Today African American people are scared of the medical field, and rightfully so. A history of misinformation, racism, and abuse of African Americans has caused the community to be fearful of seeking healthcare. This lack of faith in our healthcare system does not go without consequences, mostly in the form of bad quality healthcare for minorities and poor overall health of the community. Most prominently, is the reluctance to even see a healthcare provider in the first place, African Americans are risking their lives because of their traumatic experiences. The most important thing for medicine to do now, is try to mend this broken relationship. While there are numerous ways to go about this; such as establishing consent, or improving the black and POC doctor numbers, ultimately it all comes down to giving the African American community a connection to healthcare that is familiar to them, a newfound sense of trust.

Many African American people are reluctant to seek healthcare when it may be necessary because of a combination of factors (Rhee; Benkert), including a not so great history with medicine in the past (McVean; Moore; Skloot, 2; Kretchmer). This history is made up of multiple events and attitudes of the past which treated African Americans as less than human and disrespected their bodies in order to advance our knowledge of medicine (Williams). No singular event was the cause of this distrust, so it is extremely hard to undo the damage considering racism is ingrained within healthcare itself. There is no one apology, no one easy fix to get rid of this problem. There are multiple ways the medical community could address this. And it is important for them to do so as it is beneficial to the overall health of the African American community and it helps equality in medicine in the long run.

One way trust can be established is by gaining the consent of the African American people when conducting research. In “Restoring Trust in Medical Research among African-Americans.”, Morgan discusses what he believes to be the most beneficial way he is tackling the trust issue in medicine. He writes about informed consent, and how participants in his studies are made aware of everything going to happen to them. This is obviously an attempt to correct one of the most infamous cases of wrongdoings against African Americans by the medical field. The case of Henrietta Lacks, her cells were stolen from her and contributed to the creation and advancement of things such as; chemotherapy, the polio vaccine, in vitro fertilization, among others (Skloot, 2). Lacks did not give her consent to have her cells be harvested, but doctors did so against her will and without her knowledge. Image to the left of her family with a photo of her (Blumberg). This event was a major contributor to the distrust the African American community feels today, as it is one of the most widely known wrongdoings of medicine to people of color. However, it is not the only factor that has contributed to distrust, there are many other prominent events that have also led to this issue. By addressing consent, it could alleviate the community's fears. However, I do not believe that this is the best way to help African Americans regain trust in medicine. While consent is important, and it has the right sentiment, many people may feel like they are being lied to anyway. Because of the lack of trust already, why would anyone trust the medical professionals now even if they say only the consented to parts are occuring? Besides, this approach is too narrow in addressing community fears, it is much too closely related to one single event in history, and the fear of healthcare in minority groups does not stem from this one single event.

African Americans are facing not only past communal experiences, but also racial bias present in today’s healthcare system (Tello; James). African Americans need to be met with new positive experiences with the medical community today in order for them to start building trust. Which brings me to my next closely related solutions to the issue: using the education system to tackle mistrust. This can be done simultaneously in two different ways. One; through educating doctors in medical schools about implicit racial bias (Williams, J. Corey). If these racial biases are addressed and minimized before African Americans interact with doctors, they can start building new experiences. These positive ones will not replace the old ones, but may encourage African Americans to seek healthcare knowing that now history will not repeat itself and they will get the proper treatment they need. In “How Healthcare Is Starting to Heal Damaged Black Patient Trust.” Heath notes how minorities remember negative, potentially racially charged interactions and how they affect their behavior. These interactions, although not nearly as bad as the past events, continue to push minorities away and confirm their fears of healthcare. This issue can be tackled by racial bias training being implemented for healthcare professional’s education (Tello). This would help white doctors identify and prevent their racial biases from affecting their patients quality of care.

The implementation of racial bias training would be fairly simple, either as a course or set of courses during doctor’s education that target racial biases, or as hospital/medical care facilities programs for all workers. They would target identifying racial biases, education on stereotypes and the harm of biases, how to be as objective as possible, the harm of racial biases, etc. This would require medical school board members to take initiative and implement these programs, or for medical students to push for their schools to add these programs. This is a great solution, but I fear it may not be readily accepted into curriculums, and still does not address the issue fully. No education is perfect, and these programs may not create a huge impact on how African Americans feel about healthcare or their providers.

The importance of black healthcare professionals cannot be overstated, which brings me to the second closely related solution: Increase the number of black doctors and healthcare workers. A discouragingly low number of doctors identify as black, just 5% (Purks, Ebony). Even so, African Americans often prefer a same-race doctor as them, and rate them higher than other races doctors (Ingeno). This may be since they can relate to each other, the patient is not fearful they will be racially discriminated against (Tello). There are many outreach programs available such as Society of Black Academic Surgeons, Association of Black Women Physicians, among others. (Purks, Ebony). Since African Americans are more likely to rate Black doctors as being more satisfactory, it is reasonable to assume an increase of black doctors would help a newfound trust develop. While other race doctors cannot be guaranteed to be free of racial biases, black doctors can relate to black patients and vice versa, eliminating the discriminatory aspect almost completely. I believe this is an important long term solution which we should strive for, however it is extremely difficult to know even where to begin. There would need to be major changes in all of American society to significantly increase the amount of black healthcare professionals. From changes in colleges/medical schools, all the way down to elementary schools, education funding, etc. It has to be tackled at a large scale by society, which is difficult for any individual to do.

Some Associations that help grow the number of black healthcare workers (Purks, Ebony) are depicted above.

The previous solutions are definitely a step in the right direction, but I believe they are a bit too narrow or difficult for addressing the issue fully. The best way to encourage trust between African Americans and medicine to intertwine them. In “Regaining Minorities’ Trust” Clark discusses the real life application of reaching out to the African American community. A “community-based clinic” was put into place in a predominantly African American area through a church that had already been serving the community and their at risk population. They hoped that a connection with religion and the familiarity of the location would encourage vulnerable people to trust the medical center and help preventative measures be spread throughout the community. (Clark. Peter) I believe this a perfect way to foster trust. Not only is there an aspect of familiarity with the location being in an area where African Americans live, but it also connects them with religion. Many people put heavy importance on and trust in religion and this helps African American people feel comfortable with healthcare. Since this solution being discussed has actually been implemented, we know it is possible to do, and may even be able to be done in many other areas with some work. This solution is definitely not a very easy one, however I believe that it does the best job in addressing the trust issue as a whole. Sadly, African Americans have had to fight for their rights all through history, but this seems to be where all the change happens. Society and perceptions as a whole are often very difficult to change, but the African American community has always worked hard to build itself up, and it may be necessary in this regard as well.

Essentially, the best way for the medical community to build trust with African Americans is to use their own communities. They trust each other already, when they are able to have familiar faces advocating for their health, they will be more receptive to medicine. A perfect way to do this is for community members to have local leaders, such as church leaders or other prominent members of the community to advocate for and lead medical efforts such as creating a clinic or discussing prevention programs for the community. If there are clinics run for and by the community, in a familiar area, African Americans may feel more comfortable using healthcare related services than usual. A combination of well trained healthcare professionals and local workers can serve to bridge the gap between the community and medicine. Trust within the community can easily be leveraged as an opening for building trust, familiarity in a medical setting would allow African Americans to be more confident in their doctors and less scared, they would start to see themselves as an important part of medicine, and hopefully not as an experiment like how they were often treated like in the past. I encourage everyone, from community members to doctors, to reach out to one another to see the possibilities of opening new medical centers. There must be a push from leaders to make this happen.