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Ozge Ozduzen

Billur Aslan Ozgul

Bogdan Ianosev

Alireza KarduniNelli Ferenczi

Wenwen Dou

Matthew Adams

Monika FrtczakMay 2022COVID19 Recovery:

Building Future Pandemic

Preparedness and

Understanding Citizen

Engagement in the

USA and UK

“Medicine is

Still Against Black People"Mapping and visualising intersections of social inequalities, community mistrust, and vaccine hesitancy in online and physical spaces in the UK and US "Medicine is Still Against Black People" 2

About the authors

Dr Ozge Ozduzen is a lecturer in Digital Media and Society at the University of About the COVID-19 Recovery: Building Future Pandemic Preparedness and Understanding Citizen Engagement in the USA and UK Series "Medicine is Still Against Black People" 3

Executive summary

Acknowledge the bias and discrimination within healthcare institutions and biomedical models of health: Prioritise building strong relationships between minoritised communities and healthcare institutions: within Acknowledge the agency and moral concerns of patients: Improve the way information and data are shared with publics: Recognise the varied life experiences of vaccine-hesitant communities and avoid polarising discourse: "Medicine is Still Against Black People" 4 "Medicine is Still Against Black People" 5

Figure 1: Findings of the report

T1 Racism and discrimination

of colonialism, slbavery, and structural medical , abuse, and malpractice inform people"s , including health programmes and initiatives."I"m surprised at the uptake in my community, we know what has happened with my community... Medicine is stillc against black people. So when you hear people"s experiences, of course, that in a way impacts you even if you"ve not had it to the extent that they"ve had it. It is in your consciousness."

T2 Liberty and freedom

for negatively a?ect the willingness of people to receive the vaccine and to accept vaccine mandates."I don"t have hesitations about the vaccines, I"ve made my decision a long ticme ago, and quite informed about my decision. And I"ve got that freedom of choice to make that decision."

T3 Side e?ects

Perceptions of

and related to COVID?19 vaccines development processes feed people"s vaccine views and beliefs."But from the research I"m doing there are many who are dying. Many have adverse reactions.

One of my family members heavily sweats all

the time since beincg vaccinated. So there are side e?ects and if the government was open and saying it"s not just the sore arm, there is also paralysis that could occur as a result of the vaccine, it would be cbetter."

T4 Spiritual beliefs

Perceptions of

is associated with increased vaccine hesitancy."[...] I"m a religious person. I"m Christian and I know that there are health laws which de?initely works so that plays a part in me thinking aclso that I need to take care of my body, my temple,

God"s temple and in order to be able to

optimize its ability, the immune system to ?ight anything that isn"t deadly, even though that"s the narrative coming out"

T5 Ine?ective communication

by governments, medical institutiobns, and mainstream media were and caused confusibons about e?ectiveness and safety of vaccines."I don"t ?ind the information from public health o?icials particularly trustworthy. I don"t think the

CDC and the White House lie about ecverything

and that they are out to get all the citizcens. I don"t think there"s a massive conspiracy to harm the general public, but it is more di?icult than I tchink it ever has been to know which information from o?icial and media socurces is credible."

T6 Medical experts

for working with minoritbised communities, and of historic and contemporary medical racism impacts abilities to build e?ective relationships."There does need to be better sta? education as to why people distrust tche health care system and which communities we should expect it from and really are there certain big cases that have caused that distrust." "Medicine is Still Against Black People" 6

Introduction

1 2 3 4 5 1

Platt, L. (November 2021), Why ethnic minorities are bearing the brunt of COVID?19. https://www.lse.ac.uk/research/research-for-the-

world/race-equity/why-ethnic-minorities-are-bearing-the-brunt-of-covid-19 [accessed 24/03/2022]. 2

Oice for National Statistics (January 2022), Coronavirus and vaccination rates in people aged 18 years and over by socio-

demographic characteristic and occupation, England: 8 December 2020 to 31 December 2021. https://www.ons.gov.uk/

peoplepopulationandcommunity/ healthandsocialcare/healthinequalities/bulletins/coronavirusandvaccinationratesinpeopleaged

18yearsandoverbysociodemographiccharacteristicandoccupationengland/8december2020to31december2021 [accessed

24/03/2022].

3

Wagner, E. F., Langwerden, R. J., Morris, S. L., Ward, M. K., Trepka, M. J., Campa, A. L., ... and Hospital, M. M. (2021), "Virtual Town Halls

Addressing Vaccine Hesitancy Among Racial/Ethnic Minorities: Preliminary Findings",

Journal of the American Pharmacists Association,

62(1), pp. 317325.

4

Niño, M. D., Hearne, B. N., and Cai, T. (2021), ‘Trajectories of COVID19 vaccine intentions among US adults: The role of race and

ethnicity",

SSM-population health,

15, pp. 18.

5

Peteet, B., Belliard, J. C., Abdul-Mutakabbir, J., Casey, S., and Simmons, K. (2021), ‘Community-academic partnerships to reduce

COVID19 vaccine hesitancy in minoritized communities",

EClinicalMedicine,

34, pp.12.

"Medicine is Still Against Black People" 7 6 7 8 9 6

Omi, M. and Winant, H. (2015), Racial Formation in the United States (3rd Edition), New York and Abingdon: Routledge.

7

Lentin, A. (2000), ‘Race", Racism and Anti-Racism: Challenging Contemporary Classiications,Social Identities,6(1), pp.91106.

8

Balibar, E. and Wallerstein, I. (1991), Race, Nation, Class: Ambiguous Identities, London and New York: Verso.

9

Perkins, K. and Wiley, S. (2014), ‘Minorities" in Teo, T. (ed.), Encyclopedia of Critical Psychology, (New York: Springer), https://doi.

org/10.1007/9781461455837_188. "Medicine is Still Against Black People" 8 10 10

Sauda, E., Wessel, G., and Karduni, A. (2021), Social Media and the Contemporary City, Abingdon: Routledge.

"Medicine is Still Against Black People" 9 "Medicine is Still Against Black People" 10

Findings

T1. Racism and discrimination: Historical legacies and contemporary discrimination a?ect vaccine hesitancy

11 12 13 14

11 Kennedy, B. R., Mathis, C. C., and Woods, A. K. (2007), ‘African Americans and their distrust of the health care system: healthcare for

diverse populations",

Journal of cultural diversity,

14(2), pp. 5661.

12 Jamison, A. M., Quinn, S. C., and Freimuth, V. S. (2019), ‘"You don"t trust a government vaccine": Narratives of institutional trust and

inluenza vaccination among African American and white adults",

Social Science & Medicine,

221, pp. 8794.

13 Nuriddin, A., Mooney, G., and White, A. I. (2020), ‘Reckoning with histories of medical racism and violence in the USA", The Lancet,

396(10256), pp. 949951.

14 Marcelin, J. R., Swartz, T. H., Bernice, F., Berthaud, V., Christian, R., Da Costa, C., ... and Abdul-Mutakabbir, J. C. (September 2021),

‘Addressing and Inspiring Vaccine Conidence in Black, Indigenous, and People of Color During the Coronavirus Disease 2019

Pandemic", In

Open Forum Infectious Diseases

(Vol. 8, No. 9, p. ofab417). US: Oxford University Press. "Medicine is Still Against Black People" 11

T2. Liberty and freedom: Concerns for infringements of individuals" liberty and freedom a?ect vaccine hesitancy

"Medicine is Still Against Black People" 12 15 15

Johnston, J. (March 2020), ‘Matt Hancock insists ‘herd immunity" not part of government"s plan for tackling coronavirus", PoliticsHome,

[accessed

24/03/2022].

"Medicine is Still Against Black People" 13 T3. Side e?ects: Side e?ects and health hazards a?ect vaccine hesitancy "Medicine is Still Against Black People" 14 T4. Spiritual and religious beliefs: Religious and spiritual beliefs inform vaccine hesitancy

T5. Ine?ective communication: Conicting information from ocials, mainstream media, and social media feed vaccine hesitancy

"Medicine is Still Against Black People" 15 16

16 Edgerly, L., Toft, A., and Veden, M. L. (2011), ‘Social movements, political goals, and the May 1 marches: Communicating protest in

polysemous media environments",

The International Journal of Press/Politics,

16(3), pp. 314334.

"Medicine is Still Against Black People" 16 "Medicine is Still Against Black People" 17 T6. Medical experts: Lack of awareness and guidance regarding minoritised communities" concerns "Medicine is Still Against Black People" 18 and three "Medicine is Still Against Black People" 19 "Medicine is Still Against Black People" 20

Policy implications

and recommendations "Medicine is Still Against Black People" 21

Figure 2: Policy recommendations

Acknowledge the bias and discrimination

within healthcare institutions and biomedical models of health

T1 Racism and discrimination

T6 Medical experts

Prioritise building strong relationships

between minoritised communities and healthcare institutions

T1 Racism and discrimination

T6 Medical experts

T4 Spiritual beliefs

Recognise the varied life experiences of

vaccine-hesitant communities and avoid polarising discourse

T5 Ine?ective communication

T5 Ineąective communication

Improve the way information and

data are shared with publics

T3 Side e?ects

Acknowledge the agency and moral

concerns of patients

T2 Liberty and freedom

T4 Spiritual beliefs

T5 Ineąective communication

"Medicine is Still Against Black People" 22

1. Acknowledge the bias and discrimination within healthcare institutions and biomedical models of health

building trust

T1-Racism and

discrimination, speci?cally 2. Prioritise building strong relationships between minoritised communities and healthcare institutions

T1-Racism and discrimination,

T4-Religious beliefs

T5-Medical experts,

ithin should reduce reliance on vaccine rates "Medicine is Still Against Black People" 23
anti-racism training and practices for healthcare practitioners

3. Acknowledge the agency and moral concerns of patients

T2-Liberty and freedom, T4-Spiritual beliefs

and

T5-Ine?ective communication,

17 18

17 Graham, J., Haidt, J., and Nosek, B. A. (2009), ‘Liberals and conservatives rely on dierent sets of moral foundations", Journal of

personality and social psychology,

96(5), pp. 10291046.

18 Iyer, R., Koleva, S., Graham, J., Ditto, P., and Haidt, J. (2012), ‘Understanding libertarian morality: The psychological dispositions of

self-identiied libertarians",

PLOS ONE,

7(8), pp. 123.

"Medicine is Still Against Black People" 24

4. Improve the way information and data are shared with publics

T3-Side e?ects

and

T4-Ine?ective communication

highlighted

5. Recognise the varied life experiences of vaccine-hesitant communi-ties and avoid polarising discourse

T5-Ine?ective communications

"Medicine is Still Against Black People" 25
19

19 For an example, please see this video: Vox (2021) Glad You Asked, S2, E4. Available at: https://www.youtube.com/

watch?v=YUbSpI0J9aQ&t=19s&ab_channel=Vox [accessed 24/03/2022]. "Medicine is Still Against Black People" 26

Conclusion

"Medicine is Still Against Black People" 27
"Medicine is Still Against Black People" 28

References

Balibar, E. and Wallerstein, I. (1991),

Race, Nation, Class: Ambiguous Identities,

London and New York: Verso.

Edgerly, L., Toft, A., and Veden, M. L. (2011), ‘Social movements, political goals, and the May 1 marches:

Communicating protest in polysemous media environments", T he International Journal of Press/Politics,

16(3),

pp. 314334.

Graham, J., Haidt, J., and Nosek, B. A. (2009), ‘Liberals and conservatives rely on dierent sets of moral

foundations",

Journal of personality and social psychology,

96(5), pp. 10291046.

Iyer, R., Koleva, S., Graham, J., Ditto, P., and Haidt, J. (2012), ‘Understanding libertarian morality: The

psychological dispositions of self-identiied libertarians",

PLOS ONE,

7(8), pp. 123.

Jamison, A. M., Quinn, S. C., and Freimuth, V. S. (2019), ‘"You don"t trust a government vaccine": Narratives

of institutional trust and inluenza vaccination among African American and white adults",

Social Science &

Medicine,

221, pp. 8794.

Johnston, J. (March 2020), ‘Matt Hancock insists ‘herd immunity" not part of government"s plan for tackling

coronavirus", PoliticsHome, https://www.politicshome.com/news/article/matt-hancock-insists-herd-immunity- [accessed 24/03/2022].

Kennedy, B. R., Mathis, C. C., and Woods, A. K. (2007), ‘African Americans and their distrust of the health care

system: healthcare for diverse populations",

Journal of cultural diversity,

14(2), pp. 5661.

Lentin, A. (2000), ‘Race", Racism and Anti-Racism: Challenging Contemporary Classiications,

Social

Identities,

6(1), pp.91106.

Marcelin, J. R., Swartz, T. H., Bernice, F., Berthaud, V., Christian, R., Da Costa, C., ... and Abdul-Mutakabbir, J. C.

(September 2021), ‘Addressing and Inspiring Vaccine Conidence in Black, Indigenous, and People of Color

During the Coronavirus Disease 2019 Pandemic", In

Open Forum Infectious Diseases

(Vol. 8, No. 9, p. ofab417).

US: Oxford University Press.

Niño, M. D., Hearne, B. N., and Cai, T. (2021), ‘Trajectories of COVID19 vaccine intentions among US adults: The

role of race and ethnicity",

SSM-population health,

15, pp. 18.

Nuriddin, A., Mooney, G., and White, A. I. (2020), ‘Reckoning with histories of medical racism and violence in

the USA",

The Lancet,

396(10256), pp. 949951.

Oice for National Statistics (January 2022),

Coronavirus and vaccination rates in people aged 18 years and over by socio-demographic characteristic and occupation, England: 8 December 2020 to 31 December 2021. tionengland/8december2020to31december2021 [accessed 24/03/2022].

Omi, M. and Winant, H. (2015), Racial Formation in the United States (3rd Edition), New York and Abingdon:

Routledge.

Perkins K. and Wiley S. (2014), ‘Minorities" in Teo, T. (ed.),

Encyclopedia of Critical Psychology,

(New York:

Springer),

Peteet, B., Belliard, J. C., Abdul-Mutakabbir, J., Casey, S., and Simmons, K. (2021), ‘Community-academic

partnerships to reduce COVID19 vaccine hesitancy in minoritized communities",

EClinicalMedicine,

34, pp.12.

"Medicine is Still Against Black People" 29

Platt, L. (November 2021),

Why ethnic minorities are bearing the brunt of COVID?19. https://www.lse.ac.uk/ [accessed 24/03/2022].

Sauda, E., Wessel, G., and Karduni, A. (2021),

Social Media and the Contemporary City,

Abingdon: Routledge.

Vox (2021)

Glad You Asked,

S2, E4. Available at: https://www.youtube.com/watch?v=YUbSpI0J9aQ&t=19s&ab_ channel=Vox [accessed 24/03/2022].

Wagner, E. F., Langwerden, R. J., Morris, S. L., Ward, M. K., Trepka, M. J., Campa, A. L., ... and Hospital, M. M.

(2021), "Virtual Town Halls Addressing Vaccine Hesitancy Among Racial/Ethnic Minorities: Preliminary Findings",

Journal of the American Pharmacists Association,

62(1), pp. 317325.

"Medicine is Still Against Black People" 30

About the Academy

The British Academy is the UK"s national academy

for the humanities and social sciences. We mobilise these disciplines to understand the world and shape a brighter future. From artiicial intelligence to climate change, from building prosperity to improving well-being - today"s complex challenges can only be resolved by deepening our insight into people, cultures and societies. We invest in researchers and projects across the UK and overseas, engage the public with fresh thinking and debates, and bring together scholars, government, business and civil society to inluence policy for the beneit of everyone. The British Academy

1011 Carlton House Terrace

London SW1Y 5AH

Registered charity no. 233176

thebritishacademy.ac.uk

Twitter: @BritishAcademy_

Facebook: TheBritishAcademy

Published May 2022

© The authors. This is an open access

publication licensed under a Creative

Commons Attribution-NonCommercial-

NoDerivs 4.0 Unported License

To cite this report: British Academy (2022),

"Medicine is still against Black people":

Mapping and visualising intersections of social

inequalities, community mistrust, and vaccine hesitancy in online and physical spaces in the

UK and US

, The British Academy, London doi.org/10.5871/c19-recovery/OOBAOAK-

NFWDMAMF

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