How Therapists Can Advocate for Black Women’s Health

In January 2024, I was rushed to the emergency room. It was freezing cold outside, and I felt just as cold inside my house and colder in the hospital. I was shivering, and my body felt foreign. I didn’t know what was going on. I was scared. No, I was terrified. I had a child at home and one in college. I had clients who valued me, therapists who depended on me, and a life I wanted to keep living. But I thought I was dying. Seriously. And the medical team didn’t make it better. It wasn’t their fault, but the conversations that were circulating around me had words like heart attack, stroke, hypertension, and “Wait, I haven’t seen this before.”

Fast forward to this past weekend. I met with a friend who told me that one of our mutual friends had colon cancer. She was previously diagnosed with cancer, had the masses treated and removed, and went on living her life. A few months later, she had another pain while on vacation, went to the ER, was admitted to the hospital, had more scans and screenings, and was diagnosed with colon cancer. She agreed to let the doctors conduct surgery and remove the cancer. They accidentally left a couple of cancerous cells in her body. So, when she began to have more pain, she went to her doctor and found out that the cancer was not completely removed, had spread, and metastasized. Now, she has Stage 4 cancer.

While reading a book written by a Black woman, she explained that she was living a very fit life. Exercising every day, eating healthy foods, including lots of green veggies, drinking massive amounts of water, meditating, praying, spending time relaxing and in silence, and doing all the right things. But she was having chest pains. At the pinnacle of her pain, she went to the doctor. Everyone around her began to scramble, moving frantically, shooting off questions in rapid fire, and later explaining that her blood pressure was so high that she could have a stroke at any moment. She was admitted to the hospital. Treated. Given medication. And was released, without next steps, because… she was already living a healthy life.

What the three of us have in common is: We are all Black women, high functioning, loving our lives, feeling purposeful, and were in physical pain that we pushed and pushed and pushed until we couldn’t stand it any longer. Oh, we are all in therapy too.

I know you are thinking — ok, and what does this have to do with me?

Well, here you go: Black women are more likely than other racial and ethnic groups to die from cardiovascular disease, hypertension, stroke, lupus, and several types of cancers. They are twice as likely as white women to develop diabetes over the age of 55 or have uncontrolled blood pressure.

Chin et al. (2021) states, “Health outcomes do not occur independent of the social conditions in which they exist. The higher burden of these chronic conditions reflects the structural inequities within and outside the health system that Black women experience throughout the life course and contribute to the current crisis of maternal morbidity and mortality. The health inequities experienced by Black women are not merely a cross-section of time or the result of a singular incident.”

Again, you may be thinking, what does this have to do with me?

More Black women are increasingly engaging in mental health therapy to address a number of issues and topics like breaking generational cycles, living a life of newfound freedom, addressing mental health diagnoses, moving beyond stereotypes, addressing trauma, and learning new and healthy emotional protective/coping skills. And in all of this, rarely are they discussing their physical health with their therapist.

But it needs to be addressed because these same women who are working on their emotional health may be declining in their physical health, and they do not even know it. Or, they find out when they are admitted to this hospital because their pain is so severe that it drives them to get evaluated. And, as we see in the research conducted by Chin et al., that may be too late. It may result in death.

As a therapist who works with Black women clients, there are a few things you can do to advocate for your clients’ physical health:

1. Broach the conversation about physical health AND annual doctor appointments with your clients. Ask about their last physical, pap smear, mammogram, thyroid functioning, blood pressure, and small but lingering pains.
2. Acknowledge and address any fears they have around going to the doctor’s office and being evaluated (the Tuskegee experiments lasted for 40 years and only concluded about 50 years ago, so the medical trauma and hesitation are still fresh).
3. Pay close attention to legislation and political conversations around health disparities, healthcare, insurance, and medical injustice. The more you listen to these conversations, the more you know. And, the more you know, the more you can discuss with your clients and advocate on their behalf.
4. Discuss these topics with your friends and family members. Note, they may be uncomfortable; however, advocacy can occur in micro settings and macro settings. Plus, one or two or five of them may be positioned to advocate, help, support, or guide Black women in their physical health journeys.
5. And vote. Yes, vote. The ACA Code of Ethics encourages all of us to advocate for our clients. Code A.7- Roles and Relationships at Individual, Group, Institutional, and Societal Levels notes that we are to advocate especially when a system or structure “inhibit [s] access and/or the growth and development of clients.” This includes physical growth and development. And, we know there is a strong correlation between our local, state, and national politics and our healthcare. So, your political vote can support your Black woman’s client's physical health.

In summary, as more Black women are entering therapy and sitting across from you (virtually or physically), you can use your position in their lives to make sure they are getting the best physical health care before it’s too late.

For more information on how to care for and support your Black women clients, check out my book, The Essential Guide for Counseling Black Women.

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