Black veterans with chronic kidney disease experienced racism in the clinical setting that produced physical and emotional stress and a strong sense of distrust in the health care system, according to a recent study published by the American Medical Association in the JAMA Network Open.
“Perspectives on Racism in Health Care Among Black Veterans With Chronic Kidney Disease,” a qualitative study of 36 such Black veterans, found that participants felt angry, resentful and experienced stress as a result of encounters with racism.
They expressed a strong sense of distrust in the health care system coupled with a need to be hyper-vigilant during clinical encounters, and, when encountering racism, these veterans described using both negative and positive coping strategies, according to the study.
“We’re increasingly becoming more aware of the consequences of racism, but we still struggle to grasp how it works,” wrote lead author Kevin Ahmaad Jenkins, PhD, in Physicians Weekly. “Sometimes racist discussions or accusations are so hurtful that people shut down rather than see that the most vulnerable heroes must be able to share their experiences,” he continued.
Researchers tracked the health experiences of 36 Black veterans who received care at the Corporal Michael Crescenz Veterans Affairs Medical Center in Philadelphia, Pennsylvania, from October 2018 to September 2019.
They found that although Black veterans have access to health care through the Veterans Health Administration, every other aspect of their lives is affected by institutional racism.
The interaction of socioeconomic status and racism in America contributes to the lack of vital resources to maintain health, access to health care, and reduced stress among the Black population, researchers found. This impacts access to healthy food, safe places to exercise, transportation in proximity to clinical centers, financial worries, housing instability, and social support, the study indicated.
“In addition to institutionalized racism, individual discrimination affects the experiences of Black veterans. Black patients with CKD spend less time with health care professionals, experience worse treatment from clinicians, and feel that medical professionals do not convey necessary health care information, all while being referred, evaluated, and receiving kidney transplants less often than White patients,” authors wrote.
Dr. Jenkins offered one way healthcare institutions can lead the nation in developing antiracist healthcare is to implement care models that acknowledge racism as a traumatic experience. Trauma-informed care may mitigate adverse effects of racism in the care of this population of Black veterans, he wrote. “We need more studies that explicate the 21st century interpretations of racism in healthcare and disease management,” he said.
Ronald Beavers, PhD, a psychologist with the Positive Imagery Foundation, Inc. in South Los Angeles, has worked for decades to curb the hesitancy of Black veterans to access health care. While the covid-19 pandemic has forced many into seeking care because it exacerbated already chronic health conditions, Black veterans, particularly, are not as apt to go into institutions for care due to mistreatment, concurred Dr. Beavers.
“They feel a sense of betrayal,” he told The Final Call. “The bottom line is, ‘I gave my all. This is the way I was treated, and look at what I’ve got to go through,’ ” Dr. Beavers said. He’s seen it often, but has offered as many solutions he feels the Black community could implement overnight to offset the disparities. He acknowledged, it may be very difficult in the face of socioeconomic factors, however, start now to address their issues, he urged Black physicians, mental health professionals, and community members.
“If you really understand what’s been going on, we’re not even on the back burner, because we have not been focused on ourselves. … When we start generating more socially, economically, guess what? These things start turning around,” Dr. Beavers said.
As the son of a World War II veteran, Nation of Islam Southwest Region Representative and Student Minister Abdul Haleem Muhammad realized Black veterans did not receive the benefits of the GI Bill, which led to the denial of educational opportunities, housing, and other benefits that would have created generational wealth.
He argued the Veterans Administration health care system is broken, and fails to care for veterans retiring from combat zones. The issue with proper access and care is part of the continued failure of this society to do anything but abuse, use and refuse to give justice to Black people, stated Min. Muhammad.
“Maybe 22 veterans every day commit suicide, and some 38,000 veterans experience homelessness,” evidencing that since World War II through today, those who paid the price to serve and defend the United States don’t receive proper care when they return back home, said Min. Muhammad.
He offered as guiding light from the Honorable Minister Louis Farrakhan in his text “Torchlight for America”: “The greatest gift that we have been given is the gift of life. The essence of a very being is housed within this magnificent creation of flesh and blood known as our bodies. Unfortunately, we live in a society that misdirects us and misinforms us in such a way that we place our own bodies at risk. We take care of our clothes, our pets, and our material possessions better than we take care of our own bodies.”
And, added Min. Muhammad, “better than we take care of our veterans.”