HJAR Mar/Apr 2021

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2021 33 Joseph W. Thompson, MD, MPH President and Chief Executive Officer Arkansas Center for Health Improvement the U.S. Studies within the past ten years have shown that AfricanAmerican patients who suffer heart attacks are less likely than white patients to receive aggressive treat- ments and certain types of medication 4 and that AfricanAmerican patients are less likely than white patients to be prescribed opioids, even for the severe pain of broken bones. 5 A study published in 2016 in the Proceedings of the National Academy of Sciences found that half of white medical students and residents believe such myths as African American people have less sen- sitive nerve endings than white people or African American people have thicker skin 11% of vaccine recipients. In contrast, white people make up 68% of North Carolina’s population, but as of Jan. 25 they made up 82% of vaccine recipients. 3 Vaccine hesitancy in theAfricanAmerican community is a reflection of skepticism to- ward not only vaccines but also distrust of the public health system. It is a skepticism fostered in part by historical events. One of the most egregious examples of medical mistreatment of African American people inAmerican history is the Tuskegee Syphilis Study, which began in 1932 and con- tinued for 40 years. Initially, the U.S. Public Health Service and the Tuskegee Institute in Alabama recruited 600 African Ameri- can men for the study, including 399 who had syphilis, and told them they would be treated for “bad blood.”Unbeknownst to the subjects, the true purpose of the study was to observe the effects of untreated syphilis in African American males. Treatment was withheld from the men, even after penicil- lin became recognized as a highly effective treatment for syphilis in the 1940s. Dozens died as a result. This “study”ended less than 50 years ago. African Americans have also been the victims of forced or coerced sterilization. During the 20th century, 32 states adopted programs aimed at preventing people who were deemed unfit for society from re- producing, resulting in more than 60,000 sterilizations, many of them performed on people without their awareness. Typically, most of those considered unfit were immi- grants, those who were poor, people with disabilities, Indigenous populations, and people of color. There is also the case of Henrietta Lacks, who was being treated for cancer at Johns Hopkins University in 1951 when tissue sam- ples were taken from her cervix without her knowledge. They were the origin of the HeLa immortal cell line, which is commonly used in biomedical research today, including CO- VID-19 vaccine research. Lacks’ cells have generated millions of dollars in profits for the researchers who patented Lacks’ tissue. But Lacks’ family knew nothing about how her cells were being used until more than 20 years after her death in 1951. The white researcher who began working with her cells apparently did not see a need to ob- tain anAfricanAmerican patient’s informed consent. Sadly, we do not have to look decades into the past to see examples of inequitable treatment of African American patients in “African American, Hispanic and Native American peoplearedying fromCOVID-19atnearlythree times the rate ofwhite people, according to theCenters for Disease Control and Prevention. This is not because the disease differentiates by skin color, but because social, political and economic inequalities have placed some populations more at risk than others.”