Home / News & Research / News Detail

Black History Month: How the Past Can Shape Present-Day Patient Care

Published February 06, 2024

By Carley Andrew, Sam Houston State University College of Osteopathic Medicine, AACOM 2023 Sherry R. Arnstein Underrepresented Minority Scholarship recipient

Carley AndrewWhat does Black History Month mean to the osteopathic medical student? To some, it is simply another cultural month in the year. To Black medical students like myself, we carry the stories of our forefathers every day, and so do Black patients. In his “What to the Slave Is the Fourth of July” speech, Frederick Douglass remarks, “I say it with a sad sense of the disparity between us … Your high independence only reveals the immeasurable distance between us.”1 Douglass’ response highlighted the hypocrisy of America’s independence while millions of Blacks remained enslaved, not able to share in the country’s triumph. Similar sentiments could be echoed today. What good are America’s state-of-the-art healthcare and medical advancements when Black patients in America continue to have some of the worst health outcomes across all racial groups?

One of our osteopathic tenets states that the body is a unit; a person is a unit of body, mind and spirit.2 Part of upholding that tenet is considering the physical, spiritual, mental and even cultural facets of patients’ lives. How could we understand our Black patients culturally if we do not know their history? That is the importance of Black History Month in osteopathic medical education. To examine some Black patients’ hesitancy to seek timely medical care and follow certain directives, we must look to the Tuskegee Experiment of 1932-1972. It was a study in which 600 Black men were followed to study the progression of syphilis. The researchers did not provide effective care to those men as they should have, even after a treatment became widely available in 1943, and as a result, they suffered and died from severe health complications from the untreated disease. Informed consent was not collected from the participants.3 Those men are the reason ethical standards in human subjects research exist today.

To understand present-day disparities in care in the Black community, we need only to look at the present-day Black maternal and fetal mortality rates. Per the National Center for Health Statistics, in 2020-2021 the Black fetal mortality rate was 9.89 per 1,000, nearly double the national rate of 5.74 per 1,000.4 According to the Centers for Disease Control and Prevention (CDC), Black women have the highest mortality rate in the United States with 69.9 per 100,000 live births for 2021, almost three times the rate for white women. Black patients also led the percentage of preterm births in the United States in 2021, at 14.8 percent, as reported by the CDC.5 Disparities in healthcare, although decreasing progressively, but slowly, are still one of the top issues in patient care today.

Finally, to understand why Black patients hold certain attitudes about the healthcare setting, we look toward studies on their behavior modification in these settings. A 2022 study by the California Health Care Foundation that surveyed 3,000 Black patients, found that one in four avoid seeking healthcare for fear they will be treated unfairly or with disrespect.6 For those who do seek care, a third said they change their behavior to put the provider at ease, by tailoring their speech or becoming more deferential.7

As demonstrated above, we as future and current physicians have to look to Black history, for better or worse, to understand and shape care for Black patients today. That involves looking beyond the annual Dr. Martin Luther King Jr. “I Have a Dream” excerpts and looking into darker parts of history like the Tuskegee experiments, and present-day disparities in Black maternal and fetal care, to improve patient care outcomes for this community.

In the wake of attacks on diversity, equity and inclusion initiatives, and book bans across the country, now more than ever, we have to dedicate ourselves to the learning and preservation of history. This Black History Month and forward, let us commit to learning more about Black history, which is, in part, our American history, in our personal lives and our medical schools. Frederick Douglass ended his Fourth of July remarks with the sentiment, “I, therefore, leave off where I began, with hope.” I hope that the osteopathic medical community continues to use the lessons from Black history, past and present, to improve patient care for the Black community nationwide.

References 

  1. Wallace J. A Nation’s Story: “What to the Slave is the Fourth of July?” National Museum of African American History and Culture. Published July 30, 2021. https://nmaahc.si.edu/explore/stories/nations-story-what-slave-fourth-july 
  1. American Association of Colleges of Osteopathic Medicine. About Osteopathic Medicine. aacom.org. Published 2024. Accessed January 26, 2024. https://www.aacom.org/become-a-doctor/about-osteopathic-medicine#:~:text=Four%20Tenets%20of%20Osteopathic%20Medicine 
  1. Nix E. Tuskegee Experiment: the Infamous Syphilis Study. history.com. Published May 16, 2017. Accessed January 26, 2024. https://www.history.com/news/the-infamous-40-year-tuskegee-study 
  1. Kekatos M. Black women saw fetal mortality rates fall 4% in 2021, but still twice as high as national average: CDC. ABC News. https://abcnews.go.com/Health/black-women-fetal-mortality-rates-fall-4-2021/story?id=101632110. Published July 26, 2023. Accessed January 26, 2024.
  1. Stafford K. Why do so many Black women die in pregnancy? One reason: Doctors don’t take them seriously. AP NEWS. Published May 23, 2023. Accessed January 26, 2024. https://projects.apnews.com/features/2023/from-birth-to-death/black-women-maternal-mortality-rate.html#:~:text=Black%20women%20have%20the%20highest  
  1. Cummings L. Listening to Black Californians: How the Health Care System Undermines Their Pursuit of Good Health. California Health Care Foundation. Published October 4, 2022. Accessed January 29, 2024. https://www.chcf.org/publication/listening-black-californians-how-the-health-care-system-undermines-their-pursuit-good-health/ 
  2. Grossman D. Study: Black Americans adjust their behavior in health care settings. Scripps News. Published March 22, 2023. Accessed January 29, 2024. https://scrippsnews.com/stories/black-americans-adjust-behavior-in-health-care-settings/