As COVID-19 vaccines are rolled out across the country, there are some people in the United States that are more hesitant to get the shot than others. During February’s Black History Month, we take a closer look at how mistrust in the healthcare system has affected members of the Black community.
The Tuskegee Study
In 1932, the Public Health Service, working with the Tuskegee Institute, began the “Tuskegee Study of Untreated Syphilis in the Negro Male”—a medical study that involved 600 Black men, 399 with syphilis and 201 without the disease. There were many issues with the study, such as conducting the study without the informed consent of the patients. The project also went on much longer than it originally intended (39 years longer in fact), and participants never received proper medical treatment so that researchers could see the natural progression of the disease—again, without their consent.
The study finally ended in 1972 when an Associated Press article caused a public outcry. The Assistant Secretary for Health and Scientific Affairs convened an advisory panel to review the study and quickly concluded that the study was “ethically unjustified”, and it was immediately stopped. Two years later, a class action lawsuit was filed, and a $10 million settlement was reached for participants and their families. In 1997, former President Bill Clinton issued a public apology to the participants, acknowledging that the actions of this experiment were morally wrong.
Because of that awful and unethical study, there are now protocols and procedures in place to protect patients’ health. In 1974, the National Research Act was signed into law, creating the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. In addition, researchers are now required to get voluntary informed consent from all participants and all clinical trials are now reviewed by the Institutional Review Boards who oversee study protocols and ensure they meet ethical standards.
Racial Bias in Healthcare
Doctors take an oath to treat all patients equally, but that is not always the case. It is well documented that members of the Black community experience more illness, worse outcomes and premature death compared to their white counterparts. In addition to what we consider typical disparities such as income, housing and education, inherent racial bias in the healthcare system also contributes to these negative health outcomes. Racial bias, such as feeling that white people are nicer than Black people—whether conscious or not—can lead to prejudicial behavior, such as providers taking more time with white patients than Black patients and therefore learning more about the white patients’ needs and concerns.
We tend to gravitate toward people that look and act like us or have the same life experiences. And right now, there isn’t a fair representation of Black healthcare personnel. And if a Black patient has a negative interaction with a medical professional, why would they want to continue trusting that same system?
COVID-19 Vaccine Mistrust
In addition to the above, we also have a vaccine that was developed at “warp speed”—faster than any other vaccine before it. And COVID-19 quickly became a political issue during the 2020 presidential election, with the spread of misinformation about the virus and its health implications.
But there are many factors that led to the quick development of several COVID-19 vaccines, including significant government funding to help research teams move quickly, leaning on previous vaccine knowledge from SARS-COV-1, and global cooperation through the World Health Organization.
But knowing all of this, still doesn’t solve the decades of mistrust and racial bias in healthcare that proceeded today’s need for swift deployment of a COVID-19 vaccine. The American Lung Association has teamed up with The Center for Black Health and Equity to create resources and materials specifically for the Black community to address these issues, with support from the Anthem Foundation.
We can’t change the past, but we can better understand it and provide public health information in light of the past. We can do better to work toward a more inclusive healthcare system moving forward. We invite you to learn more about the COVID-19 vaccine and how you can help spread accurate, science-based information in your community at Lung.org/vaccine-toolkit.
Blog last updated: August 21, 2023