Racism and health care may seem like unrelated matters that are no more than issues on political pundits’ lists of debate topics. However, systemic racism has an impact on health care outcomes for communities of color in the United States. As an African American woman, I am keenly aware of how racism impacts health and health care outcomes.
Over the last 31 years, I have experienced more than one instance of dismissal at the hands of health care professionals. Most recently, a white, male gynecologist did not take heed when I was having symptoms of an ovarian cyst. The doctor came into the room and although we never met, assumed that my symptoms were indicative of stress. Realizing that he was about to send me home with nothing more than a recommendation for over the counter medications, I advocated for myself and pushed the doctor to at least take a look. Refusing to examine me himself, he sent me across the hall to an ultrasound technician, who found a cyst on my ovary. When the doctor returned to the office, he was still fumbling and in disbelief that I, as a patient and dental student, somehow managed to correctly diagnose myself when he had failed to do so.
Through the years, I have managed to use my medical knowledge, self-awareness and tenacity to push health care professionals to delve deeper into my health issues and thus avoided truly adverse, and oftentimes life-threatening, circumstances. But what about patients without medical backgrounds or those who do not know how to advocate for themselves when health care professionals dismiss their concerns? What happens to them?
According to the CDC, black women are at a higher risk of maternal mortality at 44 deaths per 100,000, as compared with their white counterparts’ rate of 13 per 100,000. Additionally, they are 49 percent more likely than whites to deliver prematurely. Black infants are twice as likely to die before their first birthday regardless of family socioeconomic status or educational level.
So what can we do about it?
We as health practitioners must respect and regard our patients as the premier authority on their lives and experiences. As such, they play a significant role in their health and deserve to be heard and understood before we ever diagnose or treat them. This ensures that we are taking into account the whole person and not just viewing our patients as laundry lists of problems to be solved.
Other resources to bridge the gap between patients and practitioners are patient advocates. They serve as intermediaries to ensure patients receive the quality care to which they are entitled. By making these professionals more accessible to patients to help them understand the information shared in appointments, diagnoses, treatment plans and their options, we enable our patients to be more autonomous when making health care decisions.
Lastly, cultural humility is an integral trait for all health care professionals. It is important to not only listen to the patient’s narrative but to also work to more clearly understand their varied and diverse backgrounds and how to better navigate and empathize with them.
The unfortunate reality is that racism is interwoven in the fabric of our country. Until we have an honest dialogue about it, we cannot hope to alleviate its burden. However, focusing in on racism in health care is just one way we can dissect the seemingly insurmountable issue of systemic racism, improve health and health care outcomes and begin to level the playing field for communities of color.
Brittanie Height is a second-year student at East Carolina University School of Dental Medicine and a 2019-20 J. Bradley Wilson Schweitzer Fellow. The opinions expressed are solely representative of the author and do not necessarily reflect those of the East Carolina School of Dental Medicine or the NC Albert Schweitzer Fellowship.