“We live the need”: Why Black patients must demand more in 2024

By Robert Phillips

“In West Oakland, there were no doctors. They all had moved out. It was a?hardship. Our thing was, ‘We are the need.? We live the need. We deal?with the need daily.’”?

????????????????????????- Mrs. Cloteal Davis, West Oakland Health, co-founder, 1967

It didn’t happen because of a movement of qualified physicians in Oakland in 1966.?

It didn’t happen because a public hospital closest to the mostly-Black West Oakland neighborhood got religion.?

It didn’t even happen because of community anger about racist or inattentive physicians in Alameda County.?

It happened because the four Black mothers–Edith Brown, Cloteal Davis, Jessie Hamilton, and Olivia Parks–who co-founded the West Oakland Health Council in 1967 understood one thing: health is more than healthcare.?

This phrase is a social media cliche in health policy and healthcare circles today. Yet, most folks don’t know the origin of this idea? was rooted in a community health model forged in Black urban and rural communities that the West Oakland Health Council helped pioneer nearly sixty years ago.??

As we stand on the precipice of 2024, I'm filled with gratitude for our achievements and a burning urgency to address the stark realities facing our community. The past three years have been a brutal crucible – COVID, racial injustice, political turmoil – each blow leaving its mark on our collective health.

But it's the Black community, historically marginalized in healthcare, that has borne the greatest weight of these collective burdens.? Let's be clear: racism is a health crisis. It's not a whisper in the shadows; it's a glaring truth that permeates all healthcare settings, impacting everything from bedside manner to treatment outcomes.

The findings from Listening to Black Californians, a California public opinion research effort including 3,325 Black Californians published in October 2022, paint a stark picture: over 30% of Black Californians have faced racial discrimination from their healthcare providers. This isn't just anecdotal; it's a systemic issue forcing our community to navigate a healthcare system with a built-in bias.

But amidst this grim picture, there's defiance of what should be unacceptable. Black Californians continue to actively seek health and well-being by advocating for themselves, researching conditions before appointments, and carefully modifying behavior to avoid bias.? While no one should navigate health concerns with such fear and doubt, and their trust being eroded by past encounters. Yet, again, here we are.?

“I feel like Black voices aren’t as loud. They are not taken as seriously. . . . I wasn’t listened to, and it ended up being a very serious, actually life-threatening problem. . . . I told [my doctor] I was short of breath, and he told me, ‘You are out of shape. . . . You just need to lose weight and exercise more.’ It ended up being that I was severely anemic and had to have two blood transfusions.”

— Black woman, focus group participant, private insurance

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Demanding More in 2024

Black Californians are demanding change. We want health services that understand our unique needs, are built on trust, and are free from discrimination. This isn't a new call. It started in the 19th century when the Black hospital movement was crucial in challenging racial segregation in healthcare and providing vital medical services to Black communities. This legacy laid the groundwork for West Oakland Health’s establishment in 1966, and it's been our driving force since our doors opened.

We aren't just another clinic. Founded by Black women leaders, community members, and physician advocates, we were built for a community that felt invisible and unheard by the medical system. We are an alternative where respect, compassion, and cultural understanding are the cornerstones of care. Our purpose is fourfold:

1. Be A Safe Haven: We offer a sanctuary for Black folks facing medical racism and neglect, a place where "disrespectful or incompetent treatment" is replaced with dignity and partnership.
2. Give All Power to All the People: We challenge the profit-driven healthcare system ethos, replacing it with a model centered on community control and empowerment. Medical expertise isn’t just for doctors and nurses; mothers, faith leaders, and community activists are vital to our operation; their wisdom and vision guide our every step.
3. Look Beyond Our Clinic Walls: We aren't just about treating illness but about building a healthy community. West Oakland Health is a hub for any service that promotes health, a platform for addressing the "circumstances surrounding" illness, from housing to economic justice.
4. Break the Mold: We expose the hypocrisy of a healthcare system that overpromises to the Black community but delivers consistently underdelivers. We were living proof of what the Black community could achieve with a lot of will and limited wealth, starkly contrasting the shortcomings of many healthcare institutions with a lot of wealth but little will to do better by us.

As we are evolving, our core beliefs remain unchanged. Being a beacon of hope, a safe harbor built on the bedrock of respect, reliability, and compassion. Building a health system where melanin is not a liability but a strength.? Maintaining open doors, culturally concordant providers, and our promise to promote health services delivered with dignity and respect.?

And in 2024, we'll stand firmly on these things as we embark on a journey to reimagine our identity, strengthen our commitment to our communities, and double down on our founders' vision.

Our next chapter will be defined by:

• Expanding Our Community Focus: We remain fiercely rooted in the Bay Area's Black communities, listening to our needs and delivering the services we deserve.
• Simplifying Our Approach: We'll cut through the complexities, making health services meet our community where it is.
• Providing Lifelong Support: Providing health and well-being support along life’s journey.

Our legacy of providing healthcare that feels like home is still needed today.

To echo one of our co-founders, at a time when the practice of healthcare is making it more and more difficult for Asian, Black, Latinx, Native American, and poor communities to feel safe, seen, and treated with compassion, we “still live the need… we deal with the need daily.”

Robert Phillips is President and CEO of West Oakland Health.