A Cultural Conundrum Paper

A Cultural Conundrum Paper

A few hours a� er receiv-ing 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 Decem- ber 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

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the medical system really stems from enslavement,” s ay s D r. Ve r o n i c a Newton, an assistant professor of sociology at Georgia State University. She is working with a research team studying C OVID-1 9 res e arch participation in the Black community. From the gynecological A Cultural Conundrum Paper

experiments conducted on enslaved African A m e r i c a n w o m e 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 assistant 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 Afro-

Caribbeans 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 A Cultural Conundrum Paper

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

www.diverseeducation.com18 Diverse | February 4, 2021

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 c onc e r ns and l ive d 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, Meharr y 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.”Copyright of Diverse: Issues in Higher Education is the property of Cox Matthews & Associates Inc and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder’s express written permission. However, users may print, download, or email articles for individual use. A Cultural Conundrum Paper

Also check: The Health Organization Report