People of Color Disproportionately Harmed by Medical Negligence & Limits on Compensation

California’s 45-year-old cap on compensation for patients harmed and killed by medical negligence disproportionately impacts communities of color, keeping people of color out of the courts and denying them justice.

The COVID-19 crisis has further exposed the racial disparities and unequal outcomes in the health care system. The cap is an example of the systemic bias that perpetuates poor health care outcomes in California’s communities of color that experience lower quality health care, suffer more preventable medical errors, and are denied answers and accountability when they are harmed.The negative impact of the cap on patients of color is compounded by the racial wealth gap. 

The current reckoning on racial justice in California, and across the country, has drawn the disparities in health care and in access to justice that the cap created and continues to impose on communities of color into sharp relief.

Disparate Care in Communities of Color 

Decades of research shows that patients of color receive worse medical care are more likely to experience adverse medical events and medical malpractice, from missed cancer diagnoses to maternal mortality

• In 1990, a renowned Harvard Medical Practice Study found that Black patients were more likely to be hospitalized at institutions with more adverse events and higher rates of medical negligence.
• In 2002, the Institute of Medicine published a landmark study finding that people of color were less likely to receive even routine medical procedures and experience a lower quality of health services, in areas such as cardiovascular care and cancer diagnostic tests.
• Today, these disparities continue. In 2018, the Agency for Healthcare Research and Quality found that Black and Native American patients received worse care than white patients for about 40% of quality measures. These quality measures include serious, often fatal events such as post-operative infection and advanced-stage cancer diagnosis.

Patients of color are more often uninsured, which puts them at greater risk of experiencing medical malpractice.

• In 2018, 11.5% of Black Americans and 19% of Hispanic Americans were uninsured, compared to 7.5% of white Americans.
• Patients without health insurance are more likely to rely on hospitals, where medical errors occur more frequently.
• The Institutes of Medicine find that patients without health insurance who are hospitalized for a range of conditions experience higher rates of death in the hospital, are likely to receive fewer services, and are more likely to experience substandard care and resultant injury than are insured patients.

Worse Maternal Health Outcomes for Non-White Mothers

The California Pregnancy-Associated Mortality Review found that Black women in California are more likely to die from treatable pregnancy-related conditions.

• Black women are roughly 4 more times likely to die from pregnancy-related causes than all other women.
• Only 5% of California births are to Black women and yet they comprise 21% of the pregnancy-related deaths.

A study by the Centers for Disease Control and Prevention found that the following disparities in maternal health were persistent:

• Even though most pregnancy-related deaths are preventable, Black women are 3.2 times more likely to die from pregnancy-related causes than white women.
• Pregnancy-related mortality for Black women with at least a college degree is 5.2 times that of their white counterparts.
• For Black and Native American women over the age of 30, pregnancy-related mortality is 4-5 times higher than it was for white women.
• Treatable conditions during pregnancy – such as cardiomyopathy, thrombotic pulmonary embolism, and hypertensive disorders – contribute more to pregnancy-related deaths among Black women than among white women.

California’s Cap Especially Limits Non-White Patients’ Rights

Damages in a medical malpractice case include lost salary due to injury. Because of the racial income gap, people of color receive less compensation for lost salary and the cap on non-economic damages makes it less likely they will find legal representation and ever get their day in court.

• The Pew Research Center found that Black men earn around 71% and Hispanic men earn around 67% of the hourly earnings of white men. Black women earn around 76% and Hispanic women earn around 71% that of white women.
• According to the US Census Bureau, in 2016, the median white family’s wealth nationally was $171,000. For Black families, median wealth amounted to $17,600, or roughly 10% of that for white families. For Latinx families, median wealth was $20,700, or about 12% of that for white families.