Lumping Native Hawaiians and other Pacific Islanders together with East, South, and Southeast Asian patients in U.S. medical studies may be obscuring disparities in outcomes, suggests a new study from JAMA Network Open.
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.
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.
- 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.
It’s been 50 years ago last month since the nation learned about one of the most shameful and consequential chapters in U.S. medical research (and there’s a fair bit to pick from). In the “Tuskegee Study of Untreated Syphilis in the Negro Male,” the U.S. Public Health Service enrolled 600 Black male sharecroppers from Tuskegee, Alabama, and intentionally withheld information and treatment from approximately 200 of the 399 Black men who had syphilis while researchers studied how the disease affected their life course.
Key takeaways for journalists
- An understanding of health care racial/ethnic disparities is essential for ethical reporting on health and medicine.
- The Tuskegee Study is a consequence of U.S. institutional racism and false beliefs about Black men, and it’s one contributor to health care disparities among Black Americans today.
- A basic familiarity with the facts of the Tuskegee Study is crucial for health reporters to know.
- Part of the Tuskegee Study’s enduring legacy contributes to the mistrust and/or skepticism many Black Americans have regarding health care and medicine.
- The Tuskegee Study alone is not the primary driver of Black mistrust in health care and should not be dismissively used as a scapegoat to explain a complex phenomenon informed by people’s personal experience, a long history of personal and structural racism in U S. health care, and the continuing systemic racism that exists in U.S. health care and medicine.
Higher levels of registered nurse staffing are associated with a lower likelihood of Medicare patients’ dying from sepsis in hospitals, according to a recent study published in JAMA Health Forum. An estimated 1.7 million cases of sepsis occur each year, killing 270,000 annually. Even more concerning is one in three patients who die in the hospital has sepsis, according to the CDC. Not all of those deaths occur because of sepsis, but it’s a contributing factor in nearly all cases.
The vast majority of infections that cause sepsis, however — 87% of them — begin outside the hospital, according to the CDC. The difference between life and death depends on early identification of sepsis and immediate treatment. Registered nurses play a significant role in that process because they have more regular interaction with patients and more opportunities to observe symptoms of sepsis.
Why does this study matter to journalists?: Nurses continue to be an under-appreciated and under-utilized resource for better understanding health care issues. Here are some key takeaways from this study:
- Nurses can play a crucial role in the prevention and treatment of a wide range of conditions.
- Journalists need to include nurses in their source lists when reporting on diseases, hospital-acquired infections, and other conditions that have traditionally involved only quoting physicians.