Legacy of Tuskegee and other medical racism lives on today

Photo by Elvert Barnes via Flickr.

In two previous posts, I discussed the history of the U.S. Public Health Service study at Tuskegee, 50 years after it was revealed to the nation. I also shared the perspectives of a Black epidemiologist and a Black HIV primary care physician on what the study’s legacy means now.

In this post, I share the perspectives of two Black psychiatrists and a Black colorectal surgeon on how the study at Tuskegee reverberates through Black communities today.

Key takeaways

  • Every field of medicine has its examples of racism, such as the theory of “drapetomania” in enslaved people and “protest psychosis” in civil rights leaders and protesters in the field of psychiatry.
  • The distrust many Black people have of the medical system is well earned, so “we have to continue to actively work to increase diversity and representation in medicine” and “educate current medical providers, so we don’t continue to repeat the mistakes of the past and harm patients.”
  • The legacy of what the Tuskegee experiment was about — withholding treatment — continues to play out in health care access issues that impact Black communities.
  • While the experiment began in the 1930s, its revelation 50 years ago is not the distant past and still lives on today.

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To collaborate or not to collaborate?: Tips to help you decide

Photo by Marcus Aurelius via Pexels.

We were all about to be let go from a television program that was closing shop, and I wanted to expand my work experience into print to flesh out my resume. A colleague and friend had previously worked in print and had contacts with editors, and generously offered to collaborate with me on a story so I could get a print byline. We divided up the reporting and wrote the article side by side.  

I sometimes reflect back on that experience and wonder if I should try collaborating again to address the isolation of freelancing and share reporting and writing on bigger stories. But I haven’t been sure how to go about it and whether it is worth the trouble. I am particularly concerned about how to divide up the reporting and writing and whether it would work out fairly. Several other freelancers have told me they are also curious about collaborating.

In a new “How We Did It,” AHCJ members and freelance journalists Laura Beil, Fran Kritz and Tara Haelle discuss their experiences working with others on stories and offer tips for fellow independent journalists. 

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Closing health care gaps in rural America

Katti Gray, AHCJ’s core topic leader on mental health, moderates “Building the rural health care pipeline” panel at Rural Health Journalism Workshop 2022. Panelists Leslie Griffin, M.D., program director of family medicine residency at the University of Tennessee College of Medicine Chattanooga and Lisa D. Beasley, D.N.P., A.P.R.N., N.P.-C., R.N., assistant professor at the University of Tennessee Health Science Center and president of the Tennessee Nurses Association, are sitting to the right of the podium.

Imagine driving an hour for a colonoscopy. Because of limited access to health care, that’s the harsh reality for many people living in rural communities, said Leslie Griffin, M.D., program director of family medicine residency at the University of Tennessee College of Medicine Chattanooga, during the “How to build a rural health pipeline” panel at AHCJ’s Rural Health Workshop 2022 in Chattanooga, Tenn.

During the talk, moderated by AHCJ core topic leader on mental health Katti Gray, Griffin explained to journalists how she’s using her platform to encourage more medical students and physicians to train and practice in rural communities.

Other featured panelists included Ashoke “Bappa” Mukherji, chief executive officer of the Java Medical Group — which has been buying and reopening rural hospitals — and Lisa Beasley, D.N.P., A. P.R.N., N.P.-C., R.N., a nurse practitioner, assistant professor at the University of Tennessee Health Science Center and president of the Tennessee Nurses Association.

During the panel, speakers emphasized the dire need to address the physician and nurse practitioner shortage in rural America, discussed barriers to recruitment in these areas, offered solutions to providing more health care access to rural communities and presented story ideas for journalists to explore.

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CMS announces plans to create a ‘Birthing-Friendly’ hospital designation

Photo by Lars Plougmann via Flickr.

The Biden administration plans to leverage the federal government’s clout as a major purchaser of health services to try to improve the quality of maternal care, with plans to create a new “Birthing-Friendly” hospital designation.

The Centers for Medicare and Medicaid Services (CMS) on Aug. 1 said it will proceed with previously announced plans to establish this hospital designation in the fall of 2023. This is being created through the rule establishing Medicare’s policies in connection with payment for care of people admitted to hospitals for fiscal 2023. 

A Medicare rule might seem an odd choice as a vehicle for addressing concerns about care provided to women after giving birth. As a program for people age 65 and older and those with disabilities, Medicare covers few births. Medicaid, which covers people with low incomes, covered 42% of births in 2020, according to the nonprofit Kaiser Family Foundation. But state governments are the drivers of much of Medicaid policy, while the federal government often seeks to raise standards of hospital care across the board in the U.S. through requirements added through annual Medicare policy updates.

The new maternity care hospital designation will be publicly reported on a CMS website, the agency said in the final version of the inpatient payment rule.

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“Many Tuskegees” occur daily in the U.S. 

Epidemiologist Dara Mendez, Ph.D., M.P.H., pediatrician Diane Rowley, M.D., epidemiologist Theresa Chapple-McGruder, Ph.D., and epidemiologist Bill Jenkins, Ph.D., who blew the whistle on the experiment at Tuskegee while working at the U.S. Public Health Service, gather at the 2017 meeting of the American Public Health Association. (Photo courtesy of Theresa Chapple)

When writing about the 50th anniversary of the revelation of the U.S. Public Health Service study at Tuskegee, I reached out to several Black health care professionals to ask for their perspectives on the study’s legacy a half-century later. Five women — an epidemiologist, two psychiatrists, a surgeon, and an HIV primary care physician — offered their insight. This post shares two of those perspectives, one focused on the man who blew the whistle on the experiment and the other on how the legacy of the experiment at Tuskegee is playing out with monkeypox.

Key takeaways

  • The whistleblower who ensured the world found out about the U.S. Public Health Service study at Tuskegee, Bill Jenkins, Ph.D., has also been a role model to Black epidemiologists in showing how to stand up to racism within the system.
  • Although the “Tuskegee study” is a convenient shorthand, it’s more appropriate and accurate to refer to the experiment as the ”U.S. Public Health Service study at Tuskegee” to keep the blame on the perpetrators rather than the victims.
  • The experiment at Tuskegee lives on in a collective memory of those in the Black community even when they don’t necessarily know the details of the specific study.
  • The distrust many in the Black community have toward the health care system is less about this one experiment than is “the everyday interactions” they have today, as “many Tuskegees” are occurring all the time.
  • The rollout of the monkeypox vaccine demonstrates how treatment is being denied to Black communities that need it.

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