Black Women’s Health and Well-Being Requires Health Justice

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Michellene Davis, Esq.

President & CEO, National Medical Fellowships Inc.

The reasons why Black women in America continually face the steepest health inequities are not unknown – they are simply unaddressed, and often even worsened. 

Poorer social, economic, and political determinants of health – proliferated by structural racism and systematic exclusion of Black, Indigenous, Latino, People of Color via discriminatory policies and purposeful disenfranchisement – contribute to higher rates of chronic and severe disease, fewer clinical screenings, and, when accessible, much lower quality physical and behavioral health care. 

More, the “weathering,” of being beautifully Black in a hostile society is killing us. The compounded physical and mental stress from being exposed to institutional and individual racism since historical dehumanization reduces our lifespan. 

Disappointedly, despite Black women having a maternal mortality rate 4-times that of white Americans, this country severely restricted access to reproductive health care (including abortion) without providing universal health care, free contraceptives, or adequate sexual health education. 

So, why does deep-rooted mistrust in U.S. health care persist? Studies have proven that patient health, compliance, and satisfaction are enhanced from having diverse medical practitioners with similar backgrounds and cultures. Hence, the lives of Black people can be saved by having more Black doctors. Periodt. 

Increasing the number of Black medical providers (5%) and clinical researchers in the U.S. to be representative of the population (13.4%) would be the quickest and most effective way to improve Black health outcomes and reduce the racism in health care that leads to misdiagnoses and delayed treatments.  

Though we have seen a record 21% increase of Black medical students since 2020, challenges remain. Medical education must change to ensure that it does not proliferate clinical bias and racism in medicine.

First, historical discriminatory government sanctioned policies and current pay inequity continue the racial wealth gap. Today, the median wealth for white households in the U.S. is nearly 8-times higher than Black households. Further, Black physicians historically graduate medical school with more debt ($30,000 more on average) and receive less compensation

Then, when Black practitioners attempt to enact institutional change, they are often targeted. A 2021 review of 19 published studies revealed a high prevalence of workplace discrimination against physicians of color

The silence of others when Black practitioners are harassed and threatened for wanting to provide solutions is dishearteningly deafening. 

Take, for example, National Medical Fellowships (NMF) alumna Dr. Aletha Maybank, chief health equity officer and senior vice president of the American Medical Association, who received social media backlash, home vandalization, and death threats for publishing the “Advancing Health Equity” language guide in 2021. 

Or the Neo-Nazis protestors disseminating flyers threatening two doctors seeking to provide more equitable health care at Brigham and Women’s Hospital and Harvard Medical School in 2022. 

These respected physicians were not promoting care of Black patients over other races or ethnicities – they were highlighting how health care must change if health equity is to be achieved for communities of color. 

Medical research must also be diversified. Although People of Color represent more than one-third of the U.S. population, they comprise less than one-fifth of clinical trial participants — leading to well-documented, more severe variations of side effects and long-term outcomes of treatments and preventative therapies.

Additionally, while telemedicine and digital health have been acclaimed since COVID-19 hit American shores, they alone cannot better health disparities. With artificial intelligence not updated to include more accurate, unbiased health care algorithms, Black Americans are too often disqualified from receiving adequate care for high-risk illnesses, including COVID-19, diabetes, and cancer. 

NMF’s alumni and scholars fighting to achieve health equity live these experiences every day. Amidst adversity, we continue the fight. But we should not have to do so alone. Support from those claiming allyship is required. 

We need allies in all spaces – in health care, education, government, corporations, philanthropies, and NGOs. With voter suppression intended to weaken the influence of communities of color, policymakers and constituents must fight back. With “reformed” school curriculums forbidding discussions on race and evolution, STEM education must become accessible and affordable to all. With false claims of “unfair” benefits in states where 60% of communities of color live, health care leaders must support the facts of Medicaid/Medicare expansion

We need the voices of community leaders and trusted allies at the table to enact real change. We must continue to share and document our struggles to ensure people listen. We must make them see, from the local to the national level, why we fight. And, if they refuse to see then we must take the charge to the global level. 

It is everyone’s responsibility to ensure we dismantle the structural and systemic racism in health care by holding not only others accountable, but also ourselves. If not during a global pandemic that has lifted the eyelids of the national mainstream media on the inequities that we’ve always known to be true, then when?