How to advocate for your health needs as Black woman
Health disparities are all around us, be that Black women are five times more likely to die in pregnancy in childbirth, Black and brown people are more likely to experience higher rates of cardiovascular disease and diabetes, or had higher mortality rates during the COVID-19 pandemic.
Within the skin health space, Black and minority communities also experience higher mortality rates from diseases like skin cancer due to much later diagnosis.
These things tell us that the healthcare system isn’t as equal as we would like it to be and discrimination, structural racism and unconscious bias are very real issues that can present at times when we are most vulnerable and in need of professional help.
Whilst you may not be a healthcare professional, I firmly believe that you know your body better than anyone else and health advocacy is as important a skill to learn as is swimming.
In this first instalment of our Get it Together series we’re giving you all the tea and tips to stand up tall and speak up in a healthcare setting. It can be the difference between life and death.
Appointment Agenda
Write out and organise all the things you want to discuss. Do this in order of importance so you can start with the most pressing issues. What is the ideal scenario and outcome of this appointment that you would like. Write these down so that you can inform the healthcare professional of the the minimum you want to walk away with.
Contextualise previous medical interactions
If you’ve had a poor experience in a medical setting previously, tell the new doctor. If you’re nervous or apprehensive, tell the new doctor so that are able to put you at ease and provide better support. If it helps for you to have a medical professional from a similar ethnic background, make this a priority when booking appointments.
We are raised to be compliant in medical settings, to not make a fuss or complain - to get on with things, especially as migrants, but I would say when it comes to matters of health, this is one piece of advice from the elders I am willing to ignore. Staying silent on issues like pain also negatively perpetuates the idea that Black bodies are more tolerant of pain and suffering.
It’s all in the detail
Keep a written and visual (if necessary) diary of any symptoms. Detail your activities surrounding the symptoms - whether it be your sleeping pattern; what you ate; how soon after you started feeling poorly; - you get the picture - anything that relates/could relate to your illness or discomfort, note it down. With skin concerns, take pictures at weekly or fortnightly intervals. Make a note of flare ups - did you just get your nails done, had you been using harsh domestic products for example.
Pro tip - create a folder on your phone for your images so they are all in one place and easy to recall. Don’t waste valuable appointment time to scroll through hundred of irrelevant images.
Paint a historical picture
When was your last blood test? What medications have you been taking or are on currently? What chronic illnesses run in your family? The women in my family are prone to high blood pressure so this is always something I disclose to doctors. If you’re advocating for children, it’s your job as much as possible to know about illness on both sides of their family tree.
Do you need a plus one or an interpreter?
Having a responsible and encouraging partner, friend or relative who can speak on your behalf if needed is always helpful, especially if the national language is not your first language. Discuss beforehand where you may need their support and agree how you will signal this to them. Whomever your plus one, make sure it’s someone you are also comfortable with asking to leave the room if you would like to have a sensitive discussion with your doctor.
Record your visit
Whilst most doctors won’t appreciate you plonking down a recorder in front of them, having a notebook to jot down important points is handy and indicates your seriousness in handling your health concerns.
Whilst you’re noting things down, it’s good to get in the habit of asking for your differential diagnosis. Many illnesses share similar symptoms, so your doctor will work on a process of elimination of various conditions to arrive at what they believe is the most likely cause your illness. All of this variety is called the differential diagnosis.
Seek clarification
If anything is confusing ask the healthcare professional to clarify in layman’s terms or direct you to any resources that will help your understanding. It’s also helpful to confirm your understanding by repeating what the doctor has explained but in your own words.
Remember that most appointments are in blocks of ten minutes, so if you have a long query or likely to have lots of questions, book a double appointment.
To maintain control, ask your healthcare professional what the expected next steps are, when you can expect a follow up and what to do if you need to access them sooner. Some doctors offer a phone call follow up either with themselves or a junior member of their team.
Discrimination in healthcare can make you feel inferior, gaslit and anxious. It’s a downright unsafe situation that places a worrisome burden on you as an already sick patient. All of these tips are designed to help you foster a positive and progressive relationship with your medical professional, but there are times when try as you may, it doesn’t click or the feeling of being dismissed sticks in your throat. So what do you do then?
Ask to speak to a different doctor for a second opinion. This is often the simplest and easiest way forward.
Secondly, find out the complaints procedure and work through the steps. Usually an informal conversation with the practice manager is a good starting point, but ultimately you reserve the right to take your complaint all the way up the professions overseeing body such as the General Medical Council or State Board.
Find a new healthcare practice. Healthcare services are not free, in the UK we pay via our taxes and in many other countries like the USA, it’s through personal insurance. Ultimately you’re spending your hard earned money and you are effectively a customer, so move on if you’re not getting the service you want.