This guest post is by Dr. Danielle Laraque-Arena, the 2019 Scholar in Residence at the New York Academy of Medicine. She is the tenured Professor of Pediatrics, Psychiatric & Behavioral Sciences, Public Health & Preventive Medicine at SUNY Upstate Medical University (UMU), the Former President of UMU, and moderated the Race & Health Series event, “How Long Will We Wait? The Desegregation of American Hospitals” on July 10, 2019.
The Race & Health Series, a powerful series of presentations, was initiated early this year, envisioning a more just society, reviewing key lessons of the past, evaluating current status of health equity, and engaging in robust dialogue with the community on the social, economic, and systemic issues that keep all people from enjoying a healthy life. The first presentation in this series reviewed the history of the Tuskegee Syphilis Study and posed the question of whether Tuskegee could happen again. The second presentation, “How Long Will We Wait? The Desegregation of American Hospitals,” was prefaced by a showing of the documentary film, Power to Heal: Medicare and the Civil Rights Revolution, followed by a community-engaged discussion of the implications of the film for our current-day realities.
Barbara Berney, Ph.D., M.P.H. produced the documentary film. Dr. Berney, a distinguished scholar in public health, environmental justice and the US healthcare system, joined us from the shores of California. Barbara was joined by Professor Adam Biggs, an American historian from the University of South Carolina. The two scholars spoke to the diverse audience of about 300 people from the Harlem area, New York City, and New York State at large. They took us on a historical journey of the deeply segregated United States of the Jim Crow period. Their focus was on recounting the impact of Jim Crow state and local laws that dictated every aspect of life for black Americans following Reconstruction. During this period, segregation was mandated in all public facilities such as restrooms, restaurants, hotels/motels, schools, and hospitals. Professor Biggs highlighted the period from 1919–1935, focusing on the desegregation of Harlem Hospital. The audience, many of whom work or have worked at Harlem Hospital, were on the edge of their seats for this important discussion.
The background analysis of the Jim Crow period led to a focused discussion regarding the segregation of American hospitals and the dire conditions of health care for black Americans. The response from black physicians, the formation of the National Medical Association, the advocacy efforts of the NAACP, and the force of the conviction of people of conscience throughout the United States led to the partnering of the American government under John F. Kennedy and then Lyndon B. Johnson with activists, to begin to transform the landscape of American life and politics. The palpable national tone of the bitter struggles of the Civil Rights movement—with activities such as voter registration in the southern states that often led to the murders of civil rights activists—was ever real for many who in the audience had lived through those dark days.
In fact, among the attendees were individuals such as Phyllis Cunningham and Roger Platt, both of whose efforts were shared in the film. I had the honor of working with both Phyllis (nurse, activist) and Roger (internist, hospital inspector) during my 24 years in the Harlem area, but had renewed respect when I witnessed—as demonstrated in the film—their immense courage during the dangerous times of the 60’s. Others featured in the film included David Satcher, M.D., Ph.D., former U. S. Surgeon General. I had the pleasure of speaking with Dr. Satcher a number of times. He spoke of the achievements of the Civil Rights movement, the passage of Medicare, and the continued aspiration for universal access for all: recognizing that health care is a right and not a privilege.
The film also reviewed the passage of the Civil Rights Act of 1964 and of Medicare in 1965. The intersection of these two landmark events leveraged their collective impact to amplify the message that health care is a human right. At the time of the passage of the Medicare legislation, the persistence of the “separate but equal” effect of Hill-Burton Act, providing for hospital construction, was alive. As Johnson noted, a hammer was needed to propel the desegregation of hospitals, and this was done by having the receipt of federal dollars in support of the care of the elderly be contingent upon desegregation of hospital services. The key lesson was that incremental progress, as had been imperfectly done in education, would not yield the fundamental results needed in health care. Civil rights were to be baked into the administrative process. Desegregation occurred through the brute application of the principle “follow the money.”
The two-hour session engaged questions from the audience. Individuals lined up to ask the obvious: How do we learn from the courage of those who achieved so much in the past decades? Does such courage exist today? What was the effect of desegregation on the elimination of health disparities—and by implication, is desegregation sufficient? The importance of history, the importance of courage under fire, and the lifelong commitment to social justice and health justice was clear from the engagement of the audience and the resounding voices of our distinguished panel.
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