Medical racism in history causes health inequalities for Black Americans

The health inequities for Black Americans, documented in a series of stories by The Associated Press, have their roots in a long history of medical racism. The AP has collected a small sample of that history related to every phase of life.

BIRTH: GYNECOLOGY

James Marion Sims, a 19th century Alabama surgeon heralded as the father of modern gynecology, pioneered a treatment for vesicovaginal fistulas, a condition that affects bladder control and fertility in women. Between 1845 and 1849, Sims carried out the once-experimental surgical treatment on a dozen enslaved women without the use of anesthesia. He has been both defended as a product of his era and panned as unethical and inhumane.

Sims’ belief that Black people could endure more pain than white people is considered a form of racism and still present in the field of medicine. From medical school students of various racial and ethnic backgrounds to primary care providers of small and large practices, this bias has adversely impacted the health outcomes of Black Americans. It’s also a source of Black American skepticism of modern medicine.

CHILDHOOD: BEHAVIORAL TREATMENT

Behavioral challenges in Black children, throughout history and typically in educational settings, have been met with inequitable, inhumane and even extreme treatment. Systemic racism in behavioral counseling and psychotherapy for school-age children has meant lifelong adverse consequences for generations of Black children — from the funneling of Black students with learning disabilities into special education tracks that lack resources and overreliance on suspension and expulsion to institutionalization and experimental brain operations.

Dr. Orlando J. Andy’s work at the University of Mississippi Medical School in the 1960s is one example. The neurosurgeon testified that he performed 30 to 40 lobotomies and other brain operations on Black children and other people with behavioral problems who had been institutionalized. Although Andy said his operations were a last resort for patients who lived with uncontrolled destructive hyperactivity, the procedure was performed on institutionalized Black boys as young as 6. Some patients lived the rest of their lives with deteriorated intellectual capacity.

TEEN YEARS: ADULTIFICATION

Black children and teens are often perceived as much older than they are. Because of this bias known as “adultification,” they get viewed as less innocent and less deserving of empathy — resulting in harsher, disparate treatment in health care and other systems. The attitudes date back to slavery, when Black children as young as 2 were made to work and punished for developmentally appropriate child behavior, according to scholars Michael J. Dumas and Joseph Derrick Nelson.

Research shows these attitudes still drive disparities in outcomes for Black children and teens. A Yale study found Black children are 1.8 times more likely to be physically restrained in a hospital emergency room than white kids, a gap that may be driven by hospital staff’s view of Black children. Georgetown researchers have found that adultification of Black girls is linked to them being treated more harshly in school.

ADULTHOOD: STUDYING BLACK BODIES

University of Cincinnati researchers led an experiment from 1960 to 1972 that exposed about 90 poor, mostly Black, terminal cancer patients to extreme levels of radiation without their consent. The Department of Defense funded it as part of Cold War radiation experiments, according to Associated Press stories.

Dr. Eugene Saenger, one of the chief researchers, said the study was meant to find experimental treatments for patients with inoperable cancer to see if he could stop the growth of tumors. But the patients and their families said they were not fully informed of the risks or asked to sign consent forms. They also weren’t told of the Defense Department’s involvement or that the results would be used to learn what might happen to troops exposed to radiation. A federal court ruling noted the patients were told they were receiving radiation for their cancer. The families’ attorneys said many of the patients died after the radiation or experienced shortened life expectancies. A judge approved a $5.4 million settlement for the families.

DEATH: STEALING BLACK BODIES

Even in death, Black Americans haven’t escaped racist acts denying them the dignity their final resting places should have afforded them. Graveyard diggers were often hired to exhume and remove the bodies of Black people for the sake of medical research and studies, unbeknownst to family members.

Harriet Washington, author of the book “Medical Apartheid,” noted that Black graveyards were regularly targeted — including by Dr. John D. Goodman, who in 1829 wrote that he paid the manager of a public graveyard “for the privilege of ‘emptying the pits’ of about 50 to 85 cadavers a month during each ‘dissection season.’” Bodies were typically exhumed during the cooler months to align with the academic year. Washington wrote that historian Todd Savitt said Black people were well aware of the grave robbery that occurred, as evidenced by one elderly, enslaved Virginia woman who once said: “Please God, I hope when I die, it’ll be the summertime.”