Misogynoir in the North American Healthcare System

By Kaamilah Moola

Ingrained in the American healthcare system is racial inequality that marginally impacts African American people. These inequalities manifest in regards to discriminatory healthcare access, uneven insurance coverage, and inequitable general quality of treatment; all contributing to the lack of safety experienced by Black patients. Specifically, Black women experience an amplified version of these inequalities when dealing with more gender-specific health related issues. Feeling misunderstood, ignored, and brushed aside are sentiments shared by many Black Americans inside and outside of the healthcare system. Being denied pain medication, being questioned on one’s ability to pay, and being refused fair treatment, are symptoms of a broken healthcare system that is beset with inequalities stemming from racial discrimination.

When understanding the ways in which racial prejudice manifests through unequal healthcare access, David R. Williams, PhD, a Harvard professor of public health, sociology, and African American Studies, assesses that “your zip code is a stronger predictor of your health than your genetic code.” This introduces the question on the equality of hospital funding in communities of color in comparison to White communities, where the answer is quite stark. Communities of color are more likely to be located in areas with higher levels of air pollution, which means members of that community are at higher risk of breathing in more dangerous particles that can lead to respiratory issues, lung cancer, and heart disease. Further, research shows that communities with over 60 percent or more of Black residents have the fewest supermarkets meaning less access to wholesome foods such as fresh and organic produce and lean proteins. The racial disparities evident in the environmental planning of the U.S. already creates a disadvantage for the majority of Black Americans in regard to the quality of life. However, inequality within the healthcare system when dealing with these health issues, caused by their presupposed disadvantage, only worsens the state of health for African Americans.

Specific to Black women, data trends showcase how these inequalities are experienced to an amplified extent. Maternal mortality rates for Black women prove higher regardless of income or education level; where Black women are three to four times more likely to die from pregnancy-related complications than White women. While all women may be underrepresented in clinical research and trials for new drugs, Black women are underrepresented to a greater extent. Black women, who are disproportionately impacted by uterine fibroids, only make up 15 percent of participants in published clinical trials for this condition. In addition, data from the FDA shows that in 77 percent of approved medical trials, fewer than 5 percent of participants were Black. In fact, contrastingly, Black participants are disproportionately over-represented in studies that do not require consent.

The patterns emerging that showcase higher mortality rates, as well as the underrepresentation of Black women in clinical trials, couple together when highlighting Misogynoir within the American healthcare system. As students, especially students that plan to enter the medical field, it is key to stay aware of the inequalities in which the healthcare systems in North America are beset with and try to actively work against them.