The shocking disparities in health between white Americans and people of color have been exacerbated in the pandemic, but the distrust of doctors among Black Americans has been simmering for generations. When white doctors still carry old misconceptions and when Black women in pain aren’t heard, it adds up to doctors generating fear and skepticism rather than a feeling of protection within the Black community. How do we fix it? Today’s Daily Dose, along with a special new “Real Talk, Real Change” episode of The Carlos Watson Show, dives in.
Joshua Eferighe, Reporter
behind the disparity
1. Structural Racism
“All I can say is: Time’s up,” ABC News chief medical correspondent Dr. Jennifer Ashton says on “Real Talk, Real Change” while discussing the structural racism the medical community is well aware of — but hasn’t addressed. Black Americans experience higher rates of poverty and malnutrition, as well as lower education levels and less access to healthy food. Yet they are met with a medical system that insists on a supposedly “colorblind” approach that doesn’t actually meet their needs. That leads to a host of health disparities: Black patients are 40 percent more likely to have high blood pressure, Black children are twice as likely to develop asthma, and Black women are more susceptible to heart disease, strokes and diabetes. “We should ‘see color,’ and we should prioritize care based on these risk factors,” Ashton says. “We should ... be doing more, not the same, and certainly not less, for women of color.”
The Black community has suffered from horrific medical abuse throughout history. Consider the Tuskegee experiment of 1932, for example, in which 600 Black men were told they were being treated for “bad blood” but were actually deprived of treatment for 40 years as scientists studied the progression of syphilis. Henrietta Lacks, a Black woman who died of cervical cancer in 1951, had her cells harvested for research without her knowledge or consent. James Marion Sims, a 19th-century physician and the “father” of modern gynecology, accomplished medical breakthroughs by practicing excruciating medical surgeries without using anesthesia on Black enslaved women.
3. Time for All-Black Hospitals?
Black people have thicker skin and suffer less pain, right? No! These are shockingly racist myths that remain entrenched in the medical community today, which means when Black people complain of pain, they are not heard by white doctors, so they suffer more. Studies show that Black patients do better with Black doctors because they communicate better, leading to improved treatment and patients who are more likely to seek preventive care. “What would happen if we created 100 all-Black hospitals around the country that were meant to be top-tier, best of the best?” asks Carlos Watson, OZY’s co-founder and CEO, on “Real Talk, Real Change.” America’s Jim Crow era saw a surge of all-Black hospitals, but they were starved of resources like other segregated institutions and were hardly “top-tier.” Today, there is only one remaining traditional Black hospital, Howard University Hospital, in Washington, D.C.
4. COVID Crisis
COVID-19 attacks the heart and lungs — areas where Black people are disproportionately vulnerable. It’s a big reason why Black people are three times as likely to be hospitalized and twice as likely to die of the virus than whites, with rates even worse for Latinos and Native Americans. These groups are also less likely to be vaccinated. One theory is vaccine hesitancy — that a history of mistrust between Black people and the medical system has deterred them from signing up and getting in line. But studies show how there’s little racial difference in reluctance to receive the coronavirus vaccine, leaving barriers like pharmacy deserts, poverty and unemployment as the more likely culprits.
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For some Black women, doctors can be what cops are to Black men: a cause for fear, resentment and distrust. “Black women are the most disrespected, unprotected women that exist. No matter how many times we’re screaming about our trauma and our experience, it doesn’t stick,” actress, producer and activist Gabrielle Union says on “Real Talk, Real Change.” And wealth, class and social status don’t bridge that divide in trust or care: Even multi-millionaire tennis star Serena Williams faced potentially life-threatening complications when doctors refused to listen to her after she delivered her daughter in 2017.
2. Birthing While Black
Black mothers are 243 percent more likely to die from pregnancy- or childbirth-related causes than white women. Imagine the resources that would be thrown at solutions if these statistics were true in the reverse. Dangers for Black patients arise from conditions such as preeclampsia — a complication involving high blood pressure that can lead to organ damage — and increased rates of hypertension, as well as hemorrhaging and infection. Black infant mortality rates are twice that of white infants, and Black patients are more likely to live in areas at risk for preterm birth, which comes with its own risks. And, as Williams exemplified, the differences in outcomes cannot simply be tied to poverty: Black women with college degrees still have a higher risk of severe complications than white women who never graduated from high school. One potential solution: Black doulas. As Sasha Mitchell-Fuller, a co-executive producer of The Carlos Watson Show, recalls, her doula cared for her, represented her and spoke for her in the hospital. With a doula who looked like her, Fuller’s birth experience was better than she thought possible.
Much like with birth outcomes, when it comes to breast cancer, social and economic disadvantages may explain the differences in outcomes between white and Black patients. For a long time, underserved areas didn’t even have proper screening technology. Research also shows that some physicians might not share treatment options with Black patients simply because they felt they’d be less likely to comply than white patients. As a result, Black women are 41 percent more likely than white women to die of breast cancer, and Black and Latina women are 30 to 60 percent more likely to be diagnosed only after their cancer has progressed beyond Stage 1.
From Golden Globe-winning actress Taraji P. Henson, who founded a mental health advocacy group, to Charlamagne Tha God, the Breakfast Club radio show co-host whose 2018 book, Shook One, spoke candidly about his struggle with anxiety, Black leaders are speaking up about mental health. “Anxiety is like Michael Jordan in the ’90s: You can’t stop it … you can just hope to contain it,” Charlamagne says on “Real Talk, Real Change.” Black patients’ rates of mental illness are similar to the general population, but disparities in care exist. According to one study, more than a third of African American patients experiencing depression or anxiety felt they would be considered “crazy” to their social groups. Some women cope by embracing the trope of being a “strong Black woman,” although studies show that pressure can sometimes lead to stress, depression and binge eating. And Black men? Too often, they don’t talk at all, making vocal examples like Charlamagne all the more critical.
2. Queering Mental Health
Both lesbian and bisexual women have far lower odds of depression when compared to queer white and Latina women. Some experts argue that is because they don’t take on an attitude of strong Black womanhood, more readily talking through their emotions and accepting vulnerability. Cisgender Black women may be more prone to ridicule and judgment around their physical aspects, such as their body and their hair, while LGBTQ women may find themselves in more affirming environments. It helps that Black women, regardless of sexuality, also report higher rates of self-esteem.
3. Finding Their Religion
Black Americans are much more likely to rely on their faith as a means of dealing with depression and anxiety than they are to utilize mental health professionals, studies suggest. But while the church can help, other approaches are available as well. Charlamagne sings the praises of meditation as a coping mechanism for anxiety, and Pew Research data indicates Black people are the most likely ethnic group in the U.S. to meditate at least once a week.
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She wasn’t content to just watch as she saw her fellow Philadelphians lacking COVID-19 testing kits and being inundated by virus misinformation online, so she contacted countless doctors of color around the country with two requests: Could they spare any testing kits, and would they appear with her on her Instagram Live to debunk the biggest conspiracies emerging in real time? She went on to hand out tests door to door and then from a local church parking lot, even offering to pay for the $50 to $100 tests herself in order to cover those without insurance. Now she’s doing the same for COVID-19 vaccines, getting a shot on camera, dispelling myths and distributing the shots in underserved communities.
She’s a white OB-GYN from Portland, Oregon, who, in her free time, frequents TikTok with stats about disparities in the way Black people are treated by medical professionals. She’s gone viral while shedding light on matters other white people may not know — the mark of a true ally. One of her most popular posts had her explaining a 2016 study that said 50 percent of medical students and residents thought that Black people couldn’t feel pain the same way because they have thicker skin. In another video, she focused on how Black Americans are less likely to seek medical attention and are forced to wait longer in emergency rooms when they do.
3. Dr. Nadine Burke Harris
California’s surgeon general is at the forefront of pushing vaccinations in America’s largest state — recently getting the one-shot Johnson & Johnson vaccine on camera as part of an effort to play up its effectiveness at a time when many people consider it a lesser cousin to the Moderna and Pfizer vaccines. But the Vancouver-born Harris, 46, is best known for her pioneering research into the long-term effects of childhood trauma, which leads to increased rates of high blood pressure, heart disease and cancer later in life. And she says there’s no doubt the pandemic is a key driver of “toxic stress” for kids around the world.
4. Dr. Altha Stewart
When it comes to allyship, the community health executive at University of Tennessee Health Science Center has some thoughts. A former president of the American Psychiatric Association, she previously got pushback from doctors who did not want to listen to her when she complained about implicit bias pervading their work. Now that she’s on top, she doesn’t hesitate to weigh in. “At times, I pull rank and I advise that this is not in the best interest of the university,” Stewart tells Watson. “I’m not beyond using those kinds of tactics if people are really dragging their feet on simple things.”
5. Christina Rice
After spending 15 years as a public relations and marketing executive, it wasn’t until 2015 that Rice started practicing yoga as a form of stress relief. Looking around the room, though, it became very clear that there weren’t many Black yogis — despite the clear ways the mental and physical effects could help them in particular. Two years later, Rice started OMNoire — a yoga and spin class geared toward diverse practitioners. She’s part of the many yoga studios shaking up the wellness industry by ensuring health brands typically marketed exclusively to white, affluent communities are accessible to people of color as well.