Misinformation helps inflame centuries of mistrust among racial minority groups, which may reduce the intent of members of minority groups to receive a future COVID-19 vaccine, Assistant Professor of Library and Information Science Charles Senteio said in his September 21 talk, “Vaccines Don’t Make Us Safe, Vaccinations Do,” which he presented to SC&I’s “Working Group on Power and Inequalities in Media and Technology.”
Senteio, who is a Dr. Martin Luther King Jr. Visiting Assistant Professor at the MIT Sloan School of Management during the 2020-2021 academic year, is a health informatics researcher focused on improving chronic disease outcomes for underserved populations. He has conducted collaborative community-based, funded research in Michigan, Texas and New Jersey, with a goal to understand health disparities among minority populations suffering from a range of chronic conditions including HIV, diabetes, hypertension, chronic kidney disease, and breast and prostate cancer.
As a result of the pandemic, Senteio has incorporated into his equity research understanding the ways COVID-19 has impacted minority populations in the U.S., for both increased infection and mortality rates, and the risk that they may not choose to be vaccinated against the coronavirus when a vaccine becomes available.
Senteio described recent research which indicate that at least half of Americans will need to a future COVID-19 vaccine in order for the vaccine to be effective. However, while Black and Brown Americans are at a higher risk of becoming infected with COVID-19 and dying from it, minority populations are also less likely to choose to be vaccinated due to hesitancy and medical mistrust.
Senteio said the reasons Black, Indigenous, and People of Color (BIPOC) are now, and will continue to be, at a higher risk for COVID transmission and mortality is due to structural racism in which drives social factors like environmental disparities such as air quality, and social conditions such as living arrangements, (such as multi-generational people living together). Disproportionate minority representation among essential workers is also a factor, he said.
While 20% of U.S. counties are disproportionately Black, Senteio said, they account for 52% of COVID-19 diagnoses and 58% of COVID deaths nationally. In New York City alone, Blacks comprise 22% of the population, but they represent 28% of the deaths due to COVID. In New York state, Blacks are 9% of the population, but they comprise 18% of the deaths. Similar patterns are being seen across the country, Senteio said.
Given these numbers, Senteio is investigating the potential impact of BIPOC choosing not to be vaccinated. The answer, he said, stems from a “medical mistrust among minority populations due to structural racism that goes right back to slavery, which of course was rooted in white supremacy,” Senteio said.
As examples, Senteio pointed to the Tuskegee Syphilis Experiment and the work of Dr. James Marion Sims, “the father of modern gynecology,” who performed experiments on eight slave women between 1845 and 1849.
“But let’s be clear,” Senteio said. “What I call racist medical malfeasance did not start with Tuskegee nor did it end with it. Racism has been a part of medical research for as long as there has been medical research. Any discussions about contemporary racial inequity and levels of medical mistrust are incomplete without acknowledging our past. Because those of us who don’t understand our history are punished by it. We must be aware of this history so we can understand its lasting influence, and we can develop strategies to appreciate it impact, and mitigate its lingering negative effects.”
Racial differences in health are present in the earliest health records the U.S. kept, Senteio said. “Up until and after the civil war, physicians debated whether the well-known racial disparities in health were due to biology -- because Blacks were inferior -- or social factors because many Blacks were enslaved and all lived in a society steeped in White supremacy, one in which Black bodies, minds, souls, and spirits just didn’t matter as much as White people’s.”
Today, minorities still experience racism during medical interactions, Senteio said, explaining that Black and Brown people are less likely than White patients to receive pain medication for acute pain. In addition, Black patients are more likely to believe they are being treated differently due to internalized and institutional racism. In the primary care setting, Black diabetes patients are more likely to believe that physicians discriminate against them, and that physicians may harbor biases that will make them likely to share test results with them, and more likely to be dominant and overbearing during clinical consultations. As a result, Black patients are less likely to share health information and less likely to follow physician recommendations.
“We health researchers are plagued by a fundamental challenge,” Senteio said. “Our daily lives are so divergent from the lives of those we are working to support -- our context for health information, our trips to the doctor, and what happens when we get there may be more distant than we appreciate. This is not about guilt or ‘gotchas.’ Our new commitment should be to the dignity of all people and make sure they can live lives of decency. Health equity work is fundamentally about striving for fairness. It’s about our responsibility as those in power to work to make this a reality.”