Medical racism in the United States

In American history, it has impacted various racial and ethnic groups and affected their health outcomes,[1] especially vulnerable subgroups such as women, children and the poor.

As an ongoing phenomenon since at least the 18th century, examples of medical racism include various unethical studies, forced procedures, and differential treatments administered by health care providers, researchers, and government entities.

Whether medical racism is always caused by explicitly prejudiced beliefs about patients based on race or by unconscious bias is not widely agreed upon.

[2][3] The history of medical racism has created distrust of health professionals and their practices among many people in marginalized racial and ethnic groups.

[2] Physicians who are not culturally competent can harm patients due to poor relationship dynamics, contributing to medical racism.

While physicians may consciously condemn racism and negative stereotypes, evidence shows that doctors exhibit the same levels of implicit bias as the greater population.

Implicit bias is also seen in mental health services, which are plagued by disparities viewed through lenses of racial and cultural diversity.

Based on this research, several authors argue that there is an intense need for cultural competence education in healthcare for explicit racism and implicit biases.

These beliefs were rooted in unfounded notions, such as thicker skin or less sensitive nerve endings in Black individuals, echoing racist ideologies of the past.

These findings underscore the urgent need for reforms in medical education to address racial biases and promote sensitivity.

Additionally, statistics show that African Americans are disproportionately subjected to less desirable healthcare services, like limb amputations, highlighting systemic inequalities that several authors state must be confronted and rectified.

[9][10] The study done on the University of Minnesota Medical School employed the use of the concept of hidden curriculum to describe the ways in which lack of representation and informal teachings can greatly influence the minds of aspiring physicians.

Researchers determined that the inclusion of specific racial or ethnic identities in those cases was intended to indicate something about that disease or health condition.

[8] The lack of representation in medical school lectures risks creating adverse impacts on the health outcomes of minority populations in the US.

During the 20th century in the United States, groups such as the American Medical Association neglected black physicians and their pursuit of success in the field of medicine.

[9] The dehumanization of certain racial groups such as black people can also contribute to disparities in healthcare due to varied perceptions, by physicians, of concepts such as pain tolerance and cooperation – one aspect of medical racism.

[11] One police officer involved in the Rodney King beating in 1991 was cited as saying that a domestic quarrel between a black couple was "something right out of Gorillas in the Mist.

The researchers attempted to determine whether or not the association of black people with apes influenced the perceptions and behaviors of 242 white and non-white students, using a format in which images were presented to the subjects subliminally and their responses were recorded.

[11] This study was done in the context of criminal justice and aimed to reveal whether associations with animals impacted the likelihood of jurors to give the death sentence.

[12] There was an interview study of 60 African Americans whom of which had one or multiple illnesses and the results showed that those of whom fell under the low-income category expressed more dissatisfaction with their health care than their fellow middle-income respondents.

[12] Discrimination based on race is among those of who fall into a minority category, especially being of low-income due to the fact that medical practitioners tend to have more racial biases towards people of color.

[14] Focus group participants described encounters with providers who made stereotypical assumptions about them: "My name is ... [ a common Hispanic surname ] and when they see that name, I think there is ... some kind of a prejudice of the name ... We're talking about on the phone, there's a lack of respect.

Within this paradigm, American doctors and institutions have historically played a large role in perpetuating scientific racism, denying equal care to black patients, and perpetuating structural violence as well as committing acts of physical assault and violence against black people in the context of medical experimentation, withholding of treatment, medical procedures performed without consent, and surgical procedures performed without anesthesia[5][15] Ideas about black people's relationship to primates and their biological and intellectual inferiority to white people, in the US, were just a few ways in which chattel slavery was justified.

With a large role in the perpetuation of such widely believed ideas, oral traditions can be highly influential, even when they are not explicitly included within medical curriculum.

It was also found that in both a significant number of laypersons and those with medical training, incorrect beliefs about differences between black and white people on a biological level were held.

[2] Journalist Richard Sanders reported that from 1956 to 1958 the US Army intentionally released mosquitoes in poor black communities of Savannah, Georgia and Avon Park, Florida.

In particular, in 1763 Sir Jeffery Amherst ordered soldiers to take the blankets and handkerchiefs of smallpox patients and gift them to indigenous people of Delaware at a peacemaking parley.

[17] This is due to a number of factors such as the fact that unequal funding plagues the Indian Health Service that is in charge of ensuring the access the federal government must provide and that around 25% of indigenous people in the US report facing discrimination in medical settings.

[19] Studies of Hispanic people living in the U.S. reveal that after experiencing an instance of discrimination in a healthcare setting they, afterward, delayed seeking medical treatment again.

[21] In addressing the issue of medical racism in the United States, there are different ways to mitigate unconscious bias that leads to the perpetuation of health disparities.

A white doctor has inserted a large needle to draw blood from a black man who stands with his arm at his side. The photo is in black and white. The black man is on the right while the white man stands to the left of him in the frame. Two other black Americans gaze down at the black man's arm as his blood is drawn.
A doctor draws blood from a patient who was unwittingly a test subject in the Tuskegee Study of Untreated Syphilis in the Negro Male. This study is widely condemned for egregious violations of research ethics [ 4 ] .
A computer-generated photo of the back of a white individuals upper abdomen is shown, near their right shoulder blade there is a red rash. The rash consists of a completely red dot and then a red outline of a circle around it, resembling a bullseye.
In this image is one of the first symptoms of lyme disease, erythema migrans, depicted on white skin. Without more diverse depictions, this rash may be harder to detect on those with darker skin tones.
A minstrel, ape-like caricature stands on the edge of a boat as it sails away from a metropolitan coast. In the top left corner, the postcard says "Give my regards to Broadway"
In this postcard, a Jim Crow caricature resembling an ape proclaims "Give My Regards to Broadway." This type of depiction of black people was once common in American history.
Five young black boys, two naked and three clothed, sit in a tree and gaze down at an alligator. The boys are perched in the tree over water while the alligator is in the foreground of the picture on grassy land. In the top right corner the postcard reads "Alligator Bait."
In an early 20th-century postcard, black children are described as " Alligator Bait " as they sit in a tree above an alligator. Images such as these, popular with Americans, helped to contribute to dehumanizing black Americans.
The photo depicts a culture of HeLa cells. They are stained in a light blue-purple color and seem to be in different phases of division. They look like abnormally shaped circles and are all squished in next to each other.
This photo shows "HeLa cells" that originated from black woman and cancer patient, Henrietta Lacks. Lacks was unaware of her stolen cells that have been used for many decades in medical advancements such as the development of the polio vaccine.
The indigenous war chief Pontiac stands in a circle of other indigenous people while brandishing a war hatchet above his head. There are trees in the background as well as what seems to be a teepee or tent. Some men in the circle also have weapons and all but one are sitting on the ground.
Depicted is war chief Pontiac holding a war hatchet. It was in Pontiac's War that Jeffery Amherst famously proposed gifting smallpox infected blankets to the indigenous peoples.
A blue colored file is titled at the top "Ethically Impossible: STD Research in Guatemala from 1946 to 1948" and includes smaller text at the bottom that says "Presidential Commission for the Study of Bioethical Issues" and "September 2011".
The document shown is the results of a 2010 inquiry into the STD research that took place by the US in Guatemala. President Barack Obama enlisted the Presidential Commission for the Study of Bioethical Issues to oversee the project.