Racism in Radiology
By: Daniella Palomino, Contributing Writer
Edited by: Fatou Yeli Kourouma , Editor; Elias Azizi, Editor in Chief
Radiology is the branch of medicine revolving around the use of imaging technology for disease diagnosis and treatment. Common imaging techniques like X-rays, CT scans, MRI, and sonograms to ones you may have never heard of like Fluoroscopies, and Angiographies, are all part of radiology. The broad spectrum of medical imaging is key for diagnosing diseases, monitoring treatments, deciding medical care, and even predicting outcomes. This key diagnostic tool, like many other aspects of healthcare, is being restricted. Racial minorities, patients of lower socioeconomic status, and patients lacking health insurance are all affected by the growing disparity of radiology access.
It All Comes Down to Money
Thorough research dedicated towards finding the root of the disparity found that the main contributing factor that has developed them is money. According to a study conducted by The Working Poor Families Project from 2014 to 2015, of the 10.6 million low-income working families in America, ethnic minorities constitute 58% of them. Low income communities and jobs typically lack access to health insurance in order to aid in the payment of adequate health care. Mira data shows that the average price for an X-ray at an urgent care facility may range between $120-$325, while an emergency room could charge between $260-$460 out of pocket, or without insurance. On the contrary, with the help of insurance providers like Medicare, 80% of the price of the X-ray would be covered. This lowers the price of an X-Ray to about $24-$65 at urgent care and $52-$92 in the emergency room, according to the Healthline. CNBC explains how the median average income of the low income community in 2016 was $25,624 annually, which amounts to about $491.42 per week. For a low income family, a payment for an X-ray without access to insurance, one X-ray payment could take up to ¼ of a week's worth of a paycheck, not to mention the other bills and provisions of the family.
A Lose-Lose Situation
Finding imaging resources like an X-ray or MRI are generally harder to find in hospitals with people of color and lower class than of patients in predominantly white or upper class communities. RSNA not only supports the previous claim, but continues explaining how radiological imaging in hospitals with more patients of color are “of lower quality” and contain “more error prone” interpretations. The inaccurate diagnoses’ and overall inability to take the imaging in time leads to greater financial expenses in the future. A 2018 study conducted by W.K. Kellogg Foundation and Altatrum found that health disparities cost 42 billion dollars in lowered productivity and 93 billion dollars in excess medical costs each year. This is because without a correct diagnosis or access to prompt imaging, the health condition of the patient may worsen, requiring higher levels of medical care. As the health status complicates requiring more attention and extensive treatment, the price of care also increases. Take into consideration the diagnosis for breast cancer, which requires a mammography (which is a form of radiology). If the mammography is taken in due time, the cancer will be caught early. Though the treatment will still be costly, it will not be as long and will increase the chances of patient survival. That is as opposed to later prognosis which would result in long term payment of medical bills and make the cancer more fatal.
There Needs to Be a Change
Radiology is a necessary form of medical treatment. Besides just disease management or disease related prognosis, it is needed to save patient’s lives. Despite its importance, it is kept out of reach for so many. The answer as to how to fix this may not seem so simple. As much as one desires to create free healthcare for all, it is not a transition that can happen over night. Instead of ignoring the issue completely or dismissing it as unsolvable, experts have concluded that pursuing multiple angles and policies working both in and out of the healthcare arena could result in the much needed change. This means addressing the barriers related to access to care. NCSL has recommended solutions such as creating accessible insurance to ease the navigation of the healthcare system, piloting new models of paying and delivering care, or even supporting health centers in underserved communities. Encouraging data collections to analyze gaps in health care may also call attention upon the lethal disparities in healthcare, not just in radiology.Recognizing the causes of these disparities in radiology and its detrimental prolonged effects on the minority and low income community lays the foundation for necessary action may take place. It is the first step of many that must be taken for equitable access to healthcare in the radiology department and beyond.