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A Brief History of Black Hospitals in America

By Brian Brown, MBA, Senior Clinical Practice Manager, TeamHealth Midwest Region

Black American child, “Dad, I think I need to go to the hospital.”

Black American parent, “Why, what’s wrong with you?  You only need to go the hospital if you’re dying.”

Unfortunately, the dialogue above has been shared more than we would like to admit in the Black American community.  You may ask yourself, “Why would a parent say something like this to their child?”  To understand this parent’s statement, it is necessary to briefly unpack the history of Black Hospitals in America.

History of Black Americans and 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. The Georgia Infirmary was founded in 1832 as the first segregated Black hospital, and several others were created by the end of the nineteenth century.

The Black Hospital Movement

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. This chasm was particularly present in the medical profession, and many hospitals did not admit Black patients or hire Black staff until the 1960s, years after the legislative end of “separate but equal.”

Black Hospitals in America

Black American child, “It never occurred to me that we had hospitals for Black people.”

Black American parent, “As great as that sounds, in some cases it was terrifying….”

With the creation of Black hospital systems, there was now a “designated location” for Black Americans to receive care. Even so, during the segregated years of America, there have been documented scenarios when a Black American needed emergent care and died trying to get to a hospital.

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. This created a lasting stigma in Black America that loomed throughout the 1900s: “you only go to the hospital if you are dying.”

The Impact of the Civil Rights Act

Black American child, “With the Civil Rights Act, didn’t that make everything better?”

Black American parent, “I don’t know….  I would like to hope so, but unfortunately I don’t know if the data shows that.”

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. They supplied medical care and professional opportunities for countless Black Americans; however, since 1964, Black physicians have gained access to the mainstream medical profession and Black hospitals have become less important to their careers. These hospitals now compete with facilities that had once discriminated against Black patients and staff.

Black hospitals have also historically served large numbers of patients of color who are poor and underinsured. Since the 1960s, staffing challenges, cycles of supply shortages, inadequate facilities and extreme debt have plagued modern-day Black hospitals.

Modern-Day Black Hospitals

A 2010 report in the Medical Care Journal found that Black-serving hospitals struggled with patient safety. For example, Black-serving hospitals surveyed faced nearly double the average rate of postoperative pulmonary embolism or deep venous thrombosis. Even when researchers adjusted for hospital characteristics, Black-serving hospitals still often faced more potential safety events, regardless of the patient’s race.

It is no secret that the health of the Black American community has always been in peril. In 2019, the U.S. Census Bureau reported that 5.2% of white Americans were uninsured. However, almost 10% of Black Americans report being without insurance. Moreover, Black Americans have lower life expectancy rates, living on average more than four years less than the national average and almost five years less than a European American’s average. Black Americans also have the highest age-adjusted death rate among all populations. Infant mortality likewise remains a concern for Black communities, as the mortality rate is significantly higher for Black women than white women. Because of this, it is vital to maintain a sharp focus on the intersections of race, socioeconomics and healthcare.

Celebrating Black History Month at TeamHealth

Black American child:  “My prayer is that we continue to find ways to improve healthcare outcomes for all patients. America has matured; however, there is ALWAYS work that must be done to improve.”

As we celebrate Black History Month, I am grateful for all those before me who made it possible for me to be in management for a large, industry-leading organization like TeamHealth. I feel blessed and a sense of esteem to be relied upon by my clinical team of 37 plus physicians and nurse practitioners, as well as fellow TeamHealth and industry colleagues.

TeamHealth is proud to promote diversity, equity and inclusion in all we do, and this month – and every month – we celebrate the contributions of Black Americans to history and healthcare while acknowledging the past and current struggles Black communities continue to face. Subscribe to our blog and follow our social media accounts to learn more and celebrate Black History Month with us.