Racism in many forms can affect people's health: Here are some examples

A young and pregnant single mother who had been having unexplainable headaches until the ceiling between her bathroom and kitchen collapsed, exposing black mold.

A middle-class manager of two bank branches who was second-guessed while being treated at the hospital about his need for medications until he is asked what he does for a living.

A physician whose wife, who had just given birth, was asked by a nurse if the father would be involved in the baby's life.

All three are Black. 

Their stories show some of the complexities of how racism in different forms can affect a person's health and well-being.

These and other racial inequities amid growing tensions and protests this summer after the death of George Floyd, a Black man, at the hands of white police prompted public officials across the country to declare racism to be a public health crisis.

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How does the color of a person's skin affect their health and well-being?

Here are three people's stories:

Young, poor and black

Jasmine Burgan, now 26, moved out of her parents house after she graduated from Akron's Buchtel High School at age 18.

She had a minimum-wage job at a donut shop.

"I was making like $8 an hour, which barely was enough for me to take care of myself," she said. "I couldn’t pay for health care and it wasn’t something my job was offering. They always made sure I only worked 39 hours so I didn’t qualify for health care."

She went a few years without health insurance. She would go to a local clinic to get birth control pills, but paid out-of-pocket for medicines. She knew if she got sick, she'd have hefty doctor or hospital bills.

When Burgan became pregnant at age 20, she went to a local pregnancy clinic.

"They gave me a hat, gave me a pregnancy test, told me I was pregnant and told me that was all they could do" since Burgan didn't have private health insurance or Medicaid at the time.

Burgan said she feels that because she was Black, young, poor and pregnant, it affected her medical care.

"I see other people who are a different color than I am and they’re getting excellent care and I'm not. What makes me so different that I can’t qualify for health care? Or what makes me different because I'm poor that I can’t get health insurance? I still don’t understand to this day," said Burgan, who now works full-time in insurance claims with her own insurance and is pursuing a dental hygienist degree. 

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Shortly after her daughter Madison was born, Burgan qualified and moved into subsidized housing in Akron. Her first apartment had roaches.

"That was something I had never been used to. They didn’t want to do anything. My daughter was 4 days old before they finally came and did something. I had to basically  have my daughter there for them to take action on it."

Burgan separated from her then-husband. Pregnant with their second child, she eventually moved with her daughter to another apartment. 

One night, Burgan and her daughter were asleep upstairs when she heard a loud crash.

She thought someone was breaking into her house.

"My ceiling in my kitchen actually caved in. And I mean, when I say caved in, it was like there was nothing but mold," Burgan said.

Burgan had been complaining of headaches to her doctor. Her doctor said maybe they were headaches related to her pregnancy or caffeine headaches. 

"I didn’t know the reason I was having these headaches was because there was mold in this apartment," said Burgan, whose doctor acknowledged that the mold was causing her headaches and took her off the caffeine pills.

The ceiling of her kitchen was also the floor of her bathroom. Workers had to remove her toilet and bathtub for repairs, but thought a patch job was enough, first putting a piece of plywood up to cover up the hole.

"There was still mold in the ceiling," Burgan said. She tried for a month complaining before any action was taken.

Burgan's community health worker, Donna Youngblood, had to step in. Community health workers are usually members of a community who work with or for a local health care system or nonprofits to be direct advocates for patients. The workers are usually working to help reduce health disparities and underserved communities.

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"This was the health disparity that was jeopardizing her and the baby and her daughter and I still had to actually go in and fight with them," Youngblood said. "I said: 'This is a concern about her health. She can’t stay there and breathe this in. It gives them headaches and also causes congestion.' "

Youngblood also had another client at the same housing complex – who was white – who had the same thing happen after Burgan's cave-in.

That client's issue was fixed within two days – with new flooring, ceiling, cabinets and stove – without Youngblood's intervention.

"I do say it was because of the color of our skin, but because I was able to talk to them... and I started calling and advocating for Jasmine," she said.

Burgan and her daughter moved out of the apartment for about a month.

But when they returned, "the landlord started treating me differently, hassling me about getting anything fixed. Two months later, my hot water heater busted all over my living room and ruined all my furniture and they didn’t want to replace anything. 

"I said: 'I have a baby on the way. You guys need to fix things.' They would literally give me the runaround about smoke detectors getting fixed," she said.

Burgan stayed about a year and then found her own place to rent.

"The last thing she told me was, 'You're never going to find a house for the same rent I’m giving you.' So I said OK. That’s when I came to Miss Donna and said I need to get out of here. That was my goal. So I went house hunting and got myself a house," Burgan said.

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Burgan is still renting but has a goal to buy her own house and finish school for Madison, 5, and Mason, 2.

She goes to school, works full-time on the second shift and wants to be a dental hygienist.

"My motivation was actually my daughter because she started kindergarten this year so I said, 'Hey, Mommy’s going to go back and I'm going to finish and go to school with you."

Pain questioned

About two months ago, a 37-year-old Northeast Ohio Black man who describes himself as a middle-class homeowner with full medical coverage and a job managing two bank branches had a medical emergency.

His uvula, which hangs above the throat, was swollen and obstructing his breathing.

He went to an urgent care, where he was told it was unknown if he was having an allergic reaction. He was given epinephrine and told that if things didn't get better, he should go to the emergency room.

The next day, his condition didn't improve. So he went to the emergency room.

"They took me right away and gave me a COVID test, which came back negative. The doctor said, 'We're going to admit you because we don't know if this is going to get worse and they would hate if I would suffocate," said the man, who asked for anonymity out of fear that discussing issues of racism might affect his job.  

At that time, he also started to get a really bad headache.

Nurses put in an IV and told him they were going to give him medication to fix the headache. They asked from 1 to 10, how bad the headache was, with 10 being the worst.

"It’s about a 9," he responded. "I've never had a headache like this."  

He ended up at the hospital for four days.

On the last day, a Caucasian male nurse practitioner came in to tell the man they were thinking of discharging him.

He was surprised, saying his headache was still bad, but he wouldn't mind going home.

A nurse told the nurse practitioner that the patient wasn't getting any better.

The nurse practitioner asked, "How bad is your headache?"

The patient answered "9."

The nurse practitioner replied, "But it's not a 10."

"It’s not a 10 because I'm not screaming for my life," the patient said. 

The nurse practitioner said he noticed the patient had an IV for pain medications. He suggested Advil. The patient protested, saying he was in a lot of pain.

The nurse practitioner then asked the patient, "What do you do for a living?"

"As soon as I said I was a banker, he said, 'We’ll keep you another day.' His intentions were to try to discharge me," the patient recalled.

"It was a profile. Am I being serious (about the pain)? Can I afford it? Compared to someone that may look the part, the perception is a little different based on what you’re wearing," said the banker.

He usually wears suits at work. But at the hospital, he believes he was seen as just another Black man in a hospital gown possibly looking for drugs. 

He stayed calm.

"This is the first time I've noticed it at a hospital. I've noticed it outside of the hospital. It didn’t really come to light until that very moment when he asked me what I did for a living and he was trying to get me to take Advil. That's kind of a weird thing."

A doctor's perspective

Dr. Carl Allamby, 49, spent 25 years as a mechanic and owner of two auto shops before going to college and medical school.

He is now a second-year emergency medicine resident physician-in-training at Cleveland Clinic Akron General.

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When he walks into a patient's room, Allamby gets positive reactions from both his white and Black patients. But in particular, his older Black patients usually have the same reaction.

"When I walk in and introduce and say, 'Hey I'm Dr. Allamby,' a lot of the older ones look up and have a look of shock almost. Then they say, 'Thank God there’s more of you that are here.' Or 'Thank God you’re here' and 'I'm so proud of you' – congratulatory statements that I know probably aren’t shared with other people who have become physicians because a lot of people already look like them."

Allamby knows the number of physicians who look like him are low nationally.

Only about 5% of physicians in a 2018 study identified as Black, compared to 13% of the country’s population. Only 7% of U.S. medical school students in 2018 were Black, according to the Association of American Medical Colleges.

Diversity – in all forms – will make for a better health care experience for patients, he said.

"The nature of these things are very subjective. You don’t know if you’re being treated unfairly because of the color of your skin or not," he said. "There’s no hard evidence to prove it. All you have is your experience and how you see others treated."  

Allamby also remembers an incident that happened to his wife right after she gave birth  by Caesarean section. Allamby was yet not in the room at the time.

"The Caucasian nurse came in and said, 'Oh, so is the baby’s father going to be involved in this child’s life at all?' 

His wife replied, "Do you mean my husband?"

"Oh, you’re married?" the nurse asked.  

"My wife was wearing a wedding ring," Allamby said. "It was just the position of this nurse that made an assumption of yet another fatherless baby."

Allamby's wife also was in pain after the C-section "and the nurse was very reluctant to give her any pain medication. Even our obstetrician called and said, 'Hey, she needs some type of narcotic.' The nurse said, 'We’re having problems with people and opioids and we don't want to get her hooked.'  

"So here was this assumption again – 'Oh, if I treat her pain, it’s going to be problematic in her future,' " said Allamby.

The couple's obstetrician, who was African American, was very upset, Allamby said.

"He said, 'I do not have this problem when my patients are Caucasian and I send them there," Allamby said. 

Still, Allamby said it's hard to know if the nurse was being racist to his wife.

"Who's to say if she was racial profiling or making an assumption based on all of her past experiences or was she really looking out and trying not to get my wife hooked on opioids? Who knows what her position is and that’s what makes it so tough," he said. 

"That's one of the reasons we need more inclusion from so many people from different walks of life in medicine – African American, Hispanic, women. We need input rather than it to be homogeneous society of health care workers. 

"I know when I walk into a room, the first thing people know about me is that I'm Black. With that may come a bunch of different assumptions about my intelligence or my education or my experiences in life. That's just the fact of how it is," he said.

Allamby said he has never had a patient request another doctor or felt that a patient did not want him to care for them.

"People have been very complimentary of me. I don’t know if it’s because of my previous business background," he said, referring to his years as a mechanic. 

"I'm just providing ordinary care like if someone was at my service garage listening to the problems they were talking about with their car. One thing that helps me with diagnosis is listening to the complaints and symptoms of what’s occurring. That's one of the most effective ways to narrow your focus and get to the answer quickly and let the patient know they’re being heard."

But Allamby said he definitely keeps his own personal experiences growing up in a rough East Cleveland and the experience he and his wife had after their third child in mind when he is caring for patients.

He remembers not having insurance and as a young man, only going to the emergency room if there was an injury or he was really sick.

He recalls taking his sick children to the ER in the middle of the night because he was too busy at work to take off during the day and being prepared for a huge bill because they didn't have insurance. 

"When you can’t afford it, you’re at the mercy of this health care system that doesn’t really work around your schedule that is only available to the privileged who have access to insurance," he said. "Even now with expansion of Medicaid, there are more people who have insurance who didn't have it before, but still, the habit is formed. A lot of people don’t know they can get a pretty quick appointment with a primary care doc and they don't have to come to the emergency department and wait for 5 to 6 hours to be seen for something that is benign to us and not to them."

He does his best to understand and try – within reason – to care for the whole patient, knowing the ER visit may be their only medical visit of the year.

"Even if they’re not coming in with what I may not consider an emergency, it's their emergency," he said.

Allamby said he has heard growing up and as a doctor now that members of the Black community are worried that they're not understood by their medical providers.

"Maybe the physician before me had seemed like they rushed through their care or prescribed these medications and didn’t understand the complexity of that patient’s life – either 'How am I going to get these medications, I can’t afford them or are these the right medications for me,' " he said.

Allamby said he tries to keep all of this in mind when he's caring for Black patients, especially those who express shock when he walks in the door.

"I wish I had time to ask. I can only wonder what has triggered that response in them. Obviously, they must have had something that had gone wrong."

 Beacon Journal staff reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ. To see her most recent stories and columns, go to www.tinyurl.com/bettylinfisher