The Impact of Police Brutality on Covid-19 and Medical Mistrust
Violence in law enforcement is affecting trust in medicine when it’s needed the most
Last week, a grand jury’s decision not to charge any of the police officers who killed Breonna Taylor set off a new wave of protests against racist police brutality across the United States. The protests have been ongoing since May, when a Black man named George Floyd was murdered by a police officer in Minneapolis.
Meanwhile, the Covid-19 pandemic has raged on, and people of color, especially Black people, have disproportionately felt its effects. Across the United States, Black people are dying at 2.3 times the rate of white people, according to the Covid-19 Racial Data Tracker. As the Coronavirus Blog previously reported, this gross disparity is due to a number of factors affecting Black people, including economic inequality, health care disparities, and redlining, a racist U.S. housing policy that pushed people of color into less desirable neighborhoods.
Another reason for the disproportionate impact of Covid-19 on Black people and people of color may be police brutality itself. In January of this year, a team of researchers led by Lehigh University’s Sirry Alang, PhD, an associate professor of sociology and health, medicine, and society, published a study revealing the links between police brutality and mistrust in medical institutions in the Journal of Racial and Ethnic Health Disparities. This study showed that people of all racial groups who had negative encounters with the police had higher levels of medical mistrust than people who didn’t have negative encounters. And this held true even if people thought the negative encounters were necessary.
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Public awareness of police brutality has increased since the start of the Black Lives Matter protests in May. And this, Alang tells the Coronavirus Blog, can have an impact on the way Black people are handling the pandemic.
“To most Black, Indigenous, and other people of color, institutions are institutions,” she says via email. “The structural racism and white supremacy that play out in our law enforcement and criminal justice institutions also play out in our medical institutions and educational institutions. Mistrust in one institution carries over to another because our experiences within and across systems are intertwined.”
She says her paper’s findings suggest that people of color dealing with the pandemic “have good and legitimate reasons” to not seek medical care, have misgivings over a vaccine, or believe that medical institutions do not have their best interests at heart.
“It means that their concerns and fears are legitimate,” she says. And it is on institutions to address this mistrust and to correct the racist policies that led Black people to be disproportionately affected by Covid-19 in the first place, she adds. Public health experts, for their part, have reassured the public that the vaccine will be safe, and that science, not politics, will guide decision-making around it.
Countless historical instances of racism led to mistrust of medical institutions among people of color. The most-cited example is the Tuskegee syphilis experiment of the 1930s, in which scientists did not tell the Black people in the study that the aim of the study was to observe the effects of syphilis when left untreated and never treated them properly for their disease even when a treatment became available. Another horrific and far more recent example is that immigrants detained by U.S. Immigrations and Customs Enforcement (ICE) were forced to have hysterectomies they did not need, as the New York Times reported this week.
Throughout the pandemic, medical and health experts like Anthony Fauci, MD, the country’s leading infectious disease expert and head of the National Institute of Allergy and Infectious Diseases, have been critical to the country’s public health response, and they will be in the future as scientists develop and distribute a vaccine. This is a dangerous time for people to lose trust in medical professionals, and yet the complex history of institutionalized racism in the United States makes this lack of trust understandable. This mistrust may not, however, be irreversible.
Moving forward, Alang says, clinicians must take steps to rebuild trust with the public: They must recognize and acknowledge the ways white supremacy plays out in medicine. They must identify how they cause harm and are sometimes entangled with the police; some examples of this, she says, are “having police officers in hospitals in the name of patient safety, first responders talking to police officers before acknowledging and listening to victims/patients.” They must also understand the ways that social factors and injustices shape the lives of their patients and be better advocates for health justice.
Alang hopes that rising awareness of police brutality causes clinicians to think about the ways they have assigned more worth and value to white patients, clinicians, and people in general. “It is not just about their actions,” she says. “It is about their policies, and the ways health care is organized and delivered.”
In the past six months, some prominent journals have published editorials raising awareness about racial justice in medicine: The editors of JAMA Network Open, for example, called for papers on the prevention of systemic racism in health, and one editorial called on medical journals to take responsibility for addressing racism in health care. Another editorial in the New England Journal of Medicine acknowledged: “At times, we fail to make even the simplest efforts: For instance, even though Covid-19 disproportionately affects Black Americans, when physicians describing its manifestations have presented images of dermatologic effects, Black skin has not been included. The ‘Covid toes’ have all been pink and white.”
Changes in ideology and policy may be coming, but as the fall surge of the Covid-19 pandemic mounts, it’s increasingly crucial that Americans trust in the leadership of public health professionals and get the medical support they need quickly.
One short-term solution, says Alang, is to allocate more resources to disproportionately impacted communities, and another is to have “credible messengers” from these communities lead the response in their communities by identifying what works for the people around them.
Lasting change, however, will take time. “There is no quick fix,” says Alang. “Really.”