Healthcare disparities and Black Women

America, the “land of the free”, but with a long history of racism, oppression, and inequality. A country built by White men for White men. Within America, Black women make up about 7.7% of the population, not much right? Black women are not only a minority group based on race but also a disadvantaged group based on gender. Navigating through a country with systemic racism, gender biases, and socioeconomic disparities is already a struggle within itself, but having to navigate those things while also trying to get the care you need is nearly impossible. The American healthcare system, while thought to be advanced, has an undeniable history of mistreatment towards minorities. I will be focusing on Black women specifically, as they often find themselves at the crossroads of endless forms of discrimination within this healthcare system, leading to poor care, negative attitudes from healthcare providers, and even medical negligence that has led to death.

Addressing these systemic issues requires a collaborative effort to tear down these biases and disparities within the healthcare system. This means not only policy reform to ensure equitable access to healthcare services but also ways to educate and train healthcare providers about the unique experiences and needs of Black women. To understand the source of these racial inequalities in the American healthcare system, it is important not only to appreciate how strong Black women are but also to recognize how there is a need for reform to make sure there is equitable access and culturally-based care within the healthcare system, and most importantly, eliminating racial biases.

From the era of slavery through the civil rights movement and into the present day, marginalized communities, including Black, Indigenous, and Hispanic communities, have faced barriers to accessing good healthcare. During slavery, slaves often received very minimal medical care, if any, and were subjected to inhumane medical experiments. Dr. J. Marion Sims, or ‘The Father of Modern Gynecology,’ is widely known for his breakthroughs in gynecology, but what many people don't know is that those breakthroughs were found by using enslaved people. Sims' experiments were far from ethical. Enslaved Black women were forced to be his ‘guinea pigs’ and were subjected to operations with no anesthesia and no consent (Holland). Dr. Sims continues to be a notable person within the healthcare community with no credit to those he used.  Following emancipation, segregation laws led to the establishment of separate but unequal healthcare facilities for minorities. Beginning in 1932 and ending in 1946, the US government went on to conduct an unethical and inhumane experiment, coined the ‘Tuskegee Experiment’. In this experiment, the US Public Health Service was conducting a study to find a cure for syphilis. They rounded up 600 Black men and told them they were being treated for ‘bad blood’. In reality, half of these men were unknowingly injected with syphilis and monitored by the government to see the symptoms and progression of syphilis. None of them were aware of this. The ones who conducted this experiment stood by as these men were going blind, insane, and even died from the untreated syphilis. “As a result of the Tuskegee experiment, many African Americans developed a lingering, deep mistrust of public health officials and vaccines” (Nix 9). This is only the beginning of minorities being treated as test subjects and our lives and health being seen as less than.  Even after the Civil Rights Act of 1964, which outlawed racial segregation, disparities in healthcare access and outcomes continued due to factors such as socioeconomic inequality, biases among healthcare providers, and lack of cultural care. A study was done to uncover the implicit biases among healthcare providers, as it was:

“A test that purports to measure test takers’ implicit biases by asking them to link images of black and white faces with pleasant and unpleasant words under intense time constraints—they tend to associate white faces and pleasant words (and vice versa) more easily than black faces and pleasant words (and vice versa).” (Bridges 6).

 There is no debate that when in healthcare, biases like these are dangerous. Though these biases are also seen in the general public as well, when it comes to receiving care to better your health, these biases can lead to mistreatment and even death. Regardless of skin color or ethnicity, we need to be treated with the utmost care, like our White counterparts. The history of minority-based healthcare serves as a reminder of racism and discrimination within the American healthcare system, and we continue to speak up for the need for reform.

Now let's talk about how this affects Black women specifically. Black women have faced a lot of discrimination and neglect within the healthcare system for years. A notable example of this is Henrietta Lacks. Lacks was an African-American woman who visited the hospital because of a lump on her cervix. Whilst Henrietta’s cancer was treated, her cells were taken without her consent and are still used today. Lacks’ cells brought breakthroughs in many medical research, including but not limited to: the effects of zero-gravity in outer space, development in polio vaccines, the study of leukemia, and even development in the COVID-19 vaccine (The Importance of HeLa Cells 3). Amazing right? But even though Lacks contributed to these advancements, not a single cent or piece of credit was given to her. Compared to Dr. Sims' patients, Henrietta was just an experiment to them. Henrietta may not have had the opportunity to speak out against her own injustices, but other Black women took the time to share theirs. These are some of their narratives. Amanda, a 32-year-old Black woman, told her story about visiting the ER: “Two years ago, I was throwing up all the time, not able to keep anything down, including water. I also had horrible stomach pain. I would go to the ER, and they would do their best to treat me and get me hydrated again. The doctor insisted that I must have been smoking weed chronically because that is the only time that she'd seen something like this. The second time that I saw her, she asked me why I kept coming back to the ER, because there was nothing that they could do for me. I explained to her that I was not able to get my vomiting under control. Turns out I had gastroparesis and there was really nothing that I could have done on my own to stop it, but because I am a Black woman in my 30s, I must have been smoking weed and lying about it to get more drugs” (Murrell 3). Another narrative from ‘Kay’ shows just how deep these biases go: I have a vivid memory of sitting in a school medical room with a sprained ankle, and the school nurse scolded a black schoolmate for exaggerating how intense her period cramps were. The schoolmate asked for an aspirin, but the nurse refused and told her to 'walk it off.' Later, a white classmate came in and complained about her period cramps. The nurse asked if she wanted an aspirin” (Murrell 9). These stories are just two of many stories and untold ones that uncover the horrible treatment that Black women go through. Many often report feeling disrespected or marginalized during medical encounters, with their concerns being minimized or ignored, and with that, they are more likely to have their pain underestimated or dismissed by healthcare providers, leading to delays in diagnosis and poor pain management.

 In modern healthcare, the journey for Black women seeking care has been halted by systemic injustices, making it hard to find the appropriate healthcare they need. Black women are more likely to experience maternal mortality, higher rates of chronic illnesses, and misdiagnosis from doctors compared to their White counterparts. Two in five Black women personally experience discrimination within the American healthcare system (Feldman 13). It is interesting how Black women are the minority but continue to pass their white counterparts in statistics like these. We need reform immediately. 

Addressing the healthcare needs of Black women requires a complex approach that acknowledges the differences in culture and gender. The only way we can dismantle common racism and gender biases within the healthcare system is to ensure equitable healthcare outcomes for Black women by centering their voices and experiences in healthcare policy and practice, and by actively challenging the biases and stereotypes that maintain inequities. In 2010, former President Barack Obama passed the Affordable Care Act. The Affordable Care Act expanded Medicaid eligibility, created a Health Insurance Marketplace, and prevented insurance companies from denying coverage due to preexisting conditions. The Affordable Care Act requires insurers to cover a list of essential health benefits” (Kenton 3). This act impacted Black women and their communities in such a positive way. More than 6 million people within these communities became insured and were able to access healthcare, but was the healthcare of quality? Even after 2010, the statistics from Black women compared to White women were astonishing and still very much disproportionate. Black women were still twice as likely to develop diabetes than White women, and Black women were three times as likely to experience maternal mortality (Njoku et al 14-15). Though the ACA (Affordable Care Act) did lessen the numbers when it came to uninsured people, it uncovered that affordability was just a small part of the problem. Black women have the ability to access affordable healthcare, but the healthcare is still not of quality. This is a case where cultural and gendered healthcare is vital. Hands up for affordable healthcare! Now, quality is needed.

We can strive towards a healthcare system that truly serves the needs of all individuals, regardless of race or gender, by: increasing representation of Black women within the healthcare system, cultural competency training, community outreach, and expanding access to affordable care. UCLA (University of California, Los Angeles) did a report on the population of Black people within America and how many of them were becoming involved in healthcare. Fortunately, since about 2005, not only is the population of Black people begun to steadily increase, but the number of Black women in healthcare makes almost a sharp incline (Rivero). The graph does not show any decline in the near future, giving people, especially Black women, hope that the next time they come into a doctor’s appointment, they are greeted by a doctor who shares cultural and gendered traits. Another way that Black women are taking power within the healthcare system is the BWHI. BWHI (Black Women’s Health Imperative) is a national non-profit that specializes in the health equity for Black women by utilizing community outreach. Through things like investments, evidence-based research, and programs, this non-profit helps Black women receive the care they need. This non-profit values things like voting which is really important to get those who value this sort of thing in power.

Black people and women alike, have been subjected to low-quality and somewhat racist forms of healthcare throughout history and are still continuing to experience these phenomena.  Though with a call to reform and just overall advocating for our health, these are just a few of many ways we can overcome these racial inequalities and achieve true equality within the healthcare system.

Healthcare Disparities and Black Women KK.pdf

Download PDF • 110KB