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

By Cecelia Ottenweller
December 23, 2020

Finally! After proper contextualization, we’ve made it full circle back to my research project entitled: Diagnosis Culture: Culture and African American Maternal Health in Houston.

If you need to catch up, you can read Part One and Part Two of my story before proceeding.

I conducted 15 hours of interviews with 11 women living in Houston. Some were Black mothers, others were Black mothers who were also medical professionals working in maternal health, others were Black maternal health professionals who were not mothers, and still others were non-Black maternal health professionals who worked with Black moms. I traveled to meet my interviewees anywhere they wished and made sure each received transcripts of our interactions. 

Ethnography is a story-harvesting method of research. Every person’s story is their own; each is different. But recurrent themes can be identified. I created a giant spreadsheet listing each story told during the interviews and then grouped them. I then examined the recurrent themes through the application of Systemic Racism Theory, described by Texas A&M sociologist Joe Feagin. I identified six overarching themes and then provided evidence for these themes from the ethnographies: 

  1. Macro-level systemic racism identifies African Americans in general and Black women specifically as “The Problem.”
  2. Macro-level systemic racism has created a labyrinthian experience for patients of all ethnicities seeking care
  3. Experiences with systemic racism has created a culture of suspicion in patients seeking care, which affects compliance
  4. Dominant white framing creates negative inter- and intra-community attitudes that directly impact health outcomes
  5. Training within the academy and medical continuing education inadequately addresses the reality of systemic racism
  6. Personal experiences of systemic racism can become fertilizer for personal and community growth

I then created two projects that could hopefully demonstrate how creative storytelling projects collaboratively created in partnership with affected communities could potentially serve as catalysts to create solutions that involve consent, shared authority, and dialogical, mutual and respectful engagement between equals to improve outcomes for all concerned. 

So – Solutions! I conducted a private experiment where I sent my thesis out to a select group of people to see who would actually read it. They all were enthused about what I’d done and were very congratulatory, but who would actually take the time to attempt to digest my 150 page tome? 

Not many people did. But, when I had one on one conversations with them about the subject matter, many of them cited life-altering artistic experiences they’d had that had given them an empathetic connection to the subject. They deeply cared about the subject because of an experience they’d had through art that built a bridge from them to the Other. 

If you do a Google search, you will find a forest-full of professional research demonstrating the intricate ways that implicit bias affects medical interactions. We are aware that implicit bias is real. No more convincing needed, right? But yet it still happens, and I believe we’re holding on to old ideas because that is how our human brains operate, like mechanical squirrels: it is my theory that we generate information in a way that we term “empirical” to create mental boxes, which we then put “things” in. Atomic science, chemistry, biological processes, etc, are empirical sciences and work well (for the most part) being put in boxes. But topics like Black Maternal Health don’t. The social human animal needs intimate experiences with other humans, connecting across each other’s rich life tapestries, in order to better understand and serve that woman across the way who just happens to have deep, dark ebony skin. She’s no different from a person with paler skin. People just need to experience that reality in order to believe it. 

We need more expression, more connection, through artistic expression. We need to create opportunities where personal stories are heard and amplified. Women who have had their time in front of the mic need to find ways to share it with others. We all have a story – we only need the room and the listeners to hear ourselves.