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Chapter 4 - Racism in American Medicine

Do No Harm to Some; Do Great Harm to Others

Published online by Cambridge University Press:  07 September 2023

Louis A. Penner
Affiliation:
Wayne State University, Michigan
John F. Dovidio
Affiliation:
Yale University, Connecticut and Diversity Science, Oregon
Nao Hagiwara
Affiliation:
University of Virginia
Brian D. Smedley
Affiliation:
Urban Institute, Washington DC
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Summary

This chapter concerns the history of anti-Black racism in American medicine. For a very long time, medical professionals either refused to treat Black patients or required they be treated in segregated, dramatically under-resourced settings. This was due to both racist laws and social customs that produced systemic racism within the medical establishment. Major medical professional organizations both actively and passively supported segregated healthcare. Black people were also largely excluded from professional schools and greatly restricted in their ability to practice medicine. Further, Black people were often abused and exploited by unethical medical practices, which included robbing their graves to provide cadavers and forcing them to participate in dangerous and unethical medical experiments. Black Americans were further harmed by physicians’ involvement in the eugenics movement. Based on gross misunderstandings of genetics and heredity, eugenics proposed that society could be improved by limiting reproduction among socially disadvantaged groups. This resulted in involuntary sterilizations that disproportionally targeted Black Americans. Most racist medical policies and practices were eliminated by legislation and changes in professional and societal norms. However, the legacy of racism in American medicine can still be seen in current healthcare practices that harm Black patients and greater medical mistrust among Black Americans.

Type
Chapter
Information
Unequal Health
Anti-Black Racism and the Threat to America's Health
, pp. 167 - 204
Publisher: Cambridge University Press
Print publication year: 2023

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References

Savitt, T. (2006). Abraham Flexner and the black medical schools. 1992. Journal of the National Medical Association, 98(9), 14151424. https://pubmed.ncbi.nlm.nih.gov/17019906/Google Scholar
Dovidio, J. F., Penner, L. A., Albrecht, T. L., Norton, W. E., Gaertner, S. L., & Shelton, J. N. (2008). Disparities and distrust: The implications of psychological processes for understanding racial disparities in health and health care. Social Science and Medicine, 6(3), 478486. https://doi.org/10.1016/j.socscimed.2008.03.019CrossRefGoogle Scholar
Laws, T. (2021). How should we respond to racist legacies in health professions education originating in the Flexner Report? AMA Journal of Ethics, 23(3), 271275. https://journalofethics.ama-assn.org/article/how-should-we-respond-racist-legacies-health-professions-education-originating-flexner-report/2021-03Google Scholar
Downs, J. (2012). Sick from freedom: African-American illness and suffering during the Civil War and Reconstruction. Oxford University Press.Google Scholar
Byrd, W. M., & Clayton, L. A. (2000). An American health dilemma: A medical history of African Americans and the problem of race: Beginnings to 1900. Routledge.Google Scholar
Hunkele, K. L. (2014). Segregation in United States healthcare: From reconstruction to deluxe Jim Crow. (Unpublished Honors Thesis). University of New Hampshire. https://scholars.unh.edu/cgi/viewcontent.cgi?article=1189&context=honorsGoogle Scholar
Williams, M. (1999, August 20). Unhealthy conditions in black area of a segregated hospital [Interview]. Documenting the American South. https://docsouth.unc.edu/sohp/K-0266/excerpts/excerpt_8777.htmlGoogle Scholar
Cornely, P. B. (1957). Trend in racial integration in hospitals in the United States. Journal of the National Medical Association, 49(1), 810. https://pubmed.ncbi.nlm.nih.gov/13385679Google Scholar
Dorsey, K. (2000, April 12). Exhibit explores city’s history of segregation. The Daily Northwestern. https://dailynorthwestern.com/2000/04/13/archive-manual/exhibit-explores-citys-history-of-segregation/Google Scholar
Reynolds, P. P. (2004). Professional and hospital discrimination and the US Court of Appeals Fourth Circuit 1956–1967. American Journal of Public Health, 94(5), 710720. https://doi.org/10.2105/ajph.94.5.710Google Scholar
Radosh, P. F. (1986). Midwives in the United States: Past and present. Population Research and Policy Review, 5(2), 129146. https://doi.org/10.1007/BF00137177Google Scholar
Du Bois, W. E. B. (1903). The souls of Black folk. A. C. McClurg & Co.Google Scholar
Thomas, K. K. (2011). Deluxe Jim Crow: Civil rights and American health policy, 1935–1954. University of Georgia Press.Google Scholar
Museum of the American Military Family. (2016, August 1). End of racial segregation in VA Hospitals. We served too. https://weservedtoo.wordpress.com/2016/08/01/end-of-racial-segregation-in-va-hospitals/Google Scholar
U.S. Congress. House Committee on Ways and Means. (1956). Public Assistance Titles of the Social Security Act, Hearings on H.R. 9120. 84th Congress, Second Session. www.ssa.gov/policy/docs/ssb/v19n9/v19n9p3.pdfGoogle Scholar
Washington, H. A. (2008, July 29). Apology shines light on racial schism in medicine. New York Times. www.nytimes.com/2008/07/29/health/views/29essa.htmlGoogle Scholar
Baker, R. B. (2014). The American Medical Association and race. AMA Journal of Ethics, 16(6), 479488. https://journalofethics.ama-assn.org/article/american-medical-association-and-race/2014-06Google Scholar
Sternberg, S. (2015, July 29). Desegregation: The hidden legacy of Medicare. US News & World Report. www.usnews.com/news/articles/2015/07/30/desegregation-the-hidden-legacy-of-medicareGoogle Scholar
Chaudry, A., Jackson, A., & Glied, S. A. (2019, August 21). Did the Affordable Care Act reduce racial and ethnic disparities in health insurance coverage? The Commonwealth Fund. www.commonwealthfund.org/publications/issue-briefs/2019/aug/did-ACA-reduce-racial-ethnic-disparities-coverageGoogle Scholar
U.S. Department of Education. (1991, March). Office for Civil Rights. Historically black colleges and universities and higher education desegregation. https://files.eric.ed.gov/fulltext/ED330264.pdfGoogle Scholar
Press, R. (2017, February 6). In his own words: Nathan Francis Mossell, Penn Medicine’s first Black graduate. Penn Medicine News. www.pennmedicine.org/news/news-blog/2017/february/in-his-own-words-nathan-francis-mossellGoogle Scholar
Wright-Mendoza, J. (2019, May 3). The 1910 report that disadvantaged minority doctors. JSTOR Daily. https://daily.jstor.org/the-1910-report-that-unintentionally-disadvantaged-minority-doctors/Google Scholar
Jefferies, K. (2020, May 11). Recognizing history of Black nurses a first step to addressing racism and discrimination in nursing. The Conversation. https://theconversation.com/recognizing-history-of-black-nurses-a-first-step-to-addressing-racism-and-discrimination-in-nursing-125538Google Scholar
Bennett, C., Hamilton, E. K., & Rochani, H. (2019). Exploring race in nursing: Teaching nursing students about racial inequality using the historical lens. OJIN: The Online Journal of Issues in Nursing, 24(2). https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-24-2019/No2-May-2019/Articles-Previous-Topics/Exploring-Race-in-Nursing.htmlGoogle Scholar
Carnegie, M. E. (1999). The path we tread: Blacks in nursing worldwide, 1854–1994 (3rd ed.). Jones & Bartlett.Google Scholar
Farrow, S. (2021, August 13). This day in history, August 13th. The Hub news. https://thehub.news/this-day-in-history-august-13th/Google Scholar
Bellafaire, J. The Army nurse corps in World War II. AMEDD Center of History & Heritage. https://achh.army.mil/history/ancwwiibook-introductionGoogle Scholar
Clark, A. (2018, May 15). The army’s first Black nurses were relegated to caring for Nazi prisoners of war. Smithsonian Magazine. www.smithsonianmag.com/history/armys-first-black-nurses-had-tend-to-german-prisoners-war-180969069/Google Scholar
National Women’s History Museum. (2019, July 8). African American nurses in World War II. https://www.womenshistory.org/articles/african-american-nurses-world-war-iiGoogle Scholar
Tomblin, B. (1996). GI Nightingales: The army nurse corps in World War II. University Press of Kentucky.Google Scholar
The New York Public Library Archives & Manuscripts. National Association of Colored Graduate Nurses records 1908–1958. https://archives.nypl.org/scm/20744Google Scholar
Scrubs Editor. (2016, February 25). Historical moments for African American nurses. Scrubs Magazine. https://scrubsmag.com/historical-moments-for-african-american-nurses/Google Scholar
Savitt, T. L. (1982). The use of Blacks for medical experimentation and demonstration in the Old South. The Journal of Southern History, 48(3), 331348. https://doi.org/10.2307/2207450Google Scholar
Kentucky General Assembly. House of Representatives. (1833). Journal of the House of Representatives of the Commonwealth of Kentucky, December 1, 1833 - February 24, 1834. Journals of the General Assembly of the Commonwealth of Kentucky. https://uknowledge.uky.edu/ky_state_journals/16/Google Scholar
Pietila, A. (2018, October 25). In need of cadavers, 19th-century medical students raided Baltimore’s graves. Smithsonian Magazine. www.smithsonianmag.com/history/in-need-cadavers-19th-century-medical-students-raided-baltimores-graves-180970629/Google Scholar
Washington, H. (2006). Medical apartheid: The dark history of medical experimentation on black Americans from colonial times to the present. Anchor BooksGoogle Scholar
Berry, D. R. (2018, February 3). Beyond the slave trade, the cadaver trade. New York Times. www.nytimes.com/2018/02/03/opinion/sunday/cadavers-slavery-medical-schools.htmlGoogle Scholar
Pilkington, E. (2021, April 23). Bones of Black children killed in police bombing used in Ivy League anthropology course. The Guardian. www.theguardian.com/us-news/2021/apr/22/move-bombing-black-children-bones-philadelphia-princeton-pennsylvaniaGoogle Scholar
Griset, R. (2011, November 15). Transmission of the body snatchers. Style Weekly. www.styleweekly.com/richmond/transmission-of-the-body-snatchers/Content?oid=1633570Google Scholar
Shuster, E. (1997). Fifty years later: The significance of the Nuremberg Code. New England Journal of Medicine, 337(20), 14361440. https://doi.org/10.1056/nejm199711133372006Google Scholar
Levin, M. (2020). “Putrid disorders and dangerous diseases”: Slave ship surgeons’ journals and medicine on the middle passage. Yale Historical Review. www.yalehistoricalreview.org/putrid-disorders-and-dangerous-diseases-slave-ship-surgeons-journals-and-medicine-on-the-middle-passage/Google Scholar
McGregor, D. K. (1990). Sexual surgery and the origins of gynecology: J. Marion Sims, his hospital, and his patients. Taylor & Francis.Google Scholar
Holland, B. (2018, December 4). The ‘Father of Modern Gynecology’ performed shocking experiments on enslaved women. History.com. www.history.com/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slavesGoogle Scholar
Stamatakos, M., Sargedi, C., Stasinou, T., & Kontzoglou, K. (2014). Vesicovaginal fistula: Diagnosis and management. Indian Journal of Surgery, 76(2), 131136. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039689/Google Scholar
South Carolina Public Health Association. (2018). Award Eligibility 2018. www.scpha.com/resources/Documents/2020%20Awards%20Eligibility.pdfGoogle Scholar
Jones, J. H. (1981). Bad blood: The Tuskegee syphilis experiment. Simon and Schuster.Google Scholar
US Centers for Disease Control and Prevention. (n. d.). The Tuskegee timeline. https://www.cdc.gov/tuskegee/timeline.htmGoogle Scholar
TulaneLink.com. (2004, June). Changing people’s minds, Tulane style. www.tulanelink.com/tulanelink/twoviews_04a.htmGoogle Scholar
Adamson, A., & Lipoff, J. (2021, January 4). Penn must cut ties with Dr. Albert Kligman, who conducted unethical human research on Black men. The Philadelphia Inquirer. www.inquirer.com/opinion/commentary/albert-kligman-holmesburg-prison-black-men-retina-a-medical-experiments-20210104.htmlGoogle Scholar
Hornblum, A. M. (1998). Acres of skin: Human experiments at Holmesburg prison. Routledge.Google Scholar
Black Youth Project. (2011, April 8). A hole in my head: A life revealed – the story of Vertus Hardiman. http://blackyouthproject.com/a-hole-in-my-head-a-life-revealed-the-story-of-vertus-hardiman/Google Scholar
Wolfe, A. J. (2010). A shameful system of research. Nature Medicine, 16(6), 633. https://www.nature.com/articles/nm0610-633Google Scholar
Stephens, M. (2002 ). The treatment: The story of those who died in the Cincinnati radiation test. Duke University Press.Google Scholar
Grim, R. (2002). American Mengele: Human radiation experiments. The Brooklyn Rail. https://brooklynrail.org/2002/10/express/american-mengele-human-radiation-experimGoogle Scholar
Skloot, R. (2010). The immortal life of Henrietta Lacks. Broadway Paperbacks.Google Scholar
Witze, A. (2020). Wealthy funder pays reparations for use of stolen cells. Nature, 587(7832), 2021. https://pubmed.ncbi.nlm.nih.gov/33122840/Google Scholar
Gaskill, H. (2022, May 17). Judge weighing motion to dismiss Henrietta Lacks’ family lawsuit against biotech firm. Maryland Matters. www.marylandmatters.org/2022/05/17/judge-weighing-motion-to-dismiss-henrietta-lacks-family-lawsuit-against-biotech-firm/Google Scholar
Buchanan, D. R., & Miller, F. G. (2006). Justice and fairness in the Kennedy Krieger Institute lead paint study: The ethics of public health research on less expensive, less effective interventions. American Journal of Public Health, 96(5), 781787. https://doi.org/10.2105/AJPH.2005.063719Google Scholar
Facing History & Ourselves. (2015). The Origins of eugenics. www.facinghistory.org/resource-library/origins-eugenicsGoogle Scholar
Gillham, N. W. (2001). Sir Francis Galton and the birth of eugenics. Annual Review of Genetics, 35, 83101. https://doi.org/10.1146/annurev.genet.35.102401.090055Google Scholar
Bouche, T., & Rivard, L. (2014, September 18). America’s hidden history: The Eugenics Movement. Scitable by Nature Education. www.nature.com/scitable/forums/genetics-generation/america-s-hidden-history-the-eugenics-movement-123919444/Google Scholar
Singleton, M. M. (2014). The ‘science’ of eugenics: America’s moral detour. Journal of American Physicians and Surgeons, 19(4), 122126. www.jpands.org/vol19no4/singleton.pdfGoogle Scholar
Pearce, J. (2020, October 28). Mississippi appendectomies: Reliving our pro-eugenics past. Ms Magazine. https://msmagazine.com/2020/10/28/ice-immigration-mississippi-appendectomies-usa-eugenics-forced-coerced-sterilization/Google Scholar
Villarosa, L. (2022). The long shadow of eugenics in America. New York Times. https://www.nytimes.com/2022/06/08/magazine/eugenics-movement-america.htmlGoogle Scholar
Rose, J. (2011, December 28). A brutal chapter in North Carolina’s eugenics past. National Public Radio. www.npr.org/2011/12/28/144375339/a-brutal-chapter-in-north-carolinas-eugenics-pastGoogle Scholar
Stern, A. M. (2020, August 26). Forced sterilization policies in the US targeted minorities and those with disabilities – and lasted into the 21st century. The Conversation. https://theconversation.com/forced-sterilization-policies-in-the-us-targeted-minorities-and-those-with-disabilities-and-lasted-into-the-21st-century-143144Google Scholar
Southern Poverty Law Center. (1973). Relf v. Weinberger. www.splcenter.org/seeking-justice/case-docket/relf-v-weinbergerGoogle Scholar
Naftulin, J. (2020, November 24). Inside the hidden campaign to forcibly sterilize thousands of inmates in California women’s prisons. Insider. www.insider.com/inside-forced-sterilizations-california-womens-prisons-documentary-2020-11Google Scholar
Campoamor, D. (2020, September 16). Mass hysterectomies’ at ICE happened on Trump’s watch. But they’re America’s problem. NBC News. www.nbcnews.com/think/opinion/mass-hysterectomies-ice-happened-trump-s-watch-they-re-america-ncna1240238Google Scholar
Lennard, N. (2020, September 17). The long, disgraceful history of American attacks on Brown and Black women’s reproductive systems. The Intercept. https://theintercept.com/2020/09/17/forced-sterilization-ice-us-history/Google Scholar
Burrell, D. E. (1994). The Norplant solution: Norplant and the control of African-American motherhood. UCLA Women’s Law Journal, 5(2), 401–402 https://escholarship.org/content/qt9861n279/qt9861n279.pdfGoogle Scholar
Portner, J. (1992, December 16). Baltimore plan to offer Norplant raises ethical, medical, legal questions. Education Week. www.edweek.org/education/baltimore-plan-to-offer-norplant-raises-ethical-medical-legal-questions/1992/12Google Scholar
Wingert, P. (1993, February 14). The Norplant debate. Newsweek. www.newsweek.com/norplant-debate-195258Google Scholar
Horvath, A. (n. d.). Frederick Osborn: “Birth control and abortion are turning out to be great eugenic advances.” Eugenics.US. https://www.azquotes.com/quote/1068479Google Scholar
Poverty and Norplant. (1990, December 12). The Philadelphia Inquirer. www.newspapers.com/clip/24246037/the-philadelphia-inquirer/Google Scholar
Payne, C., & Fanarjian, N. (2014). Seeking causes for race-related disparities in contraceptive use. AMA Journal of Ethics, 16(10), 805809. https://journalofethics.ama-assn.org/article/seeking-causes-race-related-disparities-contraceptive-use/2014-10Google Scholar

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