Did you know that compared to white women; members of racial and ethnic minorities are less likely to receive preventative health services? Often receive lower quality of care? Have worse health outcomes for certain conditions?
African-American Women
As high rates of maternal mortality in the U.S. have alarmed researchers, one statistic has been especially concerning. According to the CDC, Black mothers in the U.S. die at three to four times the rate of white mothers, and is one of the widest of all racial disparities in women’s health. That means that a Black woman is 22 percent more likely to die from heart disease than a white woman, 71 percent more likely to perish from cervical cancer, and 243 percent more likely to die from pregnancy- or childbirth-related causes. In a national study of five medical complications that are common causes of maternal death and injury, Black women were two to three times more likely to die than white women who had the same condition.
Imbalance has Persisted for Decades
In New York City, for example, Black mothers are 12 times more likely to die than white mothers. According to the most recent data; from 2001 to 2005, their risk of death was seven times higher. Researchers say that widening gap reflects a dramatic improvement for white women, however not for Black women. The disproportionate toll on African-Americans is the primary reason the maternal mortality rate in the U.S. is so much higher than that of other affluent countries. Black expectant and new mothers in the U.S. die at about the same rate as women in countries such as Mexico and Uzbekistan, the World Health Organization (WHO) estimates.
Risk Factors & Unconscious Biases
African-American women are more likely to experience chronic health conditions such as obesity, diabetes, and hypertension that may contribute to complications during pregnancy, birth and/or postpartum. The hospitals where they give birth are often the products of historical segregation, lower in quality than those where white mothers deliver, with significantly higher rates of life-threatening complications.
These issues are amplified by unconscious biases that are embedded throughout the medical system, affecting quality of care in stark and subtle ways. In the more than 200 stories of African-American mothers that ProPublica and NPR have collected over the past year, the feeling of being devalued and disrespected by medical providers was a persistent theme.
How to Combat Racism in the Workplace?
To combat these disparities, advocates say health care professionals must explicitly acknowledge that race and racism factor into health care.
This issue of Transforming Care offers examples of health systems that are making efforts to identify implicit bias and structural racism in their organizations, and in turn developing customized approaches to engaging and supporting patients to ameliorate their effects.
Less directed efforts to improve health outcomes, ones for instance that fail to consider the particular factors that may lead to worse outcomes for Black, Hispanic, or other patients of color, may not lead to equal gains across groups — and in some cases may exacerbate racial health disparities. Black women should receive health care that is respectful, culturally competent, safe and of the highest quality.
Public policies and medical practice should incentivize providing patient-centered care that focuses on Black women’s individualized needs, including non-clinical, social needs.
Moreover, policies should endeavor to eradicate cultural biases and discrimination in medical practice and medical education, increase provider diversity in maternal healthcare and hold individual providers and hospital systems accountable when they fail to provide unbiased, high-quality, evidence-based care.
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