Beyond Medical Mistrust: What Is Needed to Restore African Americans’ Trust in COVID-19 Vaccines and the Healthcare System?

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Overview:

The long history of medical abuse of African American communities will be forever embedded in the American healthcare system. The eugenics movement from the late 19th century to World War Two devalued and stigmatized communities of color. Its use of compulsory governmental sanctions to carry out the campaign that backed biological determinism and medicalized social problems like crime and poverty. Women were physically detained, socially segregated, and surgically sterilized. (“Eugenics and Public Health”). Undoubtedly, its impacts are still present today through the mistrust African Americans hold when it comes to the healthcare system. It has created gaps in health insurance, inequitable access, and worse health outcomes among populations of color. African Americans have a lower life expectancy along with a higher rate of illness. There is a multitude of factors that contribute to this issue: poverty, household income inequality, the wealth gap, food insecurity, and the lack of safe housing (Taylor). This community in need of a system that was built to serve and protect patients has subjected them to cruel, unethical practices. 

Artwork of medical professionals ignoring an African American patient (Oprah.com)

Personal Interest:

I was interested in exploring the racial inequities within the American healthcare system African Americans face for many reasons. For one, the healthcare system has always taken my interest because there is no universal coverage in the U.S., unlike in other developed countries. Pursuing a career in the field of healthcare has been an aspiration of mine for a while now. So, understanding the issues that occur within it is very important to me. Additionally, I would like to investigate this social injustice because it does impact me because I am a Black American.

Historical Background:

Poster protesting for the end of forced sterilizations of women of color (Nuriddin)

Early eugenic laws of the movement first targeted people with disabilities, whose children would also inherit them (“Eugenics and Public Health”). Dr. Walter Plecker, a white supremacist who headed Virginia’s Bureau of Vital Statistics, help push Virginia’s effort to preserve racial purity (“Negro Prof Answers Purist”). As eugenic ideas spread throughout the United States, southern physicians and policymakers perceived Black people and the disabled as threats to the integrity of white society. The fears of a “race war” provoked white scientists to use eugenics to socially reform America. With their hold over society, they could justify their desired social hierarchies along with continuing to portray African Americans as inherently inferior (Dorr). It was the innate disability Black people had as well as the need to maintain white racial purity that led to African American women being targets of involuntary sterilization (Nuriddin). Out of 7,600 sterilized women, about 5,000 were African Americans from 1933 to 1973 in North Carolina (Dorr). Its motives spurred from changing the demographics of society. Although eugenics is no longer used to belittle African Americans, its damaging impacts have created mistrust of the healthcare system still present today.

 

Present Day Problem:

Medical mistrust does not only stem from the past abuses but also the recent experiences of discrimination and inequitable access to health insurance, facilities, and treatments. Studies have shown that Black patients are undertreated for their pain compared to white people, which relates to the fact 50% of medical students hold at least one false belief about the biological differences between Black and white people (Hostetter and Klein). 70% of Black patients said that they have experienced discrimination in the medical setting at least somewhat often (Heath). Time after time, the healthcare system has ignored the physical and emotional experiences of police brutality, below standard housing and schools, and other hardships of Black Americans (Hostetter and Klein). The fear many Black people have is because history has shown that their lives are dispensable (Manning). Decades of discrimination created a fragile bond between Black patients and non-Black doctors. Experts have agreed the discrepancies are the result of health inequities like access to care, social determinants of health, and structural racism (Heath).

The mistrust only grew as the coronavirus pandemic struck the U.S and forced the confrontation of the issue (Jennings). Healthcare providers had to ask themselves why Black people are getting more sick than white people, and if the institutional barriers and oppressive history are what dampened Black patient trust. In November 2020, the CDC reported Black people were three times more likely to die from the virus compared to white people (Heath). Though when the data was released, only 42% of African Americans said they would get a coronavirus vaccine despite the higher chances of serious illness and death (Hostetter and Klein). In February 2021, more than 60% of the vaccines went to white people and less than 6% went to Black people (NPR). 

Image displaying vaccine hesitancy of African Americans (The Daily Aztec)

For Now Response:

Macro-Level Solutions:

  • Make institutional changes in healthcare services that address the root of the problem
    • Candid conversations about institutional racism and the affordability and access barriers that impact Black people’s care will bring the issue closer to the system
  • Ensure African American patients receive the same amount of respect regardless of their income, coverage, and other factors
    • Mandatory bias training for providers and an assessment of health equity of their services have the ability to uncover the inequities and then eventually, work towards eliminating them
  • Release consistent information from all levels of government along with partnering with organizations and community leaders
    • Misinformation has caused a lot of mistrust and communities that have been targeted by the government in the past are more likely to listen to messages coming from people close to their community 

What You Can Do: 

  • Respond to misinformation about COVID-19 vaccines and correct it before it spreads further
    • At the rate that false information travels, it is very difficult to respond to; if more and more people begin to correct each other, it will be minimized and the faith in healthcare will begin to be restored 
  • Avoid using the programs set up to help minority communities for vaccinations if you have not been heavily impacted by the pandemic
    • Equitable vaccine distribution will ensure everyone is able to become vaccinated and that people are not left unprotected 
  • Provide reassurance for Black communities by sharing personal experiences of receiving the COVID-19 vaccines 
    • Word of mouth is essential to overcome reservations and will instill confidence in the vaccine

 

Featured Image Attribution: Walgreens

Thank you so much for visiting my webpage! Feel free to use the comment section to share your thoughts about the proposed solutions, any questions you have, or your own answers to these questions I have for you!

  1. Were you aware of medical racism against African Americans and COVID-19 vaccine hesitancy before reading this page?
  2. Do you think the coronavirus pandemic will be a turning point where trust is restored? Why or why not?
  3. Are there other ideas you have that could potentially be a solution for this issue?
6 Comments
Sydney_58

Sydney_58

Student at Head-Royce School, Oakland, CA USA

6 comments

  1. Hi Sydney. Great job on your project. Your presentation was in-depth, nuanced, and beautifully conveyed. I was aware of some of the broad strokes when it came to systematic racism in the American medical system, but reading your historical research was definitely eye-opening. I think the pandemic will highlight and expose these inequalities in a new way. It would be interesting to take a interactive design lens when looking at the American medical system. How are the way we design spaces, institutions, and bureaucracies inclusive or exclusive?

  2. Hi Sidney,
    Great research on your project! I’ve been reading about how some African-Americans are hesitant to get the COVID vaccine, but you went into so much more detail than I’d previously come across. Your stats were especially impactful. To answer your questions, I hope that this pandemic is a turning point in the fields of healthcare and medicine so that afterwards, all Americans trust and have access to good healthcare. I think your proposed solution is easy to implement but also effective. Overall, great research!

  3. Hi Sydney, awesome research! I was not aware of specific information about the historical background of the eugenics movement and forced sterilization, and can definitely see how that plays into the current issue. I think the pandemic could potentially be a turning point for this issue, and since it shined a spotlight on racial health disparities and medical mistrust as well I hope it will be to create a more equitable medical system. Great job!!

  4. Hey Sydney! Your arguments, especially the call to action, were all written in applaudable detail. I was aware of the medical racism against African Americans and COVID-19 vaccine hesitancy but didn’t know too many statistics or the underlying causes and effects. In response to your question, I believe that the boost in awareness of the racial disparities in America’s healthcare system has and will continue to lead to strives in the restoration of trust. Your proposed solutions have a lot of promise and are realistically attainable. Keep it up!!

  5. Thank you for your work on this important issue, Sydney! I was aware of some of this history through the podcast “America Dissected: Coronavirus.” I love that you included a “what you can do now” section, along with your policy recommendations. In pursuing this project further, I wonder what specific institutional changes would best address this problem. For example, should insurance companies get tax breaks for providing materials specifically addressed to Black communities as a way to improve medical access?

  6. Hi Sydney! This is a very interesting topic you chose to research. I think it is super interesting how you explained the history of medical mistrust for African American people and how things are changing today with COVID-19. You did a very good job of explain the context to why this mistrust has been formed and you also did a great job of explain what would make African Americans more likely to feel comfortable getting vaccinated. Great job!

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