On the National Day of Racial Healing, We Must Prioritize Black Women’s Health

Today marks the National Day of Racial Healing, a reminder for many to reflect on the progress and challenges in the fight for racial equity and social justice in our nation. But this day of reflection alone cannot heal the scars that Black women face in a healthcare system that often leaves them behind.

In the Emergency Department, I have witnessed how preventable conditions escalate when care is delayed or symptoms are dismissed. Often, by the time they reach my care in the Emergency Department, what could have been a routine health issue has transformed into a critical situation, and the opportunities for early intervention are long past.  Furthermore, I have seen how these systemic failings disproportionately affect Black women, who are often left to navigate a healthcare system full of inequities. It’s a system that is inadequate in providing equitable care, often leaving Black women to advocate fiercely for themselves to receive the basic level of treatment others take for granted.

The findings from a recent study by the Breast Cancer Research Foundation confirmed what I have seen a multitude of times in my work as an emergency physician: Black women, particularly those with lower incomes, are nearly twice as likely to receive a late-stage breast cancer diagnosis. And for those who don’t have regular access to mammograms, the risk of a late diagnosis is three times higher. These numbers are staggering; but not surprising.

While tragic, worse health outcomes in Black women are not new. Black women are more likely to die from cancer-related causes compared to white women despite having the same incidence of cancer. Black women are 1.5 times more likely to die from cervical cancer than white women. Similarly, breast cancer disproportionately affects Black women, who are often diagnosed at later stages and are 40% more likely to die from it. Similarly, despite similar colon cancer screening rates as white women, black women are 1.3 times more likely to die from colon and rectal cancer. These disparities stem from various factors, including barriers to healthcare access, implicit bias, and missed opportunities for early intervention.

When Black women’s health is neglected, the result is delayed diagnosis and treatment, leading to preventable suffering and poorer outcomes. Missed opportunities for routine screenings, follow-up care, or even the simple act of listening can mean the difference between life and death. The explanation for this is simple yet disheartening—structural inequities lead to stark barriers to care which leaves black women at the margins of healthcare. The Black Women’s Health Study at Boston University’s Sloan Epidemiology Center highlights this—as their work has made it obvious that black women face greater challenges in healthcare affordability and accessing quality healthcare in a timely fashion. Additionally, their research denotes that the psychological trauma associated with racial discrimination serves as a contributing factor in the poor health outcomes that black women experience. Couple this with the erasure of the voices of black women and the disregard for their experiences and it creates a recipe for disaster, with the ultimate cost being the loss of black lives.

To be sure, there are active efforts in research to level the playing field for aggressive cancer that differentially impacts black women and there are growing efforts to improve early detection and screening. While necessary, these efforts are insufficient. Fundamental inequities in knowledge, resource access, and preventative care perpetuate cancer disparities in black women. As a physician, I know these tragic outcomes result from a healthcare system that routinely falls short.  It is time for the healthcare system to confront the inequities head-on, with meaningful action and systemic reform. Without this, the stories of women will continue to echo in our communities.

Healthcare systems must be active in addressing disparities in care for Black women. Healthcare providers need to be vigilant in addressing the needs of Black women, prioritizing their care, and making space for their voices. They must provide education to healthcare professionals on how to deliver culturally competent care with urgency. Increasing access to preventive services, such as mammograms and pap smears, through health centers and community engagement is crucial. They must invest in patient navigation support to help their most vulnerable properly navigate the complex healthcare system and ensure timely access to care. Policies that address social determinants of health—such as housing, employment, transportation, and education—may assist in closing the disparities that Black women face in medicine. By implementing these solutions, healthcare systems may begin to turn the dial on improving healthcare for Black women and dismantling the barriers that have long left them behind.

Black women are dying, and they do not have to. We must ensure a healthcare system that provides optimal care to all women equally and fairly. The cost of inaction is far too high.