Why Black Women Want Black Doctors

“Researchers from George Mason University analyzed data capturing 1.8 million hospital births in Florida between 1992 and 2015 for the new study, which was published Monday in the journal Proceedings of the National Academy of Sciences of the United States of America, also known as PNAS.
When cared for by White physicians, Black newborns were about three times more likely to die in the hospital than White newborns, the researchers found….”
https://www.cnn.com/2020/08/18/health/black-babies-mortality-rate-doctors-study-wellness-scli-intl/index.html

I know that we are tired of race baiting and people of a certain political persuasion making everything about race. But some things really are about race- not necessarily racism, but race. Perfectly nice, dedicated, solid medical staff can be essentially free of prejudices and racism per se, but still harbor some unconscious ways of categorzing their patients- for instance, if a first time mom is concerned about the amount her baby is spitting up, most pediatricians and nurses, especially if they are busy, are going to be less likely to take that really seriously. And 9 times out of 10, they are going to be right. They have experienced a lot of new mommies over-estmating how much their babies are spiting up, and how serious it is. But in a few cases they won’t realize that first time mom may be the big sister in a large family and somebody who spent time nannying another large family, and thus is somebody quite aware of what normal spit up looks like and what projectile vomiting looks like and thus a busy, overworked nurse in an open bay NICU is going to ignore the exhausted young mother and they will catch an easily treatable condition 24 hours later than they should have, and maybe there will be an even worse outcome.

We function by recognizing patterns and using them to arrange priorities, assess information, and get a feel for people. We do it unconciously, and sometimes we aren’t as good at it as we think we are. In the black community, or at least some pocets of it, there’s a higher priority put on medical attention from a professional- it’s a way of showing love. My godsons’ mom was like that- she took her boys to the ER for baby acne, colds, splinters, bug bites, bumps and bruises, and she dramatized a lot of it. So when she told me one of the boys had a problem with bloody noses that wouldn’t stop and could require a trip to ER, I blew her off completely. She had one of them convinced that if he got 7 mosquito bites he would die, after all. And then one day that boy got a bloody nose that just wouldn’t quit, and I treated it too lightly, and then found myself in a crisis with him, because I hadn’t even been willing to consider she might be right about this. Later he was not allowed to play sports because of his condition (it’s similar but less threatening then the normal haemophilia we’ve all heard of). One person, one example- but it’s human nature to build cases and patterns in our heads from not much more than this. Mostly it either works or it doesn’t matter that much if it doesn’t. But in the medical arena, it’s not good enough.

Black babies tended to by black doctors at the same hospitals have better outcomes. It’s a study of over a million babies. Let’s not be to hasty to be defensive about it.

There are whole websites dedicated to how certain conditions present themselves on black skin vs. white skin, because doctors often are only trained how to recognize it on white skin. That’s problematic.

Cultural issues are significant, too- we give more weight to comments and observations made by people who talk like us, who use regular grammar, who seem more mature and better educated. I noticed when my firstborn daughter’s son was in the NICU, the staff often ignored her and gave their oral reports to me, or somehow just treated her as less than- not meanly or hostile, but I realized they thought she was a teenager, which would give less weight to her words than if they had realized she was a college graduate in her mid twenties, and that I wasn’t there because she was unmarried and needed her mama as a sort of guardian, but because her husband couldn’t take off from work and two people are better than one. I started finding ways to state these things, sometimes dragging them into conversations by the strangest routes, and things changed.

Black women and babies may have higher rates of certain complications and their doctors might not know that. We’ve seen this in other issues- There are important gender differences in how dangerous different cholesterol levels between men and women, and for a long time doctors did not know that. Women have different symptoms than men when they have heart attacks. Intermittent fasting should be handled differently in men vs women still in child-bearing years, and not just because of possible pregnancies. Some medications work better for one sex than the other. For a long time medications were mainly tested on men- for fairly good, or at least, well meaning reasons. Women and fertility make drug testing more complicated, so it was safer to test the drugs on men and after all humans are humans, right? – – but then it turned out that female humans react differently to some meds than male humans. In our rush to ‘not see skin colour’ we are overlooking some important things about skin colour. IT’s not just the paper wrapping.
Black people have lower rates of Vitamin D and need more supplementation.

Something real is causing this difference in mortality rates. It’s probably more than one thing, but we won’t get anywhere by not acknowledging that it’s happening.

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3 Comments

  1. Frances
    Posted August 19, 2020 at 2:31 pm | Permalink

    Very interesting piece – thank you!

    My sister had to learn a lot of this with her adopted baby some 50 years ago. “Ash” for instance, was a bit of a shock.

    I choose female primary care. Present doctor is getting on in years, so knows about the pains of old ladies.

    I hope you and the Chreub are doing ok, all things considered!

  2. Frances
    Posted August 19, 2020 at 2:32 pm | Permalink

    Sorry, Cherub of course!

  3. Fatcat
    Posted August 30, 2020 at 8:59 am | Permalink

    I read this study. The healthcare organization I work for has started an initiative to work on this and try and make it better. It’s heartbreaking.

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