Tina Sacks, author of the new book Invisible Visits: Black Middle-Class Women in the American Healthcare System.(Photo by Carlos Javier Ortiz)

By Yasmin Anwar

The anxiety of being black, female and at the mercy of the US healthcare system first hit Tina Sacks when her mother was diagnosed with breast cancer. Bette Parks Sacks, then in her 50s, intuitively knew something was wrong but, like many African American women, was afraid her doctor would give her the brush-off.

It wasn’t until a conscientious technician advised Parks Sacks to follow up with her physician after a mammogram that her breast cancer was caught — in time. Less fortunate are untold numbers of African American women who did not aggressively advocate for their health for fear of being discounted.

In her new book Invisible Visits: Black Middle-Class Women in the American Healthcare System (Oxford University Press, 2019), Sacks, an assistant professor of social welfare at UC Berkeley, tells the often frightening human stories behind the statistics about delayed or denied diagnoses and/or treatment and high mortality rates among African Americans.

Invisible Visits is largely based on in-depth interviews Sacks conducted for her study “Performing Black womanhood: A qualitative study of stereotypes and the healthcare encounter,” which was published in 2017 in the journal Critical Public Health.

“When you look at inequalities in healthcare, you see a lot of studies tying the problems to race and poverty, but there’s not a lot about educated, insured black women who are not poor,” Sacks says. “Yet infant mortality rates for black women with a college degree are higher than those for white women with a high school education. I wanted to dig deeper into the personal experiences behind this disparity.”

This spring, Sacks, a former NCAA Division 1 tennis player who is married to documentary filmmaker and photographer Carlos Javier Ortiz, will give talks on and off campus about the ongoing racial disparities brought to light in Invisible Visits. Berkeley News recently sat down with Sacks to ask about the inspiration for her book, the inequities it highlights and how to address them.

What overarching issue motivated you to write the book?

There’s so much large-scale data showing racial disparities in healthcare, but I was more interested in telling these women’s personal stories to understand their challenges in healthcare settings and how they manage them. One of the running themes in the book is that black women cannot prove they are being discounted or denied treatment, but have this persistent nagging feeling that something is amiss and they’re not being treated the way they should. The book looks at why this is happening and what we can do to change it.

Why focus on black middle-class women?

Being a racial minority is usually equated with being poor, and so it’s assumed that black middle-class women should be fine because they’re not poor. But they’re not fine. They face substantial health challenges and differences in health outcomes. My work points to the persistence of racial discrimination across class, resulting in lower life expectancy and higher rates of infant mortality, and also highlights the unique challenges women in general and black women in particular face trying to be taken seriously and get their needs met by their doctors.

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