Health Isn’t the Problem. Being Heard Is.

Population health column address Black health equity

Some people say that Black people don’t care about their health. That’s just not true. Additionally, this untruth misrepresents our communities and shifts blame away from the systems that continue to fail us. As a Black doctor and public health professional, I know we care a lot about our families, our future, and living a good life.

But caring isn’t the problem. The real problems are harder to see. They have to do with unfair systems, a lack of access to care, and a long history of not being treated right in the healthcare system. Let’s be clear: we care deeply about our health. We care about our families, longevity (the number of years we live), and quality of life. But to understand the challenges we face, we must confront the root causes—not just the outcomes.

The Truth About Health in Black Communities

Yes, we see higher rates of chronic conditions like hypertension, diabetes, and obesity in Black communities (Centers for Disease Control and Prevention [CDC], 2022). But this doesn’t happen because people don’t care. It happens because:

Poor primary and secondary education systems.

Higher levels of poverty and a lack of equitable economic opportunities.

Lower rates of medical insurance coverage.

Healthy food is hard to find in some neighborhoods.

Doctors’ offices are far away or too expensive.

Some people don’t trust doctors because of how they or their families have been treated by medical providers and health systems in the past.

Why There’s Mistrust—And Why It Makes Sense

Black people haven’t always been treated fairly by the healthcare system. Here are a few reasons why some people don’t trust it:

The Tuskegee Syphilis Study (1932–1972): For 40 years, Black men with syphilis were deliberately left untreated so researchers could observe the progression of the disease. They were misled and denied care, even after penicillin became the standard treatment (Jones, 1993).

Henrietta Lacks (1951): Her cancer cells were taken without her knowledge or consent. Those cells led to groundbreaking medical research and profits, while her family remained unaware and uncompensated for decades (Skloot, 2010).

Unfair treatment today: Studies continue to show that Black patients are less likely to receive proper clinical treatment and more likely to have their concerns dismissed by healthcare providers (Sabin et al., 2015).

When people are treated badly, it’s hard to trust the system.

What Happens When We’re Heard

Despite these injustices, trust can be rebuilt—when healthcare institutions listen, adapt, and show up with cultural humility.

COVID-19 Response and Vaccine Uptake: Early in the pandemic, vaccine hesitancy was high among Black and Brown populations—not because of ignorance, but because of valid historical concerns. However, when trusted Black physicians, barbershops, churches, and community leaders were included in outreach efforts, vaccine rates improved significantly (Momplaisir et al., 2021).

Black Barbershop Health Initiatives: Studies have shown that blood pressure screenings and health education provided in barbershops—trusted, culturally resonant spaces—led to significant improvements in hypertension control among Black men (Victor et al., 2018).

These examples prove that when healthcare is delivered in spaces that feel safe and affirming, people engage. Period.

We All Have a Role to Play

Personal responsibility matters. As individuals, we must make informed choices, move our bodies, nourish ourselves, and see our healthcare providers regularly. However, personal responsibility can only go so far when systems are broken, providers don’t listen, and healthy options are unaffordable or unavailable.

Healthcare institutions have a moral and professional obligation to meet people where they are in a manner that is meaningful to them—not only where and when it’s convenient. That means:

Training providers in cultural sensitivity and treating everyone fairly.

Offer care in places where people feel safe.

Supporting policies that address education, food deserts, housing, and economic stability, because those are health issues, too.

Let’s Tell the Real Story

We must reject the narrative that Black people don’t care about their health. We do. We always have. The real story is one of resilience in the face of institutional neglect. The real need is for a healthcare system that respects, understands, and serves all people in a manner that helps them reach and maintain their best health level.

Let’s tell the whole story because everyone deserves a fair chance to live a long, healthy life.

References

Centers for Disease Control and Prevention. (2022). Health disparities. https://www.cdc.gov

Jones, J. H. (1993). Bad blood: The Tuskegee syphilis experiment. Free Press.

Momplaisir, F. M., Kuter, B. J., Ghadimi, F., Browne, S., Feemster, K. A., Shen, A. K., Frank, I., & Faig, W. (2021). Racial/ethnic differences in COVID-19 vaccine hesitancy among health care workers in 2 large academic hospitals. JAMA Network Open, 4(8), e2121931.

Sabin, J. A., Greenwald, A. G., & Nosek, B. A. (2015). Implicit racial bias and pain treatment decisions. The Journal of Law, Medicine & Ethics, 43(3), 451–459.

Skloot, R. (2010). The immortal life of Henrietta Lacks. Crown Publishing Group.

Victor, R. G., Lynch, K., Li, N., Blyler, C., Muhammad, E., Handler, J., … & Elashoff, R. M. (2018). A barber-based intervention for hypertension in Black men: A cluster-randomized trial. New England Journal of Medicine, 378(14), 1291–1301.

Dr. Frederick Echols, MD, is available as a subject matter expert on public health for press interviews and speaking engagements.

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About Dr. Fredrick Echols, MD

Dr. Fredrick L. Echols, MD is the founder and Chief Executive Officer of Population Health and Social Justice Consulting, LLC, an Obama Foundation Global Leader, sought-after public speaker, black men’s health advocate, and accomplished physician with over 15 years of experience in public health. He has worked extensively with public and private sectors to address complex health issues through evidence-informed approaches. Dr. Echols is a graduate of the Centers for Disease Control and Prevention Population Health Training in Place program and the ASTHO-Morehouse School of Medicine’s Diverse Executives Leading in Public Health program.

Passionate about health and justice, Dr . Echols’ notable roles include serving as Chief Executive Officer for Cure Violence Global, Health Commissioner for the City of St. Louis, and Director of Communicable Disease and Emergency Preparedness for the St. Louis County Department of Public Health. In these roles, he oversaw public health regulations, led COVID-19 response efforts, managed daily operations, and developed strategic partnerships. Dr. Echols also served as Chief of Communicable Diseases for the Illinois Department of Public Health and as a physician in the U.S. Navy. He continues to contribute to public health research and guides health organizations globally.