Overview:
Research finds that Black patients are more likely to say a white doctor has treated them differently than they might have a white patient. The problem is especially acute among Black women.
In a move advocates say is an important step towards healthcare equity, the California Senate will consider a bill this week that would require the state to track discrimination in hospitals and doctors’ offices, a persistent concern of Black patients.
Assembly Bill 3161 would have the state’s Department of Public Health collect self-reported patient demographics from complaints at hospitals and long-term care facilities. Current law requires health facilities to report adverse events, as described, to the health department and not doing so is a crime. Under the new law the state will collect patients’ self-identified demographic information instead of just counting the number of complaints filed.
While the bill applies broadly to healthcare, advocates say the provision also will address the ongoing maternal health crisis — a problem that disproportionately affects Black women.
Research shows that more women die giving birth in the U.S. than in any other wealthy nation, and Black women are almost three times more likely to die than white women. Some of the reasons cited for such high maternal mortality among Black women include lack of health care coverage, insufficient postpartum care, and racial discrimination.
This behavior takes many forms including being ignored or hurried out of hospitals or care centers.
“The emergency room doctor basically told the nurse, ‘We need her out of here. I want to discharge her,” Shaleta Smith, a patient from Corona, Calif., said in an interview with Public News Service. Smith said she feels bias played a role in her treatment when she began hemorrhaging after giving birth at an Orange County hospital in 2007.
“[The nurse] looked at me and she said, ‘I’m scared for you.’ And I said, ‘I’m scared for myself,'” Smith recalled. “Luckily, I was able to stay. And if I would have gone home, I would have bled to death. I wouldn’t be here today.”
Approximately 30% of Black, Hispanic, and multiracial mothers reported being discriminated against when receiving maternity care, according to an April 2023 report from the Centers for Disease Control. At the same time, 45% of all mothers said they were reluctant to ask questions or discuss concerns with their healthcare provider.
The California bill would also require health facilities to provide data on a patient’s race, LGBTQ status, and other demographics when reporting an adverse event. But individuals who experience racist or discriminatory behavior — or those who witness it — can report complaints anonymously.
Under the bill, hospitals and care centers also would need to create a “safety plan, include a process for addressing racism and discrimination and its impacts on patient health and safety.” That would include “monitoring sociodemographic disparities in patient safety events, developing interventions to remedy known disparities, and encouraging facility staff to report suspected instances of racism and discrimination.”
The bill would also require hospital patient safety plans to specify methods to address racism and discrimination in health care, including procedures for staff to anonymously report instances of racial bias.
Raena Granberry, director of maternal and reproductive health for the California Black Women’s Health Project, said the bill could make a difference in cases where patients felt staff ignored them or discounted their level of pain.
“Hearing a father come in and say, ‘We’ve asked the doctors for seven hours to intervene,’ and she laid there for seven hours and bled to death,” Granberry told Public News Service. “It is a pain that ripples through the community. It’s crippling to our collective well-being to continue to experience these types of things.”
While hospitals insist they offer a high level of care to all patients, regardless of race, healthcare advocates say otherwise.
Onyemma Obiekea, policy director for the Black Women for Wellness Action Project, said the data collected under the California proposal, when broken down by race, will tell a different story.
“It’s really important as well for patient safety plans to actually consider the role that some of our biases play in the quality of care that patients receive,” Obiekea says. “Particularly when they are people of color.”
The bill dovetails with the Biden-Harris administration’s “Blueprint for Addressing the Maternal Health Crisis,” which Harris announced in 2022.
The White House proposal includes a new set of national health and safety standards for hospitals that Harris says can help protect new mothers and stem the maternal mortality crisis. The measure requires hospitals and clinics that deliver newborn babies to have standards that establish clear and proper procedures and must stock enough specific medical supplies for any type of emergencies that a birthing mother might face.