Health care is distributed unevenly in the United States and minority populations often receive less care than others, or care of lesser quality, add on addiction to the less care and you get even lesser care.

1. Access to Substance Abuse Care: FDA-approved medications to treat opioid use disorder is fraught with multiple access issues. The medications have very restricted treatment regimen, which requires patients to show up daily to receive the medication. That daily requirement, make it nearly impossible for people in the lower socio-economic group who are mainly minorities to keep a job or manage other obligations while in treatment.
2. Addiction, Being Black and The Criminal Justice System: Three decades ago, when opioids and crack cocaine were devastating Black/African American communities, the national response was “The War on Drugs” this resulted in the mass incarceration of primarily Black/African American men. This population was criminalized for drug-related offenses at much higher rates than White Americans and this has had lasting effects and continues through the present day. As such only 10% of African Americans seek care and treatment for substance abuse disorders for fear of legal consequences.
3. Stereotyping: People who suffer from addiction, usually exhibit drug seeking behaviors. Often times, and specifically with African Americans, it becomes difficult to separate drug seeking behavior from seeking care to manage chronic illnesses.
4. Historical Inaccurate and Fantastical differences in people of color: Black Americans are systematically undertreated relative to white Americans due to the inaccurate and fantastical beliefs by Physicians that Blacks are anatomically different, examples include black people’s skin is thicker; black people’s blood coagulates more quickly all false statements.
5. The Concept of Causal Attributions : Indicates that an individuals’ causal attributions for problems are important contributors to their beliefs about solutions. Bernard Weiner’s theory outlines the importance of causal attributions in social behavior. His model states that people respond to an event by judging its cause (ie, causal attributions), which then contributes to the level of responsibility they assign, the type of emotional reaction they feel, and their ultimate response. When Physicians believe that the cause of actions is within an individuals’, for instance, rather than the social or economic environment, Weiner’s theory suggests that their reaction to them will be more punitive thereby resulting in less care.
6. The Cost of Care: Data shows that chronic diseases account for the vast majority of the total healthcare expenditures. Across economic indicators, vast disparities exist between African Americans and whites. Due to structural barriers, African Americans are more likely to be poorer than white Americans and are less likely to full-time jobs with Health-care benefits and unable to pay for multiple care programs to manage their complex needs. Health systems need to stratify people with multicomorbidity in order to better inform integrated care management approach for high-need, high-cost patients.
7. Separate and Unequal Treatment: Unequal treatment is common in many Black/African American communities, where access to treatment options is more dependent on race, income, geography, and insurance status, rather than individual preferences, or medical or psychiatric indicators.

Universal, broad, substance and disease prevention campaigns have limited impact in diverse communities, especially Black/African communities. The expectation that general prevention efforts and messaging will be equally relevant to Black/African Americans is unrealistic.

What is your perspective? comment below and lets get the conversation going.

It’s RAP (Respect science, Address systemic racism, Promote awareness of ethnic and racial health disparities)