Why some communities distrust doctors and public health efforts

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As the latest updates on COVID-19, the monkeypox virus, polio and other health issues and problems continue to circulate, one doctor noted that health care is a lot like a product.

Dr. Alexander Salerno, an internist in New Jersey, told Fox News Digital, “If you don’t trust the seller or the product, why would you buy it?”

Salerno works at Salerno Medical Associates, a second-generation family practice serving East Orange and Newark.

He told Fox News Digital that trust is the “glue” between doctors and patients, especially in underserved communities.

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“Less trust leads to patients not complying with treatment or screening recommendations and this, in turn, leads to reactive health care, as opposed to preventive care,” he said.

An Italian resident is vaccinated with the Jynneos vaccine at Spallanzani Hospital as Italy begins a monkeypox vaccination campaign. Photo taken in Rome, Italy on August 8, 2022.
(Hospital Spallanzani / Leaflet via REUTERS)

Many working Americans have limited paid time off to see the doctor, he said, so when that’s combined with “customer service that’s often indifferent on good days,” some people don’t seek medical services. medical care until they cannot avoid it. , Salerno said.

He said making care not only more accessible, but also “less of a chore would go a long way to building trust.”

In the infamous Tuskegee experiment, the federal government left a group of black men in rural Alabama untreated for syphilis for 40 years for research purposes.

Some doctors and medical professionals also believe that knowledge of the infamous Tuskegee experiment from 1972 continues to have impacts today.

This year 2022 is the 50th anniversary of when the public first learned that the federal government denied a group of black men with active syphilis proper treatment for the disease.

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The reason the treatment was discontinued? Discover how the infectious disease would naturally progress in the human body over 40 years.

On July 25, 1972, the Associated Press broke the news that “shook the American medical establishment,” as the AP itself noted.

Doctor and patient sitting together.

Doctor and patient sitting together.
(iStock)

The federal government, the AP’s Jean Heller reported, had let hundreds of black men in rural Alabama go untreated for syphilis for 40 years for research purposes.

A public outcry ensued, and the “Tuskegee Syphilis Study” ended three months later.

The men filed a lawsuit that resulted in a $9 million settlement, and then-President Bill Clinton formally apologized a few years later, on May 16, 1997, to be exact.

Still, the study is commonly cited as a reason why some African-Americans are reluctant to participate in medical research or even go to the doctor for routine checkups.

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“In the context of the story of the end of the famous Tuskegee experiment, black and brown citizens are reluctant to participate in clinical trials and often delay critical care for curable diseases to the point where there are few, if any, options. , available at the time they are presented,” Dr. Christopher L. Edwards, retired associate professor of medicine at Duke University, recently told Fox News Digital.

More details and history

In 1932, the US Public Health Service began a study of black men in an area of ​​Tuskegee, Alabama, with the highest rate of syphilis at the time, according to the Centers for Disease Control and Prevention (CDC ).

“It was originally called the ‘Tuskegee Study of Untreated Syphilis in the Black Male’ (now known as the ‘USPHS Tuskegee Syphilis Study’),” the health agency said on its website.

If left untreated, syphilis can have serious complications, including organ damage.

“The study initially involved 600 black men: 399 with syphilis, 201 who did not have the disease,” the CDC added, but the “informed consent of participants was not collected.”

If left untreated, syphilis can have serious complications. Complications include causing organ damage in the brain, nerves, eyes, heart, blood vessels, liver, bones and joints, according to the Mayo Clinic.

The Tuskegee study is “one of the main reasons why people in minority communities continue to mistrust doctors and public health efforts, such as COVID-19 vaccines,” said Dr. Edwards.

In this March 2, 2021, file photo, a pharmacy technician loads a syringe with Pfizer's COVID-19 vaccine at the Portland Expo in Portland, Maine.

In this March 2, 2021, file photo, a pharmacy technician loads a syringe with Pfizer’s COVID-19 vaccine at the Portland Expo in Portland, Maine.
(AP Photo/Robert F. Bukaty, file)

“Health disparities are the manifestation of intentional or unintentional differences in clinical outcomes based on physician and patient characteristics,” Edwards said.

He is a national expert on factors influencing health outcomes among minority and black populations and founded the Urban Healthcare Initiative Program, a community-based health and education provider.

“Without trust, patients have little reason to follow their doctors’ advice. It’s not hard to see why this is a concern.”

“When known differences in outcomes are not addressed, those most affected negatively encode a historical distrust of the physician and the medical establishment.”

Confidence is key

The COVID-19 pandemic, with its often inconsistent public health messages, worsened the problem of trust in the medical profession, Dr. Salerno suggested.

Health experts worry about declining screening tests due to delayed diagnoses, health consequences and worsening cancer disparities among women who experience health inequalities.

Health experts worry about declining screening tests due to delayed diagnoses, health consequences and worsening cancer disparities among women who experience health inequalities.
(iStock)

“Contrast that with how HIV had a relatable ambassador, like Magic Johnson, and you see the value of consistency and reducing the volume of fearful conversations,” Salerno noted.

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But ambassadors can be “a pastor or a hairdresser” or other everyday people, because “talking knowledgeably about diabetes or other chronic conditions” from people with related backgrounds has real value, the internist said.

“People literally trust doctors with their health and their lives,” Salerno said.

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“Without trust, patients have little reason to follow their doctors’ advice. It’s not hard to see why this is a concern.”

The Associated Press contributed to the reporting of this story.

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