Last Updated on October 12, 2022 by BVN
Kenneth Kipruto | Staff
Nearly one third of Black Californians – one in three people – have been treated unfairly by a health care provider because of their race or ethnicity.
A new study by the California Health Care Foundation (CHCF), one of the largest studies focused on the health care experiences of Black Californians to date, reveals the great lengths Black Californians go to prioritize their physical and mental health despite the system continuously failing them.
CHCF’s report, The Listening to Black Californians: How the Health Care System Undermines Their Pursuit of Good Health, reveals that most Black Californians (89%) are insured, have a regular provider (85%), and have made at least one visit to the doctor over the last one year.
The study also reveals that ahead of a healthcare visit, most Black Californians will adopt measures to mitigate negative experiences. Two-thirds will conduct their own research on a health condition or concern ahead of meeting a health care provider, while one-third will tailor their speech to make a provider feel at ease.
But despite these deep investments, with more and more Black Californians becoming more intentional in their pursuit of physical and mental health, the report reveals that one in three of them have been treated unfairly by a healthcare provider because they are Black.
The unfair treatment is having a toll on Black people, with more than one in four Black Californians opting to avoid care due to concerns that they will be treated unfairly or with disrespect.
The study, which interviewed 100 individuals, 18 focus groups and included feedback from 3,325 respondents to a statewide survey of Black Californians, highlights shocking racism experiences of some while seeking health care.
“We began by trying to understand racism and health,” said Shakari Byerly, the managing partner of Evitarus, a Black-owned public opinion research firm that conducted the survey.
A 60-year-old woman from the San Francisco Bay Area told the researchers how no doctor believed her when she told them she was not feeling well after a C-section.
“They sent me home. I had a sky high fever because of an infection and had to be rushed back to the hospital, rushed into surgery. If I hadn’t continued to advocate for myself, I could easily have been one of those numbers,” she said.
A significant number of Black Californians overall (38%) and of Black women in particular (47%) say there has been a time when a health care provider did not treat their pain adequately.
“I’ve had a lot of dismissive doctor experiences in the past. I’ve also had doctors like, hurt me, assuming that I wouldn’t feel pain with stuff before which I would chalk up to medical racism,” said a 33-year-old College graduate in San Diego covered by a partner’s employer. “It was a pretty traumatic experience. I was with a doctor that (was) being really rough with my body…and I would chalk a lot of them up to, you know, medical racism and misogyny and homophobia.”
Mental Health
“As a Black person, I always have to ask, did they just do that? Because I’m Black. Right? So. So even if it’s not true, it’s always on my mind… And that could contribute to someone’s poor health and even death because maybe something needed to be or would have been detected on that visit, but because they don’t want to have or I don’t want to have another negative encounter, I’m not going,” said a 50-year old San Francisco Bay Area respondent with a doctoral degree.
The research found that such experiences occur mostly for Black Californians with mental health conditions (47%), those who identify as LGBTQIA+ (43%), those with disabilities (40%) and for women (40%).
“What we found in this study is of no surprise to any Black person who has navigated our health care system,” said Katherine Haynes, senior program officer for CHCF’s People-Centered Care team.
As a result of unfair treatment and not being respected by doctors, dentists or nurses, more than one in four Black Californians avoids care. Of those who reported avoiding care due to unfair treatment, 42% were women aged between 35 and 44, 41% identify as LGBTQIA+ and 35% were Medi-Care enrollees.
But despite the negative experiences most Black Californians undergo while seeking health care, the research found that 80% of all respondents have medical insurance, and that most Black Californians put a great deal or quite a bit of effort into getting appropriate screenings or preventive care (77%) and focusing on their mental health (79%).
Nine in ten Black Californians (90%) say they currently have health insurance coverage, and 83% have access to a regular provider. Over 9 in 10 Black Californians (92%) have seen a doctor or health care provider in the last year,” the report says.
While respondents with health insurance reported positive experiences, they acknowledged that not having health insurance perpetuates the inequities in health care access.
“I can say that the health care that I receive is great only because of the insurance that I have. My girlfriend doesn’t have the same thing as I do. She doesn’t have insurance so she can’t just go to the doctor,” said a 49-year-old male participant from Antelope Valley. “The only reason why I have that [positive experience] was because [of] my employment. Without my employment, I wouldn’t have the treatment that I’m receiving right now.”
Seeking solutions for persistent inequities
In a call with journalists on Tuesday ahead of the release of the report, Haynes and Byerly said equitable healthcare is within reach and that California has a foundation to build on.
The Listening to Black Californians study’s main goal was to identify solutions for persistent health inequities Black Californians experience.
The report reveals that Black Californians have clear opinions on how to make the health care system work better for them. More than three in four respondents termed increasing Black representation among health care leaders and providers, expanding community-based education and advocacy, and training providers and holding the health care system accountable as extremely important.
Approximately 7 in 10 Black Californians think it is extremely important or very important to develop more holistic approaches to health care.
“Virtually all Black Californians consider it extremely important or very important to have a provider who listens to them (98%), who spends the time needed to answer questions (97%), and who discusses specific health goals (93%),” the report says.
Other recommendations include expanding community based resources, training providers and ensuring accountability, and developing more holistic approaches.
CHCF seeks to advance Black health equity through a people-centered system change. You can read the report here.