How racism threatens the response to the coronavirus pandemic

A complex public undertaking like the coronavirus response depends a lot on public trust. But a legacy of systemic racism across multiple institutions has eroded that trust in many minority communities.

The big picture: Health care has its own sordid history, from the Tuskegee Study to hospitals' patient-dumping practices to substandard care for black mothers and babies.

• Consequently, minorities — especially black people — tend to trust health care providers less than white people do.
• In a Pew survey earlier this month, just 35% of black respondents said they had a great deal of trust in medical scientists, compared to 43% of white respondents. Pre-coronavirus surveys found similar results.

Between the lines: Researchers also have found that a negative experience with one institution, such as the police, often translates to distrust of another, such as health care.

• A robust system of testing, disease surveillance and isolation — the recipe to keep coronavirus infection rates at bay — requires a lot of buy-in from people who are wary of exactly that kind of undertaking.
• "How do you do contact tracing in communities that deeply mistrust medical institutions and now sort of are feeling like we're in the fight of our lives because of police brutality?" said Rachel Hardeman, a researcher at the University of Minnesota who studies racism and health equity.

The bottom line: Successfully tracking and isolating the spread of the virus cannot ignore the history of a health care system "that has never really valued [minorities] as a whole person," Hardeman said.

Go deeper:

• Why the coronavirus pandemic is hitting minorities harder
• Rich vs. poor hospitals
• Busted budgets make it harder for cities to address inequality