African Americans and Their Distrust of the Health Care System: Healthcare for Diverse Populations
Kennedy, Bernice Roberts, Mathis, Christopher Clomus, Woods, Angela K., Journal of Cultural Diversity
Abstract: "To be used in some type of experiment and then be forgotten. Why are you interested in me now?" This is one of many sentiments felt by African Americans. In one of many surveys conducted by researchers, African Americans feared they would be used as guinea pigs for medical research. This survey also found that blacks were more likely than whites not to trust that their doctors would fully explain the significance of their participation in clinical research or other studies. Many scientists believe that bad feelings make it difficult for them to recruit minorities as participants in biomedical research studies in different areas. There continues to be an underlying element of mistrust between the poor populations and minority populations that may be subjects of research and the research establishment. The perception of mistrust from the African American community is in large caused by their previous experiences with the health care system. However, the mistrust is not only in perception, but has many other reasons. Mistrust of the health care system by African Americans is a major problem that has to be addressed and corrected. This paper is a historical perspective of the African Americans relating to their distrust of research and the traditional health care system.
Key Words: African Americans, Health Care System, Distrust
The now infamous Tuskegee Syphilis study is perhaps the most widely known study exclusive to African American males. It was conducted by the United States Public Health Service from 1932 to 1972, in which researchers withheld treatment from about 400 black men in Macon County, Alabama in order to study how the disease progressed (Adams, 2003). The study continued without treatment, even after penicillin became the standard cure. This study has become to many, a classic and historical case of blatant governmental racism against African Americans and is one major reason why so many African Americans' distrust the health care system. According to James Jones, professor of history at the University of Houston, in his book entitled "BadBlood", he identifies that for many African Americans, the Tuskegee study became a symbol of their mistreatment by the medical establishment. He further states, "This study was a metaphor of deceit, conspiracy, malpractice, and neglect, if not out right genocide" (White, 2000)." Although written with bias, Jones is not far off from the truth of how African Americans view the government and the traditional health care system overall. Entering the 21st century, African Americans continue to distrust research participation. They distrust that their physician would fully explain research participation more than their White counterparts, regardless of social class (Corbie-Smith, Thomas, & St. George, 2002).
The United States of America is often called the great melting pot because of its diverse population. As the diversity of this great nation continues to grow, so does the continuing problem of distrust of the traditional health care system. The more negative attitudes expressed by African Americans towards the nations health and social institutions are partially grounded in the circumstances and experiences that failed to eliminate historical racial disparities (Blendon, et al, 1995; Randall, 1996).
However, as a subculture of the American society, African Americans have experienced something that others have not: the unique combination of racism, slavery and segregation. It has caused African Americans to develop not only different behavioral patterns, values, and beliefs but also different definitions, standards, and differences in value systems and perspectives (Randall, 1996). Distrust of the health care system by African Americans runs from the feelings of ill gains for participation in clinical trials to being used only as guinea pigs. In addition, there are feelings by African Americans of whether the physician, intentional or not, do treat minority patients differently than White patients (Lake, Snell, Perry, & Associates 2004). …