Journal of General Internal Medicine

, Volume 35, Issue 1, pp 322–325 | Cite as

The Tuskegee Study of Untreated Syphilis: A Case Study in Peripheral Trauma with Implications for Health Professionals

  • Marcella Alsan
  • Marianne WanamakerEmail author
  • Rachel R. Hardeman


Racially or ethnically targeted events may have adverse health implications for members of the group not directly targeted, a phenomenon known as peripheral trauma. Recent evidence suggests that mass incarceration, police brutality, and immigration actions all have such effects, as did medical exploitation by the US government during the Tuskegee Study of Untreated Syphilis in the Negro Male. We summarize recent findings in the economics literature on population-level effects of the Tuskegee study, including a decline in health-seeking behavior and a rise of both mortality and medical mistrust among African-American men not enrolled in the study. We highlight the relevance of our findings for present-day racial health disparities. Practitioner awareness of peripheral trauma is an important element of cultural competency. But among options to substantially improve minority trust in the healthcare system, the diversification of medical practitioners may hold greatest promise.


racial disparities mistrust in institutions population health 


Authors’ Contributions

Marcella Alsan, Marianne Wanamaker, and Rachel Hardeman take responsibility for the integrity of the data and the accuracy of the data analysis, as well as the manuscript submission.

Funding Information

Drs. Alsan and Wanamaker recognize funding from the National Institute on Minority Health and Health Disparities (1R03MD011449).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Marcella Alsan
    • 1
    • 2
  • Marianne Wanamaker
    • 2
    • 3
    Email author
  • Rachel R. Hardeman
    • 4
  1. 1.John F. Kennedy School of GovernmentHarvard UniversityCambridgeUSA
  2. 2.National Bureau of Economic ResearchCambridgeUSA
  3. 3.Department of EconomicsUniversity of TennesseeKnoxvilleUSA
  4. 4.Division of Health Policy & ManagementUniversity of Minnesota School of Public HealthMinneapolisUSA

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