MANSFIELD — Nancy Mathieu has seen racial bias play out in the medical field.
“I’ve been in the ER where you can have two people walk in with the same pain from cancer,” said Mathieu, a family physician in Mansfield.
“The African American is treated very differently for that pain and is automatically viewed as drug-seeking at times, where the other person it’s like, ‘OK, here’s the pain medicine.’ We give you the benefit of the doubt.”
Mathieu was one of four panelists at the Thursday’s Local Conversation: African American Healthcare Disparities panel.
The panel was hosted by the North End Community Improvement Collaborative and featured Mathieu, an OhioHealth primary care physician, Vivian Jackson Anderson of the National Council of Negro Women, Buffi Williams of ASI Behavioral Health Group and the Rev. Angela Brooks-Wright, manager of pastoral care at OhioHealth Mansfield and Shelby hospitals.
Panelists discussed the root causes of poorer health outcomes for African Americans, disproportionate infant mortality rates and the importance of social, spiritual and mental health support.
Moderator Renee Thompson opened the discussion by asking Mathieu why she believes there had been little improvement in healthcare outcomes for the African American community over the last 20 years.
“I want to answer this question in two parts, because there’s no easy answer,” Mathieu said.
Implicit bias among physicians, a mistrust of the healthcare system and underrepresentation of African Americans in the medical field all factor in to disproportionate health outcomes, Mathieu said. So do systemic factors like a lack of primary care facilities and grocery stores with fresh produce in predominantly Black neighborhoods.
Mathieu said studies have shown African Americans are negatively affected by implicit biases among healthcare professionals and that training for physicians is key in mitigating these biases.
“We did a study on multiple physicians and everyone said, ‘Oh, yeah, there’s disparities, but not in my clinic,” she said. “We just don’t see it. It’s not like we’re trying to miss it. We just have a bias there.”
Bias can also have an impact on admissions to medical school and social work programs, exacerbating the lack of African American professionals in those fields.
Thompson cited a dean of admissions for the Ohio State University’s College of Medicine, Dr. Quinn Capers, who had his entire selection committee take an implicit bias exams in 2011.
According to the university’s Office of Diversity and Inclusion, all 140 members of the admissions committee took several implicit association tests before the 2012-2013 admissions cycle. Their results revealed that all groups in the committee — men, women, students and faculty — showed significant levels of implicit or unconscious preference for certain racial and gender groups.
Helping committee members understand their unconscious perceptions resulted in measurable change.
According to Dr. Capers, the next class of medical students that were enrolled following the implicit association test exercise was the most diverse in the program’s history at that time.
Mathieu praised the move as one important step for increasing African American representation in the medical community.
Another is encouraging youth to pursue careers in the medical field.
“That starts when you’re young, that starts with our little ones, to try to lead them to that direction,” she said.
Brooks-Wright said representation in the medical and mental health fields is key for improving health incomes in the Black community.
“Until we get to the place where we have a place of trust, that we have physicians that look like us, that we are in a safe environment, where we can talk about those traumas, we remain stuck,” she said.
Panelist Vivian Jackson Anderson shared her experiences as a longtime public servant in the public health field.
Anderson worked for the Ohio State University and Ohio Department of Health for 43 years. She began her career as a speech language pathologist, but found her true passion as part of the Ohio Infant Mortality Reduction Initiative Program.
Anderson spent much of her career traveling across the state. She estimated that she’s visited at least 60 of Ohio’s 88 counties.
“When I walked into the state health department 40-plus years ago, I saw no one who looked like me,” she said.
“Every time I made a step, it was about having to clarify who I was and, in some ways, to let them know I earned my position. It wasn’t given to me. I went to school. I have a few degrees behind my name, so I have a right to stand here.”
Anderson said that for many years, powerful figures in the department and the state sought to minimize the data on Black infant mortality in Ohio.
Ohio has the second highest African American infant mortality rate in the nation, according to data from the Kaiser Family Foundation.
“For years. I was not allowed to be on certain committees,” Anderson said. “It has taken time and had to do with political will, with people finally wanting to tell the truth or telling the truth.”
Brooks-Wright and Williams, a licensed social worker, spoke about the intersection of physical, mental and spiritual health.
Panelists encouraged audience members to advocate for themselves and speak up if they receive substandard medical treatment. This may mean writing a letter, filling out a post-appointment survey honestly or calling a hospital’s patient advocate department.
Williams said the history of institutional racism is one factor that makes the African American community hesitant to pursue mental health care or talk about their struggles publicly.
“I think that our homes were, historically, vulnerable to things that made us learn not to trust,” she said.
Brooks-Wright agreed.
“The mindset when I was growing up is what happens in our house stays in our house,” she said.
“We tended to be afraid and not have an atmosphere of trust that we can share what’s going on. And then what happens is, over the course of time, we have these many traumas that are not addressed and then they’re manifesting themselves in all sorts of ways.”
According to a March 2022 statement from the American Academy of Child and Adolescent Psychiatry, rates of suicide among Black youth have risen faster than in any other racial/ethnic group in the past two decades.
Suicide rates in Black males 10-19 years-old has increased by 60 percent. Early adolescent Black youth are twice as likely to die by suicide compared to their white counterparts.
Williams, who frequently works with young Black males, said creating environments where people feel safe to open up is crucial.
“One issue I think is language,” she said. “I’m finding that Black males and their emotional intelligence, their ability to express what they’re feeling and it being validated, is missing. Their voice has been shut down and they’ve been afraid to say what they need to say.
“A lot of Black young men I work with have resolved to dying. Dying is not something abstract to them. It’s something they accept as a part of their narrative and space.
Williams also said faith communities sometimes feed the stigma surrounding mental health.
“We as African Americans spiritualize things. We have been told that you can pray these things off,” she said. “I think we had or have to begin to give each other permission to not be OK.”
Brooks-Wright said prayer is important, but so is trauma informed care.
“I want you to go to the church down the street and get Pastor to lay hands. I want you to get prayer,” she said. “But after you do all the things, I want you to go see Dr. Nancy and have her do a blood panel and find out what’s going on with you. I want you to go and talk to Buffi.”
Williams and Brooks-Wright agreed that faith does have a role to play in personal and community wellness — and so does the church.
“We need to really redefine what are the needs of our community. How does the church need to be there?” Williams said.
“Do we need to develop small groups? My mom talks about the sewing circle. There are some things that they did back in the day that made sense I think that we need to look at that, because mental health is going to be about us being connected.
“The church was never created to be a building.”
