You may be familiar with the effects of factors like age and gender on people’s health. But did you know that race and ethnicity can play a significant role in health outcomes?
First, people of certain ethnicities experience disproportionately higher rates of certain conditions, including heart disease, for a variety of reasons.
Second, aspects like socioeconomic status, employment, and access to education can also impact health outcomes. These are known as social determinants of health. And people of color are more likely to face issues like food insecurity, un- or underemployment, and living below the poverty limit.
Third, bias and prejudice sadly interfere with many patients’ ability to receive timely, often life-saving care. In the US, numerous studies have shown that a patient’s race can significantly impact the way they experience healthcare, the level of treatment they receive, and their chances of survival.
Especially for women, who already experience medical bias and discrimination based on their gender, race can greatly change a patient’s outcome when seeking attention for serious conditions.
Here’s How Women of Color Experience Healthcare
Pregnancy and childbirth
One instance that highlights the inequality between white patients and patients of color is the disproportionate rate of pregnancy-related complications and maternal mortality between different races and ethnicities.
Tragically, Black and American Indian/Alaskan Native women are consistently at the highest risk of pregnancy-related death, with a rate that leaves them two to three times more likely to die during pregnancy and childbirth than white and Hispanic women.
The leading cause of pregnancy-related death is cardiovascular disease. Conditions like preeclampsia, peripartum cardiomyopathy, and spontaneous coronary artery dissection are the most common culprits.
Heart disease during and after pregnancy can be scary. At WomenHeart, our Champions have created a safe space to navigate the uncertainty and challenges of living as a woman with a heart condition. Click here to find peer support.
Access to health insurance
Access to timely, affordable care is critical for women’s health. Unfortunately, women of color, women with low income, and women without American citizenship are less likely to have insurance.
A study by Kaiser Family Foundation reports that 23% of American Indian and Alaska Native women are uninsured, followed closely by Hispanic women at 22%, Black women and Native Hawaiian or Other Pacific Islander women with 12% each. A stark comparison to 7% of white women who are uninsured.
Furthermore, a previous study shows that women of color who are under 65 years old are more likely to rely on Medicaid and other public health insurance than white women in the same age bracket, with 75% of white women having private insurance, second only to Asian women’s 78%.
These disparities can increase the risk of delays in diagnosis and treatment, as people with no insurance are more likely to forego preventive services and postpone seeking medical attention due to its high costs.
We commonly think of cancer as the leading cause of death for women. But across women of all races, heart disease is the number one killer. By race, heart disease is the leading cause of death for white and Black women and tied with cancer as the leading cause for American Indian and Alaska Native women. Hispanic and Asian or Pacific Islander women are the only group for which heart disease is not in the first place.
Other common conditions, like high blood pressure, increase the likelihood of suffering from heart disease and stroke. They also make disparities even more noticeable. More than half of black women live with hypertension, and up to 80% of black adults living with this condition aren’t able to manage it.
Typically, society considers heart disease a “man’s problem.” This stereotypical thinking prevents women from getting life-saving treatment. But anyone can experience heart disease. Our Champions are a diverse group of women who’ve learned to thrive in the aftermath of anything from heart attacks to heart transplants.
Type 2 diabetes is a condition in which the body is unable to process sugar effectively either because it doesn’t produce enough insulin or because it resists it.
We now know that type 2 diabetes manifests itself in adulthood, with risk factors that include being overweight or obese, having a family history, leading a sedentary lifestyle, and having high levels of triglycerides. Additional risk factors for women include having gestational diabetes during pregnancy or polycystic ovary syndrome (PCOS). Aspects like nutrition and physical activity play a vital role in developing diabetes and, unfortunately, people experiencing food insecurity, living in remote or rural areas, and those with a low household income are more likely to face these risk factors, whether individually or combined.
We also know that Black, Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander women are more likely than white women to have diabetes and that having diabetes increases the risk of heart disease.
Race and Gender Play a Big Role in Access to Timely, Quality Health Care
Women, in general, have been neglected by the medical system at large. Women of all races face discrimination and delayed diagnoses that can be deathly. Whether it is out of fear, discrimination, a lack of resources, or distrust in the medical system, delayed or missed diagnoses greatly impact women’s health outcomes.
As a result, women — and women of color — have to advocate harder to get life-saving tests done in emergency situations. You’ve likely heard about Serena Williams’ birth complications, but did you know that she had to demand a CAT scan to find the blood clots that could have killed her? Her story is a harrowing tale of a woman being talked down to by medical professionals in a life-threatening situation. Check out other womens’ stories of missed and delayed diagnosis of heart disease.
As a woman, you need a thorough understanding of your risk factors, including family history, the diseases or conditions you may be prone to based on your race and age, and your lifestyle. At the same time, we must work harder to educate and provide the research and tools needed for the medical community so they fully understand women’s heart health and can adequately address bias and the impact of social determinants of health and systemic racism on women’s health.
At WomenHeart, we’ve designed a resource center to help you educate yourself and make informed decisions about your health. Explore the WomenHeart resources here.