Modern Vectors of Economic Oppression Health & Medicine
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Welcome to our 15-module series exploring the historic basis of the racial wealth gap as a vehicle for understanding the need for repair.
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Learn about how health policy affects the racial wealth gap
Summary
The Compounding Structure of Harm
From enslavement onward, U.S. health care has treated Black bodies as economic inputs to be controlled rather than lives to be protected. Plantation “medicine” prioritized keeping enslaved people productive; pain was dismissed, consent was denied, and experimentation was normalized, setting a durable clinical culture in which Black suffering was minimized, and Black autonomy was routinely violated. After emancipation, Black communities built mutual aid networks, clinics, and hospitals, but segregation and professional gatekeeping restricted access to training, hospital privileges, and resources. Public and private systems then reinforced inequity through separate-and-unequal facilities, discriminatory coverage and payment structures, and research agendas that often ignored Black health needs while extracting data and tissue without fair benefit. Over time, these patterns hardened into institutional routines: bias in diagnosis and treatment, underinvestment in Black-serving institutions, and clinical standards built on “average” populations that do not reflect real-world diversity.
This compounding structure of harm is not simply interpersonal prejudice; it is policy design, professional exclusion, research bias, and economic structure operating together. The result is measurable and multi-generational: Black life expectancy remains roughly 5–6 years shorter than white Americans, avoidable illness and premature death impose enormous national costs through lost productivity, and chronic health burdens reduce household stability, savings capacity, and intergenerational wealth transfer. Because health determines the ability to work, learn, accumulate assets, and withstand shocks, medical racism functions as a long-term wealth-stripping system. Repair, accordingly, must be systemic: invest in Black health institutions and workforce pipelines, realign payment and access so preventive and community-based care are properly funded, eliminate algorithmic and clinical bias through transparent standards and accountability, and support community-driven models of care—because health justice is economic justice.
Personal Narratives
Henrietta Lacks: science must right a historical wrong
"Last month marked 100 years since Lacks’s birth. She died in 1951, aged 31, of an aggressive cervical cancer. Months earlier, doctors at the Johns Hopkins Hospital in Baltimore, Maryland, had taken samples of her cancerous cells while diagnosing and treating the disease. They gave some of that tissue to a researcher without Lacks’s knowledge or consent. In the laboratory, her cells turned out to have an extraordinary capacity to survive and reproduce; they were, in essence, immortal. The researcher shared them widely with other scientists, and they became a workhorse of biological research. Today, work done with HeLa cells underpins much of modern medicine; they have been involved in key discoveries in many fields, including cancer, immunology and infectious disease. One of their most recent applications has been in research for vaccines against COVID-19.
But the story of Henrietta Lacks also illustrates the racial inequities that are embedded in the US research and health-care systems. Lacks was a Black woman. The hospital where her cells were collected was one of only a few that provided medical care to Black people. None of the biotechnology or other companies that profited from her cells passed any money back to her family. And, for decades after her death, doctors and scientists repeatedly failed to ask her family for consent as they revealed Lacks’s name publicly, gave her medical records to the media, and even published her cells’ genome online..."[4]
[4] Henrietta Lacks: science must right a historical wrong
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Racism and discrimination in health care: Providers and patients
"A patient of mine recently shared a story with me about her visit to an area emergency room a few years ago.* She had a painful medical condition. The emergency room staff not only did not treat her pain, but she recounted: “They treated me like I was trying to play them, like I was just trying to get pain meds out of them. They didn’t try to make any diagnosis or help me at all. They couldn’t get rid of me fast enough.”
There was nothing in her history to suggest that she was pain medication seeking. She is a middle-aged, churchgoing lady who has never had issues with substance abuse. Eventually, she received a diagnosis and appropriate care somewhere else. She is convinced that she was treated poorly by that emergency room because she is black.
And she was probably right. It is well-established that blacks and other minority groups in the U.S. experience more illness, worse outcomes, and premature death compared with whites.1,2 These health disparities were first “officially” noted back in the 1980s, and though a concerted effort by government agencies resulted in some improvement, the most recent report shows ongoing differences by race and ethnicity for all measures." [5]
Timelines of Disparity
1619–1865: Enslavement & “Plantation Medicine”
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1619–1865 — Enslaved bodies as medical “material.” On plantations, physicians’ goal was labor extraction, not patient care; experimentation on enslaved people (especially women) was routine. Harriet A. Washington’s Medical Apartheid documents colonial-era through 19th-century practices and their ethics. Medical Apartheid - Wikipedia
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1845–1849 — J. Marion Sims’ fistula operations. Repeated surgeries on Anarcha, Lucy, and Betsey, enslaved women, without anesthesia; foundational to modern gynecology and emblematic of racialized exploitation. The medical ethics of Dr J Marion Sims: a fresh look at the historical record - PMC
1865–1910: Reconstruction → Jim Crow Medical Apartheid
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1865–1872 — Freedmen’s Bureau hospitals. First federal health system for formerly enslaved people; chronically underfunded and dismantled with the end of Reconstruction, leaving a vacuum in Black health infrastructure. The Freedmen's Bureau | National Archives
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1870s–1900s — Public-health neglect & scapegoating. State/local boards under-served Black neighborhoods (sanitation, vaccination, epidemic control) and racialized epidemics (yellow fever, smallpox, TB), treating Black communities as “vectors” rather than patients. How Yellow Fever Intensified Racial Inequality in 19th-Century New Orleans
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1895 — National Medical Association (NMA) founded after exclusion from the AMA; parallel “Black medicine” develops without equitable funding or access to white institutions. NMA History - National Medical Association
1910–1932: Institutionalizing Exclusion
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1910 — Flexner Report. Restructured medical education and led to closure of 5 of 7 Black medical schools, suppressing the Black physician pipeline for decades. The Disappearance of Black Men From Medicine: A Consequence of Racism and the Flexner Report - PMC
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Early 1900s–1930s — Eugenics laws & “race hygiene.” Dozens of states enact sterilization regimes disproportionately impacting Black women, laying groundwork for later abuses. (Context in Medical Apartheid and public records summarized below.) Medical Apartheid - Wikipedia
- 1935 - Occupational Exclusions in Social Security. When the Social Security Act was passed, it excluded agricultural laborers and domestic workers. Together, these jobs accounted for over 65% of the Black workforce in the South at the time—especially among Black women and Black men living under Jim Crow regimes. By excluding these categories, the policy denied a vast number of Black Americans access to unemployment insurance, retirement pensions, and disability support.
- 1935 - Segregated Health Services through the Wagner Act (National Labor Relations Act) The Wagner Act enabled collective bargaining rights and health protections through unionization, but many labor unions at the time were racially segregated or outright denied Black membership. This meant Black workers:
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Couldn’t access employer-provided health benefits
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Weren’t protected in health-related labor disputes
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1935 - Public Health Programs Administered by Local (Often Segregated) Authorities
1935 - New Deal health initiatives—like the Federal Emergency Relief Administration (FERA) and Public Health Service programs—were often handed off to local governments in the South, which used racially discriminatory practices to:
Domestic workers
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Allocate fewer resources to Black communities
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Deny hospital access or funnel Black patients into underfunded segregated facilities
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1932–1972: Federal Experimentation & Exploitation
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1932–1972 — Tuskegee Syphilis Study. U.S. Public Health Service withholds treatment from Black men to “observe” disease; a federal architecture of abuse that later drives modern research-ethics reforms. About The Untreated Syphilis Study at Tuskegee | Syphilis Study | CDC
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1951 — Henrietta Lacks & HeLa. Cells taken without consent become the cornerstone of modern biomedicine; family receives no compensation (ongoing legal claims underscore the unresolved equity issues). The Legacy of Henrietta Lacks | Johns Hopkins Medicine
1960s–1980s: Coercive Control, First Federal Recognition
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1960s–1970s — “Mississippi appendectomy” & forced sterilizations. Fannie Lou Hamer’s case brings national attention; Relf v. Weinberger (1974) curtails use of federal funds for involuntary sterilization after Black minors are sterilized. Fannie Lou Hamer | American Experience | Official Site | PBS
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1985 — The Heckler Report. First U.S. government synthesis acknowledging racial health disparities (≈60,000 excess minority deaths/year), leading to the Office of Minority Health (1986). The Heckler Report – Health is a Human Right
1990s–2010s: From Bedside Bias to Algorithmic Bias
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1990s–2010s — Pain undertreatment & clinical bias. Large literature shows Black patients receive less pain treatment than white peers with similar conditions, reinforcing mistrust and poorer outcomes. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites - PMC
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2019 — Algorithmic bias in care allocation. A widely used risk algorithm underrated Black patients’ needs by using cost as a proxy for illness; redesign fixes much of the bias. Dissecting racial bias in an algorithm used to manage the health of populations | Science
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2008 & after — AMA reckoning/apology for a long history of excluding Black physicians; acknowledgement of structural harm to Black health. Medical Association Apologizes for History of Prejudice | PBS News
2010s–Present: Environmental Health & Maternal Mortality
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2014–2019 — Flint Water Crisis. Lead-contaminated water in a majority-Black city; tens of thousands exposed; emblematic of environmental racism and infrastructural neglect. Flint water crisis - Wikipedia
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2023–2025 — Maternal mortality gap persists. CDC: Black maternal mortality = 50.3 per 100,000 (2023), ~3–3.5× the white rate, despite overall declines. Health E-Stat 100: Maternal Mortality Rates in the United States, 2023
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Ongoing — Life-expectancy gap & structural drivers. Black life expectancy remains several years lower than white; disparities tie to access, quality, environment, and wealth. Key Data on Health and Health Care by Race and Ethnicity | KFF
Health Disparities and the Racial Wealth Gap
Economic Burden of Racial Health Disparities
Measurement:
In 2018, racial and ethnic health disparities cost the U.S. economy $451 billion.
Wealth Impact:
Premature death, chronic illness, and untreated disease reduce lifetime earnings, shrink family savings, and suppress generational wealth building.
Source:
NIH / NIMHD
Anti-Black racism in health and medicine widens the racial wealth gap by systematically increasing the “cost of being sick” while reducing the years and capacity available to earn, save, and transfer assets. Black communities experience higher burdens of chronic disease and higher mortality—about a 4-year life-expectancy deficit and roughly 20% higher mortality—translating into fewer working years, earlier disability, and more disrupted career trajectories. At the same time, unequal treatment inside medical institutions (even when income is comparable) produces avoidable complications that are directly wealth-destroying: preventable amputations, lower likelihood of restorative procedures, and biased clinical decision-making and algorithms that steer Black patients toward less individualized care. These failures drive higher out-of-pocket spending, medical debt, lost wages, and caregiving burdens, while compounding stress and limiting access to the very “health-protective” conditions wealth buys—stable housing, preventive care, nutritious food, time flexibility, and lower exposure to environmental risk. The result is a feedback loop: health inequity suppresses wealth-building, and low wealth amplifies the damage of each medical shock.
Estimated share of the racial wealth gap attributable to health and medical racism: ~10% - 25%
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Components:
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Lost earnings and working years (mortality/disability): ~6–12%
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Medical debt and out-of-pocket costs (including delayed care due to uninsurance/underinsurance): ~2–6%
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Quality-of-care inequities and biased tools that increase complications (e.g., avoidable amputations, undertreatment): ~1–4%
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Intergenerational spillovers (caregiving, depleted savings, reduced inheritance, stress-driven impacts): ~2–8%
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These percentages should be treated as policy-relevant estimates rather than precise measurements; the key point is that medical racism operates as a recurring wealth-extraction system—reducing lifetime income, increasing debt, and shrinking the assets families can pass forward.
Methods of Health Discrimination
Algorithmic and digital bias in health care is the newest expression of structural racism—one that hides behind the language of data and objectivity. Many medical algorithms, from hospital risk scores to kidney function calculators and pain-assessment tools, were trained on datasets that overrepresent white patients and misinterpret race as a biological variable rather than a social determinant. As a result, predictive models often underestimate the severity of illness in Black patients, leading to fewer referrals, delayed treatments, and lower-quality care. Pulse oximeters, facial-recognition systems, and AI-assisted diagnostic tools also perform less accurately on darker skin tones because they were designed and calibrated on light-skinned populations. These technological inequities replicate the same patterns of exclusion seen in earlier eras of medicine—privileging white bodies as the default and rendering Black patients invisible in the data. Without intentional redesign, algorithmic medicine risks encoding the biases of the past into the infrastructure of the future, turning digital health into a new frontier of systemic harm rather than repair.
Podcast: Tackling Bias in Health Care Algorithms | Health Affairs
Rooting Out Racial Bias in Hea… - Tradeoffs - Apple Podcasts
Rooting Out Racial Bias in Health Care AI, Part 2 - Tradeoffs
In 1910, the Flexner Report, commissioned by the Carnegie Foundation and authored by Abraham Flexner, restructured U.S. medical education by promoting a standardized, science-based model tied to elite institutions — but it also had devastating consequences for Black medical education. The report recommended the closure of five out of seven Black medical schools, including Flint Medical College (New Orleans), Leonard Medical School (North Carolina), Louisville National Medical College (Kentucky), Knoxville Medical College (Tennessee), and the University of West Tennessee College of Medicine and Surgery. Only Howard and Meharry were deemed worthy of survival — and even they were under-resourced. This deliberate reduction in training institutions drastically limited the number of Black physicians entering the field, entrenching a racial gap in healthcare access and representation that persists to this day.
Listen: The report that curtailed Black medical education for over a century
The Disappearance of Black Men From Medicine: A Consequence of Racism and the Flexner Report - PMC
After the Civil Rights Act of 1964 mandated the desegregation of hospitals in the United States, many historically Black medical facilities—once crucial centers of care and professional training under segregation—were rapidly closed, defunded, or absorbed into white-dominated systems. These closures were not acts of integration but displacement. Black hospitals, many of which had been built and maintained through community labor and collective sacrifice, were deemed "redundant" or "inefficient" by newly integrated institutions that still operated with white supremacist priorities. As a result, Black doctors, who had once held leadership positions in these spaces, found themselves either excluded from hospital staff at white institutions or relegated to subservient roles. The erosion of Black medical autonomy meant a collapse in the cultural, linguistic, and communal competencies necessary for adequate Black patient care. Black patients faced increased medical neglect, racial bias, and misdiagnosis in newly integrated but still structurally racist hospitals. This destruction of Black medical institutions under the false banner of civil rights progress is a textbook example of integration without justice—a process where white institutions expand dominance while Black sovereignty is dismantled under the guise of reform.
The history of health insurance and financing discrimination in the United States reveals how racial and economic exclusion were built directly into the nation’s health infrastructure. When employer-based health insurance emerged in the 1930s and 1940s, the New Deal’s Social Security Act and later labor laws deliberately excluded domestic and agricultural workers—occupations that employed the majority of Black Americans—denying them both wage protections and access to emerging health benefits. Hospitals and clinics in redlined neighborhoods were systematically underfunded or refused federal construction grants under programs like the Hill-Burton Act (1946), which allowed “separate but equal” facilities and often left Black communities without modern healthcare infrastructure. As private insurance expanded, risk-rating practices and zip-code-based underwriting further penalized segregated Black neighborhoods, driving up costs and limiting access. This structural exclusion created enduring disparities: today, Black Americans remain more likely to be uninsured or underinsured, less likely to live near high-quality hospitals, and more vulnerable to medical debt—direct legacies of a financing system designed to tie health security to whiteness, employment, and property ownership.
Health Coverage by Race and Ethnicity, 2010-2023 | KFF
Health Insurance Coverage of U.S. Workers Increased in 2022
The Changing Medical Debt Landscape in the United States
Health Disparities in Employer-Sponsored Insurance | NORC at the University of Chicago
Advancing Health Equity for Black Communities Through Insurance Reform
Black maternal health disparities in the United States trace back to slavery, when Black women were forced to reproduce for economic gain, denied bodily autonomy, and used as subjects in nonconsensual gynecological experiments by figures like Dr. J. Marion Sims. After emancipation, racist myths about Black women’s pain tolerance and fertility continued to shape medical training and policy, while eugenics programs and state-run “Mississippi appendectomies” sterilized tens of thousands of Black women without consent throughout the 20th century. Today, those legacies persist in a maternal mortality crisis that remains one of the clearest indicators of structural racism: as of 2023, Black women in the U.S. are nearly three times more likely to die from pregnancy-related causes than white women, regardless of income or education. Contributing factors include implicit bias in care, unequal access to prenatal services, underdiagnosis of pain and complications, and the chronic stress of racism itself—known as “weathering”—which accelerates biological aging. The result is a cycle of loss that undermines both family stability and generational wealth, making maternal health repair a central pillar of reproductive and racial justice.
Further Research
Racial Disparities in Maternal and Infant Health: Current Status and Key Issues | KFF
Racism in Health: The Roots of the U.S. Black Maternal Mortality Crisis | Scientific American
9 ways racism impacts maternal health | PBS News Weekend
Solving the Black Maternal Health Crisis | Johns Hopkins | Bloomberg School of Public Health
Black newborns 3 times more likely to die when looked after by White doctors - CNN
Racial and Ethnic Disparities Continue in Pregnancy-Related Deaths | CDC Online Newsroom | CDC
What Is ‘Medical Gaslighting’ and How Can You Elevate Health Care - The New York Times (nytimes.com)
Medical bias in research, education, and technology has shaped every layer of modern health care, privileging white bodies as the scientific standard while marginalizing Black experience as deviation or deficiency. From exploitative research like the Tuskegee Study and the nonconsensual use of Henrietta Lacks’s cells to the ongoing underrepresentation of Black participants in clinical trials, R&D has produced drugs, devices, and algorithms that perform less effectively—or even harmfully—on Black patients. Medical textbooks and training materials perpetuate this bias by presenting white skin as the default for diagnosis and by embedding false biological myths about pain tolerance, lung capacity, and disease susceptibility. Equipment such as pulse oximeters and spirometers, designed and calibrated on white subjects, routinely misread Black physiology, leading to delayed or inadequate care. These distortions, reinforced through research, education, and technology, form a closed loop of inequity that reduces life expectancy, increases medical debt, and erodes trust. Dismantling them requires rewriting curricula, redesigning devices, and centering, Black-led research to rebuild medicine on equity rather than exclusion.
Racism in pain management causes needless suffering
Race, Inequality, and Health | KFF
AI chatbots in health care could worsen disparities for Black patients, study cautions | AP News
Why I Had To Fire My White Dermatologist? | by Rebecca Stevens A.
What Is ‘Medical Gaslighting’ and How Can You Elevate Health Care - The New York Times (nytimes.com)
Calling Out Racism in Nursing - Word In Black
Pulse Oximeters’ Racial Bias | Johns Hopkins | Bloomberg School of Public Health
For centuries, Black individuals in the United States have been subjected to medical experimentation and torture under the guise of scientific progress. During slavery, enslaved women such as Anarcha, Betsey and Lucy were operated upon without anesthesia by Dr. J. Marion Sims; later, the infamous Tuskegee Syphilis Study (1932-1972) allowed hundreds of Black men to suffer untreated syphilis so researchers could study the disease’s natural progression. Research institutions and health agencies repeatedly used Black bodies as test subjects without informed consent, extracting biological samples, withholding treatment, and perpetuating myths of racial inferiority. These practices not only caused immense physical harm but also generated deep mistrust of medicine in Black communities—while building scientific knowledge and therapeutic advances that seldom benefited those exploited. The legacy of this abuse continues to impact clinical trials, research ethics, and health disparities today.
Cruel Medical Experiments on Enslaved people were widespread in the south
.J. Marion Simms the “father” of modern gynecology experimented on enslaved women.
Charity Patients Irradiated to Gauge Effect on Soldiers in through 1972
Tuskegee Experiments 1932-1972
New York Foundation Apologizes for Its Role in Tuskegee Syphilis Study
Racial Inequities In Medicine The History Of Unethical Race-Based Experimentation
Why They Keep The TRUTH About … - One Mic Black History - Apple Podcasts
Racial weathering is the cumulative biological and psychological “wear and tear” that comes from living inside racial hierarchy, where chronic exposure to discrimination, surveillance, economic insecurity, and institutional neglect forces the body into repeated stress response. It shows up as earlier onset of illness, higher rates of hypertension and cardiovascular disease, complications in pregnancy, weakened immune function, and accelerated aging, not because Black and brown people are inherently less healthy, but because the conditions imposed on them are inherently harmful. Weathering is what happens when racism stops being a “social issue” and becomes a daily physiological tax, deposited into the nervous system, the endocrine system, and the organs over decades.
That tax directly feeds the racial wealth gap because wealth is not just about income, it’s about time, health, and uninterrupted opportunity. When weathering drives chronic illness and disability earlier in life, it increases out-of-pocket medical costs, reduces working years, limits promotions, forces job changes, and can push people into debt. It also drains family resources through caregiving, missed work, and emergency expenses, while discriminatory systems make it harder to access high-quality care, stable housing, safe environments, and fair insurance, which compounds the damage. Over generations, this becomes a structural trap: the same racial hierarchy that extracts health also extracts wealth, turning preventable stress and sickness into lost earnings, lost savings, and reduced intergenerational transfer.
“Weathering” And The Effects Of Racism On Public Health » NCRC
From slavery to the genomic age, the theft of Black genetic material has been a continuous form of exploitation disguised as medical progress. Enslaved people’s bodies were dissected, experimented upon, and used to build early American medicine; later, Black patients like Henrietta Lacks and the men in the Tuskegee Syphilis Study were subjected to research without consent, their tissues and data fueling billion-dollar medical and pharmaceutical breakthroughs. Even today, genetic databases, AI-driven health tools, and drug patents often rely on Black biological material collected without equitable benefit-sharing. This long history reveals how anti-Black racism in science transformed human suffering into intellectual property, reinforcing both the racial wealth gap and mistrust in medicine.
The 1910 Flexner Report, commissioned to standardize U.S. medical education, became a turning point in the systematic exclusion of Black physicians. While it elevated white medical institutions, it labeled five of the seven Black medical schools as “substandard,” leading to their closure and cutting off nearly 90% of the pipeline for Black doctors for decades. The surviving institutions—Howard and Meharry—were chronically underfunded and overburdened, expected to serve the entire Black population with minimal resources. This manufactured scarcity entrenched racial hierarchies within medicine: white physicians dominated research, hospitals, and leadership roles, while Black practitioners were confined to segregated wards or denied privileges altogether. Simultaneously, the care labor performed by Black nurses, midwives, and orderlies—largely women—was devalued, underpaid, and stripped of professional recognition even as it sustained community health. The legacy of the Flexner era persists today in a vastly underrepresented Black medical workforce, fewer Black-led institutions, and enduring inequities in both compensation and authority across the care economy.
Med Schools Are Struggling to Overcome Racism in Health Care | TIME
Trump DEI policies threaten millions in scholarships raised by Black doctors - The Washington Post
Additional Viewing and Reading Materials
It's Not Just About Tuskegee: The History of African Americans and Medicine
How Modern Medicine Was Born of Slavery
Harriet A. Washington: Discussing Medical Experimentation on Black Americans - 03/07/2017
Lack of Diversity in Health Care: A Health Disparity | Kiaana Howard, DPT | TEDxLenoxVillageWomen
Unpacking Bias in Seeking Mental Health Care for Women of Color | Chandra Carey | TEDxSMUWomen
The US medical system is still haunted by slavery
The medical ethics of Dr J Marion Sims: a fresh look at the historical record - PMC
“Closing Black Medical Schools → Shrinking Physician Pipeline.” (1910→present) — Flexner’s closures depress Black physician representation for generations. The Disappearance of Black Men From Medicine: A Consequence of Racism and the Flexner Report - PMC
“Federal Neglect → Federal Apology → Federal Data.” (1932→1997→1985→2025) — Tuskegee, Clinton’s apology, Heckler Report, and continued surveillance of gaps. Tuskegee Syphilis Study - Wikipedia
Reckoning with histories of medical racism and violence in the USA - The Lancet
Questions for Research and Reflection
Questions for Research and Reflection:
✊🏿 FOR BLACK PEOPLE
Medical Neglect, Ancestral Knowledge, and Survival
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What health-related messages were passed down in your family? Who were you taught to trust — and who to fear?
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Were your ancestors subjected to forced sterilization, experimentation, or institutionalization under the guise of medicine?
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Did your family members experience medical racism during pregnancy, birth, or pain management?
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How were you taught to navigate the healthcare system: with trust, caution, resistance, or silence?
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Were there times when you or loved ones avoided care due to cost, racism, or fear of mistreatment?
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Who provided healing in your community — herbalists, midwives, elders — when Western medicine failed or harmed?
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How did your family access food, water, rest, and safety growing up — and how did that affect your health?
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Do you or your loved ones live with chronic conditions that are often blamed on personal behavior but rooted in systemic neglect (e.g., asthma, diabetes, hypertension)?
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What does health sovereignty look like in your vision: community clinics, ancestral practices, food justice, trauma-informed care?
⚪ FOR WHITE PEOPLE
Medical Access, Denial, and Historical Advantage
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Have you or your family members consistently had access to doctors, specialists, and private insurance?
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Were your ancestors beneficiaries of employer-provided health plans, veterans' benefits, or public health infrastructure that excluded others?
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Were you taught that healthcare was a “personal responsibility” rather than a system of racialized access?
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Did you grow up assuming that health insurance was a given? What happened when it wasn’t?
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What beliefs were normalized in your household about Black people and health — pain, strength, disease, or intelligence?
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Have you ever seen a Black patient dismissed, neglected, or misdiagnosed? Did you speak up or stay silent?
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Were you told to trust the system — and who was the system built for?
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What myths about “healthy” food, “clean” neighborhoods, or “personal fitness” shaped your view of who is “deserving” of good health?
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Are you willing to challenge medical institutions, policies, or insurance structures that benefit you but harm others?
🌎 FOR ALL PEOPLE
Structural Medicine, Colonized Bodies, and Collective Healing
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Where did you receive care growing up — a private clinic, public hospital, emergency room, or not at all?
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Did your family have health insurance? If not, what were the consequences? If so, who paid for it?
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Have you or someone you know experienced medical gaslighting, dismissal, or discrimination — particularly based on race, gender, disability, or language?
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What do you know about the racialized origins of medical institutions in your country — from eugenics to gynecology to forced experimentation?
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How did the COVID-19 pandemic impact your community? Who got sick, who died, who got care, and who got ignored?
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What is the connection between your zip code and your life expectancy? Why is that not accidental?
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Have you reflected on the ways pharmaceutical industries, food systems, and environmental toxins disproportionately harm the global majority?
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How do you define health today: Absence of illness? Full-body aliveness? Ability to rest, breathe, and feel safe?
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What are you doing — or willing to do — to help build decolonial, community-centered healing systems that do not reproduce medical violence?
Reckoning with an Unjust Past: a Spoken Word Series by Veronica Wylie