Individual and Organizational Responses to Health Conditions in Harlem, New York, during the Interwar Period

Article excerpt

Between 1919 and 1940, Harlem's social activists, health workers, physicians, and politicians mounted a political action and public advocacy campaign to improve health care resources in the community. Protest as a political strategy was only one method utilized by Harlem's black population to improve institutional conditions, physical health, and well-being and thereby develop community. Simultaneously, Harlem's black residents forged alliances among themselves and with white philanthropists to formulate organizational responses, create voluntary arenas for social engagement, and sustain services aimed at improving the health and well being of Harlem residents. (2) This voluntary sector, far from being unified, was internally divided. The participating agencies constituted a social field of competing ideologies, needs, and interests, and the amount of resources available to those seeking to improve wellness--their own and Harlem's--had little support from governmental sources.

Black and white health and social welfare activists, medical practitioners and statisticians debated the causal factors in mortality rates among native blacks and immigrant groups. (3) Godias Drolet, purported that the decreased incidence of tuberculosis in whites was the result of increased immunity due to prolonged exposure to "tuberculization" and urbanization. (4) Similarly, the Journal of the American Medical Association reported that African Americans' high death rate from tuberculosis was the result of blacks' lack of immunity because of their "relatively short period of contact with the disease." (5) While not disavowing racial differences, Clark Tibbits, Chairman of the National Health Inventory Operating Council of the United States Public Health Service, maintained that more emphasis should be placed on environmental conditions in "determining Negro health status." (6) Montague Cobb, a physician and NAACP health activist, echoed Tibbits' ideas, arguing that African Americans' health problems were the "reflection of their socio-economic circumstances." (7)

Discussions of hereditary and biological factors provided conflicting data given the difficulties that inevitably arise when trying to classify individuals into distinct, pure racial groups. (8) In their organizing and activities, voluntary and philanthropic organizations concerned with black Harlem's well being stressed the social and racial neutrality of infectious microbes and argued that employment opportunities, living conditions, dietary habits, and the availability of health services were primary determinants for differences in morbidity and mortality rates among blacks and whites. (9) The work performed in the fields of charity and relief was central to broader health issues and community development as it was an attempt to ameliorate the adverse conditions affecting health. Providing relief and charity work for families and children--these were all methods and efforts that considered the multiple influences on the lived reality of Harlem residents. To understand the ways black Harlem developed, reacted to, and handled the social, physical, and economic realties; it is necessary to move away from narrow notions of health and utilize broader conceptualizations of well being.

The records of voluntary health and social welfare organizations in Harlem in the 1920s and 1930s are limited and fragmented, making the construction of a narrative of their activities, at best, tentative. Focusing on the health and welfare of children, organizations like the Children's Aid Society (CAS), the Utopia Children's House (UCH), the Urban League, and other social welfare agencies and individuals created a broad-based approach to improve Harlem's general health. For most, Harlem's children were the target population of programs because working with adults was commonly believed to yield few results. (10) The Children's Aid Societies' social work with African Americans began in 1863 when it established a school for black children in lower Manhattan. …