I went to a new health provider for my mammogram.
The first screening was conducted by a young Black woman who read questions from her laptop, typing in my responses as we talked.
“How do you identify racially?” she asked.
“What are my choices?” I queried since I couldn’t see her screen.
She shot me a quick look. Between the mask, hat, and glasses I was wearing, all she could see was some beige skin and brown eyes.
“White. Black. Asian. Hispanic / Latino. Native Pacific Islander. Indigenous Native American.”
I laughed loudly. “Wow. Y’all might want to adapt that list to get up with the times. Let’s put Black.”
I mean, I know how essential it is for our medical records to accurately reflect our identities. So, the fact that there was no Multiracial option struck me as strange in 2022.
Later the tech, a white woman, verified the health information on her screen. At the end, she asked a question I’d never heard before: “Do you have any Ashkenazi Jewish heritage?”
“Yes. Half.”
“We’ve just added this to the screening,” she said, explaining the BRCA gene mutation that gives Ashkenazi Jews a 1 in 2 chance of developing breast cancer before age 70.
Then I recalled that my family’s recent revelation that my maternal grandfather was Sephardi rather than Ashkenazi.
“Wait! Please change that Ashkenazi half to a quarter.”
She nodded and complied. I wondered how that looked on the chart: if just half of one of my breasts was at risk.
Why does all this matter?
Shouldn’t everybody be “equal” when it comes to health care?
'Collecting race and ethnicity data can provide health care organizations with useful information about patients ... '
According to the Centers for Disease Control and Prevention (CDC), “The data show that racial and ethnic minority groups, throughout the United States, experience higher rates of illness and death across a wide range of health conditions, including diabetes, hypertension, obesity, asthma, and heart disease, when compared to their white counterparts.”
Medical professionals need as much information as possible to adequately screen, diagnose, and treat patients. “Collecting race and ethnicity data can provide health care organizations with useful information about their patients, including whether any racial and ethnic patient populations are experiencing disparities in their health and health care,” reports the Colorado Trust. “As the nation’s demographics change, some of the greatest challenges many health care organizations experience in providing quality health care services are knowing the patient populations they serve … the collection of race and ethnicity data is considered crucial to providing quality health care for everyone.”
I first encountered identity questions in health care when I was pregnant, and doctors screened the babies for potential health risks.
With their dad full-Black and me Mixed-Black, they naturally tested for sickle cell disease.
I told them I’m half Jewish, so they tested for Tay Sachs as well.
I’m sharing all of this because lately I’ve seen some posts and comments from Mixed folks about resisting and resenting the idea of sharing ANY racial / ethnic data in medical settings.
Some Mixed people share that they sometimes give false identity information as a way of ridiculing the practice of noting patient’s backgrounds.
I thought about those comments during my mammogram.
This is not the time to decide that race doesn’t matter.
Or to take a stand as a Mixed identity warrior by withholding vital background information.
Granted, some people don’t have access to their family intel, but where possible, it’s vital to share all the details that we can.
Not only are some groups genetically prone to some health risks and conditions, but the systemic racism in the U.S. healthcare system increases the urgency for accurate information both for individual patients and overall medical research.
Racial and ethnic background can be as relevant to health care as blood type and impact the chances of surviving serious conditions that require transplants.
For instance, “BIPOC and Mixed-race patients have a harder time finding matches for vital organs like kidneys and hearts,” according to Diverse Health Hub. “Over half of the patients on the national waiting list for a life-saving transplant, at 58 percent, are patients from communities of color.”
Mixed people face some health challenges when it comes to bone marrow transplants.
Time.com reports that, “To find a marrow match for anyone is hard. Even within one's own family, the chances of finding one are only about 30%. According to the World Donor Marrow Association, while two out of three Caucasians find a match, the chances of a patient from another ethnic background can be as low as one in four … For a multiracial person, the chances are usually even worse. Athena Mari Asklipiadis, the founder of the California-based Mixed Marrow, one of the only outreach groups devoted to recruiting mixed race donors, says ‘the numbers are quite staggering ... People compare it to winning the lottery.’
Back to my genetic risk for breast cancer. While my Ashkenazi Jewish heritage increases the odds, the fact that I’m Mixed creates special dynamics. “If you have mixed heritage, it's important to test the whole gene, as well as other high risk genes associated with the cancers detected in you or your family,” states Sydney Cancer Genetics.
Thankfully, my mammogram results came back “normal.” But I have two #BLEWISH sisterfriends whose Mix is similar to mine, who have had breast cancer.
In health care and medicine, as in so many areas of life, identity matters – and the more accurately and specifically we can share our backgrounds, the better.
If you’re ANY kind of Mixed, please sign up for The Mixed Marrow project for the chance to help save a life. I was on this registry for decades, until I aged out. Please sign up today!
Very informative. I have resisted answering some questions on health forms, but I won’t now.