From implicit bias to lack of access: How systemic racism impacts health care for Black Americans
The past few months have focused national attention on systemic racism in American policing. But criminal justice is far from the only sector of American society that is touched by these problems. This summer, Stateside is launching a series of conversations about how racism in systemic, institutional, and everyday forms affects Black Americans. We’re starting with a discussion about health care where, as in policing, racism can be a matter of life or death.
It’s an issue that can be as macro-level as a public health crisis like the lead in Flint’s water and as personal as the way a doctor talks to a Black mother. Stateside spoke with two health care experts about how systemic racism in the health care system impacts the health of Black Americans.
Dr. Debra Furr-Holden is a professor of public health at Michigan State University, as well as the director of the Flint Center for Health Equity Solutions. Char’ly Snow, CNM is the director of midwifery services at Henry Ford Health System and the founder and president of Metro Detroit Midwives of Color.
How Black patients experience the health care system
Black women face stark inequities when it comes to maternal mortality. The Centers for Disease Control and Prevention report that Black women in the U.S. are more than three times as likely to experience pregnancy-related mortality than non-Hispanic white women are. Snow says she’s seen in her own work a number of ways in which Black mothers are treated differently than white mothers, including unnecessary drug screenings or assumptions about the marital status of Black couples.
“What we have failed to look at is the quality of care and what women experience when they are approaching care and interacting and engaging in care and health systems. And so what we do know is women, African-American women specifically, report that they are not feeling heard, they are not feeling as if they are being counseled appropriately, and they are not being involved as they should be in decision-making regarding their families, their bodies, and their outcomes,” Snow said.
What the data tells us
Furr-Holden says health care workers and organizations need to take a hard look at what the data says about the quality of health care Black patients receive. It’s important, she says, to move beyond blaming individual choices for poor health outcomes.
“It’s really time for us to rethink that, because we’ve seen with COVID, and we’ve got good data that tell us that your zip code is a much stronger predictor of how long you can expect to live and the quality of life that you can expect to live than is your genetic code. So I think it’s imperative that we start to deal with some of the systematic and structural impediments that prevent people from experiencing optimal opportunities for health,” Furr-Holden said.
Building support for health care professionals
Snow, along with two other certified nurse midwives, founded the organization Metro Detroit Midwives of Color after graduating from Wayne State University. They wanted to create a space where they could find support, help their community, and encourage other women of color to go into midwifery.
“Honestly, we didn’t have any awareness of the disparities in maternal child health care specifically until after we graduated. There was no presentation during our training, no one alerted us to what we were actually approaching as we entered our professions, and so we kind of felt stranded. We felt like we were alone in what we were experiencing, and we wanted to create a local network of midwives of color so that we could support each other as we navigated this new system for ourselves,” Snow said.
Paying attention to our blind spots
“We all learned in driver’s ed: you have a blind spot. It’s that area just behind you, just on the side of your car. Well, how do you address a blind spot? Well, we all got trained: you look over your shoulder. If you look in the rearview mirror, you won’t see that blind spot, but if you go to change lanes, and there’s a car in your blind spot, you could cause a catastrophic set of injuries out on the highway. So I think of implicit bias as a blind spot. It’s there, it’s impactful based on people’s actions, but people need the training to look over their shoulder and be vigilant and be on the hunt for it," Furr-Holden said.
This post was written by Stateside production assistant Nell Ovitt.