No place for the dying: A tale of urban health work in Philadelphia\u27s black belt, 1900–1930

The poor health status of Black Americans was a widely recognized fact during the first third of the twentieth century. In this period, much of the noted excessive mortality in blacks was linked to tuberculosis. Blacks were believed to succumb to the disease at higher rates due to physical traits, such as purported racially inherited defects, and factors related to the physical and social environment such as poor sanitation, overcrowding, and a lack of health care resources. At the opening of the twentieth century nowhere revealed the confluence of excessive mortality due to infectious disease and the dynamics of urbanization more readily than the city of Philadelphia. The Bureau of Health launched one of the city\u27s first organized attacks against tuberculosis though failed to target the black community despite excessive mortality rates existing there. In the absence of a comprehensive agenda to specifically address tuberculosis in blacks by city legislation, several voluntary associations developed strategies to thwart the effects of the disease. This study examines the collective efforts of key private charitable associations who worked cooperatively with black residents and black medical professionals to launch a community-oriented attack against tuberculosis. The collective efforts of the Starr Centre, Henry Phipps Institute and Whittier Centre to address social and health problems in the black community are explored. The physical and social milieu of Philadelphia\u27s black community is also examined and the relationship between these influences and higher rates of infectious disease is revealed. As policies related to the poor health of Black Americans are considered even today, it will require reflections on synergistic activities from urban health reformers living nearly a century ago