Race, Medicine, and Health Inequity: Medical Apartheid

This unit was created by teachers at East Orange STEM Academy, part of the 2022 cohort of The 1619 Project Education Network. It includes seven multi-day history lessons and four multi-day health lessons.

Enduring Understandings and Essential Questions

Enduring Understandings:

1. Racism in the United States has roots that extend deep into the history of medical research.
2. Diverse forms of racial discrimination have shaped the relationship between physicians and Black, Indigenous, or People of Color(BIPOC) patients and the attitude of BIPOC towards modern medicine.
3. Racial and ethnic disparities in health care occur in the context of broader historical and contemporary social and economic inequality and evidence of persistent racial and ethnic discrimination in many sectors of American life.

Essential Questions:

1. How do racist ideas from slavery continue to impact the health care of Black people in the present day? 
2. How have medicine and science been used to justify slavery and the racial hierarchy? 
3. Scientific racism is a set of beliefs developed in the 19th century to help justify the continued existence of the institution of slavery in the United States. Does scientific racism still influence how doctors treat Black patients?
4. What does the pervasiveness of discrimination mean for health?

Objectives & Outcomes 

1. Students will examine the relationship between power and race and how it has shaped science and medicine in the United States.
2. Students will engage in authentic research about the history and interconnection of race, medicine, and equity, discovering how that history impacts our community and culture today. 
3. Armed with this knowledge, students will be able to elevate the power of their voices to demand changes in medical practices that continue to harm our community. 
4. Students will be able to connect the reasons for shorter life expectancy and higher rates of diseases like asthma, diabetes, and hypertension to medical fallacies and malpractice perpetrated against generations of BIPOC.
5. Students will research and debate the influence/impact racism in medicine has had on the access to and equity of mental health services in the BIPOC community.

Unit Overview

This interdisciplinary unit focuses on the medical apartheid system that still exists in America. Our unit and lesson plans will explore the legacy of slavery in the U.S. healthcare system and how it impacts our current healthcare institutions and practices. The racist ideas regarding Black people’s bodies promoted by medical practitioners during slavery continue to affect Black people’s health and continue to inform current medical education and practices, resulting in the healthcare inequality experienced by Black Americans today.

This interdisciplinary project connects history and science teachers through the development of units and lesson plans that focus on the intersection of race, medicine, and equity in America. The units of study and lesson plans were developed collaboratively by both science and history teachers. Students will be able to develop projects that relate to both disciplines. They will be guided along the way by their ability to use student choice when selecting their research topic and deciding on the format for their projects.

This project will provide our students with a strong understanding of the legacy of slavery, their cultural identities, and the world around them, so they are the best equipped to succeed. Understanding their identities and society requires fundamental knowledge about how our history impacts our community and culture today.

Lesson Progression Recommendations: 

Greetings fellow educators! This interdisciplinary unit features lessons designed for teachers of middle and high school History, Social Studies, and Science. Teachers  are encouraged to modify the lesson progression, or the order of the lessons featured in this unit plan as needed for their school context.

We encourage you to review and implement the lessons in the order that will best engage your students, while satisfying your district or school’s curriculum requirements. Each lesson topic has been separated for you to review and implement as a stand alone lesson, or you may opt to select a combination of lessons, or  you may decide to implement the entire unit. Our overarching goal was to provide you with cross-curricular themes, differentiated resources, activities and assessments that would encourage student choice and voice, while highlighting the historical scholarship of the 1619 Project’s Education Network’s rich and abundant resources.

Lesson Progression Breakdown: Below is a breakdown of the lesson titles/themes featured in this unit, the recommended grade levels/courses they were implemented in, and the lesson timeframe. 

• History of Medical Apartheid: Recommended for History/Social Studies teachers of students in grades 10-12, and features 2-multi-day lessons. 

• Dermatology: Recommended for History/Social Studies teachers of students in grades 10-12, and features 2-multi-day lessons. 

• Black Maternal Healthcare Crisis: Recommended for History/Social Studies teachers of students in grades 11-12, and features 3-multi-day lessons. 

• Allied Health: Recommended for Science teachers of students in grades 10-11, and features 2-multi-day lessons. 

• Mental Health: Recommended for History/Social Studies teachers of students in grades 7 (or higher), and features 2-multi-day lessons. 

Performance Task

Reimagining Race, Medicine, & Health Inequity Performance Task:

Essential Question: How have healthcare inequities impacted the BIPOC community, and how can those inequities be reimagined through policy? 

Objectives:

1. SWBAT research, design, implement, and evaluate community-based solutions that advance health equity.
2. SWBAT create a shared vision and value of health equity and identify strategies that support community-based solutions to alleviate health equity.
3. Students will present their “Race, Medicine, and Health Equity” projects and facilitate panel discussion sessions with community partners.

Project Task: You are a community activist. Your task is to create a policy to address one of the following healthcare inequities:

• Impact of Iatrophobia
• Dermatology and Colorism
• Mental Health of BIPOC communities
• Impact of the COVID-19 Pandemic on BIPOC communities
• Black Maternal Health

Seven multi-day history lesson plans and four multi-day health lesson plan for teachers, including pacing, texts and multimedia resources, graphic organizers for student projects, and performance tasks. Download below, or scroll down to read the complete unit plan.

This unit contains some texts available exclusively in The 1619 Project: A New Origin Story AND/OR Born on the Water. Learn more about this/these book(s) and how to access them/it here.

Facilitation Resources

Common Core Standards 

• CCSS.ELA-LITERACY.RH.9-10.1: Cite specific textual evidence to support analysis of primary and secondary sources,
• CCSS.ELA-LITERACY.RH.9-10.6: Compare the point of view of two or more authors for how they treat the same or similar topics
• CCSS.ELA-LITERACY.RH.9-10.9: Compare and contrast treatments of the same topic in several primary and secondary sources.
• CCSS.ELA-LITERACY.RST.9-10.1: Cite specific textual evidence to support analysis of science and technical texts,
• CCSS.ELA-LITERACY.RST.9-10.4: Determine the meaning of symbols, key terms, and other domain-specific words and phrases used in a specific scientific or technical context
• CCSS.ELA-LITERACY.RL.11-12.2: Determine main ideas and how they develop
• CCSS.ELA-LITERACY.W.11-12.1.A: Introduce precise, knowledgeable claims
• CCSS.ELA-LITERACY.RI.9-10.7: Analyze various accounts of a subject told in different mediums 
• CCSS.ELA-LITERACY.WHST.9-10.4: Produce clear and coherent writing in which the development, organization, and style are appropriate to the task, purpose, and audience.
• CCSS.ELA-LITERACY.WHST.9-10.6: Use technology, including the Internet, to produce, publish, and update individual or shared writing products

Next Generation Science Standards

Science and Engineering practices

Students build toward these elements for high school:

• Practice 2: Developing and Using Models 
  • Develop, revise, and/or use a model based on evidence to illustrate and/or predict the relationships between systems or between components of a system. 
• Practice 4: Analyzing and Interpreting Data
  • Apply concepts of statistics and probability (including determining function fits to data, slope, intercept, and correlation coefficient for linear fits) to scientific and engineering questions and problems, using digital tools when feasible
• Practice 6: Constructing Explanations and Designing Solutions 
  • Apply scientific ideas, principles, and/or evidence to provide an explanation of phenomena and solve design problems, taking into account possible unanticipated effects. 

• Practice 8: Obtaining, Evaluating, and Communicating Information  
  • Compare, integrate and evaluate sources of information presented in different media or formats (e.g., visually, quantitatively) as well as in words in order to address a scientific question or solve a problem.

The following captures work by students in East Orange, NJ who engaged with this unit's study of medical apartheid and the intersection of race, medicine, and equity in America.

In the Black Maternal Healthcare Lesson, students watch the documentary Aftershock, which exposes the history of Black maternal health crisis by following two directly impacted families and the activism that followed their loss. Students reflected on what they learned from the film by completing an informed action mini-project: writing a letter, spoken word poem, or song in conversation with one of the families depicted in the film.

• Student letter by Bruce McIntyre
• Student spoken word poem by Jarrod Houseal
• Student spoken word poem by Sheik Tall & Viviana Telemaque

In the Black Maternal Healthcare Lesson, Students were also asked to respond to various prompts in journals created for the lesson.

Students were asked to respond to the question, "How much progress have we made regarding inequality and injustice in health care?"

After reading “Medical Inequality” by Linda Villarosa and "1932: Story-By: Yaa Gyasi," students were asked to reflect on whether or not their opinion on the topics of medical apartheid and maternal health has changed.

Students were also asked to respond to questions after reading “Black Maternal Health Week: Serena Williams Shares Her Near-Fatal Birthing Story.”