Contributor: Jenelle Marius

HELP US! WE ARE DYING! As a nurse and a woman of color, I can see a lot of issues in the healthcare system from both perspectives and I employ other healthcare workers to try to see it as well. I am passionate about a lot of health and social justice issues that are prevalent: how we care for the under/uninsured, how we address mental health issues, how we approach community health nursing, and how we appreciate and integrate cultural differences. However, I think the biggest matter that I am devoted to and want to help correct is the health disparities in the United States. There are a lot of significant racial health disparities that are experienced frequently in the United States: mortality and life expectancy, the burden of disease, mental health issues, insurance or lack thereof, and a dire lack of access to competent care.

How we approach these severe disparities is an important change that needs to be made in the nursing field. All of these racial disparities (biases, stereotypes, prejudices) are found to be associated with poor health outcomes and broader inequalities. Right now, out of all the minoritized people, black women, specifically, are often gaslighted in healthcare settings and made to feel as though their issues are not important enough or real enough to warrant qualified care. Black women have to deal with both racial and gender biases, which causes detriments such as a maternal mortality rate three to four times their white counterparts and unequal treatment in the ER.

Healthcare professionals do not always believe black women when they come into the hospitals with their presenting problems. A very common example is when black women present with abdominal pain, nausea/vomiting, dizziness, and heartburn and are then turned away with a diagnosis of indigestion, the flu, or the worst misdiagnosis: a bad period. These are classic signs of a heart attack in women, however, sometimes healthcare providers do not look past the color of the patient’s skin and miss the actual problem. I have personally encountered this myself. I went to the hospital with severe abdominal pain and was brushed off repeatedly; I was only taken seriously when I had a female doctor. This, sadly, is normal for a lot of black women in this country, but it doesn’t have to be.

Currently, some universities are adding cultural competency courses to their curriculum which will allow future healthcare workers to think about people holistically and not focus on any one aspect. If we change how we educate future healthcare professionals, we change who is in the field, and hopefully, that will improve care all over the world. However, one thing that healthcare workers can do now is broach this important topic in academic settings. The more we talk about it, the more awareness we generate, and the more solutions we can come up with to address the problem. Increase the conversations between the patient, and involve them in their care.

Black women leave the hospitals every day in pain and end up dying at disproportionately higher rates than white men and women. This needs to change now! When someone comes into the hospital, we, as healthcare providers, need to recognize that they know their bodies better than we think we do. We need to listen honestly and completely. Because of my experiences and those of my loved ones, I am incredibly passionate about issues, like this one, that affect my racial community more than others. I want to help fix this. I want to create a space where people feel comfortable sharing stories so that we can raise awareness of this prevalent issue, but I need help to do so. The Institute of Medicine found that we need a comprehensive, multilevel strategy to eradicate these health disparities that result in mortalities.

I know it is hard for people to think of a possible solution to this very grave problem. However, no matter what you do in the healthcare system, you have a role to play. Educators, teach your students how to deal with these complex and delicate situations. Educate them on racial biases and racial discrimination. Doctors, listen carefully to the patient. Trust what they are saying. Exhaust all options before making a diagnosis.

Nurses, provide adequate and universally competent care. Treat each person individually and listen to their concerns. Also consider interventions at the population level. The Butterfield Upstream Model for Population Health provides a framework to guide the kinds of interventions that make a great impact on the system, with the goal to reduce inequities by intervening early and broadly at the level where determinants of health take shape. 

Healthcare professionals: be self-aware. The complexity of racial health disparities flows deeper than we think it does. It is deeper than just one healthcare provider; it is in our communication, education, and understanding of different communities. It is in the system. However, to break down the system it starts with us, one person at a time. Break free of the stereotypes, and internal biases. We, as healthcare providers, need to do better now!

Resources

Moyer, M. W. (2022, March 28). Women are calling out ‘medical gaslighting’. The New York Times. Retrieved April 20, 2022, from https://www.nytimes.com/2022/03/28/well/live/gaslighting-doctors-patients-health.html

Reducing disparities in health care. American Medical Association. Retrieved April 20, 2022, from American Medical Association, https://www.ama-assn.org/delivering-care/patient-support-advocacy/reducing-disparities-health-care

Institute of Medicine Findings and Recommendations on Health Disparities. AMA. Retrieved April 22, 2022, from AMA. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/public-health/iom_1.pdf

Staff, N. W. H. N. (2018, April 12). Why is the maternal mortality rate so high for black women?: National Women’s Health Network. National Women’s Health Network |. Retrieved April 22, 2022, from National Women’s Health Network. https://nwhn.org/9318-2/

About Jenelle Marius

I am a senior nursing student at UMass Amherst, set to be graduating in one month. I am from Randolph, Massachusetts. All my life I have attended private schools, where I was a part of the minority of people of color and an even smaller minority of black people. These experiences really shaped how I view myself. It took a while for me to develop a strong sense of self, just because of the environment I was in and what I grew up seeing or not seeing. While I will be eternally grateful and appreciative of these experiences that my parents gifted me, these experiences did make my journey to myself a bit more complex. 

My parents both immigrated to America, coming from the Commonwealth of Dominica and Haiti; amassing enough money to attend college and get degrees. My mother and father both have their Masters degrees. My parents gave their all for me. And it is because of them that in a month I will graduate with two degrees. They have taught me to always push myself, always try my best to be my best. That is exactly what I aim to do. 

I am going to be a nurse. A nurse, a role that has the most patient contact in healthcare. I have always wanted to help people in one capacity or another, and nursing is the one that fit me best. I am going to listen, to believe my patients and to support and advocate for them. Because unfortunately as black people in the United States that doesn’t always happen, which is the inspiration behind this writing. “