By Pooja Bhalla, DNP, RN, Executive Director of Healthcare Services, Illumination Foundation
There are many structural barriers that prevent vulnerable and underserved populations from receiving the healthcare they need. One of these barriers is an inherent, deeply-rooted historical mistrust of the professional medical community.
Medical mistrust is not just related to past legacies of mistreatment, but also stems from people’s contemporary experiences of discrimination in health care—from inequities in access to health insurance, health care facilities, and treatments to institutional practices that make it more difficult for people of color to obtain care.
“Mistrust of the medical community is based on our historical experience,” explained Dr. Piri Ackerman-Barger, Associate Dean for Health Equity, Diversity and Inclusion and a clinical professor at the Betty Irene Moore School of Nursing at UC Davis. “Harriet Washington documented the horrific roots of this mistrust in the Black community in her book Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. Dark history like the Tuskegee syphilis experiment. And we see this mistrust playing out now with COVID vaccines and other basic healthcare services.”
Dr. Ackerman-Barger, a panelist at Illumination Foundation’s recent consortium, “Together We Can: Solutions to Address Health Equity,” stated that “distrust of the system is a significant barrier to health care that we have to work to eliminate.” The consortium brought together thought leaders from private industry, government, nonprofits, healthcare, and educational institutions to discuss solutions to lowering the barriers that vulnerable populations experience in accessing healthcare, housing, education, and work opportunities.
Access and education are slowly beginning to decrease the gap in healthcare and the deep-rooted mistrust, and there is some light ahead. According to the Kaiser Family Foundation, “Black Americans had initially (early 2021) received fewer initial doses of the vaccine due to vaccine hesitancy, a lack of sites in communities of color, and poor communication from health systems.” Healthcare providers and community organizations have worked diligently to get the vaccine to all demographics, and “while vaccination coverage has increased, it remains uneven across the country, with unvaccinated people at particularly increased risk for infection, severe illness, and death. As of April 5, 2022…over the course of the vaccination rollout, Black and Hispanic people have been less likely than their White counterparts to receive a vaccine, but these disparities have narrowed over time and been reversed for Hispanic people.”
Illumination Foundation is a California nonprofit organization that provides targeted, interdisciplinary services for the most vulnerable homeless adults and children in order to disrupt the cycle of homelessness.