Racial Bias and Women's Healthcare

What did you discuss with your healthcare provider at your last OB-Gyn appointment?

Hard truth – there’s a good chance your answer depends on your skin color.

The disturbing statistics about increased COVID risks for people of color shed much needed light on systemic injustice in our healthcare system; but you may not realize the problem extends to almost every facet of women’s health, from yearly check-ups to frightening mortality rates in pregnancy and childbirth. A recent survey of nearly 1,700 white and black, non-Hispanic women aged 18-49 pulls back the exam room curtain, indicating a double standard that often leaves women of color underserved and medically vulnerable to several risks.

Black survey participants were significantly more likely than their white counterparts to have had an office visit within the previous year, and more of them discussed their sexual health and behaviors during the appointment. But although all women have the same baseline female health concerns, survey responses show those conversations took markedly different turns.

Black women were more likely than white women to be asked about sexual behaviors (especially number of partners) vs. health concerns, more likely to be offered STD tests, and more likely to be recommended and offered condoms than a prescription for more reliable forms of birth control. A high number of black respondents reported specific instances of racial bias in their conversations with their provider, including brushing off pain and other medical concerns, shaming, and reinforcement of negative racial stereotypes.

It’s easy to understand how an interaction like that could negatively influence any woman’s decision to disclose important information during future visits, or even discourage her from returning at all. But the dangers aren’t just anecdotal. Consider these examples from other recent studies:

*Both missed diagnoses and missed wellness or prenatal visits regularly contribute to severe medical crises, from reproductive cancers to pregnancy related deaths; and several studies confirm black women are 2-6 times more likely than white women to die from complications of pregnancy.

*Lack of in-office education about and access to the most reliable birth control methods contributes to the higher number of unplanned pregnancies among black women.

*Doctors ignore or misdiagnose painful sex concerns for all women, making the topic difficult for the majority of them to discuss in the office; but 17% of women of color experience longer duration of pain during sex, which makes that conversation all the more crucial.

Although additional factors (many of which involve other systemic injustices) complicate these issues, researchers agree it is impossible to ignore the correlation between negative interactions with providers and serious health risks for women of color.

Those conversations need to change; and as the founding owner of Femina PT, it’s my pledge to help make that happen.

I chose to specialize in women’s health physical therapy because I wanted to help treat women’s bodies; but I learned quickly that education and advocacy were crucial to that mission. I’ve seen firsthand how shame and stigma from providers and the public contributes to real medical consequences for my patients. I’ve dedicated my career to speaking out against medical injustice; and I’ve spent more than a decade making sure my own practice measures up to those ideals.

At Femina PT, every woman will receive the highest standard of care – personalized to their history and concerns, guided by the most current and reputable scientific research in our field, and delivered with compassion and respect for their stories. That commitment goes beyond patient interactions to my hiring practices, my public education forums, and my discussions with fellow medical professionals.

If Black Lives Matter – and they do – there is no better arena than women’s healthcare to shatter the status quo. It is our privilege to serve women of color with women’s health physical therapy, or with referrals to other specialists in our network of trusted providers.

Citations

Townes A., Rosenberg M., Guerra-Reyes L., et al 2020. Inequitable Experiences Between Black and White Women Discussing Sexual Health With Healthcare Providers: Findings From A U.S. Probability Sample. The Journal Of Sexual Medicine online, April 30, 2020 1-9.

Townes A., Herbenick D., Carter A., 2019. Painful Sex Among White And Black Women In The United States: Results From A Nationally Representative Survey. The Journal Of Sexual Medicine 16:S1-S49 26

Flanders-Stephans M. Alarming Racial Differences in Maternal Mortality. 2000 The Journal Of Perinatal Education. 09:02 50-51.

“Racial And Ethnic Disparities Continue in Pregnancy-Related Deaths”. Centers for Disease Control and Prevention, 5 Sept 2019.