A BLACK Face In Need of a WHITE Coat
Racism in healthcare
It’s the time of year again that strikes a nerve & grinds the gears of every racist throughout the nation. It’s BLACK History month. It’s the month that black Americans are reminded of every Jim Crow law, the unjust theft of every birthright we had, every life lost, & every punishment during slavery; but we’re also reminded of the strength & resilience of our black ancestors.
Since black history month has arrived, it’s important for me to address the struggles of being black in a different area.
Last year, I discussed racism in the workplace.
A BLACK face in WHITE collar America…
We often shine a spotlight on racism in regards to police brutality, but let me accentuate where we see it most.
Here it is, 2022 & we are still addressing the same racism from 1877 following Reconstruction & the 1950's Civil Rights movement.
There are limitless stories about systemic racism, inequalities in the school system, the work system, the judicial system, & the “systems” continue.
For years now, we have been seeing media stories & hearing stories about riots related to police brutality against black Americans.
But what if I told you that most deaths in the black community are not at the hand of the police? It’s at the hand of the people we trust with our lives the most — doctors.
It should come as no surprise, as like every other aspect of America, African Americans are failed by yet another system. The healthcare system.
For some of you, this may be hard to believe but, several leaders of different U.S. health systems have identified racism as a public health threat.
Prior to my career choice of nursing, I overheard various conversations about how African Americans were mistreated & victims of both known & unknown discrimination. A scholarly article titled, “Impact of Perceived Racism on Healthcare Access Among Older Minority Adults,” caught my attention. I’ll be completely honest, I didn’t even bother to read it. The wording was an immediate turnoff. Perceived racism.
The wording is insensitive. The title is offensive, simply because racism & discrimination is never called what it actually is. It’s always insinuated that it is a figment of our imagination. It’s passed off as our “sensitivities.”
Contrary to popular white belief, in my personal research, I found that it is well-established that blacks in the U.S. encounter significantly more illness, unfavorable outcomes, & untimely death compared with whites.
I will openly admit that African Americans receive care, however, in most cases, it isn’t quality or adequate care. Inadequate or poor quality care essentially means delayed care, misdiagnosis, lack of communication during patient-provider conversations, &/or forgone care. Even when we choose to be evaluated & “treated,” black Americans “still experience illness and infirmity at extremely high rates and have lower life expectancy than other racial and ethnic groups.”
Dr. Rachel Sisodia stated:
“It’s been proven over and over that Black women who have chest pain radiating down their arm are less likely to get referred for a cardiac catheterization than white men…”
“Black women receiving care at Mass General Brigham were significantly less likely to get knee replacement surgery, even for significant knee arthritis, than white men.”
It was found that satisfaction surveys & outcome measures, only about 58% were given to black Americans in the waiting room, while it was given to 74% of white Americans waiting. Inequality occurs behind closed curtains, but the bias even takes precedent in the waiting area. This type of bias is implicit.
Let me hit you with a few more stats, just in case a nonbeliever comes across my post.
Stats courtesy of WebMd
Racism plays a part in this. How? Dr. Yancy believes that these differences in health are “less likely to be genetic. It is more likely to have to do with socioeconomics and political issues of bias.”
Following Dr. Yancy, Dr. LeRoy M. Graham Jr., says “the time is ripe for Americans to come to grips with these issues.”
Why does the difference in health care occur?
For starters, black Americans are presumed Medicaid recipients which is the start of poor quality care.
On several occasions, if I stated that my coverage was Anthem Healthkeepers, health system employees would end my sentence with “Plus?” (which is a Virginia HMO health maintenance organization). Government-based insurance, Medicaid. This statement is not to say that anything is wrong with having Medicaid (because it isn’t), but rather that it should not be assumed by health systems that every black American has it.
Medicaid (here in Virginia) isn’t the best paying when it comes to claims, but at least they pay something. Unfortunately, there were times in which some private practices didn’t even accept Medicaid due to the lower rate of paid claims. The problem is, as pictured below, between 2017–2019, African Americans held the highest average of being Medicaid recipients. Offices not accepting Medicaid, ultimately means the black Americans aren’t able to receive care. Maybe, they could be seen elsewhere, but socioeconomic & environmental factors often prevent that.
Table & facts courtesy of Health Moms, Strong Babies
In addition to the Medicaid assumption, African American patients are prematurely treated as uneducated or ignorant. Other predisposing factors of inequalities in cases of healthcare include but are not limited to: gaps in health insurance coverage, disproportionate access to health services, & indigent health outcomes or prognosis. We are “given” diagnoses that may not necessarily belong to us.
Miscommunication or misdiagnosis?
I’ll never forget the time my son was hospitalized following a tonsillectomy, adenectomy, & nasal turbinate. Initially, I took him to the ER for dehydration. Prior to the surgery, I asked for ondansetron or Zofran to ward off nausea I knew one come after the procedure. They didn’t honor my request. He hadn’t been able to tolerate anything by mouth — solid or liquid. This began about 2 days after his surgery. I had the same issue during my surgery some years ago.
Not long after he was evaluated in the ER, he was ordered to be admitted into the hospital while the doctors tried to “find out” what was wrong with him. They wanted to do a nasopharyngeal COVID test. I objected because just 7 days prior, his nasal passages were stripped, & he was still having nasal bleeding. After my objection, the nurse responded with, “we don’t do many of those surgeries here,” with a questioning attitude. To which my reply was, “I understand, but you did his.” She left because she had to “check the chart” as if I lied. Do you know that she never came back to tell me I was right?
While he was in the hospital, I was asked about 10–12 times by different physicians & nurses about his symptoms. My answer was always the same. It was almost as if they expected me to change my story or as if I had no idea what I was talking about. I should’ve been offended, but I’m used to it.
They moved through several diagnoses: appendicitis, COVID, stomach bug, etc. All of which required him to be picked & probed with a series of diagnostic imaging & blood work. They refused to believe this “young black mother” & refused to believe that his symptoms were this simple. I already identified the questioning attitudes, doubt, & hesitancy in believing me. They didn’t realize that I was a nurse, & I wasn’t going to tell them.
After being unable to nail down exactly what was wrong with him, they came up with ruling out nephroblastosis or Wil’s Tumor. Yes. Cancer. Some labs were drawn in which elevated markers were found that could be indicative of cancer. I never saw the lab work or the results. After they delivered the news, I was contacted by a hematologist-oncologist who decided it was time to do yet another test. I questioned the need for it & what exactly they were looking for. They wanted to see his kidneys. I guess the ultrasound & CT didn’t show them enough. Hours later, he called again to tell me that the same elevated blood levels were now within normal limits & there was no need for further testing.
My son’s final diagnosis: gastritis, just like I said. Do you know who made the final diagnosis? The BLACK physician I spoke with during rounds, 3 days later.
I can only imagine how many black children they diagnosed with cancer or other serious conditions after noticing they didn’t have active parents that asks questions.
It’s heartbreaking to know that this is a common occurrence for black Americans.
Dr. Angela Anderson faced an encounter of medical neglect due to her race. In an emotionally compelling account of her experience, she herself states, "I wish my story was uncommon, but unfortunately it is not.”
Here’s a full account of her story in an interview with Forbes.
This is a bold statement, but I am a bold person, so it goes:
Another area that negatively affects the black community is this…
There are Caucasian doctors that “specialize” in diseases that are experienced predominantly by black Americans such as Sickle Cell Disease. How much faith should we have in doctors that don’t have the disease, but want to give us the cure?
For example: Many people suffer from hypertension & are treated with medications. However, certain medications are not made for people of color. Lisinopril is an example of one.
Pay attention to this: “the increased stroke risk associated with lisinopril was experienced among African American but not non-African American patients.” (Source: National Library of Medicine). Basically, what this means is that while lisinopril is considered “safe,” it does not work as well for black patients. A common side effect of this medication is swelling of the face, lips, mouth, tongue, & back of throat called angioedema.
Photo courtesy of YADA
I’m sure there’s so much more that can be covered on this issue, but the main point is this — our health doesn’t matter to America. Racism is found everywhere, even in the doctor’s office.
While race may be a social construct, racism has devastating impacts on the bodies of people of color.
-From the American Medical Association’s recently published Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity, 2021–2023
About the Creator
Stephy Ellsworth
Certified Blogger | Master Life Coach | Lover of words, writing, reading, & English |Published Authoress|
“Everyone has a story, I just decided to write mine.” -Steph 💋✍🏽
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