Race and medicine: the damage that comes from distrust

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<pre><pre>Race and medicine: the damage that comes from distrust

Racial discrimination has shaped so many American institutions that perhaps it should not surprise us that medical care is among them. Simply put, people of color receive less attention, and often worse attention, than white Americans.

Reasons includes lower rates of health coverage; communication barriers; and racial stereotypes based on false beliefs.

As expected, their health outcomes are worse than those of whites.

African-American patients tend to receive lower quality health services, including for cancer, H.I.V., prenatal care and preventive care, according to vast research. They are also less likely to receive treatment for cardiovascular disease, and are more likely to have unnecessary limb amputations.

As part of the "Project 1619", Evelynn Hammonds, a historian of science at Harvard, told Jeneen Interlandi of The New York Times: "There has never been any period in the history of the United States in which the health of blacks has been equal to that of the whites. The disparity is integrated into the system. "

The study was published in 1972 and immediately stopped. To this day, he is frequently cited as a driver of documented distrust in the health system by African Americans. That distrust has helped to engage many public health efforts, including those to curb the spread of H.I.V., contain outbreaks of tuberculosis and expand the provision of preventive care.

According to the work of economists Marcella Alsan and Marianne Wanamaker, black men are less likely than white men to seek medical attention and more likely to die at earlier ages. Their analysis suggests that a third of the black and white gap in male life expectancy immediately after the study could be attributed to the legacy of mistrust related to the Tuskegee study.

His study is based on the interpretation of observational data, not a randomized trial, so there is room for skepticism about specific findings and interpretation. However, the findings are consistent with many other works that reveal the distrust of African-Americans in the health system, their lower attention and their worse health outcomes.

Tuskegee's study is far from being the only unfair treatment of non-white groups in medical care. Thousands of non-white women have been sterilized without consent. For example, between the 1930s and 1970s, one third of Puerto Rican women of childbearing age were sterilized, many of them under duress.

Similarly, in the 1960s and 1970s, thousands of Native American women were sterilized without consent, and a eugenic law in California forced or forced thousands of sterilizations of women (and men) of Mexican descent in the twentieth century. (Another thirty-two states have had such laws, which were disproportionately applied to people of color.)

For decades, sickle cell disease, which primarily affects African Americans, received less attention than other diseases, which raised questions about the role of race in how medical research priorities are established.