Exterior view of the Savannah Health Center. An African American woman is standing by an automobile.


Circulating Now welcomes guest blogger Beatrix Hoffman. Dr. Hoffman is Professor of History at Northern Illinois University and guest curator of NLM’s most recent exhibition, For All the People: A Century of Citizen Action in Health Care ReformWith the extension to open enrollment at HealthCare.gov in the news, here is the second of two postsexploring key themes from the exhibition.

Viewers of the cable TV show “The Knick” have come to know Dr. Algernon Edwards, a fictional African American surgeon at an early twentieth century New York hospital. The brilliant Dr. Edwards faces many trials as he battles the prejudices of white physicians and patients. He even opens a secret clinic in the hospital’s basement to treat African American patients who had been turned away upstairs and by other hospitals. “The Knick” is perhaps the first television series to so powerfully depict not only racial discrimination in the medical profession, but also the denial of care based on race, a tragic but central fact of U.S. health care history.

While Dr. Edwards mostly stands alone, a civil rights movement in health care began even earlier than the years depicted on “The Knick,” and continues today. In response to racial discrimination by most medical and nursing colleges in the U.S., physicians, nurses, and community activists in Chicago raised funds to open Provident Hospital and Training School in 1891. Some medical schools for blacks had been established earlier, but Provident was the first such institution controlled by an African American leadership, and founded explicitly to combat discrimination.

33 African American male and female doctors and nurses gathered for a group photograph.
Interns and nurses at Provident Hospital and Training School, Chicago, 1922
National Library of Medicine

Segregation, discrimination, and poverty led to disproportionately high rates of sickness and mortality among the African American population. Civil rights groups, churches, and community organizations fought these conditions through educational initiatives such as National Negro Health Week (1914–51), infant health stations, and nutritional programs to help curb maternal and infant mortality. Women’s clubs sponsored visiting nurse associations that provided communities with home nursing services, preventive and prenatal care, and health education.

Exterior view of the Savannah Health Center. An African American woman is standing by an automobile.
A visiting nurse stands by a car outside the Savannah Health Center, ca. 1930
National Library of Medicine #101441642

After World War II, the medical civil rights movement increasingly focused on ending segregation in the mainstream health care system. The National Medical Association, the organization of black physicians, protested the pro-segregation provisions of the 1948 Hill-Burton Hospital Survey and Construction Act, and demanded an end to racial discrimination by the American Medical Association, which permitted all-white local chapters. The interracial Medical Committee for Civil Rights (MCCR) was founded by physicians John Holloman Jr. and Walter Lear in 1963. The MCCR made national headlines by picketing the AMA’s convention in Atlantic City that year with signs asking the AMA to “end all segregation and discrimination in medical care.” MCCR members also participated in the 1963 March on Washington for Jobs and Freedom.

A group of people, black and white, men and women, in suits and dresses march under a banner reading Medical Committee for Civil Rights
Medical Committee for Civil Rights at the March on Washington, 1963
National Library of Medicine #c05461

Leonidas H. Berry, M.D. was elected president of the National Medical Association (NMA) in 1965. Berry, a renowned gastroenterologist who spent much of his career at Provident Hospital in Chicago, had personally experienced discrimination when he was repeatedly denied an appointment as attending physician at another Chicago hospital. As head of the NMA, Berry increased pressure on the American Medical Association to desegregate, and in 1968, the AMA finally agreed to end its practice of racial exclusion.

The end of official segregation did not end the differential treatment of African Americans in health care. Berry recognized continuing problems of access and affordability and turned his attention to the poorest black communities, focusing especially on the southern Illinois town of Cairo. With the support of the African Methodist Episcopal Church and Cairo civil rights organizations, Berry organized a group of Chicago health professionals who chartered two airplanes and began making regular flights from Chicago to Cairo to provide care to the people there. They called themselves the “Flying Black Medics.” As well as challenging racial disparities and unequal access to health care, Leonidas Berry had also invented the remote area medical service.