Progressive Public Health Administration in the Jim Crow South: A Case Study of Richmond, Virginia, 1907-1920

In the early twentieth century, Richmond, Virginia embarked on a campaign to modernize its public health department. One consequence of southern racial attitudes, however, was that African Americans did not constitute a primary constituency for public health intervention. This was based, in part, on strongly held beliefs that African Americans were largely responsible for creating their own particular health problems, either as the result of behavior or inheritance. As a result, improvements in black health were largely incidental to efforts to make southern cities healthier for their white citizens. By exploring the role of race in the development of three campaigns conducted by the Richmond Department of Public Health---the campaigns against typhoid fever, infantile diarrhea, and tuberculosis---this study shows that African Americans received few of the benefits derived from Richmond's move toward improved public health, and that the benefits they did receive were confined to those programs administered by the city's public health nurses. Because of the racial discrimination inherent in the system of healthcare delivery, the potential to dramatically improve the health of the city's blacks was never fully realized and Richmond's African American community benefited only marginally from the city's overall advancement in public health.