ST. JOSEPH — Mistrust of healthcare systems by Black people dates back centuries, and won’t be fixed overnight.
That was the message community members heard Thursday from award-winning medical writer and editor Harriet Washington during an online discussion titled, “Building a Trustworthy Healthcare System: Notes from History, Ethics and Contemporary Crises.”
“I think people are ready for this history and ready to look for answers,” Washington told her audience in a presentation conducted on Zoom.
During her talk, Washington highlighted medical myths regarding race, systemic inequities, and the ways in which the healthcare industry has had negative consequences for people of color.
Author of “Medical Apartheid,” Washington has taught at Harvard School of Public Health and University of Rochester. She also has served on the board for organizations such as the Journal of the National Medical Association and Young Women’s Christian Association.
Washington’s presentation was part of an education and awareness series titled, “Community Grand Rounds: Healing the Trauma of Racism,” which is a collaborative effort between Spectrum Health Lakeland and the Todman Family Foundation. She was introduced by Lynn Todman, vice president of health equity for Lakeland.
Washington met with Lakeland officials earlier in the day.
Todman said recent health studies have shown that in communities within the local health system, Black people’s life expectancy is 67 while that of white people is 86, a 19-year gap.
She said as health officials began looking into the reason for the discrepancy, there was a consistent theme: Black people have a lack of trust in the health care system.
“Trust has been deeply eroded, and Black people avoid health care. We need to earn trust,” Todman said.
In her talk, Washington said historically, there is no aspect of medicine that has not been touched by the mistreatment of African Americans.
Blacks being barred from white hospitals, “Negro” ambulances, the barring of Black doctors from hospitals and the American Medical Assoiation, and an old belief that Black bodies were different than whites have contributed to the historic mistrust, she said.
“Black slaves who ran away were given a (neurological) medical diagnosis and were punished for being ill. Sick slaves were accused of lying about it to get out of work, were beaten out of the hospital and forced to go to work,” she said. “It’s easy to see how African Americans distrust medical treatment.”
Washington said centuries ago, scientists told doctors that Blacks were “of a different species, had flawed bodies, imaginary diseases, lower intelligence, bestial sexuaity and didn’t feel pain.”
She said in her research for her book, she found ads “looking for sick Negroes” and found that Blacks were used for experimentation and for teaching purposes. She said in one case, arms and legs were removed to show medical students how to do amputations.
In the Victorian Age, she said, surgery was performed on Black women using no anesthesia, and in the 19th Century, African Americans were thought not to feel pain because “their neurological systems were crude.”
And as late as 2016, one-half of medical students believed Black people are immune to pain, Washington said.
“We need to acknowledge these past ethical breaches, not seek to excuse them,” she said.
During a question and answer session, one participant asked Washington what medical students, residents and fellows can do to fix this.
“It should not fall upon medical students to fix this,” she responded. “But I tell them, if you see something that’s not right, you need to say something. One person can change something. Take action, speak up, go out on a limb.”
Another participant asked what health systems can do to earn the trust of Black people.
Washington’s advice: “Maximize access to your system even though that might cost you something. It might mean treating people who don’t have health insurance. Devise a way to assign physicians to people who don’t have one. Increase representation of your population in your health system.”
She offered a shorter-term solution that might seem obvious.
“Ask people, ‘What do you need in your health care system?’ Let them know you’re here to be advocates,” Washington said.