The Whiteboard

Getting Real About Black Healthcare

In honor of Black History Month, I invited guest blogger Jasmine Bennett — who tirelessly spearheads VMware’s Internal R&D conference, RADIO — to share her experience on this week’s Whiteboard post. Best, Kit


It’s no secret that there’s a complex relationship between the Black community and the healthcare system, dating back to the days of slavery. While African Americans are increasingly gaining more access to healthcare, factors ranging from medical mistrust to societal stigmas continue to fuel Black disparities in healthcare.

The conversation around Black health is an uncomfortable onerooted in fragility and intricacies that often make progress difficult. While it’s great that there’s been more advocacy for Black individuals to be more proactive about their health, it doesn’t account for the challenges or past trauma associated with seeking care. For the Black community, it’s quite simple: there is no inherent trust in the healthcare system. Much of this skepticism can be attributed to the medical exploitation of Black patients, such as the Tuskegee Study in 1932, but it’s also shrouded in implicit bias that leads to a reduced quality of care.

Over the last two decades, a plethora of studies has implicated systemic bias as a cause of poorer medical outcomes in dark-skinned patients. For example, research consistently demonstrates that Black individuals do not receive the same level of care as those from other ethnic groups. This study, for example, found that Black patients who visited emergency rooms were 10% less likely than white patients to be admitted to the hospital and were 1.26 times more likely than white patients to die in the emergency department or hospital.

The COVID pandemic continues to bear out these disparities. Research shows that Black Americans are less likely to be vaccinated for COVID-19 than Americans of other races and ethnicities. Some studies found hesitancy due to distrust of the predominantly white medical establishment, while others found lower vaccine availability in communities with high rates of people of color. These lower vaccination rates among Black Americans exacerbate the inequities in COVID diagnosis, hospitalization, and mortality. (See “What Contributes to COVID-19 Vaccine Hesitancy in Black Americans,”Why Only 28 Percent of Young Black New Yorkers Are Vaccinated,” and “Experts seek to allay COVID vaccine hesitancy in Black Americans.”)

Black people in the United States also have a shorter life expectancy than those of other ethnicities. In 1990, census data showed that Black Americans’ lives were, on average, seven years shorter than those of white people. While researchers at Princeton University reported that the gap had narrowed 50% by 2018 (dropping to 3.6), the COVID pandemic has widened it again. Estimates reported in an article in the Journal of the American Medical Association indicated that COVID-19 reduced overall 2020 U.S. life expectancy by 1.31 years (from 78.74 years to 77.43 years). But the reductions in life expectancy for Black Americans (1.9 years) were twice as high as those for white Americans (.94 years).

Given these factors, the unfortunate truth remains that the best way for Black individuals to obtain optimum care is to see Black providers who can relate to their healthcare experiences. In fact, according to a 2018 study led by Stanford Health Policy’s Marcella Alsan, Black patients have better health outcomes and experience greater quality of care when seen by Black physicians. The caveat is that a Black patient may not be able to find a Black provider because only 4% of U.S. doctors are Black, despite comprising 13% of the population.

The question becomes — where do Black patients go from here? How can a Black individual who’s committed to their health get the care they need?

While I do think that members of the Black community recognize the importance of managing their health, how can one achieve this goal with limited access? As a member of the Black community, I understand the dichotomies between prioritizing your healthcare and quality care. Honestly, I often feel overwhelmed, intimidated, and hopeless. I’ve lived in Atlanta, GA — a city with one of the highest numbers of Black individuals in the United States (second only to New York City) — for nearly eight years and still have difficulty finding physicians that I feel truly care about providing the best care possible. While I’m privileged to live in a metropolis that has a high concentration of doctors who look like me, it often takes months to get on their schedule and if you don’t live in a Black part of town, you’ll need to be prepared for a 45–50-minute drive. I’ve tried visiting non-Black doctors, but my experience and confidence in their care have been underwhelming. Ultimately, this has resulted in me defaulting to an urgent-care facility for my primary-care needs. No, it’s not ideal. But I’m exhausted from trying to find a doctor that gives a damn.

I don’t write this to generate sympathy, but to shed light on how improving disparities in healthcare will require more than just shifting mindsets and giving the Black community health insurance. What’s the point in having affordable healthcare costs, if I can’t use it to access quality non-biased care? My hope is that this conversation will spark change and encourage the healthcare system to focus on how all doctors/providers — regardless of color — can get the training they need to provide quality healthcare and build better trust with underrepresented communities. 

If you’d like to play an active role in supporting Black health, please consider getting involved with or donating to the following organizations:

Comments

2 comments have been added so far

  1. Thanks Jasmine for writing this piece!! Pretty much all of what you said rang true for me as well. And ditto on not seeking sympathy — it’s about shedding light on disparity and hopefully so that folks will understand the need for healthcare providers and clinicians to be trained to listen to and advise their patients from a place of awareness of historical and cultural contexts. More broadly, these same contexts can and will lead the way to more authentic personal and professional friendships. To take a step forward from where we are today, each person must absolutely understand that their perspective, experiences, and culture are one of many and neither inferior nor superior. I hope your words trigger deeper reflection, which will lead to desperately needed critical conversations. Let each of us be inspired to take our new learnings past the parameters of our thoughts and put them into action. As our ancestors repeatedly reminded us, “when you know better, do better!”

  2. Jasmine: this post is so long overdue and so valuable. Thanks for sharing your experience. The world needs to hear your voice more often. I appreciate you!

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