Systemic Racism in Women’s Health

Systemic Racism in Women’s Health

Systemic Racism in Women’s Health is a topic that I wish I didn’t have to write about.

I wish it didn’t exist. In 2022. In the United States of America.

But it does. BIG TIME.

Holy Guacamole. 3x More Likely to Die?

Yes. 3x more likely to die during pregnancy.

3x more likely to die during delivery.

3x more likely to die during the postpartum period.

Is anyone else nauseous? Here’s the Data:

1. Depending on Where They Live, Black Women are 2-6% more likely to die from pregnancy related conditions

Centers for Disease Control and Prevention (CDC). State-specific maternal mortality among black and white women–United States, 1987-1996. MMWR Morb Mortal Wkly Rep. 1999 Jun 18;48(23):492-6. PMID: 10428091.

The CDC’s state-specific maternal mortality report from 1999 shows the grim truth.

Take a look and see how your state fares?

You need to look for yourself, as well as for your loved ones and neighbors.

2. That study was from 1999. I want more recent data that systemic racism in women’s health is still happening today!

Crandall K. Pregnancy-related death disparities in non-Hispanic Black women. Women’s Health. January 2021. doi:10.1177/17455065211019888

3. Still want more? Here’s where to look for more information on systemic racism in women’s health.

Flanders-Stepans MB. Alarming racial differences in maternal mortality. J Perinat Educ. 2000 Spring;9(2):50-1. doi: 10.1624/105812400X87653. PMID: 17273206; PMCID: PMC1595019.

The Flanders Summary is not so much a study, as it is a wake-up call and summary of various problem areas.

4. But…WHAT?!?! WHY??!?!? HOW?!?!?

That, my friends, is a meaty topic, and I’ll have an upcoming streamable course to answer that in depth….but in summary:

• Many present-day doctors hold misconceptions about biological differences between blacks and whites. (Hoffman, et al, check it out. I couldn’t make this up)

Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci U S A. 2016;113(16):4296-4301. doi:10.1073/pnas.1516047113

• “Most health care providers appear to have implicit bias in terms of positive attitudes toward Whites and negative attitudes toward people of color.” (from Hall, et al, Conclusion, below)

That quote is directly out of the Conclusion of Hall’s 2015 study.

You can’t change a behaviour if you don’t know it’s there.

Hall WJ, Chapman MV, Lee KM, et al. Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review. Am J Public Health. 2015;105(12):e60-e76. doi:10.2105/AJPH.2015.302903

5. Believe me now? Okay. Here’s Some Starter Ideas to Reduce This

Elizabeth Howell’s article has some meaty morsels and suggestions for what to do about this.

Howell EA. Reducing Disparities in Severe Maternal Morbidity and Mortality. Clin Obstet Gynecol. 2018 Jun;61(2):387-399. doi: 10.1097/GRF.0000000000000349. PMID: 29346121; PMCID: PMC5915910.

But what can I do, TODAY, to start to address this systemic racism in women’s health?

Reading this, and becoming more aware, is a great place to start.

Next steps. #1: TELL YOUR DOCTORS!!
#2: TELL YOUR FRIENDS & START POSTING ON SOCIAL MEDIA ABOUT THIS!

#1: Tell your doctors. Yep. I said it. TELL YOUR DOCTORS. Remember 8 of the 9 studies in Howell’s review on implicit bias (when doctors HAVE a prejudice and DO NOT REALIZE THEY HAVE IT), found that the bias affected patient outcomes.

I doubt that doctor wants this to be occurring.

And while negligence is not really an excuse…let’s start to be the change and let doctors know that this IS a thing.

#2: Tell your friends. Yep. You might just save one of their lives, or the life of someone they love, by letting them know they might need an advocate in the health care system.

Thanks for Reading!

This post was a bit heavy on the research, but I felt it was necessary to get the ball rolling on this important topic.

A future post will have some concrete examples of how and why black women are dying in different stages of pregnancy and postpartum, and specifics of what you can do, as a friend, lover or family member, to help advocate for them.

And, yes, full disclosure, I will be launching an online, streamable, course on Systemic Racism in Health Care for both medical professionals and ‘regular people’, soon. Check out my shop to see what courses are currently available, AND…be sure to join my mailing list (link at bottom of home page) to get first notification and BEST DEALS on all future courses, including the ones on Systemic Racism!

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