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African Centered Psychiarty & Medicine Tradition: Is Psychiatry, Psychotherapy, and Medicinal Treatment based on the core principles of  1.  Ancient Africa and the African Centered World View, nurtured through African Culture, and augmented through concepts and techniques of African Spiritualism, Psychology & Psychiatry. African Centered Psychiarty & Medicine is spiritually, pysically, herbally, naturally, medicinally based and aims to assist Blacks / Africans people (in the diaspora) and oppressed systems of the world; to become authentic and balanced within a shared energy and essence that is in alignment with the natural order of the universe, where all people of African descent are concerned.  

2.  African Centered Psychiarty & Medicinal Traditional Therapy utilizes the principles of Nguzo Saba as guidelines for harmonious living. Basic principles of African Centered Psychiarty & Medicinal Therapy include:  1. Harmony.  2.Balance.  3.Interconnectedness.  4.Cultural Awareness.  5. Authenticity. 

3. The role of the African Centered Psychiarty & Medicinal Traditional Therapist is based on the spiritual, physical, natural, herbal, and medicinal relationship with the client system since ACPMT Therapy recognizes that the healing process is a natural process in which the ACPMT Therapy must assists the client system to rediscover their natural african alignment. The five phases of ACPMT Therapy are:  1.Harmony.  2.Awareness.  3.Alignment.  4.Actualize. and  5.Synthesis.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) features the most current text updates based on scientific literature with contributions from more than 200 subject matter experts. The revised version includes a new diagnosis (prolonged grief disorder), clarifying modifications to the criteria sets for more than 70 disorders, addition of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) symptom codes for suicidal behavior and nonsuicidal self-injury, and updates to descriptive text for most disorders based on extensive review of the literature. In addition, DSM-5-TR includes a comprehensive review of the impact of racism and discrimination on the diagnosis and manifestations of mental disorders. The manual will help clinicians and researchers define and classify mental disorders, which can improve diagnoses, treatment, and research.  https://www.psychiatry.org/psychiatrists/practice/dsm

The State Of Mental Health In America

Mental Health America (MHA) is committed to promoting mental health as a critical part of overall wellness. We advocate for prevention services for all, early identification and intervention for those at risk, integrated services, care and treatment for those who need them, and recovery as the goal.

We believe that gathering and providing up-to-date data and information about disparities faced by individuals with mental health problems is a tool for change.

2023 Key Findings:

In 2019-2020, 20.78% of adults were experiencing a mental illness. That is equivalent to over 50 million Americans.

• The vast majority of individuals with a substance use disorder in the U.S. are not receiving treatment. 15.35% of adults had a substance use disorder in the past year. Of them, 93.5% did not receive any form of treatment.

• Millions of adults in the U.S. experience serious thoughts of suicide, with the highest rate among multiracial individuals. The percentage of adults reporting serious thoughts of suicide is 4.84%, totaling over 12.1 million individuals. 11% of adults who identified with two or more races reported serious thoughts of suicide in 2020 – 6% higher than the average among all adults.

• Over 1 in 10 youth in the U.S. are experiencing depression that is severely impairing their ability to function at school or work, at home, with family, or in their social life. 16.39% of youth (age 12-17) report suffering from at least one major depressive episode (MDE) in the past year. 11.5% of youth (over 2.7 million youth) are experiencing severe major depression.

• Over half (54.7%) of adults with a mental illness do not receive treatment, totaling over 28 million individuals. Even in Montana (ranked #1), over 4 in 10 adults with a mental illness did not receive care.

• Almost a third (28.2%) of all adults with a mental illness reported that they were not able to receive the treatment they needed. 42% of adults with AMI reported they were unable to receive necessary care because they could not afford it.

• 10.8% (over 5.5 million) of adults with a mental illness are uninsured. Hispanic adults with AMI were least likely to have health insurance, with 19% reporting they were not covered by insurance.

• 6.34% of youth in the U.S. reported a substance use disorder in the past year. That is equivalent to over 1.5 million youth in the U.S. who meet the criteria for an illicit drug or alcohol use disorder.

• 22.87% of adults who report experiencing 14 or more mentally unhealthy days each month were not able to see a doctor due to costs. In Georgia (ranked 51), over one-third of adults experiencing frequent mental distress are unable to afford a doctor’s visit.

• 59.8% of youth with major depression do not receive any mental health treatment. Asian youth with major depression were least likely to receive specialty mental health care, with 78% reporting they did not receive mental health services in the past year. In South Carolina, the lowest ranking state, nearly 8 in 10 youth with depression do not receive care.

• Nationally, only 28% of youth with severe depression receive some consistent treatment (7-25+ visits in a year).  Most (57.3%) youth with severe depression do not receive any care.

• Nationally, 1 in 10 youth who are covered under private insurance do not have coverage for mental or emotional difficulties – totaling over 1.2 million youth. In Arkansas (ranked 51), nearly one-quarter of youth with private insurance do not have coverage for mental health care.

• Only .718 percent of students are identified with emotional disturbance for an individualized education program (IEP). IEPs, with sufficient resources for schools and teachers, are critical for ensuring that youth with disabilities can receive the individualized services, supports, and accommodations to succeed in a school setting.

• In the U.S., there are an estimated 350 individuals for every one mental health provider. However, these figures may actually be an overestimate of active mental health professionals, as it may include providers who are no longer practicing or accepting new patients.

The State Of Mental Health In America

In the above links you will find a Collection of Data across all 50 states and the District of Columbia answering the following questions:

• How many adults and youth have mental health issues?

• How many adults and youth have substance use issues?

• How many adults and youth have access to insurance?

• How many adults and youth have access to adequate insurance?

• How many adults and youth have access to mental health care?

• Which states have higher barriers to accessing mental health care?

Our Goal:

• To provide a snapshot of mental health status among youth and adults for policy and program planning, analysis, and evaluation;

• To track changes in the prevalence of mental health issues and access to mental health care;

• To understand how changes in national data reflect the impact of legislation and policies; and.

• To increase dialogue and improve outcomes for individuals and families with mental health needs

Why Gather this Information?

• Using national survey data allows us to measure a community’s mental health needs, access to care, and outcomes regardless of the differences between the states and their varied mental health policies.

• Rankings explore which states are more effective at addressing issues related to mental health and substance use.

• Analysis may reveal similarities and differences among states in order to begin assessing how federal and state mental health policies result in more or less access to care.

• Help Us In The Fight Against Black Sterility / Theft Of Black Reproductive Organs

• Racism, African American Women, and Their Sexual and Reproductive Health:  A Review Of Historical and Contemporary Evidence and Implications For Healthy Equity.

Eugenics / Racism In Medicine:  Syphillis & The Tuskeegee Institute

JEL Codes: I14, O15 For forty years, the Tuskegee Study of Untreated Syphilis in the Negro Male passively monitored hundreds of adult black males with syphilis despite the availability of effective treatment. The study’s methods have become synonymous with exploitation and mistreatment by the medical profession. To identify the study’s effects on the behavior and health of older black men, we use an interacted difference-in-difference-in-differences model, comparing older black men to other demographic groups, before and after the Tuskegee revelation, in varying proximity to the study’s victims. We find that the disclosure of the study in 1972 is correlated with increases in medical mistrust and mortality and decreases in both outpatient and inpatient physician interactions for older black men. Our estimates imply life expectancy at age 45 for black men fell by up to 1.5 years in response to the disclosure, accounting for approximately 35% of the 1980 life expectancy gap between black and white men and 25% of the gap between black men and women.

The Tuskegee Study became a symbol of their mistreatment by the medical establishment, a metaphor for deceit, conspiracy, malpractice, and neglect, if not outright genocide.

Corbie-Smith et al. (1999)

Blacks / Africans Cannot Trust American-European Medicines:  African-American men have the worst health outcomes of all major ethnic, racial, and demographic groups in the United States.1 Although recent trends have shown signs of improvement, particularly at younger ages, the gradients for older men are still sobering; the expectation of life for black men at age 45 is three years less than for their white male peers and five years less than for black women (Murphy 2013). Compared to other demographic groups, black men have higher death rates from chronic conditions such as HIV/AIDS, heart disease, and cancer, including lung, prostate, and colon (Kaiser Family Foundation 2007). Many factors contribute to such disparities, including lower income and education, lack of health insurance, and higher rates of disengagement from the labor force. But socioeconomic status is not fully determinant of these gaps (Adler et al. 1993; Cutler, Lleras-Muney, and Vogl 2011) and a growing qualitative literature suggests that mistrust of healthcare institutions partially contributes to these inequities. Yet empirical evidence on the causal role of medical mistrust for racial health disparities remains thin.

This study uses the historical disclosure of an unethical and deadly experiment, the Tuskegee Study of Untreated Syphilis in the Negro Male (TSUS), to identify the relationship between medical mistrust and racial disparities in health-related behaviors and health outcomes. For 40 years, between 1932 and 1972, the U.S. Public Health Service (PHS) followed hundreds of poor, black men in Tuskegee, Alabama, the majority of whom had syphilis, for the stated purpose of understanding the natural course of the disease. The men were denied highly effective treatment for their condition (most egregiously, penicillin, which became standard of care by the mid-1940s) and were actively discouraged from seeking medical advice from practitioners outside the study (Brandt 1978). Participants were subjected to blood draws, spinal taps, and, eventually, autopsies by the study’s primarily white medical staff. Survivors later reported that study doctors diagnosed them with "bad blood" for which they believed they were being treated. Compensation for participation included hot meals, the guise of treatment, and burial payments. News of the Tuskegee Study became public in 1972 in an exposé by Jean Heller of the Associated Press, and detailed narratives of the deception and its relationship to the medical establishment were widespread. By that point, the majority of the study’s victims were deceased, many from syphilis-related causes.

In the years following 1972, journalists, social scientists, and medical researchers have repeatedly pointed to the Tuskegee experiment as a reason African-Americans remain wary of mainstream medicine. For example, as HIV disproportionately ravaged black communities in the U.S., a number of observers conjectured that the Tuskegee Study’s legacy had hampered public health education efforts in the black community, contributing to the epidemic’s spread (Gaston and Alleyne-Green 2013). A recent resurgence of tuberculosis in Marion County, Alabama is similarly attributed (Blinder 2016). Qualitative research aimed at understanding the reluctance of black men, in particular, to participate in medical research or engage in preventive care often produces unprompted reference to Tuskegee (Corbie-Smith et al. 1999). In sum, the Tuskegee Study is an often-cited contributor to delays and avoidance in care seeking, wariness of public health campaigns, low participation in clinical trials, and overall worse health indicators among black men.

To empirically investigate whether the study’s disclosure contributed to racial disparities in health and healthcare utilization in the years following 1972, we rely on a variety of survey and administrative data, including measures of trust in doctors from the General Social Survey (GSS) (Smith et al. 2015), health seeking behavior reported in the National Health Interview Survey (NHIS) (Minnesota Population Center 2012), and mortality data available by race, age group, gender, and cause from the Centers for Disease Control and Prevention (CDC 2014). We focus our attention on these measures for older (45–74) individuals, using other age groups as placebo tests since the mortality and health-seeking behavior of younger individuals is generally driven by acute conditions such as childbirth or trauma in which the needs for care are urgent and the benefits immediate. Because mistrust is more likely to discourage preventive and non-emergency medical care, we report results for both all-cause mortality and chronic disease mortality outcomes.

To generate testable predictions beyond those implied by the timing of the disclosure in 1972, we use race and sex as additional treatment indicators. This approach is based, in part, on the supposition that individuals for whom the news of the Tuskegee Study’s abuses was more salient should exhibit a more robust behavioral response. Economic models of trust formation and social identification (e.g., Tabellini 2008) and a vast psychology literature (e.g., Gutsell and Inzlicht 2010; Singer et al. 2006) indicate that individuals tend to be more affected by news if they can identify with the subject. We posit that individuals might perceive themselves at higher risk of medical mistreatment if they share socio-demographic characteristics with the study’s victims. In this view, the Tuskegee abuses became a signal for how black men might expect the medical system to treat them. A simple Bayesian, multi-period model of belief formation regarding physician trustworthiness implies that, under certain conditions, agents having previous experience with the medical system, e.g., child-bearing women, are less dissuaded from seeking medical treatment by bad news, again implying stronger responses among men than women.2 The model and all supplementary materials are available in an Online Appendix.

As a final exposure to treatment, we interact these demographic characteristics with a location-based measure of proximity: geographic distance to Macon County, Alabama, which contains Tuskegee. In doing so, we test whether black men living in closer proximity to the study’s victims were more heavily influenced by the TSUS revelation. Such a pattern would be observed if, for example, individuals in closer geographic proximity believe the event is more instructive for how they may anticipate being treated by their local medical system. For an alternative proximity measure, we substitute the share of black migrant inflows from the state of Alabama to an individual’s local geography. The Great Migration was characterized by strong chain migration and by substantial amounts of return migration such that individuals living in locations with higher rates of black migration from Alabama would have experienced a lasting information network, in addition to any additional salience arising from these connections.

We test these hypotheses using an interacted difference-in-difference-in-differences framework that captures post-1972 changes in the racial and gender gaps in healthcare utilization and health outcomes for those in varying proximity to the event. Whenever feasible, we condition on a rich set of control variables found to be correlated with individual health seeking behavior, including education (Aizer and Stroud 2010), income (Deaton 2002), marital status (Holt-Lunstad, Birmingham, and Jones 2008), and urbanization. Race-gender-location, race-gender-time and location-time fixed effects non-parametrically control for time-invariant factors that influence outcomes for a specific demographic group in a given locale and for changes in public health and other government policies that might have differentially affected members of each group in each year. The finest level of geography observable in the utilization regressions is a respondent’s state, and we use observations at the county or state economic area level for mortality outcomes. We focus on the short- and medium-term impact of the disclosure on health behaviors and outcomes; given the data limitations, persistent causal impacts are more difficult to identify.

Our estimates imply that a one-standard deviation increase in geographic proximity to Macon County, Alabama, reduced utilization of routine care (outpatient physician contacts) among older black males by 0.90 interactions per year, a 22% reduction in utilization relative to the pre-disclosure mean value for black men. These utilization effects are driven by the behavior of black men with lower levels of education and income. We also find weaker evidence of a reduction in the probability that black men were admitted to the hospital, though their length of stay was significantly longer, consistent with more advanced disease upon presentation. Mortality outcomes indicate that a one standard deviation increase in geographic proximity to Tuskegee was associated with a spike in the post-1972 age-adjusted mortality penalty for black men of 4 log points. Our estimates imply that the Tuskegee Study disclosure contributed to widening health disparities between 1970 and 1980, accounting for approximately 35% of the 1980 life expectancy gap between black and white men and 25% of the gap between black men and women.

An alternative explanation for our findings is that access to healthcare was deteriorating for blacks relative to whites in this period, particularly in the South, and black men were precluded from obtaining routine medical care regardless of their underlying demand. But controlling for public health expenditures and for the availability of hospital services has little effect on our estimates, and this alternative explanation is inconsistent with other research concluding that access to health services and health outcomes for black Americans improved substantially in the years immediately after the Civil Rights Act (Goodman-Bacon 2015; Almond, Chay, and Greenstone 2006; Cascio and Washington 2014). Our results indicate that the Tuskegee revelation stalled the overall pattern of convergence for older black men, producing a drag on healthcare utilization for this specific demographic group and contributing to an abrupt divergence in their mortality patterns.

We pursue a number of strategies to provide further evidence that the correlations we find are indeed causal. First, the results we find are specific to black men; coefficient estimates for the post-1972 treatment effect of being "black and female" or "white and male" in closer proximity to Macon County, Alabama, are generally not economically or statistically significant, do not exhibit an observable break in 1972, and are often opposite-signed to the main treatment effects. In additional tests, we show that our findings are robust to estimation on a within-South sample and that the baseline coefficients for mortality (utilization) based on geographic proximity to Macon County, Alabama, are larger (smaller) than 96% of placebo tests substituting proximity to all other geographies in the data. Thus the effects we measure are specific to black men and to geographic proximity to central Alabama, not to a post-1972 condition affecting the South overall.

Finally, to evaluate whether the behavioral responses we observe are driven by medical mistrust, we use survey data from the 1998 wave of the GSS on whether individuals trust a doctor’s judgment and whether they suspect that the medical establishment will deny them necessary treatment or services. When we interact race and gender indicators with a measure of the distance of an individual from Macon County, Alabama, we find the same geographic gradient apparent in our baseline utilization and mortality results. This geographic gradient in mistrust is not present for general mistrust as revealed in the respondents’ answers to other survey questions.

This paper builds on and contributes to several literatures in economics. First, our findings elucidate factors influencing healthcare demand and medical outcomes among minorities in the United States and deepen our understanding of how this watershed event affected the relationship between black Americans and the U.S. healthcare system. Second, and more broadly, our study is motivated by the theoretical contributions of Guiso, Sapienza, and Zingales (2008) regarding the transmission and updating of beliefs and empirical work by Nunn and Wantchekon (2011) regarding the role of previous exploitation in shaping interpersonal mistrust in Africa. Our findings also connect to rich empirical evidence on the importance of trust for economic development (Knack and Keefer 1997; Fafchamps 2006; Greif 1989). Finally, these findings shed light on questions in development economics regarding low demand for products that have been shown to improve health (Dupas 2011; Chapter 3 of Banerjee and Duflo 2011). The findings presented herein suggest that historical exploitation and its enduring impact on beliefs may explain some of the uptake paradox.

II. Context

The following section places the study in historical and medical context by providing background on the pathology of syphilis and the TSUS experiment, prior literature on the legacy of Tuskegee, and health patterns across demographic groups in the years surrounding the disclosure.

II.A. Background on the Tuskegee Study

The Tuskegee Study was designed to trace the course of untreated syphilis in black men. The organism that causes the disease is related to that causing Lyme disease, and both bacteria manifest themselves in stages. The first stage of sexually acquired syphilis is often an ulcer, followed by a full body rash that includes the palms and soles. However, it is the tertiary (or late-stage) syphilis that inflicts the most damage. The third stage is characterized by gummas (syphilitic tumors teeming with the bacteria) which coalesce and eat away at bone (frequently the nasal bridge) as well as other organs and show a predilection for the arch of the aorta often leading to hemorrhage. Neurosyphilis (an attack on the nervous systems) presents in late-stage syphilis with paresis, gait disturbance, blindness, and dementia (Mandell, Bennett, and Dolin 2009).3

According to Jones (1992), much of the natural history of syphilis outlined above was known at the time the study commenced:

"The germ that causes syphilis…and the complications that can result from untreated syphilis were all known to medical science in 1932 – the year the Tuskegee Study began. Since the effects of the disease are so serious, reporters in 1972 wondered why the men agreed to cooperate. The press quickly established that the subjects were mostly poor and illiterate, and the PHS had offered them incentives to participate."

These incentives included physical exams, hot meals, and burial stipends that would be paid to their survivors. Most of the men also believed they were receiving some form of treatment. Approximately 600 black men (approximately two-thirds of whom had syphilis) were recruited to the study using these techniques and followed passively for forty years while the disease took its toll.

In 1972, news of the Tuskegee Study was leaked to the press and quickly spread, including reporting from the New York Times and the Los Angeles Times, via the Associated Press wire, on broadcast television, via congressional hearings, and, of course, by word of mouth. The study was halted that same year, but few of the original test subjects were alive and dozens of their wives and children had been infected (Heintzelman 2003). Medical historian Allan Brandt (1978) summarizes the study as follows: "In retrospect the Tuskegee Study revealed more about the pathology of racism than the pathology of syphilis; more about the nature of scientific inquiry than the nature of the disease process. … The degree of deception and the damages have been severely underestimated." Those damages may include a legacy of medical mistrust among black Americans. The Final Report of the Tuskegee Syphilis Study Legacy Committee (1996) noted that "the Study continues to cast a long shadow over the relationship between African-Americans and the biomedical professions," and was "a significant factor in the low participation of African-Americans in clinical trials, organ donation efforts, and routine preventive care."4

Despite the Committee’s conclusions, the empirical evidence of a link between the Tuskegee Study and medical mistrust has been mixed and suffers from several limitations. First, and perhaps most crippling, all quantitative and qualitative studies of the relationship between medical mistrust and awareness of Tuskegee’s abuses are dated 20 or more years after 1972. By this time, the link between medical mistrust and knowledge of Tuskegee may have faded for a number of reasons, including a socialization of mistrust without an accompanying socialization of the relevant history.5 Second, a correlation between medical mistrust and knowledge of the Tuskegee Study provides no information on the direction of causation; distrustful individuals may do more to collect information on past abuses. Third, the extant literature focuses on participation in clinical trials rather than medical mistrust per se. Although these outcomes are likely to be correlated, it is the mistrust of care providers that directly impacts health conditions. Finally, samples used in these studies are frequently restricted to particular geographies.

With these qualifications in mind, the earliest quantitative study on this topic is from 1994 (22 years following the disclosure). Researchers surveyed residents of Jefferson County, Alabama (Green et al. 1997). Although 55% of the sample held knowledge of the Tuskegee Study, and the rate was no higher for black men and women than for whites, knowledge of the study by black men increased with age, reaching 74% for those aged 46–64 (who would have been 24–42 at the time of the study). The sample’s age distribution differed substantially by race, and the survey write-up does not include a conditional relationship between race, age, sex, and knowledge of Tuskegee, nor does it give a conditional relationship between willingness to participate in health research and Tuskegee knowledge. But unconditional cross tabulations indicate that 27% of black men were less interested in participation as a result of the study, compared to 20% of black women and 10% of whites. Among all African Americans (male and female), this disinterest was highest for individuals with a high school degree, but no college, and among those aged 31–65. These survey responses also indicate significant racial gaps in respondents’ perceptions of the fairness of medical care and research.6

In addition to the Green et al. study, Brandon, Isaac, and LaVeist (2005) surveyed 401 black and white adults living in Baltimore, Washington D.C., and New York City in 2003 and found that blacks were far less likely to report knowledge of Tuskegee than whites (74% vs. 25%), a statistic uncovered by White (2005) in his critique of their paper. This result, along with the survey’s high refusal rate, led White to cast doubt on the study’s methods. Brandon et al. also reported that blacks with knowledge of the study were 50% more likely to believe the PHS researchers injected the men with syphilis (75.3% vs. 52.8%) and to believe Tuskegee could "occur today" (76.6% vs. 47.2%). In this study, medical mistrust was positively related to black race, male sex and lower education, but not significantly related to knowledge of the Tuskegee Study. Shavers, Lynch, and Burmeister (2002) found the opposite: a greater unwillingness to participate in medical research among blacks who knew about the study. The Tuskegee Legacy Project of 2003, which interviewed black, white, and Hispanic men and women, found that blacks were more likely to have a higher "guinea pig fear factor" score than whites and were more likely to have knowledge of the Tuskegee Study than whites or Hispanics (56.2% vs. 38.5% and 24.3%, respectively) (McCallum et al. 2006).

As best we can ascertain, Freedman (1998) is the earliest qualitative research on the relationship between medical research mistrust and the Tuskegee Study. Freedman asserts that the Tuskegee legacy is not enough to fully explain racial differences in participation in medical research, yet cites interviewees who explicitly and vividly expressed their unwillingness to participate in medical studies in connection with the Tuskegee Syphilis experiment. Additional qualitative evidence links mistrust associated with the Tuskegee Study with take-off of the HIV/AIDS epidemic in minority communities. On May 12, 1992, the New York Times published poll results wherein blacks were more likely to believe in conspiracy theories related to HIV/AIDS, including that the virus was a genocide tool designed to limit the number of blacks in America. (These results have been replicated many times over.) According to Quinn (1997), resulting letters to the editor "clearly placed the origin of such attitudes within the historical context of the Tuskegee Syphilis Study".7 At the height of the HIV/AIDS crisis in the U.S., health publications implored medical professionals to directly confront these conspiracy theories with facts, and correct the common misconception that the Tuskegee abuses included infecting study subjects with syphilis. "Public health professionals must recognize that Blacks’ belief in AIDS as a form of genocide is a legitimate attitudinal barrier rooted in the history of the Tuskegee Syphilis Study" (Thomas and Quinn 1991).

In addition to specific Tuskegee legacy studies, the public health literature provides ample documentation that being black and male is an important predictor of health disparities, including those in life expectancy, survival rates within disease category, and health-promoting behavior. Black men are less likely to know their cholesterol levels, engage in blood pressure monitoring, or otherwise benefit from early detection of chronic conditions than their white male peers (Sandman, Simantov, and An 2000; Viera, Thorpe, and Garrett 2006). Although reasons for these disparities are multifactorial, the legacy of medical exploitation (represented in part by the Tuskegee Study) has led to research on whether medical mistrust is particularly heightened among black men (Carlson and Chamberlain 2004). Indeed, black men exhibit higher levels of medical mistrust which are correlated with reduced probabilities of routine, preventive, and early-stage disease care.8 Medical mistrust among black men is also correlated with poor compliance with treatment plans, conditional on diagnosis, for a range of diseases including HIV/AIDS, cancer, and hypertension.9

II.B. Patterns of Healthcare Utilization and Mortality

Prior to the Tuskegee experiment revelation, the 1960s marked an era of rapid convergence in healthcare access and utilization for black Americans relative to whites. Hospitals gradually integrated over the 1950s and early 1960s, a process that culminated not with the Civil Rights Act of 1964, but with President Lyndon Johnson’s insistence that any hospital receiving Medicare funding fully desegregate by July 1966. This process was quicker in the North than in the South; separate hospital wings were present in 75% of hospitals in the South as late as April of 1966. Still, full compliance appears to have been achieved by July of the same year. These decades also witnessed expansions in public health insurance coverage and services, some of which favored black Americans, including the establishment of Medical Assistance for the Aged (a precursor to Medicare), establishment of and expansions in Medicare and Medicaid (Goodman-Bacon 2015), local health center construction (Bailey and Goodman-Bacon 2015), and the expansion and funding of public hospitals.

By 1970, black Americans had gained substantial ground in terms of healthcare utilization, even if the quality of the services they acquired lagged behind their white peers.10 Using data from the NHIS, among individuals ages 45 to 74, the percentage of black women who did not have recent contact with a medical professional declined between 1964 and 1971 by about 6 percentage points. The improvements for black men were similarly impressive; the same metric declined by 8 percentage points. These gains were three to four times as large as those experienced by white males and females over the same time period.11 The convergence of black and white healthcare utilization rates in the years prior to the Tuskegee disclosure was closely mirrored by convergence in mortality rates. Using CDC-provided annual county-level mortality statistics by age, race, and gender, as described above, we plot the racial difference in age-specific mortality rates (ASMR) (black minus white) for both men (solid line) and women (dashed line) in Figure I. Panels A and B demonstrate that, for infants and children 1 to 4 years of age, there was a marked reduction in racial health disparities that continued, uninterrupted, after the 1972 disclosure. But the pattern for adult mortality is starkly different. Panels C and D plot the same data for adults aged 55–64 and 65–74. At these ages, convergence at the beginning of the period is followed by a striking divergence in the mortality rates for black men relative to white men beginning in the early 1970s, a pattern which is not reflected in the differences between black and white women. The mortality patterns for other ages (contained in Appendix Figure A.2) mimic those for infants and children.12 Unlike younger ages, where parental behavior (for early childhood) and unintentional injuries (for young adults) play key roles in determining mortality, premature and preventable mortality in older adults is more frequently driven by health behaviors and physician involvement, including timely diagnosis and management of illness. To facilitate comparisons across age groups, the mortality rates represented by Figure I are those from all causes of death; specific cause-of-death is available in the underlying data and utilized later in the paper. These stark mortality patterns for black men relative to both black women and white men motivate the paper’s focus on health behaviors and outcomes of black men in particular.

The data are from the CDC compressed mortality files and represent the black-white difference in age-specific mortality rates. Each mortality rate is calculated by dividing the number of deaths in the relevant population by the at-risk population (in thousands). The solid (blue) line represents the difference for males, and the dotted (red) line represents the difference for females. The vertical line represents the year “The Tuskegee Study of Untreated Syphilis in the Negro Male” was disclosed. For additional figures, including plots of all other age-specific mortality rates and South only, see the Appendix.

Dr. Mauricelm-Lei Millere / Prince Imhotep:  African Centered Psychiatry & Medicine

Traditional African Centered Medicine is a range of traditional medicine disciplines involving indigenous herbalism and African spirituality, typically including diviners, doulas, midwives, and herbalists. Practitioners of traditional African medicine claim to be able to cure a variety of diverse conditions including cancer, psychiatric disorders, high blood pressure, cholera, most venereal diseases, epilepsy, asthma, eczema, fever, anxiety, depression, benign prostatic hyperplasia, urinary tract infections, gout, and healing of wounds and burns and even Ebola

Who Are We? 

We are an indigenous herbal / plant based medicinal treatment source.  Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern remedies, such as the anti-malarial group of drugs called artemisinin isolated from Artemisia annua, a herb that was known in Chinese medicine to treat fever. The scope of herbal medicine commonly includes fungal and bee products, as well as minerals, shells and certain animal parts. Herbal medicine is also called phytomedicine or phytotherapy.

What Do We Believe?

Diagnosis is reached through spiritual, pysical, natural, medicinal, and herbal means; and a treatment is prescribed, usually consisting of an herbal remedy that is considered to have not only healing abilities but also symbolic and spiritual significance. Traditional African medicine, with its belief that illness is not derived from chance occurrences, but through spiritual or social imbalance, differs greatly from modern scientific medicine, which is technically and analytically based. In the 21st century, modern pharmaceuticals and medical procedures remain inaccessible to large numbers of African people due to their relatively high cost and concentration of health facilities in urban centres.

What Did / Do We Produce?

Archaeological evidence indicates that the use of medicinal plants in Ancient Continental Africa dates back to the Paleolithic age, approximately 60,000 years ago; and an additional 10.7 million years prior (Understanding The Antediluvian Race: PHP 7.3 million years - 10.3 thousand years BC).. Written evidence of herbal remedies dates back over 5,000 years to the Africans in Sumeria, who compiled lists of plants. Some ancient cultures wrote about plants and their medical uses in books called herbals. In ancient Egypt, herbs are mentioned in Egyptian medical papyri, depicted in tomb illustrations, or on rare occasions found in medical jars containing trace amounts of herbs.  In ancient Egypt, the Ebers papyrus dates from about 1550 BC, and covers more than 700 compounds, mainly of plant origin. The earliest known Greek herbals came from Theophrastus of Eresos who, in the 4th century BC, wrote in Greek Historia Plantarum, from Diocles of Carystus who wrote during the 3rd century BC, and from Krateuas who wrote in the 1st century BC. Only a few fragments of these works have survived intact, but from what remains, scholars noted overlap with the Egyptian / Ethiopian herbals.  Ethiopian / Egyptian Seeds likely used for herbalism were found in archaeological sites of Bronze Age China dating from the Shang dynasty(c. 1600–1046 BC). Over a hundred of the 224 compounds mentioned in the Huangdi Neijing, an early Chinese medical text, are herbs.  Herbs were also commonly used in the traditional medicine of ancient India, where the principal treatment for diseases was diet.  De Materia Medica, originally written in Greek by Pedanius Dioscorides (c. 40–90 AD) of Anazarbus, Cilicia, a physician and botanist, is one example of herbal writing used over centuries until the 1600s. To date herbal medicines have only increased their ancestral relevance as the basis of all treatment and cures known to man.

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