The Reasons Behind Negative Healthcare Outcomes of Black Women

Hello everyone! This article is a little different to what you’ve had from me in the past. But stay with me!

As you’ve probably picked up from my blog posts so far, I love medicine and I love science a lot. Writing these patient-facing posts has been a breath of fresh air over the last couple of months. That being said, I am also very much a nerd, and I feel like I have been neglecting some of my research-heavy skills by not exploring more of what is new to me. Therefore, I have introduced a new section to the blog called “For my Scientists”. This section is for my scientific and research-heavy writing, for those who are interested in learning more niche topics in medicine and science. The writing style will be a little different, and the jargon will be more technical, so please be aware. 

This blog entry is a heavy one for me. It addresses a serious issue that has received a lot of public attention recently – the healthcare outcomes of Black Women. Headlines such as “Black women are more likely to die in childbirth than any other race or group of people in the population” (Knight et al, 2022; UK Parliament, 2023) are both alarming and disheartening. Despite advances in medical knowledge and technology, these disparities persist. This raises pressing questions: Why does this continue, and why have there not been appropriate interventions put in place to reduce this?

Unfortunately, the negative health outcomes are not restricted to complications during childbirth. For instance, incidence rates of certain cancers, such as cervical cancer, are significantly higher amongst Black women also (Washington and Randall, 2022). Furthermore, studies demonstrate that survival rates following cancer diagnoses are lower, with women in this group being 10% less likely to survive beyond five years (Siegel et al, 2021).

The contributing factors to these disparities can be generally summarised into the following 3 points:

• Racism in healthcare: Research suggests that concerns raised by Black women are often overlooked or minimised. This contributes to unequal treatment and worse outcomes compared to other demographic groups (Douglas, 1992; Washington and Randall, 2022).
• Insufficient medical knowledge and limited representation in research: There is a lack of research and medical education addressing how diseases present in Black populations. Consequently, clinicians may fail to recognise symptoms or may misinterpret them, leading to delayed or inaccurate diagnoses.
• Higher prevalence of pre-existing risk factors in Black populations: Conditions such as hypertension, pre-eclampsia, and uterine fibroids are more common in Black women and present serious risks during pregnancy and childbirth (Harpar et al, 2007).

Understanding how these factors relate and contribute to the adverse care of black women is essential for improving health outcomes and ensuring equitable care.

Racism in Healthcare and Its Direct Impact

Marginalisation and racism in health are serious contributing factors that have been well-documented. Studies show that although black women are seeking medical care, they are often faced with perceived discrimination, which reduces the quality of treatment they receive (Washington and Randall, 2022). For example, a study by Washington and Randall (2022) found that among 48 African-American women surveyed:

• 63% reported being treated with less courtesy most of the time or always,
• 65% reported being treated with less respect,
• 68% reported poorer service, and
• 54% reported not being listened to.

Similarly, Chambers et al (2022) reported that healthcare professionals themselves acknowledged that racism directly influences both the quality and frequency of care provided during pregnancy, childbirth, and the postpartum period. Some clinicians even reported that they feel Black women “inappropriately utilise healthcare – either too frequently or not enough”, leading to their concerns often being dismissed. A UK Parliament Report (2023) further confirms that both overt and covert racism play a significant role in limiting access to treatment and reducing the quality of care received.

Although many studies highlight the role of discrimination, there is inconsistency in how “racism” is defined across studies, making data difficult to standardise and reproduce (Hamad et al, 2022). Nevertheless, the consistency of reported experiences indicates that racism is a substantial barrier to appropriate care and must be addressed urgently.

Insufficient Medical Knowledge and Limited Representation in Research

Not all the disparities in healthcare can be attributed solely to racism. A major issue also lies in the lack of medical research that adequately includes diverse racial groups (Esegbona-Adeigbe, 2023; Redwood and Gill, 2013). Oakley et al (2003) demonstrate that when study populations are representative, outcomes differ significantly, reducing population bias and allowing for more accurate conclusions and developments (Redwood and Gill, 2013).

Research is essential for many reasons in healthcare. Most importantly, it helps to develop knowledge, which leads to more tailored care and resources. By not including Black women in mainstream research, medical guidelines, resources, and interventions often fail to meet their needs (UK Parliament, 2023; Redwood and Gill, 2013). This creates barriers to access, fosters mistrust, and leaves patients feeling unseen or misunderstood.

This gap in representation in research also contributes to misdiagnosis (Baker, Buchanan and Spencer, 2010). Studies show that women and racial or ethnic minorities are 20–30% more likely to be misdiagnosed than white men (Szabo, 2024). Cardiomyopathy, for example, is frequently misdiagnosed in Black women, despite being the leading cause of maternal death within one week postpartum (Katella, 2023). Until medical training emphasises how conditions manifest across diverse populations, these diagnostic disparities will persist.

Increased Risk of Pregnancy-Related Complications

Biological predispositions and environmental factors are also significant factors that are at play in the poor outcomes. Research indicates that Black women are at greater risk of developing breast cancer, cervical cancer and sickle cell disease (Phillips, 2017). Additionally, higher rates of hypertension contribute to increased risk of pre-eclampsia in pregnancy (The Guardian, 2024). Conditions such as diabetes, fibroids, and anaemia are also more prevalent in Black women, further elevating risks during pregnancy and childbirth. These underlying vulnerabilities significantly contribute to increased morbidity and mortality in maternal health.

Although this entry is not an exhaustive analysis of the disparities faced, it highlights the key contributing factors: systemic racism, insufficient medical representation, and genetic and biological predispositions. While racism undoubtedly plays a role, other structural and biological contributors must also be acknowledged and tackled.

To achieve better outcomes, there is a need for:

• Greater inclusion of diverse populations in medical research,
• Improved education and training for healthcare professionals, and
• Proactive lifestyle and preventive health measures within affected communities.

Through systemic change and collective effort, it is possible to reduce healthcare inequities and improve the overall health of Black women.

I hope you enjoyed reading this entry! If you have any questions or if you would like to add your own input, please leave a comment below!

References:

Baker, T.A., Buchanan, N.T., Spencer, T.R. (2010) ‘Commentary: disparities and social inequities: is the health of African American women still in peril?’ Ethnicity and Disease. 20(3), pp. 304-309.

Chambers, B.D., Taylor, B., Nelson, T., Harrison, J., Bell, A., O’Leary, A., Arega, H.A., Hashemi, S., McKenzie-Sampson, S., Scott, K.A., Raine-Bennett, T., Jackson, A.V., Kuppermann, M., McLemore, M.R. (2022) ‘Clinicians’ Perspectives on Racism and Black Women’s Maternal Health’, Women’s Health Reports. 3(1), pp. 476-482.

Douglas, J. (1992) ‘Black women’s health matters: putting black women on the research agenda’, Women’s Health Matters. London: Routledge. pp. 45-60.

Esegbona-Adeigbe, S. (2023) ‘Under-representation of Black women in UK research’, MIDIRS Midwifery Digest. 33(4), pp. 306-308.

Hamed, S., Bradby, H., Ahlberg, B.M., Thapar-Bjokert, S. (2022) ‘Racism in healthcare: a scoping review’ BMC Public Health. 22 (988).

Harpar, M., Dugan, E., Espeland, M., Martinez-Borges, A., McQuellan, C. (2007) ‘Why African-american women are at greater risk for pregnancy-related death’ Annals of Epidemiology. 17(3), pp. 180-185.

Katella, K. (2023) Maternal mortality is on the rise: 8 things to know. Available at: https://www.yalemedicine.org/news/maternal-mortality-on-the-rise (Accessed: 26 September 2025).

Knight, M., Bunch, K., Patel, R., Shakespeare, J., Kotnis, R., Kenyon, S., Kurinczuk, J.J. (2022) Lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2018-20. Available at: https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2022/MBRRACE-UK_Maternal_MAIN_Report_2022_UPDATE.pdf (Accessed: 26 September 2025).

Oakley, A., Wiggins, M., Turner, H., Rajan, L., Barker, M. (2003) ‘Including culturally diverse samples in health research: a case study of an urban trial of social support’, Ethnicity and Health. 8(1), pp. 29-39.

Phillips, A. (2017) Health conditions that disproportionately affect black women. Available at: https://meyercancer.weill.cornell.edu/news/2017-03-30/health-conditions-disproportionately-affect-black-women (Accessed: 26 September 2025).

Redwood, S., Gill, P. (2013) ‘Under-representation of minority ethnic groups in research-call in action’ British Journal of General Practice. 63(612), pp. 342-343.

Siegel, R., Miller, K., Fuchs, H., Jemal, A. (2021) ‘Cancer Statistics, 2021’, CA: A Cancer Journal for Clinicians. 71(1), pp. 7-33.

Szabo, L. (2024) Women and minorities beat the brunt of medical misdiagnosis. Available at: https://kffhealthnews.org/news/article/medical-misdiagnosis-women-minorities-health-care-bias/ (Accessed: 26 September 2025).

The Guardian (2024) Black women in england suffer more serious birth complications, analysis finds.Available at: https://www.theguardian.com/society/2024/apr/08/black-women-in-england-suffer-more-serious-birth-complications-analysis-finds (Accessed: 26 September 2025).

UK Parliament, Women and Equalities Committee (2023) Black maternal health. Available at: https://publications.parliament.uk/pa/cm5803/cmselect/cmwomeq/94/report.html#heading-1 (Accessed: 26 September 2025).

Washington, A., Randall J. (2022) ‘“We’re not taken seriously”: describing the experiences of perceived discrimination in medical settings for black women’, Journal of Racial and Ethnic Health Disparities. 10(2), pp. 883-891.