Racism in Medicine

Today I want to highlight some disparities, horrific treatment, current statistics, and some current issues in the field of medicine regarding race. 

Historically, Blacks were viewed very differently than other races.  To explain and maintain White Supremacy, Blacks were thought to have thicker skin, were less likely to feel pain or heat, had smaller skulls (meaning they were less intelligent), larger sex organs (explaining their perceived promiscuity), and had weak lungs and were susceptible or some diseases.  Medical experiments were done to slaves to "prove" these theories.  John Brown was burned to see how long he could withstand it.  

According to Linda Villarosa (contributor to the 1619 project)"These fallacies, presented as fact and legitimized in medical journals, bolstered society’s view that enslaved people were fit for little outside forced labor and provided support for racist ideology and discriminatory public policies." 

These ideas were published in medical journals of the day and allowed for future doctors to rationalize using Black men and women for further experiments.  J. Marion Sims, father of modern gynecology, was one such doctor. He performed painful and dehumanizing experiments on Black women to perfect his practice of gynecology before offering care to White women that he had figured out using Black patients. 

In 1932 the famous Tuskegee Experiment began where 600 Black men came to get free medical treatment for "bad blood" ended up getting a placebo to be monitored on the progression of syphilis. Even after a treatment was discovered, they were not given the treatment because doctors involved wanted to see the full progression of the disease, unbeknownst to the men in the experiment.   According the Wikipedia article, by the end of the study in 1972, only 74 of the test subjects were still alive. Of the original 399 men, 28 had died of syphilis, 100 died of related complications, 40 of their wives had been infected, and 19 of their children were born with congenital syphilis.

Sometimes instead of experimentation and torture, Black people have contributed to medicine as "Hidden Figures" without ANY fanfare, acknowledgement, praise, or compensation.  Such is the life of Henrietta Lacks.  Henrietta Lacks was a young woman with terminal cancer who enabled scientists to discover MANY breakthroughs in various studies of medicine.  From her biopsy and tumor removed, a scientist put her cells into a petree dish and watched them grow.  These cells became known as "He-La" cells and were unlike others they had ever seen before. 

"Her cells went up in the first space missions to see what would happen to human cells in zero gravity...they helped with some of the most important advances in medicine: the polio vaccine, chemotherapy, cloning, gene mapping, in vitro fertilization...HeLa cells were one of the most important things that happened to medicine in the last hundred years"

She, nor her family, ever knew the impact she had made because after her death, she was just a Black woman, erased, until one person was able to uncover her story. (See the movie with Oprah- The Immortal Life of Henrietta Lacks or the book by the same title) 

Dr. Vivien Thomas is another hidden figure worth mentioning.  His contribution was paid for on a janitor's salary even though his research was groundbreaking in the explanation of causes of hemorrhagic and traumatic shock, and advances in cardiac and vascular surgery (Blue Baby Syndrome being one of them).  He got NO credit for his contributions (even though he told white doctors what to do).  In 1976, John Hopkins University presented Thomas with an honorary Doctor of Laws (not medicine even though he was an instructor at the medical school).  The movie "Something the Lord Made" is excellent about Dr. Thomas's Life.

What about today? 

There are health disparities still today.  According to the National Center for Health Statistics, researchers found that of the 658 women who died of maternal causes in 2018, black women fared the worst, dying 2½ times more often than white women (37.1 vs 14.7 deaths per 100,000 live births), while Hispanic women had the lowest rate of maternal mortality, 11.8 deaths per 100,000 live births. Black women have historically had the highest maternal mortality rates. Researchers do not have a clear explanation, but they suspect a combination of institutional racism in society and the health care system, as well as black women's increased susceptibility to certain health conditions, such as obesity and hypertension. Black women are also less likely to have access to quality prenatal care. (For more info read here )

What has been done? 

Preventing Maternal Deaths Act (Dec 2018): This legislation sets up a federal infrastructure and allocates resources to collect and analyze data on every maternal death, in every state in the nation. The bill is intended to establish and support existing maternal mortality review committees (MMRCs) in states and tribal nations across the country through federal funding and reporting of standardized data.

The lives of women across this nation depend on the success of this legislation, including thoughtful implementation, consistent with the law’s intent, as well as additional policy change to support the law in reaching its goals.

Maternal Care Access and Reducing Emergencies (CARE) Act (Introduced by then-Senator Kamala Harris):  focuses squarely on dismantling structural racism by creating training programs to address implicit bias among clinicians and encouraging integrated health care services that honor the strength of culture and support pregnant women with evidence-based care. (hasn't become law yet) 

Expansion of Medicaid would also be helpful.  

How are things with COVID? Not great.  Pacific Islanders, Latino, Black and Indigenous Americans all have a COVID-19 death rate of double or more that of White and Asian Americans, who experience the lowest age-adjusted rates.   

• 1 in 475 Indigenous Americans has died (or 210.6 deaths per 100,000)

• 1 in 645 Black Americans has died (or 155.2 deaths per 100,000)

• 1 in 665 Pacific Islander Americans has died (or 150.2 deaths per 100,000)

• 1 in 825 White Americans has died (or 120.9 deaths per 100,000)

• 1 in 835 Latino Americans has died (or 119.5 deaths per 100,000)

• 1 in 1,320 Asian Americans has died (or 75.8 deaths per 100,000)

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One Black Doctor spoke about what it is like to be a part of only 5% of doctors who are Black. "It's like being hit on all sides...people giving care, like myself, feel this incredible glass ceiling bearing down upon us. And then at the same time, the (Black) patients have it much worse – without jobs or health insurance, without food security, without appropriate telecommunications to make appointments," said Dr. Steven McDonald. 

Until Black Americans can have access to health care, healthy food, safer living conditions as a whole, better education and trust in the medical field, and access to at home jobs, these numbers in future pandemics as well as their overall health will continue to suffer.

Without making this entry super long, as with other areas of systemic racism, the causes for these things are long and complicated. We need more Black doctors. We need better healthcare. We need more opportunities for people of color. And we need to know and remember our history so we can understand where we go in the future.