Health care policies have ameliorated medical mistrust among minority communities

• The Affordable Care Act enabled people of minority groups to have better access to healthcare such as insurance

• The Title VI of the Civil Rights Act of 1964 allows minority groups to have equal access in healthcare

• Ameliorate minority groups from the HEI which allows the lgbtq community to have more freedom in rights for their sexuality 

Rebuttals 

• Policies exist on paper or as laws but are not properly implemented. 

  • Policies aren’t just words on paper and yes implementation may vary in several areas but at the same time they allow for the growth of medical communitites  they basically act as a blue prints to allow for possible changes to occur and again we should all remember the fact alothouh they can’t stop every mistake, they create systems of accountability and redress things that prevent those mistakes from becoming patterns of harm.

  • The Affordable Care Act (ACA) expanded Medicaid coverage, closing gaps in access for millions of low-income Black and Hispanic patients. Without that policy, those patients would still be locked out of the system entirely.

  • ADDD RIGHT HERE WHEN U FIND IT

• Non-community involvement

  • The Biden-Harris administration launched a new Health Equity Task Force and issued Executive Orders to ensure federal healthcare agencies address systemic racism.

  • With the Hospital Construction Act installed, every state would be required to provide necessary materials for healthcare centers without discrimination on race, ethnicity, or economic background. This expands people’s access to healthcare settings including in rural areas.

• Historical trauma 

  • Acknowledging historical trauma is precisely why these polcies are necessary and being created

  • Acts being developed throughout the past to make up for the government's ignorant actions and mistakes

• Health care disparities still exist 

  • Healthcare disparities will continue to exist as evolution of diseases continues to exist, however, this means that governments and organizations will continue to advocate for those in minorities

• People still don’t trust the system, so the policies clearly aren’t working

  • Trust is emotional. Policy is structural. You can’t expect policies to immediately erase fear that’s been passed down for generations.

• Most policies are reactive, not proactive; they only show up after damage is done

  • That’s true of almost every system. Legal and policy change often follows public awareness and activism. That doesn’t make them ineffective, it makes them responsive.

• Most of these policies are only in big cities—not rural areas where mistrust is just as bad

  • The Hospital Construction Act enables people in rural areas to receive proper treatment in healthcare in a healthcare setting, including proper 

Oppression occurs when there is an inequality of power and privileges between groups. For many generations, minority communities in the US have lived within the shadows of a healthcare system that was never designed to serve them equitably. From disproportionately high maternal mortality rates among Black women to the chronic underfunding of Native American healthcare services, these disparities are not accidental. They are the results of deep-rooted inequities that have shaped the nation’s policies for centuries. Today, the call for reformation is not just about statistics or policies, but about restoring humanity to a system that has long prioritized privilege over people. Addressing these injustices not only requires gradual change over time, but it is also necessary to completely restructure how healthcare is accessed, funded, and communicated to ensure the benefit of all people.

Firstly, government policies like the Affordable Care Act have been a significant step toward dismantling long-standing economic barriers to healthcare access for minority communities, thereby addressing persistent medical mistrust. Historically, Black and Hispanic Americans have faced disproportionately high uninsured rates. 40.5% of Hispanics and 25.8% of Black Americans lacked coverage in 2014 compared to 14.8% of whites, prolonging cycles of limited healthcare access that deepened the skepticism toward medical institutions. The ACA’s expansion of both public and private insurance helped bridge this gap. With uninsured rates dropping significantly, especially in Medicaid expansion states, by reducing financial obstacles and increasing opportunities for more engagement with the healthcare system, these changes provided solid evidence that the government was actively working to address racial and economic disparities in healthcare. This progress, though ongoing, represents a very critical shift. When policy prioritizes equity, it creates not only better health outcomes but also the gradual restoration of trust in a system that has historically failed marginalized communities. The ACA’s impact shows that meaningful healthcare changes must go beyond coverage, and it must also address the historical wounds that create this mistrust. And while policy alone cannot erase historical trauma, government-led initiatives like the ACA demonstrate commitment to change. 

And it’s not only economic policies driving this change. Title VI of the Civil Rights Act of 1964 has been a critical force in addressing medical mistrust by legally mandating equal access to healthcare for minority communities. For generations, racial segregation in hospitals and discriminatory medical practices reinforced systemic neglect, leaving Black, Hispanic, and other marginalized groups defensibly skeptical of the healthcare system. The Title VI Act helped dismantle these injustices by desegregating hospitals, expanding preventive care in underserved communities, and holding institutions accountable for discriminatory practices. It also sought to repair language barriers by requiring professional interpretation services for limited English proficiency patients, an essential step in ensuring informed medical care. Yet, despite its progress, the law’s impact is limited by inconsistent enforcement, persistent disparities in treatment outcomes, and a lack of awareness among both patients and staff. While the Title VI Act has helped to rebuild trust by legally affirming the right to equitable care, trust is not built through legislation alone. It requires healthcare institutions to go beyond compliance and actively invest in competent care, eliminating implicit bias and ensuring that every patient, regardless of background, feels seen, heard, and valued to further strengthen its impact. Healthcare systems must increase accountability measures to ensure that the Title VI Act is fully implemented and expand training programs that educate staff on bias and cultural competency. In addition, it also further develops community-based healthcare initiatives that directly engage with marginalized communities. Moreover, language accessibility is also another great factor that must go beyond policies, hospitals, and must prioritize hiring professional interpreters to integrate real-time translation services to raise public awareness about patients' rights. The Title VI Act is crucial in empowering people to advocate for equitable treatment. The law is not just a policy, but a promise. Fulfilling that promise requires an ongoing collective effort to create a healthcare system that is truly just, inclusive, and trustworthy.

Beyond specifically improving hospital policies, U.S. healthcare policies and services have made a significant improvement in ameliorating medical mistrust amongst LGBTQ+ minority communities as well by prioritizing non-discrimination, inclusivity, and equitable healthcare access. For example, the Human Rights Campaign’s Healthcare Equality Index (HEI) has played a crucial role in strengthening patient-centered care, with over 900 healthcare facilities actively implementing LGBTQ+ policies. Nearly 500 of these institutions have even earned the designation of “LGBTQ+ Healthcare Equality Leaders" showing a commitment to getting rid of biases and ensuring respect. Additionally, advocacy efforts by organizations like the American Medical Association (AMA) have led to groundbreaking policy changes, such as the FDA lifting discriminatory restrictions on blood donations from men who have sex with men. This is an important step in challenging the long-standing stigma in medical practices. Additionally, some states have even enacted laws for protecting gender-affirming care, with Illinois leading by legally safeguarding these services and expanding Medicaid coverage for gender-affirming surgeries. Furthermore, these policies allowed for an increase in access to hormone therapy, surgeries, mental health support, and legal protections without financial barriers, which show a commitment to addressing historical discrimination. More specifically, looking back at a specific case and its impact on transgender healthcare, a transgender woman, Patricia Cruz, and other plaintiffs sued the state (Cruz v Zucker), arguing that Medicaid's Availability and Comparability provisions were violated on their Cosmetic Exclusion claim. This allowed for the federal court in 2016 to rule that New York’s Medicaid must cover gender-affirming surgeries and treatments for transgender individuals. This set a model that led other states to further expand Medicaid coverage. Overall, while challenges remain, these policies reflect a tangible shift toward a more inclusive and equitable healthcare system.

To overcome the barrier in healthcare for minority groups, laws, and regulations have been established to protect people’s rights and improve their experience in healthcare facilities. The US government has strived to create effective change since the late 20th century on these issues. For example, in 1986, the U.S. Department of Health and Human Services’ Office of Minority Health was created and became “one of the most significant outcomes of the 1985 Secretary’s Task Force Report on Black and Minority Health.”  There have been many more acts established such as in 2003, the Healthcare Equality and Accountability Act was introduced to improve minority health, healthcare, and eliminate racial disparities in healthcare, and the National Network to Eliminate Disparities in Behavioral Health (NNED) was formed with connections to networks of more than 1,500 community-based organizations. With the help of SAMHSA and the NNED, these organizations invite community-based organizations and collaborate with them to address mental health/substance use disparities. In 2021, an attempt to reach health equity for minority groups was made by the White House Executive Order 13985 from the Biden-Harris Administration. In this regulation, the order “amplified the human costs related to racism, chronic poverty, and other disparities, and ordered the federal government to advance an ambitious, whole-of-government equity agenda” (SAMHSA). With these acts and orders in place, it demonstrates the US government’s efforts for equity in healthcare environments to ensure the safety of the people without the constant worry of the cost. As new laws and regulations are being proposed to this day, it’s important to recognize how these efforts have helped bring national attention to the challenges faced by these marginalized groups. With the help of collaboration between acts such as these, they continue to work toward a more equitable healthcare system. 

Along with the establishment of regulations and laws, the Hospital Survey and Construction Act in particular has provided many hospitals, especially those in rural areas, with necessary resources such as hospital beds and funding. V.M. Hoge, Bureau of Medical Services, discusses the need to expand beds in hospitals to provide space and comfort for patients along with the following procedures and plans for states. Dr. Parran mentions, “‘State-wide planning should be directed toward a planned network of facilities to include medical centers, district hospitals, rural hospitals, and health centers.’” His plan to expand healthcare facilities throughout states, ensures people’s safety and that they will be able to find help close by. In addition, he states, “The regulations will require that the State plan provide for adequate hospital facilities without discrimination on account of race, creed, or color, and for adequate facilities for persons unable to pay.” With these rules installed, every state would be required to provide necessary materials for healthcare centers without discrimination on race, ethnicity, or economic background. This is significant because it expands people’s access to healthcare environments in rural areas along with the availability of materials.

Mentally and physically disabled people have faced medical discrimination for many generations. At a residence in New York in 1955, The Willowbrook State School for Children for Mental Retardation, homed people that were mentally and developmentally disabled, were forced to live in incredibly inhumane conditions. The owners used this as an excuse to purposely infect many of the residents with live hepatitis without their consent, in order to test the effectiveness of gamma globulins as a vaccine. This situation was brought to national attention thanks to a New York senator. While others may argue that the conditions faced non-consensually by the residents of this school are unforgivable, there was a series of laws passed in order to protect more mentally disabled people from such injustice in the future. The Education for All Handicapped Children Act (1975) focused on improving the education provided to mentally disabled children in public education facilities, while the Civil Rights of Institutionalized Persons Act stated that federal action be made when the rights of institutionalized people are violated. Finally, The Protection and Advocacy System in the Developmental Disabilities Assistance and Bill of Rights Act is designed to protect people with developmental and intellectual disabilities from neglect and abuse. It also requires legal representation to be present when the rights of the mentally disabled are compromised and or outright violated. The legal action that was taken following the Willowbrook School experiments represents the vast efforts of authorities to improve the trust of disabled people in their healthcare providers in the United States following disturbing and traumatic events.

Throughout history, women have been deemed lesser than men by society and this is displayed in healthcare as well. Specifically, after labor, when a woman’s cut is being stitched, an extra stitch can be added without the consent of the mother. The reasoning behind this extra stitch is to make sexual intercourse “feel better” for the man, but in turn, it can make it excruciatingly painful for the woman. To combat this medical mistreatment of women, studies have been done, including one that showed that an episiotomy had little positive effect on either the mother or baby and could instead just leave the woman with severe tissue trauma. Finally, in 2016, The American College of Obstetricians and Gynecologists (ACOG) released a widespread recommendation to instead, “prevent and manage delivery lacerations through other strategies.” These strategies included warm compresses and massages, rather than cutting a woman’s tissue. In 1979, nearly 61% of women received episiotomies. However, following the recommendation sent out by the ACOG, the rate for episiotomies decreased by 1.8% from 2016 to 201. This is the lowest rate ever recorded and approximately an 87.2% decrease from 1979 to 2017. Thanks to the progressive and informed action taken by researchers, many women have been spared pain. 

Furthermore, on a national level, the National Institutes of Health continues to pioneer diversity and inclusion with the continued development of its Institute on Minority Health and Health Disparities, learning from past failures such as the Tuskegee Syphilis Study, which led to the Belmont Report (1976) to “protect human research participants and ensure safety”. This increased trust can even be observed in our own community, Vernon Hills. In a recent survey conducted by our research group titled “Your Experience with Healthcare” 101 participants observed that 86% of participants believe increased diversity among healthcare professionals has contributed to improved trust among minorities. So, while some skepticism still exists, increased representation in research teams and healthcare professionals reduces fear of exploitation. However, the next generation of healthcare professionals needs to be the ones to continue these efforts, and through educational reforms, structural racism in medicine is finally being addressed through both seminars/courses but also through longer-term majors, like “Medicine, Health, and Society” at Vanderbilt which help cultivate more culturally competent providers. Furthermore, Historically Black Colleges and Universities that have “been training Black nurses since 1863” continue to lead in training Black healthcare professionals, exemplified by the Morehouse School of Medicine’s “$100 million partnership with CommonSpirit Health” to train Black physicians. Current professors and professionals at universities have also been pivotal to supporting the next generation, with “American Indian and Alaskan native faculty…at 4 different universities” developing a “new tool to better meet the needs of indigenous students”. Additionally, in our study performed on 101 VHHS students, just 30% of students believe that accents or just lack of fluency have prevented themselves/family members from receiving the best care possible. Participants note unique challenges such as “no Russian speakers available” or that their “Chinese-speaking grandparents need a translator most of the time. In the future, hiring staff that speak a plethora of other languages for translation of material and speech, and expanding awareness on new translation resources can be a valuable way to get the word out and let people know what new resources are available to help them.

Although nationwide efforts have expanded over time, on a smaller community-based level, throughout the past few decades, both private and government-funded efforts to improve medical trust among minorities have also expanded through initiatives like free Spanish language clinics such as the ones at the University of Illinois’ Health’s Kidney Program to help patients make “safe, informed, and confident” decisions, and other community-based outreach. This can be seen on a community level, as leaders worked with the Sacred Heart of Jesus Church to establish pop-up clinics in a predominantly Latinx neighborhood and researchers at Johns Hopkins University Medicine have developed seminars where they are “working with community leaders to…provide a forum for people to ask questions and have their concerns addressed”. Additionally, increasing diversity in clinical trials is a priority, with large institutions like Johns Hopkins making commitments to addressing unconscious bias, recruiting bilingual research staff, and making trials more accessible. 

To conclude, our BD group conducted a survey with more than 100 responders to address our communities' thoughts on how US policies/initiatives have or have not ameliorated medical trust. The results show a powerful shift in how medical policies have begun to heal the long-standing wounds of mistrust among marginalized communities. 88.17% of respondents shared that they now feel safer and more respected in medical spaces, a testament to the impact of evolving healthcare protections. Along with this, 58.4% of respondents stated that they trust medical caregivers to have their best interests in mind, while 29.7% stated that they strongly trust. On this same question, regarding if they trust healthcare providers to have their best interest in mind, only 4% trust, with 7.9% remaining neutral and 0% stating that they strongly distrust. One respondent expressed, “My grandparents sometimes have a hard time communicating with the hospital doctors and nurses…One time they did get a doctor who spoke Hindi and that made it much easier for them to express their concerns and understand what the doctor was saying,” showing both the pain of past neglect and the courteous hope for a more inclusive future. Yet while policies have opened doors, true trust is not built through laws and reparations alone. It is created through every interaction, every act of compassion, and every commitment to seeing patients as whole, worthy individuals. As long are there are people, there will be problems. But there will always be people willing to fight against those injustices and stand up to create change, slowly but surely. The scars of past discrimination do not fade overnight, but with continued advocacy, education, and accountability, the gap between communities and the healthcare system can continue to close. It is not just about improving policies; it's about restoring the dignity of a person one at a time.