By Morgan Jordan
Racism and Medical Mistrust have been a barrier for the Black community for as long as medicine has been around. Black people worldwide, including right here in North Carolina, have been subjected to repeated trauma caused by the medical system. From their conditions being misdiagnosed to treatment being withheld for unwarranted reasons, for Black people, going to any medical professional is filled with trials and tribulations. This malpractice has been normalized, and medicine has adapted to include these racist notions in the schooling and training of upcoming practitioners. In “The 1619 Project,” Evelynn Hammonds said, “There has never been any period in American history where the health of Blacks was equal to that of whites. Disparity is built into the system.”
Medical mistrust is rooted in multiple atrocities that have left the Black community very skeptical about the care they receive. One of these atrocities is the Tuskegee Experiments. The Tuskegee experiments took place in Macon County, Alabama, home to 600 black men, primarily sharecroppers, poor and illiterate, who enrolled in a study that would change their lives. The purpose of the experiment was to understand the natural course of syphilis and what would happen if it was not treated. The name of the study was the “Tuskegee Study of Untreated Syphilis in the Negro Male.” Of the 600 men enrolled in the study, 399 had syphilis, and the other 201 were in the control group. Researchers told the participants that they would be treated for “bad blood,” which was the name for a plethora of diseases from fatigue to syphilis. In turn, they were promised free medical exams, meals on the days they went into the clinic, rides to the clinic, and a guarantee that when they died, their families would be provided a burial stipend so that they could have a proper burial.
The men were lied to. They were promised medical benefits and burial stipends to die right under the noses of scientists and researchers who knew what was going on. These men unknowingly passed syphilis to their sexual partners, wives and children. They were given placebos, and doctors watched as men died and experienced significant health problems, such as going blind or insane, because they were not treated. Even in 1947, when penicillin became a treatment for syphilis, these men and their families were not treated. By the time the study shut down after a story was leaked to the Associated Press in 1972, 28 men had died from syphilis, 100 others died from complications related to syphilis, and syphilis was transferred to at least 40 spouses and 19 children at birth. This 40-year experiment caused the life expectancy of Black men to be three years less than white men, and ever since then has drastically decreased the confidence of Black people in the health system.
Stephanie Atkinson, a lab technician at CommWell Health in Dunn, NC, works with HIV-positive patients who cite the Tuskegee experiments because they don’t trust doctors and how it has changed her perspective on how to care for her patients.
“They were present when this thing happened, so as somebody who was living in that age where you saw the CDC take people and use them as a test experiment and not give them the treatment that they needed to be treated and cured of something, and then you ask them to trust the same people that—so that’s why I see a mistrust in flu vaccinations because guess who does it? The CDC. And they’re like, “Well, the CDC wouldn’t give them the penicillin they needed so they’d be better.”
The Tuskegee experiment revealed a lot about the American health system that still holds today. Allan M. Brandt says that “the Tuskegee Study revealed more about the pathology of racism than it did about the pathology of syphilis.”
After years and years of subpar care given to Black people everywhere, recent studies now show that as the number of black doctors and practitioners come into the medical field, care for black patients is better when they see black doctors. This happens because when doctors and patients are matched of their same race, they are more likely to have better communication, which leads to better diagnoses and care. In some cases, Black people will wait months to see a Black physician because of their trust in them over anyone else. In Dr. Damon Tweedy’s memoir, Black Man in a White Coat: A Doctor’s Reflections on Race and Medicine, he writes about experiencing racism in urgent care because he was black. Tweedy writes, ‘I couldn’t get out of my mind how I’d been treated as two entirely different patients. Damon Tweedy, the unknown black man, dressed like he was about to mow the lawn, couldn’t get the doctor to look him in the eye or touch him; Damon Tweedy, M.D. was worthy of personal, first-class service’ (150). This is true for many other Black people, who don’t have the luxury of falling back on their white coats in situations like these, so they aren’t treated as less than. Crystal Deshazor, a Community Health Worker in Danville, Virginia, talks about how race and socioeconomic factors have often negatively affected the quality of care that she and her daughter have received.
“I noticed this a long time ago when I would take my daughter to the doctor, because she would have Medicaid, and she would go to a doctor’s office, and they had maybe four baby doctors in there, and she would see somebody different every time she would go, as opposed to a person that may have a different insurance, they’re going to see that one doctor and one care.”
Without Black doctors advocating for Black people in the medical field, racial bias and medical mistrust will run rampant through society, as it already has. Having more Black people in the medical field is so important. Time has shown us that if not us, then who. From the disproportionate number of infant mortality rates to the numbers of COVID-19 deaths caused by discrimination and bias, this has to be stopped in some way, somehow. Black people have been and are still fighting their lives against the system that is supposed to care for them, and we’re losing. Will we ever win?
“About the USPHS Syphilis Study.” Tuskegee University, https://www.tuskegee.edu/about-us/centers-of-excellence/bioethics-center/about-the-usphs-syphilis-study.
Alsan, Marcella Garrick, Owen Graziani, Grant Does Diversity Matter for Health? Experimental Evidence from Oakland American Economic Review 109 12 4071-4111 2019 10.1257/aer.20181446 https://www.aeaweb.org/articles?id=10.1257/aer.20181446
Bajaj, Simar Singh, et al. “Beyond Tuskegee – Vaccine Distrust and Everyday Racism: Nejm.” New England Journal of Medicine, 20 Apr. 2022, https://www.nejm.org/doi/full/10.1056/NEJMpv2035827.
Brandt, Allan M. 1978. “Racism and research: The case of the Tuskegee Syphilis study.” The Hastings Center Report 8(6): 21-29.
Frakt, Austin. “Bad Medicine: The Harm That Comes from Racism.” The New York Times, The New York Times, 13 Jan. 2020, https://www.nytimes.com/2020/01/13/upshot/bad-medicine-the-harm-that-comes-from-racism.html.
Hannah-Jones, Nikole, et al. The 1619 Project: Born on the Water. Kokila, 2021.
Kinlock, Ballington L et al. “High Levels of Medical Mistrust Are Associated With Low Quality of Life Among Black and White Men With Prostate Cancer.” Cancer control : journal of the Moffitt Cancer Center vol. 24,1 (2017): 72-77. doi:10.1177/107327481702400112
Nix, Elizabeth. “Tuskegee Experiment: The Infamous Syphilis Study.” History.com, A&E Television Networks, 16 May 2017, https://www.history.com/news/the-infamous-40-year-tuskegee-study.
Powell, Wizdom et al. “Medical Mistrust, Racism, and Delays in Preventive Health Screening Among African-American Men.” Behavioral medicine (Washington, D.C.) vol. 45,2 (2019): 102-117. doi:10.1080/08964289.2019.1585327
Tweedy, Damon. Black Man in a White Coat: A Doctor’s Reflections on Race and Medicine. Picador, 2016.
WFAE | By Dana Miller Ervin. “African Americans’ Mistrust of the Health Care System Could Affect COVID-19 Recovery.” WFAE 90.7 – Charlotte’s NPR News Source, 21 Oct. 2020, https://www.wfae.org/health/2020-10-19/african-americans-mistrust-of-the-health-care-system-could-affect-covid-19-recovery.