Speaker Uses Tuskegee Study as Lens to Examine Persistent Health Disparities in U.S., July 6, 2007, Harvard Public Health NOW

Bill Jenkins

Over the course of four decades in the 20th century, a government-funded study tracked the progression of syphilis in 399 African-American men. What started in 1932 as a six-month observation of the natural history of the sexually transmitted disease turned into an ethical debacle in 1945 when penicillin became accepted as the treatment of choice- yet the men were not given the drug. The study ended in 1972 after newspaper coverage of the study prompted public outcry.

The study, named the Tuskegee Study of Untreated Syphilis in the Negro Male, paved the way to ethical reforms in public health research. The study also served to exemplify health disparities between ethnicities, a topic highlighted during a recent lecture at HSPH. Epidemiologist Bill Jenkins, professor of public health sciences at Morehouse College and former epidemiologist at the Centers for Disease Control and Prevention, related the Tuskegee Study to how health disparities persist and continue to propagate in U.S. society.

Lecture Media

Infant mortality is one disparity with shockingly little change over time, said Jenkins. He noted that the number of deaths within the first year of life is twice as great for black babies compared to white babies in the U.S. That pattern has persisted from 1915 to 1997, even as increasing numbers of American mothers, including African-American mothers, have become better educated.

"Health disparities are a relatively [newly identified] phenomenon for many diseases," Jenkins said. To investigate African-American health disparities, Jenkins is developing two models. The first involves a meta-analysis to estimate how much socioeconomic status, culture, and racism contribute to disparities. The second examines levels of community-participatory research, ranging from notifying a community that a study will take place, to forming an advisory group to ask how best to get the study done, to seeking the consent of the community.

Jenkins outlined several steps to consider when addressing disparities, including:

Studying racism in all its forms, including internalized racism
Overcoming the effects of low socioeconomic status by targeted interventions using social supports
Targeting low social capital communities
Directing resources to problems. For example, he noted, less than 10 percent of disparities are due to differences in health services, but more than 70 percent of research dollars are directed there.

Jenkins' talk on May 1 was part of the Yerby Diversity Lectures in Public Health series, sponsored by the HSPH Faculty Diversity Initiative.

—MM