Why Autoimmune Disease Hits BIPOC Communities Harder

Photo by Hosein Sediqi on Unsplash

She was doing everything “right.”

Eating well. Staying active. Showing up to work. Pushing through exhaustion like a badge of honour…

…But her body was quietly falling apart.

First, it was the fatigue. Then the constant joint pain. Brain fog. Random rashes. Gut issues. Sleepless nights. She went to appointment after appointment and kept hearing the same thing: stress, anxiety, burnout, maybe hormones.

Years later, she finally got a diagnosis.

This story isn’t rare. According to the Senate of Canada, an estimated 2 million people live with autoimmune diseases, many of them undiagnosed or misdiagnosed for years. And for BIPOC people, especially women and people assigned female at birth, it rarely shows up overnight. It sneaks in. It gets normalized. It’s brushed off until the body forces you to notice.

Autoimmune diseases affect people of all genders. But they disproportionately impact women and people assigned female at birth due to immune and hormonal factors. Many BIPOC people who are nonbinary, trans, or gender-diverse share these same biological patterns and often face even more barriers in medical settings.

Hormonal transitions like puberty, pregnancy, postpartum, and perimenopause can act as flare windows for autoimmune disease. Instead of being investigated, these shifts are often written off as “normal,” delaying diagnosis and treatment.

What An Autoimmune Disease Really Is

Autoimmune disease happens when the immune system, which is supposed to protect you, starts attacking your own body, and then never stops.

Think of it like that hotel light you can never find the switch for.

The result can look like fatigue that rest doesn’t fix, chronic pain, inflammation, neurological symptoms, digestive issues, or all of the above. Symptoms tend to cycle and flare, which makes them easy to dismiss. Especially when it already takes months to get an appointment.

Autoimmune disease rarely starts dramatically. It usually begins with things we’re told to push through:

• Exhaustion that sleep doesn’t fix

• Brain fog

• Joint pain or stiffness

• Digestive issues

• Hair loss or rashes

• Recurring fevers or swollen glands

• Numbness or tingling

• Symptoms that come and go

When multiple symptoms show up, that’s not random. That’s basically your check engine light.

Why BIPOC People Are Hit Harder

BIPOC people don’t get different autoimmune diseases.

They get them earlier.
They get them more severely.
They experience worse outcomes.

The difference isn’t genetics alone. It’s exposure.

Not the kind of stress you fix with a spa day, a bubble bath, or a better morning routine.

The kind that comes from discrimination, code-switching, financial pressure, and carrying more than your share of caregiving.

Activities like constantly code-switching and monitoring how you’re perceived keep the nervous system in a state of alert. Research shows that this stress causes increased cortisol levels, and eventually those hormones stop regulating inflammation properly, which can trigger flare-ups in autoimmune conditions.

Over time, this constant state of vigilance adds up. There’s a name for it: allostatic load, the cumulative wear and tear on the body from living in survival mode for too long.

Stress isn’t a mindset issue. It’s a biological exposure.

For many BIPOC people, trauma isn’t just personal. It’s intergenerational, and it’s systemic. Research shows that trauma can alter how genes are expressed through epigenetic changes, meaning the biological effects of stress can be passed through generations even if your present-day life is relatively safe. The body keeps score long after the mind has learned to push through.

Add poor sleep, burnout, and a culture that values pushing through, and the immune system never gets a chance to reset.

Rest is rarely prioritized in our communities. If you’re seen lying down, you’re labelled lazy or ‘wotless’. But a body that never gets to rest will simply force you to rest.

And stress isn’t the only exposure.

Many BIPOC communities face higher levels of air pollution, industrial toxins, mold, and poor housing conditions. Add occupational exposure in healthcare, cleaning, beauty, or factory work, and the immune system stays under constant pressure.

This isn’t about personal wellness choices.
It’s about environment, access, and survival.

Advocating When You’re Already Exhausted

Many people only receive a diagnosis after advocating relentlessly for themselves.

Helpful questions sound like:

• “I’m concerned about autoimmune disease. What are we ruling out?”

• “Can we order inflammatory markers or an autoimmune screen?”

• “If this continues, what’s the next step?”

• “Can I be referred to a rheumatologist or immunologist?”

This shouldn’t be necessary. But for many people, it’s the only way forward.

Autoimmune disease isn’t just a medical issue. It’s what happens when bodies are pushed, ignored, and asked to survive systems that were never designed to protect them.

And until we name that, we’ll keep calling warning signs “normal” and wondering why so many people are sick.