It's not hard to see a common thread when it comes to the status of healthcare: Women's health in the U.S. only sort of matters and even less if you happen to also be black. My journey to seek medical care for eczema, a condition only treated as symptoms arise, highlighted for me the commonalities in the way that society approaches black women's health care.
Much like eczema, which can manifest in an outbreak of skin rashes, flakiness or fissures, the challenges black women seeking healthcare face are messy and complicated. With many places that direly need attention, pinpointing where to begin can be difficult.
For instance, black women are twice as likely to deal with anxiety or depression, and they're the most underserved population experiencing those forms of mental illness. Also, 49 percent of black women, ages 21 and older, have heart disease, but few know they are at a higher risk. Worse still, black women have the highest breast cancer mortality rate in comparison to their white peers. And the list goes on when you tack on other things like obesity, stroke and post-traumatic stress disorder.
How is it that in a technologically advanced country like the U.S., do black women lead the nation in health disparities in comparison to white women? The short answer is a double whammy of discrimination based on race and gender. Black people have always had to bear the burden of proof when asserting themselves against institutionalized racism. Black women facing "scientific racism" while pursuing proper health care is no different.
Furthermore, black women have faced state-sanctioned discrimination, like segregation, and limited autonomy over reproductive rights. These avenues of discrimination have created a litany of healthcare problems. Black women have less access to healthcare, and a mistrust of professionals makes them less likely to seek care.
Prior to the Affordable Care Act, women generally paid more for healthcare. In 2015, researchers found that of the 4 million people who are uninsured in America 1.4 million of those people are black and that's with the help of the ACA. As black women continue to make 65 cents for every dollar a white man does, it makes sense that many just can't afford it. Recent studies have also shown that women are more likely to be insured as a dependent and are at greater risk of losing that insurance in cases of divorce, if they are widowed, or if their spouse becomes unemployed.
The Affordable Care Act was projected to, according to Pew research, narrow "historic disparities in coverage between whites and non-whites." But given the House's vote to repeal and replace the ACA with something else, black women likely don't stand to gain any progress in health insurance disparities unless they have a combined household income of over $200,000, are already insured through their current employer, or have no preexisting health conditions.
Also, in a study from researchers at the Yale School of Medicine, experts concluded that implicit racial bias could be the root of underrepresentation of black women doctors made a similar case on the why there are so few black doctors in comparison to white ones. Even if black women doctors are able to get a seat at the table, they still face a wage gap. If you're a woman, who isn't white, on average you would earn $100,000 less than your white male peers, and significantly less than your white female colleagues.
We must prioritize the social and economic disadvantages of black women as experiences that contribute to health disparities, saying it matters only scratches the surface when the reality will remain stagnant.
Until we address the social and cultural biases and institutions that hinder black women's access to healthcare, we'll struggle in defining whose lives really matter.