Promoting health equity for marginalized peoples

Oct 16, 2023
Key Takeaways
  • COVID-19 aftermath spotlights health disparities; imperative to address marginalized communities' concerns for equitable healthcare.
  • Discrimination leads to delayed care; education and understanding essential for improved access to quality healthcare for transgender people.
  • Historical implications impact trust; addressing implicit bias among providers is crucial for combating health disparities.
  • For far too long, marginalized communities have had their concerns left unheard. These concerns are now under a microscope which has created a new healthcare culture of not only listening to these concerns but also implementing real change. 

    Marginalized peoples are those that are “othered” by a society. The marginalization of a population not only affects their personal lives, but every other aspect of their lives too. The lack of representation in research studies has reinforced stereotypes within our healthcare system. When left unchecked, these stereotypes have very apparent negative effects on marginalized peoples, clearly putting them in harm’s way. [1] This, alongside many other studies, reinforces the fact that generations of inadequate access to vital needs all influence one another and play a fundamental role in health care. 

    The intersections between lack of access to resources, stereotyping, and negative results in health care should be further explored so health professionals can be better suited to empathetically care for ALL patients.

    Intersection of race and gender

    In order to create a strong system where health equity work is centered in our care, we must first understand health disparities and the way they connect to our racial and gender identities. As health professionals, we cannot truly care for all of our patients without respecting the fact that some patients will not fully trust their health care providers. It is our job to earn that trust back and learning the historical implications of our work and how they affect our practices today is a key aspect to doing so. This includes identifying the historical fact that the father of gynecology’s inhumane treatment of enslaved Black women reflects the disregard for women’s pain, especially Black women, that continues to be perpetrated within the reproductive health world.  

    There are many avenues that showcase the health disparities that negatively impact those that are marginalized due to their race or gender identity. Pain is one avenue that our health coaches are especially focused on and that starts with fully believing our patients and working on caring for their pain in the way they see fit. 

    A 2011 study from the World Endometriosis Research Foundation identified that on average, a woman waited seven years from her first symptoms before receiving a diagnosis for this condition which happens to be fairly common. Sadly, delays in diagnosis are also commonly associated with fibromyalgia, which is a condition identifiable by widespread pain throughout the body. [3] This overall disregard for women’s pain is maximized for Black women, with studies showing that medical professionals were more likely to underestimate the pain of black patients (47%) relative to nonblack patients (33.5%). [4] 

    It would be easy for us to claim that this history is in the past and the present is much better. But this is false—Black, Indigenous, and People of Color have been expressing how harmful the current system is to health professionals across the country. We hope to shine a light on the dangers faced by our BIPOC and Trans patients by implementing a conscious way of caring for their unique needs through an empathic approach. It is our job to regain the trust of patients that have been actively hurt by our current system.

    Transgender visibility

    According to the Endometriosis Foundation, 1 in 10 trans men have endometriosis but their stories are rarely shared. 30% of transgender people have either postponed care when sick, injured, or postponed preventive health care due to discrimination and disrespect by providers. [2] When healthcare professionals do not take the necessary steps to recognize that their internalized or conscious transphobia is feeding into the feelings of distrust many patients showcase, as well as their patient’s ability to access care sooner rather than later, they are being an active participant in the problem rather than the solution.

    Combating internalized bias  

    Most health care providers appear to have implicit biases that place White people in a beneficiary position when compared to their counterparts of color. It is important to intervene and target implicit attitudes among healthcare professionals because implicit bias can contribute to health disparities faced by people of color. [5] Because of how new this conversation is in the health world, there is no one right way to counteract internalized biases that affect the way we interact with our patients. 

    With this realization, it is important to utilize the vast amount of resources available in order to actively work towards dismantling the discriminatory behaviors we’ve internalized from our environments, such as the Community Health Training Institute’s Health Equity Toolkit. This is a critical part of being a health professional or organization that truly values their patients.

    Let us join you on this journey

    Visana acknowledges the current approach to women's health is clearly not working. We recognize the health disparities faced by marginalized communities and are ready to walk alongside them in their health journey. By promoting a holistic approach to care that is centered on strengthening the relationship between healthcare providers and patients, we recognize and value all individuals and their specific needs. We're driven to provide the best opportunities for women to receive the health resources that they need.

    1. Sutton, Madeline Y. MD, MPH; Anachebe, Ngozi F. MD, PharmD; Lee, Regina MD; Skanes, Heather MD Racial and Ethnic Disparities in Reproductive Health Services and Outcomes, 2020, Obstetrics & Gynecology: February 2021 - Volume 137 - Issue 2 - p 225-233
    3. “Pain Conditions Are More Common in Women.” Harvard Health, Mar. 2021, 
    4. Hoffman, Kelly M, et al. “Racial Bias in Pain Assessment and Treatment Recommendations, and False Beliefs about Biological Differences between Blacks and Whites.” Proceedings of the National Academy of Sciences of the United States of America, National Academy of Sciences, 19 Apr. 2016, 
    5. Hall WJ; Chapman MV; Lee KM; Merino YM; Thomas TW; Payne BK; Eng E; Day SH; Coyne-Beasley T; “Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review.” American Journal of Public Health, U.S. National Library of Medicine, Dec. 2015,
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