Dismantling Stereotypes + 9 Advocacy Strategies for Black Patients
Dismantling Stereotypes
When I took my first class as an education major at Old Dominion University, I had a white, female professor that spent a good portion of the semester dismantling stereotypes about different races. She had spent her first year as an educator in inner city Chicago and had encountered so many culturally specific things about Black people that she had never been exposed to.
By the time she was my professor, she had been a teacher for many years over and she had really taken the time to try to make sense of what she had seen. For each presentation she gave, she would share several slides about a given race and she would discuss the historical background of the stereotype.
What she did next is what I appreciated back then and even more so in hindsight. For every stereotype, she focused on why the perceived behavior was a positive aspect or characteristic of the culture she was discussing.
The specific example I recall was that “Black children are more likely to talk out of turn in a classroom setting.” She went on to describe having Black students who would often blurt out, albeit the right answer, but out of turn. She was initially confused by the behavior, but instead of making a judgment about it, she used it as a learning opportunity. Shedding a positive light on the behavior, she described that Black people are communal and the way we communicate is very expressive and often vastly different than how white people interact.
Much of the Black experience is about storytelling and communicating shared experiences, and as my professor taught, I thought about how in my own family, all of our gatherings are loud, expressive and there are no “turns.” If you have something to say, you get in where you fit in or you just won’t be heard.
Now imagine growing up in a family like this, and then suddenly when you get to grade school, you’re regularly receiving harsh discipline for communicating in the only way you know and have ever seen.
Even in my personal experience as an adult in corporate America, I perceive that White colleagues impose a culture of compliance that is often subjective, and when Black colleagues in particular don’t abide, they perceive them to be difficult, noncompliant, or in opposition.
In these instances with educators or coworkers, what if instead of perceiving someone else’s behavior as wrong and projecting their own ideas and beliefs on them, they just regarded the behaviors as different?
Not wrong—just different.
What Does This Experience Look Like in Healthcare?
In healthcare scenarios, the ideas of “wrong” or “failure to comply” often translate to victim-blaming Black patients. Medical visits end up requiring more effort from the patient to receive information, services, and resources, rather than providers just meeting them where they are and recognizing that they are not wrong or at fault—just different.
Consider what we know about Black people and clinical trials. Data shows that eligibility criteria differentially exclude Black patients from participating in clinical trials. An article published by the National Library of Medicine reports that physician bias and false perceptions account for a lower number of minority participants in trials.
How about another example?
Body Mass Index (BMI) is still widely used as a primary indicator of health; however, BMI does not take variation in body composition into account. When patients visit a provider for a range of symptoms and issues and exhibit a higher BMI, they are encouraged to “just lose weight” as an end-all-be-all treatment, putting all of the onus on the patient to solve for their own health issues.
The National Institutes of Health found that healthcare providers were less likely to identify pain in the facial expressions of Black faces than on the countenances of non-Black ones. Studies also showed that Black women report lower levels of satisfaction with their healthcare experiences compared to white women, citing feelings of disrespect and mistreatment.
What about other common stereotypes?
Biological Differences: Some healthcare professionals erroneously believe that Black individuals have biological differences that affect their health, such as thicker skin, higher pain tolerance, or different metabolic rates.
Socioeconomic Factors: Stereotypes often link Black patients to poverty, lack of education, and unhealthy lifestyles. These assumptions can lead to discriminatory treatment and a failure to address the root causes of health disparities.
Drug-Seeking Behavior: A harmful stereotype portrays Black patients as more likely to seek prescription drugs for nonmedical reasons.
Aggression or Hostility: Some healthcare professionals may harbor stereotypes that associate Black patients with aggression or hostility, leading to avoidant behavior from providers and patients with unresolved health issues.
The Harm of Stereotypes
With stereotypes, there is no room for personalized treatment approaches because there are blinders that prevent some providers from seeing individual humanity as opposed to generic and preconceived ideas. Stereotypes, often rooted in historical and cultural biases, can lead to:
Implicit Bias: Healthcare providers unconsciously associate negative stereotypes with Black patients, leading to biased perceptions and treatment decisions.
Discrimination: Black patients may experience discrimination in various forms, including unequal access to care, limited information, and substandard treatment.
Mistrust: Historical and ongoing experiences of racism in healthcare can erode trust between Black patients and healthcare providers, making it difficult to establish effective therapeutic relationships.
Public Health Can Emphasize Advocacy Strategies for Black Patients
These harmful stereotypes are rooted in longstanding biases that have been societally upheld for so long that we know systemic revolution won’t happen over night. For this reason, I see the role of public health as a platform of empowerment for patients. Yes, we can speak to providers and encourage cultural humility, but we can also mobilize communities with messaging that teaches them to speak up for themselves when it may be a matter of life and death. Advocacy strategies don’t necessarily put the onus on patients but rather gives them a voice where they otherwise may not have one.
What Are The Nine Strategies?
Understand your rights: Learn about your rights as a patient, including the right to informed consent, access to medical records, and the right to seek a second opinion. Just because a doctor says something, that doesn’t make it true for everyone or absolute. If they are recommending a procedure or treatment, you can ask them to explain it in full verbally and in writing. If you know that your body still does not feel right and your health issue has not been resolved after your visit, you are allowed to find another provider.
Research your condition: If you’ve been given a diagnosis, gather information about your health condition on your own, including treatment options, potential side effects, and the latest research. Again, you don’t have to just accept what a provider tells you at face value.
Build relationships with healthcare providers: Find a provider who actually listens to you. Listen to your gut. You know when you feel seen and heard, and the doctor’s office should be a safe space. If you are feeling mistreated, seek out a different healthcare provider who is culturally competent and willing to listen to your concerns.
Ask questions: There are no stupid questions at the doctor’s office. They are there to answer your questions and should provide the transparency and information you need to feel safe and make informed decisions.
Keep a medical journal: Record your symptoms, treatments, and interactions with healthcare providers. This can be helpful when discussing your care with others or seeking a second opinion.
Document discriminatory experiences: If you experience discrimination or bias, keep a record of the incident as evidence should your issue remain unresolved or you need to file a complaint. If you believe you have been discriminated against or received substandard care, you can file a complaint with your healthcare provider's organization or a regulatory agency.
Find an advocate: Consider finding an advocate, such as a family member, friend, or healthcare advocate, who can accompany you to appointments and help you navigate the healthcare system.
Talk about it: Depending on your level of comfort sharing your health issues, it can be helpful to talk with family and friends about what’s going on. You may find that someone else has experienced what you’re experiencing or is aware of resources that can be useful to you as you navigate the healthcare system.
Advocate for yourself: If you are not satisfied with your care, you can say that. Don't be afraid to express concerns to your healthcare provider.
