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Distrust in Health Care

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Submitted By kealiagrace
Words 1016
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According to the Merriam-Webster dictionary, trust is defined as having a belief in something or someone that is honest, good, and dependable. Having trust in any relationship is vital but especially important in regards to the patient and physician dynamics. Certain past experiences can influence a person’s trust in the health care system and a negative experience can impact their ability to trust and receive effective treatment. Throughout history African Americans have been subjected to racism and discrimination in which these past experiences can be pasted down from generation to generation effecting their beliefs in the health care system. Experimentation on slaves and the Tuskegee Experiment are just a couple of negative experiences to impact African Americans and their trust in physicians and health care in general that continue to this day. Mistrust in the health field for African Americans stems from numerous events, one being that of the experimentation on slaves. Back in the day when the white population owned slaves, they were subjected at times to very painful and unethical experimentation. In the South African Americans filled hospital beds where they were used as dissection experiments to help doctors perfect their practice in the medical field (Harris, Gorelick, Samuels, & Bempong). They were also used to test new techniques and remedies. One such example is that of a slave named Fed. Fed was “secured in an open pit in the ground that was then covered and heated to test which medication enabled him to withstand heat. Each session ended when Fed finally succumbed to the heat and fainted” (Harris, et al.). Slaves were also used to test the safety of vaccines, which was obtained by injecting them with certain diseases such as small pox. Distrust in health care only continued post slavery and into the 1930s with the Tuskegee Experiment. African Americans feared they would be tested on had they had to enter a hospital and the Tuskegee Experiment only proved their fears to be correct. The Tuskegee Experiment was a government-sponsored study in which they took 600 black men from Macon County, Alabama; 399 had syphilis and 201 did not have the disease. Researchers told the men that they were being treated for “bad blood” but in reality they were not given the appropriate treatment for their disease once penicillin became the preferred drug of choice for treatment in the late 1940s (CDC, 2013). The study was suppose to only last six months but continued for forty years. The Tuskegee Experiment only reinforced African Americans distrust in health care that continues to the present day. Trust is important in any relationship but especially important with the relationship that a patient and physician has. Without trust the patient will not be willing to do such things as disclose their full medical history, want to partake in any physical exams, or follow any recommendations for follow-ups, tests, or treatments. Having a lack of trust does not allow for effective treatment of any patient. Without trust patients may be less likely to even visit a physician when they are sick which in return can affect their over all health. They will exhibit “less doctor-patient interaction, reduced adherence to recommendations, worse self-reported health, and reduced utilization of health care services; thus, Blacks’ relatively lower trust in the health care system puts them at a greater risk of all these negative outcomes” (Musa, Schulz, Harris, Silverman, & Thomas, 2009). Exuding trust thus allows for all services to be used and better patient satisfaction. If trust is not had for the health care system, patients will be less likely to see a physician and untimely creating lower life expectancies for themselves. The United States health care system has not been too kind historically to the African American population. They have been subjected to multiple events of discrimination throughout the years. Once the Tuskegee Experiment was put to an end because it was found to be ethically unjustified a lawsuit soon followed. A settlement was reached in 1974 that resulted in the government promising to pay lifetime medical expenses along with burial services to those men who participated in the study. A year later the program that was established to give the men benefits (The Tuskegee Health Benefit Program) expanded to their wives, widows, and children (CDC, 2013). African Americans are considered to be a minority in the United States and research shows that minorities have poor access to health care services. The Office of Minority Health was established to help secure a usual source of care for minorities, which would allow for better management of care (Shi & Singh, 2013). The office is imperative because it “plays a role for other federal agencies and the minority health initiatives they support. The programs developed at both the federal and state levels provide extensive services that address some of the key pathways leading to racial disparities..” (Shi & Singh, 2013, p. 265). In 1998, President Clinton launched the Radical and Ethical Health Disparities Initiative. It was aimed to eradicate racial and ethnical disparities in such cases as “infant mortality, diabetes, cancer screening and management, heart disease, AIDS, and immunizations” (Brooks, 1998). Programs and initiates such as these allow for minorities to be able to get equal care no matter what their race is or their background. In conclusion, trust plays such a vital role in the health care system. Negative events have a tendency to be pasted through generations affecting the ability to get proper care. African Americans have endured their fair share of discrimination through out time such as experimentation of slaves and the Tuskegee Experiment, all of which has lead to their distrust in health care. Having a lack of trust does not allow for proper care of any individual, as they would be less likely to seek medical attention when needed. This lack of care can compound into worse health and eventually a lower life expectancy. With initiates set up through the government and states, health care is readily available to African Americans and other minorities to allow everyone the ability to access proper health care.

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