10 Tools To Help Black People Advocate For Their Own Health, From A Holistic MD
This Black History Month, as the nation takes the time to acknowledge the accomplishments of well-known civil rights leaders, such as Rosa Parks and Martin Luther King Jr., I find myself thinking about a lesser-known figure: Rebecca Lee Crumpler, M.D.
Crumpler became the first Black female physician in 1864—right around the time the Civil War was coming to an end, and the journey of health care for Black people in America was, perhaps, just beginning.
As I struggle to wrap my mind around the tremendous hardships and challenges Crumpler must have endured, her textbook, A Book of Medical Discourses, provides insight into her determination to champion health care for women and children, as well as her drive to document the complexity and multifactorial aspects of illness.
The racial disparities in health care today.
Now, 157 years later, addressing health care disparities in America is still an ongoing topic of conversation. Based on statistics from the Department of Health and Human Services, Black people are at increased risk for a variety of chronic diseases such as diabetes, strokes, heart disease, cancer, and kidney disease.
As the current pandemic reminds us, we are also at an increased risk for infectious diseases such as influenza, pneumonia, and, of course, COVID-19. Black people develop chronic conditions such as high blood pressure at a younger age and are also more likely to die at an earlier age. Black women are three times as likely to die of pregnancy complications than their white counterparts.
A report on the health disparities in the Black community noted that Black people were 20% more likely to report feeling significantly stressed yet 50% less likely to get counseling. These statistics remind us that there is still a lot of work to be done.
How do we proceed from here?
Clearly, there is a lot that needs to change in our health care and governing institutions. Policies need to be revisited on our environment, creating access to health care, addressing food insecurity, and of course, giving cultural sensitivity training.
On a collective level, we can join groups that advocate for and prompt our leaders to move forward in the direction of these changes. On an individual level, here are 10 ways we can advocate for ourselves and our health.
10 ways Black patients can advocate for their health:
1. Be prepared.
Write out a list of your symptoms, when they started, and what your concerns are about them. For example, I have been having abdominal pain, it started a few months ago. It comes and goes. This makes it better, and that makes it worse.
2. Write down your family history.
It can be important to let your doctor know if you may be at higher risk for certain conditions. If your grandmother had colon cancer, ask if you should have a colonoscopy. Remember, Black people are at higher risk for colon cancer at a younger age, at a higher risk for a more aggressive form, and also tend to be diagnosed at a more advanced stage.
3. Take inventory of your medications.
Write down a list of all your medications (including supplements), and the dosages. This can help to determine whether your symptoms may be related to an interaction or the medications are working.
4. Ask questions.
Think of questions ahead of time and write them down so you don't forget. Examples include:
- Could this be something else, given my history?
- What are my treatment options?
- What kind of medications or tests are prescribed, and what are the side effects?
- What's the plan of action?
- If referred to a specialist, should I call them, or do you call them?
- When should I follow up if I haven't heard anything from the specialist?
- When should I follow up with you?
5. Follow up with your doctor.
If you did any kind of testing and don't get notified of your results, do not assume it is normal. Call to clarify—this is important. All you have to say is: I am calling to verify my results.
6. Find a physician who supports and advocates for you, too.
Look for a physician who thinks of you as part of the team in your health care. If someone is dismissive, dictates the appointment, and talks over you without listening, these are red flags that the doctor-patient relationship may not work.
7. Find extra support.
Look for patient advocacy groups that may be able to help you address any specific issues you're experiencing.
8. Find a physician of color.
If possible, look for physicians of color or who have had implicit bias and sensitivity training. For example, research published in 2016 found that half of medical students and residents held the belief that Black people did not feel pain and had thicker skin. Because of that, pain complaints would often be minimized, and the patient would be subsequently undertreated.
9. Reach out for help.
Culturally, we might feel that reaching out for help is a sign of weakness, but it is not. Asking for help when you're overwhelmed or stressed acknowledges that we are human, and as human beings, overwhelming, persistent stress is damaging to overall health. If you're having challenges, think of a pastor, rabbi, or priest as a starting point.
10. Educate yourself on your health.
Try to learn about your health as much as you can. Look at reputable sites like the Centers for Disease Control (CDC), Mayo Clinic, and other peer-reviewed medical journals, to learn the facts. This helps you to be a better advocate for yourself and others. For example, of Black women over the age of 20, close to 50% have heart disease, and only 20% think they are at risk. More than that, only 36% of Black women realize heart disease is one of the biggest risks to our health and well-being.
Overcoming health care disparities is a work in progress. If we all commit to participating in the process, I am optimistic that my grandchildren will see a better, healthier tomorrow.
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