By Gloria Duff
One Saturday morning over 20 years ago when my son was 8 years old he woke up with a very dry cough. He continued to cough throughout the day. It got worse in the night and his breathing became more strained. I knew then something was seriously wrong and I decided to take him to the emergency room, although it was the middle of the night and at this time our family was without health insurance. Worryingly, I had gotten laid off from my job and was the one who had the family health insurance and my husband’s enrollment period hadn’t come around yet so we were without health insurance for about six months.
After waiting in the ER for hours while my son’s breathing continued to be labored, the doctor on-call saw our son and told me to just get him some Robitussin for his cough. I don’t think he even listened to his heart or breathing. I even asked him if he could check him further, but he ignored me. Our son continued to cough in his presence, but he still didn’t order an x-ray or any test to be done; all kinds of thoughts went through my mind about the doctor’s reasoning and why he didn’t give my son a complete examination – “Is it because I don’t have health insurance?”, “Is it because we’re Black?”. I felt helpless. I just couldn’t understand why any medical professional would refuse to examine a child when it was clearly obvious his cough was more than a simple common cold. I really felt discriminated against in two ways –because I didn’t have health insurance and because I was Black.
The following Monday morning I took our son to a children’s clinic. The doctor who examined him determined right away that he had pneumonia and treated him instantly. The doctor was very shocked at why our son didn’t get treatment at the emergency room. I will never forget how that emergency room experience made me feel. I was sad, hurt and angry. All I wanted was for my son to get treated and to feel better that night. I felt embarrassed, poor, but most of all helpless to care for my child.
Unfortunately, my experience is not unique to me, but is typical of the way many Black people, uninsured people, and other people from socially and economically marginalized groups are often treated by medical professionals who make assumptions about them rooted in racial or cultural stereotypes. Discrimination shows up in many ways in many contexts within the health care system and can manifest in life-threatening situations for individuals needing vital medical care.
Relatedly, a 2018 report by Human Rights Watch entitled “It Should Not Happen: Alabama’s Failure to Prevent Cervical Cancer Death in the Black Belt” sheds light on issues preventing African American women in the Alabama Black Belt from accessing critical, life-saving sexual and reproductive health care services and information that could prevent or treat cervical cancer – a disease now highly preventable by the HPV vaccine and one of the most treatable cancers if detected and treated early.
Reminiscent of my son’s and my experience in the ER, the report provides further evidence and affirmation regarding the barriers and inequity that Black women face accessing quality care within the health care system. At the time of the report, Black women in Alabama were dying of cervical cancer at rates higher than in any other state in the US, and cervical cancer death rates in Alabama are still alarmingly above the national average, with higher mortality rates for Black women.
In addition to the state itself failing to support programs that could increase access to comprehensive reproductive health care, such as Medicaid expansion and other policies that neglect some of the most vulnerable communities in Alabama, the report, as well as follow up research by the Southern Rural Black Women’s Initiative for Economic and Social Justice (SRBWI) and Human Rights Watch in rural Georgia, highlights the impact of racial discrimination within the healthcare system and among providers and resulting fear, intimidation, and neglect that prevents many Black women from receiving quality care.
Gloria Duff lives in Sumter. She is a married, mother and grandmother, a children’s book author and community playwright, and worked as food and nutrition educator with limited resource families for 16 years. Gloria is a community-based advocate working in partnership with SRBWI and Human Rights Watch on cervical cancer education and advocacy in Alabama’s Black Belt.