Access to Medical and Mental Health Care for Black People: A Critical Conversation
- Alicia Hawley-Bernardez
- Feb 1
- 7 min read
Updated: Feb 27
February is Black History Month, a time to reflect on the contributions, struggles, and resilience of Black communities throughout history. It is also a time to raise awareness about ongoing disparities in various sectors, particularly in healthcare. Black people in the United States have historically faced significant barriers to accessing both medical and mental health care, leading to long-term consequences for their well-being. This blog post will explore these barriers, their impact on health outcomes, and the importance of addressing these issues to ensure equitable care.
Health Disparities in Medical Care: The Facts
Despite advancements in healthcare, Black Americans continue to experience poorer health outcomes compared to their White counterparts. Research from the U.S. Department of Health & Human Services (HHS) highlights several key issues:
Access to Care: Black people are more likely to experience inadequate access to healthcare services. For instance, 20% of Black adults report having no regular source of care, compared to just 10% of White adults. This lack of access contributes to delayed diagnoses, less effective treatments, and poorer health outcomes (U.S. Department of Health and Human Services, 2021).
Health Insurance: Health insurance is a critical factor in ensuring access to care. Black Americans are more likely to be uninsured compared to their White peers. In 2018, the uninsured rate among African Americans was 9.7%, compared to just 5.4% among White individuals (U.S. Census Bureau, 2019). This lack of insurance coverage directly correlates to lower rates of medical visits, fewer preventative screenings, and overall worse health outcomes.
Quality of Care: Even when Black patients have access to medical care, studies show they are less likely to receive the same quality of treatment as White patients. A 2020 study in the Journal of the American Medical Association found that Black patients were less likely to receive pain medication and were less likely to be offered life-saving procedures, such as surgeries or cardiac treatments, even when they presented with the same conditions as White patients.
These disparities contribute to significant gaps in health outcomes. For example, Black Americans have higher rates of chronic conditions like hypertension, diabetes, and heart disease, and lower life expectancy rates than their White counterparts (American Heart Association, 2022).
Mental Health Disparities: A Silent Crisis
Black Americans also face significant barriers in mental health care. Unfortunately, mental health services for Black individuals are often overlooked or misunderstood due to societal stigma, systemic racism, and cultural factors that shape how mental health is perceived and addressed.
Stigma and Cultural Perceptions: Mental health issues are often stigmatized within the Black community, leading to a reluctance to seek care. Historically, mental health has been seen as a sign of weakness or something that should be handled within the family or community, rather than by professionals. This cultural barrier contributes to the underdiagnosis of mental health conditions in Black people.
Barriers to Care: A study published in Psychiatric Services found that Black people are less likely to have access to mental health professionals who understand their cultural needs. This lack of cultural competence in treatment leads to feelings of alienation and can discourage individuals from seeking help. Furthermore, the underrepresentation of Black professionals in the mental health field means that Black patients may feel they are not being understood or properly treated.
Racial Trauma and Stress: Racial discrimination and microaggressions contribute to heightened levels of stress and trauma for Black individuals. Research has shown that chronic stress from racism and racial discrimination can lead to significant mental health challenges, including anxiety, depression, and post-traumatic stress disorder (PTSD) (Schouler-Ocak et al., 2021). This trauma is often unrecognized by mental health professionals, deepening the divide between care and treatment.
The Importance of Culturally Competent Care
Addressing these disparities requires more than just increasing access to care—it requires a commitment to providing culturally competent care. Cultural competence involves understanding the unique experiences, challenges, and needs of Black patients, and ensuring that treatment is tailored to those experiences. This includes:
Cultural Sensitivity Training: Health professionals must receive training to understand how race and cultural identity impact health and healthcare experiences. This training should be a standard part of medical and mental health education.
Increasing Representation: Increasing the number of Black healthcare providers, particularly in mental health, can help ensure that Black patients feel seen, heard, and understood. Representation in the healthcare field can also help combat biases and foster trust between patients and providers.
Addressing Systemic Racism: Ultimately, addressing the root causes of health disparities requires tackling the systemic racism embedded in healthcare institutions. This includes implementing policies that ensure equitable care, increasing access to insurance, and improving the overall healthcare system for marginalized groups.
What Can White Allies Do?
As much progress as we’ve made, the fight for health equity isn’t one that Black communities can tackle alone. White people, particularly those in positions of privilege, can and should take active roles in dismantling the systemic barriers that contribute to health disparities. Here are a few actions White allies can take:
Educate Yourself: Understanding the history and current realities of health disparities in Black communities is an important first step. Read articles, books, and studies on systemic racism in healthcare, and engage with diverse perspectives. A great starting point is the HHS Black History Month Reading List, as well as the references list at the end of this post.
Advocate for Change: Support policies that address health disparities, such as expanding access to health insurance, supporting mental health resources, and fighting for better representation in the medical and mental health fields.
Listen and Amplify Voices: Create space for Black voices to be heard in the conversation about healthcare. Listen to the lived experiences of Black people regarding healthcare access, discrimination, and care, and amplify their voices in discussions.
Support Black Professionals: Actively seek out and support Black healthcare providers, particularly in mental health. Ensuring a diverse range of providers can foster trust and a deeper understanding of cultural needs.
Challenge Bias and Racism: In both healthcare settings and everyday life, challenge and confront bias when you encounter it. Whether it’s implicit biases in medical care or racial microaggressions, speak up and work toward creating more equitable environments.
Moving Forward: What We Can Do
As we celebrate Black History Month, it’s important to remember that the fight for equity and justice extends to mental health care for black people. By advocating for policy changes, supporting community health initiatives, and promoting cultural competence in the healthcare field, we can work together to ensure that Black people have equal access to the medical and mental health care they deserve.
References
American Heart Association. (2022). 2022 Heart disease & stroke statistical update fact
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Artiga, S., Hill, L., & Presiado, M. (2024, February 22). How present-day health disparities for
Black people are linked to past policies and events. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/how-present-day-health-disparities-for-black-people-are-linked-to-past-policies-and-events/
Bailey, P., Broaduss, M., Gonzales, S., & Hayes, K. (2017, June 1). African American uninsured
rate dropped by more than a third under the Affordable Care Act: Repealing ACA and cutting Medicaid would undercut progress. Center on Budget and Policy Priorities. https://www.cbpp.org/research/health/african-american-uninsured-rate-dropped-by-more-than-a-third-under-affordable-care
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