Racial alignment between patients and providers improves health care use and outcomes and increases patient satisfaction, according to research by the Association of American Medical Colleges.
At the UCSF Black Wellness Clinic, Black sexual and reproductive health providers care for Black individuals within a reproductive justice framework. “We offer race-concordant, one-on-one gynecologic and prenatal care,” said Katherine Brown, MD, MAS, the clinic’s medical director.
Clinic providers include obstetrician-gynecologists, midwives, a perinatologist, a psychologist and a patient advocate. “People come to our clinic knowing that it’s built specifically for them,” Brown said.
Racial disparities in health care persist
According to the Centers for Disease Control and Prevention, Black women are three times more likely to die from a pregnancy-related cause than are White women.
Nearly 1 in 4 Black women in the United States is likely to report at least one form of mistreatment by health care providers, according to a study co-authored by UCSF researchers. Black women are twice as likely as White women to report that a health care provider ignored them, refused a request for help or failed to respond to requests for help in a reasonable amount of time. The study also found that 30% of Black people who gave birth in a hospital reported being treated poorly because of a difference of opinion with their providers about the right to care for themselves or their babies.
“A lot of patients come to us with the experience of not being heard, not having had options explained to them or their questions answered,” Brown said. “They can be holding a lot of trauma from their previous experiences in the health care system. At the UCSF Black Wellness Clinic, we offer longer appointment times to address these concerns.”
Barriers to reproductive freedom
Brown led a 2022 study on abortion in the context of structural racism and reproductive injustice. A group of 23 self-identified Black women who’d had an abortion were interviewed about their experiences. The main theme that emerged was that choice is a privilege that’s often constrained and unattainable in a system not built for Black people. The participants described experiences of institutional racism that created a network of difficult choices and that often led to the decision to have an abortion.
One of the study’s conclusions is that clinical care should allow space for trauma, untimely loss and multiple injustices, with the understanding that many health care experiences have been marked with disrespect for Black life.
Another study co-authored by UCSF researchers found that young people facing structural inequities are less likely to use their preferred contraceptive method. The findings suggest that contraceptive care that prioritizes method preferences, with a range of affordable options, can help address reproductive health inequities and improve reproductive autonomy for young people.
UCSF initiative addresses health care inequities
“What’s made me really passionate about health care for marginalized communities is the way that health is interconnected with racism and structures of oppression involving access to housing, food, water and clean air,” Brown said. “Those are related to socioeconomic disparities, but these disparities exist because of systemic racism. So it’s all interconnected.”
Brown co-directs the UCSF Black Women’s Health & Livelihood Initiative, which is part of a national movement to address health care inequities for Black women. The initiative prioritizes justice and equity, health and well-being, community building, education, leadership, and construction of knowledge and research.
“We’re building trust and building something that looks different than traditional care,” she said. “And we’re building up our community networks so that we can better connect people to race-concordant care.”
To learn more
UCSF Black Wellness Clinic
Phone:(415) 502-2237
UCSF Obstetrics and Gynecology
Phone:(800) 444-2559| Fax: (415) 353-4395
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