The circuitous route to recognizing February as Black History Month ended in 1976, when President Gerald Ford made it official. Maintaining this celebration has become more important, and more necessary, every year. As Lonnie G. Bunch III, secretary of the Smithsonian Institution, has said, “There is no more powerful force than a people steeped in their history. And there is no higher cause than honoring our struggle and ancestors by remembering.”
Black health and wellness
This year’s theme for Black History Month, Black health and wellness, acknowledges the history of racial disparities in the American healthcare system, along with their negative outcomes. But it also honors the legacy of Black scholars and medical professionals, and their contributions to Western medicine. Black health and wellness cannot be fully embraced without a nod to the birthworkers, naturalists, herbalists, activities and rituals throughout the African diaspora that have contributed to Black wellness.
The root of the problem in the healthcare landscape goes back centuries, beginning with slavery, when little to no medical care was available to those held as slaves. To survive, Black folk remedies, passed down through the generations with African origins, were employed to treat everything from the common cold to skin injuries and malaria. Some of these practices employed plant-based remedies, many of which are still used today, such as aloe vera for burns, salicylic acid for pain, and kaolin, as in Kaopectate. Medical procedures performed in Africa before they were practiced in Europe include vaccination, autopsy, limb traction, broken bone setting, and even brain surgery. These ancient cultures were also familiar with ensuring antiseptic conditions when required, while the Western world was only beginning to understand the importance of medical hygiene.
Traditional cures and methods were all the more valued since during the Jim Crow era, “whites only” hospitals were common, and medical facilities for Blacks were often understaffed and underfunded. As a result, Blacks were more likely to suffer from treatable conditions like diabetes and high blood pressure. Infant and mother mortality rates became disproportionately higher and life expectancy became shorter than for other groups. In fact, only last July the Chicago Sun-Times reported that Black Chicagoans are expected to live nine years less than everyone else in the city. This gap has widened due to “chronic diseases, homicide, infant mortality, opioid overdoses and HIV, flu or other infections.”
And yet, despite these disadvantages, people of color have helped shape the development of significant medical treatments and the advancement of the medical professions from doctors and nurses to teachers and scientists. Here are just a few of the standouts who’ve changed the face of medicine in America.
Mary Eliza Mahoney (1845–1926)
Mary Eliza Mahoney was the first Black professional nurse in America and an active organizer among African American nurses.
Charles Drew (1904–1950)
Charles Richard Drew was a physician, researcher, and surgeon who revolutionized our understanding of blood plasma. His work allowed blood storage for transfusions that saved thousands of lives during World War II alone.
Daniel Hale Williams (1856–1931)
The son of a barber, Daniel Hale Williams founded the first black-owned hospital in America and performed the world’s first successful heart surgery, in 1893.
Rebecca Lee Crumpler (1831–1895)
In 1864, after years as a nurse, Rebecca Lee Crumpler became the first black woman in the United States to receive an MD degree. She earned that distinction at the New England Female Medical College in Boston, Massachusetts—where she also was the institution’s only black graduate.
James McCune Smith (1813–1865)
In 1837, James McCune Smith became the first Black American to receive a medical degree—although he had to get it from the University of Glasgow Medical School because of the racist admissions practices in the U.S. He was also the first Black person to own and operate a pharmacy in the United States, and the first Black physician to be published in U.S. medical journals.
Leonidas Harris Berry (1902–1995)
Berry was the first Black doctor on staff at the Michael Reese Hospital in Chicago in 1946 but had to fight for an attending position there. He was finally named to the attending staff in 1963 and remained a senior attending physician for the rest of his medical career.
Charles Richard Drew (1904–1950)
Despite his fame for work in blood preservation, Drew’s passion was surgery, and he was appointed chairman of the department of surgery and chief of surgery at Freedmen’s Hospital (now known as Howard University Hospital) in Washington, D.C.
Marilyn Hughes Gaston (b. 1939)
Gaston was deputy branch chief of the Sickle Cell Disease Branch at the National Institutes of Health, and her groundbreaking research led to a national sickle cell disease screening program for newborns.
Alexa Irene Canady (b. 1950)
In 1981, Alexa Irene Canady, MD, became the first Black neurosurgeon in the United States, and just a few years later, she rose to the rank of chief of neurosurgery at Children’s Hospital of Michigan.
Regina Marcia Benjamin (b. 1956)
Regina Marcia Benjamin, MD, MBA, served as the 18th U.S. Surgeon General, during which time she served as the first chair of the National Prevention Council.
Improved access to healthcare took a while
It wasn’t until 1964, with the passage of the Civil Rights Act, that Black Americans were finally given a shot at better healthcare. That’s when the U.S. government threatened to withhold Medicare payments to “whites only” medical institutions and hospitals were desegregated.
More than 40 years later, the Obama administration was able to push through the Affordable Care Act (ACA), which improved health insurance options for all Americans. Still, as of 2020, 8.6% of all Americans, or 28 million people, had no healthcare coverage, indicating considerable room for improvement, with health insurance remaining out of reach for many.
Compared to our counterparts, the U.S. continues to lag behind the rest of the industrialized world in providing affordable medical care for its citizens. African Americans, other minorities, and especially the poor remain among the country’s most vulnerable populations.
Along with a history of unequal access to healthcare in the U.S., Black populations have long suffered from disparate educational and economic opportunities and, therefore, often live in low-income neighborhoods. Many times, the medical facilities available in those areas don’t maintain the quality standards of their wealthier counterparts. These residents will often go to community health centers or emergency rooms for routine care because of the lack of local primary healthcare providers.
To make matters worse, low-income areas often lack sufficient access to public transportation. Traveling outside of the immediate geographic area to access healthcare may be an option for some people, but it’s a challenge for those with limited incomes. As of January 2022, there were 87 million people living in areas underserved by primary care, and 139 million in areas underserved by mental healthcare, as identified by the Health Professional Shortage Areas.
Affordable housing–a step toward achieving healthcare equality
Affordable housing is defined as housing that consumes no more than 30% of a household’s income. Almost half of this country’s renting households, 43 million of them, spend more than 30% of their income on housing. Some of them spend more than half their income on housing.
What that means is these households don’t have enough remaining for adequate food, transportation, healthcare, and other expenses that maintain social stability. There are many reasons for this housing scarcity, from local zoning laws to the unequal distribution of wealth and the shrinking American middle class. According to Pew Research, the share of American adults who live in middle-income households has decreased from 61% in 1971 to 51% in 2019.”
Discriminatory housing practices, such as redlining and certain local zoning laws, combined with an ongoing economic imbalance, has left Blacks living in some of the least desirable and under-resourced communities in the U.S. Poverty among Black populations remains high and tends to be concentrated. According to the Economic Policy Institute, 45% of children from low-income Black households live in areas with concentrated poverty and experience poor performance in school, decreasing their chances of upward mobility.
The overall result is a negative impact on our communities.
Turning obstacles into opportunities
What can be done to stem the crisis and motivate the development of affordable housing? To help clear up any misconceptions, affordable housing in this sense is safe, high quality, comfortable housing available to those with a household income at or below the local median. All that means, of course, is that the definition can change, largely by geography.
Now, consider the many people who contribute to thriving communities. You’ll find all different sorts of professionals, business owners, teachers, tradespeople, restaurant and retail employees, government workers, and so on. A thriving community makes a place and provides a home for everyone. And this is where all enterprises, like medical facilities, want to be.
Overcoming obstacles to the development of adequate affordable housing requires a combination of policy changes—many tax-related—and updates to local land-use regulations. Developers need economic motivation to invest in the making of more of these units. The Biden administration offers resources in the 2022 Budget Resolution, providing a good place to start. Most of this work is focused on increasing supply by making more funds available to developers.
This commitment by the current administration is important and will most likely lead to an increased supply. But more work needs to be done. Legislators at every level need to understand how economic vitality stems from providing quality housing for all members of a community. Resistance to higher-density construction, an issue in a lot of neighborhoods, needs to be addressed. And we need to consider how to stem the widening wealth gap and provide more economic opportunities for all.
It’s a challenge! But think about what we can gain. With the Census Bureau reporting the median household income for Black households as the lowest compared to their white, Hispanic, and Asian counterparts, imagine the difference a gain in the availability of affordable housing could make in achieving racial equity. The current shortage of about 7 million rental units is a gap unlikely to be filled any time soon, but if every jurisdiction in every state fulfills its part, with ongoing support at the federal level, we can stem the tide and begin to help meet this growing need.