Medical Care & Race: Medical Racism
Summary
TLDRThis 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.
Outlines
🧑⚕️ The History of Medical Racism and Atrocities in Healthcare
This paragraph delves into the dark history of medical racism in the U.S., starting with the infamous Tuskegee Syphilis Study from 1932 to 1972, where nearly 400 African American men were deceived into thinking they were being treated for 'bad blood,' while in reality, they were left untreated to study the effects of syphilis. Even after penicillin became available in 1943, the patients were denied treatment, leading to many preventable deaths. The narrative further highlights how Native American women were forcibly sterilized between 1970 and 1976 by the Indian Health Service. Sterilization programs had been operating since the 1960s, affecting 25% to 50% of Native American women, devastating tribes. The U.S. also funded sterilizations of indigenous populations in Peru from 1996 to 2000. Additionally, it recounts a horrifying study from 1946 to 1948 where the U.S., with Guatemala’s government, infected 5,000 Guatemalans with STDs without consent, resulting in severe suffering and deaths. The story of Berta, a victim of these experiments, is shared to personalize the cruelty of these medical practices.
⚕️ Persistent Medical Racism: Beliefs and Practices in Modern Healthcare
This paragraph discusses the continuing impact of racist beliefs in modern healthcare. A 2016 study revealed that white medical students and residents often believed that Black patients were more tolerant of pain, resulting in Black patients being systematically undertreated for pain. This belief was fueled by myths such as Black people having thicker skin. The opioid crisis highlighted racial disparities, with white patients more likely to be prescribed pain relief medication than people of color. The systemic inequity extends beyond pain management, as studies show disparities in heart disease, kidney transplants, ICU care, and prenatal care among Black patients. The explanation that socioeconomic factors cause this disparity is debunked through examples from Medicare, Medicaid, and the VA system, which offer equal financial support yet still display unequal treatment. Minoritized children, for instance, are 34% more likely to receive less effective asthma treatment than their white counterparts. The health status gap between minoritized groups and white Americans remains significant, with higher mortality rates in diseases like cancer, diabetes, and heart disease among African Americans. Additionally, the historical mistrust of the medical system continues to discourage minoritized groups from seeking care.
Mindmap
Keywords
💡Medical Racism
💡Tuskegee Syphilis Study
💡Forced Sterilization
💡Indigenous Sterilizations in Peru
💡Guatemalan STD Experiments
💡Pain Tolerance Misconceptions
💡Socioeconomic Explanation
💡Healthcare Inequity
💡Distrust in Medical Establishment
💡Ethics in Healthcare
Highlights
Introduction to medical racism and how race affects medical care.
From 1932 to 1972, the U.S. Public Health Service and CDC conducted a study on 400 African Americans with syphilis, deceiving them about being treated for 'bad blood' while actually leaving them untreated.
By 1943, penicillin was known to be the effective treatment for syphilis, but no participants were treated, leading to preventable deaths and family devastation.
Between 1970 and 1976, the Indian Health Service forcibly sterilized Native American women, affecting 25% to 50% of Native American women.
From 1996 to 2000, the U.S. helped fund the sterilization of 270,000 indigenous Peruvian women and 22,000 indigenous Peruvian men.
Between 1946 and 1948, the U.S. National Institutes of Health, with cooperation from the Guatemalan government, injected 5,000 Guatemalans, including children and mental patients, with bacteria that caused STDs, to observe the effects.
Case study of Berta: a Guatemalan psychiatric patient was injected with syphilis, developed severe health issues, and was reinfected multiple times before dying.
The study highlighted how medical racism used people of color for experiments to benefit the treatment of white patients.
A 2016 study revealed that many white medical students believed that Black people were more tolerant of pain, leading to under-treatment of Black patients' pain.
There is documented inequity in treatment for conditions such as heart disease, kidney transplants, ICU care, and prenatal care for minoritized groups.
Economic status does not fully explain medical inequities, as inequitable treatment is seen within systems like Medicare, VA, and Medicaid, which neutralize the ability to pay.
Elderly white Americans on Medicare receive more flu shots, mammograms, and cardiac procedures, while minoritized groups face more amputations and less effective treatments.
Minoritized children are 34% more likely to receive less effective asthma treatments compared to white children.
African Americans experience higher death rates from cancer, diabetes, cirrhosis, AIDS, and cardiovascular disease, as well as significantly higher infant mortality rates.
Historical medical abuses contribute to a widespread distrust of the medical system, leading many minoritized individuals to avoid seeking healthcare.
Transcripts
in this module we're going to be talking
about medical care and race and how
race affects medical care i want to
first by start by describing a little
bit about medical racism which might not
be new for many of you
this this information but for some of
you it might be
from 1932 to 1972
and you might think oh man that was a
long time ago not that long right 1972 i
was born in 74. uh so you know for
roughly 40 years from 1932 to 1972 the
u.s public health service at the cdc the
centers for disease control which you
know
people in our time are more familiar
with because of covid
so
the u.s public health service in the cdc
performed a study on almost 400 african
americans with syphilis to observe the
effects of the untreated disease on them
they deceived the patients about what
they were studying they were told they
were being treated the patients were
told they were being treated for bad
blood
but they weren't being treated at all
by 1943 so you know just uh
11 years after they started the study
was a 40-year study
penicillin was known to be the preferred
and effective treatment for syphilis but
not a single participant was treated
with it
families were devastated
many died who could have been saved many
spread diseases to others
and the us
public health services and the cdc
intentionally
watch these people die
40 years of a medical study
from 1970 to 1976 so a little bit even
later the indian health service that's
what it was called forcibly sterilized
native american women
another program had been sterilizing
native americans since 1960
so 1976 so that would have affected like
my parents right if they were native
american
somewhere between 25 to 50 percent of
native american women were sterilized
and it still affects the tribes today so
they're really trying to get rid of them
right
from 1996 to 2000 the us helped fund for
sterilizations of 270 000 indigenous
peruvian women and 22 000 indigenous
peruvian men this is something i know
because my wife is peruvian and i
studied it this was uh during the reign
of one of their presidents fujimori who
she knew as a professional singer um and
he was sterilizing these people and it
was the us helps fund that that
sterilization of another native greek
from 1946 to 1948 the u.s national
institutes of health health with
cooperation of the guatemalan government
injected 500 5 000 guatemalans
including children orphans and mental
patients with the bacteria known to
cause stds just to observe the effects
let me personalize it a little bit
here's one case where that you can read
about
berta
one of the patients was a female patient
in a psychiatric hospital her age and
illness that brought her to the hospital
are unknown in february of 1948 berta
was injected in her left arm with
syphilis
a month later she developed scabby's
really itchy skin infection caused by a
mite
several weeks later the lead
investigator dr john cutler noted that
she had also developed red bumps where
he had injected her arm
lesions on her arms and legs and her
skin was beginning to waste away from
her body
berta was not treated for syphilis until
three months after her injection soon
after on august 23rd dr cutler wrote
that
perth appeared as if she was going to
die but he did not specify why that same
day he put got a real pus from another
male subject in both of berta's eyes as
well as in her urethra and rectum
he also reinfected her with syphilis
several days later berta's eyes were
filled with pus from the gonorrhea and
she was bleeding from her urethra
on august 27th she died
so that's just one story of the horror
of the
medical racism that was going on at this
time people were studying diseases
in
people of color
to see how it affected them so that they
could treat
other patients
white patients
these historical examples are horrific
but it's not just
historical this type of medical racism
a 2016
study of white medical students and
residents
believe showed that they believed that
black people were more tolerant of pain
the studies have shown repeatedly that
black patients are under-treated for
pain
because
they believe that black patients are
faking pain for drugs or can handle more
pain because they believe according to
the survey that black people have
thicker skin
clearly ridiculous right
um
when
the opioid crisis was going on uh or
when opioids were a lot easier um i know
that if a white person were to present
and
with pain
they would get codeine or anything like
that really quickly
whereas people of color would rarely be
prescribed
those medications now maybe that was
good in the long run but it wasn't
unintentionally good um
people
people were treated for pain some
patients are treated for pain and others
aren't because of these false beliefs so
the majority of
white medical students in 2016 believed
that black people were more tolerant of
pain and there's inequitable treatment
that's also documented in heart disease
kidney transplants icu care and prenatal
care
and you can't a lot of times people say
well you know what really explains this
is socio-economic
uh
situation you know um
people of color uh are grouped as poor
generally speaking in this society and
so
what's really going on is it medical
racism it's it's socioeconomic but you
can't explain it away because it's seen
within medicare within the va and
medicaid which equals out the ability to
pay right if you're on medicare
it doesn't matter what color you are if
you are
or what race you are if you're
part of the va
all those wouldn't matter and you still
see this example of
inequity so elderly whites on medicare
receive more hip replacements more flu
shots more mammograms
more cardiac procedures and less
amputations and castrations for prostate
cancer
minoritized children are 34
more likely to receive less effective
asthma treatment than white children and
there's lots of other examples and
that's within medicare medicaid va and
so that equals out so it's not just
about economics
there's a huge gap in the health status
of some minoritized groups in the u.s
and the status of white americans for
example african americans have higher
death rates from cancer diabetes
cirrhosis aids and cardiovascular
disease infant mortality is three to
four times higher than in whites
plus there's this understandable given
the history that i just talked about
distrust in the medical establishment
that keeps minoritized patients from
seeking help
and so
this this past and present of
inequitable treatment and medicine keeps
minoritized groups from seeking health
care and this is an ethics class so
that's what we're not just talking about
the history of this we're talking about
the simple fact that health care
taking care of the basic needs of the
body
should be equitable
but is not
equitable in
in
most countries and especially in our
country and we
are having serious issues with
keeping people healthy in minoritized
groups and we'll talk more about the
ethics of it in the next video
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