Health disparities in the Black community are not a new phenomenon. A history of medical mishaps, mistrust, experimentation and medical coercion have created a fear amongst African Americans that fans the flames of medical avoidance. Nevertheless, predisposition to several health conditions and illnesses places African Americans in precarious positions healthwise. For Black women, access to care remains one of the top issues keeping them from seeking the medical attention needed.
The United States has a long history of traumas inflicted on African Americans. Slavery gave way to a path that would make Black bodies harvest pain and trauma. Black women and their bodies have been the subjects of cruelty and a source for discovery in medicine. This has led to a breakdown in trust for medical professionals.
Economic, racial and societal biases largely impact access to healthcare for Black women. Despite the advances made in medicine, health disparities continue to plague Black women creating higher risks for chronic illnesses and death. Reproductive health and breast health are two medical issues that are crucial statistics for African American women.
“The most commonly known thing would be lack of access for discrepancies as far as breast cancer screenings and breast cancer treatment and management. It’s been well-documented that Black women are often diagnosed at later stages and also have a high mortality rate in regards to breast cancer,” said Dr. Victoria Cohen, D.O. at Ascension Michigan in Roseville, Michigan.
Despite access, trust continues to be one of the main motivators deterring Black women from receiving medical attention and treatment. The coronavirus pandemic helped to shed light on many of the issues affecting the trust between both the Black community and the medical system. Concerns of the Tuskegee experiment, Henrietta Lacks and forced sterilizations on Black women like Fannie Lou Hamer arose and reignited the strained relationship between African Americans and medicine. The mistrust continues.
“One of the major things we see is that there’s a lack of trust in the healthcare system and that comes from a long history of mismanagement, ill-treatment within the healthcare system, a lack of transparency within the healthcare system and practices and medicine as well and how we develop certain treatments,” said Dr. Cohen. “Certain procedures were originally tested out on Black women and sometimes done in very cruel manners where they may have received pain medication and sometimes may have not consented to those procedures and treatments.”
Though access and trust have been the main factors for the breakdown in medicine, Black doctors believe the relationship can be remedied. Rebuilding bonds of trust and allowing patients to be educated and participants in their health may be the first step to healing.
“I do see that creating that partnership with patients oftentimes helps to dispel some of the trust issues that we’ve had or the misconceptions about medicine in current day. Other things are just being transparent and open. Acknowledging the fact that, unfortunately, when medicine was being developed over time, we did not have equal voices in the development of certain procedures and acknowledging the fact that it was cruel and unfair that people of color, particularly Black women, did undergo those procedures and those testings and denied certain treatment options during that time,” said Dr. Cohen.
While mistrust in the medical field may not be healed overnight, communication between patient and doctor can lay the groundwork to calm fears.
“I think developing that trusting relationship with a patient; it may not be in that first visit telling them what to do, but giving them options and breaking down what those options mean and what those risks are and letting them make a decision. You guys will move forward as a team,” said Dr. Cohen.
Studies have also shown that Black patients are more willing to seek medical attention if the professional shares a similar demographic in terms of race and gender. Choosing to become a doctor after the illness of a loved one, Dr. Cohen’s presence not only helps her family, but Black women and the community at large.
“I am the first physician in my family. I felt that when one of my family members was ill, my family probably did suffer from health inequity and my family didn’t have medical knowledge,” said Dr. Cohen. “Also, I thought it would be helpful to be that advocate, that voice for other patients, too, who probably have a similar experience or a similar fear.”