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Vol. LVIII, No. 6
March 24, 2006

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Then and Now, Race Matters
Black History Month Lectures Target Gaps in Health, Care

Two Black History Month events held at NIH on Feb. 23 took different paths to reach the same point: What's past doesn't have to be prologue. Sure, African Americans historically have experienced poorer health and received inferior health care, but current and future generations can change all that by learning our history lessons.

Adopting the 2006 national theme for the month, "Celebrating Community: A Tribute to Black Fraternal, Social and Civic Institutions," the Office of Equal Opportunity and Diversity Management hosted a lecture in Lipsett Amphitheater featuring Roslyn McCallister Brock, vice chair of the NAACP's board of directors.

At the 2006 NIH observance of African-American history, Roslyn McCallister Brock, vice chair of the NAACP’s board of directors, recalls work of black pioneers and civil rights leaders.  

Introduced by NEI's Angela Neal as a "contemporary trailblazer," Brock began by discussing contributions to the health field by some of her organization's pioneers. Early papers written by noted black scholar W.E.B. DuBois were some of the first in the nation to document differences in health between Caucasians and African Americans. His 1906 report, The Health and Physique of the Negro American, is often hailed as the earliest observational study of the well-being of blacks in the post-Civil War period.

In addition, Brock spoke briefly about former NAACP president Dr. W. Montague Cobb, a renowned anthropologist and longtime editor of the Journal of the National Medical Association whose 1946 testimony on unfair health care conditions in the U.S. led eventually to the Medicare program being established in 1965.

Brock said the country has studied and discussed the issue for more than a century now — long enough. The time for action is past due. "Is anybody listening? Does anybody care?" she wondered aloud. "It appears that the rising tide that was intended to lift all boats out of poverty has capsized and left many of our brothers, sisters, mothers, Big Mamas and granddaddies drowning in despair.

"The truth is that when viewed through the lens of bigotry and hatred," Brock continued, "race matters in this country, and it matters in health care delivery and access. The pendulum of justice is moving backward for communities of color across this nation." Recalling a question posed recently by civil rights leader Rev. Joseph Lowery at the funeral of Coretta Scott King, she asked, "When will words become deeds that meet needs?"

Public education, Brock said, is a major part of the solution. The NAACP has teamed up with a number of other civic organizations and private corporations such as the Girl Scouts, the Prince Hall Masons, the Kidney Foundation and Pfizer to get the word out about the importance of quality health care and open access to it. These partnerships, she said, can serve as models to spur even more joint efforts and collaborations around the country. The goal is action and the enemy is complacency, she concluded.

  A former NIMH postdoctoral fellow, Dr. Kirby Randolph of the University of Kansas Medical Center is currently researching race and psychiatry in the 19th and 20th centuries.

In the afternoon's second black history lecture — this one hosted in the Lister Hill Center by the National Library of Medicine's History of Medicine Division — guest speaker Dr. Kirby Randolph posed her own question: How can medical historians help address health deficits?

"Health disparities research usually fails to ask how we got here," she said. "A historical perspective can help us understand whether health disparities have changed over time."

A former NIMH postdoctoral fellow, Randolph now serves as director of the Office of Cultural Enhancement and Diversity and as assistant professor at the University of Kansas Medical Center in Kansas City. Her current research focuses on race and psychiatry in the 19th and 20th centuries, but it was her casual observations of a homeless man named Andre that led her to imagine ways history could shed light on health gaps.

Randolph was a grad student in Philadelphia when she happened to notice a man searching the curb for cigarette butts and eating food foraged from trash cans. Although he appeared to have a home base at a men's shelter, she said, Andre could usually be found near the corner of 34th and Walnut Sts. downtown.

"I wondered what would have happened to Andre — or any black man — who lived in predominantly white public spaces and occasionally yelled at walls, over a hundred years ago," said Randolph, who then based her dissertation on how black people with mental illness were diagnosed and treated following the Emancipation Proclamation, which signaled the end of slavery.

A library search steered Randolph to the Central Lunatic Asylum for the Colored Insane, a state-run Virginia facility established in 1868 to segregate blacks who had mental disabilities. Published hospital records of the era describe fascinating patients: 24-year-old Anthony Jackson suffered from "paroxysmal mania brought on by an unfortunate marriage" and 27-year-old ex-slave Godfrey Goffney, diagnosed with "homicidal mania as the result of freedom," tried to kill every white man he met.

Randolph thinks the stories of these patients, the way their ailments were categorized, the resources society devoted to helping them, whether their cultural beliefs were ignored or incorporated into their treatment and the general care (or lack thereof) that was afforded them can all be instructive for tackling today's unequal health burdens.

As if to answer Brock's query about whether anyone was listening to or caring about the disparities, Randolph briefly mentioned her latest research project. She and colleagues are interviewing 50 African Americans who have chronic mental illness, capturing for the first time, perhaps, glimpses of the disorders from the patient's perspective. By attacking current and past problems from a fresh angle, she suggested, health care providers and medical historians alike may get closer to closing the gaps sooner.

"Answers about what hasn't worked can save us time," Randolph concluded.

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