Changing Disparities in Health Care Several studies have found that racial and ethnic minorities, as well as those of low socioeconomic status, experience discrimination in healthcare. One study showed Black individuals with private insurance reported the same level of perceived discrimination as uninsured white individuals. Intervention methods, like Soft Systems Methodology, have been introduced in some hospitals to address disparities through education and analyzing how systems can be improved. However, more research on effective intervention strategies is still needed. It is important for healthcare providers in Burlington, which has higher rates of poverty and racial diversity than national averages, to limit implicit biases and prioritize understanding each patient's individual needs and experiences to help reduce systemic inequities in healthcare.

1. Changing Disparities in Health Care
Avery Underwood and Mia Bylykbashi

2. Statistics on Healthcare Disparities
This discussion begins with information from research studies on the disparities in healthcare.
Though it is often referenced, few understand the broad scope of the institutional and individual
discrimination marginalized groups face when seeking treatment. One study found that white
individuals with no healthcare insurance or of low socioeconomic status experienced as much
perceived discrimination as educated, insured Black individuals. Both groups experienced more
discrimination than educated, insured white individuals (Stepanikova). This demonstrates one
example of intersectionality. If financially secure, white individuals reported no discrimination,
and financially secure Black individuals and financially insecure white individuals reported a
level of discrimination, there are levels to how identity terms can combine. Financially insecure
Black patients are subject to experiencing discrimination both due to their race and
socioeconomic status. This understanding is especially important to consider as many patients as
possible in the Burlington area are low-income.

3. SOURCE: Kaiser Family Foundation, March/April 2006 Kaiser Health Poll Report Survey, April 2006 (Conducted April 2006).
A separate study by the Kaiser Family Foundation performed in 2006 interviewed individuals of
different races to determine what their perceptions are of disparities in health care (figure above).
According to the Kaiser Family Foundation, the poll showed that nearly 6 out of 10 people did
not believe there was a difference in care between black individuals and white individuals.
Following this, 5 out of 10 people did not identify a difference in cape between Latinx
individuals and white individuals. This study presented the idea that not only do providers need
to be educated on disparities in their career, but the general public needs to be educated as well.
In order to achieve change, education is widely important. An additional study found that Black
and Latina women in NYC are two times as likely as white women to experience a potentially
life-threatening complication during their pregnancy. This research determined that provider’s
perceptions of racial and ethnic groups influenced patient-provider communication and treatment
and is contributing to the healthcare disparities between white patients and patients of color.
There is little to no evidence that suggests Black and Latina women have genetic factors that
influence their mortality rate from these complications (Janevic et al.). Providers must keep
patients at the forefront of their consideration. Only through provider care disparities is this
statistic possible. Subconscious beliefs about different identities can influence provider actions
without one’s knowledge. Though this is difficult to admit, being aware of one’s biases is the
only effective method to control them.
Intervention Methods

4. To understand that changing our institutions is possible, an intervention method that has
previously been implemented is described below. Soft Systems Methodology (SSM) is an
approach to address intricate social issues (Midgley, 2006; Williams, 2005). Soft Systems
Methodology brings attention to the importance of moral decisions and ethics in creating
interventions to change institutions. SSM emphasizes to participants that carefully analyzing the
world as it exists and how it could be improved (Griffith). It has already been introduced to
certain hospitals, alongside anti-racist community organizing, and education about these topics.
As society begins to demand change, we must implement steps like SSM to further spread
knowledge, education, and support. In searching for successful methods, our findings were
lacking. There is very little research regarding ways that disparities can be lessened, which must
be changed. Much more abundant, however, was research on reasons for the existence of said
disparities. One researcher discovered that patients who seek care with Medicaid instead of
private insurance are less financially valuable patients for providers, and consequently, this
contributes to them receiving worse quality of care, writing: “There is clearly a need for
concerted societal-wide efforts to confront and eliminate discrimination in education,
employment, housing, criminal justice, and other areas of society which will improve the
socioeconomic status of disadvantaged minority populations and indirectly provide them greater
access to medical care” (Williams, et. al). As stated above, it is certain that for equity to be
reached, intervention methods must be further explored and prioritized.
Why should you care?
It is important to keep the patient’s needs at the forefront of providers’ actions. The Burlington
area is disproportionately affected by poverty and has a higher rate of marginalized individuals.
North Carolina’s median household income is $73,000; the average income for Burlington is

5. approximately $63,000. The poverty rate for Burlington NC is 19.13%, well above the national
average of 11.6%. 27.7% of the population is Black (compared to the national average of 12),
and nearly 9% identifies as an “other race” (World Population Review). With a diverse
population as well as low income, it is essential to recall the dual oppression that individuals
with complex identities often experience. Many individuals in the Alamance County area face
issues due to their finances as well as race, gender, and sexuality. By committing to limiting
provider biases, one can ensure that these systemic issues are not worsened by their actions. One
step further, which we strongly advise, is to begin looking into ways to implement interventions
that prevent biases within healthcare.
What can you do?
Limiting implicit biases is key to reducing systemic racism, sexism, and discrimination. Training
courses and moral evaluations will induce deeper thinking about social contexts. It is highly
important to use generic language rather than jargon-heavy speech when discussing issues with
patients. This will help reduce the gap in quality of care between higher and lower
socioeconomic stratus groups. Continuous education is also crucial to reaching equity of care.
Providers must take steps to read and learn about the differences in care quality and common
misconceptions of medicine to avoid them and stand against them. The most important step of all
is to interact with each patient as an ally and by actively listening. It’s easy to presume when a
patient describes their symptoms that they have whichever disease or illness is most associated
with what they’ve described. Race, gender, sexuality, and other aspects of identity also play into
the constructed idea of diagnosis. However, by setting aside bias and openly hearing what a
patient says, providers can become better at their craft.

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