The Thread of Racism: The Mistreatment of Black Americans in the American HealthCare System
Imagine your body being experimented on without your consent. This might sound like a scene from an alien movie, however, it was the reality for many black Americans. From the origins of American slavery, black bodies have been degraded, experimented on, and exploited by white Americans to achieve societal goals. After the abolishment of slavery, white Americans continued to use coercion to exploit black Americans and their bodies to advance medical knowledge. This allowed white health care workers to control the black population and created a gap in the quality of care experienced by the black population. Black bodies are the foundation of our medical system and have been sacrificed for the well-being of white Americans.
Black bodies as a foundation of the American medical system can be traced back to the desperate need for medical cadavers to be used as educational tools. In the 19th century, black bodies proved to be the answer to this problem and led medical institutions, including The University of Virginia, to hire people to dig up bodies from black cemeteries (Meier). This process of obtaining cadavers was performed by medical schools across the country. After the bodies were used by medical students, they were discarded in undignified ways, such as “dropping them in the city’s sewers, by shallow burial in vacant lots, by dumping them on city streets, or through their incineration with household garbage” (Killgrove). Black bodies were used for educational needs, just as enslaved people were sold for the needs of white plantation owners. Black bodies that should have been resting in peace were disfigured and abused by white medical officials and served as tools to educate future white doctors.
White healthcare workers went on to violate and exploit living black bodies, making no distinction between the treatment of deceased and living bodies. The horrific treatment and exploitation of living black Americans for medical research began with Doctor James Marion Sims in the 1840s. Doctor James Marion Sims was a famous surgeon who saw a need for advancement in women’s health. During this time, “the practice of examining the female organs was considered repugnant by doctors who were almost all males” (Ojanuga). Because white doctors disrespected women and their bodies, women were denied adequate care. The same disrespect and disgust were intensified for black women and contributed to Sim’s sense of entitlement to the bodies of enslaved women. Both white and black women were considered inferior to white men, however, the intersection of race and gender caused enslaved women to be treated even worse than white women.
Sims decided to advance health care for women by dedicating his career to developing solutions to common problems from which women suffered. Through brutal experiments on enslaved women, Sims developed the vaginal speculum as well as a technique to repair a common complication from childbirth (Holland). On June 21, 1841, Under Sims, a slave endured thirteen operations without anesthesia (Ojanuga). Sims used his privilege and power to experiment on enslaved women, leading to permanent damage to their bodies. Their suffering resulted in successful tools and techniques that would be used on white women (Washington). This is just one example of how enslaved women suffered for the progression of women’s health care.
Enslaved women also suffered for the benefit of slave owners. Enslaved women were forced to carry children to sustain slavery. Laws allowed slave masters to rape enslaved women and force them to carry their children. Slave owners also manipulated enslaved women to want to be pregnant by giving them extra food and decreasing their labor (Roberts). They used the basic necessities denied to enslaved people to manipulate them to perform actions that would benefit the slave owner and left enslaved women vulnerable to the slave master’s power. Enslaved women were forced to help continue a system that was oppressing them. They were exploited for the benefit of slave owners and to achieve the social objective of preserving slavery. Hundreds of years later, black women and men were still being exploited by white health officials to achieve social objectives.
Even after the abolition of slavery, descendants of enslaved people could not escape the horrors of medical experimentation. From 1932-1972, African American men participated in a syphilis study to aid in finding a cure for the disease but were unaware of how it would lead to their deaths. The Tuskegee Syphilis Experiment was conducted to study the effects of syphilis on the body and to aid in the creation of a drug that would cure the illness. In this experiment, black men were injected with the disease and left untreated (Nix). The uninformed participants were only told that they had “bad blood” (CDC). Six hundred black men were misled and did not have the ability to give informed consent. These black men were under the impression that they were receiving the healthcare they deserved. Instead, the study caused their deaths in order to contribute to the efforts of finding a cure.
Health officials chose these men because of their vulnerability and economic circumstances. The six hundred men recruited for the study were impoverished black males who worked as sharecroppers. White healthcare workers took advantage of their socio-economic vulnerability. Health officials used the promise of receiving free health care, meals, and burial to entice these men into joining the study (Ushan). Black men were exploited for the goal of progression in the treatment of syphilis and to better understand the disease.
Through the suffering of these black men, white health officials learned the impact of syphilis on the body. When men in the study died or became stricken with illnesses, researchers continued to ignore the need for care, and instead merely observed the effects of the disease on the body. Not only did this experiment result in the deaths and injuries of hundreds of black men, but future black generations were also affected. Under the care of white healthcare workers during the experiment, “28 participants perished from syphilis, 100 more had passed away from related complications, at least 40 spouses had been diagnosed with it and the disease had been passed to 19 children at birth” (Nix). Black men and their families were harmed to gain a new understanding of the disease. White Americans would later benefit from the study’s discoveries while disregarding the evil behind them. The concealment of the experiment contributed to black Americans’ distrust of the medical field (Ushan).The decision by white healthcare workers to hide their research shows how they intentionally abused black men, and that they were aware of the harm they caused. Even though slavery was abolished, white health care workers still viewed black bodies as disposable and exploitable. The impact of syphilis on the American people was a severe problem, and just like the cadaver shortage, white healthcare workers used black bodies as a solution.
Unlike The Tuskegee Syphilis Experiment, Henrietta Lacks was experimented on in a doctor-patient setting, not in the context of research. Lacks was a mother of five who entered John Hopkins Hospital seeking care but left without knowing that experiments would be conducted on her cells (Butanis). In 1951, after suffering from vaginal bleeding, it was revealed that Lacks had cervical cancer, of which she died in the same year. Lacks traveled to Johns Hopkins Hospital from Virginia because it was one of the few hospitals that would treat impoverished black Americans. Even then she was forced to enter through a back door to a segregated ward (Skloot). Not only did she not receive the same standard of care as white Americans, her white doctor --who she trusted-- sampled her cells during an exam without her consent.
Research soon revealed that Lacks' cells had the ability to multiply at a rapid rate, while other cells quickly died during experiments (Skloot). The amazing capabilities of Lacks’ cells led her doctor, George Gey, to employ her cells in research. The doctor who sampled her cells was searching for an “immortal cell line” to conduct cancer research. After stealing the cells, Gey took ownership of them and named her cell line the Hela Strain. The ease of Gey taking possession of Lacks’ cells recalls the ease of purchasing black bodies during slavery. White health officials claimed ownership of black bodies to benefit medicine, just as white Americans purchased enslaved people for their own benefit.
The stolen Hela Cells had a global impact on health care. Lacks' cells contributed “to the development of drugs for numerous ailments, including polio, Parkinson disease, and leukemia” (Britannica). Her cells also led to “two Nobel Prizes in research, and the development of vaccines, cancer treatments, in vitro fertilization and a genome sequence” (Brown). Her cells have been used in the understanding of toxins, hormones, and the effects of radiation. There are scientists around the world who are still using her cells to conduct ongoing research (Brown). Currently, there are 17,000 U.S patents that include Hela Cells (Bostick qdt. in Brown). The important trust between a patient and doctor was sacrificed to advance health care. Many people continue to benefit from this broken trust and the exploitation of Lacks’ body. Everybody, that is, except Lacks herself.
While George Gey was showered with awards for discovering the Hela Strain, Lacks’ family was unaware of the impact her cells were having on the world. They did not know that their mother’s cells were being sold online and benefitting scientific research until 1975 when a reporter tried to investigate the origins of the Hela Strain (Skloot). This inspired Lacks’ family to fight for compensation and to shed light on her story. Lacks' son, Lawrence Lacks, is currently fighting for the ownership rights of Lacks’ cells as well as restrictions on who can use them (Mcdaniels). In 2013, the National Institute of Health announced that they would allow Lacks' family to approve requests for the use of Lacks’ cells (Mcdaniels). However, this plan never came to fruition. Her family has been left powerless, just as Lacks was left powerless on the examination table when Gey stole her cells. This story shows a continuation of the imbalance of power between black Americans and white health officials.
White health officials have controlled black women’s bodies with surgical precision. Sterilization and birth control shots are examples of the practices used. In North Carolina, between the 1930s and 1970s, “65 percent of sterilization procedures were performed on black women” (Krase). The large percentage of black women who received the procedure shows how black women were specifically targeted to undergo sterilization. The government has used sterilization and birth control to inhibit reproduction by black women. Historically, reproduction is a form of power for women to have their own agency and freedom over their bodies. By restricting this freedom for black women, it was like enslaving them again, using sterilization as a weapon to restrict their agency over their bodies. In contrast, for privileged white women in the 1970s, birth control was a symbol of reproductive freedom and sexual expression, when it first became available to the public. For several decades, peaking in the 1970s, government-sponsored family programs encouraged black women to use birth control and coerced them into being sterilized. In hospitals, there was also a practice of performing hysterectomies on poor black women for medical training in the 1970s (Roberts). This procedure strips black women of their reproductive power and is also a continuation of the use of black bodies as tools to educate white medical students.
Decreasing the black population was also a goal of the US government. It sponsored sterilization procedures and threatened to take away welfare benefits from black women if they didn't agree to the procedure (“Relf v. Weinberger”). Forcing black women on welfare to be sterilized also relieved the government from having to provide more money to women once they had children because children created a greater need for financial support. Black women were forced to choose between a future family or the financial support that they direly needed. Black women were used as pawns by the government in order to reduce the black population through sterilization. During slavery, enslaved women were also used as pawns but instead were used to increase the enslaved population. Even though white people’s goals may have changed over centuries, black bodies are continuously used as a solution.
The government’s funding for sterilization procedures empowered white health workers to make reproductive choices for black women. The 1973 story of the Relf sisters explicitly displays the disregard of white health workers for the wellbeing of black women. The Relf sisters were 12 and 14 years old at the time and were living in poverty. Their mother allowed the two girls to receive an injectable birth control Depo Provera (Jones). However, it was still in its experimental phases and caused horrible side effects. After the study ended, the white nurses believed that the girls should be sterilized but didn’t consult with their mother. Unfortunately, the Relf sisters’ mother wasn’t able to read or write. She was only capable of writing an “X” in place of her signature and was under the impression that her daughters were receiving birth control shots, not sterilization. Their mother, with the help of the Southern Poverty Law Center, filed a lawsuit against the clinic that performed the procedure. This groundbreaking case resulted in the ban of using federal funding to perform sterilizations without the patient’s consent (“Relf v. Weinberger”). The Relf sisters weren’t the only victims of forced sterilization, but they are a prime example of black Americans having procedures done without their consent. The sisters were targeted by white health officials due to their impoverished and uneducated background, showing the government’s targeted exploitation of vulnerable black Americans.
During the 20th century, even though black bodies were being used to improve the health care system, black Americans were still receiving unequal care. Jim Crow Laws segregated hospitals and restricted black people from entering the medical field (Newkirk). Only white males in the 1960s were given the opportunity to enter medicine and would later contribute to the racist health care system. Black people were forced to be treated predominantly by white doctors, who at times didn’t always provide equal care. Black hospitals were understaffed and had very little resources, resulting in preventable deaths (Newkirk). The abuse toward deceased black bodies in medical school evolved into the unequal treatment of living black bodies when medical students became doctors. The unequal treatment black Americans received in the 1960s has continued into the 21st century.
The continuous mistreatment of black Americans and the racism rooted in our medical system defines the health risks experienced by black women and men today. Black Americans experience significant disparities from white patients regarding chronic conditions, access to care, preventive screenings, and mental health (“African-American Health Disparities”). Black women are three to four times more likely to die during or after delivery than white women (Roeder). Black infants are often brought into this world without their mothers because of a health care system that is failing black mothers. It is a paradox that enslaved women were the foundation of women’s healthcare, but black women are still dying at the hands of their doctors. Black bodies are the step-stool on which the healthcare system stands, a system that is currently insufficient for the wellbeing of the black population.
The stories of black women and men who have been abused and degraded by white health officials point to the source for the current disparities in our healthcare system. The disposability of enslaved people by white slave owners is one thread of racism that was woven into later centuries, leading to the medical abuse experienced by black Americans today. The pain and evils experienced by black Americans resulted in remarkable medical advancements that have saved lives. Unfortunately, despite the abolishment of slavery, medicine has been continually used to control and degrade the black population. Our medical system needs to recognize how black bodies are the victims of its exploits and must strive to cut the thread, woven into modern history, of mistreating black Americans. Recognition looks like taking down the statue of James Marion Sims in Central Park. Recognition looks like returning the ownership of Lacks’ cells to her family. Recognition looks like honoring the Tuskegee men and compensating their families for having to live with the syphilis disease for generations. Recognition is only the first step to improving the relationship between black Americans and the American health system. The ultimate goal is to improve the quality of care provided to black Americans.