The Treatment of Minority Women in Healthcare

Edited Catherine Verdeflor

History has made it clear that the society we have lived through in the past and present is a predominantly patriarchal/patrilineal one that has marginalized its female population by either not granting women liberties in a way that is equitable or by granting them at a significantly later time. While this notion retains its validity for all women, intersectionality has played a role in making such disparities between all genders even larger and more devastating for minority women/women of color. While many might be aware of the gender wage gap between men and women and how women have been known to earn less per a man’s dollar, what many fail to realize is that this gap between a woman’s wage and the (White) man’s dollar varies based on the race of the woman. According to data gathered through the US Census Bureau concerning the 2018 median earnings of full-time, year-round workers by race/ethnicity and sex, Asian women earn $0.90 to a man’s dollar, White women earn $0.79, and Black, Native American and Alaska Native, and Hispanic or Latinx women earn $0.62, $0.57, and $0.54 respectively (Bleiweis, 2020, para. 3).

Many look to the year 1920 as the year in which women in the United States were given the right to vote; this was not the case since, at that time, many women of color were not considered citizens (and if they were, their rights were stifled either by the federal or state governments so that they weren’t allotted the same rights as white and/or male citizens) and, therefore, couldn’t vote (PBS, 2020). Native American women would be subjected to tactics from individual states, such as poll taxes and literacy tests, until 1962 (despite gaining citizenship in 1924) (PBS, 2020). Asian American women wouldn’t be allowed their voting rights until the passing of the Immigration and Nationality Act of 1952. Even though 19th century amendments like the 14th and 15th amendments should have allowed all African Americans citizenship and voting rights, it wouldn’t be until the Voting Rights Act of 1965 that granted African American women the right to vote (PBS, 2020). Furthermore, Latinx women would still experience hindrances to their rights as citizens until the Voting Rights Act made an extension 10 years later in 1975 that would “expand voting access to women who rely heavily on languages other than English” (PBS, 2020, para. 4). However, such disparities don’t just exist when it comes to salary and voting rights. In fact, these disparities are quite common in our healthcare systems.

When it comes to disparities among women in healthcare, one of the most relevant subjects within that topic is maternal mortality rates. Statistics have shown that African American Women are “three to four times more likely to die from childbirth than non-Hispanic white women” (Chalhoub & Rimar, 2018, para. 4) as well as 2 to 6 times more likely to die of pregnancy-related complications based off where they live (Flanders-Stephens, 2000). These facts are the results of several other factors in which minority women are discriminated against or treated poorly in comparison to White women. For starters, women from minority communities have significantly less access to health care and health insurance (Chalhoub & Rimar, 2018). These instances of minority women not being given access to such necessities can be traced back to the practices of redlining in the US. Redlining is a term that describes “illegal discriminatory practice in which a mortgage lender denies loans, or an insurance provider restricts services to certain areas of a community, often because of the racial characteristics of the applicant’s neighborhood” (Britannica, 2014).

Beginning in the 1960s, as notable policies such as the Civil Rights Act of 1964 were passed and the federal government mandated that everything from schools to public services and even neighborhoods became integrated, many white residents began to leave their homes in the cities (which is why mostly minority communities live in “urban” areas and many white homeowners can be found living far outwards in the “suburbs”) out of opposition to these new changes. These areas then became underserved with many minority women not being able to afford insurance or not living close enough to medical facilities to receive healthcare or reproductive healthcare products, like contraception, birth control, tests for STIs/STDs. These problems only seem to be worsening as maternity wards, like the Providence Hospital and United Medical Center in Washington D.C., have been closing their doors to the lower-income women that they serve (Chalhoub & Rimar, 2018). As a result of the lack of prenatal and postpartum care given to Black women, for instance, they are more likely to succumb to maternal mortality and postpartum disability compared to white women (Beim, 2020). Moreover, they have higher chances of infertility and are less likely to seek medical intervention (Beim, 2020). These issues can have devastating effects on women from minority communities since they lead to more conditions that they suffer from being left untreated.

In addition to poor access to healthcare facilities and an inability to afford healthcare insurance, minority women must also deal with racial and cultural insensitivity, which tends to be a recurring theme in their visits to clinics and experiences. Often African American women suffer from pregnancy complications (before or after childbirth) as the result of medical professionals, whether unknowingly or willfully, being inattentive to their experiences and medical needs (Chalhoub & Rimar, 2018), often through the dismissal of “health-seeking behaviors'' (Flanders-Stephens, 2000, para. 2). One would possibly think that this problem, like many others, wouldn’t affect members of these communities who are of a higher socioeconomic status than the average person; however, that assumption would be wrong.

Beloved icons like singer-songwriter Beyonce and professional tennis player Serena Williams have had to deal with discriminatory behavior against them when delivering their children. Serena Williams’ instance of unjust behavior towards her threatened to end her life. After successfully delivering her daughter, Alexis, she discovered that she was suffering from shortness of breath and that blood clots were forming in her lungs (Jackson, 2018). Having been previously hospitalized for a pulmonary embolism, she recognized these conditions as symptoms of another one (Jackson, 2018). Unfortunately, her medical staff disregarded her concerns, and it wasn’t until a CT scan was performed that Williams confirmed her suspicions to be true. Many minority women aren’t as lucky though, and there are many times when their concerns are brushed aside and ignored resulting in preventable complications that are often fatal (Jackson, 2018). Racial inequalities when it comes to the inadequate care given by medical professionals is so severe that it has, at times, increased the racial disparities seen in pregnancy risk factors, such as “hypertension, anemia, and gestational diabetes,” as a result of the stress they cause to their patients (Chalhoub & Rimar, 2018, para. 3).

These instances of racism and sexism within the medical field and our healthcare systems have gone on for far too long and need to be addressed as well as combated against. Efforts from the government need to be made in order to ensure that all US citizens have adequate access to health care and affordable health insurance; after all, they have demonstrated their efficiency in lowering these problematic trends in infant and maternal mortality. A study observing the impact of Medicaid expansion discovered that in states that expanded Medicaid, infant death for African Americans declined by more than twice the rate that it did in non-Medicaid expansion states (Chalhoub & Rimar, 2018). Even though access to insurance would not fully eliminate the racial disparity in maternal and infant mortality among women, it could contribute to healthier pregnancies and births (Chalhoub & Rimar, 2018). Moreover, funding and support for organizations dedicated to improving these disparities should be given. Notable groups include Black Women’s Health Imperative that works toward making healthcare better for black women, Mamatoto Village that is a D.C.-based organization “dedicated to supporting women of color during pregnancy and postpartum as well as empowering them to be providers in the maternal health space” (Chalhoub & Rimar, 2018, para. 8), the Black Mamas Matter Alliance which advocates for lowering black maternal mortality by making advancements in research and legislation, and Fertility for Colored Girls which provides fertilaid for couples of color and allows access to professional counseling, treatment, support groups, and more. Perhaps the most pressing matter of each of these reparations, however, is making sure that minority women are taken care of and given personalized care that is sensitive to their racial and cultural traditions/needs (Beim, 2020). This can only be done by including minority women in clinical trials and key biomedical research datasets, ensuring that caretakers of minority mothers are put through anti-racism and implicit bias training when dealing with minority women and held accountable when shown to be ignorant, disrespectful, or dismissive of their minority patients as well as encouraging more minority women to work and employing more women of color to work as physicians.

References

Beim, P. (2020, June 6). The Disparities in Healthcare for Black Women. Endometriosis Foundation of America. https://www.endofound.org/the-disparities-in-healthcare-for-black-women

Bleiweis, R. (n.d.). Quick Facts About the Gender Wage Gap. Retrieved from https://www.americanprogress.org/issues/women/reports/2020/03/24/482141/quick-facts-gender-wage-gap/

Britannica, T. Editors of Encyclopaedia (2014, September 11). Redlining. Encyclopedia Britannica. https://www.britannica.com/topic/redlining

Chalhoub, T., & Rimar, K. (2018, May 10). The health care system and racial disparities in maternal mortality. Center for American Progress. https://www.americanprogress.org/issues/women/reports/2018/05/10/450577/health-care-system-racial-disparities-maternal-mortality/

Flanders-Stepans, M. B. (2000). Alarming racial differences in maternal mortality. The Journal of perinatal education, Vol. 9(2), 50–51. doi: https://doi.org/10.1624/105812400X87653

Jackson, K. (n.d.). Serena Williams and her Experience with Pulmonary Embolisms. Retrieved from https://vascularcures.org/2018/01/13/serena-williams-and-her-experience-with-pulmonary-embolisms/.

Not All Women Gained the Vote in 1920. (n.d.). PBS. Retrieved from https://www.pbs.org/wgbh/americanexperience/features/vote-not-all-women-gained-right-to-vote-in-1920/

[Untitled image of women]. ABA Journal. Retrieved from https://www.abajournal.com/news/article/most-minority-female-lawyers-consider-leaving-law-aba-study-explains-why