As Americans, we are told that when we are feeling sick or unwell, we should go see a doctor. While that’s a seamless process for some, for others, getting care can be a traumatic experience that feels like a constant uphill battle—a battle where they are always on the defense. This is especially true for Black, Indigenous, or People of Color as well as other groups that have been historically marginalized, who may not feel listened to or believed by their health care practitioner.
As a current graduate student in public health, I’m interested in learning—and sharing—all I can about the term “medical gaslighting,” and how it impacts the BIPOC community. And as a campaign manager at the Ad Council, I’m interested in how work like ours can help.
The bottom line is this: the system is not taking care of its people. We need to unpack the barriers these individuals are up against beyond the typical healthcare barriers we consider such as access to healthcare facilities. Canvas8’s article, Medical Gaslighting Can Reveal Healthcare Bias, by Elizabeth Gabrielle Lee, dives into the nuanced perceptions, challenges, and barriers around this topic to unveil a broken healthcare system that is built around mistreatment and misdiagnosis for people of color.
What is medical gaslighting?
“Medical gaslighting” is a term that women and people of color are adopting to push back against the systemic inequalities they face in assessing healthcare. Simply put, it is when a health care professional assumes a diagnosis because of their biases based on gender, race, ethnicity, age, or weight without appropriate testing. (This can often mean dismissing or trivializing pain and other symptoms.) Currently, the term is gaining traction. On Instagram alone, individuals are sharing their stories of misdiagnosis and dismissal with the hashtag #medicalgaslighting, which has been used over 9,000 times.
Medical gaslighting shows up when a medical professional:
- Makes a patient feel belittled or like a time waster
- Acted like a patient’s condition is not real or is “in their head”
- Minimized their symptoms by saying "it’s normal"
- Assumed a diagnosis based on gender, race, ethnicity, age, or weight without appropriate testing
- Dismissed symptoms or requests for treatment
Women and people of color are now calling out medical gaslighting and speaking out against injustices on both a personal and societal level. They are expecting institutions and companies to deliver on accountability, but these promises are sometimes not kept. Algorithmic bias reveals that Black people have to be significantly more ill than White people before being referred for additional help. Women’s pain remains largely undertreated, and we see this play out when looking at maternal health. Black women are three times more likely to die from a pregnancy-related cause than White women. These are just a few very real examples of the disparities people face when attempting to access care.
How can we address it?
Now that we have a good understanding of medical gaslighting, how do we authentically weave this acknowledgement into our industry standards when we develop health promotion campaigns, which are focused on achieving health equity through positive health outcomes?
Here are two frameworks to consider when building your health communication strategy for communities of color:
Focus on cultural humility over cultural competence
To start, we can think through our strategic communications plan through a public health fundamental known as “cultural humility,” which is different than its sister framework known as “cultural competence.”
As defined by the NIH (National Institutes of Health), cultural competence is the ability to deliver services that are respectful or and responsive to the health practices, and cultural and linguistic needs of diverse patients. From an advertising perspective, we can see this shake out through learning about other cultures, controlling our biases, and adapting our behaviors and communication style.
The downside of cultural competence, though, is that is leads us to rely on generalizations about certain groups, rather than recognizing the uniqueness of each individual. That’s where cultural humility comes into play. To practice cultural humility, one has to be aware of power imbalance and biases and respecting others’ values. So, while cultural competency is more of a goal, cultural humility is more of a mindset.
Rethink your call to action
We need to reassess our call to action to our audiences in need beyond just asking them to take a quiz, watch a video, or complete an assessment to learn more about their health condition. If we stop here, it risks leading our audience to a dead end. Sure, we can encourage them to speak with their doctor about their medical result, but what if their needs aren’t being met and heard when they do?
One way we can approach this is to speak directly to our medical partners and HCPs, and work with them to help them recognize and remove their biases when providing care. Last year, the Ad Council launched the COVID-19 Vaccine Education Initiative, the largest campaign in our history. Through this work, we discovered the importance of going deep into communities to make sure doctors, healthcare workers, and pharmacists had the information they needed. This community-level engagement “ground game” complemented our nationwide “air game,” which included PSAs and other efforts. I see an opportunity to take future engagement with our HCPs one step further by encouraging them to identify and address unconscious biases in both themselves and the healthcare system they operate in, such as explaining how a provider’s implicit bias and stereotyping can affect their patient interactions.
Exploring other ways marketing and communications can play an active role in addressing health inequities including medical gaslighting is something I am deeply passionate about, but whatever forms those communications efforts take, it’s critical that they drive more awareness and education around gaslighting, support anti-racist practices by encouraging more cultural humility, and recognize how much work must be done to ensure HCPs engage with their patients with equitability, compassion and care.
My hope for the industry is to develop a coordinated communications platform to help humanize and educate Americans about the realities of racial inequity and injustice, how that currently transpires in our broken healthcare system, and how we move that system forward.
This article is the sixth in a series spotlighting trends produced in partnership with CANVAS8.
Photo by Klaus Nielsen / Pexels