As we’ve discussed in class, disparities among rates of sexually transmitted diseases exist between people of different ethnicities, races, genders, levels of income, and many other factors. Data published in 2016 by the Centers of Disease Control and Prevention (Link) asserts that the rate of reported chlamydia cases was found to be 5.1 times greater among African American women compared to white women, and this number increased to 6.6 when comparing African American and white men. The report states similar disparities between whites and other ethnic groups for both gonorrhea and syphilis. Researchers in 2014 studied disparities among differing socioeconomic classes, as well as the interaction between race and income levels. (Harling et al., 2014) (Link) The study found that the prevalence of STDs was associated with low income as well as ethnicity and race, though the disparities were much greater between racial and ethnic groups, rather than groups of different income levels. When considering the factors causing these imbalances, aside from income, I found myself reflecting upon readings from Medical Apartheid.
In particular, one reading that came to mind was Harriet Washington’s discussion of the Tuskegee Syphilis Study. As we learned, this study, which began in 1932 in Macon County, and examined 400 African American patients as they suffered throughout the course of untreated syphilis cases, under the pretense that they were undergoing treatment. (Washington, 2006) In addition to this case, Washington’s writings include stories of forced sterilization and various other incidents through U.S. history in which African Americans were treated as test subjects, facing horrific atrocities at the hand of medical professionals. After spending much of the semester reading Washington’s examples of what she refers to as “scientific racism’, it can certainly understand how lingering distrust could exist between the African American community and the medical community. In fact, a 2007 study addresses this distrust in a multivariable analysis that examines distrust of physicians among racial groups, socioeconomic levels, genders, education, and access to health insurance. (Link)
This study claims that African Americans and Hispanics reported more distrust in their physicians than whites. Within the discussion of why this discrepancy exists, this particular study addresses the Tuskegee Syphilis Study as an example of the historic causes of distrust between minority communities and medical professionals. The study also addresses recent trends in distrust, claiming that the levels of distrust in the medical system has risen among the U.S. population over the past 40 years, and attributes this trend to “the growth of managed care and for-profit health care, disclosures of prior episodes of unethical medical research, growing public access to medical information, and publicity surrounding medical errors, malpractice, and fraud and abuse within the medical system” (Armstrong et al., 2007) (Link)
The evidence put forth through these studies presents a correlation between an increase in distrust in the U.S. medical system and heightened rates of sexually transmitted diseases among minority populations. While correlation doesn’t necessarily indicate causation, I think it’s entirely possible that lingering distrust from historical abuses plays a role in disparities of STD rates today. Another CDC article discusses this connection, saying, “Many racial/ethnic minorities may distrust the health care system, fearing discrimination from doctors and other health care providers. This could create negative feelings around getting tested and treated for STDs.” (CDC, 2017)(Link) The article presents the idea of “health equity”, in which everyone has an equal opportunity to access healthcare and be healthy, regardless of his or her race or background. I believe addressing this distrust could reduce disparities amongst racial and ethnic communities and move closer to this idea of health equity.