Hospitals, Black

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Since the days of slavery, there have been a number of hospitals in the United States run
solely for black patients. In the beginning, the majority of hospitals for blacks were
started in the South by white slaveowners who wanted to protect their investments. That
changed in March 1865 with the federal passage of the Freedmen's Bureau legislation,
which placed some responsibility for black health care in the hands of the federal
government.

That legislation mandated the establishment of ninety health care facilities for blacks
throughout the South. However, once the Freedmen's Bureau bill expired in 1869, local
communities were forced, where possible, to take responsibility for these facilities
themselves, leaving many African Americans with virtually no access to health care
services.

BLACK HOSPITALS FOR THE FREED PEOPLE

Beginning in the late nineteenth century, a number of hospitals founded to treat African
American patients were established by charitable institutions with help from donations
from philanthropists. The largest contributor to this cause was a Jewish philanthropist
named Julius Rosenwald, who donated to black hospitals in several large cities in the
North.

The first of these was the Provident Medical Center in Chicago, which opened its doors
in 1891 as a result of the efforts of African American physician Dr. Daniel Hale
Williams, a pioneer in the field of open-heart surgery. Next came the Frederick Douglass
Memorial Hospital in Philadelphia, founded in 1907 by Dr. Nathan Mossell, the first
African American graduate of the University of Pennsylvania Medical School. Among
the black hospitals established in the South, Hubbard Hospital in Nashville, Tennessee,
was founded in 1911, and the Tuskegee Institute Hospital in Alabama was opened in
1913.

By 1900, there were forty black hospitals and eleven black medical schools in the United
States. Yet by 1932, there was still only one black hospital for every 100,000 African
Americans in the nation, which was the equivalent of one hospital bed for every 1,000
black patients (compared to one hospital bed for every 110 white patients). The realities
of widespread segregation and lack of black hospitals contributed to black mortality
being far higher than that of whites nationwide.

EVOLUTION OF THE BLACK HOSPITAL

A different kind of hospital for blacks evolved over time. These hospitals began as
integrated facilities but eventually became all-black hospitals because of population shifts
in the communities where they were located. The public hospital in Harlem is a good
example of this; once an integrated hospital, it is now almost exclusively black—not by
design but because the population of Harlem is primarily black.

The first real attempt to eliminate some of the inequalities in medical care was made
during the late 1930s with President Franklin D. Roosevelt's New Deal. However, it was
not until World War II that genuine improvements in health care really materialized.
These changes were made primarily because large numbers of soldiers were stationed in
the South, where large segments of the hospital system were inadequate.

With desegregation beginning in the 1960s, African American patients and physicians
increasingly chose to use the best facilities available to them, and these were most often
hospitals that had previously been reserved for whites. Thus, all-black hospitals, left with
inadequate resources and fewer patients, declined in number. Between 1961 and 1988,
seventy-one black hospitals around the nation were closed, merged, consolidated, or
converted.

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