Monday, February 21, 2011

Sick and Tired of Being Sick and Tired

 Susan L. Smith, Sick and Tired of Being Sick and Tired : Black Women’s Health Activism in America, 1890-1950, Philadelphia, University of Pennsylvania Press,1995.

As the subtitle of this book implies, it is about the role of black women in black health care.  The time period under consideration, 1890-1950, was a time of legalized segregation, but it was also a time when the American welfare state was expanding.  Unfortunately those benefits generally did not cross the color line.  In response to this, and as part of the political agenda for black rights and equal access to government resources, black activists attempted to draw attention to black health issues.

The creation of a black health movement began as a private crusade instituted primarily by black club women.  These women constructed the infrastructure of their communities through their work in religious and secular groups, groups that included not only church associations, but also female auxiliaries and women’s clubs.  These clubs started day nurseries and kindergartens.  They opened working girls’ homes in the North and the Midwest to help young black migrants from the South with housing, employment information, and moral instruction.  But because segregation and racism prevented African Americans from getting even the most basic health care, these clubs focused most of their interest on public health work.  Despite personnel and monetary limitations, they provided health education and some basic health services to impoverished communities and in Atlanta and Chicago they tried to provide African Americans with the same basic urban amenities that white communities received as a matter of course via tax-supported city services.

In 1915 these reform efforts became part of a national black health movement when Booker T. Washington launched a health education campaign from the Tuskegee Institute in Alabama.  This campaign, known as National Negro Health Week, was seen by black leaders and community organizers as a way for advancing the race through the promotion of black health education and cooperation across racial lines.  The Tuskegee Institute served as the headquarters for the campaign until it was taken over in 1930 by the United States Public Health Service (USPHS) and turned into a year-round program.

In the 1930s the statistical information now available revealed the plight of black Americans in the form of higher mortality and morbidity rates as compared to the white population.  Growing awareness of the problem among health officials did not necessarily lead to better health treatment for blacks, but rather led white officials to blame the African Americans themselves for their illness by saying that it was due to their behavior and, in the case of venereal disease, to their sexual immorality and promiscuity.  In response to these accusations, the black leaders responded with the statement that a population was only as healthy as its sickest members and called for an end to racist practices and the integration of health services, seeing these measures as the only real solution for the health issues facing black Americans.

By the 1940s the medical civil rights movement arose as black health workers struggled to integrate hospitals and medical and nursing schools and associations.  The effort was met by resistance within both the white and black communities.  But in 1950 the USPHS pronounced the end of the National Negro Health Movement and the Office of Negro Health Work on the grounds that the nation was moving towards integration.

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