“The History of Medical Racism”
The History of Medical Racism
Throughout history, the field of medicine has often reflected and reinforced the social inequalities of its time. One of the most persistent and damaging forms of this inequality has been medical racism—the systematic discrimination, exploitation, and neglect of people of color, especially Black and Indigenous populations, within medical research, healthcare practice, and public health policy. Far from being isolated incidents, these injustices form a continuous thread from the era of slavery to the modern healthcare system. Understanding this history is essential for addressing the deep mistrust and health disparities that persist today.
Medicine and Slavery: The Roots of Exploitation
The origins of medical racism in the United States are closely tied to slavery. During the 18th and 19th centuries, enslaved African Americans were frequently subjected to unethical medical experimentation and exploitation. Physicians such as J. Marion Sims, often celebrated as the “father of modern gynecology,” performed surgical procedures on enslaved Black women—including Anarcha, Lucy, and Betsey—without anesthesia or consent. Their suffering was dismissed under the racist assumption that Black people were less sensitive to pain, a myth that continues to influence medical bias today.
Similarly, enslaved individuals were used as subjects in anatomical dissection and medical training without consent. At the same time, so-called “scientific racism” emerged as doctors and scientists attempted to justify racial hierarchy through pseudoscience. Practices such as phrenology and craniometry falsely claimed that differences in skull shape and brain size proved the inferiority of nonwhite people. Figures like Samuel Cartwright even fabricated “diseases” such as drapetomania, which he described as a mental illness causing enslaved people to run away from bondage. These ideas were not merely theoretical—they legitimized slavery and shaped medical thought for generations.
Colonial Medicine and Global Racism
Medical racism was not limited to the United States. In colonies across Africa, Asia, and the Americas, European powers used medicine as a tool of control rather than healing. Colonial doctors often carried out experiments on Indigenous populations without consent, framing their work as part of a “civilizing mission.” Public health efforts were designed to protect colonizers rather than colonized people, while Indigenous medical knowledge was dismissed as superstition. Medicine thus became another arm of empire—reinforcing racial hierarchies and the exploitation of native peoples.
The Twentieth Century: Institutional Racism in American Medicine
Even after slavery and colonialism formally ended, racial discrimination remained deeply embedded in medicine. One of the most infamous examples is the Tuskegee Syphilis Study (1932–1972). Conducted by the U.S. Public Health Service, the study observed 600 Black men in Alabama who were told they were receiving free medical care for “bad blood.” In reality, researchers withheld treatment for syphilis—even after penicillin became widely available—in order to study the natural progression of the disease. The men were never informed of their diagnosis or given consent forms. When the study was exposed in 1972, public outrage led to major changes in research ethics and informed consent laws, but the damage to trust between Black communities and the medical establishment remains profound.
Another major form of medical racism during this period was forced sterilization. From the early 1900s through the 1970s, thousands of Black, Indigenous, Latina, and poor white women were sterilized without consent under eugenic laws designed to prevent the reproduction of those deemed “unfit.” Native American women were particularly targeted; the Indian Health Service sterilized roughly one in four of them during the 1970s. Such practices were rooted in racist beliefs about intelligence, morality, and social worth, turning reproductive health into a tool of oppression.
Segregation also defined much of 20th-century healthcare. Hospitals, medical schools, and professional associations excluded Black patients and physicians alike. Black doctors were barred from joining the American Medical Association until the mid-20th century, leading to the founding of the National Medical Association (NMA) as a separate institution to serve African American medical professionals and patients.
Modern Manifestations: The Legacy of Bias and Inequality
Research also shows that implicit bias continues to influence medical decision-making. Studies have found that some healthcare providers still believe outdated myths, such as that Black people have thicker skin or feel less pain than white patients. These biases can result in under-treatment of pain, delayed diagnoses, and preventable deaths. For example, Black women in the United States are three to four times more likely to die from pregnancy-related complications than white women, even after accounting for education and income levels.
Historical abuses like the Tuskegee study have also fueled medical mistrust among Black Americans, particularly in response to public health efforts such as vaccination campaigns. Although mistrust is often framed as irrational, it is in fact a rational response to centuries of exploitation and neglect.
Resistance and Reform: Building an Anti-Racist Future
Despite the weight of this history, communities of color have continually resisted and redefined medicine on their own terms. Pioneering figures such as Dr. Rebecca Lee Crumpler, the first Black woman physician in the United States, and Dr. Charles Drew, whose research on blood plasma saved countless lives during World War II, challenged both racism and exclusion in their fields. The Civil Rights Movement brought new attention to healthcare inequality, leading to hospital desegregation and the passage of the 1964 Civil Rights Act.
Today, a growing movement within medicine calls for anti-racist practice—an approach that acknowledges structural inequality and works to dismantle it through education, research, and policy reform. Medical schools are beginning to teach the history of racism in healthcare, and community-led research is gaining recognition as an ethical and equitable model of public health. Addressing medical racism is not only about repairing past harm; it is about building a future in which all people receive care with dignity and trust.
Conclusion
The history of medical racism reveals that medicine has never been a purely objective or benevolent science. It has been shaped by power, race, and inequality at every stage of its development. From the exploitation of enslaved bodies to the ethical violations of Tuskegee and beyond, this history explains why health inequities persist and why trust in the medical system remains fragile. Confronting this past honestly is the first step toward a more just and humane future—one where healing is no longer determined by the color of one’s skin.
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