Tuskegee Study of the U.S. Government, HIV and Blacks

Tuskegee Study of the U.S. Government, HIV and Blacks

A recent study by Rand Corporation and Oregon State University revealed that a significant number of African Americans believe that HIV was created and spread by the U.S. government as a form of genocide against blacks. These fears are rooted in historical reality--a person's past experiences influences that person's level of trust. Negative experiences result in a lower level of trust. A patient who has experienced racism or discrimination from individuals and institutions would be less willing to be vulnerable and place trust in a system of unknowns such as medical care. Consequently, when a terrifying new plague swept the land in the 1980s and 1990s, the Tuskegee study predisposed many Black Americans to distrust health authorities. However, Tuskegee is not the only justification for this mistrust of the medical community. It can also be attributed to a long history of exploitation in the name of research that dates back to slavery as well as the ongoing disparities in access to health care.

Health officials who worked in black communities reported that the Tuskegee study had spawned a legacy of suspicion and distrust toward public health authorities. Testifying before the National Commission on AIDS in December 1990, Dr. Mark Smith, a physician from the School of Medicine of Johns Hopkins University in Baltimore, declared that many Afro-Americans felt "alienated from the health care system and the government and as a result were somewhat cynical about the motives of those who arrive in their communities to help them." The Tuskegee study, he asserted, " provides validation for common suspicions about the ethical even-handedness in the medical re- search establishment and in the federal government, in particular, when it comes to black people."

African Americans who regularly encounter prejudice may develop what has been termed "healthy paranoia" — a cultural response style based on experiences of racism and oppression in white society. This goes all the way back to historical abuses of slaves by white doctors for medical experimentation. At that time the slaves could neither consent nor refuse to participate because of their low social status and were frequently victimized, even to the point of being used as examples of surgical techniques for medical students. In Medical Apartheid Harriet Washington details the history of medical experimentation on African Americans from colonial times to present day. It shows how both slaves and freedmen were used in medical experiments without their knowledge. Another well-known example is the story of Henrietta Lacks. Without her consent or knowledge her doctor at John Hopkins took two dime-sized pieces of tissue from her cervix: one from the tumor and one from the healthy tissue nearby in 1951. Like many doctors of his era, he often used patients from the public wards for research usually without their knowledge. Many scientists believed hat since patients were treated for free in the public ward, it was fair to use them as research subjects a s form of payment. Henrietta’s samples went on to be the most prolific cells used for cancer research in the United States. The Immortal Life of Henrietta Lacks chronicles the advances and profits that continue to come from these samples to the medical community both public and private. Most importantly, the author raises questions about the ethics of scientific research and who should profit from it. As Lack’s youngest daughter says, "If our mother cells done so much for medicine, how come her family can't afford to see no doctors?" (Sloot 21).

Lorene Cary, a Newsweek contributing editor, summed it up best when she said, "We Americans continue to value the lives and humanity of some groups more than the lives and humanity of others. It is not paranoia, it is our historical legacy and present fact." She also pointed out that such thinking influences the way we spend our public money and explains how we can read the staggering statistics on areas where the degree of disparity between African Americans and the white population is actually worsening instead of improving – infant and maternal mortality are examples. On average, blacks live 5 to 7 years less than whites. Cancer mortality increased 50 percent for blacks and only 10 percent for whites since 1950, which is very startling. If you look at low birth weight, it’s 136 percent higher in blacks than whites. If you look at diabetes, it’s 33 percent more common in blacks. Heart disease is one and a half times more common in blacks. And the black maternal death rate is three to four times higher than whites. There are access factors. There is also the problem of stereotyping, bias, prejudices, clinical uncertainty affecting health providers and institutions, and cultural factors. In addition, there are differences in health care quality. In the Institute of Medicine report called “Unequal Treatment”, a major finding was that racial and ethnic disparities in health and health care occur in a context of broader historic and contemporary social and economic inequality, and are evidence of persistent racial and ethnic discrimination in American life.

After reviewing the evidence of disparate and unethical medical treatment of African Americans in our country’s short history, it is easy to understand how the community may feel distrustful of the medical establishment. In addition, since the medical system is overseen by the government, the suspicion extends there as well. These fears are rooted in historical reality--a person's past experiences influences that person's level of trust. Negative experiences result in a lower level of trust. A patient who has experienced racism or discrimination from individuals and institutions would be less willing to be vulnerable and place trust in a system of unknowns such as medical care. Consequently, when a terrifying new plague swept the land in the 1980s and 1990s, the Tuskegee study predisposed many Black Americans to distrust health authorities. However, Tuskegee is not the only justification for this mistrust of the medical community. It can also be attributed to a long history of exploitation in the name of research that dates back to slavery as well as the ongoing disparities in access to health care. AIDS now serves as a substitute for syphilis as seen by the early attribution of AIDS’s spread to Haitians then later discussion about its origin in Africa.

BIBLIOGRAPHY

1. Alcabes, Philip. Dread: How Fear and Fantasy have Fueled Epidemics from the Black Death to the Avian Flu. New York: Public Affairs, 2009.

2. Bird, Sheryl and Bogart, Linda. “Conspiracy beliefs about HIV/AIDS and birth control among African Americans: implications for the prevention of HIV, other STDs, and unintended pregnancy. Journal of Social Issues.61 (2005): 109-126. Print.

3. Byrd, Michael and Clayton, Linda. An American Health Dilemma, Volume 2: Race, Medicine and Heath Care in the United States. New York: Routledge, 2003. Print.

4. Corbie-Smith, G. and Thomas, St.George. “Distrust, Race, and Research”. Archives of Internal Medicine. 162(2002):2458-2463

5. Sloot, Rebecca. The Immortal Life of Henrietta Lacks. New York: Crown, 2010. Print.

6. Washington, Harriet. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. New York: Doubleday, 2006. Print