For most people in public health today, the role that trust — or more accurately, distrust — often plays in racial health disparities may seem obvious. When both lived experience and research confirm that implicit and intentional bias in the system have resulted in real harm, it’s a rational response to be wary or distrustful. However, for years after the Tuskegee experiment, public health was actually quick to blame other cultural, educational, or individual factors for low levels of trust in public health and medicine. That is, until my guest in this episode came along.

Sandra Quinn and her co-author Stephen Thomas were the first two researchers to connect Tuskegee’s impact on trust to beliefs and behaviors in the African-American community during the emergence of HIV/AIDS. Since then, Dr. Quinn and her colleagues have gone on to lead some of the most important research on trust and racial health inequities (and I’m proud to have been involved in a small part of that research with such a fantastic mentor!)

The first of my two-part interview is a must-listen for anyone interested in health equity: You’ll hear some history you’ve never heard before about the ripple effect of Tuskegee, from the AIDS crisis to the anthrax attacks. (In Part 2 we’ll talk about COVID, plus future challenges when it comes to building trust).

Resources:

The article that made people sit up and take notice:

Thomas, S. B., & Quinn, S. C. (1991). The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV education and AIDS risk education programs in the Black community. American Journal of Public Health, 81(11), 1498–1505. https://doi.org/10.2105/AJPH.81.11.1498

Historic background on the topics mentioned:

• Public Health Service Study of Untreated Syphilis at Tuskegee and Macon County, AL - Timeline - CDC - OS
• 30 Years of HIV in African American Communities: A Timeline (cdc.gov)
• Why Black AIDS History Matters - AAIHS
• The Anthrax Mail Attack | National Postal Museum (si.edu)

Sandra Crouse Quinn’s bio

Communivax Coalition

Maryland Center for Health Equity (where Dr. Quinn has just retired but Dr. Stephen Thomas continues to conduct research and outreach).

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