Date of Completion

2023

Document Type

Project

Department

UVM Larner College of Medicine Office of Inclusive Excellence

Faculty Advisor/Sponsor

Eileen Cichoskikelly

Second Advisor

Tiffany Delaney

Keywords

Black American health, racial health disparities, health equity

Abstract

In the late 1800s, several Black physicians were denied membership in the American Medical Association (AMA) due to their race. These discriminatory practices lead to the formation of the National Medical Association (NMA). The journal of the NMA (JNMA) began publishing in 1909 with a focus on Black American health. Throughout the twentieth century, both organizations and their respective journals discussed health and disease with perspectives that are now recognized as the social determinants of health. The journals of the AMA and the NMA preserve a record of the discourse surrounding race and health, and the influence of racism and segregation on Black health. This annotated bibliography focuses on 60+ papers from JAMA and JNMA to demonstrate how the approach to Black health and disease was once disparate and has now converged. We structured our analysis around the division of two distinct time periods: 1909 to 1960 and the 1960’s to current day.

Although both journals acknowledged the higher prevalence of diseases such as tuberculosis and syphilis in Black Americans during the early 20th century, their causes for concern, reasoning behind such drastic disparities, and proposed solutions differed. From 1909-1960, heritable factors discussed by JAMA contributors implied that little could be done to change the outcome of greater disease prevalence in Black populations, whereas environmental factors discussed in JNMA implied changeable elements that could save Black American lives. During this earlier time period, a majority of papers published by JAMA focused on personal opinions rooted from racism and lacked scientific rigor when discussing Black American health.

In contrast, during the period of 1960 to the current day, studies from both journals increasingly focused on the interplay between genetics, environment, and Black health outcomes. JNMA maintained a consistent commitment to examining racial disparities across a wide range of health topics, while JAMA gradually adopted a similar focus. Both journals have emphasized actionable solutions, such as culturally sensitive care and increasing minority representation in medicine. This evolution reflects a broader societal move toward health equity and systemic reform in healthcare.

We presented our findings at the 2023 UVM Health Equity Summit. The journals of the AMA and NMA, alongside others, continue to contribute to the ongoing discussion of racial health disparities today.

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