Black Health Care, Black Art: A Texas Perspective

Galveston, Texas, may best be remembered as the provenance of Juneteenth. However, in the universe of Black history, the island city also serves as an obscure yet poignant touchstone for an inquiry into Black health care. Galveston won the site of the state’s first medical school — the University of Texas Medical Branch (UTMB)—opened in 1891. Their “negro” department of the hospital attracted Black people in need of medical attention from as far away as Houston, presumably until the first better appointed Black hospital in the city—Houston Negro Hospital—was built 1927. It was also in Galveston that the second organization of Black medical professionals in the nation — the Lone Star State Medical, Dental, and Pharmaceutical Association— was established in 1886. As an anthropologist concerned with paradigms of health, these early trajectories of Black medicine in Galveston, and more broadly in Texas, provide historical reference points for beginning to think through the socio-cultural context and texture of Black health care— a paradigm of care I observe as a blend of science, politics, and art.

This past year’s COVID-19 pandemic brought historical racial inequities in health and health care into high relief. According to the American Public Media Research Lab, Black Americans along with Pacific Islanders and Indigenous people experienced the highest death tolls from COVID-19. The Centers for Disease Control point to how social determinants such as discrimination, poverty, housing, occupation, and limited access to healthcare contributed to these populations’ susceptibility to the virus. Over a century earlier, Dr. Henry E. Lee in his 1915 essay in The Red Book of Houston connected poor housing, food, sanitation to Houston’s Black population’s vulnerability to diseases such as typhoid fever, cholera, and tuberculosis. The social determinants of health have formed a critical persistent part of the complex ecology of Black health, that include the racially-motivated ways the medical establishment in the US looks upon Black patients. Part of my exploration of Black health care—which I use interchangeably with Black medicine for convenience’s sake—is to not only recognize the longstanding health needs of the Black population and the political mobilization of Black people around healthcare, but how Black physicians like Dr. Lee, conceptualized, and practiced their medicine and healing work. 

The origins of UTMB in Galveston offer a lesser-explored place to investigate early Black health care. When the medical school opened, Black patients were treated in a separate “large frame building in the backyard” of Sealy, the city hospital.¹ In the antebellum period, enslaved people made up as much as 16 percent of the city’s population, with enslaved men often labored at the international port as longshoremen and cotton jammers, and enslaved women as domestic workers.² Archival research might confirm the types of care Black residents received in the midst of their exacting lives in addition to discovering whether Black residents also helped construct and maintain the medical buildings. With the Great Storm (hurricane) of 1900 came the construction of a separate and new “negro hospital” in 1902, funded by a private donation. This became the first state hospital for Black people and was later replaced in 1937 with a larger one that eventually closed in 1958. While the storm’s aftermath created a new Black facility, environmental historian Andy Horowitz contends it also revealed the “ongoing human disaster of racialized terror” endured by Black residents including physical violence and political disenfranchisement. This racial climate raised questions about the health risks and medicine, allopathic and otherwise, used to treat, heal, and protect Black people, during this period on the island.