The Black-White Mortality Differential In New York State, 1900 - 1950: A Socio-Historical Reconsideration
One of the most perplexing issues that has confronted modern medical policy makers and social scientists has been the persistent discrepancy in black and white American health. This study will outline the major discrepancies between the health of black and white New Yorkers that emerged just before World War I through the mid-twentieth century. Second, this study will describe common medical and sociological perspectives of this period that attempted to explain these broad racial differences -- differences in general mortality rates, infant and maternal mortality rates, and illness. These views were frequently distortions that influenced strongly public health and medical policy toward blacks of New York State throughout the Depression and World War II era.
Third, this research will highlight perspectives and programs of black medical activists and social welfare groups that addressed health problems of pre-1950 black New Yorkers. We conclude that it was largely black medical professionals and black community social welfare researchers who strove to develop more accurate, empirically-based explanations for the black-white health differential, as well as specific services to try to eliminate this black-white health gap. As the World War II decade comes to a close, however, their challenge to the medical establishment remained largely unmet.
During the first five decades of the twentieth century, New York, like other northern states, experienced a sweeping change in its racial and demographic make-up. Along with the massive influx of European immigrants, the so-called Great Migration delivered a steady wave of black newcomers to the Empire State.(1) The Great Migration was the urbanization and northward trek of thousands of formerly rural, southern-centered blacks. During 1910 to 1920, New York state's black population climbed from approximately 134,000 to 198,000. While the majority of New York state's black residents centered in New York City, nearly one-third (about 64,000) lived throughout other parts of the state. From 1920 to 1930 the black population of New York climbed even higher, to about 412,000, an increase of over 100 percent that placed blacks about one-fifth of the state's total population.(2)
In addition, New York state's other four largest cities -- Buffalo, Syracuse, Albany and Rochester -- experienced marked gains in their black populations throughout the first three decades of the twentieth century. (see Table I) The black community of Buffalo, for instance, rose more than 100 percent from 1910 when it was 1,773, to 1920 (4,511), and over 200 percent from 1920 to 1930 (13,563). By 1930 black Buffalo comprised 2.4 percent of that city's overall population, a fourfold increase from 1910 when blacks were but four-tenths of a percent. As the figures indicate in Table I, the black community of Rochester more than tripled during the 1910 to 1930 period (879 to 2,749). So it is important to recognize that, during the opening decades of the twentieth century, the urban growth of black New York was not restricted to New York City; this growth was a statewide phenomenon.
This statewide spread of black communities also made New York's total black population, in 1930, the second largest among northern states, while its white population was the largest of any state in the nation. By 1946 New York's black population reached approximately 571,200, the largest concentration of blacks in any area outside of the South.(3)
THE EARLY BLACK-WHITE HEALTH CRISIS: A PROFILE
At the same time that the black population in New York and other northern industrial states spiraled upward, data accumulated by the federal census bureau and New York health agencies revealed increasingly that a crisis in black health had unfolded.(4) As early as 1913 in New York state mortality for blacks (per 1,000 population) was 21. …