Medical Care & Race: Medical Racism

Summary

This module explores the impact of racial disparities in medical care, detailing both historical and current examples of medical racism. It highlights unethical practices such as the Tuskegee syphilis study, forced sterilizations, and experiments on indigenous and minority populations, all conducted without consent or proper treatment. The video also discusses ongoing biases, such as the belief that Black patients feel less pain, which continues to affect treatment quality and outcomes. By examining these issues, the module addresses the ethical need for equitable healthcare to improve trust and health outcomes for marginalized groups.

Takeaways

• 🩺 Medical racism has a long and disturbing history, such as the Tuskegee Syphilis Study conducted from 1932 to 1972, where African American men with syphilis were deceived and left untreated despite the availability of penicillin.
• 💉 The Indian Health Service forcibly sterilized Native American women from 1970 to 1976, and other sterilization programs had already targeted Native Americans since the 1960s.
• 🧬 Between 1996 and 2000, the US helped fund the forced sterilization of over 270,000 indigenous Peruvian women and 22,000 men during the reign of President Fujimori.
• 🦠 From 1946 to 1948, the US National Institutes of Health, with cooperation from the Guatemalan government, injected 5,000 Guatemalans with STDs to observe their effects, including children and vulnerable individuals.
• 😷 Berta, a Guatemalan psychiatric patient, suffered severe and unethical medical experimentation, ultimately leading to her death after being deliberately infected with syphilis and gonorrhea.
• 📊 A 2016 study revealed that white medical students and residents believed black people were more tolerant of pain, contributing to the under-treatment of pain in black patients.
• 💊 Studies have shown that black patients are often undertreated for pain due to false beliefs that they are either faking pain or have thicker skin, leading to discriminatory medical practices.
• 🫀 Medical racism extends beyond pain management, affecting treatments for heart disease, kidney transplants, ICU care, and prenatal care, where racial disparities persist even in programs like Medicare, Medicaid, and VA healthcare.
• 👶 African American children receive less effective asthma treatment, and overall, minority children are more likely to experience inequitable healthcare, contributing to wider health disparities.
• ⚖️ Historical and ongoing medical racism leads to a justified distrust in the healthcare system among minoritized groups, further exacerbating health inequities and limiting access to necessary care.

Q & A

What is medical racism, and why is it relevant to this discussion?

Medical racism refers to the systemic bias and discriminatory practices in medical care based on race. It is relevant because the module focuses on how race affects medical care, providing historical and contemporary examples of racial inequities.

What was the Tuskegee Syphilis Study, and why is it significant?

The Tuskegee Syphilis Study was conducted by the U.S. Public Health Service and CDC from 1932 to 1972. It involved nearly 400 African American men with syphilis who were misled and left untreated, despite penicillin being discovered as an effective cure in 1943. The study is significant because it highlights the unethical treatment of African Americans in medical research.

What was the impact of the Indian Health Service's sterilization program?

Between 1970 and 1976, the Indian Health Service forcibly sterilized Native American women. This program sterilized between 25% to 50% of Native American women, affecting their communities deeply and creating long-term impacts on their population and social structures.

How did the U.S. government's involvement in sterilizations extend to other countries?

From 1996 to 2000, the U.S. helped fund the sterilization of 270,000 indigenous Peruvian women and 22,000 indigenous men, under the presidency of Fujimori in Peru. This shows how the U.S.'s involvement in unethical medical practices extended internationally.

What was the unethical medical experiment conducted in Guatemala between 1946 and 1948?

In cooperation with the Guatemalan government, the U.S. National Institutes of Health injected 5,000 Guatemalans, including children, orphans, and mental patients, with bacteria that caused STDs. The goal was to observe the effects of these diseases without offering proper treatment.

What are some contemporary examples of medical racism in pain treatment?

A 2016 study found that many white medical students believed that Black patients had higher pain tolerance due to myths like 'thicker skin.' This led to under-treatment of Black patients for pain, as it was falsely assumed they could endure more pain or were faking it.

How does medical racism manifest in the treatment of heart disease, kidney transplants, and prenatal care?

There is documented evidence of inequitable treatment in heart disease, kidney transplants, ICU care, and prenatal care, where Black and other minority patients receive less care or lower quality treatment than their white counterparts.

Why can't socio-economic status fully explain the racial inequities in medical care?

Socio-economic factors can't explain the racial inequities because these disparities are observed even in systems like Medicare, Medicaid, and the VA, where access to care is theoretically equalized across race and economic status.

What are some examples of racial disparities in medical procedures within the Medicare system?

Elderly white patients on Medicare receive more hip replacements, flu shots, mammograms, and cardiac procedures, while minoritized groups face higher rates of amputations and castrations for prostate cancer.

How has historical medical racism contributed to modern distrust in the medical establishment among minoritized groups?

Historical events like the Tuskegee Syphilis Study and sterilization programs contribute to a deep mistrust in the medical system. This distrust, combined with present-day inequities, leads many minoritized groups to avoid seeking medical care.