In the past, black people had little to no access to proper health care. The Progressive Era American South was no exception. Healthcare professionals and scientists felt that there was an inherent divide between the races, and this divide was itself responsible for the disproportionate amount that black Americans were afflicted by disease. Venereal diseases, also known as sexually transmitted diseases, were of particular interest to healthcare professionals of this era. Lawrence Lee, a doctor writing in 1915, claimed that fifty percent of black Americans had syphilis on the basis of his experience as a city doctor in the South. Due to the limited knowledge of how to treat syphilis in the Progressive Era, the disease was extremely deadly. Historian Andrea Patterson claimed in her work “Germs and Jim Crow: The Impact of Microbiology on Public Health Policies in Progressive Era American South” that the poor quality of health services and living quarters that the black population had access to lead to the higher rate of death and disease than the white population, eventually causing an empirical difference between the races. However, there existed a prevalent belief that black Americans were more promiscuous than white people. Perhaps more dangerous than the disease itself was the negative perception of sexuality, the route by which the disease was spread. Syphilis became a moral issue, furthering the divide between races as seen by professionals of the time. L.C. Allen, one such medical professional, made a point to note that the fact that both black men and women enjoyed the tabooed sexual intercourse, leading to the high morbidity of syphilis. The views carried by white healthcare professionals in the Progressive Era American South with regards to black sexuality created a greater obstacle for the public health of black Americans than Patterson suggests.
It is of particular interest that syphilis may have had a higher morbidity within both the black and white races than statistically evident. Lee claimed that “syphilis is almost the important factor is the high death-rate of the negro race.” Lee continues, providing evidence of the systemic failure of reporting mortality rates of syphilis. According to Lee, it was common practice for physicians to include a cause of death other than syphilis on the death certificate. Physicians would instead claim that the cause of death was instead “a complication of bronchitis, pneumonia and tuberculosis.” If this is indeed the case, then it can be concluded that mortality rates of pneumonia, tuberculosis, and bronchitis were significantly lower than the empirical data suggests. The three aforementioned diseases are symptomatic of undesirable home and work environments. While it is undeniable that there was a significantly high occurrence of diseases stemming from poor living conditions, the invisible damage done by syphilis cannot be ignored. Lee was clear in his fear that intentional misdiagnosis of syphilis-related death “reduces the chance of a successful fight against these diseases.” Syphilis was considered to be a disease originating and existing almost entirely among black Americans. A cure or treatment for syphilis would most certainly benefit the black population in greater numbers. This concerted effort of omitting syphilis from death certificates was thereby of direct consequence to the public health of black Americans.
The high instance of syphilis and other venereal diseases amongst black Americans living in the American South during the Progressive Era was met with racial discrimination and a reluctance to treat the ill blacks. Allen disclosed these beliefs, revealing that medical professionals, among others, felt that black Americans had “deteriorated physically and morally since slavery times.” This is indicative of the perception of white and black being two distinct races, with the white race being superior to the black. During slavery, black Americans were not allowed by their masters to engage in sexual conduct. For this reason, sexually transmitted diseases were not as prevalent among the population. When syphilis grew to the point it did, with Lee claiming that fifty percent of the black race carried syphilis, the concept of rampant, immoral black sexuality gained popularity. Patterson noted that many diseases were considered racial in nature; blacks were presented as “a ‘notoriously syphilis soaked race’ who lacked ‘stamina and resisting power.’” The racialization of syphilis and sexuality promoted an ideological division between races in the minds of medical professionals.
One of the main reasons that black public health improved was self-interest. Allen discussed how it was the “white man’s burden” to improve the health of the black population. He believed that “disease among the negroes is a danger to the entire population.” This motivation was out of self-interest, as Patterson wrote, in order to protect the whites from an epidemic. There existed a fear that the diseases carried by black people would infect white people, and this was especially so for the then-deadly syphilis. Allen expressed his concern for the spread of venereal diseases from black Americans to whites. He pointed to the fact that gonorrhea is carried by many black women. He was of the opinion that white men would contract venereal diseases through sexual intercourse with infected black women. After marriage, the white men who now carried the disease through this means would spread sexually transmitted diseases to “our innocent daughters.” It is important to note that it was the fault of black people for whites contracting venereal diseases in this discourse. In Allen’s perspective, these diseases were borne of sexual behaviour with black women, innocent on the end of whites. In order to prevent disease in the white population, Allen called for expansion of health care for blacks. However, this deeply-held belief that black Americans were propagators of disease perpetuated the perception of the black race as inferior to the white race. Since this ideology is harmful and self-interested in nature, it is understandable that there was little willingness in the black population to visit hospitals. Allen’s cry to extend vital health services to blacks was just one view carried, however, on how to cure these diseases.
Social Darwinism, the theory that groups and peoples were subject to evolution via survival of the fittest, played an important part in emergent eugenics during this time. Time and time again, scientists attempted to prove their racial biases scientifically, a phenomenon called scientific racism. This included the utilization of IQ scores and health data. Scientific racism was interconnected with social Darwinism and the advent of eugenics. The high morbidity and mortality of various deadly diseases among the black population helped to feed into the idea that the black population was doomed for extinction. Some white healthcare professionals felt that rather than cure the black population of illness, it would be more prudent and less expensive to simply allow the black population to become extinct. Syphilis and other sexually transmitted diseases were singled out as a reason for the “inferiority” of the black race. This can be observed in the infamous Tuskegee study, which concluded, “syphilis in the Negro is in many respects almost a different disease from syphilis in the white.” This application of theory paved the way for a growth in the popularity of eugenics. It was claimed that all of mankind can progress thanks to eugenics. With the large expense caused by increasing access to healthcare for blacks, eugenics would prove to be much less expensive. This would have been enacted by way of inaction – not treating black patients – as well as forced sterilization.
The negative view of black sexuality in the Progressive Era American South carried by white healthcare professionals was a major barrier to black public health. However, the perception of black people, especially women, being sexual beings persists in the modern day. Music videos, including those created by non-black musicians, commonly feature black women dancing in the background in a sexually provocative manner. These black women are also commonly scantily clad in form-fitting clothing. One notable musician to do this is Miley Cyrus in her “We Can’t Stop” music video. Media is often credited as being a time capsule of the thoughts and ideas surrounding the time in which the media is created. It is evident that black sexuality is continued to be considered wild and inherently unlike white sexuality. This is damaging to the societal image of the black race. Sexually transmitted diseases can naturally be found more prominently in individuals who are more sexually active. With black Americans pervasively conceived to engage in higher amounts of sexual activity, this can effectively reduce the willingness of individuals affected by sexually transmitted diseases to seek critical medical care. It is important that the perception of black people as a wholly sexual race be stopped for the betterment of their public health.