Working Paper: NBER ID: w22323
Authors: Marcella Alsan; Marianne Wanamaker
Abstract: 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.
Keywords: Tuskegee Study; Medical Mistrust; Health Disparities; Black Men
JEL Codes: I14; O15
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Tuskegee Study's disclosure (I13) | medical mistrust (I13) |
| Tuskegee Study's disclosure (I13) | mortality rates (I12) |
| Tuskegee Study's disclosure (I13) | life expectancy gap (J17) |
| proximity to Tuskegee (I29) | outpatient physician contacts (I11) |
| proximity to Tuskegee (I29) | age-adjusted mortality rates (J11) |