The Long Shadow of Medical Racism

In the first decades of the twentieth century, medical experts insisted that Blacks were not susceptible to polio, based on presumed biological differences between Blacks and whites that had, conversely, also been used to allege that Blacks were more vulnerable to syphilis.

There is of course no racial difference in susceptibility to polio, or to syphilis, or to most other medical conditions. There are substantial racial differences in how we treat and approach medical conditions, and an equally long history of grappling with bringing an equitable approach to treating these conditions.

President Roosevelt claimed he had overcome polio at Warm Springs’ polio rehabilitation center. During the 1936 presidential campaign, Roosevelt was confronted about the center’s all-white admission policy. Roosevelt, who enjoyed extraordinary support among Black voters, responded by announcing, in 1937, the formation of the National Foundation for Infantile Paralysis (later called, The March of Dimes), which soon became the nation’s largest disease philanthropy, and quickly announced “the disease attacked all races.”

The March of Dimes went on to play an outsize role in the eventual trials of the polio vaccine. In the massive clinical trial of the Salk vaccine, begun in 1954 and funded by The March of Dimes, Black children were included, enrolled at the Tuskegee Infantile Paralysis Center. It was the year of the Brown v Board of Education ruling, and the integration of Black and white professionals made news as white nurses assisted Black physicians in administering the vaccine to Black children. The new science of polio, however, did not counter the pervasive medical racism of the time—Warm Springs remained segregated, separatist hospitals and treatment persisted, and white children got preference over Black children when the Salk vaccine administration rollout began in 1955.

We are at another moment where public health, politics, and civil rights activism have converged. Covid-19 has exposed again racial inequities in access to and quality of medical care. This latest mass inoculation program provides a test of whether we can break the inequities of the current health care and public health systems, and whether new trust can be fostered among vaccine recipients. This vaccination program depends on Americans believing that the initial, limited supplies of doses will be allocated fairly—to those who need them most, rather than to those with the most political clout or historic advantage.


Michael Stein & Sandro Galea

As we re-emerge from the pandemic, 2021 stands to be a turning point year for public health. In The Turning Point’s weekly essays, we reflect on what we learned during 2020, and what we are learning during 2021, that can guide us to the creation of a better, healthier world.