For most women educated on the treatment of women of color in the world of healthcare it’s not much of a surprise that Black women are deeply affected by implicit bias in the American healthcare system. Implicit bias is defined by PubMed as “a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender” caused by “ associations outside conscious awareness”. In laymen terms, this means often times doctors may misdiagnose or under-diagnosed patients because of racist or sexist conclusions. Ones that they may not even be aware that they are making.

According to a report by USA Today, this might have been the case for  Tashonna Ward.

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On January 2nd, Ward– a 25-year-old daycare teacher from Milwaukee–  died while attempting to seek medical attention. 

Ward had sought help from an emergency room at Froedtert Hospital after experiencing severe chest pains and trouble breathing. After reporting her symptoms the young African-American woman waited over two hours to see help. After hours and hours of waiting she left the hospital to seek quicker assistance elsewhere. According to USA she collapsed and ultimately died shortly after she left. No her family wants answers. 

“How can you triage someone with shortness of breath and chest pain and stick them in the lobby?” Ward’s cousin, Andrea Ward asked in an interview with USA Today. “Froedtert needs to change their policy.”

According to USA Today: “The Milwaukee County Medical Examiner’s Office has not determined the cause of death. Its report doesn’t say whether Ward was admitted or seen by a doctor at Froedtert before she left. Ward’s family says she was kept in the waiting room and was not under any monitoring when she decided to leave.”

Hospital staff  checked her heartbeat with an electrocardiogram and reportedly decided that things appeared normal.

After her first initial check-in she was asked to wait in the waiting room until she could be admitted. According to Ward’s family she posted on Facebook at 5:45 p.m. “I really hope I’m not in this emergency room all night.” Nearly two hours later at 7:35 p.m., Ward posted to her Facebook page an update stating that she had been told by ER staff that her wait to see a doctor could be anywhere from two to six hours.  “Idk what they can do about the emergency system at freodert (sic) but they damn sure need to do something. I been here since 4:30 something for shortness of breath, and chest pains for them to just say it’s a two to SIX hour wait to see a dr.”

A chest X-ray after her death revealed that Ward was suffering  from cardiomegaly. 

 According to USA Today, Ward had a history of cardiomegaly, or an enlarged heart. Last year in March, Ward experienced the death of a baby after the umbilical cord wrapped around the baby’s neck. According to a medical examiner’s report, Ward had been told at the time that she had developed an enlarged heart during her pregnancy. Cardiomegaly can be either short-term or permanent and can put a person at risk for cardiac arrest, and other severe heart complications. It is known as to whether or not Ward’s heart had remained enlarged  since her pregnancy.

A spokesperson from Froedtert hospital issued a statement expressing “sympathy” for the family. 

“The family is in our thoughts and has our deepest sympathy. We cannot comment further at this time,” the spokesperson said. 

Many experts blame doctors’ failure of black women on their implicit bias.

This problem of implicit bias among the medical community is exasperated by the lack of diversity among doctors, with only 5% being Latino (regardless of the fact that Latinos are the fastest growing ethnic group in the U.S.), and only 4% of doctors in the U.S. being black.

Linda Blount, president of the Black Women’s Health Imperative, is very matter-of-fact when describing the realities that implicit bias has at the doctor’s office: “We want to think that physicians just view us as a patient, and they’ll treat everyone the same, but they don’t,” she says. “Their bias absolutely makes its way into the exam room.”

Somewhat surprisingly, this bias transcends social and economic factors and has little to do with class. “When you look at inequalities in healthcare, you see a lot of studies tying the problems to race and poverty, but there’s not a lot about educated, insured black women who are not poor”, says Bette Parks Sacks, Assistant Professor of Social Welfare at UC BerkeleySacks. “Yet infant mortality rates for black women with a college degree are higher than those for white women with just a high school education.”

The under-diagnosis of PCOS in black women is just another example of the way the American healthcare system is letting down black women.

Because of the structural racism within the healthcare community, black women are often told that their very real symptoms are “all in their heads” or simply stress-related.

The most dangerous facet of this pattern is that once physicians decide that a patient’s symptoms are simply stress-related, they stop searching for another diagnosis. This leaves many Afro-Latinas struggling with their PCOS alone, believing that their long and intense periods, hair loss, weight gain, insulin resistance, and often, mood-related disorders, are simply a symptom of self-induced stress.

It’s time that women of color stop being told that all they need is an Advil and a yoga regimen to improve the sometimes debilitating symptoms of PCOS. What they need instead is doctors to get real to the internalized racism they may enacting, and start taking black women’s pain seriously.