The history of Black Americans in modern medicine tells two powerful stories at once. Even following emancipation, dominant forces shut doors to medical schools, hospitals, and professional societies. The Black experience in American healthcare is one of deliberate exclusion from care, even as Black Americans made world-changing scientific advancements. From building independent hospitals in the face of Jim Crow segregation to leading the development of the COVID-19 vaccine, Black Americans have consistently challenged a discriminatory system, while making essential contributions to American medical care, training, and discovery.

After Reconstruction in the late nineteenth century, segregation became the law of the land. Professional organizations like the American Medical Association (AMA), founded in 1847, barred Black physicians from membership. In response, Black doctors and their allies built a parallel medical world from the ground up. They founded pioneering medical schools at Historically Black Colleges and Universities (HBCUs) like Howard University, Meharry College, and Morehouse School of Medicine. In 1895, they established the National Medical Association (NMA). This new group created a professional home for Black medical professionals who were denied entry elsewhere.

The Black hospital movement created havens of both care and opportunity. Leading figures included Dr. Daniel Hale Williams and nurse Emma Ann Reynolds, who founded Provident Hospital in Chicago in 1891. Provident was the first hospital in the country owned and operated by Black Americans. This institution became a vital place of healing for the Black community. It was also where, in 1893, Dr. Williams performed the world's first successful open-heart surgery, a globally recognized medical advancement. Institutions like Provident became even more critical after the 1910 Flexner Report. While this report standardized medical education and diagnostics, it also led to the closure of all but two Black medical schools, severely limiting opportunities for generations of Black doctors. Additionally, institutions such as the American Hospital Association (AHA), founded in 1898, similarly excluded Black- controlled institutions. This led the NMA to create a National Hospital Association (NHA) in 1923.

The Civil Rights Movement of the mid-twentieth century brought monumental changes. The passage of Medicare and Medicaid in 1965 created federally funded health insurance for millions of elderly and low-income Americans. Crucially, the government used this new financial power to enforce desegregation. Through Title VI of the Civil Rights Act of 1964, federal funds were withheld from any hospital that practiced segregation. This forced institutions across the country to open their doors to all patients. However, this landmark victory created a difficult paradox. Many historically Black hospitals had served as pillars of their communities for decades. After 1964, they had to compete with larger, historically white institutions that were better funded. Unable to compete, many of these vital Black institutions were forced to close. This wave of closures later spread to other inner-city and rural hospitals. This left many poor and minority communities with fewer healthcare options than before. In this new landscape of integrated yet unequal access, activist groups like the Black Panther Party launched their own community-based health programs, creating free clinics to fill the gaps left by the mainstream system.

Today, this long history can still be felt. On one hand, Black scientists like Dr. Kizzmekia Corbett, a key leader in developing the Moderna COVID-19 mRNA vaccine, are among America’s top innovators. On the other hand, a deep-seated mistrust of the healthcare system persists in many Black communities. This hesitancy is not unfounded. It is rooted in the long history of injustices, from the infamous Tuskegee Study, where Black men with syphilis were deliberately left untreated by researchers for forty years, to the ongoing inequities in how patients of color are treated today. The journey of Black Americans through American medicine thus reveals a constant struggle against manufactured scarcity and discrimination, and a powerful story of resilience, self-determination, and indispensable contribution to health in the United States and beyond.