April is National Minority Health & Health Disparities Month. The 2021 theme is #VaccineReady. As recognized by the HHS Office of Minority Health, the COVID-19 pandemic has disproportionately impacted racial and ethnic minority communities and underscores the need for these vulnerable communities to get vaccinated as more vaccines become available. America still has a long way to go when it comes to equality on many levels. Healthcare is just one category. The pandemic has made it so that virtually no one has been able to escape the recent news regarding injustices towards minorities. In addition, it has shone a light on minority mistrust in medicine as evident in many minority groups refusing to be vaccinated against the deadly COVID19 virus.
If you ask me what we can do about minority mistrust in medicine, I would advise on three steps. The first step is acknowledging that racial inequities are embedded in the US research and health-care systems. The second step is increasing minority representation in medicine. I sit on the Alumni board of my medical school and we have accepted 6 Black students out of 267 incoming medical students this year. The third idea is to provide more medical resources in minority communities that would prevent certain pathology and disease progression. Instead of offering amputation to poor blacks with poor healing wounds from uncontrolled diabetes, perhaps increase vascular clinics and improve food deserts in these areas. This blog post will discuss the first idea.
We start tackling minority health disparities by acknowledging the reasons why many minorities lack trust in the medical system. We (doctors, scientists, politicians, clergy, and other community leaders) must first admit Blacks have been the victims of medical experimentation in America since they were brought to this country in the 1600s. Dr. Marion Sims is touted in the medical field as the “father of modern gynecology”. Yet all of his pioneering tools and surgical techniques were performed on enslaved Black women without anaesthesia. But we don’t even have to go that far back.
There was the Tuskegee experiment in 1932 in which scientists studied 399 Black men with Syphilis and did not treat them for the purposes of studying the effects of the venereal disease on the human body. The study was funded and conducted between 1932 and 1972 by the United States Public Health Service and the Centers for Disease Control and Prevention. The men unknowingly passed this disease to their spouses and children and many men died from disease complications.
Then you have the forced sterilization policies in the US which targeted minorities and those with disabilities. From 1950 to 1966 Black women were sterilized at more than three times the rate of white women and more than 12 times the rate of white men. This pattern reflected the notion that Black women were not capable of being good parents and poverty should be managed with reproductive constraint.
I’ll share one more example of the story of Henrietta Lacks. Lacks was a Black woman with an aggressive cervical cancer. The world renowned Johns Hopkins hospital where her cells were collected and unknowingly donated, was one of only a few that provided medical care to Black people. Her cancer cells are the source of the “HeLa” cell line, the first immortalized human cell line and one of the most important cell lines in medical research around the world today. HeLa cells are used to study the effects of toxins, radiation, drugs, poisons, hormones and viruses on the growth of cancer cells without experimenting on humans. None of the biotech or medical companies that profited from her cells gave any money back to her family. And, for decades after her death in 1951, doctors and scientists never asked her family for consent as they revealed Lacks’s name publicly, submitted her medical records to the media, and even published her cells’ genome online.
These are only 4 examples of United States government issued assaults on Black bodies in the name of science. These victims have families and these families have memories of the horror. If you are Black in America, you quite naturally have apprehension in regards to public health mandates such as COVID19 vaccines. Why trust the government now? A government cannot encourage a community to get vaccinated without addressing how this time it is different. As a Black physician, I struggle internally for all the aforementioned reasons. My family is from North Carolina and I have plenty of personal family experiences that could easily dissuade me from getting vaccinated. Many of my family and friends look to me and trust me because I understand the science and I am able to explain it in a way they can comprehend and find comfort in their safety. But what about the minorities who don’t have a doctor in the family that they can talk to? I might not have solved the dilemma of health disparities in this post, but I hope I have sparked a light to speak about it. Only then can we move forward to close the gap in racial health inequality.