Tag Archives: healthcare

The Race Gap in 21st Century American Healthcare

A man reading a newspaper headline about healthcare, explains to his wife that, he believes, racial health inequities is what led to Michael Jackson’s skin color change.
A man reading a newspaper headline about healthcare, explains to his wife that, he believes, racial health inequities is what led to Michael Jackson’s skin color change.

Racial health inequities have been an issue in the United States since at least the nineteenth century when the Jim Crow laws, which enforced racial segregation in the South, were put in place. The end of Segregation occurred in 1964. While Civil Rights did much to improve discrimination caused by segregation, there are still issues of inequality that remain, like in healthcare.

On March 20, 2002, the Institute of Medicine, now known as the National Academy of Medicine, released a report, titled “Unequal Treatment: What Healthcare Providers Need to Know About Racial and Ethnic Disparities in Healthcare” (Institute of Medicine). It provided the first comprehensive look at racial disparities in healthcare among people who have health insurance (Stolberg). Racial health disparities were a topic that had been looked at well before this study, but the report claimed that a majority of the problem was due to lack of access offered to minorities. For instance, the Institute of Medicine’s report found that blacks have higher death rates when it comes to cancer, heart disease, and H.I.V. infection (Stolberg). Additionally, blacks are twice as likely to develop diabetes than whites, which also contributes to higher death rates. These outcomes were due to the fact that the appropriate medications, surgeries, transplants, or treatments were less likely to be given to African Americans.

The persistent gap in health care due to race is the subject of Mike Luckovich’s political cartoon, published on March 25, 2002, in The Atlanta Journal-Constitution. In the cartoon, we see a black couple reading a newspaper with the headline, “Report: Whites Get Better Healthcare.” In response to the paper’s headline, the husband comments to his wife, “I finally understand why Michael Jackson bleached himself.”

Michael Jackson was, a very successful African-American singer, songwriter, and dancer, but he was also the subject of much controversy in the late twentieth century. One controversy involved his lightening skin tone. People began speculating about Jackson’s appearance once his skin color began to noticeably lighten. They assumed that the change was done with intentional bleaching treatments. Additionally, he had plastic surgery to change some of his facial features, such as his chin and nose. Due to the many cosmetic changes, many people speculated that Jackson was intentionally changing his appearance in order to try to look white (Harris). In a 1993 interview with Oprah Winfrey, however, Jackson said “I’m a black American. I am proud to be a black American. I am proud of my race, and I am proud of who I am. I have a lot of pride and dignity of who I am.” (Park). He explained that the reason his skin began to lighten was due to vitiligo, a disease that causes the loss of skin pigmentation.

The meaning behind Luckovich’s cartoon resonates with that of John Knott’s 1931 cartoon, “The Shadow” (Dallas Morning News 18), and its accompanying editorial, “The Black White Plague” (Dallas Morning News 18). Knott’s cartoon and the editorial were published during the middle of a big tuberculosis epidemic. Due to racial segregation of the time, whites were given priority over blacks when it came to healthcare. This neglect of equal health care, at the time, led to many black deaths. Both Luckovich’s and Knott’s cartoons illustrate how race affects people’s access to healthcare; and both cartoons depict the negative effects resulting from discrimination in healthcare.

Inequities in healthcare today still remain a problematic issue. People of color place their trust in the healthcare system, hoping to get the best care possible, are often let down. Mike Luckovich’s cartoon, highlights the sad fact that the color of one’s skin can change the way one is treated within the healthcare system, an issue that has persisted for the past three centuries.

Works Cited

Harris, John E. “Did Michael Jackson Have Vitiligo?” University of Massachusetts Medical School, 18 Jan. 2016, www.umassmed.edu/vitiligo/blog/blog-posts1/2016/01/did-michael-jackson-have-vitiligo/.

Institute of Medicine. “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.” Nationalacademies, 20 Mar. 2002, www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2003/Unequal-Treatment-Confronting-Racial-and-Ethnic-Disparities-in-Health-Care/PatientversionFINAL.pdf.

Knott, John. “The shadow” Illustration. Dallas Morning News 25 Feb 1931: 18. News Bank. Web. 2 May 2018. < http://infoweb.newsbank.com.ezproxy.lib.utexas.edu/iw-search/we/HistArchive/?p_product=EANX&p_theme=ahnp&p_nbid=V50N4DWHMTUyNTc2MTEzOS4yNjA3MDU6MToxMjoxMjguODMuNjMuMjA&p_docref=v2:0F99DDB671832188@EANX-104D1FAAE39AFF33@2426398-104D1FAB9E250B09@17

Luckovich, Mike. Illustration. The Atlanta Journal-Constitution 25 March 2002. AJC. Web. 2 May 2018. < https://www.ajc.com/news/opinion/michael-jackson-cartoons-mike-luckovich/L7LO4mAObSWzVoaI5iSytK/#6>.

“Michael Jackson.” Biography.com, A&E Networks Television, 18 Jan. 2018, www.biography.com/people/michael-jackson-38211.

Park, Madison. “In Life of Mysteries, Jackson’s Changed Color Baffled Public.” CNN, Cable News Network, 8 July 2009, www.cnn.com/2009/HEALTH/07/06/skin.color.vitiligo/.

Smith, Troy D. “Medicine and Medical Care.” Gale Library of Daily Life: Slavery in America, edited by Orville Vernon Burton, vol. 2, Gale, 2008, pp. 48-49. Gale Virtual Reference Library, http://link.galegroup.com.ezproxy.lib.utexas.edu/apps/doc/CX3057200169/GVRL?u=txshracd2598&sid=GVRL&xid=b844d00c. Accessed 2 May 2018.

Stolberg, Sheryl Gay. “Race Gap Seen in Health Care Of Equally Insured Patients.” The New York Times, The New York Times, 21 Mar. 2002, www.nytimes.com/2002/03/21/us/race-gap-seen-in-health-care-of-equally-insured-patients.html.

Urofsky, Melvin I. “Jim Crow Law.” Encyclopædia Britannica, Encyclopædia Britannica, Inc., 19 July 2017, www.britannica.com/event/Jim-Crow-law.

The Shadow

A White Plague figure and its shadow loom over the door of impoverished blacks.
A White Plague figure and its shadow loom over the door of impoverished blacks.

Tuberculosis, also known as the White Plague, was a major health problem within the United States during the nineteenth century. The disease continued into the twentieth century and was the cause of many deaths. In 1936, it was estimated that one out of every twenty-one deaths was due to tuberculosis (Baughman). Among those deaths, a disproportionate number of them occurred among blacks (Ward). African-Americans had a higher death rate during the tuberculosis epidemic because they could not get the treatment they needed.

Racial segregation has a long and unfortunate history in the United States. One of the downstream consequences of racial segregation was that white people who were diagnosed with tuberculosis were likely to be treated in a residential sanatorium, a medical facility that was used during the time to treat tuberculosis; but black people, even if diagnosed early, were given few or no treatment options, which resulted in higher death rates.

In February of 1924 African-Americans led a state-wide campaign to obtain funds to build a tuberculosis hospital in Kerrville, Texas, for blacks living in the south-western states of Texas, Oklahoma, Louisiana, and Arkansas (The Austin Statesman). It wasn’t until 13 years later, however, on June 1, 1937, that such a facility was opened. Named the Kerrville State Sanatorium, it offered free and better care and amenities for blacks up until 1949. After its closing, the remaining patients were sent to another hospital in Tyler, Texas (Winkle).

In a cartoon titled, “The Shadow,” published in the Dallas Moring News on February 25,1931, cartoonist John Knott depicts the White Plague as a white robed figure entering a room labeled “Destitute Negro.” (One thing to take into account when viewing this cartoon is that while we now consider the term “Negro” to be offensive, at that time it was considered to be the appropriate term to use.) The shadow cast by the White Plague is a gloomy figure, like the Shadow of Death, looming and foreshadowing what will happen to the impoverished people behind the door.

The cartoon’s accompanying editorial titled, “The Black White Plague,” also could be misunderstood upon first reading (e.g., tuberculosis being carried by blacks constitutes a plague). However, the editorial actually promotes a progressive message. It comments on how cruel it was to refuse medical aid to people because of their skin color and explains that by doing so, race-based health inequities harm all people.

Race and segregation played a big role in who got what during the nineteenth and early twentieth centuries. If people like John Knott saw that Segregation was unjust, one would think that the matter of health inequities would have been controlled by now; but that’s far from the case. Unfortunately, 54 years after the end of segregation, health disparities continue to be a problem and people’s health and well-being are still too often determined by the color of their skin.

Works Cited

Burns, CHESTER R. “University of Texas Medical Branch At Galveston.” Texas State Historical Association, 15 June 2010, tshaonline.org/handbook/online/articles/kcu29.

Joseph, D. George. “Tuberculosis.” Dictionary of American History, edited by Stanley I. Kutler, 3rd ed., vol. 8, Charles Scribner’s Sons, 2003, pp. 235-238. Gale Virtual Reference Library, http://link.galegroup.com/apps/doc/CX3401804292/GVRL?u=txshracd2598&sid=GVRL&xid=51e75362. Accessed 2 May 2018.

Knott, John. “The shadow” Illustration. Dallas Morning News 25 Feb 1931: 18. News Bank. Web. 2 May 2018. < http://infoweb.newsbank.com.ezproxy.lib.utexas.edu/iw-search/we/HistArchive/?p_product=EANX&p_theme=ahnp&p_nbid=V50N4DWHMTUyNTc2MTEzOS4yNjA3MDU6MToxMjoxMjguODMuNjMuMjA&p_docref=v2:0F99DDB671832188@EANX-104D1FAAE39AFF33@2426398-104D1FAB9E250B09@17>.

“Negro.” International Encyclopedia of the Social Sciences, edited by William A. Darity, Jr., 2nd ed., vol. 5, Macmillan Reference USA, 2008, pp. 458-459. Gale Virtual Reference Library, http://link.galegroup.com/apps/doc/CX3045301725/GVRL?u=txshracd2598&sid=GVRL&xid=0d4d2874. Accessed 2 May 2018.

“Negros Propose to Build Tuberculosis Hospital At Kerrville.” The Austin Statesman (1921-1973), Feb 24, 1924, pp. 5. ProQuest, http://ezproxy.lib.utexas.edu/login?url=https://search-proquest-com.ezproxy.lib.utexas.edu/docview/1643861748?accountid=7118.

“The Great White Plague.” Dallas Morning News. 25 Feb., 1931, http://infoweb.newsbank.com.ezproxy.lib.utexas.edu/iw-search/we/HistArchive/?p_product=EANX&p_theme=ahnp&p_nbid=S4CE4EAIMTUyNTM5NDI1Ny42MTY5MTc6MToxMjoxMjguODMuNjMuMjA&p_docref=image%2Fv2:0F99DDB671832188@EANX-104D1FAAE39AFF33@2426398-104D1FAB9E250B09@17-104D1FAF50A85223

“‘The Great White Plague’—Tuberculosis Before the Age of Antibiotics.” American Decades, edited by Judith S. Baughman, et al., vol. 4: 1930-1939, Gale, 2001. Gale Virtual Reference Library, http://link.galegroup.com.ezproxy.lib.utexas.edu/apps/doc/CX3468301286/GVRL?u=txshracd2598&sid=GVRL&xid=eadf7701. Accessed 2 May 2018.

Ward, Thomas J., Jr. “Health Care.” The Jim Crow Encyclopedia, edited by Nikki L.M. Brown and Barry M. Stentiford, vol. 1, Greenwood Press, 2008, pp. 363-371. Greenwood Milestones in African American History. Gale Virtual Reference Library, http://link.galegroup.com.ezproxy.lib.utexas.edu/apps/doc/CX3256100137/GVRL?u=txshracd2598&sid=GVRL&xid=c6eb623d. Accessed 2 May 2018.

Winkle, Irene Van. “TB Hospital for Blacks Gave Hope to Many Who Recovered.” Wkcurrent.com, 21 Feb. 2008, wkcurrent.com/tb-hospital-for-blacks-gave-hope-to-many-who-recovered-p1416-71.htm.

Too Far Apart

John Knott’s illustration depicts a sick, middle-income American staring up at a building with the words “high-class income” inscribed on its side.

The political cartoon Too Far Apart offers a comedic yet eye-opening perspective on the imbalanced distribution of healthcare during the Great Depression. The Great Depression devastated the middle class, further excluded the lower class, and ruined the lives of several members of the upper class. Many Americans lost their jobs, and droughts across the country caused many farmers to lose their major source of income. This drastic spike in the poverty rate led to a significant decrease in the quality of healthcare received by the public. Furthermore, many impoverished citizens were unable to consistently eat and this made them more susceptible to the various illnesses that were prevalent during the 1930s. Many children suffered from rickets (a disorder that stems from a lack of Vitamin D, phosphate, or calcium) and since there were many areas that didn’t have running water, a large number of people became ill from the constant spread of germs. Physicians often found themselves unable to handle the sudden influx of unemployed and underprivileged patients, and this eventually created a gap in the quality of healthcare Americans received.

The article that complements this cartoon, titled ”The Medical Problem”, aims to provide insight on the medical issue from the perspective of the many physicians that were working during the Great Depression. The article claims that much like the majority of citizens, many doctors were negatively affected during the Great Depression. Countless physicians were being overworked and did not receive any compensation for their efforts. Additionally, many unemployed Americans that were unable to afford medical care were under the assumption that doctors failed to understand their troubles and doctors eventually began to feel the same way about the American populace. The article also pessimistically analyzes several proposed solutions to the medical problem that was prevalent during the Great Depression. The author repeatedly asserts that doctors and American citizens were “unable to agree” on a way to ensure that Americans received quality healthcare and that doctors were equitably salaried. However, agreement on a solution was not a simple task. The author highlights the complexity of the medical crisis by saying that it was a “many-sided problem” and that “even the soundest medical thinking has difficult cross-currents”.

Too Far Apart, a political cartoon drawn by John F. Knott, accurately illustrates the rift that was created between upper class healthcare and middle class healthcare. According to “Poverty in America: An Encyclopedia”, “public-relief programs enjoyed widespread support” during the Great Depression. For example, many middle-income Americans (income of $150 to $424) heavily relied on the Work Projects Administration (WPA) to supply them with medical care. The WPA did what they could, but they often lacked the proper facilities to treat their “3.5 million patients”. However, families that were considered to be financially comfortable (income of $425 and up) were, on average, able to pay for medical care 45.9 percent of the time. Middle-income families were only able to pay for medical care 18.8 percent of the time. This meant that many of these families (31.4 percent) were forced to rely on the free programs that were being offered through Franklin D. Roosevelt’s New Deal. Knott’s cartoon exemplifies this fact by showing an ill and hopeless man lying in a bed with the words “medium income sickness” inscribed on the blanket. The man is looking up towards a rather large building with the words “first class medical care” etched on its side. The fact that the man in the medium income bed is unlikely to ever be able to reach the first class medical building that is not only physically separated from him but also metaphorically separated implies that there was indeed an issue that needed to be resolved and that many unlucky, downtrodden, and sick Americans were suffering due to the lack of a solution.

The humor in this cartoon is particularly subtle. Neither the character nor the environments in this cartoon are drawn in an exaggerated form. Knott undoubtedly choose this realistic style to illustrate the seriousness of the medical problem that affected millions of Americans during the Great Depression. Knott’s goal for this cartoon was not to make people laugh. He instead aimed to inspire thought amongst his viewers. However, this cartoon does contain some humor. Many viewers of this cartoon could probably relate to the man in the bed since millions of Americans were either unemployed or unable to pay for topnotch medical care. Knott takes advantage of the human capacity to empathize with another individual or situation in an effort to further emphasize to his message through humor.

John Knott’s cartoon Too Far Apart accurately captures the despondent attitude many Americans had towards the medical industry during the Great Depression. Many families could not afford decent medical care and they were forced to rely on public-relief programs whenever they became ill. Various solutions were drawn up but because of the disparity between the ideals of doctors and patients, there was never any agreement. These numerous disagreements created a gap between the health care received by the upper class and middle class. As this gap became increasingly apparent, journalists and artists like John Knott yearned to expose this problem and one impactful result of this desire was the political cartoon Too Far Apart.

Works Cited

“Great Depression.” Poverty in AmericaAn Encyclopedia. Russell M. Lawson and Benjamin A. Lawson. Westport, CT: Greenwood Press, 2008. 61-65. Gale Virtual Reference Library. Web. 2 Dec. 2014.

“The Human Impact of the Great Depression.” The Human Impact of the Great Depression. N.p., n.d. Web. 01 Dec. 2014. <http://bigmateo0.tripod.com/id2.html>.

“Health Conservation and WPA – Social Welfare History Project.” Social Welfare History Project. N.p., n.d. Web. 28 Nov. 2014. <http://www.socialwelfarehistory.com/eras/health-conservation-wpa/>.

Perrot, George St. J. “Medical Care during the Depression: A Preliminary Report upon a Survey of Wage-Earning Families in Seven Large Cities.” NCBI. N.p., Dec. 2005. Web. 28 Nov. 2014. <http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2690273%2F>.