While it might seem unimaginable to deny someone excellent healthcare because of the color of their skin, it’s happening.
Scholars in the health care industry have studied health care disparities for over 30 years. One study estimates that 83,570 minority patients die every year due to health care disparities. (Source: JSTOR) These disparities result in black and brown patients consistently receiving inferior medical treatment compared to white patients, such as fewer:
- bypass surgeries
- organ transplants
- cancer tests and treatments
- access to pain treatment
- rehabilitative services
- asthma remedies
- and nearly every other form of medical care (Source: JSTOR)
We scoured the internet and identified the top 6 books about racism in medicine. Regardless of whether you’re a patient, healthcare professional, concerned citizen, or inquisitive student, you’ll find these books insightful.
1. Just Medicine: A Cure for Racial Inequality in American Health Care
In Just Medicine, author Dayna Bowen Matthew explores the significant role that bias plays in how healthcare is provided in America. Matthew helps readers understand what is at stake for tens of thousands of patients through her assessment of the damage caused by unconscious racism.
Her data reveals that even when doctors explicitly prefer to be fair and nonprejudiced, their implicit biases will dominate. This means their implicit biases have a greater impact on their conduct and decisions than their explicit preferences. (Source: C-SPAN2 BookTV)
In this book, Matthew interviewed doctors and was surprised to learn that some were unaware that health care disparities exist. And many of the doctors she interviewed did not believe they were personally influenced by implicit racial and ethnic biases.
Thus, her findings are important because the first step in fixing a problem is recognizing that a problem exists. How can we expect change if doctors aren’t even aware that there is a problem, or that they may be unintentionally contributing to the problem? Arguably, this book should be required reading for all doctors and healthcare workers.
In addition, Matthew explores how biases not only affect how healthcare is provided, but it also affects how healthcare is received. Bias affects doctor-patient communications and interactions. Matthew breaks it down simply in saying, “bias affects how both parties hear, see, and respond to one another.” That, in turn, affects the patient’s quality of care.
Matthew says she wrote this book because “health disparities is killing people of color daily. It’s causing people of color in this country to live sicker and die quicker because of the color of their skin.” (Source: C-SPAN2 BookTV) Her book discusses how health disparities based on race are not just medically wrong, but morally and legally wrong too.
Matthew acknowledges that nothing short of radical change will solve the issue of race-based health disparities. But she offers hope. She suggests solutions on how physicians might be able to control their biases. And she explores how civil rights laws have failed to fix health inequality in the past but may still be a powerful tool for future protections against racism in healthcare. (Source: JSTOR)
What is Implicit bias? Bias that results from the tendency to process information based on unconscious associations and feelings, even when these are contrary to one’s conscious or declared beliefs.
Bias: Unreasonably hostile feelings or opinions about a social group; Prejudice; A particular tendency, trend, inclination, feeling, or opinion, especially one that is preconceived or unreasoned.
Implicit: Implied, rather than expressly stated.
Explicit: Fully and clearly expressed or demonstrated; leaving nothing merely implied; Clearly developed or formulated.
2. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present
Awareness of history is a great starting point in understanding racial disparities in America. And the same is true for racial disparities in medicine and healthcare. In the book Medical Apartheid, author Harriet A. Washington shines a light on the history of medical and scientific experimentation on black Americans.
The author gives an account of events that took place dating back to the colonial era. She discusses how black people, unknowingly and without consent, have been used for scientific experiments in hospitals. And according to Washington, it still goes on today. Furthermore, blacks have been victims of grave robbing, unauthorized dissections, and autopsies.
Many people are familiar with the infamous Tuskegee Syphilis Study. However, this book opens our eyes to many other incidents of abuse in the medical field that disproportionately involve black people. Including incidents that occurred after the Tuskegee Syphilis Study.
What was the Tuskegee Syphilis Study?
Also known as “The Tuskegee Experiments,” this study enrolled 600 black males to track the progression of syphilis. The men were not told they were participating in medical research for syphilis. And they were never given treatment for it, even after penicillin became the recommended treatment 15 years into the study. The study went on for 40 years until a whistleblower leaked it to a reporter. Public outrage caused the study to shut down in 1972. (Source: History.com)
Unfortunately, most people only know about the Tuskegee Experiments and not about other abusive research involving black people. Washington was surprised to learn that many medical historians and researchers are also not aware of the many other abusive studies and research that disproportionately affected black people. This alone has consequences which include:
- The fears of black people to receive healthcare and engage in medical research.
- The belief that repeated abuse of blacks in medical research is a myth.
One of Washington’s goals in writing this book was to encourage medical professionals to explore “how we can interpret events today in light of our history to understand and hopefully not repeat” these abuses. And to educate and inspire aspiring medical students to want change. (Source: Harriet Washington, “Medical Apartheid” author interview)
Do laws help prevent abuses in medical research?
Today, there are laws in place to protect human subjects in government funded research. For example, in 1972 Congress passed the National Research Act. That Act created a Commission with 11 members who produced ethical guidelines called, The Belmont Report. (Source: National Library of Medicine)
But Washington says the laws are not enough because they “are only as good as the people who enforce them.” Therefore, it’s important for medical professionals and public officials to understand the history of racial disparities in medicine and the ethics involved.
3. The Health Gap: The Challenge of an Unequal World
In The Health Gap, author Michal G. Marmot offers a different view about why there’s such a significant difference in health care within countries and around the world. He says it goes beyond race. And beyond poverty. He asserts that social injustice is the greatest threat to global health. (Source: Bloomsbury).
Marmot acknowledges that healthcare disparities in the USA are “closely linked with race, largely because of widespread and institutional discrimination.” But he emphasizes that it’s “inequalities in social and economic conditions through the life course” that cause many health inequalities. (Source: National Library of Medicine)
Marmot’s research reveals that within countries, health is tied to an individual’s social status. In other words, the higher the social status, the better their health. He reveals that “the average person would have eight extra years of healthy life if they had the same opportunities as the richest in our society.” Note, he’s not saying everyone needs to be rich. But if we could give everyone the opportunities that rich people have, we could reduce health inequalities in America and globally. (Source: Bloomsbury)
He believes we can reduce health inequalities by creating conditions where people can lead flourishing lives. He gives examples of what we can do to provide social equities to individuals during their life cycle. From early child development and education to working conditions and better conditions for the elderly. Marmot argues that we have the tools and resources to make a difference. Thus, not doing so is a form of injustice. (Source: National Library of Medicine)
4. An American Health Dilemma
An American Health Dilemma, is a comprehensive history and analysis of race and medicine in America. Authors W. Michael Byrd and Linda A Clayton created two volumes. The first volume covers “A Medical History of African Americans and the Problem of Race: Beginnings to 1900.” The second volume covers “Race, Medicine, and Health Care in the United States 1900-2000.”
The two volumes combined present a study of how racism has impacted medicine and public health over the past 400 years in America. These books break down early conceptions of race as a whole, “beginning with the origins of western medicine and science in Egypt, Greece and Rome.” The authors detail the relationship between race and healthcare both before and after slavery. It also explores race and medicine from the early 1900’s, during the Great Depression, World War II, the Civil War, Reconstruction and the Civil Rights Movement. They cover more recent decades through the 1980’s and 1990’s as well. (Sources: Routledge and Taylor & Francis Group)
In addition to the historical context, they cover topics such as:
- The legacy of presumed inferiority of black people as a race.
- The different indicators of “normal” health status for blacks compared to whites.
- The dual-tier healthcare system based on race and class.
- The continued use of the inferiority fallacy by the medical profession that undermines the work of black doctors and nurses. (Source: Routledge)
Overall, the authors take you on a journey where you’ll see the struggles black people have endured towards quality healthcare and medical equality for hundreds of years.
5. Against the Odds
In the book Against the Odds, author Wilbur H. Watson explores race and healthcare from the perspective of black doctors. He shines a light on the achievements black doctors have made despite the barriers created by racism. Watson describes successful efforts made by black Americans throughout history to “to establish a strong black presence in the medical profession.” (Source: The University of Chicago Library)
This book is unique because it includes first-hand experiences as told by older black doctors who lived through years of America’s racial separatism and through the first decades of desegregation. The author interviews older black doctors who reveal stories about themselves both as physicians dealing with a racially segregated society. And as people in their everyday life. The lived experiences of those interviewed give the reader a more grounded understanding of how race impacted people’s actual lives and professions.
The reader gains insight into the stigma associated with being a black doctor. That stigma is often spurred by the myth that black doctors are less competent than white counterparts. Watson successfully debunks that myth, although it persists still today.
Against the Odds uniquely reveals how racism and white dominance obstructed black people’s access to medical education, their practice of medicine and their mobility within the medical profession. Despite this, the book highlights notable triumphs and successes. (Source: Routledge)
6. The Immortal Life of Henrietta Lacks
This book is the true account of a woman named Henrietta Lacks, who made one of the greatest medical contributions ever. The problem, however, is that her contributions were the result of medical experimentation done with cells taken from her body, without her knowledge or consent. Author Rebecca Skloot tells Lacks’ story and reveals the racist practice of using unsuspecting black people for medical experiments. Lacks’ cells were used for various experiments, and some of her cells are still alive in culture today – nearly seventy years after her death.
Henrietta Lacks has been called one of the most important women in medical history. The irony is that “Henrietta’s cells have been bought and sold by the billions, yet she remains virtually unknown, and her family can’t afford health insurance.” (Source: Rebecca Skloot)
“None of the biotechnology or other companies that profited from her cells passed any money back to her family. And, for decades after her death, doctors and scientists repeatedly failed to ask her family for consent as they revealed Lacks’ name publicly, gave her medical records to the media, and even published her cells’ genome online.” (Source: Nature)
Mrs. Lacks’ story raises questions about the ethics involved in medical research and what rights we have over our own bodies. The book reminds us that at the root of medical science is humanity, and real human beings, not just subjects.
This book will take you on an incredible journey leaving you awe-inspired at medical discoveries and at the same time dismayed about the human consequences behind such discoveries. Mrs. Lacks’ story was also made into a film by the same name, produced by Oprah Winfrey.
Frequently asked questions about Henrietta Lacks
How did doctors take Henrietta Lacks’ cells?
In 1951, doctors took samples of Henrietta Lacks’ cells while she was being treated for an aggressive cervical cancer. A sample of her cells were sent to a tissue lab. The cancer researcher in that lab learned that Mrs. Lacks’ cells were exceptionally durable and could survive outside of the human body. The researcher shared her cells with other scientists and the cells became essential in biological research. (Source: John Hopkins Medicine)
How are Henrietta Lacks’ cells immortal?
Researchers learned that Mrs. Lacks’ cells had an extraordinary ability to survive and multiply in the lab. Her cells doubled every 20 to 24 hours. Thus, they became known as the first “immortal” human cells. (Source: John Hopkins Medicine and Nature)
Immortal cells are important because it makes the research process more productive and efficient. Mrs. Lacks’ cells were the first cells that could be easily shared and multiplied in a lab setting, outside of the human body. Before Mrs. Lacks’ cells were available, “scientists spent more time trying to keep cells alive than performing actual research on the cells.” (Source: Popular Science)
How have Henrietta Lacks’ cells been used in medical discoveries?
Mrs. Lacks’ cells are now 69 years old (as of 2020) and have been used in countless medical studies and developments. Here’s some of the ways her cells have been used:
- Research for COVID-19 vaccines.
- Research for leukemia
- Research for the AIDS virus
- Research for cancer worldwide
- Research on the effects of zero gravity in outer space
- Developing the polio vaccine
- Gene mapping
- In vitro fertilization
These books provide truths, both hidden and blatant, backed by scientific, historical, and evidentiary research. They show how thousands of brown and black lives are lost every year due to avoidable, unjust, and unfair treatment that results in low quality health care.
The result is a high level of distrust by blacks for the healthcare system, which we’re witnessing first-hand during the Covid-19 pandemic. And an unjustifiable gap between black people and white people in life span, quality of life, and other measures of health and well-being.
The authors and books discussed above provide suggestions and actionable ideas that are worthy of exploring to eliminate health disparities and inequalities.