evidence to the claim that they will act. Despite the racial disparities that exist within the healthcare system, Anastasia Onque, the new-born daughter, was safely brought into the world.