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Skin Colour Bias in healthcare

A Pervasive issue in Healthcare

Within the fields of medicine and healthcare, countless studies have uncovered data that backs up horror stories from people existing in intersectional groups across the globe.

Within the medical field, bias is referred to as a term that encompasses implicit stereotypes and prejudices that one group may make about another.

In the context of skin colour bias or colourism, the model for the creation and cultivation of these biases and who they are made against is rooted in racism, where 'whiteness' others all groups that do not embody its traits.

The motivation behind this theory is that whiteness is seen as the standard and any other group that holds a differing identity or trait is unimportant, if not inherently unworthy.

In healthcare, the subconscious, or in some cases, conscious idea that patients worthy of healing and care are inherently white people, leads to the perpetuation of stereotypes against non-white individuals.

In essence, the root of skin colour bias is cultivated in the theory of the other.

This means that the stereotypes made about black and ethnic groups by healthcare professionals who hold this bias, can affect the quality of their healthcare and in many cases it has.

Research on skin colour bias within American Psychiatry showed that implicit biases made by healthcare providers held against black individuals resulted in misdiagnosis of mental conditions, where African Americans were more likely to be misdiagnosed with schizophrenia than White patients.

This is a direct highlight as to how racism can directly result in impartial care, but in understanding colourism, the entire concept becomes more complex, as discrimination becomes intersectional.

The coagulation of a discriminatory stereotype occurs through allowance.

The absence of consequence (often paired with verbal discrimination) towards a person considered to be within the group of other, solidifies the idea that they are not worth the same amount of respect as a white person is, where whiteness is centred.

In medicine, this is prevalent in the learning of how diseases attack primarily white bodies. Where symptoms like redness in the skin will not apply to all race groups because of melanin load. It manifests in comments made by medical and healthcare providers in their personal capacity, reflecting their views and beliefs, which then goes on to affect their capacity to provide care. This discrimination is many times covert before it is overt.

To understand the extent, a definition of colourism needs to be stated. Colourism in healthcare differs from skin colour bias as it comprises intersectional identity bias that skin colour bias may not. Understanding colourism as preferential treatment of people within the same race group based on skin colour brings to light a new platform for discrimination.

Colourism is racially charged and can be the result of internalised racism.

This form of bias sees the proximity to whiteness in physical identity as preferential over those who do not hold these physical traits.

This is seen in the different treatment of lighter-skinned black women in comparison to darker-skinned black women, and the same type of sentiment is carried on into other races as well.

The idea that light-skinned women are more feminine is rooted in racism and sexism, where darker-skinned individuals are masculinised and treated or invalidated based on the perception that they hold masculine traits.

This is illustrated in the idea that women with darker skin have higher pain tolerance, and cannot be in as much pain as they say they are.

This stereotype has been perfectly encapsulated in Serena Williams’ retelling of how nurses had handled her post-pregnancy complications.

Williams, who had a history of suffering from pulmonary embolisms, suspected that she needed medical attention for this potentially life-threatening issue after giving birth to her daughter, Alexis Olympia.

However, Williams' concerns were rejected by a nurse who thought her pain killers were making her confused.

Later it was discovered that Williams had indeed suffered blood clots in her lungs.

The attitude that the nurse held, that Serena was being confused by pain medication, is rooted in the colourist stereotype that (dark-skinned) black women have a higher pain tolerance and the racial bias that Serena was creating a baseless complaint.

This scenario illustrates how black women are facing a mortality crisis within the USA and how the uniform discrimination against them results in partial care, within pregnancy or not.

The key with colourism and racially charged skin colour bias means that discrimination on the basis of skin colour is not exclusively a black versus white battle, and is a battle to fight the internalised racism causing medical professionals to assume bias.

The common premise here is that the proximity to whiteness displayed by an individual, the more favourable their treatment, and when a healthcare provider is biased, this guarantees impartial care which in the scenario explained above, can be life-threatening.

Overall, this concept shows how racism affects all areas of life for black and ethnic individuals.

Places of care that are designed to preserve human life, consequently see people get more ill, or even lose their lives because of impartial care that is rooted in skin colour bias.

This is a problem, and antagonising deep-seated beliefs is one of (if not the first) steps in solving inequalities within the healthcare system (and beyond).

Discrimination and prejudice grow where they are accepted.



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