HISTORICAL BACKGROUND AND PROJECT PURPOSE

The U.S. medical system has contributed to numerous injustices inflicted on historically marginalized racial and ethnic groups. From unethical experiments like the Tuskegee syphilis study that withheld treatment from Black men for decades1 to the sterilization of thousands of Native American women even after legislation designed to protect women from forced sterilization was passed in 1974.2 The damaging implications of these historical events continue to be reinforced through inefficient health policies and discriminatory practices that maintain racial and ethnic minority groups at a disproportionate risk of being uninsured, lacking access to care, and experiencing worse health outcomes from preventable and treatable conditions such as high blood pressure and type 2 diabetes.3 The rejection and mistreatment encountered within the system have generated a deep distrust in the intentions of the public health system of the United States. Medical mistrust, defined as “an absence of trust that health care providers and organizations genuinely care for patients’ interests, are honest, practice confidentiality, and have the competence to provide the best possible results,” stems not only from the past legacies of mistreatment but also from present-day experiences of discrimination in health care.4 It is important to note that medical mistrust is a natural protective response against pervasive structural inequities that result in restricted access to resources and daily experiences of racism, stigma, and discrimination. Medical mistrust is simultaneously empowering when it encourages reform and social change and harmful when it prevents people from getting the care they need.

 

Strengthening the relationship between patients and their healthcare providers is a step forward in undoing years of mistrust in the medical system. The purpose of this project is to open up a door for health workers to begin establishing trust with the local communities. Having willing health providers take their time to sit down with their patients and ask them genuine questions that explore their past experiences within the health care system, their goals, and safety concerns brings humanity to the foreground. The database will be most useful as a relationship-building instrument to engage in productive conversations.