Medically Approved

5 racial inequalities that persist in health care

African American woman sitting in doctor's office

Black Americans are at greater risk for worse health outcomes from cancer, stroke and other serious conditions. Here’s why — and what can be done about it.

Kim Robinson

By Kim Robinson

Improving the quality of health care is a key goal of the U.S. government. And we’re making strides in that direction. For one, more people have health insurance. This can help boost access and bring down the cost of services people need most.

But a grim fact persists: Simply being born Black is tied to a higher risk of worse health outcomes.

Why? The reasons are varied and intertwined, says Valinda Nwadike, MD. She’s an ob-gyn at Luminis Health Anne Arundel Medical Center in Maryland.

“That includes poor treatment options, as well as poor access to health care,” Dr. Nwadike says. “Racial discrimination, bias in treatment, a historical mistrust of African Americans and the [bad] relationship to health care providers are also factors.”

Even with factors such as income and health insurance being equal, Black Americans can suffer because of implicit or unconscious bias. In recent years, more attention has been paid to these race-based disparities, says Girardin Jean-Louis, PhD. He’s a professor of population health and psychiatry at NYU Grossman School of Medicine in New York City. “But even more focus and funding are needed.”

A common culprit in many disparities is access. If you’re having trouble affording your prescription medications or seeing a health care provider, we may be able to help. Search for free medication coupons here (you could save up to 80%) and explore our virtual providers here.

In the meantime, if you’re a Black American, here are some of the health disparities you should know about and what you can do to protect yourself and your loved ones.

1. Black Americans are twice as likely to get Alzheimer’s or other dementias

Not only are Black Americans more likely to develop dementia, they’re “less likely to have a diagnosis of their condition, resulting in less time for treatment and planning,” says Carl V. Hill. He’s the chief diversity, equity and inclusion officer for the Alzheimer’s Association.

Living conditions can also up your risk. “If the air quality is poor, or noise or light pollution is common, the rate of dementia is much higher,” Jean-Louis says. “Black people tend to reside in places where there’s more noise. Other risk factors are poor nutrition, poor exercise and shift work.

What you can do: Try to be open with your health care provider about any worrisome changes in your health. And help others do the same.

According to the Alzheimer’s Association, the early warning signs of dementia include:

  • Memory loss that disrupts daily life
  • Trouble following plans such as family recipes
  • Difficulty doing daily tasks
  • Misplacing things
  • Changes in speech or personality
  • Poor judgment

Staying active in your community and taking care of your heart health can help reduce your risk of dementia, too.

2. Black women are 3 times more likely to die from a pregnancy-related cause than white women

Every year, about 700 women in the U.S. die during pregnancy, according to the Centers for Disease Control and Prevention (CDC). Tragically, 2 in 3 of those deaths are preventable and many more of them occur in Black women.

“It’s important to be clear that a growing body of research shows that racism affects the health of Black mothers and infants in this country,” says Neel Shah, MD. He’s an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and co-founder of the nonprofit March for Moms.

“Black patients’ reports of pain are often discounted or ignored,” Dr. Shah says. “Black mothers are more likely to report feeling a loss of bodily autonomy during their prenatal care and being pressured to undergo a C-section. And that increases the risk of hemorrhage and other serious complications.”

What you can do: Bringing up racism to a health care professional can naturally be uncomfortable. So Dr. Shah encourages patients to have a support person — a family member, friend or doula — with them during medical appointments. “Most importantly, I tell patients that they are the expert in their pregnancy,” he says.

It’s also helpful to be aware of the biggest signs of potential pregnancy problems. According to the CDC, these include:

  • Severe headache
  • Severe belly pain
  • Nausea and vomiting
  • Extreme swelling of the hands or face
  • Trouble breathing
  • Heavy vaginal bleeding or discharge
  • Overwhelming tiredness

3. Black Americans are 50% more likely to have a stroke than white Americans

Black Americans have the highest rate of stroke, and death from stroke, of any race. Some of that is because 75% of Black Americans have at least 1 risk factor for stroke. According to the American Heart Association (AHA), this includes high blood pressure, obesity, diabetes, smoking and sickle cell anemia.

Learn more about the connection between race and high blood pressure.

What you can do: Take care of yourself as best you can. Some of the risk factors for stroke are out of your control. These include your age, gender and family medical history. But up to 80% of strokes can be prevented by managing chronic conditions and prioritizing self-care, according to the AHA.

Lifestyle changes aren’t easy, or even feasible for some. Yet even 1 step each day can add up when it comes to health. Ways you can reduce your risk of stroke include:

  • Eating more fruits and vegetables
  • Reducing salt in your diet
  • Working more movement into your day
  • Quitting smoking
  • Losing excess weight
  • Managing stress

If you’re ready to make healthy eating changes, this diet can help protect your heart.

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4. Black Americans are 20% more likely to get colon cancer and 40% more likely to die from it

Black Americans have the highest rates of colon cancer among all races and ethnicities, according to the American Cancer Society (ACS).

A combination of factors is at play. They include less access to cancer detection and screening, eating a diet lower in fiber (i.e., not enough plant foods), and a higher level of mutation in a specific gene called KRAS, which may increase cancer growth.

What you can do: Get your screenings on time — and encourage others to do the same. The ACS recommends that people of average risk start screening for colorectal cancer at age 45. People who have certain risk factors might need to start screenings earlier. These include a personal or family history of colorectal cancer or an inflammatory bowel disease.

(Did you know that some colon cancer screening tests can be done at home?)

You can also be on the lookout for early warning signs of colon cancer. According to the ACS, these include changes in your bowel habits, rectal bleeding, blood in your stool or unexplained weight loss.

5. Five years after a melanoma diagnosis, 66% of non-Hispanic Blacks were still alive, compared with 90% of non-Hispanic whites

Rates of skin cancer are highest in non-Hispanic whites (and are quickly rising in the Hispanic population). But Black Americans have lower survival rates from skin cancer.

A few reasons may be behind this. One is that the most common kind of skin cancer diagnosed in Black Americans has a lower survival rate than other types of skin cancer, according to the ACS. It’s called acral lentiginous melanoma (ALM). It makes up 46% of melanoma diagnoses in Black people, compared with 2% for white people.

Another major concern with ALM is that it tends to show up in hard-to-spot areas such as nails, palms or soles of the feet. Because of this, they are often diagnosed later, when they’re harder to treat, according to the ACS. (This is what it’s like to live with melanoma.)

What you can do: Check your skin and nails regularly for any new moles, spots or streaks. ALMs tend to be dark spots of skin that differ from your normal skin color. They may look like a bruise or stain, but they can grow and change over time.

To help prevent skin cancer, the American Academy of Dermatology also recommends:

  • Seeking shade whenever possible
  • Wearing sun-protective clothing and sunscreen
  • Doing monthly self-checks and seeing a dermatologist if you notice anything out of the ordinary

You are the expert on you. If something feels off, you deserve to be heard and taken care of — no matter where you come from or the color of your skin. Lean on your support system and the resources you trust and you can help reverse the tide.

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Additional sources
Early warning signs of dementia:
Alzheimer’s Association
Pregnancy outcome statistics: Centers for Disease Control and Prevention
Urgent pregnancy warning signs: Centers for Disease Control and Prevention
How Black Americans are impacted by stroke: American Heart Association
Colorectal cancer statistics: American Cancer Society
Skin-cancer survival rates for Blacks and whites: American Cancer Society
How to protect yourself from skin cancer: American Academy of Dermatology