Throughout history, Black hospitals have had a significant impact on the lives of Black individuals.
They evolved not only out of critical need but as a symbol of pride and achievement within the Black community.
To understand their significance, it is crucial to examine the historical context that led to their creation and their subsequent role in providing medical care and professional opportunities for countless Black Americans.
The Era of Segregation and the Rise of Black Hospitals
Until the 20th century American Civil Rights Movement, Black Americans were either denied admission to hospitals - both in the North and in the South - or faced segregated wards.
To provide a safe space for Black Americans to receive care, segregated Black hospitals were created.
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Historically, Black American medical students were excluded from training programs, and Black American physicians lacked resources for their practices.
Black physicians created spaces within medicine during the Black hospital movement, between 1920 and 1945.
Their aim was to educate and train Black doctors and nurses.
During this time, characterized by the “separate but equal” doctrine, few Black physicians had options and access to training, as separate never meant equal.
With the creation of Black hospital systems, there was now a “designated location” for Black Americans to receive care.
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For many Black Americans seeking emergency care, a white hospital might have been within 5 miles.
Yet, the Black hospital was 60+ miles away.
The white hospital would deny admission, forcing individuals to make the trek to the closest Black hospital, causing many to die trying to access proper care.
The first exhibition in Holman Biotech Commons features "A benefit to themselves, to the sick, and to the community": The Story of Philadelphia's Black Hospitals & Nurse Training Schools.
Notable Black Hospitals and Their Founders
Several Black hospitals emerged as crucial institutions, providing essential medical services and opportunities for Black healthcare professionals.
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Provident Hospital and Training School for Nurses, the first Black-owned and operated hospital in America, was founded in 1891 by Dr. Daniel Hale Williams.
Freedmen's Hospital was established 1862 in Washington, DC by the Medical Division of the Freedmen's Bureau to provide the much needed medical care to slaves, especially those freed following the aftermath of the Civil War.
It still exists today as Howard University Hospital, one of only three remaining traditional Black hospitals.
The Freedmen's Bureau existed for only four years, but during that time a movement was started that paved the way for some ninety new hospitals for Blacks and other health care facilities.
Each state acquired some type of health care facility around 1865 through the turn of the century.
Lincoln Hospital was founded by Dr. Aaron McDuffie Moore (1863-1923) in 1901 when he convinced Washington Duke that a hospital would be a more valuable investment than Duke's idea of building a monument on the Trinity campus to honor African Americans who had fought for the confederacy.
Saint Agnes Hospital established (1886) in Raleigh, North Carolina on the grounds of St. Augustine's College.
Despite obvious handicaps, it was referred to in 1922 as the "only well equipped hospital for Negroes between Washington and New Orleans, serving not only North Carolina, but adjacent Virginia and South Carolina."
The hospital closed in April 1961 after nearly 65 years of service.
Mercy-Douglass Hospital started as two separate hospitals for African Americans: Frederick Douglass Hospital and Nurse Training School, the first African American hospital in Philadelphia, founded by Dr. Nathan Mossell, the first African American physician to graduate from the University of Pennsylvania, in 1895 on 1512 Lombard Street.
Mercy Hospital and Nurse Training School was founded in 1907 by Dr. Eugene Hinson on 17th and Fitzwater Street, becoming the second African American hospital in Philadelphia.
Nurses at Mercy-Douglas Hospital circa 1950s
In 1944, there were 124 Black hospitals in the United States catering exclusively to "colored" patients.
Of these 124 hospitals, 23 were fully approved by the American College of Surgeons and three were provisionally approved.
The Civil Rights Act and the Decline of Black Hospitals
The Civil Rights Act of 1964 and the enactment of Medicare and Medicaid in 1965 benefited millions of people.
The federal campaign to desegregate hospitals, culminating in a 1969 court case out of Charleston, S.C., guaranteed Black patients across the South access to the same health care facilities as white patients.
No longer were Black doctors and nurses prohibited from training or practicing medicine in white hospitals.
But the end of legal racial segregation precipitated the demise of many Black hospitals, which were a major source of employment and a center of pride for Black Americans.
Uninsured Rates by Race/Ethnicity, 2010-2022
“And not just for physicians,” said Vanessa Northington Gamble, a medical doctor and historian at George Washington University.
“They were social institutions, financial institutions, and also medical institutions.”
When Kansas City, Mo., opened a hospital for Black patients in 1918, people held a parade.
Taborian Hospital in Mound Bayou included two operating rooms and state-of-the-art equipment.
It’s also where famed civil rights activist Fannie Lou Hamer died in 1977.
“There were Swedish hospitals. There were Jewish hospitals. There were Catholic hospitals. That’s also part of the story,” said Gamble, author of Making a Place for Ourselves: The Black Hospital Movement, 1920-1945.
“But racism in medicine was the main reason why there was an establishment of Black hospitals,” she said.
By the early 1990s, Gamble estimated, there were only eight left.
The loss of social institutions fell casualty to social progress.
“It has ripple effects in a way that affect the fabric of the community,” said Bizu Gelaye, an epidemiologist and program director of Harvard University’s Mississippi Delta Partnership in Public Health.
The Impact of Desegregation on Black Health
Researchers have largely concluded that hospital desegregation improved the health of Black patients over the long term.
One 2009 study focusing on motor vehicle accidents in Mississippi in the ’60s and ’70s found that Black people were less likely to die after hospital desegregation.
They could access hospitals closer to the scene of a crash, reducing the distance they would have otherwise traveled by approximately 50 miles.
An analysis of infant mortality, published in 2006 by economists at the Massachusetts Institute of Technology, found that hospital desegregation in the South substantially helped close the mortality gap between Black and white infants.
That’s partly because Black infants suffering from illnesses such as diarrhea and pneumonia got better access to hospitals, the researchers found.
A new analysis, recently accepted for publication in the Review of Economics and Statistics, suggests that racism continued to harm the health of Black patients in the years after hospital integration.
White hospitals were compelled to integrate starting in the mid-1960s if they wanted to receive Medicare funding.
But they didn’t necessarily provide the same quality of care to Black and white patients, said Mark Anderson, an economics professor at Montana State University and co-author of the paper.
His analysis found that hospital desegregation had “little, if any, effect on Black postneonatal mortality” in the South between 1959 and 1973.
