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Medical, Cultural
By Dianne Anderson
Doctors and medical practitioners of every category could learn a thing or two beyond their textbooks, starting with how to listen to their Black patients.
Somehow, their pain gets lost in translation.
Alicia Coulter sees part of the problem of why Black patients die disproportionately more in nearly top health conditions than white patients, and why Black women are three times more likely to die from a pregnancy-related cause than white women, has a lot to do with how providers communicate with Black patients.
She would like to see the same kind of help in the system as white women get when they go see their doctor.
“A lot of times a white woman knows her body. She’s smart enough to understand what she feels, but clearly as Black women, we don’t know our bodies,” said Coulter, CEO of Advantage Health Now, a Diversity, Equity, and Inclusion consulting firm.
Black women are not given the same courtesy of common care, she said.
Numerous legal and medical cases detail how Black women try to tell providers that they know something has gone wrong. It’s not just the pressure of the unborn’s head against the bladder, something doesn’t feel the same.
“The next thing you know blood is pouring from our bodies and now you’re taking us seriously? Why does it always have to get to crisis management with us?” said Coulter, MPH, MSW.
Recently, Coulter gave a talk at Long Beach City College, and also at the American Council of Physicians, about James Marion Sims, an American plantation gynecologist who performed torturous tests without anesthesia on enslaved Black women. The atrocity is compared to the Nuremberg experiments.
Coulter said it marks the origin of the systemic racism that continues in gynecology and obstetrics today.
“Think about it, a woman who has men holding her down. They are going to cut the baby out with the “father of gynecology” practicing the cesarean method on her body. She’s a slave. Can she scream if she’s in pain? Who’s going to rescue you? No one,” she said.
Coulter, who grew up in South Central Los Angeles, said her life mirrors the people that she now serves, understanding and sharing in the plight and struggle of Black people.
“[It’s] the fight we have to receive even basic services. I couldn’t help but get into this space professionally. I went to school and got my credentials so people would have to listen to what I have to say,” she said.
Compared to the early 90s, she believes the situation today is worse. Back then, at least they had food banks, they had Boys Market, they had resources. Today it’s all severely limited, and groceries stores are few and far between.
Gentrification adds a whole different layer, pushing Black people out of neighborhoods that they built and lived in, she said. Medical services remain scant in impacted areas, and the community overuses emergency rooms for lack of access to preventive care.
Few clinicians are available, or follow-up services with physicians. She said the wait time to see a doctor could be months.
“That could be the difference between life and death for those with chronic illnesses,” she said.
Mobile units may be an option, but there isn’t much confidence because of historic medical abuses. Some fear DNA database collections from the bloodwork. When the community goes for help, the questions are intrusive, and she said practitioners are not trained in cultural relevance as it applies to medicine in the community. They are disconnected from the demographic they claim to serve.
She teaches a Health Navigation Education Class at the Community Resource Center in Long Beach to open up conversations for the community on how to survive healthcare. AHN has received funding from the City of Long Beach and County of Los Angeles.
For ten years, Coulter has worked in health systems, and said the way Black patients are treated is deplorable, but she shares what she has seen to help others avoid potentially life-threatening healthcare.
So far, she counts her best accomplishment as securing funding through the state of California as a Black-serving organization.
“I can fill out an application and say this application is centered in Blackness, that’s the group we are serving with this funding. This year, the goal is to get funding to educate the practitioners on how to communicate effectively with Black people.”
She wants to reach doctors, nurses, dentists, physicians, to teach them how to serve the community. Her mission is to take some of the onus of healthcare off the people and put it on the academicians, physicians, practitioners and clinicians.
Among added economic pressures resulting from housing, discrimination, the impacted community is dealing with how to pay utilities, how to feed the family, and being called to jump through unnecessary hoops of the medical system, she said.
“On top of that – add you need to know how to talk to your doctor to get something done. I’m sorry, at what point does the doctor need to know how to talk to the patients to make sure they don’t die?” she said.
For more information, see https://advantagehealthnow.com/
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