- Whose health matters?

- Black health matter.

- Louder, whose health matters?

Black lives matter is more than just talking about police brutality.

At the root of saying black lives matter is caring about black life not just black death.

We have to start to preserve black lives now and that's why I feel like health disparities and other forms of health inequity are so incredibly important.

How many people do you think have died without us really knowing and counting because of systematic racism in hospitals for centuries.

(frequency searching) (soft music) - [Narrator] The COVID-19 pandemic made Americans more aware than ever of the inequities in our healthcare system.

It also laid bare that racism and healthcare is often more subtle and insidious than overt acts of discrimination.

- COVID-19 is exposing longstanding riffs in American society.

- [Narrator] Hidden prejudice can affect how patients of color are viewed and treated - Implicit bias it runs deep if we're talking about race then it would be the negative racial stereotypes or beliefs that we would hold towards someone else and whether it was informed by family, our upbringing, the classroom, media.

And then it's the microaggressions that are the perpetuation and the manifestations of those implicit biases.

There are biases that providers hold towards patients that have a detrimental effect on outcomes.

- [Kemi] Providers are at risk of all the stereotypes that all of us live with with people of color in this country.

We have stereotypes around who's lazy and who's hard working, we have stereotypes around who lies and who is honorable and tells the truth.

Pick a stereotype, you name it there's almost a multitude of different ways it can show up in any given clinical encounter.

- [Narrator] Unchecked bias influences things like how long a patient is seen for, their diagnosis and whether they're referred to further testing.

It impacts the treatment they receive including what medications that are prescribed or have something as routine as pain management is handled.

Much of this issue is rooted in a persistent stereotype that black people have a higher tolerance to pain.

A myth that traces its origins to slavery.

- [Lindo] You have a physician in the mid 1800s by the name of Dr. Samuel Cartwright.

He was a white man who went to UPenn Medical School and he was a slave owner in the South.

And he was also a psychiatrist.

He argued that black folks in the South on the plantations as slaves had a tendency and a psychological disease of rascality because they were black, that they were lazy and that they would do anything to get out of the labor of working on the plantation but what he also added in that diagnosis was that black folks lost their sensitivity of the nerves.

- [Ashley] In order to torture people, in order to treat them inhumanely, in order to force another human being to work every day of their life for no pay and to have extraordinarily violent consequences you have to dehumanize them first.

And an aspect of dehumanizing somebody and then being able to treat them that way is to assume something like they're different than me they don't feel pain the same way I do.

- [Narrator] These medical falsehoods still persist to this day as we saw in a 2016 survey done at the university of Virginia.

Researchers surveyed medical students and community members asking them biologically false statements.

- [Lindo] They asked them, "Do you believe that black people's blood coagulates differently?"

They asked them, "Do you believe black people have thicker skin?"

And they asked them, "Do you believe that black people have a higher threshold of pain?"

The medical students 50% of them believed at least one of those things, outside of the medical school in the community 75% believe in one of those things.

It was in that same survey and they said, "Providers or students that believed one of those things provided less pain medication for the exact same pain level of a black person versus a white person."

So that means this stereotype belief is now scientific practice.

(bell rings) - I have two stories that would like to share, my personal experiences.

The first one was when I was giving birth to my child.

- [Narrator] When Nait Misgina was going through a long labor with her first child hospital staff advocated for cesarean.

- They wanted to hurry up the process and get this baby out.

- [Narrator] Their story echoes a common concern from black patients that they don't feel listened to or believed by their healthcare providers.

- And then the doctors kind of made it seem like I wasn't progressing in the a the way I should have.

I said yes because I was just like I just wanted to get it over with.

There was so many people in the room and I just it's a lot of pressure and I just wanted it to be like done.

They got me ready for surgery.

He starts cutting me open and the way that he was going about it was very rough.

I told the anesthesiologist that I could feel everything and she was like, "Well, it's normal to feel pressure."

I was like, "It's not pressure.

I know what pressure feels like and that's not it."

My whole entire body got really cold and I could still feel what he was doing to me.

My body started shaking and my partner started freaking out because he thought I was gonna die.

The next thing I heard was my son crying.

and so they had officially gotten him out.

I didn't feel good about what happened.

- [Kemi] So we know black women's pain is disregarded in many healthcare settings and I don't think gynecology is any different.

- [Narrator] Dr. Kenny doll studies women's reproductive health and inequities in healthcare.

She says the US has lots of work to do.

Every year, roughly 700 women in the US die from pregnancy or childbirth related causes.

Another 65,000 nearly die.

- [Kemi] The rates at which women die in childbirth in the United States is similar to in countries that have very minimal healthcare structure.

- [Narrator] When compared to similarly wealthy nations like Germany, Australia or Canada the US ranks dead last.

- [Kemi] And when we look into why that is it's black women's death that drives that statistic.

- [Narrator] Black women are three times more likely than white women to die in childbirth, an American-Indian and Alaska native women twice as likely.

- [Man] What are we here for?

Justice.

- [Man] What are we here for?

- Justice.

(man shouts) - [Man] What are we here for?

- Justice.

- [Kemi] In many ways this conversation around reproductive health and racial disparities also can be seen as the tip of the iceberg because what the maternal mortality crisis is actually demonstrating is the overall worst quality of healthcare that black women receive across their entire reproductive life course.

- [Narrator] Advocates say that hospitals, clinics and providers all need to be held accountable.

- [Lindo] We can't say, "Oh, but we treat everyone equal."

Well, if that's true then there wouldn't be these health inequities.

The data's there.

Racism is killing people.

What we need to figure out is how do we change the way medicine behaves, the way our providers care and the way that we teach medicine to ensure that we no longer have those inequities because I don't think we need more research we need more action.

(soft music) (crowd chants) - [Narrator 2] This series is made possible in part by the generous support of Premera Blue Cross.