[Celebrating Juneteenth] Slavery Still Has Dire Impact On African Americans’ Health

This is the fifth of our six-part series ‘Celebrating Juneteenth’ – June 19th is Juneteenth, the oldest known celebration commemorating the ending of slavery in the United States. It is also known as African American Independence Day or Freedom Day. Unfortunately, due to the pandemic, the Annual NC Juneteenth Celebration will be not be held in 2020 but will return on June 19, 2021, from 1 pm – 10 pm in downtown Durham. The Celebration is always free and open to the public.

In the 18th through early 20th centuries, in attempts to understand the impact of slavery, white physicians studied black slaves and their descendants’ legacy. They believed that all questions about health could be answered in the body; therefore, if blacks had poorer health outcomes than whites, the differences must be due to inherent racial weaknesses, not disparities in economic circumstances. This research played a significant role in constructing a narrative of race in the United States, the repercussions on their legacy are still being felt in the lives and health of African Americans today.

Free blacks after the Civil War were the first advocates for federal health care. They argued that the right to health care should be among the benefits of being a citizen of the United States.

The discriminatory Jim Crow laws enacted in southern and some western states following the Civil War also took a toll on the health of African Americans. Research documents show higher black infant mortality rates in Jim Crow states prior to the passage of the 1964 Civil Rights Act, which abolished the laws. Research also shows a heightened risk of estrogen receptor-negative breast cancer (which tends to have worse survival rates than ER-positive breast cancer) among African American women raised in Jim Crow states.

Considerations of health and well-being as fundamental human rights have always been at the heart of serious attempts to understand the experience and history of enslavement in the Atlantic world. As a profoundly oppressive, destabilizing, and deeply exploitative social system—and a toxic method of utilizing human labor—slavery in the Americas guaranteed negative health outcomes and enduring health problems in all of its geopolitical and historical contexts.

Breaking down core elements of the enslavement process and slavery’s oppressive governance and exploitation of slave life and labor highlights how the system relentlessly undermined physical, psychological, and emotional wellness. The initial acts of capture, incarceration, human commodification, and forced transportation all weakened health. So too did the separation of families and disruption of communities and being held in captivity under constant surveillance, with labor coerced and closely supervised.

Indeed, the well-being of the enslaved was constantly threatened by the rigid regulation of all aspects of daily life. Slave health was also vulnerable to the use and constant threat of violent punishment, dangerous and debilitating occupations, as well as environmental exposure. Poor housing and sanitation and inadequate food, water, and clothing also put enslaved people at risk of a range of debilitating diseases.

Sexual interference and abuse were major assaults on slave health. During slavery, the black African woman was regarded as an object of economic value. At the same time, she was also treated as an object of sexual abuse by white slave owners.
There was a belief that a black woman was sexually promiscuous and she could be raped and abused at the slave master’s will.

Throughout the history of their enslavement, however, Africans and their New World descendants vigorously resisted the destructive effects of oppression and pursued a struggle for health reliant upon their own knowledge, practices, and resources, absorbing new ways of healing through encounters and cross-cultural exchanges with white Europeans and the indigenous peoples of the Americas.

Eighteenth- and nineteenth-century abolitionist activists recognized slavery’s dire health impact, which they brought to light in their campaigns and writings. Late-20th-century public health discourse encouraged policymakers, governments, and health professionals to consider a broader range of determinants beyond the role of individual behaviors and the health-care system—especially structural, material, and psycho-social factors—in an effort to fully evaluate and improve the health status of population groups.

Historians of slavery in the Americas and medical researchers have adopted innovative and interdisciplinary approaches in exploring the health histories of enslaved peoples, with the increased availability of sources in the digital age and new collaborations all promising ever more robust, holistic, and systemic analyses.