Skepticism, Survival, and the State: Race and the Politics of Public Health Trust

Skepticism toward public health institutions in Black communities is often misunderstood as hesitation, misinformation, or resistance to science. However, when examined through a historical and structural perspective, skepticism is not a flaw but a logical response. It is rooted in generational memory and built on centuries of medical exploitation. Black mistrust acts as a survival strategy—an understanding shaped by lived experience rather than abstract theory. Jonathan Spector’s Eureka Day, although set within a predominantly white progressive context, serves as a crucial space for exploring these issues. The play shows how public health discourse often assumes a universal trust without acknowledging how race fundamentally influences access, vulnerability, and belief.

The roots of mistrust stem from the early history of American medicine. During slavery, medical knowledge was often gained through experiments on enslaved people without their consent, anesthesia, or proper care. Black individuals were treated as research subjects rather than patients. This exploitation continued after emancipation, with forced sterilizations, segregated hospitals, and unethical clinical studies into the 20th century, all of which reinforced racial hierarchies within public health. The Tuskegee Syphilis Study is perhaps the most well-known example—not because it is unique, but because it exemplifies ongoing harm. It serves as a reminder of the government's willingness to sacrifice Black lives in the name of science and national interest.

This context clarifies that mistrust is not an irrational emotional reaction. It is a historically justified judgment of institutional behavior. When public health systems have repeatedly failed or endangered Black communities, skepticism serves as a form of protection. In contrast, Eureka Day depicts a community where institutional trust is often assumed. The play examines how progressive ideals of consensus, inclusivity, and dialogue break down under the pressure of a public health crisis. However, the play’s framework presumes that institutions ultimately serve the community’s best interests—an assumption that cannot be universally applied when these systems have long failed to protect Black lives.

In contemporary America, the legacy of medical racism remains evident. Black maternal mortality rates are disproportionately high, medical pain is often under-assessed for Black patients, and public health crises disproportionately impact Black neighborhoods. Technological systems designed to improve care can still perpetuate inequity through algorithmic bias. These patterns show that mistrust is not just inherited memory; it is continually renewed by ongoing violations. The system that caused historical harm still influences outcomes today.

By positioning Eureka Day alongside this history, the absence of race in the play becomes meaningful. It reflects the wider cultural tendency to universalize public health discussions—treating "the public" as if all experience the system similarly. Yet, true consensus exists only when participants believe that the system works for them. Black communities do not have equal access to that belief. The play then serves as a lens to explore the limits of collective trust. It shows how ideas of community break down when trust is assumed rather than built.

If public health aims for greater equity, trust shouldn't be seen as just a behavioral problem to fix. Instead, it should be viewed as a relational matter that needs repair. Institutions must recognize past and current harm, work on rebuilding trust through accountability, and prioritize Black voices in decision-making. Skepticism shouldn't be met with punishment but with understanding that it often comes from lived experience, not ignorance.

Public health trust, then, must be built through structural change—not just rhetorical persuasion. Repair requires more than outreach efforts or culturally aware messaging. It calls for policy changes, resource reallocation, and a commitment to transparency. It demands that institutions clearly show, in tangible ways, that Black lives are valued and protected.

Seen through this perspective, Eureka Day resonates not because it depicts the Black experience but because its thematic concerns reveal how fragile trust becomes when it lacks historical context. The play exposes the tension between ideology and lived reality, between belief and risk. In relation to the history of Black medical skepticism, it emphasizes that trust is not a neutral expectation but a political and historical negotiation.

Skepticism in Black communities is not a rejection of public health; it is a memory of survival. It stems from a long history of state violence and medical neglect. Until institutions directly address this history, mistrust will remain justified—not as resistance to progress, but as a protective strategy in a system where harm has been the norm rather than the exception.