despair and disparities.

“Lord I have seen your goodness and I know the way You are.  Give me eyes to see you in the dark.” – Christy Nockels, Revive Me.

Those words have haunted me today.

About 1/3 of women in this country are a member of a racial or ethnic minority group. Healthcare providers have become increasingly aware of disparities in access to care as well as health care outcomes for women who belong to these minority groups. Our job as care providers is two fold.  One, we should appropriately document a patient’s race/ethnicity so that information collected on healthcare issues for these women is accurate.  Second, we should attempt, collectively, to identify and address factors that contribute to these differences.  We cannot fix what we fail to recognize.   Black women have an increased risk of stillbirth and preterm birth. Native American women are less likely to receive prenatal care in the first trimester.  Despite having an equal or lower rate of breast cancer, black women are more likely to die from their disease. Minority women are more likely to report their health as poor and less likely to have health insurance coverage.  These women are less likely to get their mammogram or Pap test at the recommended interval and a quarter report having no personal physician.

Disparities in health vary among each state. However, in those states where there are fewer disparities it is most likely because both white AND minority women are in poor health and have less access to healthcare resources.  We must recognize that there are many barriers to good health for minorities, especially women of color. Poverty, lack of education, gender wage gap and single parent households all contribute to poor health. Health disparities are not simple problems to solve and they are not simple to correct. And the truth is there is not a set of winners and losers in healthcare.  When we fail to correct these healthcare disparities, healthcare costs for all increase and our overall health as a community suffers. More than those reasons above I think we should all be concerned when the most vulnerable among us aren’t being made whole.  If you have worked in healthcare long enough you will encounter the despair in these disparities.  You will feel the despair when one of your patients, who happens to be a woman of color, dies from her cancer.  You will ache with despair when a minority woman presents to your office after the death of her infant.  You will notice the ones that don’t come for many of their doctors visits.

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In the light we see all the good that screening programs and medications and preventative services do. In the light we see all our good outcomes and lives saved and people helped. But in the dark spaces are where the disparities hide. In the dark is where, unless we look closely and carefully and with serious intent, we will miss the most vulnerable among us. We will fail to recognize the despair that awaits if we continue to ignore the women of color that are daughters, sisters, mother and patients just like we are. In the dark is where we need eyes to see, ears to hear and feet to move towards better health for all individuals regardless of race, ethnicity, gender or socioeconomic status. Give us eyes to see.

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Author: gynecologyandtheology

Academic OBGYN. Married to a theologian. Thoughts and words are based on research as well as my opinion. Enjoy.

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