- [Cara] Do you trust your doctors?
You don't think they'd ever use you as a guinea pig
or withhold treatment for a life threatening disease
just for science, do you?
- Hell yeah.
- It turns out in the U.S.,
trust in medicine varies significantly by race.
African Americans are more likely than white Americans
to be suspicious of doctors.
- Second opinion please.
- [Cara] About 50% believe conspiracy theories about HIV.
And they have good reason to be suspicious.
But studies show that mistrust of medicine can be bad
for your health.
- Walk it off, you're fine. - Ah.
- So how do we draw the line
between being prudent and paranoid?
African Americans are three times as likely
to be diagnosed with HIV as the rest of the country.
There are a lot of reasons for that.
- Institutionalized system of inequality.
- Access and insurance.
- Stigma.
- But one reason that isn't talked about much
is trust.
- Talking with people in the community very early
in the epidemic
was difficult conversation
because there were rumors.
- The government lied about inventing the HIV virus
as a means of genocide.
- They ain't cured it 'cause there ain't no money
in the cure, the money's in the medicine,
that's how you get paid.
- [Cara] These ideas might sound paranoid to some,
but for many African Americans, mistrust of doctors
has deep roots.
And they were planted by real historical conspiracies.
- [Doriane] The Tuskegee Study
took place in Tuskegee, Alabama with African American men
who had syphilis to quote unquote figure out
the natural course of the disease.
- These men were promised that
they would be cared for,
they would be given free medical treatment.
- [Cara] But they were never treated as anything
but guinea pigs.
- [Dexter] Ten years after,
a cure was found for syphilis and medical treatment was
withheld from these men.
So it resulted not only in the men dying from syphilis,
but also their wives contracted congenital syphilis.
And this experiment continued for 40 years
until a whistleblower brought it to the whole attention
of the public.
And then the experiment was shut down.
- [Rob] That sounds like a prototypical conspiracy theory.
This shady experiment that was put on by the government,
which involved people's health and
keeping important information from them.
But it's absolutely true,
that's documented, that happened.
- When you have like, your grandfather
telling you about growing up in Alabama
and how the white doctors did A, B, and C,
automatically in your brain you're gonna be thinking like,
I can't trust these people, you know?
- It's not just an isolated incident.
It's really an institutionalized system of inequality.
- [Alicia] Henrietta Lacks,
samples being taken unbeknownst to you.
- [Maya] African Americans being used in
dissections, unauthorized uses of their bodies.
- [Dexter] The American Medical Association found
that even after controlling the income and education,
African Americans were offered subsistent services.
More outdated drugs, more harsh drugs,
and offered more harsher diagnoses compared
to their white counterparts.
So when you talk about levels of mistrust,
is it paranoia or is it self care?
- [Cara] Then, less than a decade after Tuskegee,
a mysterious new disease started ravaging several
marginalized groups, including African Americans.
- [Reporter] It's mysterious, it's deadly, and it's
baffling medical science. - The number of AIDS cases
passed the 100,000 mark. - Black people were
disproportionately impacted from the very beginning.
- [Cara] It was perfect conspiracy fodder.
- [Thomas] Something's not right here.
What I'm saying it
was targeted.
- So some psychologists talk about an idea called
prudent paranoia, and this is the idea
that it might be a good idea to be mildly suspicious
most of the time.
Because people don't always have our best interests in mind.
When you look at the history of institutionalized racism
in the United States, it begins to make sense why
African Americans might be more receptive
to certain conspiracy theories.
- [Dexter] This sort of embodied
a larger level of mistrust that was happening for decades.
- So I don't put anything past American government
when it comes to people of color in this country,
I'm sorry.
- We all experience prudent paranoia from time to time.
If someone does you wrong, you watch your back.
When we experience a history of conspiracy.
- Well I'm not a crook.
- [Cara] We begin to expect it.
We become hyper vigilant,
looking out for signs that someone's trying
to pull one over on us.
Sometimes, prudent paranoia escalates
into its dangerous cousin,
conspiracy thinking.
And that can have real consequences
especially when it comes to your health.
- Rather than go to the doctor,
we'll ask another man if they had the same symptoms we had,
like, hey man, does your heart ever just stop?
- [Cara] Sometimes it's hard to know where
to draw the line between being prudent
and being paranoid.
Is the healthcare system in America racially biased?
Yes.
Are doctors spreading HIV on purpose
or withholding a cure?
The probability of that is harder to calculate.
So we asked this mathematician.
David Grimes wanted to answer an age old question.
How can know if a conspiracy theory is true or not?
So he researched several real conspiracies
and how they unravel to try to determine the limits
of conspiratorial behavior.
When we he crunched the numbers,
some realities emerged.
- The longer you wanna keep something a secret for,
the more difficult it is.
The other thing you see is conspiracies are very, very
difficult to sustain if you have a lot of people in them.
Benjamin Franklin once said that, "Three men can keep a
"secret if two are dead."
This illustrates the whole phenomemon
that the more people you involve,
the quicker your conspiracies fail.
- [Cara] According to Dr. Grimes,
the chances of a global, decades long conspiracy
to fake climate change or hide a cure for cancer
are pretty much zero.
And if it couldn't work for cancer,
it probably wouldn't work for HIV either.
- The idea of being able to sustain that many people
for that long in a dangerous, unethical fiction?
It's just, doesn't work when you put the numbers to it.
- But here's the catch.
- Just because you can,
so you say,
create an algorithm or whatever to
kind of debunk things,
I'm telling you that
pales to the
strength of the human mind
to believe whatever it wants.
- That's the thing about conspiracy theories.
If they're rooted in fear and mistrust,
facts can't dispel them.
We have to address the underlying causes
of prudent paranoia
that are real and legitimate.
- The problem isn't the mistrust
in the African American community,
it's the lack of trustworthiness in the medical community.
- [Cara] So what's the antidote to mistrust?
We can start by acknowledging the wrongs
of our past.
And helping patients regain a sense of trust
and control over their own health.
- [Maya] How are you?
- [Byron] Dr. Green's like a sister.
I can ask her any question
and she can do the same with me.
- You know me, I'm not gonna like push some medicines
or anything like that, but,
make sure whatever you're gonna do is healthy for you.
The care part is what's gonna get that medicine
to that patient and get the patient to be
the leader and feel that autonomy.
- [Cara] And the most important antidote?
People who are trusted members of the community you serve.
- [Alicia] If you don't have anyone present in the community
who represents the community,
there's no way you're gonna be a successful
healthcare organization.
You need to become a part of the fabric of the community.
Whether it's doing
flu shots at a church
or whatever vaccinations at a school.
- Thank you. - And I feel like
that's where it begins with trust.
- Doctors aren't the only people we have
a hard time trusting in America.
Our trust in government and other civic institutions
is at an all time low.
- You Republicans in the house have been lying nonstop.
- Democrats will defend any lawlessness.
- Wherever there's mistrust,
there will be conspiracy theories.
And consequences.
- [Man] There's evidence that engaging
with conspiracy theories promotes alienation.
It makes people less likely to engage in
pro social behaviors, like voting.
And so these are worrying effects.
- Even more worrying?
Americans increasingly don't trust each other.
Why are we so divided?
It's not what you may think.
More on that in our next episode.