The Legacy of Tuskegee

Forty-six years have passed since the whistle was blown on the Tuskegee syphilis experiment for its unethical treatment of poor Black men in Alabama, but a recent working study suggests its aftereffects still linger. The study suggests lower life-expectancy for Black men in the South may be linked to mistrust of the medical establishment among that group.

The Tuskegee study enrolled Black men with and without syphilis by enticing them with incentives like free healthcare, meals, transportation to and from the clinic, and burial insurance. The men were also given incomplete or inaccurate information about their condition and their care – often told they were being treated for “bad blood,” a local term used to describe anything from fatigue and anemia to syphilis.

When the U.S. Public Health Service began the study in 1932, its goal was to better understand the natural history of syphilis, for which no effective treatments existed at the time. That didn't stop the researchers conducting the study from leading study subjects to believe they were receiving treatment during numerous blood draws and spinal taps.

In fact, when penicillin became a standard treatment for syphilis in 1947, the medicine was withheld from all of the men enrolled in the study for another 25 years.

Finally, in July of 1972, this highly unethical study reached the national spotlight with multiple news agencies reported details of the experiments.  A public uproar followed that put an end to the study in November of the same year. After 40 years, it was over.

But research continues to show the lasting impact the study has had on the relationship between Black Americans and the medical establishment. The new working paper by the National Bureau of Economic Research is the latest in a long line to investigate the legacy of the Tuskegee Study.

The paper reports that older black men in close geographic and cultural proximity to the Tuskegee study's subjects utilized less medical care after 1972 – the year the Tuskegee study became national news. That effect grew more prominent the closer a subject lived to Macon County where the study took place.

The authors suggest that disclosure of the Tuskegee Study in 1972 correlates to a decrease of up to 1.4 years in the life expectancy of Black men at the age of 45. They believe this could also account for approximately 35 percent of the life expectancy gap between Black and white men reported in 1980.

While this working paper has its limitations, such as a lack of peer-review and exclusion of Black women, it reignites a long-running discussion about the disconnect between Black or African American communities and medical providers. It adds to a growing pile of evidence that histories of trauma can create enduring barriers to healthcare.  

Michael Hazard | 8/18/2016

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