Racism mars the history of health care in America. For years, black patients were relegated to separate — and appallingly unequal — hospitals and wards. Many were simply denied medical attention, either “dumped” into the care of other facilities or turned away at the hospital door.
Fifty years ago this week, that started to change as Lyndon B. Johnson signed into law two programs — Medicaid and Medicare — that constituted real progress in the cause of health care justice. For one, these programs greatly expanded health care access for the elderly and the poor, of all races. Also, building on years of civil rights work and legal challenges, Medicare was wielded to finally end explicit hospital segregation; hospitals hoping to become certified for the program were required to comply with Title VI of the Civil Rights Act.
Yet despite this important achievement, racial justice in health remains an aspiration, not an achievement.
After the death of Freddie Gray in April, and as the nation debated race and the criminal justice system, Americans were reminded of some disturbing racial inequalities in health. Not least among these were the differences in life expectancy between some of Baltimore’s segregated neighborhoods, which were as high as one to two decades. Meanwhile, across the nation, black males in 2010 had a life expectancy almost five years lower than white males; black women could expect to live three years fewer than white females.