Don’t Blame History for Black Americans’ Mistrust of the Healthcare System

Early in the COVID-19 pandemic, the vaccination rate in the Black community lagged well behind that of Whites, a gap many in the media speculated was the result of fears based on historical health-related injustices like the infamous Tuskegee Syphilis Study. But new research by psychologists at the University of California, Los Angeles shows that vaccine hesitancy and mistrust of medical professionals among Black Americans may hinge more on their current unsatisfactory healthcare experiences than on their knowledge of past wrongs.

Researchers surveyed approximately 300 Black and White participants in December 2020, just as vaccines were becoming available. Black respondents expressed less trust in medical professionals and reported significantly less positive experiences with the healthcare system than their White counterparts. They were also less likely to report an intention to get vaccinated. Participants were also queried about their familiarity with the 1932–72 Tuskegee Syphilis Study, in which the U.S. government studied Black men with syphilis without their informed consent and intentionally withheld treatment, leading to medical complications, fatalities, and transmission of the disease to family members. Some 66 percent of Black participants and 62 percent of White participants said they were familiar with the study, though Black participants generally knew more about it. Familiarity, however, was not associated with greater medical mistrust or vaccine hesitancy in either group, the researchers found.

“History is important, no doubt, but Black Americans do not have to reach into the past for examples of inequity in healthcare — many have experienced it themselves,” said Kimberly Martin, who led the research as a UCLA doctoral student and is now a postdoctoral scholar at the University of California, San Francisco.

Co-author Annette Stanton, a distinguished professor of psychology at UCLA, added that “the findings point to Black Americans’ present-day experiences in the medical system as an important factor among multiple contributors to inequities, and physicians and health systems can indeed take action to improve these experiences. Respectful, competent, and caring medical professionals can be agents of change.”

“Characterizing race-related disparities in health care experiences as a relic of the past excludes current medical experiences and absolves the current health care system from making needed change,” concluded co-author Kerri Johnson, a professor of communication and psychology at UCLA.

The full study, “Current Health Care Experiences, Medical Trust, and COVID-19 Vaccination Intention and Uptake Among Black and White Americans,” was published on the website of the journal Health Psychology. It may be accessed here.

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