It’s Not “Them,” It’s Us: Real Life Adventures in Health Equity and Discrimination, Part One

By Cecelia Ottenweller
December 14, 2020

I am a recent graduate in Cultural Sustainability from Goucher College in Maryland, and my final thesis is entitled Diagnosis Culture: Culture and African American Maternal Health in Houston. I undertook the project to look at how cultural differences between Black mothers and maternal health providers in Harris County could be leading to the huge disparity in maternal health outcomes. 

So, why me?? Let’s be clear about my positionality: I’m not Black. I’m a middle-aged white woman living in the Houston Heights, one of the more affluent areas of Houston. Immediate appearances suggest Black maternal health wouldn’t be my subject interest at all. 

But I know there is discrimination in the clinical setting because I’ve experienced it: I’m the child of a medical family and worked as a teenager in a medical setting until I was in my early 20s.  And, as an adult, I have suffered multiple events of discrimination against me by medical professionals because of my size. 

I’ve experienced both sides of the equation and have a great deal of empathy for the people involved. 

In regards to my medical experience, I worked as a Central Sterile technician, phlebotomist and certified nurse technician in my late teens. My mother ran the operating room at our community’s small hospital in the mid ‘80s and I became her “dishwasher” at the tender age of 16 after her Central Sterile tech fell and broke her tailbone. I cleaned and sterilized surgical instruments for nearly a year, then became a phlebotomist and then a certified nurse technician working the floors. I also worked for a doctor. 

Personally, as an adult, I’ve struggled with a wide variety of health issues related to my endocrine system, which threw my body into a wild roller coaster ride of weight issues. I’m larger than the average woman (I prefer “voluptuous Amazonian woman”;) and overweight due to my wacky chemistry. Weight is one of the issues that often underlies discrimination in clinical encounters. That’s proved true in my life. I have suffered two misdiagnoses; one cost me my ability to have children and the other nearly cost me my life. 

The truth is, one person can have a terrible diet and still be thin while another can eat like a sparrow and still be obese. There are reasons for what that can be true, but those underlying causes can be overlooked because of implicit bias on the part of the health practitioner. Bias against size is a huge problem in American medicine because of the belief that obesity is solely attributable to poor eating habits. 

My story is long and ugly (but it does end well), so I won’t go into it here. 

I believe that it’s almost impossible for most people to go through life-altering issues and traumas and not be emotionally affected. Because of my experiences, I became aware of the suffering of others around me for what I feel are needless reasons and my study was an effort to shed a light on how attitudes were affecting maternal health outcomes and to gain some modicum of justice for Black moms. 

Over the next week and a half,, I’ll be sharing more about the disparities in maternal mortality, what my research has revealed, and finally some solutions I believe can change the narratives of the future.