Addressing Medical Racism: 5 Best Practices for Facilities

Medical racism refers to institutionalized discrimination within healthcare that results in unequal treatment, poorer health outcomes, and diminished trust among communities of color. It’s not a relic of the past, but a present-day crisis that harms both patients and care providers. Racism in the medical field is more than individual biases — it shapes who receives care, how they’re treated, and whether they survive.

Below are some medical racism statistics and facts to know as a facility leader:

• Staff are witnesses to racism and discrimination. Nearly half of healthcare workers report witnessing discrimination against patients, and younger healthcare workers are more likely to report racism. Addressing racial disparities is important for Gen-Z workers, with 2 out of 3 healthcare workers in this age group believing that healthcare is inequitable.
• Workplace violence is linked to burnout and can lead to the depersonalization of patients. Staff who repeatedly experience violence at work may stop seeing patients as people and may be more likely to act on implicit biases.
• Staff discrimination remains a problem in modern healthcare. According to research, 6 in 10 Black healthcare workers and 4 in 10 Latino, Asian American, and Pacific Islander workers report being discriminated against.
• Racial abuse and discrimination from patients contribute to burnout among healthcare workers and may also lead to higher job turnover.

How can you work toward addressing medical racism in your healthcare facility? Read on to learn about the history of racism in medical care, current examples, and how you can foster social justice for your patients and staff.

What Is Medical Racism? 

This term refers to discrimination based on race, color, and ethnicity in the healthcare setting. It’s a broad phrase that encompasses individual microaggressions and biases as well as systemic, policy-level decisions that disproportionately affect people of color. This type of racism affects how patients are treated, how healthcare is delivered, and who gets access to resources and support. Below are four interconnected forms of racism and how they can show up in healthcare:

Interpersonal racism 

This form of racism occurs between individuals, including explicit slurs, discriminatory behavior, or more subtle forms like tone policing, assumption of noncompliance, or disbelief of symptoms. Black patients frequently experience microaggressions and discrimination from healthcare workers, which can understandably lead them to mistrust providers and forgo care.

Internalized racism

This refers to predisposed beliefs about the superiority or inferiority of one’s own racial group. In healthcare, internalized racism might lead a Black physician to work harder than their White peers in an effort to prove themselves. Other examples include idealizing White professionalism or shedding one’s own culture to assimilate into the dominant culture.

Institutional racism

Racism within institutions manifests as policies and practices within organizations that, intentionally or not, produce racially unequal outcomes. This can include hospital policies that limit interpreter services, hiring practices that exclude people of color, or using biased clinical algorithms that perpetuate disparities.

Structural racism

The overarching system of culture, values, history, and norms that reinforces racial group inequity is known as structural racism. Many racial health disparities can be attributed to racism at the structural level. For example, redlining practices in primarily Black neighborhoods are linked to increased risk of heart disease, diabetes, and hypertension among Black people. While redlining is no longer legal in the U.S., the practice still contributes to health disparities.

A Brief History of Medical Racism

Understanding the history of racism in medicine is essential for addressing today’s problems. Structural racism in the U.S. healthcare system is not accidental — it’s deeply rooted in a legacy of slavery, segregation, and dehumanization that continues to influence clinical practices and policies.

The U.S. medical system grew up alongside institutions that profited from slavery and racial inequality. Early healthcare policies often excluded or mistreated Black Americans, Native Americans, and other people of color — from hospital care to insurance coverage and public programs like Medicare and Medicaid. These exclusions were not just social but also structural, written into the fabric of public health programs and institutions.

One of the most infamous medical racism cases is the Tuskegee Untreated Syphilis Study (1932–1972), in which Black men in Alabama were misled and denied treatment for syphilis so researchers could observe the natural progression of the disease. Even after penicillin became the standard of care, participants were never treated — a violation that damaged trust in medical institutions for generations.

But Tuskegee is far from the only example. In the early 70s, Native American women were forcibly sterilized by the Indian Health Service with funding from the federal government. The IHS only admitted to this program after an independent study found that a quarter of American Indian women had been sterilized. The lasting effects are still felt through diminishing populations and a lack of political power.

Meanwhile, medical schools throughout the 19th and 20th centuries perpetuated harmful racial myths — including that Black people feel less pain than White people. This belief persists: A 2016 study found that half of White medical students and residents at the University of Virginia believed false statements about biological differences between Black and White patients — such as thicker skin or fewer nerve endings — which affected their clinical decision-making and pain management practices.

Medical Racism Today

Medical racism persists in modern healthcare, though it’s often more covert than the clear-cut abuses of the past. Today, it frequently shows up as unequal access to care, biased decision-making, or the uneven distribution of healthcare resources — all of which can quietly contribute to worse health outcomes for communities of color.

The COVID-19 pandemic exposed many of these disparities. During the first years of the pandemic, Black, Indigenous, and Latino communities faced higher infection rates, hospitalizations, and death, with Black patients experiencing the highest death rates across all age groups. Access to testing and treatment was also unequal. Early in the pandemic, Black communities had less access to COVID-19 tests despite higher exposure risk.

Lack of health insurance disproportionately affects minority groups. People with lower incomes are often uninsured, and minority groups account for over half of the uninsured population. Lack of insurance is one of the biggest barriers to care, affecting everything from timely diagnosis to ongoing treatment.

Unequal resource allocation happens on a smaller scale, too. For example, a unit may have only a handful of translation tablets or interpreters available for dozens of patients. When only three devices serve thirty beds, patients who don’t speak English may experience delayed care or misunderstand medical instructions — a quiet but serious form of inequity.

These systemic barriers have psychological and cultural effects. People of color and minority groups tend to be less trustful of the medical system, due to both personal experiences and historic abuse. This distrust can contribute to delays in seeking care, avoidance of preventive screenings, and worse overall health outcomes.

The Effects of Medical Racism on Patients

Examples of the differences in outcomes between racial and minority groups are well-documented. View the condensed list below:

• Maternal and newborn outcomes: Black women in the U.S. are 3 to 4 times more likely to die from pregnancy-related causes than White women. Additionally, Black infants are more than twice as likely to die compared to White infants.
• Cardiovascular disease: Black young adults are nearly 4 times as likely to experience a stroke as their White peers, and Black Americans are more likely to die from stroke than any other racial group. Similarly, hypertension is more common among Black adults, yet they’re less likely to receive timely diagnosis and treatment — a pattern that increases the risk of heart disease, kidney failure, and stroke.
• Mental health: Black and Hispanic patients are less likely to receive mental health treatment, yet have some of the highest rates of mental health-related ED visits. Black patients are more likely to be chemically sedated and physically restrained than White patients, increasing their risk for harm and medical trauma.
• Melanoma: White patients are overwhelmingly more likely to be diagnosed with melanoma, yet their survival rates are far better — only 66% of Black patients diagnosed with melanoma survive 5 years or more, while 90% of White patients do. These outcome disparities can be attributed to factors such as lack of care access, leading to later diagnosis, and lack of education about how the disease manifests in Black patients.

Addressing Medical Racism in Your Facility: 5 Tips

Medical racism can show up in both overt actions and unconscious systems. As a facility leader, you play a critical role in shifting your team toward more equitable care. Here are five ways to take action.

1. Promote Learning Among Staff

Racism in healthcare can stem from long-held beliefs or gaps in education. Promoting continuous learning keeps your team informed and accountable.

• Host regular in-service training or book clubs on topics like implicit bias, cultural humility, and anti-racism in care delivery.
• Share academic articles or patient stories in staff huddles to encourage reflection and discussion.

2. Build Safe Spaces

Talking about racism and bias can be uncomfortable. As a leader, it’s your job to create a culture where accountability doesn’t feel punitive.

• Establish regular debriefs or case reviews where staff can reflect on challenges without fear of judgment.
• Model vulnerability by sharing moments when you’ve recognized or experienced bias in your own practice and how you addressed it.

3. Think Critically About Policies and Resources

Bias can be baked into policies, workflows, or even resource distribution. Healthcare leaders should regularly audit how policies affect patients from marginalized backgrounds.

• Ask questions like: Who isn’t showing up for follow-up visits and why? Do we provide enough translation support? How are triage decisions made?
• Push for flexible visitation or discharge planning policies that better serve patients with limited resources or support systems.
• If you notice an unjust policy, take steps to address it and ask staff to take an active part in problem-solving.

4. Support Staff

Countering medical racism requires emotional labor, especially for staff from marginalized groups. Your team needs to feel seen, heard, and supported.

• Let team members know that you will not tolerate racial abuse and that they can come to you with complaints against a patient or coworker.
• Provide protected time or mental health resources for staff.
• Amplify the voices of BIPOC staff in leadership meetings and ensure their ideas are acted on, not just acknowledged.

5. Foster Pathways to Leadership and Equity Work

Representation matters. Intentionally fostering career development opportunities for BIPOC staff helps shift power and culture.

• Nominate diverse staff for hospital committees or leadership fellowships.
• Support mentorship programs that pair junior staff with leaders who prioritize equity.
• If a staff member comes to you with a complaint, ask them how they might address it.

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