“Health is a Human Right: Race and Place in America” at the David J. Sencer CDC Museum through April 25, was originally scheduled to close in March, but its popularity at the Centers for Disease Control and Prevention (whose tight security makes it a not readily accessible venue) prompted the extension. I visited it three times. On my second visit, I was accompanied by Louise Shaw, the museum’s curator. While telling me about David J. Sencer, the former CDC director for whom the museum is named, she shared his pithy distinction between medicine and public health: “In clinical medicine, the individual is the patient. In public health, the community is the patient.” The individuals presented in this exhibition are health practitioners, educators, activists, and social scientists; the communities encompass the nation’s racial, ethnic, and gender diversity, with primary emphasis on populations identified by race and region.
A mural-size photograph of school kids first greets visitors. It’s an ordinary grade school photo and displays extraordinary diversity. Immediately recognizing it as an old photo, viewers know they’re walking into history. Posing perhaps for their first class photo, these anonymous children are arranged in three lines: a front row of boys, arms folded and sitting cross-legged on the floor; in the back is another row of standing boys; and, in the middle, sit girls, hands politely in laps. They’re outnumbered two to one. Gender segregation is the only immediately apparent disparity in this classroom of ethnic diversity.
Is it possible to inspect old photos of children without wondering who and where they are now? Yet, all we can know of these kids is that they would now be over 60 years old, at least those who are still living. Past. Present. Future. These are public health’s temporal trinity: understand the past; assess the present; intervene for our future’s sake.
Bidden by the image, viewers have already glimpsed much of what this exhibit aims to do: picture cultural diversity, identify education, display gender challenges. It’s a fine preface, but a haunting afterthought lingers: how common today are racially and culturally integrated classrooms posed with such matter-of-fact happenstance? Along with history, this photo of a 1944 San Francisco classroom establishes some cultural dimensions that “Health is a Human Right” explores with care. While the classroom photograph announces the scope of the show, a short film shows us its depths.
A precious gem, the film All My Babies: A Midwife’s Own Story follows the training and work of midwives. Created by documentary pioneer George Stoney, this high-contrast, black-and-white film narrates a government public health program in action. It shows community involvement while simultaneously presenting consequences of health disparity within a rural African American community. The film also celebrates the heroism of midwifery through the story of “Miss Mary” Francis Hill Coley. The film begins in a local clinic. A white doctor and nurse are instructing a full room of at least 25 community midwives about the importance of sterilizing all their implements. With no attendant difficulties, Miss Mary facilitates the birth of a child to a stable, middle-class home: curtains, painted walls, small vases on display, a large framed photograph of an ancestor sits proudly. All goes well with the birth and the mother.
But the birth that follows has social and medical complications. The poor childless couple lives in a weathered, decaying home. Flattened cardboard insulates and covers the walls. Possessions are meager: bed, chair, and small table are all the viewer sees. Sores on her face and arms, weak and ill-fed, tired and afraid, the mother sits and waits and cries. Her previous child was born dead, says the father, standing by helpless. Miss Mary improvises. A cardboard box becomes a cradle. She starts a fire and sends the father out to chop wood. The birth is long and painful. The infant is premature. Here the clinic enters the story, brining a portable incubator to be warmed by continuously reheated bottles of water. Miss Mary recruits a neighbor to keep the mother fed well. Months later we see two thriving babies, healthy mothers and happy families.
Commissioned in 1953 by the Georgia Department of Public Health for instructing midwives, the film is much more than an instructional apparatus. Direction and cinematography add visual pleasure. There’s a powerful sense of the immediate. We are always inside, close, right there, in each home and the clinic. This genuine intimacy is never broken by objective distance. We’re provided with ethnographic glimpses of an African American community in Dougherty County, Georgia, in the decade following World War II. In 2002, the Library of Congress placed All My Babies on the National Film Registry (listed alphabetically between All About Eve and All Quiet on the Western Front).
Exhibits do what books cannot. And when exhibits act like books, viewers act like readers—led or dragged to foregone conclusions. Exhibits that regiment, express, and impose a particular logic may leave one informed, but not actively engaged. Public health requires comparable engagement from many angles, complimentary methods and skills, and broad involvement. In this sense “Health is a Human Right” mirrors public health, its interdisciplinary science and multidimensional practice. Visitors have to make it up as they go, making sense of what’s offered to them, choosing what grabs them, as they construct their own narratives. The layout is carefully arranged to keep possibilities open. Separated L-shaped partitions occupy the hall, each devoted to a named general topic. Although each viewer creates her own pathway, there remains a broad thematic movement from front to back of the curved hall. Despite its open-ended character, three initial displays establish a foundation.
The first includes basic definitions of health equity and health disparity. Moral imperative and objective knowledge are two sides of a coin. Activism is signaled by word and image in Hypertension Kills, a poster by Emory Douglas. Completing the introduction, two stacked screens display maps of the U.S. The states are shaded to represent various factors that measure health outcomes: diabetes, poverty, and many others. The maps seem to rotate randomly and demand we try to compare and contrast the map above with the one below. When engaged visitors seek co-relations between the two maps, they engage in public health analysis, perhaps without knowing it. Predicated on data collection, the science of public health builds by discovering correlations between disparate observations and measurements.
“Facts,” an adjacent display of charts and tables, identifies data and its collection as the foundation of public health. Spanning the last century, data tables present facts about the country’s ethnic and regional diversity from the rural South, Alaska, and Hawaii to the Southwest and the Northeast. Each table or graph is from a particular time and place and collectively testify to well over a century of careful data collection, the hard work of social scientists, statisticians, and on-the-ground health professionals. Products of their labor are on display throughout the show. Of course, no visitor could take all this in, nor would one want to, but the abundance of data makes its point. No, two points! The necessity of data about endlessly changing conditions and, sadly, the seeming ease with which facts can be ignored.
“Structural Racism” addresses the exhibition’s subtitle Race and Place in America and rounds out the show’s introduction. This section places both in an understanding of life as it is now and has been lived in America. It frames public health historically by drawing attention to social, economic, and political systems. In “Facts” I had been drawn by color, font, and style to a century-old table that compared mortality rates of blacks and whites in major Southern cities. I knew immediately it was from the pioneering efforts of W.E.B. Du Bois. After graduating Harvard with a Ph.D. in history, Du Bois studied in Germany among scholars who in the late 19th century were crafting the research tools that would become the foundation of sociology as an empirical enterprise. It is heartening to see Du Bois acknowledged, listened to, and revered today. His words are presented throughout. The exhibition embodies his spirit and identifies the premise underlying all of the activities chronicled in “Health is a Human Right.”
Du Bois helped introduce those features to the American social science. Hired at Atlanta University in 1897 with the express charge to organize a series of annual conferences on urban Negro problems, Du Bois found upon arrival an active sociology club, which he chided for its moralizing discussions of Negro issues. Du Bois challenged, instructed, and led students out into the community, without pay, to talk with people, describe conditions, and record data. (The Georgia government refused to provide any funding, in part because Atlanta University admitted white students.) From 1897 to 1914 the project produced 17 volumes that covered an impressive gamut of Negro life. The first volume addressed mortality.
I should note that Du Bois’s early contributions to the empirical study of social problems and issues, while hailed in the African American community, were acknowledged by some white reformers and very few white scholars. This is structural racism in action. White sociologists, with scientific visions premised on social Darwinist dogma, stunted the growth of American sociology and hampered social reform. Meanwhile empirical sociology flourished in Negro colleges and universities, at a time in the South when sociology sounded like the revolutionary socialism espoused up north by Eugene Debs.
In “Immigration and Displacement,” two government atrocities are on display. Two poignant images depict forced government displacements. An enlarged early postcard shows an Indian boarding school, the Sherman Institute in Riverside, California. In front of the building, the student body stands at attention, girls in single file on one side and on the other boys in three parallel lines. Indian Schools were also sites of tubercular genocide. The other image, labeled Our Barrack, is from the Japanese internment camp in Lordsburg, New Mexico, during World War II. Viewers see a stark confining interior sketched by George Oshida. Its beauty and economy strikes a biting contrast: the freedom embodied in the artist’s simple strokes and the barrack, one of tens of thousands constructed with monotonous bureaucratic efficiency.
These two images occupy an entire wall and rightfully claim the surrounding space. Like the film, each is a singular encounter in an otherwise necessarily packed space. Two other displays show an Asian immigrant being interrogated and Mexican braceros being sprayed with DDT as they enter the country. Also on view are efforts to educate immigrants. There’s a fine selection of New York City pamphlets translated into at least a dozen languages.
A large colored map of the continental United States from 1903 subtly asks, Who are the immigrants? It presents numbers and nationalities of immigrants during a period of rising immigration and mandated racial quotas. A box in each state graphs proportions of the state’s largest eight immigrant populations. The curious will discover a color-coded index in a lower corner denoting each “scientific” racial category: Teutonic, Keltic, Slavic, Iberic, Mongolic, and Other. The point is that, with the exception of the people who discovered Columbus staking a banner on their shores, all other Americans are immigrants, some forced in chains, others seeking safety from hunger and genocide, some seeking opportunities for a better life.
The CDC is in Atlanta, partly because its predecessor agency was placed in the South, where malaria threatened health and profits. In efforts by the Georgia State Board of Health to educate Southern whites on why they should be concerned about malaria, which threatened poor African-Americans who live in and near swamps, focused on the impact the disease had on white farmers’ profits. What does this convoluted message reveal about the South’s white farmers. Did they not realize malaria hurts their profits? Or was Negro labor so cheap it didn’t matter to them? This baffling predicament is spoofed in a grotesque 1926 cartoon titled “The Southern Farmer’s Burden.” Surely a regional echo of Kipling’s White Man’s Burden, the caption states “Malaria Mosquito. Sick Labor. One-Crop System.” In the image a white farmer stoops and struggles along on his bent back a huge bale of cotton—on which a lethargic black man sits perhaps asleep—on whose nodding head a gigantic mosquito perches, its long proboscis buried in the man’s skull. The cartoon, which today can be read as spoof, was apparently distributed to educate white farmers to help them understand the threat malaria posed to them.
While documenting disparities and their causes, “Health is a Human Right” emphasizes activism. Each illustrates organized efforts of people to control their own and our collective health. Each example in its own particularities reveals and challenges structural racism. Examples are too many to list. On display are struggles to stop uranium mining on Indian reservations, to reshape diet with community gardens, to improve urban sanitation in Los Angeles barrios, to communicate health messages in people’s own languages, to close toxic waste dumps that across the South are placed near African American and other poor communities. Robert Bullard’s pioneering book Dumping in Dixie is on display along with a poster-size enlargement of the iconic 1979 photograph showing protestors lying in the road blocking toxic dumping in Warren County, North Carolina. The non-violent protest inaugurated the movement against environmental racism.
It’s no surprise that many of the exhibits demonstrate artistic concerns: the better to speak to hearts as well as minds. Posters inform emotional and moral sensibilities. They intend to spark awareness and to promote earnest and urgent understanding—in ways aesthetically satisfying. Political art aims to direct attention, to guide and ennoble actions, and just as fundamentally, to catch the eye, ring in the ear, and demand attention. Posters alarm and invite. Their purpose is always to disrupt habit—individual, community, and institutional. Posters often also aim to change or disrupt some aesthetic habits. Posters grab and push.
Five impressive posters by Black Panther Party Minister of Culture Emory Douglas appear in this show. Others include, Mujeres Embarazadas! Pregnant Women!, a quiet silkscreen by Lincoln Cushing (under the name Insurgent Squeegee) that shows a women, hoe in hands with a massive field behind. Threatening this abundance, in an upper corner, a biplane trailing a dark cloud scatters pesticides. Produced by for the Proyecto de Salud, San Diego, it addresses workers’ pregnancies. In Honor the Treaties by Ernesto Yerana, yellow and red lines radiate from a low horizon. In the foreground, the same colors and black shadows define a young girl, arms stretching for the sun. It is based on a photograph from Pine Ridge Reservation by Aaron Huey. A mammoth blowup of an ACT UP (AIDS Coaliton to Unleash Power) postcard represents one of 20,000 graphic postcards sent to CDC during a long 1990 protest demanding the agency to expand definitions to include infections specific to women and others.
By displaying political posters with others items that present their historical contexts, “Health is a Human Right” affords viewers opportunities to imagine the conditions that generated the posters. Is there a poster more lonely than one torn from its post and displayed as objet d’art, to be contemplated in isolation, its time and place erased, its vital particularities subjugated to an imagined universal, a living moment that gave it birth reduced to mere provenance, eclipsed by an inventory of subsequent ownership, its end antithetical to its beginning? It’s satisfying to examine, appreciate and enjoy these posters in something closer to their natural habitat.
Consider the challenge of finding physical objects for this exhibition. Along with the posters already considered, most artifacts are pamphlet, books, and documents. Healthy and sustainably produced packaged foods are on display. One case displays polio artifacts, a leg brace and crutches used by patients during the early 1950s at the Infantile Paralysis Center at Tuskegee Institute. By far the most remarkable are two 5-gallon plastic buckets. One is from the Louisiana Bucket Brigade that promoted clean air, justice, and sustainability. They are kits that measure pollution and produce viable alternative statistics with which to challenge polluters. The brigade manual proclaims, “Take back your air.”
The phrase “Health is a Human Right” is born of community activism, and this show amply illustrates redundancies of the phrase. As a proclamation, the phrase states a fundamental belief and existential assumption. As a self-evident moral imperative, its strength and truth is authored through individual and collective experience. Visitors to this exhibition may find themselves drawn into the ever-changing nexus of public health, each putting together his or her own understanding drawn from the diverse images, objects, and stories presented. The experience is the reward.
Daryl White is an anthropologist and a professor at Spelman College. His interests include contemporary culture and mass media, social theory, and issues surrounding social stratification and power. He recently co-edited the book Religion in the Contemporary South: Diversity, Community and Identity.