Black health care providers look to end treatment inequality
Black patients around the country have reported having symptoms and pain dismissed or misdiagnosed. For pregnant Black women, such mistreatment drastically increases the possibility of death.
When Chantina Wilson was six months pregnant, she started having abdominal pains. She scheduled an appointment with her doctor, a white man, who told her she was having Braxton-Hicks contractions.
But this wasn’t Wilson’s first pregnancy. She knew what contractions felt like. Still, her doctor ignored her protests and sent her home with prescription-strength Tylenol.
“He didn’t even touch me,” Wilson said. “He just assumed I was having contractions.”
But she wasn’t. It was appendicitis, which Wilson discovered only after going to Stroger Hospital, where she was treated by another OB-GYN — a Black woman.
“I will never forget this lady,” Wilson said. “She came in and she was like, ‘The pain you’re describing, that’s not contractions. You’re pointing to your appendix.’ I ended up having emergency surgery right then because she told me I could die if I didn’t.”
Black patients around the country can tell similar tales. Many report having symptoms and pain dismissed or misdiagnosed. For pregnant Black women, mistreatment drastically increases the possibility of death.
In Illinois, Black mothers died from pregnancy-related issues six times more than white mothers in 2020, according to a report from the Illinois Department of Public Health. And a 2021 CDPH report found that Black infants are almost three times more likely to die within their first year than non-Black infants.
Wilson’s been fighting against these statistics as a patient care navigator with MyOwnDoctor, a Black-owned holistic telehealth service.
While telehealth services have expanded over the last few years to provide everything from counseling to prescription deliveries, MyOwnDoctor focuses on “culturally relevant” care.
The service connects patients of color to Black and Latino physicians, who often better understand their patients lives and experiences. These physicians work in primary care, specialty care and mental health care.
“It has a platform that allows you to connect with a doctor, a nonprofit and a faith-based organization,” said Cheryle Jackson, MyOwnDoctor CEO. “We know how important that is in improving health outcomes, particularly for Black and Brown populations that really bear the brunt of health disparities.”
With 130 providers, the telehealth service offers virtual visits, care coordination, remote patient monitoring and education.
Some telehealth providers have brick-and-mortar offices to treat patients in person if needed. If a telehealth provider has no office, it can refer patients to doctors committed to the same principles.
MyOwnDoctor was created in 2016 as a telemedicine software company, licensing software to other entities. In 2020, the devastating effects of the COVID-19 pandemic on the Black community pushed the company into care delivery.
Others trying to tackle racial inequities in health care include Health in Her Hue and Poppy Seed Health. Both offer telehealth services, though Poppy Seed focuses on helping women with pregnancy-related issues.
Black Americans are more at risk of contracting COVID-19, being hospitalized for the virus and dying from it than white Americans. Reasons for this include less access to testing, high-quality health care and vaccines, and higher rates of other chronic conditions, such as heart disease or high blood pressure.
“The pandemic ... forced everyone to face a brutal truth,” Jackson said. “Health care in this country is neither equal or accessible, or the outcomes the same for everyone. And that really does depend on where you live and the color of your skin.”
Health care inequity also stems from implicit biases and institutionalized racism.
A 2016 study by the Proceedings of the National Academy of Sciences found a “substantial number” of white medical students and residents hold “false beliefs about biological differences between blacks and whites and demonstrates that these beliefs predict racial bias in pain perception and treatment recommendation accuracy.”
Those beliefs included Black patients having thicker skin and less sensitive nerve endings.
A 2019 report found practitioners fell prey to those same biases — as well as beliefs that Black patients are more susceptible to drug abuse.
“Very early on when you’re in medical school, you understand how the health system works,” said Dr. Rachel Villanueva, OB-GYN and member of the National Medical Association, the nation’s oldest and largest professional organization representing African American physicians and patients.
“You see marginalization of clinic patients, either by race or socioeconomic status, and people are treated differently,” she added. “It’s a system that indoctrinates and educates the upcoming doctors to not necessarily have respect for a clinic patient.”
Villanueva said it’s no surprise there’s been a lack of trust between communities of color and the health care system. The system hasn’t done much to build that trust.
“I’ve actually seen an exponential growth in the patients of color coming to see me at my office who are looking for a provider of color, someone who they feel will listen to them,” Villanueva said. “I hear a lot of (patients say) this is the first time I feel like someone’s actually explained what was going on or even listened to what I was saying.”
It’s something Dr. Christal West, OB-GYN and MyOwnDoctor’s medical director for women’s health, has also encountered.
Often, “my patients that have come in are seeking care from a Black female because they are” Black women, West said. “They feel like they will be more comfortable, we’re more sensitive and really understand their experience.”
For West, culturally relevant care means getting to know her patients. That includes letting them talk first about their needs and wants.
Then, she focuses more on being educational than just being authoritative. That means bringing in literature for the patient to review, asking if they have more questions.
Now, MyOwnDoctor has partnered with Aetna Better Health of Illinois, hoping to expand services and access to care for the entire state. They’ve also launched the Partners for Heart & Health referral program.
The program refers MyOwnDoctor’s patients to partner nonprofits and organizations, and those organizations refer members in need of care to MyOwnDoctor.
Another effort to deal with inequity in health care is underway on the South Side.
Jeanine Valrie Logan, a certified nurse midwife, wants to create the Chicago South Side Birth Center. Her vision is for a facility led by Black midwives and staffed by nurses, a physician collaborator, doulas and educators.
That desire was borne from experience. Logan was a doula for 11 years, but when she was pregnant with her first daughter, she and her husband had trouble finding Black doulas in Chicago.
“Then we had a really hard time finding not only Black midwives, specifically, but midwives of color that were providing out-of-hospital care,” she added.
Since then, Logan has worked with other birth advocates to pass HB 738, which expands access to city birthing centers.
Thanks to the nonprofit Chicago Beyond, Logan now can focus full time on getting that birth center built.
Chicago Beyond finds groups, community leaders and research opportunities to invest in. It picked Logan for its latest Leadership Venture.As a result, she now gets a salary and benefits, as well as professional support.
While she doesn’t have a location picked just yet, Logan hopes to open next fall.
“Right now on the Southeast Side, there’s only three hospitals that have OB units, and that’s a huge amount of geographical area that has limited access to services,” Logan said. “Folks deserve autonomy and equitable and safe access to healthcare with providers that look like them.”
Part of having equitable health care in the center, Logan said, means providing resources she’s used, explaining what to expect when patients arrive and even if she thinks they’ll need a snack while they wait.
“I’m envisioning a birth center where everyone can come in, feel safe to speak about anything,” she said. “We want to be a place where whatever is important to the immediate community is important to us. We want to be a staple in the community.”
Villanueva isn’t surprised by the growth of culturally relevant providers.
“It’s well researched that people of color have better health outcomes when they’re taken care of by providers of color,” she said. “They have better experiences, and there’s more adherence to treatment plans.”
There is plenty more to be done.
“To maintain our board certification, we’re required to do a certain amount of continuing medical education, credits, keeping abreast of all the new technologies and issues in our field,” Villanueva said.
That should include addressing biases in health care, she said.
“I think we have a generation of individuals that grew up very differently than I did. They could have grown up in a segregated time, so ... I’m not saying that everybody is racist, but they’re definitely coming in with different biases.”