Tag Archives: health-care disparities

The Tuskegee Syphilis Study revelation’s legacy 50 years later

Photograph of participants in the Tuskegee Syphilis Study (Photo courtesy of National Archives)

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.

Continue reading

Two counties illustrate health care disparities

Anna Tong and Phillip Reese of The Sacramento Bee write about health care disparities. They use two local counties to explain many of the issues that are central to the debate over changing the nation’s health care system.

In Yolo County, where many people are uninsured, the residents are diverse in occupation and age. Placer County’s “demographics makes it one of the best for insurance coverage: wealthier, older residents employed by large companies.”

Tong and Reese explain the ties between being uninsured and health outcomes, as well as the cost to society. They also look at the types of businesses that dominate the two counties and point out that employers in Yolo County, where many people are work in agriculture, service and food industries, are less likely to offer insurance than in Placer County, where many people work in the financial industry, professional and business services and high tech.

Other factors they look at include the links between income, ethnicity, age and insurance coverage.

The package includes an interactive graphic that shows California’s counties and how many people in each are uninsured and a series of graphics that breaks down the number of uninsured based on race, income, age, education, employment status and place of birth.

Homeless man teaches MD about inequalities

The Chicago Tribune‘s Judith Graham tells the story of a doctor who befriended a homeless man who sold StreetWise magazine at a local pharmacy, then offered him a place to live. As the doctor has worked to help his friend achieve financial independence, he has learned to view health care inequalities from a different perspective.

Now (Dr. Allen) Goldberg uses insights from (Everett) Atkinson — for example, how African-Americans in poor communities can distrust white doctors — in his volunteer work in tough city neighborhoods. “He helps me understand a lot because who knows better about being disadvantaged?” Goldberg said.

Goldberg said he’d never been exposed to true poverty before, and that the exposure has changed his thinking and informed his approach to medical outreach.

The doctor said he’s learned the need to listen to other people deeply, carefully and without judgment — a lesson he’s using in volunteer work with the Chicago Asthma Consortium. The group plans “listening sessions” with residents of poor neighborhoods this year about ways to reduce asthma’s burden.

L.A. doctors go to barber shops to reach black men

Los Angeles Times reporter Mary Engel follows the Black Barbershop Health Outreach Program founded by Dr. Bill Releford in December 2007. According to Engel, “African Americans have the highest rates of diabetes and heart disease of any group, yet black men are among the least likely to see a doctor regularly. So if the men wouldn’t come to a doctor, he would bring a cadre of volunteer doctors and nurses to the barbershop.”

The response was so enthusiastic that Releford expanded the program to 50 other L.A. barbershops, and then to barbershops in other states. This year, at 750 shops in 50 cities across 13 states, men who ordinarily would go nowhere near a doctor’s office will be offered a health checkup in a setting so familiar that it will seem as routine as a haircut.

Engel found the problems addressed by the program to be both urgent and under-funded.

At almost every screening, at least one person’s blood pressure or blood sugar is so high he’s sent straight to a hospital emergency room.