"The Tuskegee Effect"
​In 2020, Michael Che, co-host of SNL's"Weekend Update," quippted “I’ve got mixed feelings about the [COVID-19] vaccine. On the one hand, I’m Black, so naturally I don’t trust it. But on the other hand, I’m on a white TV show, so I might actually get the real one.” As usual, Che couldn’t deliver the line without cracking up, but the joke betrays a dark truth: the American medical establishment has a long history of mistreating people of color, particularly Black people. As a result, mistrust in American medicine persists in many communities of color. In a February 27, 2021, interview on MSBNC, even as she urged Americans to get the COVID-19 vaccine ("Let's save our lives"), Vice President Kamala Harris still acknowledged the "righteous skepticism" in communities of color.
Beginning in 1932 and continuing for four decades, hundreds of mostly impoverished Black men were intentionally infected with syphilis. Under the direction of the U.S. Public Health Services and Centers for Disease Control, the men were subjected to toxic experimentation, or they went untreated, informed they simply had “bad blood.” (That's the exact phrase Wendal uses in Before It Hits Home as he resists his HIV-positive diagnosis.) This was all despite access to highly efficacious penicillin. Because the U.S. Public Health Services collaborated with a historically Black college in Alabama, the experiment came to be known as the Tuskegee Study. Dr. Rueben Warren, Director of the National Center for Bioethics at Tuskegee University, has said of the study, “It’s in what I call the institutional memory of people throughout this country in ways they don’t even know it." In the play, when a doctor confirms Wendal's positive status, Wendal calls it a "conspiracy."
A November 2020 survey by the Pew Research Center found that only 42% of Black Americans were willing to take the novel coronavirus vaccine. Mistrust of the health care system is the result of centuries of mistreatment of Black Americans, from surgical experiments performed on enslaved persons, to forced sterilization of women in the early and mid-twentieth century, to Tuskegee, to the statistics that show people of color are three times more likely to die of COVID than whites.
​​
These, of course, are the result of anti-Black discrimination that has been a part of American history since the first enslaved Africans arrived in Jamestown, Virginia, four hundred years ago. For centuries white American physicians and others were dedicated to proving that Black bodies were biologically different than white bodies. In his Notes on the State of Virginia, Thomas Jefferson appeared sympathetic to the abolitionist cause but ultimately decided Blacks were not constitutionally capable of living in freedom. “The first difference which strikes us is that of colour,” Jefferson wrote, concluding “that the blacks, whether originally a distinct race, or made distinct by time and circumstances, are inferior to the whites in the endowments both of body and mind.”
​​In his 1855 autobiography, Slave Life in Georgia: A Narrative of the Life, Sufferings, and Escape of John Brown, A Fugitive Slave, Now In England, Brown recounted the so-called treatments to which the plantation owner and doctor Thomas Hamilton of Georgia subjected the man. Hamilton applied “blisters to my hands, legs and feet, which bear the scars to this day. He continued until he drew up the dark skin from between the upper and the under one. He used to blister me at intervals of about two weeks.” After nearly a year, "the Doctor’s experiments had so reduced me that I was useless in the field.” A 2016 study published in Proceedings of the National Academy of Sciences found that a third of white med students subscribed to at least one myth that purports that Black bodies require different treatments than white bodies.
Adding to historical discrimination are today's inequities in medical treatment. Black Americans are vastly under treated for chronic pain in comparison with whites. Discontinuous health coverage and the relative dearth of physicians of color can contribute to higher rates of hypertension, diabetes, prostate cancer, and infant mortality. End-of-life care costs approximately $7,000 more for Blacks than for whites. From historical inadequate access to fresh food and clean water, to screening in early stages of disease, to housing inequalities, systemic inequities for some Black Americans have long-lasting effects on health. The "Tuskegee Effect" may take its name from the most notoriously racist medical event in American history, but its cultural underpinnings continue to contribute to inequitable health care and the resultant skepticism of the medical establishment.
Sources: Alabama Public Radio, The Atlantic, Centers for Disease Control, Commonwealth Fund, National Public Radio, NBC News, University of North Carolina Center for the Study of the American South
Return to The HIV/AIDS Epidemic
Return HOME