15 Minutes With: Dr. Neel Shah Talks to HealthyWomen About Racism in Healthcare

Shah is featured in “The Color of Care,” an original documentary from Oprah Winfrey’s Harpo productions and the Smithsonian Channel that chronicles how people of color suffer from systemically substandard healthcare in the U.S. and how Covid-19 exposed the tragic consequences of these inequities. He recently spoke with HealthyWomen’s editor-in-chief Jaimie Seaton.

And that's not a coincidence. Historically, these have been Black neighborhoods and they just have less investment and, therefore, less infrastructure. So hospitals tend to have less resources and therefore struggle more to take good care of people. The other way that it operates, honestly, to make it very concrete: I'm an obstetrician in Boston, and one major way that redlining works is that it's actually harder to get from place to place through public transportation.

And then there's a whole bunch of other ways too, where because of the fact that, for hundreds of years now, we've treated Black people as biologically different, we have baked that into the way that we provide care in 2022. Everything from measures of how kidneys filter toxins to the likelihood of needing a C-section are based on calculators where Black people have different thresholds than white people, and those differences basically gatekeep care from people who are Black.

One example is this calculator that calculates the odds of needing a C-section. For most of the last 15 years, if somebody came into your office and they’d had a C-section in the past and wanted to know their odds of success in having a normal vaginal delivery the second time, you would put their age, their body mass index and their race into a computer and it would spit out a number. And if you put in that they were Black, it would drop the odds considerably, and nobody ever questioned that.

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