Deluxe Jim Crow: Civil Rights and American Health Policy, 1935-1954

Abstract

Deluxe Jim Crow examines the struggles of black civil rights activists, public health officials, and liberal southern politicians to address racial health disparities during the Roosevelt and Truman eras. In their efforts to provide medically underserved African American communities with expanded access to health-related federal funding, reformers embraced what Thomas describes as a “devil's bargain,” adopting an ethically complex system that significantly reduced racial health disparities but which left the principle of segregation intact. By framing health reform as critical to the nation's economic well-being and military defense—rather than as a campaign for racial equality—advocates were able to accomplish a series of legislative measures, culminating in the Hill-Burton Act of 1946, which provided for the construction of biracial hospitals, modern medical facilities with segregated wards. While not explicitly aimed at the alleviation of racial health inequalities, reformers required that funding for such institutions be distributed according to a need-based formulation and included a substantive “nondiscrimination” clause, mandating a degree of racial parity in the allotment of funds and hospital provisions. Through this system of “deluxe Jim Crow,” reformers found a means to provide valuable medical resources to impoverished African Americans suffering from debilitating conditions throughout the South. Although the practice of segregation remained, their reforms proved remarkably successful at improving the health of African Americans and reducing racial disparities during the time period.