Racism in healthcare has led to vaccine hesitancy

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Experts say vaccine hesitancy among people of color has been influenced by past and current medical practices. Chaiwat Subprasom/SOPA Images/LightRocket via Getty Images
  • Experts say racism in the health industry has led to vaccine hesitancy in some communities of color.
  • They say medical racism in the past as well as current practices have made some people of color suspicious of the healthcare industry.
  • They say system-wide solutions are needed to overcome this reluctance.

There are many reasons why people become hesitant about vaccination.

Among them are fear of harm, misinformation about effectiveness, and lack of a sense of urgency.

But for many people of color, there is often another cause: medical racism.

A new study reports that nearly one in 10 people from minority ethnic groups who have refused a COVID-19 vaccine report having experienced racial discrimination in a medical setting during the pandemic and twice as many incidents of discrimination as those who volunteered to receive the vaccine.

“Our results support evidence from before the current pandemic, which found associations between experiences of racial discrimination and distrust of the healthcare system and doctors among ethnic minority adults.” Elise Paul, Ph.D., lead author of the study and senior researcher in epidemiology and statistics at University College London, said in a press release.

Although this study took place in the United Kingdom, experts say it is likely that these dynamics persist as a reason for vaccine hesitancy among people of color in the United States.

“We also have minorities who have had negative experiences with the healthcare system and believe the system is biased against them,” said Michele Ruiz, co-founder and CEO of BiasSync, a software-based assessment and development solution. on science designed to help organizations reduce the negative impact of unconscious bias. “If they’ve been disrespected or abused, it’s easy to understand that they’re reluctant to see medical professionals. »

Experts note that the United States has a history of medical racism toward people of color, from medical testing on slaves to using people as non-consensual test subjects for medical experiments to forced sterilization.

“Black Americans are acutely aware of the history of the US government experimenting with them and it’s no surprise that they are suspicious,” Ruiz told Healthline.

Looking beyond the past, experts note that the medical profession today is still plagued by unconscious biases and doctors who sometimes have false beliefs about biological differences between races as well as the undertreatment of people. of color.

It’s all part of what America is and something we have to reckon with, said Kenneth Campbell, DBe, program director of Tulane University’s online Master of Health Administration and assistant professor. at the Tulane School of Public Health and Tropical Medicine in New Orleans.

“We live in a very highly racialized society, and the American healthcare industry is not socially excluded,” Campbell told Healthline. “Minority communities have been the hardest hit by the COVID-19 pandemic, and many state and federal policymakers have done very little to address the social determinants of health, relationships of trust, as well as issues of health disparity, with a disproportionate proportion of medical and public health resources provided to white communities compared to minority communities.

“So yes, there are similar correlations here in the United States between vaccine hesitancy and BIPOC. [Black, Indigenous, and people of color] experiences in American health care,” Campbell added. “I have seen the damage and erosion of trust due to established standards of care in healthcare that have devalued many minority patient lives. This needs to change.

Misinformation about vaccines among minority groups is also a problem, just as it is among vaccine-resistant whites.

“There has also been evidence of deliberate misinformation via social media,” Ruiz said.

Because the problem of racism in health care is systemic, only systemic solutions are likely to be enough to fix the problem, experts say.

The first is overhauling the current model for organizing patients in the medical system, Campbell said.

“I co-authored a paper in 2017 that incorporates a new patient organizing framework that recognizes traditional elements of informed consent and incorporates a new organizational obligation to address issues such as population health, patient outcomes, health and health disparities,” he explained. “Shared decision making (SDM) in the context of this model provides a strong ethical framework for all patients. The SDM has the potential to reduce overtreatment, improve communication and health outcomes, health disparities and health inequities. »

But it needs to go beyond that and deeper into the minority communities themselves.

“[Minority] communities feel that the government, the medical community and public health have forgotten about them,” Campbell said. “Like any long-lasting relationship, trust is essential as well as transparency in your health and public health policies for inclusion.”

Some approaches include working with local community and faith-based organizations and minority leaders to build trust before rolling out a vaccination program — something Campbell said he was able to do in Illinois.

“Health organizations must become collaborators in increasing health literacy rates, partnering and building housing spaces for the most vulnerable as well as building rundown communities and making these new structures spaces – places learning, high quality living and better quality of life,” he said. “This is how the healthcare industry will help mend this broken trust.”

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