Is Trust Enough? Anti-Black Racism and the Perception of Black Vaccine "Hesitancy"

In this article, I offer a preliminary exploration of the heavy lifting that the word "trust" is doing in questions about Black distrust of medicine and what, if anything, comes from it. I also offer an account of why questions like, "Why don't Black people trust vaccines?" are not only the wrong questions to ask but also insulting, and I go on to provide a Black feminist analysis of racial injustice in medicine-an analysis that does not center a notion of trust. I begin by arguing that implicit in these questions is a pathologizing of Black people-the idea that there is something wrong with Black people rather than something wrong with the conditions within which Black people exist. The sense that there is something wrong with Black people both further disadvantages them and ignores the role that health care institutions have played and continue to play in fostering a climate of distrust. I show that even attempts to explain distrust fail to adequately capture the harms committed against Black people, even if such efforts gesture at institutional responsibility. I sketch out what is important about trust but also briefly discuss why trust may not be the answer to the problems that Black people face in health care encounters.