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Because of a long-standing mistrust in the American healthcare system, some African-Americans in the United States are more reluctant to sign up for COVID-19 immunizations (Elliott, 2021). This distrust is well rooted in history, notably the infamous research project on syphilis conducted in the United States, which violated the rights of some African-American males to suffer from the disease for the purpose of medical research (Elliott, 2021). African-Americans familiar with the syphilis study have begun discussing the vaccine's deployment (Elliott, 2021). The coronavirus epidemic and its disproportionate impact on people of color have brought to light the deficiencies in the healthcare delivery system in the United States (Elliott, 2021). For example, no hospital in Tuskegee serves the general public, and it was difficult to obtain coronavirus testing in the early stages of the outbreak (Elliott, 2021). African-Americans' unwillingness to participate in clinical trials is another factor that has residual effects (Durant et al., 2014; Swanson & Ward,1995).
Smedley, Stith, and Nelson (2003) cite research that implies the lower number of minority participants in trials is caused by bias on the part of physicians, incorrect impressions, and prejudices around medical decision-making. According to research by Smedley, Stith, and Nelson (2003), medical professionals are less inclined to prescribe particular treatments to their minority patients. According to Smedley, Stith, and Nelson (2003), doctors make decisions based on a cognitive heuristic taught them during their medical school and residency. This heuristic causes them to carry prior expectations to each contact they have with their patients.
Research incorporating concepts of race and ethnicity can advance not only public health but also clinical care, health care, and medical science (Bhopal, 2008; Quinn, 2021). Nevertheless, researchers and practitioners need to be aware of the broader events of health improvement that are needed, particularly among African Americans (Bhopal, 2008; Wedge, 2020; Ndugga et al., 2022). Due to the distrust within the medical system, healthcare practitioners must be aware of the risks associated with providing healthcare to minority groups in public health (Bhopal, 2008; Quinn, 2021). Intentionally focusing on “doing good” should be the goal, regardless of the individual's racial or cultural background (Bhopal, 2008). Showing kindness toward members of underrepresented ethnic groups is inconsistent throughout time or across demographics (Bhopal, 2008; Quinn, 2021). According to Bhopal (2008), doing good means that enhancing the health and care of ethnic groups should be an absolute necessity and not require any particular attention or a feeling of justice (Bhopal, 2008). During the original COVID-19 epidemic, people of color and people experiencing homelessness were disproportionately affected in some communities that were underrepresented in the population (Wedge, 2020). The study conducted at the Boston Medical Center (BMC) and reviewed by 2,729 different laboratories confirmed that COVID-19 adult patients who were treated were members of underrepresented groups. According to research, knowledge of the primary purpose of making gains to health concerning the possibility of unintended consequences is still an ethical and cultural issue (Bhopal, 2008). In public health, many people were categorized differently based on age, race (ethnicity), underlying medical concerns, and whether or not they were housed. These findings show that the effects of COVID-19 on altered settings are extremely unequal (Wedge, 2020). According to the statistics, 44% of COVID-19 patients who were hospitalized were black, 30% were Hispanic, and 16% were homeless. Hispanic patients comprised 46.5% of those admitted to the hospital, much higher than the percentages for black patients (39.5%) and white patients (34.4%). According to the data (Quinn, 2021; Ndugga et al., 2022) collected during the study, most patients were older than 60.