Medicine in Black and White
Photo: TJU Archives
It wasn’t that long ago in America that separate hospitals for black and white patients were the norm. In places where a black hospital didn’t exist, black patients might be directed to separate entrances, waiting areas, and wings of a white hospital—or they would simply be denied care.
By the 1950s, a movement was growing to challenge segregation. The civil rights movement was gaining momentum, and in Greensboro, North Carolina, a group of black doctors and patients set the foundation for the changes in healthcare with a lawsuit in which black healthcare professionals applied for staff privileges at a white hospital. When they were refused, lawyers challenged the federal status quo that allowed hospitals to get federal funding, even if they were for whites only. They won—but almost nothing changed.
At that time, hospitals didn’t rely heavily on federal money. And without any major penalties, they didn’t have a big motivation to change to allow black patients or doctors through their doors. Lawyers would have had to take each and every health facility that continued to segregate to court.
However, in 1965, the landscape radically changed when Medicare became law. Medicare was the new health care program that would cover seniors and Americans with disabilities. Under the program, the government would now generously pay for the care of millions of people. However, the rule was that no hospital would get any funding until they were completely integrated. Change was now taking place.
Edith Mitchell, MD, professor of medical oncology at the Sidney Kimmel Cancer Center at Thomas Jefferson University, remembers that her grandmother was one of the first people to get a Medicare card.
A few years later, Mitchell was on her way to becoming a doctor herself. She’s also a researcher now, leading efforts to reduce racial disparities in cancer. But as a young med student in Virginia, she got to see the changes from the inside.
“Nursing staff integrated, so they could work on any ward. Black doctors were given medical privileges, so that they could admit and take care of their patients in those hospitals,” Mitchell says. “It was just amazing.”
She says in the years right after Medicare took effect, fewer black babies died. Health improved. Racial inequities narrowed.