How History Has Shaped Racial and Ethnic Health Disparities

This timeline offers a historical view of significant U.S. federal policies and events spanning the early 1800s to today that have influenced present-day health disparities.

It covers policies that directly impacted health coverage and access to care, relevant events in medicine, social and economic policies and developments that influence health, and efforts to tackle inequalities.

Some events impacting people of color, like the Louisiana Purchase, Westward Expansion and the Transatlantic Slave Trade, predate this timeline.

While not exhaustive, the timeline aims to provide context for addressing disparities, acknowledging the complex history that shapes racial and ethnic health and health care disparities that persist today.

Medical Exploitation of Enslaved Black Women

The importation of enslaved people from foreign countries was outlawed in 1808. This ban had profound economic implications, as it increased the value of the existing enslaved populations and spurred slave owners to focus on their reproductive viability, contributing to medical experimentation on enslaved women.

For example, while renowned for his contributions to the field of obstetrics and gynecology, Dr. J Marion Sims developed new surgical techniques through medical experiments on enslaved women, including Anarcha, Lucy, and Betsey in Alabama from 1845 to 1849. Dr. Francois Marie Prevost honed his cesarean surgical procedure by practicing on at least 30 enslaved women in Haiti and Louisiana during the 1830s. 

Dr. Ephraim McDowell, considered the father of abdominal surgery, developed surgical treatments for ovarian cancer in the early 1800s, often on enslaved women. The experimental procedures were often conducted without anesthesia due to the inaccurate belief that Black people felt less pain than White people.

This racial bias in pain perception persists in modern medicine, affecting the way medical students and residents view and treat pain among different racial groups.

In recent years, there have been efforts to reevaluate the ethics of these physicians’ work and acknowledge the exploitation of enslaved women in the development of modern reproductive surgical procedures, especially in the context of the ongoing maternal health crisis.