Medicine in the United States stands as an exemplar for medical breakthroughs throughout the global medical community. But underneath the history of the United States’ success in medicine lies the systematic unethical mistreatment of minorities and women in medical studies, professional training, and treatment. 

The effects of America’s problematic and exclusionary history within medicine can still be measured today. 

“There have been some major problems, major disparities as well as just outright abuse of communities of color by the medical institutions,” biology teacher Michael Pistacchi said. “And in large part because of that history, we still see massive disparities in everything from access to healthcare, in quality of treatment, in life expectancy, just about any metric you could look at for communities of color, they are worse than they would be for equivalent populations.”

The maternal mortality rate, defined as the death of a woman during pregnancy or up to a year after the end of pregnancy, for Black women in 2021 was 69.9 deaths for every 100,000 live births. This is 2.6 times the rate for white women. The number of deaths from preventable pregnancy-related causes in the U.S. has more than doubled in the last two decades among all ethnic groups, with Black, Native American and Alaska Native women bearing the highest number of deaths, according to the Journal of the American Medical Association. 

Women in particular in Black, Native American and Alaska Native communities have faced increasing rates of maternal deaths in the last twenty years. These communities are also most likely to be diagnosed with diabetes. Black people have the highest death rate for cancer, and are more likely than white people to be diagnosed at later stages for breast cancer.  White people have a higher 5-year cancer survival rate than Black people.

The dismal health metrics of racial minorities in comparison to white communities reveals the underlying issue of a lack of accessibility to healthcare. This inaccessibility can lead to fatal situations stemming from delayed disease detection. 

The lack of accessible healthcare today results from several factors, from socioeconomic standing and cultural barriers to physical distance from medical help. The built-up history of American scientists’ stand as a foundation for the  inaccessibility to medical institutions throughout the nation today. 

“The Tuskegee project, the Havasupai Indians in Arizona,” head of Upper School science department Anita Chetty said. “It was okay to do things to them without their knowledge in order to benefit the rest of society, because [medicine is] mostly for the people who can afford medical care.”

In the Tuskegee project, which was conducted from 1932 to 1972, scientists tracked the progression of syphilis in infected Black males without their consent. Even when medication became available, they did not offer a diagnosis or medication to these men. 

In 1989, poverty-afflicted, uneducated members of the Havasupai Indian tribe approached professors at Arizona State University (ASU) to help them understand the increase in diabetes within members of the tribe. ASU researchers did investigate the issue of diabetes, but they also utilized Havasupai samples to conduct research on the tribe’s other internal disorders and ancient origins without their consent. 

Chetty asserts that this mistreatment of minorities’ consent in the 19th and 20th centuries demonstrated white scientists’ view of struggling minority communities as dispensable and undeserving of full disclosure.

“The researchers would say, ‘Well, we were doing it for the greater good,’” Chetty said. “But we know that you weren’t, because why did you happen to choose this group of men who were not educated, not informed? Why select them and not a group of people in an urban area who were educated?”

Such communities were further impacted by the physical distance from medical treatment. It is still necessary for many individuals to travel long distances to receive basic treatment due to a lack of availability of resources. As a result, visits to medical specialists have decreased in rural areas. 

“They don’t have medical insurance or they’re living in either urban areas without any medical care, or they tend to be in rural areas farther away,” Chetty said. “Hospitals are not doing enough to increase the interest in doctors even going to live in those areas and we are not doing anything about building hospitals that are within reach.” 

Unequal distribution of medical resources also plays a large role in the unjust treatment of minorities throughout the nation. Economic inequity stands as a main factor behind this issue, and it is minority groups who largely stand in lower socioeconomic statuses. 

Compounded with America’s historic exclusion of minorities in education, access to treatment and medical consent, the following result culminates: medical care remains directed towards one particular demographic. 

“If you take a look at the number of women who are minorities or of a lower socioeconomic status, they don’t know that they can get screened early for lung cancer,” Chetty said. “We’re not reaching out to those communities, so it gets back to the infrastructure that we have that seems to be set up for an educated group that can afford medical care. This is who this is all set up for.”

80% of pain studies today are carried out on male specimens, despite women accounting for 70% of people impacted by chronic pain. In terms of direct care, women wait an average of 65 minutes in the ER when reporting acute abdominal pain, while men only wait an average of 49 minutes reporting the same pain. Even then, women are not granted the same care as men. 

The mistreatment of women in medical settings can be attributed to ingrained misconceptions about women’s emotional states and pain tolerance in a largely white, male-dominated field.

“Women’s pain and symptoms are often dismissed,” WiSTEM and HOSA club officer Sahngwie said. “There are lots of stories of people being ignored and medical professionals pushing off their pain, especially for people of color like in the past. Doctors were taught that Black women don’t experience pain the same, and so oftentimes they would skip out on anesthetic or just treat them more harshly.”

The vulnerability of marginalized groups in medical settings stems from the exclusion of minorities from medical professions themselves. Doctors can produce better health outcomes in ethnically underrepresented patients if they themselves come from diverse communities. However, studies show that students of color face extreme barriers such as financial difficulties that hinder them from actually reaching medical school. In Santa Clara County today, a lack of racial diversity within doctors lingers. 

Pistacchi cites the Flexner Report as a critical piece of reform that targeted and excluded women and people of color from obtaining access to education for medical professions. 

The Flexner Report, an initiative taken on in 1910, examined American medical schools and suggested reform within schools based upon biomedical standards and hands-on training. The report led to the closure of many schools which were deemed unable to uphold these standards. 

“The Flexner report allowed the American Medical Association to essentially shut down nearly every medical school that allowed Black students,” Pistacchi said. “I believe every single women’s medical school in the country was shut down because they didn’t meet these standards. So you go back to 1910, it’s close to impossible for a Black person or a woman to get a medical degree. There’s just no representation.”

Community medical outreach is essential to connecting with underserved populations and beginning to work for their needs. Fully understanding the needs of minority communities can improve their relationship with medical institutions. 

“There definitely is a solution,” Sahngwie said. “An evolving solution where it’s important that we adapt to different situations and learn more and more about different communities. If we continue to question assumptions and really get to know the experiences of people and how they’re affected, we can work to resolve this issue.”

Organizations like the National Association of Free and Charitable Clinics work to ensure equitable access to healthcare for all. Volunteer efforts that work to go to communities in need ensure that the underserved receive the care they need. Such efforts are necessary in high-income countries like the U.S., which spends more money per capita on healthcare than other wealthy countries even though 70% of U.S. adults feel that the system has failed with its high costs and inaccessibility. 

Chetty affirms that education on past history as well as minorities’ struggles today must remain first and foremost to finding solutions in healthcare today. The upcoming generation of medical professionals and citizens will be instrumental in directly digging to the source of healthcare issues in the U.S. and working to rectify the lasting impacts of historical mistreatment by American scientists. 

“I think it’s important to recognize that your generation is willing to listen to the hard truths,” Chetty said. “You’re willing to explore those things you are very interested in. But I think you have to remember that you have to go beyond just talking about it, and be a part of the change that we need to see in this country.”