Three things Black people should know about health care (Part 3)

Part 3: Don’t settle, choose the high-quality hospital

Check out Part 1 and Part 2 of this series.

Ever visit a hospital with a posh lawn, a fountain that screams “luxury,” and valet service at the entrance? Then they casually mention check-in is just past the grand piano? It’s tempting to think, “Are these services priced in gold?” and fear you’ll get the VIP (Very Intimidated Patient) treatment. Despite having access to world-class medical facilities nearby, often people with the most serious health concerns may bypass the “nicer” hospitals. Here’s why that happens, and why you might consider trying out these hospitals nonetheless.

Why do some hospitals in the community serve fewer Black patients?

US health care is segregated

It would seem crazy to have separate airports segregated by race in the same city…yet we have de facto segregation of hospitals in many urban markets. Research from the Lown Hospitals Index finds that many of the most and least inclusive hospitals are in the same metro area. Eleven cities were identified by Lown as having significant hospital market segregation, with more than 20% of their hospitals ranked most or least inclusive. New Orleans, St. Louis, and Detroit top the list.

In cities where hospital markets are divided, we frequently see major disparities in life expectancy linked to race. Take St. Louis County, for instance, where white residents enjoy a life expectancy nearly 9 years longer than Black residents. A significant number of Black adults (67%) highlight the limited access to quality health care in their communities as a major reason for overall poorer health outcomes.

Furthermore, Black patients frequently receive care from a subgroup of providers whose qualifications or resources may be inferior compared to those serving white patients. This concentration and disparity emphasizes the need for efforts to encourage referrals to quality healthcare for all communities.

Facing intimidation

Even as an insured patient, many individuals opt to steer clear of certain hospitals, because they feel intimidated and are afraid of the costs. In California, more than one in four Black residents avoid seeking care due to genuine concerns about potential unfair treatment or disrespect during their care experiences.

Why does it matter?

Inequities in health

Around half of Black adults believe that a major reason for worse health outcomes is that healthcare providers are less likely to prioritize their well-being and offer advanced healthcare. Often Black patients don’t have access to the “high-quality” hospitals known for great clinical outcomes and patient safety. As a consequence of not having better health care access, a study on primary doctors found that most doctors treating Black patients were less likely to be board certified than physicians visited by white patients, more likely to report “that they were unable to provide high-quality care to all their patients,” and  reported more challenges in securing access to quality sub-specialists, diagnostic imaging, and non-emergency hospital admissions.

How hospitals are changing

Hospitals are feeling the heat to tackle health issues for Black patients. This involves hiring chief equity officers, tracking outcomes across racial and socioeconomic groups, understanding disparities, and assessing the impact of interventions.

Investing more into communities of color

Some hospitals collaborate with local communities, training, employing, or contracting with them to improve minority health issues. For example, CommonSpirit Health and the Morehouse School of Medicine announced a 10-year, $100 million partnership to develop and train more Black providers to address health disparities. In order to better represent voices in the community, UChicago Medicine’s Community Advisory Council is led by civic and faith leaders and guides the Medical Center on vital community health issues including racial disparities and social determinants of health.

Improving health disparities

To tackle organ transplant disparities among Black patients, the Center for Liver Disease and Transplantation (NewYork-Presbyterian) is aiding community providers in fast-tracking specialty referrals for Black patients with liver disease. 

Addressing issues in maternal health, especially for Black women who face the highest maternal mortality rates, is becoming a priority for hospitals. To improve maternal health, the Cleveland Clinic Akron General and four other national hospitals launched TeamBirth. This initiative empowers minority patients by encouraging conversations about recommended procedures. The goal is to ensure patients have a say in their care and can make decisions to fit their needs.

Similarly, Alameda Health System’s Beloved Birth Black Centering program provides culturally sensitive support for Black patients through midwife-led groups and educational resources. 

You don’t have to compromise

While navigating healthcare can feel overwhelming, choosing a reputable hospital within your network, especially one that specializes in treating your specific condition and treats you well, shouldn’t be a hard decision. The good news is that you may not have to settle. Some hospitals have great clinical outcomes and are also racially inclusive. For example, Boston Medical Center is number one in the country for racial inclusivity and they have an “A”in patient safety. The Lown Hospitals Index ranks the most socially responsible and racially inclusive hospitals to help you choose the best care. If you are concerned about potential high medical costs, financial assistance may be available to you. Even if you have insurance, eligibility often extends to households earning up to 400% of the federal poverty level. In many regions, a family of four earning less than $100,000 annually can qualify.

It’s important to advocate for yourself by requesting the best referral that accepts your insurance coverage. Your well-being deserves the specialized expertise and attentive care that the best providers can offer. Don’t settle for arbitrary hospital referrals; prioritize your health by seeking high quality care at a superior facility.