Estimated reading time: 6 minutes
Systemic racism has plagued the United States since the country began. These oppressive systems impact every sector including healthcare. Black people, but especially Black women, have struggled to find equitable treatment from medical professionals for centuries. For nearly 30-years, Boston University has led the largest and longest running study of Black Women’s health in the country and according to their research there are some glaringly problematic statistics.
“Black women are more likely than other racial and ethnic groups to die from cardiovascular disease, hypertension, stroke, lupus, and several cancers,” and also “Black women face greater challenges in accessing affordable and quality healthcare, including a lack of health insurance, higher medical debt, and longer travel times to hospitals.”
The Bias of Medical Research
Medical research has historically excluded Black women, utilizing mostly White males as its study group. These long-standing women’s health disparities have left us with many unanswered questions. If “Black women are less likely than White women to develop breast cancer, why are they 40 percent more likely to die from it if they do develop it?” The reality? Stressors such as racism and poverty play a bigger role in our health and wellness than genetic predisposition or individual self-care choices do. “The psychological trauma of racial discrimination may increase cortisol (the body’s stress hormone) and weaken the immune system, potentially leading to elevated blood pressure, memory problems, and other conditions.”
Food Deserts and Their Impact
Food deserts are regions where individuals have a lack of access to healthful or affordable foods. These deserts can contribute to conditions such as obesity, diabetes, cardiovascular disease, and micro-nutrient deficiencies. This is mostly due to having a low income or having to travel quite far to find healthy food options.
The United States Department of Agriculture (USDA) defines a food desert as “an area that has either a poverty rate greater than or equal to 20% or a median family income not exceeding 80% of the median family income in urban areas, or 80% of the statewide median family income in nonurban areas.” To qualify as a food desert in urban areas, at least “500 people or 33% of the population must live more than 1 mile from the nearest large grocery store. In rural areas, at least 500 people or 33% of the population must live more than 10 miles from the nearest large grocery store.” The USDA identified roughly 6,500 food deserts within the country between 200 and 2006, with 23.5 million people living further than 1 mile from the nearest grocery store.
According to the 2012 USDA report, some research suggests that “neighborhoods consisting primarily of low-income minority ethnic groups have limited access to supermarkets compared with wealthier, predominantly white neighborhoods.” This research is not 100% conclusive. However, it has also been found that when minority groups do have access to grocery stores, they are often not affordable groceries for low-income families. Physical access does not result in monetary access to healthy foods.
Food Insecurity
Black women also often experience food insecurity because of these food deserts. This lack of access to nutritious foods impacts the physical health of Black women and their mental and spiritual well-being. According to the National Library of Medicine, “Poor mental health is among the most debilitating consequences of food insecurity, including acute psychological pain, anxiety, shame, and depression.” And there are even more staggering statistics. “In the United States, roughly 12% of the population faces some level of food insecurity, and rates are even higher—upwards of 20%—among non-white households.”
The Reality for Black Women’s Health
Despite improvements over the last century, racial disparities within the medical system of The United States persist. According to the National Center for Health Statistics, “Black women continue to experience excess mortality relative to other U.S. women, including—despite overall improvements among Black women—shorter life expectancies and higher rates of maternal mortality.”
Health outcomes do not occur independent of the social conditions in which they are built. The higher rates of chronic health conditions amongst Black women are undeniably tied to the structural inequities. These exist within and outside of the healthcare systems that Black women face throughout their lifetime. Obesity, hypertension, cardiovascular disease, and more are a direct result of the systemic oppression that Black women face daily. Whether it is a lack of access to nutritional food, or the daily stressors of racism, the impacts on Black women’s health are not the fault of Black women and their health choices. It also is not caused by a lack of desire to live a healthy lifestyle. These systemic barriers make it unimaginably difficult for Black women to succeed in living mentally and physically healthy lifestyles.
What Healthcare Providers Can Do
According to the Health and Human Services (HHS) Office of Minority Health, there are distinct steps that healthcare providers can take to further the cause of Black women’s health:
- Address patients' concerns with respect by recognizing the implicit bias that Black women experience daily. Especially as it relates to medical questioning and other implicit biases in medical settings. Often, Black women are stereotyped by medical practitioners as “drug-seeking” patients. This is despite people seeking treatment for unmanageable pain that is hindering their day-to-day life. It is critical to treat all patients with respect and to understand the life circumstances that may be influencing your own biases as it relates to the patient.
- Help patients by educating them on common health concerns and provide them with tangible resources to improve their health and wellness. Arrange appropriate screenings and treatments as needed.
- Leave time for patients to ask critical questions. Take these questions seriously and treat all patients with the respect they deserve. After all, that’s the bare minimum you can provide as a practitioner.
Whether you are a medical professional or not, consider the impact racial bias plays in the health and wellness of Black people. We have not yet crossed the finish line for equitable and accessible healthcare for all! There is more work to do.
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