When a patient walks into a medical facility, the assumption is that the quality of care they receive will not depend on the color of their skin. For millions of Black Americans and other people of color, that assumption does not hold because of Racial bias.
More than 10% of Black adults in the United States report being unfairly discriminated against or judged by a healthcare professional, with rates rising among Black women and Black adults in lower income households. That figure represents a fraction of the full picture. Racial bias in healthcare operates across diagnosis rates, treatment decisions, pain management, maternal mortality, and increasingly, the algorithms that inform clinical decisions.
What racial bias looks like in practice
Racial bias in healthcare takes two primary forms, and both cause measurable harm.
Racial bias occurs when a healthcare professional’s unconscious stereotypes and assumptions shape their clinical judgment without their awareness. Research analysis of available literature has found that implicit racial bias can alter both treatment decisions and clinical outcomes. Among the documented effects is a pattern in which Black patients are less likely to receive adequate pain management, a disparity that reflects longstanding false beliefs about biological differences in pain tolerance that have persisted in medical culture.
Algorithm bias presents a less visible but equally serious problem. Healthcare algorithms, including diagnostic tools and risk calculators used across clinical settings, are frequently built on datasets that overrepresent white patients and underrepresent communities of color. When those datasets are skewed towards Racial bias, the outputs are skewed. Risk calculators built on racially biased statistics produce inaccurate results for Black patients and other people of color, and those inaccuracies can affect everything from the urgency of a referral to eligibility determinations for certain treatments.
Both forms of bias, operating simultaneously across a system, make genuinely equal healthcare outcomes nearly impossible to achieve without structural intervention.
Who is most affected and how
The consequences of Racial bias show up across virtually every major health category. Black women are more likely to die from pregnancy-related complications than women of other racial groups, according to the Centers for Disease Control and Prevention. Black people experience higher rates of diabetes-related complications, according to the American Diabetes Association. Black men face disproportionately high rates of hypertension diagnosis and adverse outcomes, according to the American Heart Association. Black people are more likely to be misdiagnosed or over-diagnosed with mental health conditions, according to Mental Health America.
The pandemic made the scope of these disparities impossible to ignore. Analysis of COVID-19 data found that Black Americans were more than 3.5 times more likely to die from the virus than white Americans. Hispanic, Asian, and American Indian communities also experienced higher hospitalization and death rates than white Americans, demonstrating that the problem extends across all communities of color, not only Black communities.
Andrea Heyward, Director of the Community Health Worker Institute at the Center for Community Health Alignment, described the issue as one rooted in structural, institutional, and systemic racism that extends well beyond the healthcare setting into education, employment, and other domains. Addressing it, she noted, requires a response that is equally broad.
What meaningful change requires
Training individual healthcare providers in cultural competency and implicit bias awareness is a necessary starting point but not sufficient on its own. Heyward emphasized that sustainable change requires system-wide investment, including diversity within integrated care teams, long-term support for nonclinical roles, and the formal integration of community health workers into both clinical and community settings.
Community health workers play a specific and underappreciated role in addressing racial bias before it reaches the clinical encounter. Research documents that bias shows up before a patient ever schedules an appointment, in the structural barriers that prevent access entirely. Community health workers, as trusted members of the communities they serve, help people of color navigate healthcare systems, advocate on their behalf, and close gaps that institutional processes alone do not reach. This model has been implemented through programs such as PASUS at the Center for Community Health Alignment, which uses the community health worker framework to connect Latino and immigrant populations with healthcare and social services.
Investment in healthcare facilities serving marginalized and low-income communities, along with expanded access to Medicare and social healthcare programs, are identified in recent literature as among the most impactful structural changes available. Diversity within care teams matters alongside training, because representation shapes both the quality of clinical relationships and the range of perspectives informing institutional decisions.
For patients who believe they have experienced discrimination, a Civil Rights Complaint can be filed with the HHS Office for Civil Rights. Filing an additional report with the relevant state licensing board is also an option depending on the type of provider involved.
