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Study: Hair care might be barrier to health for black women. Should doctors be talking to us about it?

by Erika Nicole Kendall
Dr. Sophia Tolliver (left) examines a patient at The Ohio State University Wexner Medical Center after discussing ways to preserve her hairstyle during exercise. She led a study that found few primary care providers acknowledge hair care as a barrier to exercise for African American women. (Credit: The Ohio State University Wexner Medical Center)

Years ago, I made the gentle suggestion that perhaps what might be behind the reluctance to work out for many black women might be the fact that we’re not trying to sweat into our hair, knowing it’s difficult to maintain a straightened hairstyle if you’re sweating into it.

(I mean, years ago, I also was declaring that I’d never go natural… so “years ago” doesn’t really mean much, does it?)

However, I was reminded of this when I saw this study from Dr. Sophia Tolliver at the The Ohio State Wexner Medical Center:

African American women face a unique challenge to regular exercise – their hair. However, it’s a problem that is not often acknowledged by primary care doctors as a barrier to a healthy lifestyle. A new study by researchers at The Ohio State University Wexner Medical Center finds that, while doctors value conversations about exercise with their African American female patients, they rarely discuss how hair care affects physical activity.

“As physicians, if we don’t have those specific conversations, we’re not doing everything that we can to decrease this barrier and really help African American women overcome what they feel is holding them back from exercise,” said [Dr. Tolliver].

The study found 95% of primary care doctors have had conversations about exercise with their African American female patients. However, more than 3/4 have never discussed hair care as a challenge and only about a third felt comfortable discussing it.

“It’s going to come down to increasing education about African American hair care, cultural practices when it comes to hair and ways to counsel a patient in an office visit about decreasing that barrier,” Tolliver said. [source]

I want to look back at a question I asked a few years ago, about this specific topic:

Stakes are high for black people in this economy. Unemployment for black people, right now, is in the double digits. We watched many of our loved ones lose their houses. Hell, many of us have loved ones living with us until they get on their feet. Entire households are anchored solely on us remaining employed in our “good jobs.”

And, in the midst of it all, we may desperately want to work out. But, if we never learn how to care for our hair while working out, or if we don’t have the time to straighten/re-straighten our hair as frequently as we need… the choice becomes clear: skip the workouts and keep my job; or workout anyway, let my hair suffer, and potentially face office harassment because of it. —The Beauty Shop: How Does Your Job and Dating Life Affect How You Wear Your Hair? (2013)

I have a theory.

I feel like, in the current political climate, it’s important to call things what they are, right? Politeness is doing us a grave disservice if it means we’re simply hand-waving the things that subtly have a harmful effect, right?

The idea that black women have to be mindful of maintaining a particular hairstyle—a hairstyle that is expensive and difficult to maintain—in order to maintain their employment (or, for that matter, their relationship in case their partner dislikes kinky, curly hair) is a function of white supremacy. I can’t come to work and earn my living without straight hair? I can’t wear locs if I want? The only way to wear my hair in my place of employment is the way most familiar to white women? That’s white supremacy. Hairstyles that can only be found in the black community are banned from wear in the workplace? That’s white supremacy.

For crying out loud, California Governor Gavin Newsom just made it illegal to discriminate against black women’s natural hair in schools and workplaces. In 2020. In the year two thousand twenty.

I also think about the research that outlines all of the racism in the health care industry (most of which is chronicled here)—how doctors refused to prescribe pain medication to black patients en masse, how doctors disregard black patients own assessments of their ailments, how medical students perceive black people to have a genetic ability to take pain—and how that racism also serves as a function of white supremacy. The racism, and doctors’ inability to see their own biases, is literally killing black women as we speak.

So, when you show me research that suggests that the answer to a problem created by racism is for doctors with their own racist biases to talk to black women about it? Doctors who don’t listen to black women? The same doctors who struggle with empathizing with black women?

Are our expectations a little too high for the health care industry right now?

(Not to mention, if a doctor’s basic suggestion is going to be “eat less, move more,” is it even going to be worth it?)

If racism is already contributing to negative health outcomes for black women, because doctors aren’t listening to us, we’re supposed to expect doctors to actually hear us when we talk about our problems?

We can barely get doctors to hear us when we talk about the pain from bones dangling from sockets, or other real and sincere health problems. Doctors are supposed to care about something they’d likely find super petty?

Black women are facing unique challenges in 2020, and it’s going to take people who respect, care about, and empathize with us to ensure that those challenges are addressed adequately. Are we being with ourselves about what it’s going to take for doctors to be a part of that conversation?

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