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Study: Black Americans adjust their behavior in health care settings

The study found one in four Black patients avoid health care settings for fears they will be treated unfairly.
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Many Black Americans modify their behavior just so they can receive adequate health care, according to a study from the California Health Care Foundation.

The study surveyed more than 3,000 Black men and women in California and found one in four Black patients avoid seeking health care for fear they will be treated unfairly or with disrespect. For those who follow through with a visit, a third said they change their behavior to put the provider at ease, whether that is tailoring their speech or becoming more deferential.

“The problem is the institution, not Black people,” said Dr. Michael LeNoir, the founder of the African American Wellness Project. “It’s how [the system] perceives Black people, how they treat them.”

In 2021, the Urban Institute published an analysis that found Black patients are much more likely to suffer problems related to surgical procedures than white patients. A study published in January by the Dana-Farber Cancer Institute found that older Black and Hispanic patients with advanced cancer were less likely to receive opioid medications for pain than white patients.

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LeNoir believes the issues need to be addressed so patients don't feel further undermined. 

“I think most of them are embarrassed,” he said. “You know, because they were treated like that and they accepted that simply because they were afraid it would affect outcomes. You know, make them mad, and they may not make the right decision or may not give you the kind of consideration that your problem requires.”

A 2021 UCLA study found the proportion of U.S. physicians who are Black is 5.4%, an increase of only 4 percentage points over the past 120 years. It is why LeNoir believes change will not come from those in charge, rather from those on the other end of the equation.

“I’m one of those people who do not believe this system will be handled from the top down,” said LeNoir. “We’ve handled people from 2000, 2005, 2010, 2020, and the situation with chronic disease and the gap between health of Black and Browns has not changed so I believe it has to happen from the bottom up.”

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