by Anissa Durham
This is part three of “Dismantling Dismissal” Word In Black’s patient advocacy series, exploring the ways Black Americans navigate the health care system and what equity leaders are doing to make health care more accessible. Read the series.
In a complicated health care system, where do you go for equitable health care?
Each of the Black women in this story is taking a different, but necessary, approach. In this guide, we highlight the importance of accessing culturally competent care and spotlight the different apps and organizations leading the change.
Why this matter: Too many Black women have experienced dismissal of their pain and report negative health care experiences. In one survey, 55% of Black women say they had to speak up to get proper care and felt like they were treated with less respect than other patients.
When Black women feel dismissed in health care settings, this can lead to worsening health care outcomes, them looking for different providers, or no longer seeking care altogether, according to a KFF health survey. Currently, only 6% of physicians, 4% of psychologists, and 2% of psychiatrists are Black — but their impact matters.
What the data says: Black women who saw a health care provider who shared their racial and ethnic background, reported more positive interactions. Even Black women who less than half of the time saw a provider of the same race and ethnicity, reported feeling understood and involved in their care.
Part 1 of Dismantling Dismissal: In the first story, Why Black Women Need Black Doctors, three different Black women from different states shared their experiences navigating the health care system. They talked about the ways they’ve had to speak up for themselves, do their own research, get a second, third, and fourth opinion, and ultimately seek out a Black doctor.
“Nobody is going to love your body … and your mental health more than you do,” Chantelle Grant says. “It’s not our responsibility to make (providers) comfortable. If they’re scared, they’re not going to know the answer, you better go find it for me.”
Part 2 of Dismantling Dismissal: In the second story, Hope and (Some) Change for Black Medical Patients, three different Black women from different sectors of health care shared how they are leading the effort to create equitable care. Health care doesn’t happen just with a physician or a hospital system, it’s in communities. And it’s critical that the burden that so many Black and Brown patients face is shifted to the health care model in place.
“This is a great opportunity to think differently in terms of what health care means,” Shonta Chambers says, executive vice president of health equity initiatives and community engagement at the Patient Advocate Foundation. “I think it is so important for communities to understand that what is, does not have to be.”
The truth is efforts to advance health equity are underway. But it’s important folks know where to access care and are informed about the latest initiatives, oftentimes lead by Black women. And Chambers implores health care leaders to think about the questions not being asked to further health equity initiatives in and outside of the traditional health care setting.
“If the reason why we’re not asking these questions is because we don’t want to be responsible for the responses that we get and having to bring forth tangible solutions, we have to begin to ask different questions,” Chambers says.
What health care organizations can do: Uché Blackstock, founder of Advancing Health Equity, engages with health care organizations across the country to dismantle racism and eradicate racial health inequities. The organization provides training, consultations, and assessments to organizations to identify practices and policies that can be reformed with equitable approaches.
“I really despise the onus and the burden on patients to have to advocate for themselves in a system that has never really engendered their trust,” Blackstock says. While it’s important to shift the burden away from patients, she says patients can prepare questions to ask their health care provider. Blackstock suggests the following questions:
- What do you think is going on with me?
- What is your plan for me?
- What are symptoms that I should go to the ER for?
- When should I follow up?
When you need therapy: Looking for the right therapist can take time. But it doesn’t have to be that way. Therapy for Black Girls and Therapy for Black Men are two organizations who have built directories of hundreds of Black and culturally competent providers in various cities and states across the country. The easy-to-use directory allows folks to select gender, specialty, insurance, and type of therapy preferences.
When you are a birthing person: With the rates of maternal mortality among Black women, finding and accessing proper care, can literally mean life or death. The Irth app, founded by Kimberly Seals Allers allows birthing people to find prenatal, birthing, postpartum, and pediatric reviews of care from other Black and Brown women. Often touted as a Yelp-like platform, birthing people can search for doctors and hospital reviews in their community.
When you need access to sexual wellness and reproductive health care: Kimbritive is a sex-positive company where Black women can reclaim their sexual wellness and reproductive health. Part of their approach is initiating conversations about health care with different leaders in this space, to allow Black women to dive deeper and learn more about pleasure, self-love, and connection. The organization offers guides and workshops through its membership.
When an organization needs help to advance equitable care: Violet, a health equity platform is building infrastructure for culturally competent care, making it easier for patients to find inclusive providers. The company offers data-driven interventions and partners with digital health platforms and hospital systems.
Where to find culturally competent care: Health in Her Hue, an organization founded by Ashlee Wisdom, is working to bridge the gap for Black women who are looking for Black and Brown providers. The platform connects patients with care providers, articles on specific health conditions, and a community forum.
Wisdom started the organization after her own experience working in an academic medical center that she describes as a “really toxic racist environment.” As a grad student at the time, she was learning about the poor health outcomes Black women face, like heart disease, maternal mortality, and diabetes.
“I was learning that it wasn’t because there wasn’t anything necessarily wrong with Black women. It’s the social and structural factors that we have to live in, in America,” she says. “I got really angry, and felt like I needed to channel that anger, rage, and energy into something constructive.”
So, Wisdom built a solution.
It’s not just about connecting Black women with Black doctors — she says all Black patients should be able to walk into a health care setting and receive care that every human and patient deserves. “It’s unfortunate that too often we only feel safe being seen by providers that look like us, when all doctors take an oath to provide care to all of their patients,” Wisdom says. But she still makes a point to tell Black women that there are non-Black doctors who are compassionate and provide culturally responsive care.
“Black women deserve to feel seen. We deserve to have our full context taken into account and cared about by our health care providers,” Wisdom says. “We also deserve to be heard. We deserve empathy and understanding from our health care providers.”