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It is a brutal truth that Black patients generally face worse health outcomes than their white counterparts, even when adjusting for insurance coverage and socioeconomic status. The majority of individuals with sickle cell disease (SCD) are Black and suffer from health inequity.

This study investigated this correlation by distributing a survey on race and healthcare issues at a sickle cell disease center to hematology/oncology staff (focusing on healthcare providers), patients with SCD, and their families. Of those who participated, approximately 93% of patients with SCD were Black, while about 94% of the staff were white.

Interestingly, while significantly more patients and families felt that race was a factor in the quality of care for patients with SCD, it was the hematology/oncology staff who perceived unequal treatment of patients. The staff agreed at a higher rate than patients and families that medical racism was a problem nationally and at their institution.

A small and relatively equal number of patients, family members, and staff perceived differences in treatment and pain management by race. Patients and families were much more likely to report emotional responses as a result of race in care settings and the belief that race was affecting interpersonal relationships between patients and staff.

This survey illustrates an essential point concerning provider attitudes and SCD care. While providers understood and agreed that medical racism was a problem, they were less likely to perceive its role in the care of their own patients with SCD. Additionally, while providers were able to recognize when their patients with SCD were treated unequally, they were not able to correlate this disparate treatment with race.

Considering that the evidence overwhelmingly shows that race negatively impacts medical care, this point highlights a critical gap in provider understanding of medical racism.

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This study shows that while healthcare providers tend to be aware of medical racism as a concept, more work has to be done to help them recognize it when it occurs at their institutions and possibly their own hands. Until Black patients are more equally represented among healthcare workers, all healthcare staff should be trained to recognize their own implicit biases and learn to recognize racial disparities at a systemic level [1].


[1] Nelson, S. C., & Hackman, H. W. (2012). Race matters: Perceptions of race and racism in a sickle cell center. Pediatric Blood & Cancer, 60(3), 451–454. https://doi.org/10.1002/pbc.24361

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