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Black Health Matters: Putting the ‘Care’ Back in Healthcare

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This is Black Health Matters, a series shedding light on the health realities of Black people in America. Akilah Cadet, DHSc, MPH, in partnership with Healthline, aims to educate about inequities to inspire a world where everyone can attain their full health potential, regardless of the color of their skin.


What started as a flutter would change my life forever. 

I was on a plane to London for our annual family trip in August 2017. I’ve flown all over the world and been to London a few times. That’s why I couldn’t understand the flutter in my heart.

I wasn’t nervous. I was happy to be on a trip with my family. We landed and I felt fine… until we arrived in Paris.

I had such extreme night sweats that I had to constantly wash my pajamas. Then, while enjoying the Egyptian Antiquities section at the Louvre, I felt the most excruciating chest pain. 

No one in my family has had cardiovascular issues, and I’ve been a vegetarian all my life. I was at a loss. 

I thought maybe a spirit was trying to talk to me. As crazy as it sounds, it’s the only thing that made sense to me in the moment.

I arrived back home in Oakland, California, after a great trip. While nursing my jet lag with intermittent sleep and TV, I suddenly jolted upright.

My heart was racing. I grabbed my phone, checked my heart monitor app, and saw that my heart rate was 100 beats per minute (BPM). A normal resting heart rate is between 60 and 100 BPM. 

It didn’t make sense. 

The next day I had a client meeting. In the short 5-minute drive to the cafe, I had to pull over with pain in my left arm when my heart rate spiked to 130 BPM. Although I’m not a clinical doctor, I was pre-med and graduated from a medical school. I knew these were signs of a heart attack.

But how? I was healthy.

The next day I woke up short of breath and in pain. During a phone call to the advice nurse, my left arm became numb.

“Call 911!” she shouted repeatedly. 

I told her to send a note to the ER and that I’d get a ride.

As a 34-year-old Black woman, I knew I wouldn’t be admitted to the hospital. Even with health insurance, being admitted is the only way to avoid a large ambulance bill. These are things white people do not have to think about.

My neighbor took me to the emergency room. This was the beginning of a long road of being misdiagnosed, overlooked, discriminated against, nearly dying, and fighting for a diagnosis. 

I’d eventually learn it was tachycardia, a condition where your resting heart rate is 100 beats per minute or higher.

A history of medical violence

Healthcare in America is rooted in white supremacy.

It all begins with the enslavement of Black people, in which white people viewed Black bodies as property in order to justify the amount of pain and violence they inflicted.

James Marion Sims was a white doctor who experimented and operated on enslaved women with no anesthesia. He’s known today as the “father of gynecology.” 

Sims owned enslaved Black people and was known to treat other plantation owners’ “property.” He invented the vaginal speculum still used today.

His first patient, Lucy, was noted in his book to have been “in agony.” 

One 17-year-old enslaved Black woman was operated on by Dr. Sims 30 times, resulting in the perfection of his fistula surgery. He then practiced on white women with anesthesia. Sims believed, like many doctors today, that Black people did not experience pain like white people.

With the Emancipation Proclamation in 1865, Black people started to live their lives freely. This very freedom continues to be a threat to white supremacist systems.

Healthcare has historically been one way to maintain dominance over Black people that’s only slightly more subtle than slavery. In some cases, this is still true.

The Tuskegee Syphilis Study is a noted example of the medical community not valuing Black bodies or Black lives.

From 1932 to 1972, the United States Public Health Services partnered with the Tuskegee Institute, now Tuskegee University, Historically Black College and University (HBCU), to study the effects of syphilis. 

Six hundred Black men, 399 of whom had syphilis, were told they were being treated for “bad blood” and given free meals, healthcare, and — when the time came — burial insurance. 

What they weren’t given was actual treatment for their disease, and what was planned for 6 months lasted 40 years.

Penicillin was proven to be effective in the treatment of syphilis in 1947, but researchers never informed these men. A government review in 1972 found the study to be unethical.

The families of the participating men were awarded $10 million a year later. Reparations are still being paid to the descendants.

Black pain is real

Although there are many instances from discrepancies in healthcare for Black people from childbirth to chronic illness, COVID-19 has brought the conversation back to the forefront.

According to a Centers for Disease Control and Prevention (CDC) report, the average life expectancy for Americans in the first half of 2020 dropped by one year. It’s dropped by 3 years for Black men and 2.3 years for Black women. 

COVID-19 is killing Black people at a faster rate due to lack of demographic data collection, less testing in Black communities, and because our pain and suffering is not believed.

Dr. Susan Moore, a Black physician and advocate, struggled to get appropriate treatment for her pain while dealing with COVID-19. The white male doctor who treated her made her “feel like a drug addict,” she said in a social media video. This is something I have experienced all too much.

Moore eventually died from COVID-19 complications. She died advocating for herself. Black people lost a physician who advocated for us.

Black achievements in healthcare

Many Black people have contributed to advances in healthcare. The social determinants of health are connected with the healthcare system. 

Black leaders, scientists, doctors, educators, and activists’ representation in healthcare is crucial. Their experience and appreciation of Black culture, community, food, and more adds to improved delivery of care.

In 1721, an enslaved African man named Onesimus shared the African practice of vaccination. In an African village, pus from someone infected was placed in a cut of a healthy person to prevent spread. This technique would be used to help protect soldiers during the American Revolutionary War.

The Howard University School of Medicine, an HBCU, was formed in 1868 and has educated countless Black physicians since.

Dr. Daniel Hale Williams performed the first heart surgery in 1893. His patient, who had been stabbed in the heart, lived 20 years longer due to his pioneering efforts.

In 1951, a Black woman named Henrietta Lacks unknowingly contributed her cancer cells to science. After she died of cervical cancer, her resilient and quickly reproducing cells were used without her or her family’s knowledge or consent by John Hopkins University. 

HeLa cells went on to become the most widely used human cells in the world, helping with cancer research, the polio vaccine, and HIV treatment. The HeLa cells made the medical industry billions of dollars, while the Lacks family received nothing. 

The Moderna COVID-19 vaccine is in part due to Kizzimekia Corbett, PhD, a Black scientist. She’s helped establish trust within the Black community around the safety and importance of the vaccine. 

What you can do

Advocate

If you’re Black, understand your Patient Rights before you go to any appointment, test, or procedure. If you’re able, bring someone with you and encourage them to take notes so you can focus on the appointment. 

If you’re white, offer to be that person for your Black friends.

If a doctor refuses to test or prescribe something you ask them to, have it recorded in your medical chart. This is a way to rule things out, get what you need, and hold healthcare professionals accountable.

Learn, research, support

Read the Immortal Life of Henrietta Lacks and learn about her and her family’s story.

Determine a cause in health that’s important to you, like childbirth, cancer, COVID-19, asthma, and more. There is discrepancy in care, education, advocacy, or research for Black people in the topic you’re passionate about. 

Research where to donate and how to be an ally.

Learn about the history of Black people’s contribution to medicine. The history is expansive and ever-changing. It shows Black people’s dedication to health for all people.

Support Black healthcare professionals.

Black people trust their providers more when they’re Black themselves. Having shared understanding with a medical professional offers a feeling of safety and improved medical outcomes. 

Unfortunately, only 5 percent of physicians in the United States identify as Black or African American, while 56.2 percent identify as white.

More representation is needed, and you can support those efforts. 

Organizations to support

The Society of Black Academic Surgeons (SBAS) diversifies faculty in academic surgery, promotes their members into leadership positions, and eliminates health disparities against BIPOC patients.

The Association of Black Women Physicians (ABWP) is a nonprofit organization that supports BIPOC women in healthcare. They fund projects committed to eliminating disparities in health and improving the health of minority patients.

The National Medical Association (NMA) is committed to improving health quality for disadvantaged and marginalized communities through professional development, advocacy, community health education, research, and partnerships.

The National Black Nurses Association (NBNA) is a nonprofit that supports Black nurses and works for quality healthcare for patients of color.

The American Black Chiropractic Association (ABCA) recruits, encourages, and supports Black chiropractic students. They foster leadership among chiropractic doctors, instructors, technicians, and students.

Healthline

Bringing it home

It was during my fourth emergency room visit that I saw firsthand that my life did not matter to the medical establishment. 

I had been sent in by my doctor yet again to rule out a heart attack and was admitted the same time as a white woman in her 40s who was there for the exact same reason. 

I was assessed and sent to the waiting room. The white woman was assessed and given a room and an IV.

Eventually, I ended up next to her, divided by a curtain.

Her doctor explained that, due to a pre-existing diagnosis, she most likely had a panic attack. She’d be admitted just to be sure. He saw that she was panicky and said something would be administered to calm her down.

She was admitted for overnight observation and “would be taken care of by one of the best cardiologists.” 

I was discharged after I refused to accept a pain medication I was allergic to. This allergy was noted in my chart and signified by a bright band around my wrist. Once tests showed that I didn’t have a heart attack, I no longer mattered. 

I had been there three times before for the same symptoms. I was in the system. Every time, I was asked if I used cocaine or told I was just stressed. I’ve never been admitted for observation or been given something to settle my nerves.

The white woman’s anxiety was more important than my life.

It’s been several years since my flutter started. After about a year of advocating for myself, I was diagnosed and live with coronary artery spasms, also known as silent heart attack. 

My body thinks it’s having a heart attack every single day. I live in chronic pain on my left side from my jaw down to my thigh. I have regular shortness of breath, weakness on my left side, and night sweats.

Daily heart medication keeps me in less pain, but I always need to have nitroglycerin with me in case I have an actual heart attack. My life is forever changed. 

My condition means I have to repeatedly visit the very place where I’m not seen as worth saving. Healthcare has decided that my value as a Black woman is not important.

Trauma or care?

Black people don’t get the same healthcare as white people. We are profiled. Mistreated. Our pain levels are ignored. We are dismissed. The healthcare system polices our bodies. Doctors are taught stereotypes that make Black lives of less value than white lives.

I will always have to go to the ER for the rest of my life to assure I get the fastest treatment if and when I have an actual heart attack.

But the ER is a place of trauma for me. I have to fight for my life while fighting for my life. I hope that one day I and all Black people will no longer have to fight for equal care.


Akilah Cadet, MPH, works with tech companies, nonprofits, retail, and small businesses to assure diversity, equity, and inclusion strategies that support Black Indigenous People of Color (BIPOC), women, and the marginalized communities in the workplace. As a Black woman, she uses her personal and professional experiences to inspire her anti-racism work through coaching, strategy, facilitation, and organizational change. She’s proud to live in Oakland, CA, has a rare heart condition, and is a proud Beyoncé advocate. Follow her here.

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