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To Understand Black Hesitancy Over Vaccines, Look Beyond Tuskegee

Whenever I read about hesitancy in the Black community toward the COVID-19 vaccine, it's almost universally attributed to "Tuskegee." This annoys the hell out of me, and I've been meaning to write about it for a while. Today, however, Tyler Cowen points me to a piece at KQED that's practically a mind meld of my exasperation:

“It's ‘Oh, Tuskegee, Tuskegee, Tuskegee,’ and it's mentioned every single time,” says Karen Lincoln, a professor of social work at the University of Southern California. “We make these assumptions that it's Tuskegee. We don't ask people.”

When she asks the Black seniors she works with in Los Angeles about the vaccine, Tuskegee rarely comes up. People in the community are more interested in talking about contemporary racism and barriers to health care, she says, while it seems to be mainly academics and officials who are preoccupied with the history of Tuskegee.

“It's a scapegoat,” Lincoln says. “It’s an excuse. If you continue to use it as a way of explaining why many African Americans are hesitant, it almost absolves you of having to learn more, do more, involve other people – admit that racism is actually a thing today.”

A white doctor draws blood from a Black patient during the Tuskegee study.

The problems with "Tuskegee, Tuskegee, Tuskegee" are (a) it's mostly wrong, and (b) it allows everyone to ignore the fact that the real problem is current racism, not a scandal that began its life nearly a century ago.

In fact, it's even worse than that. Focusing on Tuskegee allows white people to shake their heads (privately, of course) over all those Black folks who are still obsessed with this one injustice that happened a long time ago. If they won't give up on the whole Tuskegee thing, then goodness. What on earth can we do about it?

The answer, of course, is to take the current treatment of Black patients seriously—and in fairness, I think the medical community has come a long way on this over the past couple of decades. But there's still a long way to go.

By the way, the KQED piece by April Dembosky is really, really good. I don't usually learn a whole lot that I didn't already know from pieces like this, but I did this time. It's well worth your time to read the whole thing.

28 thoughts on “To Understand Black Hesitancy Over Vaccines, Look Beyond Tuskegee

  1. bebopman

    Sir, you (and kqed ) are correct. Here in Denver, there’s a greater effort to take clinics out to the neighborhoods but it’s a bit late in starting.

  2. akapneogy

    Tuskegee is a convenieit short hand for the despicable treatment of Blacks in the past and the deplorable shortcomings of their current treatment. But I take your point.

  3. Solar

    I don't dispute that the issue isn't about Tuskegee, which I wouldn't be surprised many don't even know about since it happened so long ago, however I don't understand the rationale for the alternative response.

    "People in the community are more interested in talking about contemporary racism and barriers to health care"

    This makes perfect sense to be concerned about if someone can't get access to the vaccine even if they want it, but if the question is why are they reluctant to take it in the first place, how do the two square up?

    One would be reluctant to take it if one is afraid the vaccine might not work or even worse make you sick, which is why the Tuskegee excuse fits since that is precisely what happened in the past. Or perhaps some have been caught on the anti-vaxx sentiment that has become more widespread over the past 20 or so years, or in extreme cases perhaps they are adherents to the lunatic fringe beliefs that it's all a ploy from Bill Gates, the illuminati, or whatever boogeyman to track you and control your life. I would be reluctant too if I thought it would be harmful to me or bring negative consequences.

    But people saying "I won't take the vaccine because I'm concerned about the lack of access to healthcare and racism"? Isn't that like cutting your nose to spite your face?

    What am I missing or what am I misunderstanding here?

    1. LowBrow

      The article is more about why Black people are reluctant to participate in medical research. And it turns out it's not so much because of Tuskegee as simply that they don't get invited -- or if they do, their hesitancy is taken as refusal. The KQED article is a very good read/listen.

      As to hesitancy to take the vaccine, it may be a compounding result from the fact that it's effect on Black people has not been examined very deeply. I hear this complaint from women too: A lot of medical research relies heavily on the while male population as the "normal" sample.

      1. skeptonomist

        So black people are refusing to take the vaccine because they know that only white people were in the test sample? It seems to be true that minorities have been underrepresented in previous trials, but that most black people know this and consider it important is conjecture at best. This question won't be resolved until there is thorough and competent polling of the people involved.

    2. Crissa

      Have you heard of the studies that found white doctors took black people's reports of pain much less seriously? Yeah, there are current problems of access and respect.

  4. pjcamp1905

    I taught at Spelman College for 11 years. Whenever my students and I talked about things like this, the first thing they said was "Tuskeegee." But not as the one and only cause; rather as a salient instance of how the health care system has a long history of racist medical treatment. As far as I could tell, they were black.

    1. Midgard

      The problem is, racist treatment is a proof that is unprovable. Were rural whites being mistreated by urban whites??? Racism goes along many ethnic barriers. Blacks have the most power they ever had in American history, but still whine like it is 1960. To me, that is failure.

      Similar to proggies who don't realize how Jewish trumpism is in spirit. The neoconservatives that simply want to install their regime by force. That is all it is. Look at the organizers of cpac, they ain't Aryan bro. The fact they work with Russia to try and create racial unity around Zionism is funny. Daily Stormer, Vdare, the base: all run out of Russia with jews as leaders. Maybe some Jewish democrats should bring this up........

        1. Midgard

          Again, the game is the game. Progressives simply say the same stupid thing over and over again: challenge the dialect!!! Ask Trump and Stewart Rhodes+the Greeneberg chick for dna. Actually notice who finances what. Labour at least called a spade a spade, the British people will slowly catch on. Calling a man who organized cpac junk a Nazi despite him being jew is sad. It's my point about rising black power, yet you act like a crippled people. It's all upstairs. Heck, I would love, Schiff or Rosen to call Trump a jew. Make the point clear, nobody is perfect.

          1. Joel

            The fact that you are obsessed with calling people Jews is a tell. The fact that you think this is a game is another tell.

            Less racist trolls, please.

        2. MontyTheClipArtMongoose

          Midgard is an fleft-wing affinity troll with a strong Brazilian barely legal gayporn bent.

          He's Greemwald, Jr.

  5. cmayo

    On the other hand, and I know it's anecdotal, but I've had black front-line workers at my workplace say straight up that they don't trust the vaccines because of the history of unsanctioned and impermissible "medical experiments" on black people. It's hard to attribute distrust of the vaccines among the black community to anything BUT the legacy of Tuskegee. These aren't stupid people, they've all got graduate degrees in human services fields, but they still don't trust the vaccine because of these crimes.

  6. berryinteresting

    My banker is a negro/colored/black/African-American/person of color. He said that he won't get vaccinated because of Tuskegee.

  7. ProgressOne

    I got on the vaccination list in my county. When they auto-call me to give updates, the message tells me to also try to get on lists in surrounding areas. So I also got on the list in two other counties. The counties take people in the order they signed up. If whites are getting vaccines in black areas, it's because they signed up early. Not sure how this points to mistreatment of blacks.

    1. Joel

      You are making Kevin's point. The reluctance of Black Americans to get vaccinated for COVID-19 isn't due to lack of access. it is due to suspicion of a white-dominated process.

      1. ProgressOne

        He also wrote, "The problems with "Tuskegee, Tuskegee, Tuskegee" are (a) it's mostly wrong, and (b) it allows everyone to ignore the fact that the real problem is current racism". I guess it's not clear if he is talking racism specifically for getting vaccines, or more broadly about US healthcare.

  8. audio

    And post-natal black mother are STILL, CURRENTLY dying at a higher rate than other post-natal mothers.

    There was a recent study that found CURRENT medical students underestimate the pain of black patients: https://www.pnas.org/content/113/16/4296

    These are real, concrete, current examples of real bias in the medical profession.

    1. Rattus Norvegicus

      A story similar to this one was run on NPR earlier this week and the poor treatment of blacks by their own doctors and the lack of trust in the medical system this engenders was cited as the most salient reason for vaccine hesitancy. Tuskegee was way down the list, although it is emblematic of the problem.

  9. UrbanLegend

    This is a strawman. I don't think anybody ever suggests that any lack of participation comes from specific knowledge of the Tuskegee experiments, or that refence to it is meant to exclude current disparity and racism in medical treatment -- or even to pretend that it means only something that happened a long time ago that has no bearing on the present. It happens to be the most prominent example of that. Any kind of distrust of participation in medical experiments due to fear of disparate treatment may well be traceable in part to awareness in general that there has been mistreatment in the past.

    Don't quite get why this should be a tear-your-hair-out matter, rather than one perhaps of minor annoyance. If anything, it provides a specific historical justification for the suspicion.

    1. justknuckles

      Somewhere along the line, grown adults are expected to behave as such and not project on the living the deeds of the dead. In doing so, such people sabotage their own health and then ensure themselves the poor outcomes they were supposedly trying to avoid.

      And it's also racist.

  10. justknuckles

    Kind of sad to see this but not surprising. When Kevin, who generally is known to compile data and weigh to get an accurate picture, on topics like this, specifically race, does the opposite and assumes white villainy is the cause.

    Unequal outcomes in and of themselves aren't proof of anything. Healthcare is a very diverse profession and the idea that a huge racial oppression conspiracy is the culprit is laughable.

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