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Racial Disparities in Healthcare
31
Sam Howald, Jack Battaglia, Jane Ramsay, Logan Kesler
Racial Disparities in Healthcare
Discussion of Henrietta Lacks, the Tuskegee studies, and Mental hospitals
Intro
- Health disparities between white Americans and African Americans dates back to slavery
- Contributing factors:
- Lack of sources for primary care
- Social, financial, cultural and insurance barriers
- Liguistic barriers
Hisorical Cases
Hisorical Cases
Specific events and establishments throughout U.S. history highlight the differences in treating racial groups
- Henrietta Lacks
- Tuskegee Studies
- Mental Hospitals
Henrietta Lacks
- Diagnosed with cervical cancer in 1951
- Was treated at Johns Hopkins Hospital
- Unknown to Lacks, Dr. Lawrence Wharton Jr. took samples of her tumor while doing her biopsy
- Lacks was not informed that surgery to treat her tumor would leave her infertile
- Signed a form consenting to any procedures and anasthetic her doctors needed to use in order to get proper surgical care and treatment
The Ethical Issues
The Ethical Issues
https://commons.wikimedia.org/wiki/File:Henrietta_Lacks_(HeLa)_Timeline_(26453304954).jpg
National Human Genome Research Institute (NHGRI) from Bethesda, MD, USA 12
https://commons.wikimedia.org/wiki/File:Henrietta_Lacks_(HeLa).jpg
OI a.urabain 11
- The study of HeLa cells was unethical because the doctor did not tell Lacks that he would be doing tests on a sample of her cells.
- In the book The Immortal Life of Henrietta Lacks, Rebecca Skloot tells the story of Henrietta Lacks and her family, but Skloot got permission from the family before researching and publishing the book.
HeLa and Tuskegee
- The National Foundation for Infantile Paralysis (NFIP) used HeLa cells to help create the polio vaccine
- The Tuskegee Institue became a HeLa distribution center
- First sold them to polio testing labs, then began selling them to any scientist
- With the cells produced, scientists helped prove the Salk vaccine effective
HeLa and Tuskegee
Tuskegee Study
- African American males were lured into the study with promises to be treated for rheumatism, bad stomachs, or bad blood.
- Injected with syphilis instead.
- Clinical study from 1932-1972 that observed the natural progression of untreated syphilis in African Americans
- National Commission of the Protection of Human Subjects of Biomedical and Behavioral Research
- Disease was contracted through sexual contact, blood, and childbirth
Tuskegee Study
Tuskegee Study
- 399 males contracted the diseases while there was a control group of 201 males
- Unethical because of failure to treat patients
- Researchers did not tell patients they had syphilis
- Henderson Act
- Led to lack of seeking healthcare
- "What was done cannot be undone..."
Images
Mental Hospitals
- During the late nineteenth century public officials thought that the expense of hospital treatment was wasted on blacks.
- Instead of recieving treatment they were put into jails
- Twentieth century eugenics forced sterilization of poor women of the "Negro race"
- This type of medical abuse was built on racism.
State Mental Hospitals
State Mental Hospitals
- African Americans were more openly accepted in state mental hospitals
- They were placed in segrgated wards or separate buildings where they were treated different than white patients.
- "In a devastated economy, poor and "insane" individuals were not a priority."
- Nonconsensual experiementaion was done on lower class black citizens for "scientific purposes."
The Disparities Continue1
Some diseases are very high in the African American population as compared to the white population
The Disparities Continue1
- Cancer
- The incidence of cancer for African Americans is 10% higher than for white americans
- When compared with White Americans, African Americans 5 year survival rate is substantially less for any stage or type of cancer
- Chronic disease
- 48% of African Americans suffer from chronic diseases as compared with 39% of the regular population
- Obesity
- Seven out of ten African Americans age 18-64 are obese or overweight
- Infant mortality
- Preterm birth rates:
- Non Hispanic African American infants- 18.3%
- Non Hispanic White infants- 11.5%
- Hispanic infants- 12.3%
Visual
3
Infant mortality rates seperated by race.
Causes1
There are a few areas of concern that contribute to these disparities in healthcare
Causes1
- Lack of insurance
- More than 1 in 3 Hispanic and American Indians are uninsured
- Less than 1 in 5 african Americans are uninsured
- Low income/poverty
- related to the lack of insurance
- Lack of regular source care
- 35% of African Americans report they do not have regular doctors visits, as compared with 25% for White Americans
- Stigma
- Fear and lack of trust of doctors and the system based on personal or observed experiences
- Health literacy
- Poor literacy leads to poor health outcomes
4
What is being done?3
- Centers for Disease Control (CDC) health disparities and inequalities report highlighted some public health programs that have improved health disparities
- Some interventions the CDC has implemented:
- Increase vaccination recommendations for hepatitis A virus have reduced the disparities of infection in the US
- Programs in boston to reduce hospitalizations of asthmatic African American and Hispanic children
- Approaches to change policies and structures of communities to reduce violence
Sources
1. Javaid, Sadia; Barker, Narviar C.; Shahid, Ali; Jabeen, Shagufta; and Bailey, Rahn Kennedy (2009) "Disparities in Health Care among
African Americans," Challenge: Vol. 15 : Iss. 2 , Article 3.
Available at: http://digitalcommons.auctr.edu/challenge/vol15/iss2/3
2.“Strategies for Reducing Health Disparities.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 3 Oct. 2016, www.cdc.gov/minorityhealth/strategies2016/index.html.
3. By Mathews TJ, MacDorman MF [Public domain], via Wikimedia Commons
4. By Centers for Disease Control and Prevention; specific persons unknown [Public domain], via Wikimedia Commons
5. Gutenberg, Project. “Tuskegee Syphilis Experiment.” Tuskegee Syphilis Experiment Project Gutenberg Self-Publishing - EBooks Read EBooks Online, www.gutenberg.us/articles/eng/Tuskegee_syphilis_experiment.
6. “Memorandum Terminating the Tuskegee Syphilis Study.” DocsTeach, 16 Nov. 1972, www.docsteach.org/documents/document/memorandum-terminating-the-tuskegee-syphilis-study.
7. “Final Report of the Tuskegee Syphilis Study Legacy Committee -- May 1996.” Bad Blood: The Tuskegee Syphilis Study, exhibits.hsl.virginia.edu/badblood/report/.
Sources
8. Protections, Office for Human Research. “The Belmont Report.” HHS.gov, US Department of Health and Human Services, 15 Mar. 2016, www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html.
9. “In 1943 the Henderson Act Was Created as a Public.” In 1943 the Henderson Act Was Created as a Public Health Law Requiring, www.coursehero.com/file/p1sojm0/In-1943-the-Henderson-Act-was-created-as-a-public-health-law-requiring/.
10. Skloot, Rebecca. "The Immortal Life of Henrietta Lacks". 2010
11.OI a.urabain, https://commons.wikimedia.org/wiki/File:Henrietta_Lacks_(HeLa).jpg
12.National Human Genome Research Institute (NHGRI) from Bethesda, MD, USA, https://commons.wikimedia.org/wiki/File:Henrietta_Lacks_(HeLa)_Timeline_(26453304954).jpg
13. Brown, DeNeen L. “‘You’Ve Got Bad Blood’: The Horror of the Tuskegee Syphilis Experiment.” The Washington Post, WP Company, 16 May 2017, www.washingtonpost.com/news/retropolis/wp/2017/05/16/youve-got-bad-blood-the-horror-of-the-tuskegee-syphilis-experiment/?utm_term=.639e75cc8f0f.