NIH Record - National Institutes of Health

The Medicare Hospitalization Certification Program

NIH’ers Volunteered on Behalf of Social Justice

Image
Black and white image of street corner where a group of people including police and photographers gather at a storefront.
Scene from Apr. 21, 1965. Crowds, police and photographers in the street during a race riot in Bogalusa, La. That summer Bogalusa became the battleground between Congress of Racial Equality activists and White supremacists in the Ku Klux Klan. Dr. Stanley Rapoport entered this volatile situation to inspect the local hospital for compliance to Medicare segregation rules.

Photo:  State Library of Louisiana

Would you volunteer to help solve some significant infractions of social justice? 

Perhaps you would be followed or tracked by people in pickup trucks brandishing rifles—as happened to Drs. Norman Robbins and Stanley Rapoport. Or perhaps you could be threatened with instant death when trying to help peace marchers who had been brutally clubbed by state troopers—again as Robbins encountered. Or perhaps you would get arrested because you stayed in the homes of Black citizens and went around asking too many questions—as Rapoport experienced. You might even be involved in preparing hospitals and jails for race riots on the streets of Washington, D.C.—as did Dr. Jesse Roth. 

These events really happened to NIH scientists during the 1960s Civil Rights movement. A somewhat little-known history, their experiences have been recently documented in oral histories conducted by the Office of NIH History and Stetten Museum. 

In 1965 and 1966, four young scientists working at NIH, all members of the Public Health Service, volunteered to go to the southern United States on a government-sanctioned mission: to assess whether hospitals provided integrated health care and whether Black health-care workers were given equal access to education and jobs in hospitals. The NIH scientists were aware of Jim Crow laws and the disregard for the well-being of Black citizens who were segregated into hospital areas in which the quality of services and environment were notably substandard compared to areas reserved for Whites. 

Johnson signs a paper, with four people looking on.
President Lyndon Johnson signed the 1965 Medicare bill in a ceremony held in Independence, Mo. Standing behind him were Lady Bird Johnson and Vice President Hubert Humphrey. Sitting next to him was President Truman and his wife Bess.

Photo:  Credit National Library of Medicine

Segregation in Southern hospitals had continued despite two federal laws that called for equal treatment for all, namely, the Hill-Burton Hospital Construction Act of 1954, and the Title VI of the Civil Rights Act of 1964. Both laws demanded an end to discrimination, but neither had the administrative teeth to produce a result in medical care. Something more had to be done to mitigate the limited medical care available to people of color. In the Medicare Act of 1966, therefore, the federal government would only guarantee payment to hospitals that integrated as required by the law. If hospitals did not integrate, they would not receive Medicare funding.

The need for government investigators to assess the situation in each hospital in the South and to help hospital administrators implement the new laws were the reasons the federal government approached Public Health Service officers to volunteer in this endeavor. But there were hazards in undertaking these responsibilities. Many White Southerners wanted to maintain segregation and were often violently militant, as the volunteers soon discovered.

New oral histories from four of the NIH investigators who took up the challenge to help integrate health care provide stirring stories of their experiences. The example of Black protestors and the scientists’ own participation in this volunteer project subsequently led these NIH’ers individually to additional acts of social justice on behalf of the underprivileged, socially disparaged and frequently mistreated people. 

Find an introduction and links to the transcripts at https://history.nih.gov/display/history/Medicare+Hospital+Certification+Program+Oral+Histories.  

The Results Are In

Three fellows in the lab, including one holding a beaker with blue liquid and another holding up and examining a small vial of blue liquid.
Sadtler’s lab mates include (from l) Kenneth Adusei, Maria Karkanitsa and Tran Ngo.

Photo:  Credit NIBIB

Results from the antibodies study reveal there were nearly 17 million undiagnosed Covid-19 cases in the U.S. by July 2020, far exceeding the known number of cases in a pandemic that has affected the country unevenly. 

Analysis of participant blood samples—along with the collected health, demographic and socioeconomic data—offers insight into the undetected spread of Covid-19 and subgroup vulnerability to undiagnosed infection. 

“The estimate of Covid-19 cases in the United States in mid-July 2020, 3 million in a population of 330 million, should be revised upwards by almost 20 million when the percent of asymptomatic positive results is included,” said NIBIB’s Dr. Kaitlyn Sadtler, about the study published June 22 in Science Translational Medicine. “This wide gap between the known cases at the time and these asymptomatic infections has implications not only for retrospectively understanding this pandemic, but future pandemic preparedness.” 

The NIH Record

The NIH Record, founded in 1949, is the biweekly newsletter for employees of the National Institutes of Health.

Published 25 times each year, it comes out on payday Fridays.

Assistant Editor: Eric Bock
Eric.Bock@nih.gov (link sends e-mail)

Staff Writer: Amber Snyder
Amber.Snyder@nih.gov (link sends e-mail)