Catalina Ramirez
Timothy K. Dalton
Narrative Medicine 10113
November 30, 2023
Patriarchal Standards and Governmental Regulations’ Effects on Healthcare Equity
For centuries, patriarchal standards have perpetuated gender-based discrimination, not only permeating the psyche and mentality of all people to create social standards that disadvantage and marginalize women, but also highly influencing healthcare and the standard of care for women, especially women of color today. Patriarchal standards have led to dismissive attitudes towards women’s health concerns and a lack of comprehensive reproductive health care options. Additionally, government policies have often failed to address the unique healthcare needs of marginalized communities, particularly people of color. This results in a vicious cycle of unequal access to healthcare resources, leading to poorer health outcomes and exacerbating socioeconomic disparities. One of the major problems is its lack of personalization or attention to detail for the individual receiving care. Healthcare in modern day has become almost commercialized, at least significantly in the United States. Even by taking just one step to truly listen to patients when receiving care, and taking note of their cultural, social, and economic background it will improve healthcare by creating a personalized treatment for the individual that can be sustained long term for optimal health. Patriarchal standards and governmental and institutional regulations placed minorities such as women and people of color at a disadvantage in receiving equitable care throughout history, and its effects can be seen in modern day, however with a feminist and empathetic lens to healthcare treatment these issues may begin to be resolved.
The influence of the patriarchy in conjunction with sexist social standards have negatively affected women in receiving equitable care. Unfortunately, when many women seek the help of medical professionals in a time of suffering there is a commonality among older male doctors as well as young ones where female pain is misdiagnosed or dismissed. Furthermore, it is well known that there is a large discrepancy in the number of female doctors in the healthcare field as medicine is still a male-dominated field. There needs to be a greater call for more female physicians to provide a level of solidarity that male doctors don’t have due to their lack of experience in being a woman. There will always be male doctors dismissing female pain or symptoms and conclude it’s all because of the uterus/period and not truly diagnose them. “Women continue to have greater challenges accessing quality healthcare. These outcomes are borne from pre-existing gender inequalities globally, where women bear both the greatest burden of disease and make up the largest proportion of unpaid and undervalued workers” (Matheson et., al.). Additionally, the male-dominated medical profession historically undervalued women’s health issues and neglected research on conditions primarily affecting women. For example, heart disease was long thought to mainly affect men, resulting in failures to study its manifestations in women and provide early prevention among female patients. The patriarchal view that women should endure pain and illness with fortitude further contributes to the normalization of subpar care. Moreover, as Acephie reflects in Farmer’s book On Suffering and Structural Violence concerning the way of life that plagued many Haitian women, “What would you have me do? It was a way out, that’s how I saw it” (Farmer 5). This quote reflects how poverty created a disadvantaged woman who would need to marry and commodify herself in order to live a decent life. The pressure on Haitian women to do this led to her contracting AIDS and not having proper treatment until she died. The level of patriarchal rules ingrained in poor Haitian society was a barrier that prevented her from ever receiving proper care and treatment. After Acephie’s death, her brother hung himself, exemplifying how suicide is common for some victims of an absent government in relation to healthcare and equity. Overall, these systemic biases stemming from patriarchal ideals directly reduce standards of care and access for women patients.
Governmental policies and institutional regulations have also imposed barriers that prevent women from accessing needed healthcare and constrain providers from offering comprehensive services. In America, statistics show women have less healthcare access and higher mortality rates compared to other developed nations. A study by MIT economist Peter Ikeler shows that the United States of America has regressed materially to a third-world nation for most of its citizens (Ikeler). This is partially due to the lack of medical access and proper medical treatment in rural areas, as well as those not able to afford it as America does not recognize healthcare as a constitutional right and as most other countries do. America continues to be the only country that doesn’t have universal health coverage. It also has the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among the highest suicide rates (The Commonweath Fund). Furthermore, laws restricting reproductive care like abortion and contraception make it difficult for women to obtain these vital services, which are essential for their health and autonomy. TRAP (targeted restriction of abortion providers) laws imposing medically unnecessary requirements on clinics have forced many to close, reducing critical access to abortion and reproductive health services for women nationwide (Mercier et., al.) Other policies like the Hyde Amendment ban federal funding and insurance coverage for abortion care, meaning low-income women often cannot afford it (Mercier et., al.). In addition, historical exclusion of women from health research and clinical trials also contributed to subpar standards of care, as most medical evidence and protocols were based solely on male physiology (Liu and Mager). While progress has been made, modern healthcare systems and government policies still limit women’s access to basic care through funding constraints, restrictions, and lack of providers due to conservative regulations. These systemic barriers prevent women from fully exercising their right to healthcare self-determination.
The role of patriarchy within different races, focusing on Black people/African Americans, shows there are still stigmas within the black community placed on women but still black people as a whole receive less care due to the patriarchy. According to Flanders-Stephans, “In the United States, black women are 2 to 6 times more likely to die from complications of pregnancy than white women” (Flanders-Stephans 50). Additionally, statistics show stark differences between black babies’ birth complications versus white babies’ birth complications, as well as differences in longevity. The patriarchy affects both men and women, especially people of color in general. In the Latino community, the theory of machismo restrains women and even men (because it is not seen as masculine to need help) from receiving equal healthcare. Patriarchal attitudes intertwined with racism have distinctly affected the quality of care for people of color and continue to do so today. The stereotype of the strong black woman who silently endures pain leads providers to discount symptoms reported by black female patients, causing conditions like heart disease, cancer, and autoimmune diseases to go undiagnosed (Woods-Giscombé). Belittling of women’s issues and focusing on women’s reproductive capacity over their general health has particularly impacted minority women throughout history. Additionally, assumptions of masculinity deter some men of color from seeking preventative care. The stigma in many communities against men openly discussing health concerns or seeking help compounds this issue. Distrust of the medical system also hinders care, partly due to past unethical practices like the Tuskegee syphilis study; these implicit racial biases cause some providers to perceive minority patients’ pain as less severe, resulting in inadequate treatment (Scharff et., al.). Overall, patriarchal gender norms magnified by entrenched racial bias have created additional obstacles to equitable care.
Laws, policies, and resource allocation patterns by healthcare institutions have also perpetuated racial healthcare disparities. As Williams and Rucker explain, “Systematic discrimination is not the aberrant behavior of a few but is often supported by institutional policies and unconscious bias based on negative stereotypes” (Williams and Rucker 75). They add, “Compared with white persons, black persons and other minorities have lower levels of access to medical care in the United States due to their higher rates of unemployment and under-representation in good-paying jobs that include health insurance as part of the benefit package” (Williams and Rucker 76). Many minorities come from poor immigrant families and are forced to live in situations where the discrimination they face becomes a tangible disparity. It is clear that Medicare and Medicaid pay physicians less for treating people of color versus white patients, encouraging discrimination in access. Racially biased medical research, including the omission of minorities from studies, has led to race-based differences in care guidelines that disadvantage people of color. FDA approval processes often fail to adequately test for variation in medication efficacy across racial groups (Williams and Rucker 77). A particular example of the manifestation of institutional racism in healthcare would be uprise in sickle cell anemia cases, which seemed to only target the African American/Black population in America. As Wailoo describes, “The repetitive and enduring pain of a sickle cell patient was symbolic of the long-ignored social condition of black Americans” (Wailoo 7). As Wailoo states, “By serving the poor, i.e. African Americans who migrated from the surrounding cotton-based farming country to the city, health care could attract federal healthcare + research money and private insurance” (Wailoo 12). The population most affected by this disease was used for personal and economic gain, not in the interests of the people. Additionally, government policies have allowed segregation to persist, with hospitals still predominantly serving either white or minority communities, making care access geographically unequal. Historically, institutions restricted admissions for Black physicians, limiting their numbers and representation. (Sarrazin et., al.). All these systemic inequities stemming from regulations and institutional practices reinforce disproportionately poor outcomes among minority populations. A more recent form of the effects of racially discriminating policies and regulation was seen during the outbreak of COVID-19 in 2020. “Approximately 97.9 out of every 100,000 African Americans have died from COVID-19, a mortality rate that is a third higher than that for Latinos (64.7 per 100,000), and more than double than that for whites (46.6 per 100,000) and Asians (40.4 per 100,000) “ (Reyes). In a video poem outlining the systemic racism seen during the COVID-19 pandemic it was powerfully stated “Perhaps a virus need not discriminate, if the humans it is infecting have created systems that do the discriminating for it” (Simpson). The disproportionate representation of African Americans in both confirmed COVID-19 cases and death tolls highlights that the coronavirus pandemic has accentuated and potentially worsened pre-existing social inequalities associated with race, socioeconomic class, and access to healthcare. Still, a focus on increasing diversity and cultural competence among providers and policymakers helps build trust and mitigate healthcare disparities in continuing to do so will aid in providing more equitable care to all patients.
Despite all the aforementioned issues on healthcare inequity, there is a way to improve the disparities that disproportionately affect women and people of color. Particularly through a feminist and empathetic lens to healthcare treatment, as well as being culturally informed, we will be able to improve as a collective to be able to provide equitable care for all people especially the marginalized. As stated in a poem on racism “The World Could Be” written by Alan L. Nager MD, MHA, Director of Emergency and Transport Medicine at Children’s Hospital Los Angeles, “New rules of engagement are what we need / To gain trust and acceptance, a path to succeed” (Nager). The choice of diction in his poem places emphasis on establishing a foundation of trust between healthcare providers and patients. This is particularly crucial for marginalized communities that may have experienced historical injustices and continue to battle this present day. In acknowledging previous injustices with intent lsitening and actively working towards creating an inclusive and empathetic healthcare environment, there will be greater changes in healthcare practices, with a path towards achieving positive outcomes. Applying these principles could lead to a more equitable and effective healthcare system for women and people of color. Moreover, feminism encourages using “rich empiricism” to under the effect of systemic barriers on individuals and finding proper solutions for them (Rogers). By encouraging open communication and understanding in a healthcare setting, patients will be more inclined to trust thier doctors and build emaningful relationships. This shift in perspective not only addresses immediate healthcare needs but also contributes to the broader goal of dismantling deeply ingrained societal inequalities.
In conclusion, the historical impact of patriarchal standards and government regulations on the healthcare of women and minorities is undeniable. These systemic issues have perpetuated disparities in access to equitable healthcare. However, a transformative approach grounded in feminism and empathy offers a promising solution. By prioritizing the voices of marginalized groups and genuinely understanding their unique needs, we can begin to address the root causes of healthcare inequities. Central to this solution is the concept of personalized care, which acknowledges the individuality of each patient and tailors medical approaches to their specific cultural, social, and economic backgrounds. This approach is pivotal in dismantling the oppressive power structures within healthcare systems that have historically marginalized certain groups. By recognizing and challenging these power imbalances, we can pave the way for a more inclusive and just healthcare environment. Moreover, a feminist and empathetic lens calls for active listening and engagement with the concerns and experiences of women and minorities. In essence, adopting an open and compassionate viewpoint is the cornerstone of creating a healthcare system where all individuals, regardless of their gender or ethnicity, receive the quality and equitable treatment they rightfully deserve. Through continuous efforts to reform healthcare practices and policies, we can work towards a future where healthcare is truly inclusive, responsive, and meets the diverse needs of every individual.
Works Cited:
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