The Community Research for Health Equity (CRHE) program, managed by AcademyHealth and funded by the Robert Wood Johnson Foundation (RWJF), supports community-led research to address local health care system issues of importance to communities of color, people with disabilities, LGBTQ+ individuals, and other historically marginalized populations. Throughout the year, we will be featuring interviews with CRHE grantees to showcase and celebrate their work during relevant celebration and recognition months.
In the fifth interview of this series, AcademyHealth Senior Research Associate, Maura Dugan (she/her), speaks with Dr. Tanya Funchess (she/her) and Warren Jones (he/him), from the Institute for the Advancement of Minority Health (IAMH) to discuss their current project and to celebrate community-led research during Black History Month. IAMH’s project seeks to determine the impact of implicit bias and perceived discrimination on accessibility and availability of health care services among African American women in Mississippi. The conversation has been edited for length and clarity.
Maura Dugan: What have you learned in your study? What are the main findings that you'd like to share?
Tanya Funchess: Our project studies the association of perceived racism for African American women and their access to health care. It was important for us to understand if women are perceiving racism, does that impede them from accessing any type of health care? The focus of this study was to see if there was bias and if it really impacted or impeded African American women from accessing health care.
Warren Jones: More than 50 percent of our respondents reported that they felt that because they were African American, they were getting less favorable insurance and care. Fifty percent of the sample also reported that they felt that because of their race, their input was not really taken into consideration for their health care and their treatment. This can be something that could possibly lead to misdiagnosis. That's why this question isreally important. During this study, we've seen that African American women in Mississippi, and especially within our sample, have all experienced some form of implicit bias within a health care system. That was a really strong data point to notice. We wanted to understand their lived experiences and understand their perceptions as it relates to their overall health care experience.
Tanya Funchess: In reality, of the 200 women we researched, about 45 percent reported that they felt “often ignored or not taken seriously by my health care provider.” We asked questions like “my medical and nursing staff often assume that I'm sicker than I am,” and 59 percent of the women felt that way. “Because I'm Black, I feel as if I'm expected to be more mentally balanced,” we found more than 50 percent felt that way. Women just wanted to be heard by their provider; they wanted to be seen. They wanted quality care.
Maura Dugan: How does being from and embedded within the community of focus inform your work?
Warren Jones: Now doing this work as an epidemiologist and you know all the data collection and analysis and things that I do as now as a professional, I'm largely inspired by the health disparities that I witnessed within my community and within my own family. My lived experience informs me of how to go about this work at this time. If we're looking at older women, like my grandmother was, I have a very close in-depth look at the lived experiences of our target population. Being from this community allows me to be better informed and better acclimated to address the disparities that are present.
Tanya Funchess: I try to stay connected as much as possible to the community. For me, it helps inform my work to be at church, to be in the community, to be involved. Understanding and knowing where people are but also understanding and seeing what I see through their eyes. It really helps me understand. Being in the community helps me say ‘let me make sure I talk to those particular people,’ because they could tell me things that I would probably have never thought of, or even realize it was happening. Many times, as a researcher, when we're doing this work, we don't go into the grassroots of the community. There are so many beautiful people in the community that we take the time to get to know and to get to work with.
The community is smart and understands and they can do things that we could never do, and they can make their own decisions. They can come up with solutions. Because I’m from their community, it helps me stay grounded. I'm protective of my community. And not just my community, but all communities.
Maura Dugan: How do you want to celebrate and think about your work, and the future of research for and about Black American Women, during Black History Month?
Warren Jones: We've been able to disseminate our findings at different conferences for this project, and that's what I celebrate. That’s what brings me joy to see, to witness other folks being able to see the findings, to share our research methods with other researchers and other folks. I think that's the beauty around this. Even with the challenges that we've had during this project, being able to disseminate this work so folks can be able to see the data and for folks to be able to see the work that's being done.
I also find joy in seeing progress--that we're even here able to do this work and that we can see the progress. I celebrate the progress, the opportunity to do the work, the opportunity to disseminate the information and to also work alongside a diverse group of individuals. Even though the work can be difficult, it can be tough working through this tough subject matter. Those things bring me a lot of joy and just make me feel good about what we're doing.
Tanya Funchess: Resiliency is what comes to mind when I think about the women that we studied and when I think about the researchers and our team. When the going gets tough and you get down… you just keep working and you keep working hard with the understanding and the belief that you're going to win. I don't think we can give up even during these times. I am not afraid. Not scared. Because I know that anything that's built on values and truth is the safe ground that we have to stand on. And I truly believe that it will prevail over anything.
We have the highest maternal mortality deaths in the state of Mississippi—we can't ignore that biases exist. We cannot ignore them because people are going to die, and they are dying at higher rates right now. If we pretend that doesn't exist, it would just continue to be exacerbated and cause more deaths, particularly for African American women. For me, we have to keep fighting. No matter what, I just believe that the truth will prevail. Hard work will prevail. Values will prevail. We will continue to do this work to fight for any marginalized communities that are facing these types of disparities.
If you would like to read more about the Institute for the Advancement of Minority Health’s CRHE grant, you can view that here. To watch an interview with CRHE project team member Sandra Melvin, on the value of community-led research, you can view that here. Earlier posts in this series featured CRHE grantees during Pride Month, Disability Pride Month National Disability Employment Awareness Month, and Native American Heritage Month. This work is made possible with a grant from the Robert Wood Johnson Foundation (RWJF). The views expressed here do not necessarily reflect the views of RWJF.