The Sexual Health Gap: How Women's Health in Black Communities Has Been Compromised

by Dionne Dyches

The sexual health of black women, and black people in general, has been compromised due to a long history of inequality. Sexual health education has been inadequate, and access to proper care has been lacking. Black women still have the highest rates of sexually transmitted infections compared to white women. And regardless of socioeconomic factors — such as income or education —  black women die or get injured from pregnancy-related complications at least three times more often than white women.

Racial injustices and discriminatory practices, as well as socioeconomic factors, have all contributed to this gap in sexual health education and healthcare for black communities. However, empowered with the right information, we can steadily work to close it.

Appropriate Sex Education
Knowledge is power, but sex education in the United States has long been considered insufficient and unequally dispensed. For black women and members of the black community, when this information is withheld or takes a shame-based approach, it can result in a higher rate of teen pregnancy and STIs

And because most clinical studies view black women through the same lens, (i.e., as one massive group with few distinctions among the study subjects), factors such as socioeconomic status, psychological stress, and other complexities typically are not considered when evaluating the sexual behavior of young black women. The result is information that does not resonate, nor is it paired with educational programs, resources and treatments that are targeted and meaningful for this audience. 

Racism and Social Factors
Numerous incidences of discrimination in healthcare have plagued black women since slavery, and these practices continued throughout the Civil Rights Era. One study analyzed how these historical instances of racism still impact sexual and reproductive outcomes today, and researchers found that African American women are more vulnerable because of how institutionalized racism has affected their access to and quality of care, from dictating where they can live to their employment opportunities. 

Social factors like poverty, joblessness and limited education contribute to the sexual health gap and make it more difficult for black women to have healthy sexual outcomes and attitudes. Racism is a fundamental cause. Many black people have historically been denied access to educational opportunities that would lead to higher paying jobs, housing in better areas and the financial means to seek the best doctors and healthcare. Racism has affected the way practitioners interact with women of color and even their decisions about whether to pursue the best treatment versus the bare minimum.

Underrepresentation in Research
The COVID-19 pandemic has emphasized the need to improve the underrepresentation of black people in clinical research trials. With the disparate impact on black people, Hispanics and low-income populations, the need for research targeted to minority populations is paramount to finding the right treatment for many diseases that impact black people at disproportionate rates. For example, black women are significantly more impacted by uterine fibroids than women of other ethnicities. Yet, they make up only 15% of the clinical trial participants. In another example, most of the trials for FDA-approved cancer drugs included less than 5% of black people, even though black people in the United States have the highest incidences of death and the shortest survival rates for most types of cancer.

Making Change
Although not an easy task, a coordinated effort can bring about change to close the gaps in healthcare disparities between black women and other races. To equalize the playing field, scholarly work must focus on addressing black women and their unique health histories and sexual health, taking the cultural, genetic and social differences under consideration so that studies truly reflect this group. Black women comprise a multifaceted group that can’t be medically lumped together as a unit — change will come when that is recognized by all communities.

Yes, black women should be empowered to ask questions when seeking medical treatment or guidance, and they should speak out to counteract any racism or exclusion when it presents itself.  But eliminating discrimination in healthcare, combatting racism and improving the sexual and reproductive health for black women (and the black community as a whole) is everyone’s responsibility. 

Dionne Dyches, MS, is a communications professional and writer specializing in the healthcare, hospital and pharmaceuticals industry. Her niche includes internal communications, crisis communications, corporate communications, market research, management and business development.


References

  1. https://www.shankerinstitute.org/blog/lets-talk-about-sex
  2. https://muse.jhu.edu/article/565537/pdf
  3. https://www.endofound.org/the-disparities-in-healthcare-for-black-women
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167003/
  5. https://www.statnews.com/2020/07/22/clinical-trials-include-more-black-and-other-minority-participants
  6. https://www.researchgate.net/publication/303552704_The_Impact_of_Racism_on_the_Sexual_and_Reproductive_Health_of_African_American_Women
  7. https://www.aafp.org/news/blogs/leadervoices/entry/20181204lv-clinicaltrials.html

 

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