The American Health Dilemma: The Medical History of African Americans and the Problem of Race

In the first of a projected two-volume work, the authors, both physicians and senior research scientists at the Harvard School of Public Health, document how, from their first arrival on these shores, blacks received inferior health care. Slaves faced a multitude of health risks: among them were accidents, whippings, cold, heat, exhaustion (pregnant slaves often miscarried) and poor sanitation. Planters rarely summoned white physicians to treat their slaves; generally, black grannies, midwives, root doctors and healers cared for their people. African-American health got worse during and after the Civil War, when the imperfect plantation health care system vanished overnight. A racist postwar society used Darwinism, biological determinism and skull measurements to argue that African-Americans were destined to poor health and extinction. In response, led by pioneering black doctors like James McCune Smith and David John Peck, African-Americans built their own medical schools and hospitals. Black physicians became community leaders and proclaimed health care a civil right. Still, at century's end, African-Americans were segregated and excluded from the mainstream health system. This is an important book, but it is not a well-organized, well-written work of history. The authors attempt to pack several books under one cover: a history of racism over the last 2,000 years; a survey of ancient Greek, Roman, Egyptian and Arabian medicine; an indictment of the U.S. health care system and of modern America as a hopelessly racist land; and a book of political advocacy and reform. The best part of this volume is its last half, containing the actual history of African-American health from 1619 forward. The dense, stilted, academic prose style serves the authors poorly, but their book contains too much valuable information to ignore. (Sept.)