M.Mcbride Thesis

UNIVERSITY OF CINCINNATI

Date:November 16, 2004

I, Michelle McBride , hereby submit this work as part of the requirements for the degree of: Master of Science, Health Planning and Administration in:

School of Planning, College of Design, Architecture, Art and Planning It is entitled: African Americans and the Journal of the Outdoor Life: A Content Analysis of Volumes 10-20, January 1913-December 1923

This work and its defense approved by:

Chair: Jan M. Fritz, Ph.D.

Christopher Auffrey, Ph.D.

AFRICAN AMERICANS AND THE JOURNAL OF THE OUTDOOR LIFE: A CONTENT ANALYSIS OF VOLUMES 10-20, JANUARY 1913-DECEMBER 1923

A thesis submitted to the

Division of Research and Advanced Studies

of the University of Cincinnati

in fulfillment of the requirements for the degree of

MASTER OF SCIENCE

in the School of Planning of the College of Design, Architecture, Art and Planning

2004

Michelle L. McBride, B.A. University of Cincinnati 1994

Committee Chair: Jan M. Fritz, Ph.D.

Christopher Auffrey, Ph.D. 1

ABSTRACT

This content analysis reviews volumes 10-20 (1913-1923) of the Journal of the

Outdoor Life, a historical health journal targeted toward tuberculosis patients in the early twentieth century. Feature articles were researched citing references to African

Americans.

It was known that there was a much higher infection rate of tuberculosis among

African Americans during the period of time in which the researched journals were published. However, few references to African Americans were identified through this content analysis. The number of articles found with references to African Americans was conversely proportionate to the high tuberculosis infection rate among African Americans during the early twentieth century.

Articles with references to African Americans were further reviewed and classified by their type, focus and tone. The type classification of articles with found references was predominately “informational” as opposed to “educational” or “personal viewpoint” and the tone was classified primarily as “positive” rather than “negative” or

“neutral”.

African Americans were the focus of the content in only a third of the articles found to have references. This leads one to question what impact these articles had on society at the time, and perhaps more importantly, what impact they could have had in decreasing the mortality rate among African Americans in the early twentieth century.

TABLE OF CONTENTS

TABLES AND GRAPHS………………………………………………………………...4

CHAPTER 1 INTRODUCTION………………………………………………………………...5

CHAPTER 2 STATEMENT OF THE PROBLEM…………………………………………….10

CHAPTER 3 METHODOLOGY………………………………………………………………19

CHAPTER 4 DATA……………………………………………………………………………23

CHAPTER 5 ANALYSIS………………………………………………………………………34 Representation of Articles with References to African Americans………………………………………………………………..34 Frequency of Articles with References to African Americans…………. 36 Summary of Type, Focus and Tone…………………………..………….37 Pictorial References to African Americans………………………………38

CHAPTER 6 CONCLUSION…………………………………………………………………..40

REFERENCES…………………………………………………………………………..44

TABLES

Table 1: Volume 10, 1913, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 23

Table 2: Volume 11, 1914, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 24

Table 3: Volume 12, 1915, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 24

Table 4: Volume 13, 1916, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 25

Table 5: Volume 14, 1917, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 25

Table 6: Volume 15, 1918, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 26

Table 7: Volume 16, 1919, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 26

Table 8: Volume 17, 1920, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 27

Table 9: Volume 18, 1921, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 27

Table 10 : Volume 19, 1922, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 28

Table 11: Volume 20, 1923, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue...... 28

Table 13: Feature articles with references to African Americans, Volumes 10-14 Journal of the Outdoor Life, January 1913 through December 1917: Title, length, author’s name, author’s location and author’s race by article...... 30

Table 14: Feature articles with references to African Americans, Volumes 15-20 Journal of the Outdoor Life, January 1918 through December 1923: Title, length, author’s name, author’s location and author’s race by article...... 31

Table 15: Feature articles with references to African Americans, Volumes 10-14 Journal of the Outdoor Life, January 1913 through December 1917: Type, focus, tone and pictorial reference by article...... 32

Table 16: Feature articles with references to African Americans, Volumes 15-20 Journal of the Outdoor Life, January 1918 through January 1923: Type, focus, tone and pictorial reference by article ...... 33

Table 17: Summary of Type in 37 Articles With References to African Americans...... 37

Table 18: Summary of Tone in 37 Articles Found With References to African Americans ...... 37

GRAPHS

Graph 1: Feature Articles with References to African Americans vs. Total Feature Articles...... 34

Graph 2: Pages in Feature Articles With References to African Americans vs. Total Pages in Volumes 10-20 ...... 35

Graph 3: Frequency of Publication of Articles With Reference to African Americans by Year...... 36

CHAPTER 1

INTRODUCTION

The purpose of this research is to analyze the content of all feature articles that appeared in the Journal of the Outdoor Life, between January 1913 and December 1923, for references to African Americans. All issues published between 1913 and 1923 can be found in volumes 10-20, with 12 monthly issues bound in each annual volume.

The Journal of the Outdoor Life was a monthly publication that evolved from an earlier journal titled The Outdoor Life. The Outdoor Life was published from 1904-1905

(Shyrock, 1957: 162-63). The Outdoor Life became the Journal of the Outdoor Life in

1905, and was made an official publication of the National Tuberculosis Association in

1906. The purpose of the journal was to “be helpful to persons seeking health by an outdoor life, and to disseminate reliable information looking to the prevention and cure of tuberculosis” (Knopf, 1922: 15).

In the early nineteenth century, many individuals believed spending time outdoors, particularly at high elevations, promoted a healthy lifestyle and could even help cure tuberculosis. This belief was supported by the fact that elevation increased heart and lung action, allowing pure, aseptic oxygen to penetrate deeper in the lungs and aid in healing (Ott, 1996: 40). The association between an outdoor lifestyle and health benefits led to the entitlement of the American tuberculosis journal as the Journal of the Outdoor

Life. In his book documenting the fight against tuberculosis, Mark Caldwell (1988: 48) notes,

the name of the National Tuberculosis Association’s popular magazine, the Journal of the Outdoor Life, conveys the idea that the sanatorium (facilities established for the treatment of patients with tuberculosis as well as other communicable

diseases) was not just a hospital but a community, a microcosm among the sick of the world of the well.

For the purposes of this research, feature articles are defined as individually titled entries, excluding poems, located in the primary section of the journal. Other sections of the journal, not included in this research, include games and activity pages, summaries of current events in cities and states and advertisements.

This research is concentrated on references to African Americans in a health journal. “African American” refers to an individual having origins in any of the black racial groups of Africa (Office of Minority Health, 2003). African Americans were considered a minority race in the United States at the time period during which the researched issues of the Journal of the Outdoor Life were published. African Americans still are a minority in the United States (Office of Minority Health, 2003). In his book, A

Documentary History of the Negro People in the United States, Herbert Aptheker (1951:

828) notes that, “In 1900 there were 8,800,000 Negroes in the United States.” At that time, African Americans represented roughly 11.5% percent of the total population, which was just over 76,000,000 individuals (United States Census, 2004).

The researcher reviewed the Journal of the Outdoor Life, looking for references to

African Americans in feature articles. At the time that the Journal of the Outdoor Life was published, African Americans were often referred to as “negro” or “colored”. These terms, and derivatives of these terms, will be used in the identification of references to

African Americans. Additional adjectives that were used to identify references to

African Americans include the words: race, racial and minority.

The higher prevalence of tuberculosis among African Americans was documented as early as 1896 in studies such as Race Traits and Tendencies of the American Negro by

Frederick Hoffman. In this volume, Hoffman noted that there was “high tuberculosis mortality” among African Americans (Keiger, 1998: 7).

A content analysis was used to review the feature articles (January 1913 and

December 1923) of the Journal of the Outdoor Life. For the purpose of this content analysis, the articles within the journal serve as the units of analysis. The primary concern was the manifest content, which was classified and coded, analyzing references to African Americans. The researcher has a general interest in studying social trends in health and wanted to determine whether or not the content of the Journal of Outdoor Life appropriately recognized and addressed a known greater prevalence of tuberculosis among African Americans. The researcher was also interested in the significance this information may hold as it is applied toward the treatment of similar health issues today.

This research is the first step in answering these questions.

One hundred and twenty issues of the journal were reviewed for this content analysis. References to African Americans were recorded, charting article frequency against the total number of feature articles published by issue during the decade included in this research. The article type was classified as informational, educational or personal viewpoint. The tone was classified as negative, objective or neutral. The appearance and frequency of pictures within feature articles was also recorded.

This is the first known content analysis of the Journal of the Outdoor Life. The review of this publication for reference to African Americans proves helpful in identifying historical trends in the establishment of health publications and organizations while also providing insight into the treatment of health issues that are known to affect

9 different races at inconsistent rates. This research also contributes to a growing body of knowledge in African American studies.

The thesis chapters include a statement of the problem. The methodology section includes a literature review and content analysis of the 120 issues of the Journal of the

Outdoor Life (published between January 1913 and December 1923). This section also includes an explanation of how relevant articles were identified, followed by the subsequent recording and coding of these articles. The data section describes the findings of the content analysis and the analysis critically reviews these findings. The conclusion summarizes the research included in the content analysis while also presenting suggestions for further research.

CHAPTER 2

STATEMENT OF THE PROBLEM

This section of the thesis introduces the problem. In order to discuss the problem, the following information was reviewed: the historical context of the United States from the late nineteenth century to the early twentieth century, a history of terms used in referencing African Americans, a history of African Americans and health, a history of tuberculosis, the history of the National Tuberculosis Association and the history of the

Journal of the Outdoor Life.

The early 1900s were a period of great transition and growth in the United States in which “the structure of society was changing” (Hraba, 1994: 5). This period in history follows the Civil War, 1861-1865, and the issuance of the Emancipation Proclamation in

1863, which provided freedom for African Americans from slavery in areas of the

Confederacy (History of the United States, 2004). Following the Civil War, “free blacks were treated a little better, but were still considered subhuman” (Debro, 1988: 181). This environment led to “disparities in education, housing, employment, the judicial system, transportation, and health care. African Americans were subjugated to a subordinate status of second class citizenship” (Watts, 2003: 3).

World War I lasted from 1914-1918 and had a great impact on many facets of life in the United States, namely industrialization (History of the United States, 2004). At the start of the twentieth century, during World War I, “the United States also became an industrial nation, and the stream of immigration from other lands began to flow into

American cities” (Hraba, 1994: 5). America had long before been noted as the country where various races had the greatest opportunity to assimilate into one society. In 1782,

J. Hector St. John de Crevecoeur, a French visitor, said of America, “here individuals of all nations are melted into a new race of men, whose labours and posterity will one day cause great changes in the world” (Rabinowitz, 1994: 228-9). Individuals from all over the world came to the United States when, “late in the nineteenth and early in the twentieth centuries, immigration into the United States represented 60 percent of the world’s total immigration” (Hraba, 1994: 8).

Increased immigration and rapid industrialization in the United States led to

“overcrowding, poor diet, long working hours, lack of fresh air, and generally insanitary habits and surroundings” (Shyrock, 1957: 22). Tuberculosis thrived in such environments and, “although the disease affected the entire population during the nineteenth century, after 1900 it was concentrated among poor people, especially immigrants and people of color” (Abel, 1997: 1808). Such conditions left immigrants susceptible to disease and higher rates of mortality as “social circumstances seemed to explain much if not all of the high death rate among these immigrants” (Shyrock, 1957:

22).

During the early twentieth century, African American individuals were referenced by titles and classifications that are no longer generally used. The term

“Negro”, when referring to an individual African American or “Negroes”, when referring to multiple African American individuals were most common during the period of time included in this research (McBride, 1991: 9). The terms “negro” and “negroes” began to be used widely in the nineteenth century and it was toward the end of this century that they were actually adopted as official titles (McBride, 1991: 9). As Sterling Stuckey

(1987: 195), an authority on American culture and race relation notes, African Americans

12 preferred to capitalize “Negro”, regarding the lowercase version of the term as “an insult to their people”. African Americans were also referred to as “colored” as compared to

“white” individuals, especially when noted in health surveys and studies (Stuckey, 1987:

197).

The period of time covered in this research was a period of uncertainty and conflict for African Americans in the United States. African Americans strived during this time period for equality, recognition and inclusion. Such efforts led to the organization of the National Association for the Advancement of Colored People

(NAACP) in 1910 (Meier, 1966: 200). However, such recognition and distinction sometimes led to a greater prevalence of segregation and racial inequity with regard to social opportunities that included income, education and health care (Osofsky, 1967:

215). In fact, the term “segregation” evolved from a label used primarily to refer to the separation of sick people from healthy people before 1890, to become a term more frequently used in the twentieth century to refer to racial separation (Keiger, 1998: 9).

Just as African Americans experienced segregation in society, the availability of health care and devotion of resources to study the epidemiology of disease among

African Americans could also be classified as “segregated” (Keiger, 1998: 9). There was great disparity in the availability of treatment and health care between white and black individuals during the twentieth century (Jones, 1981: 16). The health of African

Americans was much poorer than that of other individuals, as the overall mortality rate for African Americans was almost twice what it was for members of other races

(McBride, 1991:11).

African Americans had limited access to health care and health education. This can be attributed to the fact that, “society restricted the options of black people in virtually all phases of life – education, housing, employment, medical care, and recreation” (Bates, 1992: 289). When medical care was available to African Americans, some individuals were skeptical about the care being offered. According to health researcher, Vanessa Northington Gamble (1997: 1773-74), “Black Americans’ fears about exploitation by the medical profession date back to the antebellum period and the use of salves and free Black people as subjects for dissection and medical experimentation.” Such fears caused many African Americans to become, “negligent in health matters. They usually did not report until they were seriously ill. They were hesitant about accepting hospitalization” (Myers, 1977: 248).

Rather than specifically address health issues among African Americans, physicians occasionally generalized medical symptoms and occurrences by asserting that,

“blacks were medically inferior to whites without offering a plausible medical explanation based on racial differences” (Jones, 1981: 17). The presence of tuberculosis in the African American community is just one example of a medical epidemic that was known to affect African Americans at a greater rate, where the “absence of effective medical care also contributed somewhat to the mortality differential” (Beardsley, 1987:

14).

Tuberculosis is an infectious disease which is spread by the tubercle bacillus, a germ (Myers, 1977: 63). Scientist Robert Koch first isolated the tubercle bacillus which is now known as mycobacterium tuberculosis (Tomes, 2002: 631). This discovery confirmed that tuberculosis was contagious. Germs, such as those linked to tuberculosis,

14 can be spread through the air by way of coughing, talking or sneezing. As this occurs, germs can enter one’s lungs and are usually destroyed by defensive cells. However, in the case of tuberculosis, the tubercle bacilli may multiply and kill the defensive cells leading to infection. This infection usually begins in the lungs, “but other sites in which the disease often occurs include lymph nodes, bones, kidneys, the reproductive system, intestine, skin and central nervous system.” (Collins, Grange, Yates, 1985: 3).

Prior to 1900, tuberculosis was a disease that was about to become an epidemic.

By the early 1900s, tuberculosis was the leading cause of death in the United States

(Wachbroit, 2003: 3) and remained the leading cause of death until the early 1930s

(Wallace and Wallace, 1998: 84). Although tuberculosis is no longer the leading cause of death in the United States, “it seems almost incredible that during this century and the previous one, a single disease, tuberculosis, was responsible for the deaths of approximately a thousand million human beings” (Ryan, 1992: 3).

Individuals of every ethnicity, gender and age were (and are) susceptible to becoming infected with tuberculosis (Caldwell, 1988: 142). Tuberculosis affected

African Americans at a much greater rate than it affected individuals of other ethnicities or backgrounds during the twentieth century (Beardsley, 1987: 13). However, the availability of health care and the amount of attention devoted to the epidemiology of the disease with regard to African Americans did not reflect this known and documented greater rate of infection (Beardsley, 1987: 13-14).

The infection and mortality rate of tuberculosis among African Americans in

1900 was almost three times greater than that of whites (McBride, 1991:11). Yet, the amount of health information specifically referring to African Americans and rates of

15 infection from start of the twentieth century to the mid 1910s is sparse (McBride,

1991:10). Likewise, African Americans infected with tuberculosis generally did not seek care in a timely fashion or could not find medial assistance when sought (Beardsley,

1987: 14). Treatment facilities specializing in tuberculosis care, known as sanatoria, were not widely established for African Americans until the 1920s, which was years after they were made available to other Americans (Beardsley, 1987: 14).

The National Tuberculosis Association was established in 1904 as a means for consolidating the efforts of separate national health care organizations that focused on the treatment and prevention of tuberculosis: the American Congress on Tuberculosis and the

American Congress for the Prevention of Consumption (Knopf, 1922: 22). The name of the association was originally accepted as the National Association for the Study and

Prevention of Tuberculosis, with the National Tuberculosis Association being an acceptable abbreviation in 1919, and in later years, a more widely used title (Knopf,

1922: 29). With the eventual decline of tuberculosis and the need to address other pulmonary illnesses, the National Tuberculosis Association became known in 1968 as the

National Tuberculosis and Respiratory Disease Association, and in 1973 evolved into the

American Lung Association in 1973, as it remains known today (Myers, 1977: 68).

In 1904, the newly established National Association for the Study and Prevention of Tuberculosis had the organization had three objectives. These objectives were: “The study of tuberculosis in all its forms and relations, the dissemination of knowledge about the causes, treatment, and prevention of tuberculosis and the encouragement of the prevention and scientific treatment of tuberculosis” (Knopf, 1922: 29). The first meeting of the National Association for the Study and Prevention of Tuberculosis took place on

June 6, 1904 in a schoolhouse in Atlantic City, New Jersey, at which time Dr. Edward

Livingston Trudeau, a pioneer in the American sanatorium movement, was elected president (Shryock, 1957: 77).

The National Tuberculosis Association relied on the support of state and

“affiliated associations.” Affiliated associations existed when the need for the association’s presence in a state included representation in specific cities in addition to state wide representation. This was the case with the cities of New York City,

Philadelphia and Chicago (Knopf, 1922: 76). Although some of these state and affiliated associations would periodically report specifically on tuberculosis among African

Americans, the National Tuberculosis Association did not dedicate a specific committee to study this topic until 1931, when the Committee on Tuberculosis Among Negroes was established (Shyrock, 1957: 235). Such response was late considering a higher prevalence of tuberculosis among African Americans was reported more than thirty years earlier (McBride, 1991: 11).

The National Tuberculosis Association felt one of the best ways to combat tuberculosis was through education. Publications including information on tuberculosis appeared regularly in vehicles of the American Medical Association, the American Public

Health Association, as well as in the Medico-Legal Journal, a publication of the Medico-

Legal Society of the City of New York (Shyrock, 1957: 70). According to Richard

Harrison Shryock (1957:162), a historian of the National Tuberculosis Association, no less than four European periodicals were devoted entirely to the topic of tuberculosis prior to the establishment of a comparable American health journal. These periodicals

17 were: Tuberculosis (Milan, 1891), Revue de la Tuberculose (Paris, 1893), Tuberculosis

(London, 1901) and Tuberculosis (Leipzig, 1902).

The first American journal dedicated to the topic of tuberculosis was the Journal of Tuberculosis, which was first published in 1899 and was edited by Dr. Carl von Ruck of Asheville, NC (Knopf, 1922: 15). As mentioned earlier, The Outdoor Life, founded by

Dr. Lawrason Brown at the Trudeau Sanatorium in 1904, was the first periodical representing the National Tuberculosis Association (Shyrock, 1957:162). This publication became known as the Journal of the Outdoor Life in February 1905, and it became an official publication of the National Tuberculosis Association in 1906. The

Journal of the Outdoor Life was published for 31 years; publication of this periodical ceased in 1935 (Shyrock, 1957: 163). The Journal of the Outdoor Life gave way, in

1935, to the Bulletin of the National Tuberculosis Association, changing in name to the

American Lung Association Bulletin in 1973 (Myers, 1977: 66).

In addition to the Journal of the Outdoor Life and numerous pamphlets, the

National Tuberculosis Association also regularly published a bulletin that was originally titled Confidential Bulletin in 1908. The purpose of this publication was to convey information specifically to state and local societies of the National Tuberculosis

Association (Shyrock, 1957: 163-64).

While this research covers the period from January 1913 to December 1923, it is of interest to note that tuberculosis rates have increased in recent years and there remains a known association with race and ethnicity. Tuberculosis remains a worldwide public health issue; the International Union Against Tuberculosis estimates there are eight to ten million new cases each year (Taylor, 1986: 280). Tuberculosis mortality rates are greater

18 than that of any other infectious disease as, “twenty million people suffer from the disease, and each year nearly three million people die from TB” (Alvin and Silverstein,

1994: 9).

The number of reported tuberculosis cases in the United States between 1985 and

1993 increased 14% from 22,201 to 25,287 (McCombs, Onorato, McCray and Castro,

728: 1996). It was noted that by the American Lung Association that “African

Americans in 2002 represented 12.9 of the American population, while they accounted for 29 percent of reported tuberculosis cases” (American Lung Association, 2003). The resurgence of tuberculosis and a continued higher infection rate among African

Americans reaffirms the need for public health issues to be addressed in a manner that can transcend ethnicity and relative economic and social inequalities (Moss and Krieger,

1995: 302).

CHAPTER 3

METHODOLOGY

This content analysis includes a review of volumes 10-20 (1913-1923) of the

Journal of the Outdoor Life. Through a content analysis of volumes 10-20 of the journal, representing the middle years of its publication, feature articles with references to African

Americans were identified. These volumes were selected for review as they were all accessible in their entirety at the downtown location of The Public Library of Cincinnati and Hamilton Country. Volumes from earlier or later publication periods of the journal were not all easily available for review.

The Journal of the Outdoor Life was published monthly by the National

Tuberculosis Association from 1906-1935. The National Tuberculosis Association is now known as the American Lung Association (Caldwell, 1988: 48). All issues of the journal for this time period, 120 in total, were reviewed for this content analysis.

Content analysis is a research method that reviews a specific area of literature for special elements, which may or may not be included in its composition (Babbie, 1998:

308). In this case, the researcher reviewed the Journal of the Outdoor Life, looking for references to African Americans in feature articles. At the time that the Journal of the

Outdoor Life was published, African Americans were often referred to as “negroes” or

“colored” (Stuckey, 1987: 197). These terms were used in the identification of references to African Americans as were other adjectives such as race, racial or minority.

Every issue of the journal published from January 1913 to December 1923 was reviewed. The length of each issue, number of feature articles and number of pictures that appeared within feature articles were recorded by volume. Feature articles were read

20 for references to African Americans. If a reference to African Americans was apparent in the title of the article, the piece qualified for further review. If a reference to African

Americans was not apparent in the title, the researcher reviewed the content of the article for the appearance of words such as negro, colored, race, racial or minority. The appearance of such words was cited as a reference to African Americans. Once a reference was identified, either verbal or pictorial, the reference was recorded and the article was photocopied in its entirety for further review. Upon further review, the content of the article and the reference(s) to African Americans were evaluated as to type, focus and tone.

Type refers to the subject matter of the article. The type of each article was classified as education, information or personal viewpoint. For example, an article could be aimed at tuberculosis prevention within the African American community or society in general. This type of article was classified as an educational piece. An article could be a critical review of tuberculosis rates among African Americans or health statistics in general. This type of article was classified as informational. If the article was not able to be classified as having educational or informational values, it was classified as personal viewpoint, as it was based on personal opinion and/or experiences. It also was noted whether or not African Americans were the focus of the article’s content.

Tone was used to define the author of the article’s attitude toward African

Americans. Tone expresses distance from subject matter. For this analysis, there are three classifications of tone. The article was classified as negative if it was found to express a derogatory attitude toward African Americans. The article was classified as positive if it expressed an attitude that promoted issues and/or was optimistic toward

African Americans. A positive article might have been an advocacy piece. An article was classified as neutral if there was no statement made implying the author’s attitude toward African Americans. When classifying tone, it was necessary for the researcher to review the articles in the context of the period of time in which they were written. Labels such as “negro” and “colored” were commonly used at the time of publication and, because of that, were not viewed as negative references.

A content analysis is useful in identifying trends in the publication of articles in the Journal of the Outdoor Life. However, this analysis cannot reveal the intentions of those who created the journal or the affect that articles within the journal had on those who read them. This kind of analysis does not involve any interviews in connection with the topic and therefore did not need to be reviewed by the Human Subjects Review

Board. A full analysis of this topic would require the use of additional methods of evaluation.

The researcher obtained volumes 10-20 of the Journal of the Outdoor Life from

The Public Library of Cincinnati and Hamilton County. The journal is bound with 12 issues in a volume, each volume representing one calendar year. The researcher reviewed feature articles and pictures in 120 issues of the journal. Information that was recorded for all 120 issues as bound in volumes 10-20 and published between January

1913 and December 1923 included: number of pages, number of feature articles, number of references to African Americans and number of pictures within feature articles. This information was then totaled by volume, providing data necessary for the researcher to analyze frequency and percentage rates for articles with references to African Americans.

Once feature articles with references to African Americans were identified, they were photocopied and reviewed twice, once to record the article’s title, length, author, author’s location and author’s race. The second review of the feature articles was used to classify: type, focus, tone and whether or not the article included pictorial references to

African Americans.

The journal did not vary greatly in content over the years it was published, especially within the decade included in this research. Every journal published between

January 1913 and December 1923 included between 2 and 10 feature articles in the main section of the journal with additional sections following these articles. The additional sections varied slightly, but typically included a section on news from state and affiliated agencies of the National Tuberculosis Association and a section with games, puzzles and/or crafts followed by advertisements.

The researcher has interests in health history and the social patterns that may exist within it that history. The researcher has no association to the American Lung

Association. The researcher is not involved in any programming or fund raising activities that support the treatment or prevention of tuberculosis or other pulmonary diseases.

CHAPTER 4

DATA

In order to tabulate the references to African Americans found in the Journal of the Outdoor Life for volumes 10-20, as published from January 1913 through December

1923, every feature article within these 10 volumes was evaluated by issue.

The following information was recorded for each issue, therefore classifying the information by the month in which it was published: number of pages, number of feature articles, number of references to African Americans and the number of pictures included in feature articles. Tables 1 through 11 provide this data for each issue published from

January 1913 through December 1923 by year. Each table represents one complete year or volume of the Journal of the Outdoor Life. Information is listed by issue or month, with 12 months being evaluated within each volume.

Table 1: Volume 10, 1913, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Americans articles 1 January 34 2 1 11 2 February 34 6 0 6 3 March 34 6 0 13 4 April 34 7 0 1 5 May 35 7 1 5 6 June 33 8 0 4 7 July 34 7 0 2 8 August 34 7 0 1 9 September 34 7 0 12 10 October 34 7 0 9 11 November 34 10 0 8 12 December 34 9 0 5 Total: 408 83 2 77

Table 2: Volume 11, 1914, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue

Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Americans articles 1 January 33 3 0 15 2 February 34 5 0 10 3 March 34 7 0 8 4 April 34 9 0 0 5 May 34 6 0 16 6 June 34 5 0 11 7 July 34 8 0 11 8 August 34 4 0 12 9 September 34 9 1 1 10 October 34 4 0 7 11 November 34 4 0 8 12 December 34 5 0 20 Total: 407 69 1 119

Table 3: Volume 12, 1915, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Ame ricans articles 1 January 33 8 0 10 2 February 34 11 3 5 3 March 34 8 0 6 4 April 34 6 5 8 5 May 34 5 0 6 6 June 36 7 0 10 7 July 36 7 0 1 8 August 36 7 0 10 9 September 36 6 1 4 10 October 34 7 0 6 11 November 34 5 0 19 12 December 33 6 0 3 Total: 414 83 9 88

Table 4: Volume 13, 1916, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue

Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Americans articles 1 January 35 7 0 4 2 February 33 8 0 7 3 March 34 6 0 9 4 April 34 7 1 3 5 May 34 7 0 13 6 June 34 6 0 8 7 July 34 6 0 2 8 August 34 6 1 3 9 September 40 7 0 10 10 October 34 3 0 11 11 November 34 5 0 0 12 December 34 7 0 4 Total: 414 75 2 74

Table 5: Volume 14, 1917, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Americans articles 1 January 33 7 0 0 2 February 32 4 0 2 3 March 33 2 0 15 4 April 34 5 0 4 5 May 34 6 1 14 6 June 34 6 0 6 7 July 34 5 0 2 8 August 34 7 0 3 9 September 34 4 0 17 10 October 34 6 0 4 11 November 34 7 0 0 12 December 34 6 0 1 Total: 404 65 1 68

Table 6: Volume 15, 1918, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Americans articles 1 January 33 5 0 2 2 February 33 5 0 2 3 March 34 4 0 1 4 April 34 5 0 2 5 May 36 6 0 1 6 June 36 5 0 2 7 July 36 5 0 2 8 August 35 6 0 0 9 September 36 3 2 1 10 October 36 7 0 6 11 November 36 6 0 4 12 December 36 6 1 1 Total: 421 63 3 24

Table 7: Volume 16, 1919, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Americans articles 1 January 33 7 0 3 2 February 34 6 0 1 3 March 36 5 0 10 4 April 36 5 0 5 5 May 36 7 3 11 6 June 36 6 0 0 7 July 36 4 0 6 8 August 36 7 2 23 9 September 36 4 0 5 10 October 36 5 1 9 11 November 34 5 1 0 12 December 33 4 0 0 Total: 422 65 7 73

Table 8: Volume 17, 1920, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue Issue Date Number of Number of Number of Number of pages feature article s references to pictures in African feature Americans articles 1 January 33 3 0 4 2 February 33 6 0 2 3 March 33 4 0 0 4 April 34 5 1 7 5 May 34 5 0 1 6 June 36 6 0 1 7 July 28 6 0 1 8 August 28 6 0 4 9 September 28 7 1 3 10 October 28 4 0 1 11 November 35 5 0 1 12 December 33 8 1 2 Total: 383 65 3 27

Table 9: Volume 18, 1921, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Americans articles 1 January 33 5 0 2 2 February 32 7 0 4 3 March 34 6 0 0 4 April 33 6 0 1 5 May 32 7 0 0 6 June 32 5 1 0 7 July 36 3 0 0 8 August 34 8 1 0 9 September 32 6 0 0 10 October 34 4 0 2 11 November 32 3 0 2 12 December 39 5 1 1 Total: 403 65 3 12

Table 10: Volume 19, 1922, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Americans articles 1 January 31 7 2 1 2 February 36 6 0 1 3 March 35 6 1 1 4 April 36 8 0 1 5 May 36 6 0 2 6 June 36 3 1 0 7 July 48 7 0 1 8 August 44 5 0 1 9 September 44 6 0 2 10 October 32 6 0 3 11 November 32 6 0 4 12 December 39 7 0 6 Total: 449 73 4 23

Table 11: Volume 20, 1923, Journal of the Outdoor Life: Number of pages, number of feature articles, number of references to African Americans and number of pictures by issue Issue Date Number of Number of Number of Number of pages feature articles references to pictures in African feature Americans articles 1 January 40 9 0 1 2 February 40 6 0 8 3 March 40 9 0 6 4 April 40 9 0 11 5 May 40 5 0 20 6 June 39 8 0 5 7 July 40 7 1 3 8 August 42 6 0 4 9 September 42 9 1 3 10 October 42 7 0 12 11 November 41 6 0 10 12 December 43 9 0 3 Total: 489 90 2 86

The data gathered for volumes 10-20 and categorized by issue was then tabulated by volume and the categories were totaled for the entire period of research, January 1913-

December 1923. Table 12 illustrates the summary of this information.

Table 12: Summary Information, Journal of the Outdoor Life, Volumes 10-20, January 1913-December 1923: Total number of pages, number of feature articles, number of references to African Americans and total number of pictures Volume/ Total Number of Number of articles with Number of Total Year Pages Feature references to African pages in Number Articles Americans (total) articles with of references Pictures 10 408 83 1-January, 1-May (2) 6.5 77 (1913) 11 407 69 1-September (1) 1 119 (1914) 12 414 83 3-February, 5-April, 1- 19.5 88 (1915) September (9) 13 414 75 1-April, 1-August (2) 4.25 74 (1916) 14 404 65 1-May (1) 3 68 (1917) 15 421 63 2-September, 1-December (3) 14 24 (1918) 16 422 65 3-May, 2-August, 1-October, 28.25 73 (1919) 1-November (7) 17 383 65 1-April, 1-September, 1- 8 27 (1920) December (3) 18 403 65 1-June, 1-August, 1-December 7 12 (1921) (3) 19 449 73 2-January, 1-March, 1-June (4) 16 23 (1922) 20 489 90 1-July, 1-September (2) 6.75 86 (1923) Total 4,614 796 37 114.25 671

Following the identification of feature articles with references to African

Americans, the articles were photocopied and then further reviewed. Additional information was recorded for each article, classifying it by the volume in which it was bound and consequently the year of publication, followed by the month of the issue in which it appeared. Additional information that was recorded included: the title of the article, length of the article, author’s name, author’s location and author’s race. In many

30 instances, a title or association for the author was given following the listing of their name. This information was recorded in the same field as the author’s name if it was provided. Table 13 illustrates this information for volumes 10-14, January 1913 through

December 1917.

Table 13: Feature articles with references to African Americans, Volumes 10-14, Journal of the Outdoor Life, January 1913 through December 1917: Title, length, author’s name, author’s location and author’s race by article Vol./ Title Length Author Author’s Author’s Issue (Pages) Location Race 10/1 Tuberculosis and Public Health 4.5 James A. Honeji, M.D. Boston, MA Not Noted in South Africa 10/5 Tuberculosis in State 2 Philip P. Jacobs, PhD, Assistant Not Noted Not Noted Legislatures Secretary of the National Association for the Study and Prevention of Tuberculosis 11/9 The Frequency of Tuberculosis 1 Howard D. King, M.D. New Orleans, Not Noted Among Negro Laundresses LA 12/2 Status of Anti-Tuberculosis 1.5 Ethel M. Hendriksen Grand Not Noted Work in the Mississippi Valley Rapids, MI 12/2 Problems of Tuberculosis in the .75 Dunning S. Wilson, M.D., Louisville, Not Noted Negro of the South Medical Director Board of KY Tuberculosis Hospital 12/2 Tuberculosis and the Negro 1.25 A. Wilberforce Williams, M.D., Chicago, IL Yes – Attending Physician, Municipal noted as Tuberculosis Dispensary colored 12/4 The Negro Health Problem in 3.75 W.F. Brunner, M.D., Health Savannah, Not Noted Southern Cities Officer GA 12/4 Negro Anti-Tuberculosis Work 1.75 Rosa Lowe, Secretary Atlanta Not noted Not Noted in Atlanta Anti-Tuberculosis and Visiting Nurse Association 12/4 The Great Need of Hospital 3.5 Martin F. Sloan, M.D., Towson, MD Not Noted Facilities for Negroes with Superintendent of Eudowood Tuberculosis Sanatorium 12/4 Education of the Negro on 3 William A. Harris, M.D. Savannah, Yes –noted Tuberculosis GA as colored 12/4 An Unusual Statistical Report, A 2.5 Not Noted Not Noted Not Noted Review of the Tuberculosis Death Rate in Maryland 12/9 Five Tuberculosis Conferences 1.5 Not Noted Not Noted Not Noted This Fall 13/4 A Survey of Monmouth County 2.5 Anna L. Stanley Cleveland, Not Noted New Jersey OH 13/8 Virginia Legislation Results 1.75 Frederick D. Hopkins, Field Not Noted Not Noted From a Commission Report Secretary, National Tuberculosis Association 14/5 Handicrafts for the Handicapped 3 Marion R. Taber, Secretary New York, Not Noted Committee on Occupation of the NY Department of Public Charities

Table 14 illustrates the same information for feature articles within volumes 15-

20, January 1918 through December 1923 as identified for volumes 10-14 in Table 13.

The same classification categories used in Table 13 were also used in Table 14.

Table 14: Feature articles with references to African Americans, Volumes 15-20, Journal of the Outdoor Life, January 1918 through December 1923: Title, length, author’s name, author’s location and author’s race by article Vol./ Title Length Author Author’s Author’s Issue (Pages) Location Race 15/9 Mortality From Tuberculosis 10.75 Louis I. Dublin, PhD, New York, Not Noted Among Wage Earners, 1911 to Statistician, Metropolitan Life NY 1916 Insurance Company 15/9 The Tuberculosis Death Rate 1.5 Not Noted – Editorial Review Not Noted Not Noted 15/12 Personal Hygiene and Public 1.75 Not Noted - Editorial Review Not Noted Not Noted Health 16/5 Negro Health Education Week 2.5 F.A. McKenzie, President, Fisk Nashville, Not Noted University TN 16/5 Field Work and Field Clinics 2.5 Blanche Webb, Field Nurse, Not Noted Not Noted Virginia Anti-Tuberculosis Association 16/8 The Value of Organization .5 Not Noted – Editorial Review Not Noted Not Noted 16/8 Tuberculosis in California State 10 L.L. Stanley, M.D., Resident Not Noted Not Noted Prisons Physician, San Quentin Prison 16/8 A Day at a Negro Sanatorium 3 Blanche F. Webb, R.N., Richmond, Not Noted Executive Secretary, Richmond VA Anti-Tuberculosis Association 16/10 Medical, Hospital and Social 4.75 Estes Nichols, Lt. Col., M.C., New Haven, Not Noted Aspects of Reconstruction for the Commanding U.S. Army General CT Tuberculous Hospital No. 16 16/11 Essays on Tuberculosis, XX, 5 Allen K. Krause, M.D. Not Noted Not Noted Some Phases of Resistance, Part IV: Immunity: Its General Types 17/4 A Statistician’s View of the 2 Not Noted – Editorial Review Not Noted Not Noted Tuberculosis Campaign 17/9 Tuberculosis Among the Negroes 3.5 Dr. H.G. Carter, Supt., Piedmont Burkeville, Not Noted Sanatorium VA 17/12 Organization for the Prevention 2.5 Philip P. Jacobs, Assistant Not Noted Not Noted and Control of Tuberculosis in Secretary of the NTA the United States 18/6 How I Would Run a Sanatorium 1.5 Francis J. Scully Prescott, AZ Not Noted By a Patient Who Never Will 18/8 Broader Health Aspects of 1.5 Philip P. Jacobs, PhD Not Noted Not Noted Tuberculosis 18/12 The Evidence of Intensive Anti- 4 Lee K. Frankel, PhD, Third Vice New York, Not Noted Tuberculosis Effort Upon the President, Metropolitan Life NY Death Rate Insurance Company 19/1 The Clinic for Negroes 2.5 H.R.M. Landis, M.D., Director, Philadelphia, Not Noted Henry Phipps Institute PA 19/1 The Negro as a Sanatorium 1 H.G. Carter, Superintendent, Burkeville, Yes – Patient Piedmont Sanatorium VA colored 19/3 The Indigent, Migratory 3.5 Jessamine S. Whitney, New York, Not Noted Tuberculous in Certain Cities of Statistician, NTA NY the Southwest 19/6 A Year’s Work, Report of the 9 Charles J. Hatfield, M.D., Not Noted Not Noted Executive Offices of the NTA for Managing Editor the Year Ending 5/1/22 20/7 Contact Infection in Tuberculosis 3 James H. Stygall, M.D., Medical Not Noted Not Noted Director, Indiana Tuberculosis Association 20/9 The Tuberculosis Division of 3.75 W. Nelson Mercer, M.D., Not Noted Not Noted Richmond, VA Director, Tuberculous Division, Richmond Health Bureau

Following the identification of these articles, they were read in detail and the type, focus, tone and pictorial reference for each article was noted by the researcher. Table 15 includes this information for articles in Volumes 10-14 as published from January 1913 through December 1917.

Table 15: Feature articles with references to African Americans, Volumes 10-14, Journal of the Outdoor Life, January 1913 through December 1917: Type, focus, tone and pictorial reference by article Vol./ Title Type of Are African Tone Pictorial Issue Article Americans the Focus Reference of the Content? 10/1 Tuberculosis and Public Health in Informational No Neutral No South Africa 10/5 Tuberculosis in State Legislatures Informational No Neutral No 11/9 The Frequency of Tuberculosis Informational Yes Negative No among Negro Laundresses 12/2 Status of Anti-Tuberculosis Work Informational No Neutral No in the Mississippi Valley 12/2 Problems of Tuberculosis in the Informational Yes Positive No Negro of the South 12/2 Tuberculosis and the Negro Educational Yes Positive No 12/4 The Negro Health Problem in Informational Yes Negative No Southern Cities 12/4 Negro Anti-Tuberculosis Work in Educational Yes Positive No Atlanta 12/4 The Great Need of Hospital Educational Yes Positive Yes Facilities for Negroes with Tuberculosis 12/4 Education of the Negro on Educational Yes Negative No Tuberculosis 12/4 An Unusual Statistical Report, A Educational Yes Positive No Review of the Tuberculosis Death Rate in Maryland 12/9 Five Tuberculosis Conferences Informational No Neutral No This Fall 13/4 A Survey of Monmouth County Informational No Neutral No New Jersey 13/8 Virginia Legislation Results From Informational No Positive No A Commission Report 14/5 Handicrafts for the Handicapped Informational No Positive Yes – no written reference in article

The same information was recorded for articles found in volumes 15-20. Table

16 illustrates the same information for these feature articles.

Table 16: Feature articles with references to African Americans, Volumes 15-20, Journal of the Outdoor Life, January 1918 through January 1923: Type, focus, tone and pictorial reference by article Vol./ Title Type of Are African Tone Pictorial Issue Article Americans the Focus Reference of the Content? 15/9 Mortality From Tuberculosis Informational No Positive No Among Wage Earners, 1911 to 1916 15/9 The Tuberculosis Death Rate Informational No Positive No 15/12 Personal Hygiene and Public Informational No Neutral No Health 16/5 Negro Health Education Week Informational No Positive No 16/5 Field Work and Field Clinics Educational Yes Positive Yes 16/8 The Value of Organization Informational No Positive No 16/8 Tuberculosis in California State Informational No Positive No Prisons 16/8 A Day at a Negro Sanatorium Informational No Positive Yes – no written reference in article 16/10 Medical, Hospital and Social Informational Yes Positive Yes – no Aspects of Reconstruction for the written Tuberculous reference in article 16/11 Essays on Tuberculosis, XX, Informational No Neutral No Some Phases of Resistance, Part IV: Immunity: Its General Types 17/4 A Statistician’s View of the Informational No Negative No Tuberculosis Campaign 17/9 Tuberculosis Among the Negroes Informational No Positive No 17/12 Organization for the Prevention Informational Yes Negative No and Control of Tuberculosis in the United States 18/6 How I Would Run a Sanatorium Informational No Positive No By a Patient Who Never Will 18/8 Broader Health Aspects of Personal No Negative No Tuberculosis Viewpoint 18/12 The Evidence of Intensive Anti- Informational No Neutral No Tuberculosis Effort Upon the Death Rate 19/1 The Clinic for Negroes Informational No Positive No 19/1 The Negro as a Sanatorium Patient Educational Yes Positive No 19/3 The Indigent, Migratory Informational Yes Positive No Tuberculous in Certain Cities of the Southwest 19/6 A Year’s Work, Report of the Informational No Neutral No Executive Offices of the NTA for the Year Ending 5/1/22 20/7 Contact Infection in Tuberculosis Informational No Neutral No 20/9 The Tuberculosis Division of Informational No Negative No Richmond, VA

CHAPTER 5

ANALYSIS

The data that were recorded from the content analysis of feature articles in the

Journal of the Outdoor Life, in volumes 10-20 can be analyzed in four different categories. These categories are: representation of articles with references to African

Americans, frequency of articles with references to African Americans, a summary of type, focus and tone, and a review of whether or not pictorial references to African

Americans were made.

Representation of Articles with References to African Americans

The content analysis of volumes 10-20 of the Journal of the Outdoor Life, revealed minimal references to African Americans. Out of the 796 feature articles published in these volumes, only 37 feature articles were found to include references to

African Americans, which is less than five percent. The illustration of feature articles with reference to African Americans as compared to total feature articles in volumes 10-

20 can be seen in Graph 1.

Graph 1: Feature Articles with References to African Americans vs. Total Feature Articles

710 610 510 410 310 210 Number of Articles 110 10 Feature Total Articles Feature With Articles References

Feature articles found with references to African Americans encompassed 114.25 pages. There are 4,614 total pages in volumes 10-20 of the Journal of the Outdoor Life.

Feature articles with references to African Americans therefore represent less than three percent of the total content of the issues of the journal in volumes 10-20. The visual representation of this comparison can be seen in Graph 2.

Graph 2: Pages in Feature Articles With References to African Americans vs. Total Pages in Volumes 10-20

4050 3050 2050

1050 Number of Pages 50 Pages in Total Pages Feature Articles With References

Of the 37 articles that were identified, the authors of three of the articles were noted as “colored”. Author’s names were not given for six of the 37 articles. Of the 31 remaining articles, all but seven were written by individuals involved in health care or health promotional activities, primarily those of the National Tuberculosis Association.

The content analysis also recorded the author’s location. The author’s location was noted for 20 of the 37 articles. The location of these authors was distributed throughout the United States and across geographic regions. The majority of the cities noted were located in the northeastern and southeastern portion of the United States.

Frequency of Articles with References to African Americans

At least one article with a reference to African Americans was found in each researched volume of the Journal of the Outdoor Life. The frequency of articles published with references to African Americans in volumes 10-20 of the Journal of the

Outdoor Life ranged from one article to as many as nine articles. Graph 1 illustrates the frequency of the articles by year.

Graph 3: Frequency of Publication of Articles With Reference to African Americans by Year

6 Number of Articles with References to 4 African Americans by Volume 2

0 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923

The publication frequency of articles with references to African Americans remained consistent from 1913-1923 with the exception of two years. In 1915, nine articles were found with references to African Americans and in 1919, seven articles were found with references to African Americans. The frequency in both of these years exceeded the average number of feature articles published with references to African

Americans within volumes 10-20, which was found to be between three and four articles.

The researched did not identify anything through this content analysis that allowed for an

37 explanation of the exceptional number of articles with references to African Americans in published in these two years.

Summary of Type, Focus and Tone

The analysis of the type, focus and tone of the articles provides further insight as to their content and intended purpose. Of the 37 articles identified with references to

African Americans, the type of articles was classified in the following manner: 29 were classified as informational, seven were classified as educational and only one was found to be an expression of a personal viewpoint. This information is summarized in Table 17.

Table 17: Summary of Type in 37 Articles With References to African Americans

Informational Educational Personal Viewpoint Number of Articles 29 7 1

African Americans were the focus of the content in 13 of the 37 articles found to reference African Americans, or 35%. Few articles included references to African

Americans and even fewer included them as the focus of the content.

The tone of the articles was categorized as follows: eight articles were classified as having a negative tone, 19 were classified as positive and 10 were found to be neutral.

Of the 13 articles where African Americans were the focus of the content, four were found to have a negative tone and nine were found to have a positive tone. The summary of tone by article can be found in Table 18.

Table 18: Summary of Tone in 37 Articles With References to African Americans

Negative Positive Neutral Number of Articles 8 19 10

Pictorial References to African Americans

Only five of the 37 articles were found to have pictorial references to African

Americans. It is interesting to note that in three of these five articles, the pictorial references to African Americans were not supported by written content.

In the article, “Handicrafts for the Handicapped” by Marion R. Taber

(1917: 134), a picture of an African American man is included in the body of the article.

However African American individuals are not mentioned by title in any portion of the written content of the piece (Taber, 1917: 134).

The titled article, “A Day at a Negro Sanatorium” by Blanche Webb

(1919: 232-34), includes a photographic representation of African Americans at a sanatorium. The article includes 21 pictures of African Americans, with footnotes as to what the individuals in the photographs are doing. The only written reference to African

Americans is in the title of the article.

A third article, “Medical, Hospital and Social Aspects of Reconstruction of the Tuberculous” by Estes Nichols (1919: 289-94) includes a photograph of African

American schoolchildren. African Americans are not specifically noted by a written reference at any place in the article. The article, instead, makes general references to individuals with tuberculosis.

African Americans are the focus of the content in the remaining two articles that were found to have pictorial references to African Americans. The photographs are supported by relevant written content.

CHAPTER 6

CONCLUSION

The content analysis of volumes 10-20 of the Journal of the Outdoor Life, citing references to African Americans, reveals minimal information about African Americans.

Articles with references to African Americans in the Journal of the Outdoor Life

(volumes 10-20), comprise a very small portion of the total content published at the time, despite the fact that tuberculosis affected the African American community at a much higher rate than that of society in general. This treatment of African Americans is consistent with the actions of predominantly white institutions in the United States at that time.

This content analysis could be improved in several ways. The researcher was not able to review the biographical backgrounds of the authors of feature articles found to reference African Americans. If some biographical information was provided with the article, it was cited in this analysis, however further research on the authors’ individual histories would allow one to discuss their motivation for the articles they wrote. Such research would also provide background on their involvement in health care and public health promotion. It also would have been helpful to complete a history of the officers of the National Tuberculosis Association, with special focus on those that served on the

Editorial Review Board of the Journal of the Outdoor Life.

The researcher suggests having a second party, or perhaps a panel of more than one individual, review the content of the articles. Additional reviewers could also review the articles for the categorization and analysis of information. The findings of the researcher and the reviewer(s) could then be compared for similarities and differences. It

40 is possible that when working alone, the researcher’s classification method could directly impact the finding of this analysis.

This content analysis involved the review of issues of a health journal that were published more than 80 years ago. It would be interesting to outline two parallel content analyses, one oriented in the period of time for which the article was written and a second oriented in the period of time in which the research is transpiring. This type of research would assist in identifying differences in language, categorization and social acceptance during the two different time periods.

The researcher also recommends analyzing additional volumes of the Journal of the Outdoor Life. While it is difficult to obtain all issues of the journal, as they are not available at one location, it may be valuable to compare references to African Americans by analyzing a cross section of articles published in each of the three decades of its existence.

This analysis is only a starting point in understanding the rate of tuberculosis infection among African Americans in the late nineteenth and twentieth centuries.

According to the 2000 United States Census, African Americans accounted for 12 percent of the American population, or nearly 35 million individuals (United States

Census, 2004). While the general population of the United States has increased considerably since the start of the twentieth century, the percent of the population comprised of African Americans has remained fairly consistent.

Tuberculosis and other epidemics such as acquired immune deficiency syndrome

(AIDS) have been proven to infect different ethnic groups at inconsistent rates (Farmer and Ferraro, 1996: 27). The infection rate among African Americans remains alarmingly

41 high as African Americans are eight times more likely to contract tuberculosis than whites (American Lung Association, 2003). Such statistics suggest a need to increase awareness and health programming in the areas of society with the greatest concentration of susceptible individuals.

The importance of tuberculosis programming is a relevant, and perhaps more urgent issue in many countries outside of the United States. Tuberculosis remains, “the most frequently encountered mycobacterial disease in the world and, although its incidence has diminished significantly in the industrially more developed countries, it remains a major public health problem in most developing nations.” (Collins, Grange,

Yates, 1985: 3). Developing countries, and particularly those with a greater disparity in socioeconomic statuses, experience issues that were common in the United States in the late nineteenth and early twentieth centuries. Such issues include a greater prevalence of poverty and inequalities in educational opportunities (Watts, 2003: 3).

Evidence of the magnitude of tuberculosis infection worldwide is substantiated by the fact that one third of the world population becomes infected by tuberculosis each year and over two million individuals die from tuberculosis related illnesses (Division of

Tuberculosis Elimination, 2003). Treatment has been complicated by “AIDS and the emergence of multi-drug resistant germs, and it (therefore) is rapidly growing.” (Ryan,

1992: 416-17).

Although time has improved the quality and scientific knowledge of health and the treatment and prevention of infectious diseases, the need to address such issues relative to ethnicity remains a very pertinent issue. Perhaps, Frank Ryan (1992: 416) in

42 his book, The Forgotten Plaque: How the Battle Against Tuberculosis Was Won – and

Lost, summarized the need to learn from our health history best when he said of tuberculosis and its devastating affect on societies worldwide, “The hard lessons of the past failure must be learnt so that we do not make the same mistakes again.”

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