“[Doctors] believe black women less when they express concerns about the symptoms they’re having, particularly around pain,” Dr. Neel Shah, a Harvard Medical School professor, said in an August CBS News story called Maternal mortality: An American crisis.
A 52-second clip from the segment — which says black women are often dismissed by and receive worse care from doctors — recently went viral on Twitter. It has more than 15,000 retweets and over 33,000 likes.
In response, black women shared their own harrowing “doctor stories.” In one quote tweet that also received thousands of retweets and likes, a woman described how she was undertreated for a brain aneurysm.
In the dozens of replies to both tweets, there’s a common thread: black women seek medical treatment and are dismissed, only to find that their doctors failed to detect serious problems, like hormonal disorders and tumors.
Because of their gender and race, black women are doubly disadvantaged when it comes to being heard in medical spaces. This is demonstrated most explicitly in rates of black maternal mortality; although maternal mortality rates are already high in the U.S., black women are three to four times more likely to die from pregnancy or delivery complications than white women, according to the Centers for Disease Control and Prevention.
As mentioned in the CBS news segment, this disparity is not fully explained by socioeconomic status or access to healthcare. Even tennis star Serena Williams said had she not demanded a CT after giving birth last year, she would have died of a pulmonary embolism.
Regardless of race, women’s pain is often dismissed as being “all in their heads.” A 2014 study from Sweden found that women wait an average of 15 minutes longer in emergency rooms than men. Women’s pain is often called “emotional, psychogenic, hysterical or oversensitive” and therefore “not real” by doctors, according to the American Academy of Pain Medicine.
Black patients are 22 to 30 percent less likely than white patients to receive medication for abdominal pain, researchers at Brigham and Women’s Hospital found. A growing body of research shows that overall, minority patients receive a lower quality of care than non-minorities, even with similar healthcare access.
Black women are 60 percent more likely to be obese than non-Hispanic white women. This can add another barrier to receiving adequate care; in addition to psychologizing her pain for being a woman and underestimating it for being black, a doctor may blame an obese black woman’s symptoms on her weight. Studies show doctors often do just that; a meta-analysis published in Obesity Reviews found that physicians’ bias toward overweight people can lead to misdiagnosis and delayed diagnoses.
Medical biases related to gender, race, and sometimes weight add up for worse patient outcomes among black women. Some medical schools and hospitals like Mayo Clinic, Kaiser Permanente and Vanderbilt University Medical Center recognize this fact and have introduced implicit bias training. But experts say that change will only happen if sexism, racism and fatphobia in medicine is reckoned with on a larger scale.