Posted: April 24th, 2023

Capstone Discussion essay

16 Diverse | February 4, 2021 www.diverseeducation.com
A few hours a er receiving the second dose of
the COVID-19 vaccine,
Dr. Valerie Montgomery Rice,
president of Morehouse School
of Medicine (MSM), says she was
“feeling great.” Rice, who says she
has “a history of participating in
clinical trials,” received her fi rst
dose of the vaccine on December 18 with CNN anchor Sanjay
Gupta to raise awareness and
public trust in the vaccine.
Rice and MSM are part of a group of
higher ed professionals, doctors and public
health experts known as the Black Coalition
Against COVID, which is working to
address community concerns and dispel
misconceptions about the disease and the
vaccine and to inspire trust in the medical
community around these
issues to hopefully save
Black lives.
is is no small feat.
“Black folks’ mistrust in
the medical system really
stems from enslavement,”
says Dr. Veronica
Newton, an Helpant
professor of sociology at
Georgia State University.
She is working with a
research team studying
COVID-19 research
participation in the
Black community.
From the gynecological
experiments conducted
on enslaved African
Ame r ic an wome n
without anesthesia, to
the forced sterilization
of Black women after
emancipation as a form
of social control, to the
Tuskegee experiments Dr. Veronica Newton
A Cultural
Conundrum
Physicians are fighting against historic distrust and
misinformation in their quest to save African American
patients, who are dying from COVID-19 at disproportionally
high numbers.
By Autumn A. Arnett
www.diverseeducation.com February 4, 2021 | Diverse 17
that withheld treatment for Syphilis from infected
Black men, to even more recently not believing
Black women and putting their lives at risk during
childbirth, there has been systemic institutional
violence against Black bodies by the medical
community, Newton says.
“I think it’s really important that we remember
that it’s institutional racism and sexism that has
led Blacks to mistrust medical professionals, not
just, ‘Oh, Black people don’t have a trust of medical
professionals,’” she says. “It’s more than Blacks all
having a bad experience with a specifi c type of
doctor. It’s across all facets and specifi cities within
the medical fi eld.”
ese disparities don’t only aff ect poor Black
people. Dr. Geden Franck, an Helpant professor in
the school of medicine at Texas A&M University,
pointed out how a lack of cultural responsiveness has
impacted patient care.
“Yes, there are errors
within the system,
there are misdiagnoses
within the system, but
we tend to see there
is a higher percentage
of these when dealing
with cultures or races
that physicians are
unfamiliar with —
like what happened
with Serena Williams
during her pregnancy,”
Franck says. “That
showed us that even
when the African
American patient is
very affl uent, they still
face these disparities
in treatment. It’s not a class issue or a disenfranchisement
issue, it’s a system issue.”
Franck says other cultural customs come into play as well,
such as historic disenfranchisement and a lack of access to
healthcare.
“Many Black people across the diaspora, especially AfroCaribbeans and Afro-Latinos, have always relied on their
elders and homeopathic remedies before seeking any type of
Western medicine,” Franck says. But since most doctors are
trained primarily in fi rst-line techniques, it becomes harder
to treat patients who come for treatment later when it comes
to the progression of disease.
And then there’s a proliferation of misinformation on the
internet, he says, which doesn’t only aff ect Black people, but
exacerbates the fact that this population is already dying at
higher rates than others.
“We’ve entered the world in which misinformation is very
prevalent,” Franck says. “Any mistrust in any system, whether
it be medical or in the democratic system, is further amplifi ed
with the spread of misinformation when you politicize things
that shouldn’t be politicized, like saving lives.”
Dr. Wayne A.I. Frederick, president of Howard University,
says getting information to the Black community is a
constant challenge. Howard is also a member of the Black
Coalition Against COVID, which has worked to broadcast
webinars and virtual town halls featuring public fi gures —
such as Dr. Anthony Fauci, director of the National Institute
of Allergy and Infectious Diseases, and National Urban
League President Marc Morial — in an eff ort to push out
accurate information about the coronavirus pandemic and its
impact on the Black community.
A January report from the APM Research Lab found over
55,000 Black people — or more than one in every 750 — had
died from COVID through January 5, a higher mortality
rate than every other demographic group, except Indigenous
Americans.
Frederick pointed out the eff ort is literally a matter of life
and death, but it is diffi cult to win the trust of the community.
“You remember very, very early on in the pandemic, there
was some conversation that maybe it doesn’t aff ect Black
people. So there’s a lot of disinformation as well that you have
to deal with and overcome,” he says. “But Black people are
more likely to have comorbidities, more likely to be frontline
and essential workers, less likely to be able to isolate. All of
the social determinants of health are working against our
community.”
“What we’re trying to do is educate people about why they
should take a vaccine and then have them make the right
decision,” Frederick says.
He is most worried about the way the positive rates and
death rates are trending, and what that could mean for the
Black community overall. “ ere is a scenario where in the
early spring, in April or May, we could have a circumstance
where lots of people have been vaccinated. And despite that
happening, we may not have a lot of African Americans
vaccinated,” Frederick says. “So we could actually have a really
bad outcome in which (the Black community gets) hurt
disproportionately on top of what has already happened, and
that worries me.”
Understanding the vaccine
“ ere are a lot of people who talk about Tuskegee syphilis
experiment, the Mississippi appendectomy experiment, they
talk about Henrietta Lacks. … And one of the things that I tell
them that’s diff erent from then and now is that we have Black
Dr. Geden Franck
Dr. Wayne A.I. Frederick, president of Howard University, receives a COVID-19 vaccine.
18 Diverse | February 4, 2021 www.diverseeducation.com
scientists at every stage of the development of this vaccine,”
says Rice. “Whether it was the early stage work, looking at
the history of whether the messenger RNA could be used in
the vaccine, whether it was the launching of the early trials,
starting with animals and moving onto people, … even down
to the marketing, there have been Black and Latinx scientists
at every stage of that development, so we have been in the
rooms where decisions have been
happening.”
Franck pointed out that in the
Tuskegee study, which is the most
widely-cited example of egregious
mistreatment, the treatment for a
very curable disease was withheld
from Black people. They were not
injected with syphilis to study its
impact, he points out, they were
refused treatment.
“In this case, we’re trying to offer
Black people a vaccine that could
combat the disease — which, by the
way, is disproportionately killing us
— not keep it from them,” he says.
There has also been a lot of
discussion of how fast the vaccine
was developed. Many do not
understand how the vaccine can
possibly be safe for wide use in only
a few months.
“People are minimizing the
effect that the coronavirus has
had globally,” Franck says. “The
global impact has created a huge financial interest for the
development of this vaccine, which has led to it being
developed so quickly and the recruitment of a number of
people into initial trials. Those are usually the two biggest
barriers in the development of any vaccine: funding and
participation. In this case, it quickly passed all the normal
steps that any other vaccine would normally have to pass
in order to be approved, because of the compelling global
interest to get it done.”
Another misconception is that the vaccine is intended to
prevent people from contracting the disease, Franck says.
“In contrast to other vaccines, which have either dead or
live virus in it, [an MRNA, or Messenger RNA, vaccine] has
none of that,” Franck says. “It takes it two steps down the
road and takes what the body would normally have to build
immunity and puts more of that into itself and gives the body
instructions to build its own antibodies for immunity. This
doesn’t mean you can’t get the disease, but it’s giving your
body information to defeat it quickly.”
Changing the narrative
Franck is a member of a group of roughly 20 young, Black
doctors who are working the social media angle to reach the
community under the hashtag #RMRN — Real Medicine,
Right Now.
“Fortunately or unfortunately, a majority of people are
consuming their news on social media these days,” says
Franck. “So we’re leveraging it to gain the exposure of
providing the right information, providing the access to
people, as far as testing and vaccines, but also, quietly, one
of the biggest things is the exposure that we get as a group
to motivate the younger population to pursue careers in the
field of medicine.
“When they see doctors who look like them, and who
they can also see having regular
lives with regular interests —
representation matters.”
Newton agrees.
“We need Black doctors that
have the same list of demands
and concerns and lived
experiences — knowing Black
folks. Actually knowing what
Black life is like, and having that
rapport and those relationships
with your patients. We need
people who can actually relate to
Black folks. Not talking at people,
but talking with and centering
those voices,” she says.
Frederick pointed out that, in
the 1800s, there were eight Black
medical schools dedicated to
the production of Black doctors
in the U.S. Now, there are four:
Howard, Morehouse School of
Medicine, Meharry Medical
School and the Charles R. Drew
School of Science and Medicine.
“We’re not trying to absolve other medical schools across the
country from educating more students of color to be doctors,
but we’re going to do more,” says Rice, whose institution
recently entered a partnership with CommonSpirit Health,
one of the nation’s largest healthcare providers, to train more
Black physicians. “We need more physicians who are Black
and Latinx, who come from rural communities, who have
more cultural competency with the communities they serve.”
Newton says it is important to acknowledge the systemic
failures that have brought us to this point. In addition to
needing more Black and Latinx doctors, she says, White
doctors and doctors of other races should still be held
accountable for being able to relate to their patients. Newton
is a proponent of all medical students being required to take a
sociology course to help them better understand the cultural
nuances that impact their patients.
“If we can’t use the words to describe the institutional
racism, sexism in the medical field, we’re never going to be
able to get there,” Newton says. “We’re just going to think it’s
individual biases from doctors and not a structural problem.”
“These groups really need to learn the language so that
they know how to communicate with folks who don’t look
like them,” she says. “Not looking at Black folks as just Black
bodies, but as actual human beings who do want folks in
these positions to help us, but these systems haven’t shown us
anything different.” D
“There are multiple ways to build confidence in people who are
trying to ever have a better understanding of why they should
be confident in something,” said Dr. Valerie Montgomery Rice,
president of Morehouse School of Medicine. “Sometimes
people have to see you actually participate.”
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