The racialization of disease can be seen in the association between tuberculosis and the African-American community in Harlem in the early 1900s. The notions of racial inferiority and black susceptibility to disease, in particular Tuberculosis, an air-borne disease that more commonly affects the lungs, worked in ways that further marginalized and inflicted dangerous stereotypes. Prior to the discovery of the bacteria in 1882, tuberculosis was perceived to be a disease of the upper class. With the increasing understanding of the transmission of the disease, not only did the bacteria become stigmatized and feared but the person who carried the illness.[1] And along with this greater fear among the public, fueling racist thought and ideology, as a black physician states, there was "a malicious, unfavorable publicity...associated with tuberculosis among Negroes." In particular in Harlem, with the Great Migration of blacks to NYC, tuberculosis plagued the black community and the neighborhoods became a topic of racialized space and disease. The framing of the disease as a spot on a map paved the way for the Baltimore-inspired model of "Lung Block" interpretation of NYC blocks. [2] The issue of "Lung Block" is not unique to the African-American community in Harlem, as Hernnan Biggs points out the outbreak of disease and the issue of surveillance to the tenements in Lower Manhattan among European immigrants.[3] Dr. Samuel Roberts claims the process of representing a disease as a dot on a map "disassociates illness from [the] social process[es] that create health disparities."
Portraying the high level of prevalence of tuberculosis among the black community in Harlem as a public health phenomenon inherently aligned with racial susceptibility and personal behavior denies all structural and social processes. It takes the attention away from the real causes of proliferation of disease among a population. Poverty, residential segregation, and lack of adequate health care are at the root of the spread of disease among a community. Since tuberculosis is spread through close contact, residential segregation becomes a powerful institution in creating the ideal conditions of poverty that allow such dissemination of illness.
Harlem hospital as an institution, founded in 1887, is a site where the suffering of people with tuberculosis is strongly felt as it cared for a lot of the population in the community. The hospital also inspired collective activism in the fight against the disease, racism, and poverty. As the healthcare facilities during the 1900’s were fairly inadequate in serving the community, the hospital with just 150 beds in 1907 became known as “the Morgue.” As members of the community, such as social workers and physicians, joined together to fight the disease, a more inclusive goal to improve public health took over discourse of change. Groups such as the New York Tuberculosis Association and the Harlem Tuberculosis and Education Committee were formed. Today, Tuberculosis is mainly a disease that plagues the poor in developing countries. It is interesting to see how the disease remains one embedded in poverty, and how in other communities issues of housing and healthcare still apply.
- Olga Diaz and Elizabeth Perry
[1] Calhoon, Claudia Marie. "Tuberculosis, Race, and the Delivery of Health Care in Harlem, 1922-1939." Radical History Review 80, (2001): 101-19.
[2] Samuel Kelton Roberts, Jr. Infectious Fear: Politics, Disease, and the Health Effects of Segregation. Studies in Social Medicine. Chapel Hill: University of North Carolina Press, 2009.
[3] Biggs, Hermann M. "The Registration of Tuberculosis." Philadelphia Medical Journal 6, no. 22 (1900): 1023-29.
