Black Women’s Healthcare Struggles in the US
- Christina Brown was 18 years old the first time she had to correct a doctor when advocating for health.
- Breast cancer runs in her family, so she had been taught early by relatives how to examine her own body – what was normal, what wasn’t and when...
- At each appointment, Brown, a 30-year-old content creator in New York City, said she explained the same concern, pointed to the same spot, and was met with the...
Christina Brown was 18 years old the first time she had to correct a doctor when advocating for health.
Breast cancer runs in her family, so she had been taught early by relatives how to examine her own body – what was normal, what wasn’t and when something warranted attention. When she found a lump in her breast in September 2014, she didn’t hesitate.She went to a doctor.
At each appointment, Brown, a 30-year-old content creator in New York City, said she explained the same concern, pointed to the same spot, and was met with the same response. They told her they couldn’t feel anything. That there was no lump.That she was wrong.
“I literally had to grab their hands and show them where the lump was, and they would be surprised and then just pass me to the next doctor to do the exact same thing,” Brown said. It took four rounds of this before anyone agreed to schedule a biopsy. By then, months had passed.
That experiance reshaped how Brown approached medical care: it taught her that knowing her body better than the experts is vital. Additionally, it prompted her to seek out black doctors whenever possible because she figured a Black physician would be more likely to believe her the first time around.A 2023 survey found that Black patients who have more visits with Black healthcare providers report having more positive medical experiences.
brown’s story is not unique. Across gynecology, primary care, and reproductive health, many Black women describe navigating medical care as a nightmare. “To be a Black woman in America is to have an adverse experience at the doctor’s office, and with her health,” Brown said. “It’s one where you are constantly feeling dismissed, misunderstood, gaslit, downplayed and straight up lied to.” Whether through relentless self-advocacy, intimate knowledge of their own bodies, or the intentional choice to seek out Black physicians, many Black women move through medical settings strategically, as a means of survival.
In 2018, Serena Williams revealed that after giving birth via emergency C-section,she nearly died when doctors at St Mary’s Medical Center in West Palm Beach,Florida,initially ignored her insistence that something was wrong.Williams, who had a known history of blood clots, explained that she had to push repeatedly for proper imaging and treatment.The realities that Black women face during pregnancy and childbirth have been thrust back into public discourse after the recent death of Dr Janell Green Smith. Smith, a Black certified nurse-midwife, died on 1 January from complications after a ruptured incision. It was less than a week after she gave birth at Prisma Health Greenville memorial hospital in Greenville, South Carolina.
In other cases, understanding standard medical protocols and knowing when care deviates from them has become a critical tool for self-advocacy. When Christine Thomas, a 33-year-old strategy consultant living in Washington DC, went in for her annual pap smear in 2018, she said her gynecologist made derogatory comments about her sexual history, then proceeded to use the largest speculum without lubricant.During the exam, she says the provider scraped her cervix with enough force that it caused extreme pain and bleeding.Aware that lubricant is routinely used during cervical screenings,Thomas asked for it to be applied. But the damage had already been done. The experience left her traumatized, and the following year, she skipped her annual pap smear entirely.
‘I feel like a lawyer making a case for my health’
Dr Kristamarie Collman,a primary care physician in Houston,points to dismissal of concerns,negligence,and mistreatment as a key factor in patients falling behind on their health. “In my experience, when patients don’t have to defend their own lived experiences, and when they feel listened to, the visits are just more efficient for them. They’re more likely to be involved, and to follow through with their care, which all lead to improved outcomes,” she said. Dr Chiamaka Ilonzo-Ukwu, an obstetrician-gynecologist in Tampa, said several of her Black patients have expressed struggling to fully connect with or trust prior healthcare providers, which has led to their hesitancy in voicing concerns or symptoms during appointments. “When communication and trust are lacking, it can result in a breakdown of the patient-provider relationship,” she added. “Sadly, this breakdown can contribute to poorer outcomes, including missed diagnoses, inadequate care, or the dismissal of patient concerns.”
Implicit bias and the chronic dismissal of pain have been widely documented
Black Patients Frequently enough Feel They Must Advocate for Themselves, and Racial Concordance May Help
Many Black patients report feeling they must actively advocate for their health when seeing doctors who are not Black, often feeling like they need to “perform” or “make a case” for their concerns. While not a complete solution, research suggests that having a doctor of the same race can lead to better health outcomes.
For Aisha brown, medical appointments with non-Black doctors often feel like an uphill battle. “I automatically feel like I have to be proactive about my health,” she said. “I feel like I have to be my own doctor. I come in like a lawyer trying to make a case for my health.”
Brown is careful to point out that racial concordance isn’t a guaranteed fix. She acknowledges that bias and inadequate training can occur regardless of a providerS race. Though, she notes a significant difference in her experience.”I don’t have my guard down fully,” she added. “But I do feel more relaxed and like I can just be a patient in the room. I feel like they’re going to understand me culturally and the discrepancies we deal with.”
Recent research supports Brown’s experience. Studies indicate that patient and provider racial concordance may contribute to:
- Lower emergency department use
- Reductions in racial disparities in infant mortality for Black infants
- Increased preventative care visits and treatment
This month, Brown once again encountered dismissal in an emergency room setting. After six months of worsening shortness of breath, chest tightness, and abnormal lung tests, she sought care for a severe asthma flare-up. During a 12-hour visit,Brown repeatedly requested a specific type of scan – one she had researched herself – that could possibly identify conditions missed by previous imaging. Despite her persistence and ongoing symptoms, doctors initially dismissed the possibility of chronic obstructive pulmonary disease.