Reprinted from the New York Medical Journal for
May 17, 1919.
THE HEALTH QUESTION OF THE MAN
NEXT DOOR.
By Algernon Brasiiear Jackson, M. D.,
Philadelphia,
Surgeon, Mercy Hospital.
1 he recent war through which America has so
successfully passed gave us a wonderful opportu¬
nity to take a health inventory, which has upset
many of our preconceived notions. Many ideas
have been proved and disproved by the acid test
of war, going a long way toward emphasizing
the educational assets gained through bloody
strife. It is therefore difficult to escape the fact
that there is but little difference between revolution
and evolution. The shock which comes to our pre¬
conceived notions by a rude awakening always tends
to shake off the lethargy of ignorant contentment
and should give us a new consciousness of personal
duty and a more careful judgment regarding the
future. If out of the red rimmed crater of war
there shall pour an altruistic consciousness preg¬
nant with a sense of duty to our fellowman, we
shall all feel content that men have not bled in vain.
Up to the beginning of the war very little care
or study was given to the question of the negro's
health, beyond a rather indifferent generalization
which declared the race decadent and reeking with
sickness and death. In face of this general notion
the following note from the report of the provost
marshal general must be considered at least inter¬
esting. 'Tn the first draft, in June, 1917, there were
737,628 colored registrants, or nearly eight per cent,
of the total registration of the country, which was
9,586,508. Of the first group of 208,953 colored reg¬
istrants examined under call before November 12,
1917, 36.23 per cent, of them were accepted for serv-
Copvritdit, iQ"5- t>y A. R. Elliott Publishing Company.
Jackson: Health of Man Next Door.
ice. Of 2,873,996 white men examined at ap-
proximate]y the same time, 24.75 Per cent* °f them
were accepted. In groups representing nearly an
identical proportion it will be seen that in relative
military fitness the negro race outranked the whites
by about twelve per cent." A still later report,
Table 53, shows that for every 100 men examined
physically, the ratio of colored men found qualified
for general military service was substantially higher
than the ratio for the white men by just five per
cent., viz., 74.60 per cent, as against 69.71 per cent.
The reports are interesting from two standpoints.
First they show that the American negro is not
altogether the unhealthy menace we have heretofore
regarded him, and in face of these facts we owe it
to him and the nation to see that he gets a human
chance to preserve his health integrity. Next it is
shown that a better physical type of both races came
up for later examination. This is possibly ac¬
counted for by the exercise of greater care on the
part of the examining physicians of the local draft
boards.
Yet with these facts before us there is no reason
for chagrin or fear upon the part of the white race
that it is becoming decadent, nor is there cause for
too much satisfaction on the part of the negro that
he has won out in an old dispute, founded more on
fancy than on fact. Some of the findings in the
army have been tinged with a bit of humor, for
instance it was found that an old joke about the
negro and his "flat foot" did not hold good, for
white men showed a slightly higher proportion of
that condition. Also in several other instances he
shows a higher degree of physical perfection than
the white man, but when we come to a closer
analysis of the health condition of the negro we see
a greater need for making a careful study of the
same with the idea of improving it, as a national
measure.
In the army, venereal disease was found to be
the greatest cause of disability. From the data now
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Jackson: Health of Man Next Door.
available it appears that the annual venereal rate
to the thousand is approximately 138.6, of which
eighty-five to ninety per cent, were brought into the
army from civil life. Reports from a group of
tamps in which were stationed troops of both races
would seem to show that from six to fifteen per
cent, of the white troops and from twenty-five to
forty per cent, of the negro troops entering the
service were infected with venereal disease. In the
matter of venereal diseases the negro has .made a
miserable showing and it is imperative that steps
of a nation wide character be taken to check this
terrible menace.
That venereal disease is amenable to regulation
and reduction was most gloriously proven by the
■experience of our army. Under the commission
on training camp activities a most intensive
and carefully planned campaign was so successfully
waged against venereal disease that the cases of
infection acquired after enlistment were reduced to
a minimum. It is further interesting to record that
the venereal disease rate after enlistment among
negro men compares favorably with the rate among
white men. Too much praise cannot be given the
commission on training camp activities for the
impartial and thorough manner in which they
tackled and overcame what threatened to be a
serious menace to our fighting forces. Nor can we
commend too highly Captain Arthur B. Spingarn,
who had charge of the campaign of education con¬
ducted among negro troops. These men have all
met the issue like men, like Americans, and have
won out in their fight, nor can they be less proud
of our American soldiers, black and white alike, who
have so heartily responded to their plea to be "Fit
to Fight."
The psychological tests proved the greatest
amount of venereal disease to be among those of
low grade mentality, black or white. The educa¬
tional campaign conducted among all alike brought
about a remarkable improvement in conditions,
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Jackson: Health of Man Next Door.
which truly proves the value of such propaganda.
General Ballou is responsible for the statement that
of the 1,250 negro men admitted to the first negro
officers' training camp at Fort Dodge only five were
found to be venereally infected—a record that could
not be duplicated among a similar number of men
in any camp of white men. It is significant to
record that the majority of the young men who en¬
tered this first officers' training camp were college
bred, and possessed a high degree of culture and
refinement. Thus we are bound to conclude that
venereal disease occurs most frequently in the
ignorant classes, and the many ignorant negroes
who entered the army have made the venereal rate
among that race alarmingly high.
What then is the answer to this question? An
intensive educational campaign carried directly to
this group of our citizens. If the methods adopted
in the army were so successful a slight modification
of the same can be made just as effectual in civil
life. No half hearted or weak kneed method will
get us anywhere; only carefully planned and care¬
fully executed propaganda will bring results. Nor
should this campaign be confined to venereal dis¬
ease alone, for there is a most urgent need of vital
national importance to carry the light of a general
health education to our negro citizens. In order to
emphasize the need of such an educational cam¬
paign I "want to relate the following story. A dear
old negro woman called at the home of a white
woman for whom she regularly worked to get the
week's washing. The kind hearted, intelligent
white woman met her at the door and said, "No,
Amanda, 1 shall not let you take my clothes to
wash, for my children have the measles, and I don't
want your children to get it." "Oh, that's all right,"
exclaimed the negro washwoman, "my children's
done had the measles two weeks ago!" This we
can charge up 10 ignorance and nothing else!
The inadequate provision for the prevention,
care, and treatment of the tuberculous negro is
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Jackson: Health of Man Next Door.
especially marked throughout the entire country.
Some time ago a leading popular weekly magazine
called attention in a strong editorial to this sad and
unfortunate neglect. It went on to say that we in
America are quite derelict in this phase of health
economics and cited an instance in which the only
provision made by a certain Southern State for the
treatment of the tuberculous negro was in a prison
hospital. This would seem to indicate that if a
negro be so unfortunate as to have tuberculosis his
only hope for institutional care rests in his be¬
coming a prisoner. It seems hardly in keeping with
our American spirit of fair play, our economic ethics
and principles, to allow such a dereliction to exist,
and must be regarded as decidedly outrageous to
permit it to continue. During the coming recon¬
struction period, what will be our answer to this all
important question?
Booker T. Washington has said: "Without health
and until we reduce the death rate, it will be im¬
possible for us to have a permanent success in busi¬
ness, in property getting, in acquiring education, or
to show other evidences of progress. Without
health and long life all else fails. We must reduce
our high death rate, dethrone disease and enthrone
health and long life. We may differ on other
subjects, but there is no room for difference here.
Let us make a strong, long, united pull together."
The question of health is a national one rather
than a racial one. The remedy therefore must be
oi a national character in its application rather than
racial. The negro has made for himself an unen¬
viable reputation for being unhealthy and the victim
of unnecessarily high death rate. In a great meas¬
ure the negro himself is to blame for this, but the
entire fault is not his. Yet the accusing finger of
race prejudice points to this &s one of the most
glaring evidences of the undesirability of the negro
as a citizen. When Booker Washington made the
statement, he evidently was speaking of the negro
in particular, but the same statement might as
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Jackson: Health of Man Next Door.
well and with equal purpose have been addressed to
our nation. The whole hearted methods adopted to
preserve the health of the white Americans, when
compared with the half hearted methods to preserve
the health of black Americans, make a jest of the
whole procedure. The negro always receives the
by product of expended energy in this direction, yet
he is expected to measure up to the same physical
standards as those who enjoy every opportunity and
privilege in the matter of conserving health. This
biracial tendency, which prevails in America regard¬
ing all matters great and small, is not consistent
with our boasted intelligence and foresight in its
attitude toward national health and its relation to
national economics.
The negro is not a victim of ill health and a high
death rate simply because he is a negro, but he is a
victim of circumstances and conditions imposed
upon him by American prejudices. For a long
time he had no control over these circumstances
and conditions, but happily today he is beginning in
a small way to overcome them. Yet those of that
race who are devoting their live? to this sort of
work are not getting the support they should from
either blacks or whites. With the blacks, it is to
them a new idea, which requires a carefully laid
campaign of education, and with the whites it is
greatly a matter of indifference, which also needs
education. Good health must be regarded as a na¬
tional asset equally important in time of peace and
war, which is always purchasable. This is an invest¬
ment that will yield perpetual dividends of comfort,
happiness, protection, and safety. Many philan¬
thropic persons have seen fit to devote large funds
for preserving and protecting the health of white
Americans, but comparatively nothing to be spent
in the preservation of the health of the black
Americans. Here lies a wonderful virgin field for
the righteous immortalization of some good un¬
biased American, to establish a foundation for the
study and improvement of health, social, and eco-
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Jackson: Health of Man Next Door.
nomic conditions among negroes. Such a fund
could and would do immeasurable service to the
negro race and to the nation.
Throughout the United States there are a num¬
ber of institutions operated by negroes who are
attempting in a small way to handle their health and
economic problems; but are prevented from doing
a large and telling work because of the lack of
sufficient funds. In most instances both negroes
and whites are doing something by way of contrib¬
uting to the support of these institutions, but
neither are doing what they should in the matter.
Most assistance is expected from the whites, for
they have most, but negroes themselves must learn
to know the value of such institutions to their race
and make, if necessary, sacrifices for their support.
Again the whole matter resolves itself into the
question of education. It has been but recently that
the whites have learned and appreciated the value
of institutions a a the best constituted agencies for
preserving their health. The negro is learning the
same lessons by the same process that the white
man learned them. His cry for health giving insti¬
tutions is increasing and with this must come an
increased support and a conscious realization of
their value, demanding a greater interest and devo¬
tion to them. Since the time of emancipation, great
amounts of money have been spent in educational
institutions for negroes, and wisely so, but their
health bringing organizations have not been
so favored. Yet one must recognize that today the
modern hospital or sanitarium is always educational
in purpose and intent. They are indispensable to
our civilization, for education without health or the
facilities for acquiring and maintaining health
means an economic and social loss, for which the
nation must pay.
The problem of ill health with its consequent
high death rate among negroes is most acute within
the ranks of the city dwellers. When thoughtful
consideration is given to the crowded and unsani-
7
Jackson: Health of Man Next Door.
tary conditions in which the masses of the negroes
are forced to live, the question naturally arises;
how do they manage to keep their sickness and
death rate so low? rather than, why is it so high?
The attempts made by the housing commissions of
the larger cities may be sincere in purpose but they
are not resultant in evidence of improvement. The
laws are explicit enough, but the American custom
of employing political influence to evade the law,
on the part of the landlords and real estate agents
defeats the purpose of the law. Then too there is
a general feeling that anything" is good enough for
negroes, and that they are content with the deplor¬
able conditions under which they are forced to live
in the cities. This is an expression of the typical
American sentiment in regard to the negro, but cer¬
tainly is contrary to theoretical American ideals and
principles. Yet where the negro is concerned
American ideals always suffer from rough usage
and injudicious handling. There are classes of
negroes just as there are classes of whites who are
apparently content to live in conditions surrounded
by squalor of every sort, but this ciass is decreasing
among all races. As education seeps down into the
lower types there comes a desire to improve home
comforts with their attendant blessings of love,
loyalty and a reaching out for better things in life.
For the whites there is always an easy avenue of
escape from these abhorred conditions, but for the
negro escape is almost impossible except by means
which the masses are generally too poor to take
advantage of.
That all negroes are not content to live amid such
vicious surroundings is evidenced by the fact that
certain cities have deemed it wise to adopt a
method of segregation, legalized or understood,
either of which is just as potent in its application
as the other. This un-American policy would never
have been adopted if only a few negroes had sought
better living conditions. It came only after there
was a wholesale and decided movement on the part
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Jackson: Health of Man Next Door.
of negroes to free themselves from unhealthy life
in miserable dwellings. This proves that anything
is not good enough for negroes, and they are not
content to live an unsanitary and vicious life. They
have certainly expressed their own feelings in the
matter in a way which has caused alarm to spineless
municipalities.
The negro himself must be made to thoroughly
realize that this is his personal fight to free his
people from the blight of unhealthfulness, and the
exaggerated accusation that they are a weak and
unsanitary people. Particularly should the negro
business man be interested in this matter for he
must appreciate the economic loss which goes with
ill health and its presumption on the part of whites.
These impressions must be corrected by fact and
not theory. A convincing lesson must be carried to
the hearts of white men that the negro is not an
unhealthy menace to American institutions but a
race of stamina, virility, resisting power and a will
to dispute every inch of the way toward a full and
wholesome recognition in all avenues of endeavor.
It remains for him to prove in no uncertain way
that negro health means negro wealth, and negro
v/ealth means national wealth.
It just happens that the affairs of this world are
so nicely adjusted that the success, happiness and
comfort of one individual depend to a great degree
upon the success, happiness, and comfort of the
other individual. This is no new condition, but
only in the last few years has it been emphasized
by our advanced civilization, and what is better, it
has been placed upon a practical basis. It matters
very little whether we call it altruism or coopera¬
tion ; it is in the final analysis a truth and a neces¬
sity which is making friends and converts who im¬
mediately find themselves willing to drop the
shackles of selfishness.
In this recent development of the altruistic con¬
sciousness the question of conserving the health of
mankind has played and is playing an important
9
Jackson: Health of Man Next Door.
part. The business man with his modern efficiency
methods realizes that a sick man is a poor worker
and a poor producer. Poor workers and poor pro¬
ducers are always small wage earners. Small wage
earners cannot be satisfactory purchasers and con¬
sumers. Thus sickness becomes a loss in dollars
and cents of vital consequence to every one. The
wage earner who has sickness in his family is an
economic loss to his community and to the business
man who depends upon him and his kind for the
success of his endeavor. When one stops to con¬
sider that a great proportion of all disease is pre¬
ventable, and about the whole question revolves
the matter of education, it is expected that the
business man should at once grasp the importance
and economic value of good health, and do his part
to improve conditions. Good health is a good in¬
vestment. Poor health represents a money loss.
Business men always prefer a good investment;
they abhor a loss.
This condition of affairs particularly applies to
the negro business man and his clientele. All the
interests of this race must be more closely welded
if they hope to improve racial integrity to the de¬
gree demanded by the ruthless onrush of modern
civilization. They cannot afford to be merely on¬
lookers, but must get into the procession—as near
the front as possible. Wonderfully significant,
illuminating, interesting and impressive is the fact
that the concrete application of a health propaganda
knows no color line:
It is the exception rather than the rule that large
corporations make the slightest effort to provide
welfare work for their negro employees. Little or
no effort is made to afford for them healthful forms
of recreation, yet they are expected to keep as fit
as the white workers. Here again indifference
leaves the negro employee to provide his own rec¬
reation, unguided by trained workers, more fre¬
quently than otherwise to his physical detriment.
This is one sided, hence poor economics. It should
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Jackson: Health of Man Next Door.
not require any great amount of argument to per¬
suade employers that a man healthy and strong
always feels like doing a full day's work easier,
better and more satisfactory to himself and his
employer. In this his color should play no part at
all. Good health doubles the value of one's services
to God and man. Good health and cleanliness breed
and create a contempt for ignorance, immorality
and depravity, and stimulate a desire for intelli¬
gence, clean living, morality and a greater faith in
God and man. This comes as a result of the
economic advancement of any people without re¬
gard to race, in the process of which all people
gain. If there is a consistent application of hy¬
gienic and sanitary science directed toward the
welfare of the negro, his health will be conserved
as well as that, of the whites and the nation gets
the results thereof. Sickness and death must come,
but in many instances both are preventable if a
conscious effort is directed against their onslaught.
If economics insists upon drawing the color line in
this matter, the nation must pa)' the penalty. Pa¬
triotism should decree otherwise.
We are beginning to observe with a great deal of
satisfaction and interest a tendency upon the part
of the whites to awake to a sense of dutiful co¬
operation in the matter of relieving health condi¬
tions among negroes. The beginning is rather en¬
couraging, and if we are able to develop within
them a consistent and continuous effort, it will not
be long before the health and living conditions
among negroes will be on a par with those of the
average American.
But one great crime committed against the health
of a race and a nation is the discriminating tactics
practiced by State and civic institutions against the
sick negro. Nor is this crime confined to the South,
indeed it is only too frequent in Northern com¬
munities where we have been led to expect better
dealing. The shame of it all becomes greater when
we realize that such practices are masquerading
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Jackson: Health of Man Next Door.
under the name of science. What a travesty on
. science when it permits itself to be hampered in the
attaining of results by the color line. It does not
require a mind of scientific training to at once
realize that any such half hearted methods im¬
pregnated with prejudice, are on their face un¬
scientific, inhuman, and farcical.
When it is considered how closely the races are
brought in daiiy touch, it must at once become ap¬
parent that any effort intended to conserve the
" health of a nation must include all. If it presumes
to dictate who shall be benefited and who shall not,
it results in little or no benefit to any one. In short,
the white man must realize that his health problem
cannot be solved as long as he is indifferent or care¬
less regarding the negro's health problem. But it
.is science which should blush with shame for the
inhuman and unscientific sins committed in her
name by those weak kneed individuals who would
call themselves scientists, when in truth they are
"but opportunists playing to the gallery. Yet in
many instances the institutions themselves stand
upon the high ground of equal care for all, theoreti¬
cally and legally speaking. But their maladminis¬
tration is perpetrated by individuals in charge who
evade alike law and theory by deeply laid plans,
adroitly executed to make negroes dissatisfied with
the attention given them. The result then follows
that the institution gets a bad name among negroes
and is tabooed by them. Then the records of the
institution show that few negroes come for treat¬
ment, and the assertion is made that they are not
interested in improving their health conditions, but
these same records never show the real cause of tfie
black man's antipathy. The lav/ may decree fair
treatment and care for all, but experience has
shown us that it very seldom takes a strong and
determined stand when the rights of the nergo are
- concerned.
This brings us back to the matter of the negro's
own health institutions. It may be an unfortunate
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Jackson: Health of Man Next Door.
and expensive condition of affairs which makes
necessary such institutions. The question of the
negro's health demands a satisfactory answer both
for the welfare of the negro and the nation. This
is just as much the white man's problem as it is
the negro's, for it is a problem which comprehends
and transcends both, in that it is a national problem
upon which our whole system of economics de¬
pends. Can we too strongly urge that some big
hearted fair minded philanthropist come forth and
establish a foundation for the study and improve¬
ment of health, social, and economic conditions
among negroes ?
The immigration of negroes into the North has
tended to intensify both social and health problems
but has created no new ones. Upon the other hand
it has relieved a perilous economic condition in the
North. In many instances the negroes have been so
thoroughly recognized as an economic asset, that
corporations have found it both wise and expedient
to create welfare advantages for them. This is a
step in the right direction and points toward a
hopeful outcome. Thus the thing which was at
first regarded as a calamity by many whites and
blacks in the North has turned out to be a- help to
both. The negro in this particular instance held
a strategic point, in that he was able to supply a
demand when that demand was most urgent.
Negro labor has saved the economic situation in the
North, and the North is beginning to respond to
the negro's needs in a kindlier and more practical
tone than ever before. It is true that negroes com¬
ing from the South must face different climatic
conditions than those to which they have been ac¬
customed, and they must pay the penalty. It is true
that many of them have sickened and died, but after
all death is worth while if it pays the price for
liberty. No race or people has ever won liberty
without paying for it with their blood, and the
negro cannot hope to be an exception to the rule.
Today and every day, strong, healthy men are
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Jackson: Health of Man Next Door.
needed. This is not an individual or a racial need
but a national need, and the nation is short sighted
which does not realize its duty tc all men at such a
time. The negro is ready, willing, and anxious to
play a man's part at all times, but he wants to feel
that the nation has a heart interest in him, com¬
mensurate with that which goes with a patriotic
citizenship. He cries for a human justice, which
gives him a man's chance, an American's chance to
build up his social, health, and economic protecting
walls about the most sacred of all institutions, his
home—his family.