TUESDAY, DECEMBER 20, 2022
For the historical record: Near the end of the first Covid year, a certain demographic problem seemed to be developing.
An elevated degree of "vaccine hesitancy" was being recorded among black Americans. At the Washington Post, Michele Norris offered some data concerning this unfortunate state of affairs.
(Norris: "A Pew study from mid-November found that only 42 percent of Black adults said they would get the vaccine. Other studies put the figure even lower. This is compared with 61 percent of Whites, 63 percent of Hispanics and 83 percent of (English-speaking) Asian Americans who said they would take the vaccine.")
Sensibly, Norris regarded this as a dangerous problem. At the start of her column, she also said, headline included, that this state of affairs made a lamentable type of sense:
Black people are justifiably wary of a vaccine. Their trust must be earned.
Trust is earned. We all know that. But if a national vaccine campaign is to succeed, we must quickly figure out how to earn the confidence and cooperation of African Americans who are justifiably wary of a coronavirus vaccine.
The world is at war with covid-19, but a successful distribution of a vaccine in the United States will be won and lost on a battlefield with a long history of medical racism. Government-approved medical experiments from the past have undermined Black America’s trust in this moment.
“Vaccine hesitancy” from Black Americans is different from an “anti-vaxxer” stance. It’s not that Black Americans don’t believe in vaccines. They don’t trust a public health system that has in too many cases engaged in grievous harm by experimenting on Black bodies without consent or ignoring the specific needs of Black people.
We wouldn't necessarily disagree with any of that. We would say that Norris was possibly being a bit selective, even in her choice of language, as she constructed her portrait of the developing problem.
We won't focus on that possibility today. Today, we're going to focus on a specific factual claim Norris made as she explained why so many black Americans were exhibiting vaccine resistance.
Norris recalled some of the historical medical racism which, she said, explained the justifiable reluctance of black Americans. Nor was this simply a matter of history. At one point, she offered this:
NORRIS (12/9/20): We are not just tussling with historical wrongs. A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain and were more likely to prescribe inadequate medical treatment as a result.
We'll admit it! When we read Norris' column, we wondered if the highlighted statement was, in fact, actually accurate.
Was it true? Was it true that, in a recent study, half of white medical students said they "believed that Black patients had a higher tolerance for pain?" Was that an accurate statement?
Several questions came to mind as we pondered Norris' statement. We wondered why a study would have surveyed white medical students rather than white physicians. But we also wondered if that statement was factually accurate—was true.
We proceeded to take a look at the study in question. You can review it here.
Citizens, can we talk? Even today, that particular study has the feel of a slight academic scam—or at least, it has that feel to us.
We'll assume it wasn't a deliberate scam, if it was anything like an actual scam at all. But for today, we'll restrict ourselves to the widespread influence that study has had, at least within our own blue tribe.
Over the course of the past two years, we've seen some version of Norris' claim repeated on several occasions. These White Medical Students Today, our tribunes routinely declare.
Most recently, we saw a version of Norris' claim in a column by Damon Young. Young is one of the roughly three thousand columnists currently employed by the Washington Post. Near the end of last month, he started a column as shown:
YOUNG (11/21/22): Race is a social construct with an arbitrary and elastic hierarchy. The only static element is that people deemed “Black” exist at the bottom. American University’s Antiracist Praxis subject guide defines anti-Blackness as “specific forms of racism contingent upon or cast through the denigration, disenfranchisement, and disavowal of people racialized as Black.” And anti-Blackness is atmospheric—felt everywhere, but usually only seen if you know what you’re looking for.
It’s not just a word. Not just another unnecessarily complex form of academese. It’s tangible. Material. Tactile. It’s the belief, for instance, from actual medical professionals today, that Black people have higher tolerances for pain than White people do. Imagine how that fallacy dictates treatment and medication and aftercare and insurance premiums. And then imagine all the societal ripples—the maternal mortality rates, the life expectancy disparities, the mis- and missed diagnoses, the distrust in medicine—stemming from that one misbelief.
We agree with Young about the widespread, atmospheric existence of "anti-Blackness," and about the vast harm this cultural construct can cause. But there was that familiar statement again, sourced, by virtue of a link, to that same recent study.
In Young's treatment, those "white medical students" were now described as "actual medical professionals." But the basic claim was the same, and Young asked readers to "imagine" how much harm can "stem from that one misbelief."
At that time, we went back and looked at that recent study again. We came away with the same impression of that widely cited research.
Then, as the current year drew to an end, we saw a certain widely praised book on several "Best Books" lists. The book was written by Linda Villarosa, a highly regarded author and journalist. As we noted last Saturday, the book in question is this:
Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation
We couldn't help wondering if a version of the claim in question appears in this highly praised book. Yes, it does, on page 40—and a few years ago, Villarosa had offered this version of the claim in a lengthy report for the New York Times Magazine:
VILLAROSA (4/11/18): In 2016, a study by researchers at the University of Virginia examined why African-American patients receive inadequate treatment for pain not only compared with white patients but also relative to World Health Organization guidelines. The study found that white medical students and residents often believed incorrect and sometimes “fantastical” biological fallacies about racial differences in patients. For example, many thought, falsely, that blacks have less-sensitive nerve endings than whites, that black people’s blood coagulates more quickly and that black skin is thicker than white. For these assumptions, researchers blamed not individual prejudice but deeply ingrained unconscious stereotypes about people of color, as well as physicians’ difficulty in empathizing with patients whose experiences differ from their own.
In Villarosa's rendering, "many" of the "white medical students and residents" who took part in that study falsely believed that blacks have less-sensitive nerve endings than whites. Villarosa listed two other false beliefs that "many" of these research subjects held.
"Many" isn't the same as "half." But when we looked again at that UVa study, it didn't seem clear to us that any of the white medical students and residents had actually said that they believed the principal statement in question.
The vast majority of the students and fourth-year residents had said that they didn't believe the statements in question. It still isn't clear to us that any of them had actually said that they did!
In short, the study still seems shaky to us. But its conclusions, stated in rather fuzzy form, have traveled far and wide.
Villarosa is very highly regarded, and so is her new book. We aren't able to evaluate the vast sweep of her findings—and we agree with Young about the massive harm which is caused by the atmospheric anti-Blackness which lingers on as a malevolent part of the brutal racial history of our nation and our world.
We agree with Young about that. We further assume that there's a great deal of merit to Villarosa's widely praised book.
That said, the statement in question might lend itself to a bit of a tiny case study. If we conducted such a cast study, our question would be this:
During this era of Donald J. Trump, the red tribe has often surrendered itself to manifestly crazy belief. Is it possible that we Over Here in our own blue tribe are inclined to put our thumbs on the scale, even if only a tiny tad, as we give voice, on the rare occasion, to our own tribal beliefs?
We'll conduct that case study this week. We offer this for the sake of the historical record, though several despondent anthropologists have told us that none of us humans actually care about any such construct as that.
It has been our experience that we in our highly self-impressed blue tribe have our thumbs on the scales a great deal of the time. The treatment of this study's claims strikes us as one such example.
We'll conduct a case study of those claims this week. According to anthropological experts, your lizard is going to scream and yell and loudly insist that what we're saying is thoroughly wrong, oh so wrong.
Tomorrow: A slightly odd research design?
Yet another legacy from the United States long history of mis-treatment of black people.ReplyDelete
Actions have consequences.
If you think crime is up, and CRT is being taught in K-12.you're a gullible fool, no matter which tribe you belong.ReplyDelete
Bob was right. The January 6th commission is over now and they did not prove Trump helped plan the violence nor did they tie him to the planning of the violence for January 6th. Journalists "tended to jump beyond what they've actually shown in their pursuit of Trump. Dating to the Clinton / Gore / Clinton years, this is the way they tend to play"ReplyDelete
His simple point was on point as usual.
The evidence against Trump comes from the testimony of Republicans, Trump's own staff and associates. It is not up to the 1/6 Committee to prove anything -- they have collected evidence, summarized it and turned it over to the DOJ. It is also being made public, so that anyone can form their own opinion. A new grand jury will decide whether to indict Trump and his cronies. The special prosecutor will PROVE that case and a jury will decide.Delete
It is difficult to call this a partisan effort when ALL of the testimony comes from Republicans who were there, witnessed what happened, and testified based on their own experiences. Journalists didn't conduct the investigation. The elected representatives of the people in the House did that.
The violence that occurred on 1/6 was just a small part of the criminal acts of the Donald J Chickenshit.Delete
The Committee did not limit their work to investigation of only the attack on our capitol.
I'm grateful for the work of the January 6 Commission. I had originally thought 1/6 was just a bunch of Right-wing snowflakes throwing a childish temper tantrum in public. I now see how it was connected to the RepublicanDelete
(cont'd) Party and anti-democracy groups, like the Proud Boys and other Right-wing fascists.Delete
Well anyone who watched the rally pre riot rally in its entirety (one wonders if Bob ever did) and thinks Trump did not in incite a riot must be as a knuckle dragging a MAGA boob as at 11:30Delete
obviously is. It may not have been
planned as a riot, but the idea was
clearly to overthrow the Government
by scarring Pence. Go live
someplace else; you lowlife
It's just interesting to know Bob was right that the press and the committee alluded to some kind of evidence that would connect Trump to the planning of the riot that broke out. And it didn't happen. Now the whole thing is over and no such evidence was ever presented. Not that it's such a perspicacious take on Bob's part, the same thing happened with the Mueller Report with countless bombshells and claims that the "walls were closing in". Still I think we should all congratulate Bob for making yet another correct call.Delete
If you didn't hear a connection (during the entire series of hearings), then you have your fingers in your ears.Delete
Exactly. That was his point.
The evidence was presented. Somerby has a cottage industry here for ignoring evidence in order to defend the indefensible.Delete
No. The simple point was that there wasn't any evidence Trump was secretly urging on instigators, such as the Oath Keepers or Proud Boys which is what partisan media outlets and the committee itself had hinted at. That's all. And that has not even been alleged now by the committee so it was really misinformation at the time on the part of the partisan media outlets. But the Justice Department has evidence no one has seen so maybe it will come out from them. But that's a side issue to the smaller issue Bob presented in which he was once again, completely correct. Time and time again he has made accurate, perspicacious calls.Delete
The Proud Boys and Oath Keepers are pleading guilty and being convicted of seditious conspiracy. What do you suppose that means?Delete
(these accurate, perspicacious calls are worth paying attention to since they have real world ramifications like the media's tanking of Al Gore which led to the ban on abortion.)Delete
Is it supposed to mean Trump was involved in and aware of their planning? I don't think so. So let's all congratulate Bob on making yet another accurate criticism of the media.Delete
It went from Trump to Mark Meadows to Roger Stone to the militias.Delete
No. That was the claim but there was never any evidence presented. Maybe it'll come out through the Justice Department though.Delete
So January 6 was really just a bunch of racist snowflake Right-wingers throwing a childish temper tantrum, just because black people's votes counted in the 2020 Presidential election?
Well, that explains why Trump thought those racist snowflake Right-wingers who threw a childish temper tantrum, just because black people's votes counted in the 2020 Presidential election, are heroes. It also explains why the Republican Party, made-up of racist snowflake Right-wingers who threw a childish temper tantrum, just because black people's votes counted in the 2020 Presidential election, should be more accurately described by the corporate-owned Right-wing media as nothing but a bunch of bigots.
Oh. The point is though that the media that supports Democrats and dislikes Trump and the committee itself hinted that they had tied Trump to the rioter's planning. And they never did. Bob's reports on the matter turned out to be correct. He i has a strong record of being correct about these types of criticisms of the media. It doesn't help to distract from the point with conversation terminating cliches, a common tactic of brainwashed cult members.Delete
Hey, troll boy, the committee made 3 specific criminal referrals to the DOJ.Delete
When did the media "hint" what you say they "hinted"? Back up your bullshit with specific examples.
Hi. Bob wrote about it extensively in the summer with examples. But really, you're doubting that? You're doubting that that was hinted at? Really? Tell me why!Delete
You made a claim, troll boy. Prove it.Delete
You nailed it!
"...the media that supports Democrats and dislikes Trump ..."Delete
Damn you, Mother Jones Magazine (shaking fist).
Maybe, but Bob whiffed on the one about "the Others" not just being a bunch of bigots. Let's give Bob a gentleman's C as a grade.
It sounds bad that only the the media that supports Democrats and dislikes Trump, got the January 6th Commission proof wrong.Delete
Meanwhile, the entire media from stem to stern failed to report that the Republican voters are nothing but a bunch of bigots. That sounds like a much bigger problem with our media.
Oh wow. Cool.Delete
Is Bob a Right-wing bigot, or is he just afraid of telling the truth about Republican voters, because he's afraid of being called "politically incorrect"?Delete
Somerby has presented these mistaken arguments before and they were debunked before. Last time he brought this up, I cited numerous studies showing that black people are undertreated for pain in a variety of settings (dentist offices, emergency rooms, cancer treatment) with a consistent undertreatment based on chart reviews comparing black and white patients. Somerby doesn't read his comments, so he continues to repeat the same mistaken beliefs and now brings the same objections forward again, as if none of the previous discussion had happened.ReplyDelete
It is a waste of time to go through this again. Somerby is wrong about this. He is also wrong to think that his criticisms of one study (even if they were valid) would undermine the concerns about black vaccination rates or Villarosa's new book.
This is called the broken record technique. If you keep repeating the same arguments over and over, eventually people get tired of arguing, you break down their resistance and get your way. Simple repetition doesn't make Somerby right about this stuff.
Today Somerby broadens his attack on the idea that there is racism in health care to challenge the notion that there is racism at all. This is right wing extremism on the same level as holocaust denial. Not only do many studies demonstrate the continuing existence of racism in our society, but any person of color knows what they have experienced in their lives. The incidents involving police called because of attacks on people of color who are just going about their daily lives also show it. This is racist on Somerby's part.
I am not going to invest more time in countering the repetition of Somerby's lies about race. I DO think that it is especially crass to raise this as we enter the week before Christmas and the start of Chanukah, a time of good will toward all, with hopes for peace and tolerance. Somerby should be ashamed of himself. But he won't be. Like all right wingers, he no doubt considers himself the victim.
tl;dr. ...way too much scummy race-mongering to our taste...
But whoa, are you still a BlueAnon member of the Branch Covidian cult, dear Bob?
...oh yeah: you are a liberal, dear Bob, aren't you. it figures...
Stereotypes about black people do affect how physicians relate to them and treat them. I believe I told this anecdote last time Somerby raised this claim that physicians do not hold problematic views of pain and black people.ReplyDelete
I was having dinner with several physicians and one of them asked me about my pain research. I explained what I was doing in my study. He then told me about his recent encounter with a woman who came to see him for acute pain, bringing along her 8 year old daughter. The doctor said that he knew she was just trying to con him out of pain meds because in the middle of describing her terrible pain, she turned and smiled at her daughter. That smile was how he knew she was faking, he said.
What are the stereotypes involved? First, physicians have been pressured to crack down on overprescription of pain. The stereotype is that black people are more likely to be medication-seeking (trying to con doctors into prescribing pain meds). This causes the physicians to have a suspicious mindset or framework in which normal patient behaviors appear to be evidence of lying. Second, there is also a widespread belief that people in pain do not smile. That is untrue. In my study, where we videotaped people undergoing a cold pressor task, in which pain was elicited by submerging one's hand in near-freezing water, we found incidence of smiling across all of the ethnic groups we tested. Subjects endured the task alone, with no experimenter present, so they were not smiling at anyone. In the case of this black patient, she was smiling at her daughter. Most women will recognize what was going on -- she may have been trying to reassure her daughter, to keep her from being upset by the unfamiliar medical setting and her talk about her pain. She was caring for her child, not joking or happy or comfortable or any of the other things that smiles can mean. The doctor, being male, misinterpreted her smile and also believed that no one can smile while in pain, which is empirically not true.
So, this instance illustrates the way in which mistaken beliefs can entertwine to result in denial of sufficient pain meds to address a patient's pain effectively. That shows up in chart reviews as undertreatment of black patients.
A white patient might not have evoked suspicion in the physician, but also might not have needed to bring a child to her medical appointment.
My study found no physiological differences in things like GSR (skin conductance, measured in the non-submerged hand), heart rate, blood pressure. We did find differences in expressivity between white and black subjects. That too may cause physicians to react negatively to patients who seem to be "exaggerating" their pain. If a doctor's norm of expressivity is based on less expressive white patients, a black person (who tends to be more expressive in many situations) may seem to be too expressive and thus faking it, in the context of an expectation of medication-seeking by black patients. So racist stereotypes will cause the expressivity of the patient to be discounted among black patients.
My study wasn't the first to find these results. This is part of the literature on undertreatment of pain in medical settings, which I cited last time Somerby raised this complaint.
I assume that physicians are being better trained these days, but given the pervasiveness of racism, I doubt this has changed as much as it needs to.
In addition to a culture tendency to be more expressive in general, black people might feel a greater need to smile in a medical setting, in order to ingratiate themselves with medical staff in order to receive better treatment. Many people do this, but an expectation of being less well treated may contribute to efforts to be extra nice to the phsycian and nurses, which includes more smiling (which works against acceptance of claims of pain and other symptoms at face value). Women tend to smile more in general, and they too have been found to be undertreated for pain in the literature.
Somerby is way too quick to dismiss claims that have been supported by research, not simply activist statements and anecdotes. This is a real phenomenon and Somerby doesn't know what he is talking about on this subject.
So in the process of discussing your research on pain, a physician told you that he had patient come in who is female, is black, has chronic pain, and had come in with her eight-year-old daughter?Delete
He gave you these details in order to launch into a conversation (with a someone doing pain research) about drug seekers faking pain.
He labeled his patient as being a med seeker, because he thinks that people who are in serious pain are unable to smile at their children.
Consider that this physician is an utter outlier to the point where you might question whether he’s really an MD.
That study that Somerby denigrates was done to see whether such people are outliers. It found that half of the participants endorse at least one or more false beliefs about black people. That tells you how prevalent the problem is. Somerby, instead of acknowledging this, pretends that the study was lying when it said "half" because their use of the word "half" did not apply to each and every question on their questionnaires (which was full of different false and fantastical beliefs about black people). That is a dishonest way to disparage a study that never meant what he attributed to it -- and anyone familiar with statistics can see for themselves.Delete
How many of these people with wrong beliefs does it take before there is a measurable difference between the way white people are treated and black people are treated? Should even one person's pain or other medical needs be ignored because of white fantasies? Those are the important questions. They are so important that the federal government revised its standards for treatment of pain, insisting that it be considered a vital sign that is charted and treated in every patient.
You are too willing to believe Somerby when he uses sophistry to argue away the research that he doesn't want to know about, in order to preserve his own favorite narratives.
I didn't review the study (if TDH pursues this he's likely to show the survey has flaws and/or doesn't prove what it says about these med students)- but - first I don't see why the possible fact that doctors are less likely to prescribe "pain medication" to blacks than to whites based on this survey, doesn't provide a rational reason for blacks to fail to take the vaccine (though I doubt that the survey has anything to do with whether they take the vaccine or not). There are all kinds of variables, and I doubt the ones who did this study considered every variable.Its based on statistics and percentages - so lots of whites don't get enough pain medication too. Why is that - racism? If it were the other way around and blacks got a higher percentage of pain medication (narcotics I assume) maybe they''d be saying that's racistically turning them into addicts. The whole thing seems to be what unfortunately libs desperately want is to find racism everywhere. And it's not an either/or: tons of racism or no racism. The identity politics has gotten out of control, it seems like a type of hysteria. Some larger percentage of blacks don't get the shots - it's because of 'racism, like they have no agency. When all this right wing whites don't get the shots - they're deplorable.Delete
Your whole comment sounds like someone desperately trying to avoid seeing racism anywhere.Delete
anon 5:29, it's there all right - just like there are all sorts of crimes and wrongdoings. So many of the examples that get publicized are bogus or overblown. It just seems to me (and a lot of people) that the degree of it is wildly exaggerated. We are humans, not different species.Delete
That’s easy for you to say, being white and all.Delete
anon 8:38, it doesn't matter what color I am, it's whether what I say has some validityDelete
You would consider racism a more serious problem if you were on the receiving end. Don’t play dumb.Delete
Anonymouse10:29pm, you’d see things differently if you, and half your professional colleagues, were accused of thinking that African Americans had Superman’s nerve endings.Delete
If racism isn't real, then explain the draw of the Republican Party.Delete
anon 10:29, have you been on the receiving end?Delete
"Many" isn't the same as "half."ReplyDelete
As was made clear last time, half endorsed at least one or more of the fantastical beliefs. Somerby objected because it wasn't half believing EACH and EVERY fantastical belief.
If you have that many physicians and med students believing wrong stuff, it doesn't take "half" to result in a statistically significant degree of undertreatment for pain. And what is the cost of such errors due to mistaken assumptions by physicians? It can range from extra pain to death. How many wrongful deaths are needed before the percentage satisfies Somerby?
And don't lose sight of the fact that suspicion of the medical system is contributing to resistance to getting vaccinated, which itself may lead to preventable deaths. If white defensiveness, like that shown by Somerby, a legitimate reason not to address concerns of the black community?
Many black people do not know about the pain undertreatment studies or the vaccination resistance stats. They know about the Tuskeegee Institute ethical violations that harmed black people and they know how they are treated when they visit their doctor. These additional studies are aimed at convincing white doctors that they have a problem and need to look at their own behavior. Somerby's defensiveness here and on other race-related topics is an example of that defensiveness. Thank god he only became a standup comedian and not a physician, with the mistaken beliefs he spews here about bigotry.
Cornell West recently said he didn’tDelete
care much that we lost the Supreme
Court (with his help, actually)
because the original justices
were slave owners. As if
Justice Marshall had never
existed. So at some point if
only certain parts of history
exist to the chip on your
shoulder, you are bound to
the suffering you will suffer
At least in a general sense we can sayReplyDelete
Bob’s post is worth considering today.
Yes, as the mildly sophisticated understated,
playing fast and lose with academic
studies is one way advocacy journalism
Can cheat. Whereas the tabloid Fox
style is to simply lie, as in the recent
Biden, ten year old trying to get an
This is fine except Somerby hasn't shown there was any cheating going on.Delete
“we agree with Young about the massive harm which is caused by the atmospheric anti-Blackness which lingers on as a malevolent part of the brutal racial history of our nation and our world.”ReplyDelete
He says this, but never lists any examples that convince him that it’s true.
Instead, he debunks cases that purport to show this, such as police shootings or this pain study, and he seems to side with Republicans who oppose teaching about this anti-Blackness that still exists.
Good point, dear mh.
May we suggest that this is how dear Bob's cognitive dissonance manifests itself?
As a good-decent person, he knows that he's supposed to goodthink. And yet in every particular case he can't help but be logical and crimethink.
...it's a tragedy, really...
Black people are justifiably wary of a vaccine. Their trust must be earned.ReplyDelete
...They don’t trust a public health system that has in too many cases engaged in grievous harm by experimenting on Black bodies without consent or ignoring the specific needs of Black people.
Really? I don't know of many such cases. I know of one horrible case -- the Tuskegee Syphilis Study. That study began 90 years ago and ended 50 years ago. I don't think this horrible event means that today's health community would do the same thing.
IMO there's far too much discussion of Tuskegee, mostly by people trying to diss America. This sort of continuing discussion discourages today's blacks from getting vaccinated. It costs black lives.
That's right. Those liberals who love too bring up Tuskegee are killing black people.
It is discussed in the context of teaching ethics to med students.Delete
Try reading “Even the Rat was White” by Robert V Guthrie, for a history of abuses of black people in research.Delete
Old Republican white people have a high rate of vaccine resistance. I wonder what their grievance is.ReplyDelete
Same as young Republican white people, they hate government representation of non-whites.Delete