RACE IN HEALTHCARE: STORIES OF GRACE IN THE FACE OF SYSTEMIC DISCRIMINATION
Background: Black women experience higher rates of infant mortality and adverse birth outcomes compared to white women. Structured inequity, along with interpersonal discrimination, are primary contributors. Within Kalamazoo County, black mothers are twice as likely to live in poverty, report experiencing discrimination on a regular basis and are significantly more likely to have inadequate prenatal care. Research aims: To understand women's personal experiences with medical providers, explore their expectations of medical providers and practices, and examine variations by race/ethnicity and socioeconomic status.
Methods: One-hundred-and-seventy-eight women were pre-recruited from the Mom's Health Experience Survey. Fifty-seven of them participated in Community Voice Panel (CVP) focus groups. Twelve focus groups were conducted by two female facilitators and discussed women's experiences spanning from home life to medical office experiences and back. All focus groups were recorded, transcribed, and consensus-coded for themes.
Results: Thematic analysis revealed differences in treatment of women of color (WOC) in the health care system and differences in their responses to this treatment. Powerlessness and invisibility were pervasive feelings in WOC, described as feeling "like a mouse in a corner." Despite the power differential they experience in their healthcare experiences, WOC were understanding and willing to justify the actions of their providers.
Conclusion: WOC described systematic discrimination within the healthcare system and gave suggestions for improving quality of care. Their extension of grace to providers in response to poor experiences and treatment demonstrates a coping mechanism that may be unique to WOC.