Introduction
There are many factors that contribute to the increased rate of morbidity and mortality among the black population. Even so, one of the key factors is the healthcare they receive from the healthcare givers. According to a report from the National Academy of Medicine (NAM) in 2005, the fact that black people get sick more often and live short life spans compared to whites cannot only be accounted for by the poverty some of them live in. Basically, black people are not receiving similar healthcare compared to the healthcare their white counterparts receive even when income, age, insurance status, and all conditions are comparable (Bridges, 2020).
Among the black population, black women happen to be one of the most affected groups when facing the risks of health discrimination. This happens when medical professionals do not take their concerns seriously and as a result of biological wear and tear that results from chronic stress. According to (Walton, 2020), the issue of the healthcare system failing black women goes way back to the country’s long history of structural and systematic racism. Thus, this paper aims to evaluate how the healthcare system fails Black women. Healthcare discrimination against black women is evident in different healthcare settings, including cancer treatment, sexual and reproductive healthcare, and mental health, whereby black women are ignored when stating their concerns.
Racial discrimination, including the use of discriminatory healthcare practices, is the main reason why the sexual and reproductive healthcare of black women has been compromised. The Centers for Disease Control and Prevention has established that cases of infant mortality, maternal mortality, and contracting sexually transmitted diseases, including HIV/AIDS are high in black women. According to (Prather et al., 2018), during the 246 years of enslavement, most of the racial mistreatment that happened to African American women and their children mostly involved sexual and reproductive acts of violence. Sexual and reproductive exploitation of black women was legalized. The economic system also favored white slave owners in matters involving childbearing, whereby black women who showed strength qualities were sold to breeders, and those who got pregnant were forced to abort. There was no access to healthcare for black women other than medical experiments. For instance, James Marion Sims, also known as the “Father of Modern Gynecology,” treated many childbirth conditions using his experimental surgeries among black women without using anesthesia (Prather et al., 2018). Other experimental reproductive surgeries done on black women by physicians include cesarean sections and ovariotomy, which would then be used on white patients.
During the Civil Rights era, poor quality, limited, and no health services for many black women, especially those in poor conditions, was the replacement for inhumane healthcare conditions during the previous era of, the Jim Crow era. Therefore, the United States healthcare system has been harsh to black women in both civil rights and post-civil rights periods in history. For instance, not long after the Medicaid program, healthcare facilities were forced to adhere to the Act that declared they should only hire medical practitioners who would treat black Americans but unequally. This racial discrimination has become a routine and has found its way into the current medical facilities. For instance, medical professionals currently recommend contraceptives as the most efficient and effective means of contraception for many women, including young adults, regardless of race. However, African women have reported challenges they face when seeking family planning services in healthcare settings. There are also cases whereby they have been advised to restrict childbearing, which leaves the patients with mistrustful feelings.
According to research done by the Center for Disease Control and Prevention, black women are 2 to three times more likely to experience a high burden of Sexually Transmitted Infections and pelvic inflammatory disease compared to white women. When these conditions are left untreated, they cause pregnancy complications and sometimes infertility. Black women die of pregnancy-related complications three times the rate of white women (Seervai, 2019). Pregnancy-related hypertension and chronic hypertension are also common in women of color because they do not have access to the required maternal care and other preventive services from the healthcare givers. In research by (Thompson et al., 2022) on the sexual and reproductive health experience of black women, respondents referred to healthcare givers as unconcerned and dismissive. They added that they do not receive any information on reproductive health conditions, their experiences of pain are ignored, and post-delivery care is usually not offered. Across the United States, black women have continued to encounter poor reproductive healthcare access, which puts their health at risk of physical and mental conditions which could lead to death or self-harm.
Cancer affects people from all communities, but the healthcare system has systemic issues that can result in negative impacts for black patients, to be particular. For instance, due to the high rates of mortality cases of black women compared to white women with cervical cancer, racial health discrimination is evident in strategies used in cancer treatment. Women of color are the second highest in high mortality rates resulting from cervical cancer, usually diagnosed at a later stage. According to studies conducted recently, the mortality rates of black women with this condition are worse than previously thought. Early screening for cervical cancer is key for early detection and treatment procedures. A lot of research has been done to understand what could be increasing mortality rates of black cervical cancer women; it has been established the key reason is a lack of awareness and knowledge of cervical cancer. This puts a barrier to screening black women.
In an article (RUSSELL, 2021), Beth Jones is an example of a black woman who was a cancer patient and endured months of chemotherapy for colon cancer treatment as she watched other patients celebrate, waiting before her time to come. Unfortunately, on her treatment day, the nurse informed her that the treatment would not be possible at that moment. She continued to endure the treatment process for six more weeks with no bell to ring. She was eventually happy after her treatment, but she fears for other black women who lack medical health coverage. Other than Ben Jones, other black women have also reported experiencing discrimination in cancer healthcare settings.
Also, the medical system has failed black women in cancer treatment by a lack of research on black patients. Without inclusive studies, it can be difficult to determine how upcoming conditions and treatment strategies will affect a certain population. For instance, common cancers like breast and colon cancer have risk factors such as smoking, poor diet, and alcohol consumption. However, recent data has pointed out there are only a few black women who consume alcohol and tobacco, but many black women are still dying from these cancers (RUSSELL, 2021). There are efforts being made by healthcare facilities and the government to study individuals of different backgrounds, but this population has been underrepresented. Cancer care is also quite expensive, and it can be challenging to access for low-income black populations. Once the diagnosis is made, healthcare facilities that offer treatment for cancer are not readily available for black women. Future interventions should address the poor quality of medical encounters that women of color are experiencing.
People with mental illness have always faced discrimination in society, whereby they have been denied participation in society and labeled as dangerous individuals. Institutions have been designed similar to prisons to lock up people with mental illness. As bad as the conditions for people with mental disorders, they are even worse for marginalized groups such as people of color. According to the Health and Human Services Office of Minority Health, people of color are 20% more likely to get serious mental health problems but seeking therapy is just not something they normally do. Even though the term self-care has become part of the vocabulary, it is still stigmatized to talk about mental health in the black community. This is because asking for help has always been viewed as a sign of weakness and a troubling character flow for this community. Lack of treatment for these mental conditions becomes harmful, especially for black women.
Approximately 86% of psychological health healthcare givers in the U.S. are white, and the American Psychological Association has less than 2% African Americans (Perzichilli, 2020). The topic of racial discrimination and inequality in the healthcare system, specifically in mental health, has been documented. The findings have established that compared to Whites, black women have less chances of receiving mental health services and receive the required care. Instead, they have a high chance of being bullied, receiving poor quality care, and therefore ending sessions too early. Mental health maintenance is essential for reaching the maximum potential in every individual. With limited access to needs, black women will continue to face major challenges.
Healthcare givers have always assumed that black women do not know or understand how they feel because they are not educated about their bodies. There is so much judgment whereby if they are relaxed, it is said that they are not sick, and if the patient shows signs of pain, it is said that they are overreacting. In 2016, a study in a certain medical school found that most first-years and second-years believed that black people have thicker skin than whites. In another study, medical health professionals are less likely to give black patients medication for acute pain, unlike white patients.
Implications for Public Health
Racism related to access to healthcare facilities for black women has existed for a long time, and there is a need to develop new strategies or models to ensure health promotion in this underrepresented group. On sexual and reproductive healthcare obstacles, the use of sociological models can be helpful in order to understand the actual issues in both race and gender challenges. Examples of programs that would help in this include programs designed to address the personal level (self-esteem and resilience), interpersonal level (to reduce stigma), community level to avoid residential seclusion, and most important of all, system level. This strategy can lead to long-term and better-quality healthcare services for black women. Secondly, is to guarantee approaches have contextually and culturally the required research and prevention solutions. This is because understanding theories and points of view is the key to prevention efforts. When designing, evaluating, and implementing the kinds of research and the programs agreed upon, it would be important to involve black women.
Also, the reduction of obstacles to accessing quality health care by improving access to medical coverage and encouraging culturally appropriate and specialized care for all patients would be one way to address the issue of unequal access to reproductive health information and poor health care services (Prather et al., 2018). The Affordable Care Act (ACA) could play a significant role in leading in implementing such healthcare issues. This Act was designed to increase access to preventative screening services that are not available for black women, increase maternity coverage, and finance small community health centers situated in communities with a high population of the black community. In addition, public health agencies could also play a role in addressing the causes of adverse sexual and reproductive health results by expanding their partnerships and including people who might be having the knowledge or have a direct experience with social factors that directly or indirectly affect the health status of black women. Lastly, the relationship between the physician and patients benefits the quality of healthcare provided. In the study by (Thompson et al., 2022), the participants reported having received better healthcare from same-race healthcare professionals. Therefore, ensuring a diverse racial and ethnic workforce could promote better healthcare access among underserved populations. “Lack of trust among healthcare providers and the medical system also accounts for underutilization of healthcare by African Americans” (Belgrave & Allison, 2019).
In the future, the research should attempt to explore the quality of healthcare encounters for black women. It should also include qualitative and quantitative methods to understand the quality of cancer treatment they receive and the potential impacts of cancer screening. Involving the actual patients would give more accurate results because they continue to engage in care despite racial discrimination.
Conclusion
Looking at the history of black women’s challenges with healthcare facilities, it can be concluded that for too long black women have been told to wait their turn. The health care system will have a better chance of eradicating the main causes of health care services inequalities when the imposed strategies result from social and epidemiological research. Such studies can support the creation of strategies that consider the specific experiences of black women.
References
BEIM, P. I. R. A. Y. E. (2020, June 8). The disparities in healthcare for Black Women. Endometriosis: Causes – Symptoms – Diagnosis – and Treatment. Retrieved December 8, 2022, from https://www.endofound.org/the-disparities-in-healthcare-for-black-women
Belgrave, F. Z., & Allison, K. W. (2019). Chapter 12: health, illness, and disability. In African American Psychology: From Africa to America (Fourth). Essay, SAGE Publications, Inc.
Bridges, K. M. (2020, September 7). Americanbar.org. Retrieved December 8, 2022, from https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/
Perzichilli, T. (2020, July 7). The historical roots of racial disparities in the Mental Health System. Counseling Today. Retrieved December 8, 2022, from https://ct.counseling.org/2020/05/the-historical-roots-of-racial-disparities-in-the-mental-health-system/
Prather, C., Fuller, T. R., Jeffries, W. L., Marshall, K. J., Howell, A. V., Belyue-Umole, A., & King, W. (2018). Racism, African American women, and their sexual and Reproductive Health: A review of historical and contemporary evidence and implications for health equity. Health Equity, 2(1), 249–259. https://doi.org/10.1089/heq.2017.0045
RUSSELL, T. O. N. Y. A. (2021, April 15). Racism in cancer care is failing black patients. can we change the system? Prevention. Retrieved December 8, 2022, from https://www.prevention.com/health/health-conditions/a35473538/racism-cancer-black-patients/
Seervai, S. S. (2019, October 18). How our healthcare system treats black mothers differently? Commonwealth Fund. Retrieved December 8, 2022, from https://www.commonwealthfund.org/publications/podcast/2019/oct/how-our-health-care-system-treats-black-mothers-differently
Thompson, T.-ann M., Young, Y.-Y., Bass, T. M., Baker, S., Njoku, O., Norwood, J., & Simpson, M. (2022). Racism runs through it: Examining the sexual and reproductive health experience of black women in the South. Health Affairs, 41(2), 195–202. https://doi.org/10.1377/hlthaff.2021.01422
Walton, J. (2020, November 13). Black women’s biggest health issue is the system. Hopkins Bloomberg Public Health Magazine. Retrieved December 8, 2022, from https://magazine.jhsph.edu/2020/black-womens-biggest-health-issue-system
write