New study shows how complex trust in science and medicine is for black Americans
A majority of black adults have had at least one negative experience with a health care provider, according to a new report. But young black women are especially likely to report a harmful interaction during routine health care.
More than 70% of black women aged 18 to 49 said they had experienced at least one negative interaction with healthcare providers, including rejection of their pain or having to speak up to get appropriate care. Young black women are also more likely to prefer seeing a black doctor, expressing that healthcare providers who share their racial background are better able to look out for their best interests and treat them with respect.
The finding was one of many in a Pew Research Center study that analyzed Black Americans’ perspectives on science, including medicine, healthcare, STEM education and science-related news.
The researchers highlighted the nuanced opinions of black adults about scientists and the healthcare system. Of more than 14,000 participants, black adults made up about 3,500, including those who identify as monoracial, multiracial and Hispanic.
Among black women, “a lot of patients don’t feel heard,” said Cheryl Clark, assistant professor of medicine at Harvard Medical School. “They don’t always feel like their symptoms are taken seriously.”
And the impact is terrible. In the United States, black women are three to four times more likely to die from pregnancy-related complications than white women. Amid the coronavirus pandemic, the crisis has grown.
“Looking at what young black women are saying about their experiences of care is really important if we’re going to prevent this mortality,” said Clark, a physician at Brigham and Women’s Hospital in Boston.
The study also found that Black Americans’ trust in medical scientists has dropped since November 2020, a trend similar to that of the general public. Among white adults, the decline was particularly large. According to the study, there is now little difference in how white, black and Hispanic adults view medical scientists, a change from previous surveys in which white adults were more likely to report high self-confidence. .
More than 60% of black adults say they believe serious medical malpractice is just as likely today as it was in the past, though those more familiar with the work of medical researchers are more likely to see them in a positive way.
In the survey, researchers pointed to the Tuskegee experience, in which black men were intentionally denied treatment for syphilis beginning in the 1930s, as an extreme breach of trust. But individual interactions with the health care system can have an even greater impact, said Darrell Hudson, health disparities researcher at Washington University St. Louis. Stories told within families and local communities about hospitals that mistreat black patients are eroding trust in health and medicine.
“There are individual interactions at the patient-provider level, things that I’m not even sure providers are even aware they are doing that could be construed as dismissive or seen as disrespectful,” he said. . “It reinforces the idea that these people don’t care about us.”
Respondents’ perception that their pain is ignored is supported by research on these experiences. In 2019, research from George Washington University showed that black ER patients were 40% less likely to receive painkillers than white patients.
Yet in the Pew Research study, a majority of black respondents said their provider was excellent or very good the last time they visited. That’s an indication that trust is complex, Hudson said.
“People may not have much faith in the healthcare system, maybe they don’t trust vaccines, but they have a really good primary care provider,” he said.
Considering all the factors that influence health, more than 60% of black adults believe that less access to quality medical care in their neighborhood is a significant reason why black Americans face poorer health outcomes. health.
This perception, experts say, tends to match reality. Neighborhood segregation persists across the country, said Dr. Gbenga Ogedegbe, director of NYU’s Institute for Excellence in Health Equity. “Forget race and ethnicity — your postcode is a major predictor of your life expectancy,” he said. If you live in a poor neighborhood, “your chances of living longer are much less than if you live in a wealthy neighborhood.”
Hospital density is higher in wealthier neighborhoods, Ogedegbe said, and resources dwindle in less wealthy neighborhoods.
At the same time, “health is more than access to health care,” Hudson said. “Do people actually have access to the things they need to follow doctor’s orders?”
The survey also explored the feelings of professionals in STEM – or science, technology, engineering and math – and their educational experiences. Among those working in STEM, half of black college graduates recall mistreatment in their schooling, more than any other racial group.
The rate of abuse of black students “is probably higher,” said Ebony McGee, associate professor of diversity and STEM education at Vanderbilt University. She noted how excessively praising black students for getting the answer right can make it seem like they believe in students, but, racially speaking, it could mean they don’t expect that black students have the correct answer due to stereotypes.
“In STEM classes, we don’t get told about racial microaggressions,” she said.
A majority of black respondents also said they believed more young people would pursue careers in STEM if they saw more high achievers in the field who looked like them. McGee noted that the depiction of black scientists and engineers provides more than inspiration.
Racial prejudice and the belief that black skin is more resistant to pain and trauma affect how drugs are provided to black Americans, she said. For example, pulse oximeters, which measure blood oxygen levels, are less accurate in black patients. The NFL’s former ‘racial normalization’ practice, which assumed that black players had lower cognitive function than white players, influenced the dementia tests used to determine payouts in an injury settlement cerebral. And the algorithms used to calculate kidney function take the patient’s race into account, adding a “racial correction” that in some cases pushes black patients back on the transplant list.
Better representation in STEM could protect against such policies, she said. “It really is life or death.”
This story was originally published on April 14, 2022 by Capital B.