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a cce s s H ea l t h N ews . n e t M a rc h 2 0 2 6 Volume 11 | Issue No. 104 28 I n a recent installment of a webinar series titled "Racial Equity and Mental Health," panelists examined the importance of providers contextualizing medical racism when helping patients of color. "The Big Picture: The History of Mental Health and Race" explored the history of race and epidemics in the U.S. and a timeline of global health care advancements. Together they painted a broader picture: There is a well-documented history of providers aligning themselves with the oppressive side of systemic racism. Racial equity in health care is not achievable without first acknowledging this history and actively working to provide a safe, comfortable, and trusting experience for patients of color. Race and Epidemics in the U.S. According to panelist Kirby Randolph, Ph.D., observing and tracking what happened to slaves and newly freed Black Americans throughout health epidemics was not a priority. Because of this, the medical research we have on these health crises lacks countless experiences. Dr. Randolph pointed to the 1792 Yellow Fever epidemic in Philadelphia where Black people were believed to be immune and were therefore excluded from treatment and data collection. Similar mishandling of Black experiences occurred throughout the smallpox and HIV epidemics. Slavery created the furthest-reaching loss of Black lives. Possessing the want for freedom, considered a mental illness in slaves at the time, was one of many reasons a slave could be killed or sold. "If you had serious mental illness – depression, delusions, mania, hallucinations – and you were property of someone else, that person could dispose of you in any way they see fit," said Dr. Randolph. Slave owners sometimes chose to disguise disabilities and frailties in slaves to sell them for a profit. Aggressive slaves were sedated with alcohol, morose slaves were given cocaine to look lively or dance, and hair and faces were often painted to look more youthful. Physicians a ended auctions along with slave owners to vouch for the soundness of slaves. "You see how the physicians had the interests of slave owners in mind," said Dr. Randolph. Throughout the COVID-19 pandemic and national vaccination efforts, examples of racism in medical history were brought to light as reasons for caution. Black Americans hesitant to receive a vaccine pointed to the Tuskegee experiments as one example of many to be wary of trusting providers. While the intention to achieve herd immunity is positive, some vaccine campaigns may have alienated Black people by failing to recognize or validate their concerns. Lacking the historical context of racism in health care both weakens patients' trust in medical professionals and allows for more risk of malpractice. aH Mental Health Equity Requires a Reckoning with Medical Racism Providers especially need to educate themselves and their teams on implicit biases, the historical context of racism in medicine and how these combine to create health disparities. Published in August 2021