Race, gender and law scholar discusses racial disparities in health care

March 01, 2021

Dorothy Roberts

Medical professionals continue to make assumptions about race and genetics when treating patients in spite of the fact that race is not a biological category — but a social and political one, said Dorothy Roberts, a scholar of race, gender and the law.

The University of Pennsylvania professor said when doctors use race to figure out what’s wrong with a patient, or to treat a patient, they really are using race as a proxy for something else, with negative effects to the Black community.

Roberts discussed the history of race-based medicine, its scientific fallacies and the destructive toll it has taken on generations of Black Americans at a Feb. 23 Black History Month webinar moderated by Don C. Sawyer III, Quinnipiac’s vice president for equity and inclusion, and Professor Abayomi O. Akanji, MD, a professor in Quinnipiac’s Netter School of Medicine. The virtual program was open to the public.

Roberts has published numerous books and articles examining the intersection of health, race, gender, social justice, bioethics and the law. In her opening remarks, Quinnipiac President Judy Olian called Roberts’ work crushing in what it reveals. For Sawyer, who lost his father to complications from COVID-19 in December, it hits close to home.

“A careful, scientific analyses of the type conducted by Dr. Roberts demonstrates that it is not the genetics of race that causes these adverse effects; it is the inequality that is associated with race that causes these pernicious consequences,” said Olian.

“Inequality in access to preventive medicine, to advanced treatments, to prenatal care, to healthy water and air, to early childhood education, to balanced diets, to good schools and ‘good’ jobs are out of reach for many vulnerable populations … and it is this inequality that causes bad health outcomes,” Olian said.

Roberts began by tracing the history of race-based medicine to the concept of race itself in 17th- and 18th-century America.

“Race is a political invention used to categorize human beings and manage a society where populations are racialized,” Roberts said, explaining that disguising this political category as a biological one propagated inaccurate views about Blacks as a means to justify slavery, medical exploitation and other abuses. It also gave rise to the idea that biological inheritance—genetics—is to blame for poor health outcomes, or susceptibility to certain conditions.

This same logic, Roberts pointed out, has been used as an attempt to explain the disproportionate toll that COVID-19 has taken on the Black community. “There are too many problems with the idea that you can explain health inequities by some kind of innate predisposition,” she said.

By May 2020, it was clear that Blacks were experiencing a heavier burden of infection and death from COVID, up to 3 times as high as white people in America, she said. Although some thought there were biological factors that predisposed Blacks to getting the disease and dying from it, Roberts said the susceptibility to infection occurs because they are more likely to have jobs that expose them to the virus, more likely to get to those jobs using public transportation, less likely to be able to stay home and avoid contact with people, less likely to be adequately protected at work, and once infected, more likely to die partly because they have been subjected to conditions that are bad for their health including living in racially segregated neighborhoods.

“Race is not a risk factor for disease—racism is,” she said.

Akanji commented that the Netter School strives to mold culturally sensitive physicians who value inclusion, diversity and equity. He asked Roberts what medical schools could do to mitigate race-based medical practices. Among other things, Roberts suggested revising curriculums to teach new generations of students not to diagnose and prescribe based on race, thus ending the prevalence of stereotyping, stigmatization and patient shaming, and increasing cultural competency.

Roberts also urged Webinar viewers to join organizations dedicated to addressing structural reasons for health inequities, rather than waiting on the results of medical research for change.

“The world’s healthiest societies are the most equal ones,” Roberts said. “Anything you can do to fight for that equality can be done right now.”


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