Disparities for Black women with uterine fibroids

Many of the glaring disparities that exist in care for the 26 million women in the United States who suffer from uterine fibroids, which disproportionately affects up to 80% of Black women, are being aggressively addressed though a new multifaceted campaign called UNmuting Fibroids.

The Black Women’s Health Imperative (BWHI) and Hologic have partnered in authoring a whitepaper titled Unmuting fibroids: meaningful action toward equity for Black women.1

“Because of the health disparities, devastating impact and effects of uterine fibroids -- and to save and extend the lives and well-being of Black women -- BWHI commissioned the white paper to amplify the voices of Black women to advance health equity and shift the public perception and policies for social change,” said Tammy Boyd, JD, MPH, chief policy officer and counsel for Atlanta-based BWHI, which also has a satellite office in Washington, D.C.

As an advocate for policies that improve health outcomes for Black women, BWHI “is inspired by opportunities to leverage its extensive knowledge of and reach among Black women to create awareness around uterine fibroids and other pertinent health causes,” Boyd told Contemporary OB/GYN®.

According to the whitepaper, nearly 80% of Black women will develop uterine fibroids by age 50, 3 times the rate of other racial groups.

Black women also typically have an earlier onset of uterine fibroids than white women. For instance, even in their 30s, 74% of Black women will develop multiple fibroids compared to only 31% of white women.

Furthermore, Black women are more than 2 times as likely to undergo a hysterectomy for fibroids than non-Black women, and are nearly 7 times more likely to undergo a myomectomy; despite studies that show increased morbidity with either procedure.

“The widespread prevalence and disabling nature of uterine fibroids among Black women often surprises some clinicians,” Boyd said. “Moreover, disparities in diagnosis and care of uterine fibroids result in Black women waiting longer than white women before seeking treatment: normally 4 years of more. Black women are also more likely to have severe pelvic pain and anemia due to heavy bleeding.By any measure, these statistics and outcomes are dire and indicative of a pressing public health crisis.”

Adding to the overall disparities are that only 4% of Black men and women are active physicians in the workforce, of whom half are Black women, despite 13% of the US population being Black.

“To prioritize care for every patient, it is essential for health care providers to be knowledgeable about the experiences patients may be facing during the course of treatment and care,” Boyd said. “In particular, educating health care providers about uterine fibroids and the Black woman’s experience to better connect women to culturally competent care is important.”

However, more research and education are essential to eliminate disparities and provide more treatment options for Black women with uterine fibroids, according to Boyd. “By bringing this pertinent issue to the forefront, BWHI strives to promote overall wellness of Black women,” she said.

Promoting evidence and practice-based care options to address health inequities are key.

“Another pressing issue is to ensure that all physicians in the workforce, regardless of race, are educated in culturally competent care, thus relieving Black women of the burden of finding a provider who understands their care needs,” Boyd said. “Physicians should be trained to recognize their own biases and learn strategies to prevent them from influencing the care they deliver.”

Since its beginning in 1983, BWHI has championed comprehensive public education initiatives that promote the overall wellness of Black women. “We will continue to lead the effort to make optimal health and wellbeing a reality for all Black women and girls,” Boyd said.

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Reference

  1. Whitepaper. Unmuting fibroids: meaningful action toward equity for Black women. https://unmutingfibroids.com/wp-content/uploads/2021/11/PHE-Roundtable-White-Paper-Final.pdf