On July 25, 1972, Associated Press reporter Jean Heller disclosed in the New York Times that the United States Public Health Service had been conducting a clinical experiment on black men in Macon County, Alabama. Beginning 1932, these close to 400 share-croppers were left untreated for the disease that can decimate the body in its late stages, despite the fact that antibiotic treatment had been available for decades. Heller wrote: “For 40 years, the U.S. Public Health Service has conducted a study in which human guinea pigs, not given proper treatment, have died of syphilis and its side effects.”
The Tuskegee tragedy (recently described in a stellar book by Susan Reverby) has come to exemplify health inequality and racial discrimination in medicine. Numerous studies show that public awareness of the syphilis study has had a residual, negative impact on healthcare practices. Blacks, in particular, have developed a strong distrust of mainstream medicine and clinical research that is attributed to past abuses–and, especially this exploitative study.
Harriet Washington’s award-winning book Medical Apartheid was an urgent reminder that African Americans’ apprehensions about biomedicine were both abiding and perfectly warranted. In other words, if we take a longer historical view, the Tuskegee study is an important symbol, but it was not the first or even the most appalling instance of medical discrimination. As Washington notes, such practices have extended “from the colonial era to the present.”
The Black Panthers’ foray into health politics also suggests to us that we need to rethink how important “the shadow of Tuskegee” was in shaping black consciousness about the healthcare sector. As I describe in Body and Soul, the Party’s activism began several years before Tuskegee became a national scandal. In these preceding years, the Black Panthers, drawing on a tradition of African American health activism, identified and condemned the issues that are now attributed to the the public revelation of the syphilis study. They argued that:
- the healthcare needs of blacks were neglected–to the point that a systematic plan of racial genocide was feared (as this provocative and somewhat hyperbolic statement below from an August 1972 issue of its newspaper shows)
- the poor were relegated to pitiable healthcare services at the hands of callous, inexperienced doctors
- African Americans were treated as guinea pigs in biomedical encounters
Today, we should recall the sacrifice of the 399 poor black men and their families who were exploited by medical researchers–American citizens abused by agents of their own state. As former President Clinton said in his national apology to these men: “It was a time when our nation failed to live up to its ideals, when our nation broke the trust with our people that is the very foundation of our democracy… today America does remember the hundreds of men used in research without their knowledge and consent. We remember them and their family members. Men who were poor and African American, without resources and with few alternatives, they believed they had found hope when they were offered free medical care by the United States Public Health Service. They were betrayed.”
Tuskegee embodied the longstanding fears and inequalities that had been given voice, shape and torque by the Black Panther Party and prior health activists. If these apprehensions are more historically deep-seated than commonly believed, what similarly intensive solutions are necessary to achieve health access and equality? How can our responses to the crisis in racial health disparities turn the tide of mistrust?