Growth Mindset: Fighting to Be Heard

The complicated relationship between Black women and health-care providers

by Mary Stutts

Imagine being in a relationship in which you don’t believe you can trust your partner and feel unseen, unheard, and completely misunderstood. That is the relationship Black women have with health-care. To dissect the issue, we must face some stark realities.

Black women experience the following:

• They are three to four times more likely to die from pregnancy-related complications.

• They are 41 percent more likely to die from breast cancer.

• They are disproportionally affected by COVID-19.

Black women are at the center of a public health emergency. But why?

Just as in many relationships, a breakdown in communication and lack of trust occur between Black women and health-care providers.

Black women are disproportionately underrepresented in clinical trials and biomedical research. Clinical trials are 85 percent white, with all women underrepresented, especially Black women. Data from a recent STAT study show that 80 percent of Black women would be willing to participate in trials if offered to them, and that they view trials as contributing to a legacy of health care for future generations.

They feel stereotyped and ignored by healthcare providers. They also experience racial inequities that lead to late diagnosis and comorbidities. Because of bias, Black women have their symptoms dismissed and their pain undertreated, and are referred less frequently to specialty care.

Relationships are hard work. It’s time for health-care companies and providers to rebuild their relationship with Black women. It’s time to act and learn from past mistakes.

We need to see more Black women in health care, including in positions of power, to address health inequities. We must ensure representation through equitable hiring and the support of Black entrepreneurs and leaders. We are in the beginning stages of seeing the American Hospital Association and other leaders lean in to provide venture capital funding for Black women and men launching businesses designed to improve equitable access to health care.

Health-care providers and companies must stop putting all the pressure on patients to be health-care literate, and instead focus on being culturally relevant in communication and delivery of care. By excluding underserved communities, companies are not only not reaching people who need them the most, but are also leaving billions of dollars on the table every year. That is in addition to the uncountable cost of lost lives due to inequities, delayed diagnosis, and inappropriate care.

We must see more regulatory bodies create policies that promote inclusion in the development of lifesaving therapies. The Centers for Medicare & Medicaid Services’ policy on standardized screening for social determinants of health and recent draft FDA guidance on increasing diversity in clinical trials are first steps in increasing public education and outreach. To better connect to underserved communities, health-care companies should partner with community-led groups that can help them authentically engage.

Companies should invest in debiased AI to combat implicit bias in medicine. Through innovative automatized methodology connecting patients to clinical trials and equitable care-process models, we can create more access to care for all.

Relationships evolve and change over time. I am hopeful we can change the health-care experience for Black women and underserved communities for the better. But it’s going to take a commitment to rebuilding trust. DW

Longtime health equity and inclusion leader Mary Stutts is the chief global health equity and inclusion officer at Real Chemistry.

“Health-care providers and companies must stop putting all the pressure on patients to be health-care literate, and instead focus on being culturally relevant in communication and delivery of care.”

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