The National Negro Health Movement and the Fight to Control Public Health Policy in the African American Community, 1915-1950

ENTHRONING HEALTH: THE NATIONAL NEGRO HEALTH MOVEMENT AND THE FIGHT TO CONTROL PUBLIC HEALTH POLICY IN THE AFRICAN AMERICAN COMMUNITY, 1915-1950 A Dissertation Submitted to the Temple University Graduate Board In Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY by Paul Alexander Braff Diploma Date December 2020 Examining Committee Members: Dr. Bettye Collier-Thomas, Advisory Chair, History Dr. Bryant Simon, History Dr. Lila Berman, History Dr. James Downs, External Reader, Gettysburg College ii © Copyright 2020 by Paul Braff ________________ All Rights Reserved iii ABSTRACT In the early 1900s, African Americans died at higher rates, got sick more often, and had worse health outcomes for almost all diseases when compared to whites. This disparity was due to a combination of racism, discrimination, and segregation. Most blacks could only afford to live in unhealthy conditions and had little or no access to medical professionals. Problematically, poor black health led many whites to think of blacks as being inherently diseased, promoting the segregation and discrimination that contributed to black ill health in the first place. This project examines Negro Health Week (NNHW), which became National Negro Health Week (NNHW), a public health campaign designed by African Americans as a systematic effort to improve their health that lasted between 1915 and 1950. The dissertation reveals the strategies African Americans used to empower themselves to combat ill health and the ways medical ideas became accessible to blacks. The racism of the white medical establishment limited the ability of African Americans to enter the medical profession. The small number of black doctors and nurses meant that NHW had to rely on non-medical professionals to teach health practices. Originally begun as a local campaign in Savannah, Booker T. Washington adopted Negro Health Week as a program to teach formerly enslaved blacks in Tuskegee, Alabama how to live. Working as sharecroppers and living in the small cabins they had inhabited as enslaved people, the majority of blacks lived in squalor. Margaret Murray Washington, who co-founded the National Association of Colored Women in 1896, laid the iv groundwork for NHW at Tuskegee. During her tenure as Lady Principal of Tuskegee, she created the Tuskegee Woman’s Club and brought together local organizations and women’s clubs to work with women in improving their homes by providing advice on basic hygiene and sanitation that they could implement with little cost. Booker T. Washington coopted the TWC program and brought Monroe Work from Savannah to Tuskegee to head up a more ambitious program which he envisioned expanding throughout the rural South. In 1900 Washington founded the National Negro Business League (NNBL) which included key black business men from throughout the nation, especially the South. The NNBL was instrumental in helping Washington to expand and publicize Negro Health Week. Under the leadership of Booker T. Washington and his successor, Robert Moton, NHW continued to focus on providing advice on basic hygiene and sanitation in one’s home and neighborhood. The emphasis on low-cost individual health practices, such as basic privy sanitation or proper whitewash technique, gave African Americans the ability to take ownership of their health. The Week explained how blacks could improve their health and that of the community even without medical professionals. After Booker T. Washington’s death in 1915, Moton succeeded in getting the support of the national Public Health Service (PHS) and National Negro Health Week came into existence in 1921. The Service’s vast network of health professionals and connections with state and local health departments allowed the campaign to expand out of the South. However, with the involvement of the PHS, the Week began to change. As hygiene practices became more accepted, the Service reframed NNHW to focus on vaccinations and regular physician and dentist visits. As medical professionals became NNHW v leaders, the campaign’s message transformed from emphasizing how individuals could improve health on their own to describing how much people needed physicians to obtain good health. Under the PHS, lay people could do little to improve their health. Instead, they had to rely on the medical profession. The PHS used NNHW to reposition the medical establishment as the ultimate arbiter of African American health. Today, there is still a wide racial disparity in participation in, and access to, public health, and indeed in health outcomes in the United States. Understanding the Week can better position scholars and public health officials to understand how race and health intersect and the ramifications of health policies on race relations. vi To my parents and to Kaitlyn, Maya, and Elias vii ACKNOWLEDGEMENTS As a people person, I found the isolation of archival research and writing particularly challenging. I would not have made it to the finish without the support of everyone who pushed me to succeed. The Temple University History Department’s faculty and graduate students encouraged me and were helpful in thinking through and around my work. My research was generously supported by the Consortium for History of Science, Technology and Medicine, and Temple University’s College of Liberal Arts. A special thank you also goes to the Society for the Social History of Medicine and the National Science Foundation for supporting travel to several conferences where I presented my work and received valuable feedback. My committee members were kind and hands-off, allowing me to work on my own schedule. I would like to thank my original advisor, Kenneth Kusmer, for helping guide me through this complicated and at times frustrating process, and Bettye Collier-Thomas for aiding me the rest of the way. James Downs was also instrumental in providing me useful and timely feedback and encouraging me when times seemed bleak. My family has always been there for me and has supported my love of history for as long as I can remember. I will always cherish your positivity and can do spirit, and will seek to instill it in the next generation. To my daughter Maya, who came just within the last two years, thanks for sleeping through the night from an early age. Dada really appreciates it and it was very helpful. Same thing goes for you too Elias during the final stages of revisions! Finally, my wife Kaitlyn has borne the brunt of my worries, need for complete silence while writing, and long writing days where I would not talk to a soul until she came home in the evening to a tired husband with a great deal viii to say about everything, so excited was he to talk to another human being! Thank you for your love, your support too, but especially your love. I feel so lucky that I get to see you and be with you each and every day. ix TABLE OF CONTENTS Page ABSTRACT…………………...…………………………………………………...…… iii DEDICATION..………………………………………………………………………… vi ACKNOWLEDGMENTS…………………………………………………………....… vii LIST OF FIGURES…………………………………………………………………....… x CHAPTER 1. INTRODUCTION .........................................................................................................1 2. WHAT DOESN’T KILL YOU DOESN’T NECESSARILY MAKE YOU STRONGER: THE STATE OF, AND PERCEPTIONS ABOUT, AFRICAN AMERICAN HEALTH, 1890-1914 ............................................................................38 3. IN THE BEGINNING: NEGRO HEALTH WEEK, 1915-1919...............................105 4. THE PRICE OF POPULARITY?: NATIONAL NEGRO HEALTH WEEK AND THE EXPANDING ROLE OF THE MEDICAL ESTABLISHMENT, 1920-1930 ..................................................................................................................204 5. THE LEADERSHIP OF THE PUBLIC HEALTH SERVICE: IT’S NOT ABOUT CLEANING UP ANYMORE, 1931-1941 ..................................................296 6. THE DEATH OF THE MOVEMENT: TIMELY OR UNTIMELY? 1942- 1950………………………………………………………………………................369 7. CONCLUSION ..........................................................................................................436 BIBLIOGRAPHY ............................................................................................................447 x LIST OF FIGURES Page FIGURE 1. 1927 NNHW BULLETIN COVER ...........................................................................259 2. 1929 NNHW POSTER ..............................................................................................260 3. 1929 NNHW BULLETIN COVER ...........................................................................260 4. PAGE 12 OF THE 1932 NNHW BULLETIN ..........................................................304 5. 1936 NNHW BULLETIN..........................................................................................350 6. 1941 NNHW BULLETIN COVER ...........................................................................366 7. BACK COVER OF THE 1948 NNHW BULLETIN ................................................401 1 CHAPTER 1 INTRODUCTION On July 7, 2008, the American Medical Association (AMA), the largest association of medical physicians and students in the United States, issued a press release apologizing for “its past history of racial inequality toward African-American physicians.”1 A panel of independent scholars prompted this apology when they found that from the AMA’s inception in 1847 until 1968, the Association supported “many state and local medical societies [that] openly discriminated against black physicians, barring them from

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