Sonja Foster/KFF health news
When Kristie Fields was being treated for breast cancer nine years ago, she got some unsolicited advice in the hospital: Share your story on the local news, a nurse told her. Viewers would definitely send money.
Fields, a Navy veteran and former shipyard worker, was 37 years old and had four children at home. The food processing plant where her husband worked had just shut down. And Fields’ medical care had left the family thousands of dollars in debt.
It was a rough time, says Fields, who has become an outspoken advocate for cancer patients in her community. But Fields and her husband, Jermaine, knew they wouldn’t go public with their struggles. « We looked at each other like, ‘Wait. What?' » recalls Fields. « No. We won’t. »
Part of it was pride, he says. But there was also another reason. « Many people have misperceptions and stereotypes that most African Americans will plead with, » explains Fields, who is black. « You just don’t want to be seen as needy. »
Healthcare debt now burdens an estimated 100 million people in the United States, according to an investigation by KFF Health News-NPR. And black Americans are 50 percent more likely than white Americans to go into debt for medical or dental care.
But as people flock to crowdfunding sites like GoFundMe for help with their medical debts, asking strangers for money has proved a less appealing option for many patients.
Black Americans use GoFundMe much less than white Americans, studies show. And those who do typically bring in less money.
The result threatens to deepen long-standing racial inequalities.
“Our social media is flooded with stories of campaigns that work really well and are being shared everywhere,” she says Nora Kenworthy, a health researcher at the University of Washington in Bothell who studies medical crowdfunding. « These are wonderful stories and are not representative of the typical experience. »
In one recent studies, Kenworthy and other researchers looked at 827 medical GoFundMe campaigns that raised more than $100,000 in 2020. They found that only five were for black women. Of these, two had white organizers.
GoFundMe officials acknowledge that the platform is an imperfect way to fund medical expenses and that it reaches only a fraction of people in need. But for years, healthcare was the largest campaign category on the site. This year alone, GoFundMe has seen a 20 percent increase in cancer-related fundraisers, says spokeswoman Heidi Hagberg. As Fields has learned, some healthcare providers are even encouraging their patients to crowdfund.
Black patients’ divergent experience with this approach to medical debt may reflect the persistent wealth gap that separates black and white Americans, Kenworthy says. « Your friends tend to be of the same race as you, » she says. « And so, when you reach out to those friends through crowdfunding for assistance, you’re essentially tapping into their wealth and their income. »
Nationally, the average white household now has about $184,000 in assets like homes, savings and retirement accounts, according to an analysis by the Federal Reserve Bank of St. Louis. The average black family’s fortune totals just $23,000.
But there’s another reason black Americans use crowdfunding less, say Fields and others: a sensitivity to being judged for seeking help.
Fields is the daughter of a single mom who worked at a fast food restaurant while in school. The family never had much. But Fields says her mother taught her and her brother a hard lesson: Getting a helping hand from her family and friends is one thing. Asking strangers is another matter.
« In the black community, a large portion of the older generation is not taking benefits because the stereotype is being fed, » says Fields.
His mother, who Fields says never failed to pay a bill, refused to seek assistance even after she was diagnosed with late-stage cancer that plunged her into debt. She died in 2019.
Dealing with stereotypes can be painful, Fields says. But her mother left her another lesson. « You can’t control people’s thoughts, » Fields said at a conference in Washington, DC organized by the National Coalition for Cancer Survivorship. « But you can control what you do. »
Fields says she was lucky that she and her husband had such a close network of family and friends during their cancer treatment.
“I have a strong family support system. So, one month my mom would take the car payment and her aunt would do the groceries or anything else we needed. we took. ‘ »
That meant he didn’t have to turn to local news outlets or a crowdfunding site like GoFundMe.
UCLA political scientist Martin Gilens says Fields’ sensitivity is understandable.
« There’s a kind of age-old suspicion of the poor, a cynicism about the degree of real need, » says Gilens, who is the author of Why Americans hate welfare.
Since the 1960s, that cynicism has been reinforced by the growing view that poverty is a black problem, even though there are far more white Americans living in poverty, according to census data. “The discourse on poverty has swung in a much more negative direction,” Gilens explains, citing an increase in critical media coverage of black Americans and inner-city slums that helped spark a backlash against government assistance programs over the years. 80s and 90s.
Fields, whose cancer is in remission, decided she would help others sidestep this stigma.
Sonja Foster/KFF health news
After finishing treatment, she and her family began delivering groceries, gas cards, and even medical supplies to others undergoing cancer treatment.
Fields is still working to pay off his medical debt. But this spring she opened what she calls « a cancer care boutique » in a shopping center outside central Suffolk. PinkSlayer, as it’s called, is a non-profit store that offers wigs, implants, and skin lotions at discounted prices.
« The one thing my mom always said was, ‘Fight any spirit you don’t want around you,' » Fields said as she cut the store’s ribbon at a ceremony attended by friends and family. « We’re fighting this cancer thing. »
In one corner of her small boutique, Fields has installed a comfy couch beneath a mural of pink and red roses. « When someone is in need, they don’t want to be plastered all over your TV, Facebook, Instagram, » Fields explained recently after opening the shop. « They want to feel loved. »
KFF health newsformerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism on health issues.