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America's healthcare failed black men, but we still need to go to the doctor

By George M. Johnson

In October of 2007, my little brother Garrett walked into my father’s bedroom to find him laying on the bed, nearly incapacitated. Despite his raspy, labored breaths, my father had no sense of urgency to find out what was wrong with him. “Daddy, are you okay?” Garrett asked, to which my father responded “Yeah, I just don’t feel well.” The thing is, even if my dad wasn’t okay, he was not going to ask anyone for help. He certainly wasn’t going to go to the doctor himself. Thankfully, even my teenage brother knew this.

“Either I can take you, or I can call the ambulance, but you are going to the hospital,” Garrett told him. My father — seeing a look on my brother’s face that clearly meant he wasn’t taking no for an answer — agreed, and they went to the hospital. My father checked in, got examined, and ended up with a diagnosis of congestive heart failure — a result of a build-up of fluid around the heart which makes it pump ineffectively.

My father would be in that very hospital for nearly three weeks, missing my 21st birthday in the process. It was an important milestone to him. I remember seeing him in that hospital bed, upset that he let himself get that sick.

Unfortunately, he didn’t learn his lesson. In 2015, after letting another heart condition intensify, my father would need open-heart surgery. Thankfully, today he’s alive and a little more responsible about his health, but his mentality around healthcare is one that many Black men continue to hold strong.

Disparities in healthcare have been well-documented in this country, many of them based on discrimination and the dehumanization of Black bodies. During the past 400 years, Black Americans have been subject to some of the worst treatment from the health care system — we are America’s human lab rats. There are endless stories in fairly recent history about experimental medical procedures done on Black people, with or without anesthesia. Then there’s the Tuskegee Experiment, a 40-year study during which the US government studied untreated syphilis in black men in Alabama, cloaked in a promise of free healthcare, without disclosing their intentions to them or actually treating them. This, and instances like it, still have lasting effects (medical mistrust, for one) on the Black community. So Black men have valid reason to be wary of the medical community, even to their own detriment.

Courtesy of George M. Johnson

Post Traumatic Slave Syndrome, a term coined by author and social worker Joy DeGruy, touches on how Black Americans today are still dealing with the passed down trauma and ramifications of chattel slavery, which dates back to 1619. Although generational trauma is often hard to break, we have to take effort to address it in order to take back ownership of our health. There are already barriers in the healthcare industry that make it challenging for Black Americans of all genders to gain access, from unaffordable insurance to racial bias in pain management, so it’s important that we figure out how to control the things that we can. Black women face these struggles in different forms, from disproportionately high maternity mortality rates to being oversexualized and stereotyped in medical settings.

To gain a little more insight into our thick, palpable, centuries-bred fear of the mainstream medical world, I spoke with Frederick T. Joseph, a friend and activist. Although many may know him for his philanthropic work — a few years ago, he raised over a million dollars with his Black Panther Challenge and sent thousands of Black kids to see the movie — Joseph has been very public about living with Multiple Sclerosis and the challenges that come with the illness.

There are several instances when Joseph has placed his work before his health. “When I first got diagnosed with MS, I had symptoms for months and still didn’t go [to the doctor].” He charges his unwillingness to being “conditioned that way.” The tough-it-out mentality is nothing new for Black men when it comes to their own wellbeing. “I had this idea from my uncles, other family members, and from TV, that to be Black means you have to persevere and fight. The inability to do so is a sign of weakness.”

Joseph, who stands 6’3” with a muscular frame, also talks about how public perception plays a role in some of his decision making around how he talks about and deals with his health issues. Although he’s living with MS, he feels that people equate his physical appearance with an ability to handle anything, failing to consider his physical and emotional struggles.

Matthew Butler

“There are times I have flare-ups and can’t move, or I’m too weak to stand up in the shower,” Joseph says. “It’s a constant struggle of not seeming weak in the public eye, while having the expectation to always be ‘on.’”

So how do we begin to chip away at this pervasive problem? First, we might want to be more intentional about who’s caring for us. Research from 2018 showed that when Black male patients are provided services from Black male doctors, the outcomes are much more beneficial. Harvard Business Review reported about an experiment where researchers randomly assigned black male patients to Black or non-Black male doctors to see whether having a doctor of their race affected patients’ decisions about preventive care. They found that Black men seen by Black doctors agreed to more invasive, preventive services than those seen by non-Black doctors. This effect seemed to be driven by better communication and more trust.

There are a multitude of factors that can explain why Black men avoid the doctor, said David Malebranche, a Black California-based physician with an expertise in sexual health. “Obviously, racism, white supremacy, and how Black men are treated and mistreated in facilities makes us mistrust medical spaces and not access them even when we need them. [There are] cost issues, access, and transportation issues,” he says.

Malebranche also draws attention to the way men are socialized to suppress fear and pain. “Masculine socialization brainwashes us to think a real man doesn’t go to the doctor,” he says. “There’s also the fear of getting diagnosed with something bad.”

He explains that at times, there can also be a “let go and let God” mentality to deciding on treatment in the Black community. I’ve heard similar phrases used more times than I would like to admit — especially from older people in my family — when it comes to serious medical issues and conditions. Faith and religion have often been the backbone of Black American culture; with everything from physical ailments to clinical depression, praying is often a go-to remedy for pain. But there’s a real danger to discarding the function of an actual doctor.

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Malebranche also highlights the structural barriers embedded in health policies and the systemic issues that make it harder to navigate our healthcare system, something he works hard to change every day. In addition to seeing patients at his practice, he’s given lectures and hosted educational forums on the topic so that Black men can understand the healthcare system better. “My job is to provide Black men with a different experience. So when they see me there providing care and treating them like the gold that they are, they will realize that they’re worth quality medical care,” he says.

He also stresses the need for racial and cultural sensitivity training in graduate school and during doctors’ residencies, so healthcare professionals can put a mirror up to their faces and identify their own implicit biases in providing care. While there’s more attention being given now, to how minority patients are treated differently than their white counterparts, in training programs as well as in the media, there’s still a long way to go.

Overall, Malebranche feels that Black men who have chosen to prioritize their health by engaging with the medical system must lead by example. “We can talk all day, but until folks walk the walk it doesn’t matter,” he says.

We as Black men have to break the generational cycle of poorer health outcomes. This cycle though, can only be interrupted if we re-examine a system that’s consistently betrayed the Black community. Arming yourself with information and being a patient advocate for your loved ones is important. If you’re fearful about going to the doctor, bring someone you trust with you. There’s no need to feed into the myth that we have a higher tolerance for pain. If you aren’t feeling well and it seems serious, it probably is serious.

Take a vested interest in your day-to-day health needs. Don’t just go to the doctor when it’s an emergency. Find a doctor you actually like. Have yearly check-ins with your doctor, and better yet, foster open communication where you feel comfortable to ask questions when you are unsure of something. For me, this was the first step to breaking the cycle of harm we inflict on ourselves when we don’t take action around our health. It can be yours, too.