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  • Sasha Anand

The African American Community and Mistrust Within Healthcare


By Iza Piatkowski



As Black History Month comes to a close, The Youth Press wants to highlight an important issue that continues to impact the community today: the mistrust towards the medical system held by many African Americans.


Dr. Laura Bogart, a behavioral scientist and social psychologist at the RAND Corporation, defines medical mistrust as “an absence of trust that health care providers and organizations genuinely care for patients’ interests, are honest, practice confidentiality, and have the competence to produce the best possible results.”


This mistrust is justified, as the healthcare system has failed African Americans completely throughout history. Myths about physical racial differences, torturous medical experiments, and unfair medical treatment have all contributed to this failure.

 

Myths about physical racial differences, once used to justify slavery, are still viewed as true by many doctors today. Historically, one of the most widely believed myths is that Black people have a significantly higher pain tolerance than white people. As a result, physicians often used slaves in painful medical experiments. Dr. J. Marion Sims, regarded as the father of modern gynecology, used Black women to practice painful gynecological operations without anesthesia between 1845 and 1849. Dr. Thomas Hamilton, who believed black skin was thicker than white skin, experimented on his slave John Brown for nine months to prove his theory. Today, as published in a 2013 review in The American Medical Association Journal of Ethics, Black people continue to receive inadequate pain management. A survey of medical students and residents from The Proceedings of the National Academy of Sciences revealed that when given examples of Black people in hypothetical medical scenarios, the students and residents believed the black patients felt less pain and were therefore less likely to recommend appropriate treatment. A third of them also believed Dr. Hamilton’s disproven theory that black skin was thicker than white skin. 


Even in the twentieth century, the federal government was conducting experiments on black people. In 1932, the U.S. Public Health Service began a study on the natural history of syphilis called the Tuskegee Syphilis Study. It initially involved 600 black men, 399 with syphilis and 201 without. Subjects did not give informed consent for this study, simply being told they were being treated for “bad blood.” Although penicillin, the treatment for syphilis, was widely available, participants in the study were not treated. According to the World Health Organization, untreated syphilis can “affect multiple organs and systems, including brain, nerves, eyes, liver, heart, blood vessels, bones and joints” and can even “cause death.” Syphilis, an easily transmissible STD, can also be congenital. 67% of women with syphilis “will have an adverse outcome of pregnancy,” with 26% experiencing “fetal loss or a stillbirth.” Despite these risks, the study went on for another 40 years until a 1972 Associated Press article revealed the study to the public. 


Given these facts, it should not be surprising that a Pew Research study revealed only 42% of black Americans said they would be willing to take the COVID-19 vaccine. Despite the structural inequality black Americans face, the healthcare system has not been forgiving. According to a KFF study, Black people continue to face barriers to healthcare and are more likely to report unfair treatment while seeking medical care. There is work that can and should be done to reduce the health disparities the African American community faces. 


 


An article from the USC Sol Price School of Public Policy presents the following solutions: raising awareness among health care providers, increasing health literacy in affected communities, advancing health equity, providing more resources, and tracking results.


The United States healthcare system needs to work to improve all of these things, or Black Americans will continue to rightfully mistrust the system that is supposed to help them stay alive. 



 


If you would like to learn more about the health inequalities African Americans face, we encourage you to read the following sources used to help write this article:


USC solutions:






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