Where is the Hesitancy Coming From?
Providing effective health promotion in the Black community has been a struggle for a long time. Dating back to historical studies such as the 1932 Tuskegee experiment, in which Black men were intentionally left untreated for syphilis3; to prominent figures such as Henrietta Lacks, whose cells were secretly stolen to help inform cancer research4; it can be understood why the Black community is hesitant to trust the health care system, when historically their health was not prioritized. The historical mistreatment of Black individuals, as well as the passing of misinformation on Black health and the discreditation of Black pain, has given the Black community every confirmation to not trust the health care system and those who operate within it.
There are several myths related to the Black community that are still passed around in the medical community today. These myths have a huge impact on how people of color are treated in the medical world:
- Symptoms for Black individuals are the same as they are for the white community. Medical schools tend to only study disease and illness in the context of white populations and communities, which doesn’t provide an accurate representation of the entire population.
- The idea that race and genetics solely determines risk in health. You may hear things like Black people are more likely to have diabetes, but it is more accurately due to social determinants of health, such as the environment a person is living in, the stress they are under (i.e. racism) and the care they are able to receive. Race’s influence on health and access to health care are not actively discussed or studied in the medical community, which causes doctors to study Black individuals, and their health, as one large group instead of individually or with a community focus.
- Black patients can’t be trusted. This is due to the stereotypes and misinformation passed through the medical community. According to Wallace’s findings, the medical community tends to believe that Black patients are untruthful about their medical condition and are there seeking something else (i.e. prescription medication).
- The previous myth also feeds into the fourth; that Black people exaggerate their pain or have a higher pain tolerance. This includes believing that Black people have thicker skin, and their nerve endings are less sensitive than that of white people. To reinforce ideas like this, a research study has shown that 50% of the 418 medical students questioned believe at least one racial myth when it comes to medical care. Myths like these create a barrier in health care, and when thinking back to myth two, it is understandable why the Black community may have higher rates of health conditions.
- Lastly, Black patients are only there for medication. Historically, Black patients are viewed as addicts, and pain is less likely to be properly treated in Black patients. This does not only factor into adult health but really starts when patients are children. In a study of about one million children with appendicitis in the US, researchers found that, compared to white children, Black children are less likely to receive pain medications for both moderate and severe pain.2 Again, going back to myth two, this points to social determinants of health (i.e. the access of appropriate care) that influences a Black patient’s short-term and long-term trust in the system.
Now, stepping into the world of COVID-19 and the vaccine, there’s a lot of reasonable hesitancy around trusting the government and more importantly, trusting the health care system to supply proper care. This not only stems from the historical mistreatment of Black people in the health system, but also from the treatment Black communities receive from all systems in the United States. We have seen videos that seemingly show police brutality, have learned about cases that showcase the lack of justice in our country’s judicial system, and have seen through the recent insurrection at our nation’s capital when systems of power are challenged. Looking at recent laws, policies, and violence and how the media reports these issues, it can be seen why people of color and their communities are reluctant to believe the health care system is looking out.
Then what should we do? How do we get more Black people and people of color to trust the health system and overcome the reasonable doubt? While there are several steps to truly building trust, a big step is increasing representation in the health care system. Representation can also greatly influence trust. One study found that from a group of 1,300 Black men that were offered a free health screening, those who saw a Black doctor were 56% more likely to get a flu shot, 47% more likely to agree to a diabetes screening, and 72% more likely to accept a cholesterol screening.5 If this shows anything, it is that when you can see yourself in someone, it makes a huge impact on being comfortable. Along with racial representation, we also need more education around health equity and providing equitable care for physicians. Through these thoughtful changes to our health care system, that trust can be built, but it will take time and lots of work.
So, as a Black woman, will I get vaccinated? The answer is simply yes and here’s why – I feel it is the right thing for me to do to protect myself, my loved ones, and my community. The Centers for Disease Control and Prevention (CDC) found that when compared to the white community, Black persons are 1.4 times more likely to have cases of COVID-19, 3.7 times more likely to be hospitalized, and 2.8 times more likely to die from COVID-19.1 So, while getting a vaccine can be unknown and scary, the facts of COVID-19 are also scary. If you find yourself questioning if you want to get the vaccine, do your research, talk to your circle, and ask questions. You can also check out the CDC’s website, where they respond to the myths and the facts of the COVID-19 vaccine.
- Centers for Disease Control and Prevention, CDC. (Feb 12, 2021). Hospitalizations and death by race/ethnicity. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html
- Wallace, A. (Sep 30,2020). Race and Medicine: 5 Dangerous medical myths that hurt black people. Retrieved from https://www.healthline.com/health/dangerous-medical-myths-that-hurt-black-people#Myth-3:-Black-patients-cannot-be-trusted
- Nix, E. (Dec 15, 2020). Tuskegee experiment: The infamous syphilis study. Retrieved from https://www.history.com/news/the-infamous-40-year-tuskegee-study
- (Sept 1, 2020). Henrietta Lacks: Science must right a historical wrong https://www.nature.com/articles/d41586-020-02494-z
- Torres, N. (Aug 10, 2018) Research: Having a black doctor led men to receive more effective care. Retrieved from https://hbr.org/2018/08/research-having-a-black-doctor-led-black-men-to-receive-more-effective-care