By Amiyah King •
Shortly after a video collaboration with Grammy-winning artist Beyonce Carter and Olympic medal-winning tennis player Serena Williams, the two were banded together by more sobering terms, to raise awareness of the disparities in healthcare for Black women in the United States.
Williams, who experienced “uncertainty” after giving birth to her daughter in 2017, spoke to reporters about her experience with blood clots, pulmonary embolism, cesarean section, and feeling neglected as a black woman.
Coincidentally, the 23-time grand slammer’s long-time friend also experienced birthing complications with her twins, in the same year. Carter, who is usually relatively private about her life, took the recent birth of her twins to help Black women all over America feel less alone in the healthcare system by sharing her story of suffering toxemia or preeclampsia.
Testimonies of other black women speaking out on their mistreatment at doctors’ offices swept mainstream media immediately surrounding Serena’s interview. Instances such as these have arguably hindered the societal growth of Black women and have been known to present insecurity issues. What was less discussed, is the effects racism has had on Black women’s healthcare today, historically.
STEREOTYPES
Sapphire Stevens didn’t make her first debut in a doctor’s office. The character emerged as an emblem of racism directed toward African-American women in the 1920s in the popular satire radio show, Amos and Andy. During this time, racial stereotypes and representations were normalized, almost socialized into every day American life. Black women were being depicted in media as Mammies, Jezebels, and Sapphires, images that may be more familiarly recognized now as Madeas, “hoes” and the Angry Black Woman. These representations of black women perpetuated in tv and film throughout the 20th century and have manifested in modern day recreations, that continue the spread of pervasive narratives of Black women.
Stereotypes inherently affect behaviors in which people treat one another, whether consciously or not. These misconceptions are what are often to blame when analyzing racial discrimination.
“A lot of it’s cultural and a lot is the unconscious bias that all of us carry,” said Dr. Brenda Shelton-Dunston, Executive Director of the Black Women’s Health Alliance Philadelphia that works to promote health education and training to reduce health disparities among Black women.
Dunston analyzed the effects stereotypes have on Black women who may not feel comfortable with their healthcare providers.
“I believe unconscious bias plays a major role in negatively impacting the ability to develop those relationships needed to encourage patients to comply with their doctor’s orders and take care of themselves.”
Victoria Richards, a nutritional therapy practitioner who runes Restoring Roots Wellness, a program geared towards helping women balance their hormones naturally, spoke out on the lack of seriousness and concern given to women during treatment.
“I think it’s incredibly frustrating. You’re just dismissed, if they can’t prove it on some lab work, they tell you that you’re fine,” she said.
Dunston asserted that she believes when women aren’t comfortable with their healthcare providers, they will be less likely to be open, hindering the treatment process.
“The negativity they’re afraid to receive will result in them staying home instead of going to the doctor,” said Dunston.
Tina Sacks, author of Invisible Visits, an in-depth analyzation of the disparities African American women face when seeking help in the healthcare system, explained that in her research, she was lead to believe that many Black women put on a façade, or persona in their doctor’s offices in an attempt to dismantle the stereotypes and be treated fairly.
“One of the things that’s important to recognize,” said Sacks, explaining how stereotypes effect everyone, “is that having socioeconomic resources doesn’t protect you from the stigma that comes with being both a woman and black--and from that stigma comes lack of credibility.”
LACK OF RESOURCES
The legal separation of people by race in the late 1800s became known as the Jim Crow Era, which lasted until the Civil Rights time period. Jim Crow laws were enacted to keep African-Americans legally separate from whites. This legislative recourse meant that many black people could not work and were concentrated in subpar neighborhoods ad subjected to living with fewer than enough socioeconomic resources.
Nancy Krieger, professor of social epidemiology at Harvard T.H. Chan School of Public Health who has devoted research to the commonalities in Jim Crow laws to healthcare disparities among Black women today emphasized the lasting effects of this historical point in time.
“The Jim Crow time period is emblematic of the profound types of racism we face in the United States that is embedded in our history,” she said.
Krieger has researched the relation between health issues in Black women who were born during and in Jim Crow ruling states. Her extensive research draws a clear connection between the women who’d experienced harsh racism before, and their health concerns and treatment today. Most notably, Krieger exposed the correlation between Jim Crow and increased risked for breast cancer in African-American women.
For years, Jim Crow laws hindered African-American people from advancing or even having an even playing field in American society. Research has shown that these effects are still prevalent today, crippling Black communities by lack of resources and opportunity. Krieger highlighted the effects environmental racism plays in the stagnation of African-American people in America.
“The reason is systematic racism that is set up on white supremacy which is vultured by terror. Economic and environmental factors along with segregation is what makes for adverse living conditions where racial discrimination can harm health.”
Dunston weighed in on the conversation of systematic racism creating an uneven financial playing field for African-Americans.
“It’s a racism issue, that’s poverty. One of the biggest things that gets in the way is the copay, so poverty is a major factor.”
As African-American families continue to multiply in impoverished neighborhoods, fewer people will go with access to adequate healthcare. Coupled with long-lasting stereotypes, some believe that even having sufficient resources is not enough.
Erika Stallings, author of The Article That Could Help Save Black Women’s Lives, published that details her experience of facing racial disparity in healthcare weighed in on the discussion of resources affecting Black women’s health.
When asked about the relation between resources and care, Stallings pointed to famous examples such as Serena Williams to emphasize that being affluent or knowledgeable in healthcare does not protect you from being discriminated against.
“If you’re a white provider, the concept of a rich black person is foreign to you, the stereotypes are so ingrained in you,” she said, “it’s hard to overcome and as a result, people are quick to dismiss our pain.”
Stallings suggests that African American women research their doctor’s before going and always take someone else as a health advocate. For that reason, she not dedicated herself to being a healthcare advocate for her family members.
“Anytime someone goes to the hospital, everyone in my family calls me as a resource to be there and help make sure they get treated well,” she said.
REPRESENTATION
While having a family member or friend accompany you at the doctor’s may be ideal, it’s not always easy for Black women. Following Reconstruction, African-Americans had made a lucrative presence for themselves in economics, establishing the Black Wall Street. Complying with laws of segregation, Black business owners thrived during this time where the black dollar was generated and recycled within our community.
Following the 1921 demolition of the Black Wall Street, many African-American business owners were out of jobs and money. This began the end to representation in America for Black people. No longer did your barber look like you, your mailman or even your doctor.
This still reigns true today, where African-Americans can enter a corporate or service office
and not see a familiar face for hours on end, or perhaps ever.
“I believe the educational institutions for providers needs to place more focus on this area when individuals are being trained to be providers,” emphasized Dunston, “It’s not just the doctor, it’s the nurse, it’s making sure your diversity training for the entire staff helps us see who we are from the inside out.”
While filling doctor’s offices with more Black women seems like an easy fix, Sacks highlighted the issue with physician training and its effect on how doctor’s practice. One concern of Sacks’, was the behind the scenes training that physicians receive which she believes do not put enough emphasis on black feminine healthcare.
“We know [representation] can help but it doesn’t mitigate all the problems of the healthcare system or undo some of the training because black physicians are also trained in a predominately white space,” she pointed out.
Some believe that if Sapphire Stevens’ doctor had been black, she may have been more
comfortable with opening up about her body pains.
“When your doctor is black, it makes a big difference,” said Stallings, “because there’s an empathy aspect. Depression and anxiety present differently in black people so it’s about knowing the right questions to ask.”
The expectation is for patients to provide relevant health information to their doctors in a precise, timely manner but the truth is that many doctor’s visits are hectic, unplanned and confusing.
“Considering the time pressures that physicians are under—some only have 10-15 minutes for each patient—it’s difficult under those constraints to deliver the care that everyone needs,” Sacks said, “let alone if you have the stigma black women do.”
This explains why Dr. whateverhisnameis felt accomplished, having “treated” Stevens in under 15 minutes. Meanwhile, Stevens had not been relieved of her pain because she was so uncomfortable from the beginning of her doctor’s visit.
Dr. Dunston says women are not to blame for withholding information from their healthcare providers.
“It’s easier to establish a relationship when the doctor looks like the patient,” she said.