Access to Black Healthcare Providers and Child Health Outcomes: Insights from the 1900-1910 Censuses

Ben Chrisinger, Tufts University

Health disparities between Black and White communities have been persistent features of racial inequality in post-Civil War America. These disparities are largely explained by the social determinants of health, including experiences of structural and overt forms of anti-Black racism. The nascent American medical profession of the early 20th century was one field where structural racism presented numerous barriers to aspiring Black physicians, especially in terms of opportunities for medical training. This left many communities with few or no Black doctors and limited opportunities for Black patients to be seen by White physicians. This paper uses a set of unique questions asked of women in the 1900 and 1910 Censuses - the number of children ever born, and the number of children surviving - to estimate the incidence of child mortality during this decade. Using occupational records from the 1900 and 1910 Censuses, and the 1906 American Medical Directory, I summarize racial patterns of physician availability at the county level during this period. I then investigate whether the relative under-supply of Black physicians is associated with child mortality, adjusting for a variety of individual and community-level factors, such as rurality, employment, and education. Furthermore, I consider whether the racial disparity in availability - separate from the overall availability of doctors - has any relationship to child mortality, representing a latent construct related to the social structure of a given place. Taken together, this paper provides a unique perspective on one plausible pathway for racial health disparities during this period.

No extended abstract or paper available

 Presented in Session 196. Disparities in health care