DIVERSITY IN SCIENCE
Addressing Medical Mistrust within Black and Indigenous Communities
By Shu‘ayb Simmons
Introduction: Medical Mistrust Within Black and Indigenous Communities
C
lose your eyes for a second and imagine you are in the waiting room for a checkup. You patiently sit, waiting for the nurse to call out your name so that you can begin walking into the doctor’s office. But, upon entering, you see your trusted doctor ready to inject you with dangerous substances. Sound like a nightmare? For Black and Indigenous peoples, who were the subjects of many non-consensual experiments in the past, this is a real fear. Even currently, healthcare quality is disparate across the racial majority and minority groups. These transgressions fomented feelings of medical mistrust within Black and Indigenous communities. This article aims to discuss the existing medical mistrust within Black and Indigenous communities and provide potential avenues to mitigate its consequences.
36 | IMS MAGAZINE SPRING 2022 PATIENT ENGAGEMENT
Getting into it: Medical Mistrust Medical mistrust is a noticeable lack of trust and suspicion with the medical system,1 usually caused by the medical system itself. It can stem from various sources, for example, a lack of education—a socioeconomic barrier—can lead to medical mistrust. A key factor behind medical mistrust, however, is history. Communities previously betrayed by the medical system are less likely to trust healthcare. In a study published by the American Journal of Public Health, it was found that Black individuals are more likely to distrust physicians than their white counterparts.2 This mistrust proves detrimental in the long term as Black, and Indigenous individuals are more likely to under-utilize psychiatric help.1,4 In this manner, medical mistrust is a social determinant of health. It plays a role in racial disparity across illnesses,2 so much so that it intertwines with long-term non-adherence to HIV medication among Black males positive for HIV.3 The primary victims of medical mistrust are Black and Indigenous
communities and, to a lesser extent, sexual minorities.1,4
Looking Back: Medical Violence Towards Black and Indigenous Communities To understand the basis of medical mistrust in Black and Indigenous communities, we need to look back at historical acts of medical violence against these populations. The Black populace has been subject to much medical violence and betrayal by healthcare, the most prominent and evident of which is slavery. Another particularly stark example is the Tuskegee Syphilis Experiment, which ran from 1932 to 1972. Here, scientists tricked 600 men (399 with syphilis, 201 without) from a Black community in Tuskegee, Alabama into participating in an observational study under the pretense that it was a “bad blood” treatment. As the virus took its course, they were observed and not given penicillin even as the symptoms grew more severe. Out of the experimental group of 399, only 74 survived. Funded by the U.S. Public Health Service, the Tuskegee Graphic design by Mchie (Xingyu) Wu
