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Open Letter to the Medical Community: Black America, Trust, and Health Outcomes

As a medical student nearing the end of my studies, I have come to understand many of the challenges and rewards inherent to caring for people at every stage, and every walk of life. I can understand the pain and joy that define the experience of being a physician because I am a member of this group.

I am also a descendant of slaves. And, as a black person born, raised and educated in this country, I have come to understand the challenges and fears that come with being black in America. I understand the pain and joy that define the experience of being black in America because I am a member of this group.

The co-existence of my identities as a provider of medical care and as a member of a social minority places me, and others who can relate, in a unique position to personally experience, and therefore understand, the sentiments and beliefs that arise as a result of membership in these groups. For this reason, I would like to share my reflections on the impact of current events in America, on the persistence of poor health outcomes and distrust of the medical community among black Americans.

The advent of cell phone cameras and recording devices is allowing members of other racial groups to witness what black Americans in this country have felt to be true for a long time: that they are unfairly targeted and mistreated by law enforcement personnel. Consider the video (two min in) of a man who was fatally shot by a policeman, after which the policeman planted his taser next to the man so that the policeman could justify shooting his weapon at the unarmed man. Or, consider the video (two min in) of a young, teenage girl being slammed to the ground by a policeman during an incident at a pool party. The officer also pulled a gun on unarmed teenage boys during the incident.

I am not highlighting these videos to launch a discussion about how blacks are treated in this country. Rather, I am presenting these images and sharing the collective sentiment of the black community so the roots of mistrust that black patients may exhibit in the clinical setting may be understood.

When one feels he is unfairly targeted because of his color, and his accounts of these experiences are not believed by others, he starts to mistrust the face of those who do not believe.

This extends beyond mistrust of law enforcement. It extends into medicine as well. There is already a history of mistrust when it comes to the black community and medicine — experiments on slaves in the interest of medical discovery, the Tuskegee syphilis experiments, and so forth — but present day experiences of injustice, even outside of medicine, compound this sentiment. As clinicians, we need to be aware of this. Patients who have come to distrust the face of “others” will not want to get care, or follow the clinical advice of people who they see as ‘other.’

So as clinicians, what can we do? We must be allies for black patients.

First, when things happen in America that break these patients’ hearts, we must understand their pain and feel for them. It is very evident to patients when medical providers are indifferent to the issues that affect their lives.

Second, believe them. If all the black people in America are saying something is a problem, it most likely is. If they say they are being targeted, framed, and abused, believe them. Millions of people wouldn’t and couldn’t fabricate the same story of mistreatment.

Finally, fight for them. Mistrust of “others” is one of the fundamental contributors to the poor health outcomes of black Americans. To fight for the resolution of subtle racial injustices in this country is to fight for inter-racial trust. To fight for justice and trust is to fight for health care improvement. And that is what we are here for.


Alicia Stallings Alicia Stallings (1 Posts)

Contributing Writer Emeritus

Cleveland Clinic Lerner College of Medicine

Alicia Stallings is a fourth year medical student at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve. Her research interests include medical resource allocation, health outcomes and medical education.