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08:35  04 april  2021
08:35  04 april  2021 Source:   womenshealthmag.com

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It's no secret that racism is a public health issue. From racial trauma and post-traumatic slave syndrome to the impacts of microaggressive behavior, it exists in more spaces than you might think — including health care. In fact, Black and brown patients are more likely to die at early ages of all causes, regardless of socioeconomic status or geographical location, according to research conducted by the Centers for Disease Control (CDC).

a woman sitting on a bed: Getty Images © Provided by Shape Getty Images a woman sitting on a bed: Kimberly Wilson was tired of being dismissed by white doctors. She knew wasn't alone and founded HUED to connect BIPOC patients with culturally competent physicians of color. © Provided by Shape Kimberly Wilson was tired of being dismissed by white doctors. She knew wasn't alone and founded HUED to connect BIPOC patients with culturally competent physicians of color.

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African Americans are more likely to die of natural causes at any age and younger Black people are experiencing diseases and disorders that are most commonly diagnosed amongst the elderly, including diabetes, high blood pressure, and strokes, according to the CDC.

In an effort to address these health disparities, Kimberly Wilson created HUED, an online database that connects Black and Latinx patients with doctors of color. "The concept of HUED came from my own frustration," Wilson tells Shape. "I'm not a physician, a clinician and I don't have a health care background, but what really makes any founder a great founder is being part of the problem that you're trying to serve."

Wilson was diagnosed with uterine fibroids back in 2017 when she was living in New York City. ICYDK, uterine fibroids are typically benign growths that develop from the muscle tissue of the uterus. Some patients can be essentially asymptomatic, while others with uterine fibroids can experience severe pain.

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Wilson had more than 30 fibroids on her uterus, with the largest being "the size of a grapefruit," she says. She experienced frequent urination, constipation for weeks at a time, back and leg pain, and pelvic pressure, she added. "I had severe abdominal pain that would have me crouched on the floor, and nothing was able to help," Wilson told Shape.

Nearly two out of three women experience uterine fibroids by the age of 50, according to the University of Michigan Health Lab. Black women are three times more likely to be diagnosed with fibroids than white women, and they are also more likely to develop fibroids at an earlier age and experience more severe symptoms caused by larger and more fibroids.

During her own fibroid treatment, Wilson visited hospitals and consulted four different white male providers — and she wasn't satisfied with any of their care. Despite telling doctors her abdominal pain was so severe it kept her from getting out of bed, she was merely recommended an over-the-counter pain med. "If I'm coming to the doctor's office, it's clearly beyond taking some Advil," she says. "They either dismissed my pain and trauma altogether or stated that a hysterectomy was my only option," says Wilson.

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This permanent and invasive procedure involves surgically removing a person's uterus, and research and experts argue that it's overperformed in the U.S., especially for fibroids and especially for women of color. In fact, Black women are twice as likely as white women to undergo a hysterectomy.

Wilson was convinced that this could not be her only viable option to combat her fibroids.

"As a 30-year-old Black woman at the time, for somebody to tell me that I had to remove my uterus altogether and be prevented from ever having children was very traumatic," she recalls. "It wasn't until being referred to a Black physician in Baltimore, MD more than 200 miles away from home that I received the culturally competent care that I needed and deserved," explains Wilson. Luckily, she ultimately received the right treatment for her condition and symptoms but says her experience sheds light on the larger inequality problem in the health care system.


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"It was tone; it was language; it was dismissiveness," says Wilson, of her experiences with white male providers. "I felt completely unseen and unheard. When you go to a Black physician, the bedside manner is different and you feel like the physician actually cares about you beyond that appointment."

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Through reaching out to other members of the Black and Latinx community, Wilson knows there are many shared experiences when it comes to discriminatory or biased behavior from doctors and other health care workers. "Being Black or being a person of color is bad for your health because, from the birth of the nation to the present day, Black people and other disadvantaged groups have endured health outcomes that are generally worse than white people," says Wilson.

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"Racial tension" can show up in various ways during appointments with health care providers, says Wilson. For example, she recalls going into a physician's office only to have the doctor refuse to make eye contact as he rushed her through the appointment.

She believes "simple things" such as eye contact, putting a hand on your shoulder, or following up with you after an appointment to see how you're doing, can make all the difference in quality, culturally competent care.

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FTR, Wilson defines cultural competency as "the ability providers, organizations, and health care professionals have to effectively deliver services that meet the social, cultural, emotional, or linguistical needs of patients." She says found it startling that the relationship between race, genetics, life expectancy, and health was so prominent in communities of color, and she holds providers accountable for taking the first step to improve the quality of health care services given to diverse populations. These steps can include being more aware of their own unconscious bias, being more responsive to the cultural beliefs of their patients, and rethinking their bedside manner in order to properly care for the patient's individual needs, she says.

"When you think about racism and unconscious bias, and when we think about health equity in general, equity does not equal equality," says Wilson. "We have to address health equity through innovation and through education, and that education component is really centered on cultural competency."

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Wilson wanted to be a part of that change and took action herself with the creation of HUED. Patients can log into HUED for free, fill out information regarding their region, insurance provider, and the type of help they're seeking, and the app will match them with an appropriate physician. Patients can also read reviews of doctors before beginning outreach for their appointment scheduling.

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The database, which she calls "a ZocDoc for us, by us," allows users to find anything from a therapist to a gynecologist to a cardiologist. "Our goal is to really be the most comprehensive platform to be able to find culturally competent care and BIPOC providers that specifically can identify the needs of communities of color," says Wilson.

Dermatology is one area in which racial disparities have come to light, including a lack of representation of skin of color in medical textbooks and a lack of Black and Hispanic doctors that's even more pronounced than other areas of medicine. In response to issues presented by non-culturally competent dermatologists and BIPOC skin-care needs, HUED partnered with Unilever and Vaseline to provide a downloadable skin-care guide available on the HUED site. The company is continuing to work side-by-side with organizations to provide more community-based programming in underserved communities, explains Wilson.

HUED's overarching goal is to not only create behavioral changes among physicians but also patients, to draw attention to microaggressive behaviors and dismissiveness as well as promote genuine bedside manner and patient care. Cultural competency training for physicians, providing health literacy resources, and making quality care more accessible for patients of color, can help move the needle, says Wilson.

"We need to be our own self-advocate," says Wilson. "We cannot rely solely on what doctors or health care professionals tell us." To that end, HUED aims to provide resources to better equip people with questions they can ask their physicians, such as important questions regarding their specific conditions.

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Wilson recognizes that these inequalities have a disproportionate and lasting impact on people of color and other marginalized groups, thus contributing to gaps in health insurance coverage, uneven access to health care services such as area-based clinics and free resources, and poor health outcomes.

"There are also a lot of barriers that prevent patients of color from getting access to quality care," she says. "Oftentimes when people think about those barriers, they only factor in geographic or economic barriers without recognizing the psychological barriers that exist within our communities as well." Some of the psychological barriers include fear, distrust (a long-standing effect of mistreatment of people of color in studies such as the Tuskegee Experiment), and how "the entire system was designed without us in mind," she says. "When you think about HUED in the future, we're trying to put trust back into the health care system."

Considering the effects of racial bias throughout the health care system in addition to racial trauma and the daily experiences of communities of color, Wilson knows that finding the right provider is of utmost importance to BIPOC patients' mental health. The hope is that these patients will be able to find doctors with shared experiences, who look like them, and who ultimately provide the best care for every single patient.

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