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

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

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

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


Plagued by geographic isolation, poverty, and acute shortages of health professionals and hospital beds, the South was dubbed by Surgeon General Thomas Parran "the nation's number one health problem." The improvement of southern, rural, and black health would become a top priority of the U.S. Public Health Service during the Roosevelt and Truman administrations.

Karen Kruse Thomas details how NAACP lawsuits pushed southern states to equalize public services and facilities for blacks just as wartime shortages of health personnel and high rates of draft rejections generated broad support for health reform. Southern Democrats leveraged their power in Congress and used the war effort to call for federal aid to uplift the South. The language of regional uplift, Thomas contends, allowed southern liberals to aid blacks while remaining silent on race. Reformers embraced, at least initially, the notion of "deluxe Jim Crow"--support for health care that maintained segregation. Thomas argues that this strategy was, in certain respects, a success, building much-needed hospitals and training more black doctors.

By the 1950s, deluxe Jim Crow policy had helped to weaken the legal basis for segregation. Thomas traces this transformation at the national level and in North Carolina, where "deluxe Jim Crow reached its fullest potential." This dual focus allows her to examine the shifting alliances--between blacks and liberal whites, southerners and northerners, activists and doctors--that drove policy. Deluxe Jim Crow provides insight into a variety of historical debates, including the racial dimensions of state building, the nature of white southern liberalism, and the role of black professionals during the long civil rights movement.


Brand new segregated hospitals constitute a
kind of de luxe Jim Crow which is supposed to
be more palatable than the customary variety
and therefore more acceptable. De luxe Jim
Crow is just as objectionable as any other kind.
It is merely a new line of defense against the
slow, but irresistible advance of liberal change.

“The Crushing Irony of De Luxe Jim Crow,”
Journal of the National Medical Association, 1952

The phrase deluxe Jim Crow was first coined in the Baltimore Afro-American in 1927 to describe the first-class compartment for blacks on the Memphis Special, a train running through the heart of the segregated South. Thurgood Marshall later applied the phrase to the southern states’ attempts to shore up segregation by improving black school facilities. For the purposes of this book, deluxe Jim Crow conveys the ethical complexity and ambiguity of segregation in health policy during the Franklin D. Roosevelt and Harry S. Truman administrations. In 1952, medical civil rights activist and Howard University anatomy professor W. Montague Cobb employed the term to decry the publicly funded proliferation of thousands of new hospital beds for blacks in segregated wards, floors, and wings across the South. He denied that any form of segregation, no matter how purportedly beneficial, could ever be considered equal, and he feared that this allegedly kinder, gentler strain might become impossible to eradicate, like an . . .

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