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Experts say vaccine hesitancy among people of color has been influenced by past and current medical practices. Chaiwat Subprasom/SOPA Images/LightRocket via Getty Images
  • Experts say racism in the healthcare industry has led to vaccine hesitancy in some communities of color.
  • They say medical racism in the past as well as current practices has made some people of color distrustful of the healthcare industry.
  • They say system-wide solutions are needed to overcome this reluctance.

There are many reasons that people become vaccine-hesitant.

Among them are fear of harm, misinformation about efficacy, and lack of a sense of urgency.

But for many people of color, there’s often another cause: Medical racism.

A new study reports that nearly one in 10 people from ethnic minority groups who refused a COVID-19 vaccine report experiencing racial discrimination in a medical setting during the pandemic and twice as many incidents of discrimination as those who volunteered to receive the vaccine.

“Our findings confirm evidence from before the current pandemic, which found associations between experiences of racial discrimination and distrust of the healthcare system and physicians among ethnic minority adults.” Elise Paul, Ph.D., a lead study author and a senior research fellow in epidemiology and statistics at the University College London, said in a press release.

While this study took place in the United Kingdom, experts say it’s likely these dynamics persist as a reason for vaccine hesitancy among people of color in the United States.

“We also have minorities who have had negative experiences with the healthcare system and feel the system is biased against them,” said Michele Ruiz, the co-founder and chief executive officer of BiasSync, a science-based assessment and development software solution designed to help organizations reduce the negative impact of unconscious bias. “If they’ve experienced disrespect or mistreatment, it’s easy to understand they have reluctance to see healthcare professionals.”

Experts note the United States has a history of medical racism toward people of color from medical testing on enslaved people to using people as non-consensual test subjects for medical experiments to forced sterilization.

“Black Americans are acutely aware of the history of the U.S. government experimenting with them and it’s no surprise that they exhibit mistrust,” Ruiz told Healthline.

Beyond the past, experts note the medical profession today is still rife with unconscious bias and medical practitioners who sometimes hold false beliefs about biological differences between races as well as the undertreatment of people of color.

All of that is part of what America is and something we have to reckon with, said Kenneth Campbell, DBe, program director of Tulane University’s online Master of Health Administration and an assistant professor in the Tulane School of Public Health and Tropical Medicine in New Orleans.

“We live in a very highly racialized society and the American healthcare industry is not excluded from society,” Campbell told Healthline. “Minority communities were hit the hardest of any other communities during the COVID-19 pandemic, and many states and federal policymakers did very little to address the social determinants of health, trust relationships, as well as the health disparity issues, with a disproportionate of medical and public health resources being provided to white communities versus minority communities.”

“So yes, there are similar correlations here in the U.S. between vaccine hesitancy and the BIPOC [Black, Indigenous, and people of color] experiences in American healthcare,” Campbell added. “I have seen the damage and the erosion of trust due to set standards of care in healthcare which has devalued many lives of minority patients. That has to change.”

Misinformation about vaccines among minority groups is also a problem, much as it is among vaccine-resistant whites.

“There has also been evidence of deliberate misinformation via social media,” Ruiz said.

Because the issue of racism in healthcare is systemic, only systemic solutions are likely to be sufficient to solve the problem, experts say.

The first is overhauling the current model of how patients are organized in the medical system, Campbell said.

“I co-authored an article in 2017 that incorporates a new patient-organization framework that acknowledges traditional elements of informed consent and incorporates a new organizational obligation to address issues like population health, health outcomes, and health disparities,” he explained. “Shared decision-making (SDM) within the context of this model provides a robust ethical framework for all patients. SDM has the potential to reduce overtreatment, improve communication and health outcomes, health disparities and health inequality.”

But it has to go beyond that and more deeply into minority communities themselves.

“[Minority] communities feel that the government, the medical and public health community have forgotten about them,” Campbell said. “Like any sustainable relationship, trust is essential as well as being transparent in your healthcare and public health policies for inclusion.”

Some approaches include working with the local community and faith-based organizations and minority leaders to improve trust before rolling out a vaccination program – something Campbell said he was able to do in Illinois.

“Healthcare organizations must become collaborators in increasing the health literacy rates, partnership and building housing spaces for the most vulnerable as well as building up dilapidated communities and making these new structure spaces – places of learning, high-quality living, and better quality of life,” he said. “This is how the healthcare industry will help repair this broken trust.”