Health Care for Black People in America

I’ve dedicated this blog to telling my family’s story about misdiagnosis and healing within the American health care system. It’s been a cathartic way to process my grief over what happened over nine years to my daughter, Sammi.

Today, you won’t read anything about that here.

I had a significant advantage all those years: I am a white woman. I was more likely to have health insurance (which I did, for me and for my family); I was more likely to be listened to (sometimes, I was!); I did not interact with doctors from a position of deficit in a system that is implicitly and sometimes explicitly devaluing my life and the life of my child. So today, I’m going to share some links to articles about what it is like to operate within that system for Black people.

Spoiler alert: it’s way, way harder.

The Century Foundation: Racism, Inequality, and Health Care for African Americans 

“African-American women are three times more likely to die of pregnancy-related causesthan white women (see Figure 1).25 The African-American infant mortality rate is twice the rate for white infants (see Figure 2).26 African Americans are more likely to die from cancer and heart disease than whites, and are at greater risk for the onset of diabetes.27:

Nature: Millions of Black People Affected by Racial Bias in Health Care Algorithms

“An algorithm widely used in US hospitals to allocate health care to patients has been systematically discriminating against black people, a sweeping analysis has found…. the algorithm was less likely to refer black people than white people who were equally sick to programmes that aim to improve care for patients with complex medical needs. Hospitals and insurers use the algorithm and others like it to help manage care for about 200 million people in the United States each year.”

American Bar Association: Implicit Bias and Racial Disparities in Health Care

“…one study of 400 hospitals in the United States showed that black patients with heart disease received older, cheaper, and more conservative treatments than their white counterparts. Black patients were less likely to receive coronary bypass operations and angiography. After surgery, they are discharged earlier from the hospital than white patients—at a stage when discharge is inappropriate. The same goes for other illnesses.”

Zora: What No One Tells Black Women About Heart Disease

“A 2010 study from the American College of Cardiology found that only 3% of practicing cardiologists in the United States are Black. Having a Black doctor increased Boucicaut’s confidence in her treatment plan. ‘The doctor said he’d treated many people my age — mainly Black men — who had the same heart condition,’ she says. ‘That gave me comfort.’ Kalinowski shared a similar sentiment. “It is extremely crucial… to increase the pipeline of Black women and men who are addressing these issues,” she says. ‘We need to continue to invest in the diversity of researchers and providers who are researching these issues and committed to seeing these data turn.'”

NBC: Black Kids Get Less Pain Medication Than White Kids in the ER

“If there is no physiological explanation for differing treatment of the same phenomena, we are left with the notion that subtle biases, implicit and explicit, conscious and unconscious, influence the clinician’s judgment…”

Washington Post: The Disturbing Reason Some African American Patients May Be Undertreated for Pain

“Researchers at the University of Virginia quizzed white medical students and residents to see how many believed inaccurate and at times ‘fantastical’ differences about the two races — for example, that blacks have less sensitive nerve endings than whites or that black people’s blood coagulates more quickly. They found that fully half thought at least one of the false statements presented was possibly, probably or definitely true.

“Moreover, those who held false beliefs often rated black patients’ pain as lower than that of white patients and made less appropriate recommendations about how they should be treated.”

New York Times: Black Americans Face Alarming Rates of Coronavirus Infection in Some States

“For many public health experts, the reasons behind the disparities are not difficult to explain, the result of longstanding structural inequalities. At a time when the authorities have advocated staying home as the best way to avoid the virus, black Americans disproportionately belong to part of the work force that does not have the luxury of working from home, experts said. That places them at high risk for contracting the highly infectious disease in transit or at work.”


Though this blog focuses mostly on health care, it’s important to understand not only the extreme challenges in attaining quality medical attention as a Black person, but on the overall racist and structures that form the base for American society. There are many lists of articles and books you can read to educate yourself. This week, I also listened to several podcasts that formed a good introduction to this important consciousness-raising decent white people must undertake:

The Daily: The Systems That Protect the Police

Stay Tuned with Preet: Protest, Pain & Hope (with Karen Attiah)

Unlocking Us: Brené with Ibram X. Kendi on How to Be an Antiracist

Finally, please, if you do nothing else, watch this:

We owe this to our fellow Americans.

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If Then That

if-then-that

She was born fourteen years, six months, and thirty days ago, right on her due date, after a quick and powerful birth with most of the labor at home. She was 7 lbs 8 oz, two pounds heavier than her older sister, but we marveled at the similarities — her thick, curly black hair, her deep blue eyes, the slight jaundice that kept her under bilirubin lights for a day or two.

She came home and we all fell in love with her immediately. Her extra two pounds made sleep and nursing and everything so much easier, and it was like a dream compared to her sister’s nightmarish infancy. Like her sister, she was healthy and hearty, and in photos of the two of them at one month, two months, three months, they were impossible to tell apart. Until she got old enough for her eyes to turn the same dark brown as my mother, with long gorgeous eyelashes, they could have been the same baby.

At 12 weeks, I went back to work, photos of my two dark curly girls on my desk, side by side, baby and preschooler, carbon copies. Every few hours, I locked the door and pumped. Every night, I picked them up from daycare and buried my face into their necks that smelled like the daycare’s baby wipes, and we went home and ate takeout or macaroni and cheese and peas, with the baby gleefully nursing and then, eventually, eating jarred sweet potatoes and carrots and bananas and spinach. I felt a twinge of guilt — should I be making baby food? it doesn’t take that long… — but instead, we sat on the living room floor and cheered as the baby crawled between us, filling our time with each other.

I could have applied to graduate school, like I’d planned, but work was going well, so well that I thought I’d give it another year, not shake things up until the baby was two, or maybe three. I got a raise. “I can’t believe how well you’re doing,” my boss told me. “I was a wreck when I had my second baby!”

“Well, she’s a great sleeper,” I told her. Continue Reading…

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Easy Valentine

easy-valentine

 

 

I spent Valentine’s Day at O’Hare Airport, mostly.

That’s the punch line, but the lead-up is that my husband David — my organized, thoughtful, careful, good-planning husband — usually does everything logistical for our travel. He always has. There are these clear, colored plastic file folders into which he has, for at least the last couple of decades, placed copies of our boarding passes and hotel reservations, photocopies of our passports, printouts of hotel reservations, lists of things to do. They have neat notes in the margins, sometimes (“spoke with Marla at the front desk, they will have a Pack-n-Play ready, 7/16). I used to get frustrated that it seemed like this was the only thing he ever did when it came to our travel — I packed up the kids, canceled the mail, used up the milk in the fridge, made sure we had sunscreen, and on and on, a mountainous pile of tasks, while he sat in his office printing things — but the truth is that his jobs meant we would always get there and always had a place to stay and (usually) appropriate beds for everyone. Continue Reading…

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What I’m Learning, Part Six

library

Someone asked on Twitter last week for their followers to share something good. It was as open and unspecific as that, and the first thing that came to mind for me was libraries.

I’ve always loved libraries, ever since I was old enough to bike the three-and-a-half miles to my public library in Mequon, Wisconsin. Situated next to the municipal swimming pool, it was a beautiful two story, circular room, with children’s books below and adults’ above. It made me feel calm and hopeful, as does my beloved main branch library here in Evanston, Illinois today. The thought that passes through my head as I step inside is always thank goodness. There are so many stories here.

In the end, the happiest I ever feel is when I am sucked deep into a book, fascinated and immersed. All avid readers feel this way, I think – we all talk about it with the same vocabulary of being surrounded, transported, brought inside. It’s such a gift to have both the reading aptitude and interest in books. I’m grateful for it in every season and in every environment.

This year, I spent a lot of time reading books about health and medicine as part of research for my book. You can read the previous posts: about Gavin Francis and Jill Bolte Taylor, Seth Mnookin and Henry Jay Przybylo, Susannah CahalanAtul Gawande and Heather Armstrong, and finally, most usefully, Heather Harpham. As I finished my book proposal, I had to find a few more that closely mirrored the structure or voice or topics of my memoir, and I’ll share some of the ones I liked best below.

Continue Reading…

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Trigger

triggering

 

She was sitting on the couch facing me when I opened the door to the apartment. In a deep-cut v-neck t-shirt, beaded necklaces dipping into her cleavage, my roommate asked me why I’d put the ironic knick-knack I loved back on top of the stereo speaker.

“Because I think it’s funny,” I said.

“But you know I hate it,” she answered, her fingernails pressing into her thighs.

“I know,” I answered her, clutching my backpack, “but you do a lot of things that I hate, too, and you don’t seem to care. Why should I?”

“So you put it up there for revenge?!” she asked, still sitting. I watched a patch of red begin to creep up from between her breasts into the v of her shirt.

“Basically, I guess?”

“You know,” she said, rubbing her hand along the knee of her jeans, “I sometimes come home at night when you’re sleeping, and I stand outside the door to your bedroom, and I have to force myself not to come in there and beat the shit out of you in your sleep.”

“You’re crazy,” I answered, staring at the french doors to my room, and then at her neck, which has grown crimson to match her chest. “That’s what a crazy person says.”

“I’m not crazy. I just hate you.” Continue Reading…

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