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Perspectives www.thelancet.com Vol 383 January 4, 2014 19 Exhibition Memories of race and place in the USA I often tell stories about my grand- parents to health professionals I teach to introduce a discussion on disparities, race, and culture. I share my memories of their lives in a rural town in Georgia, where a railroad track served as both a physical and metaphorical divide between races. These experiences ultimately provided the passion that drives much of my work and coloured the lens through which I viewed the powerful exhibition, Health is a Human Right: Race and Place in America, at the David J Sencer CDC Museum in Atlanta. The exhibition examines the legacy of race, poverty, and other determinants of health in the USA through historical pictures, artifacts, documents, video, sound, and interactive atlases. Many of the exhibits expose the often difficult history of race and health in this country. The recurring relation between discrimination and poor health among all minority racial and ethnic groups is evident. Photographs of a boarding school in the late 1800s, established with the goal of assimilating Native American children to white American norms, are compelling. Many Native American children were removed from their families and placed in such institutions, where they were malnourished and endured inadequate sanitation and overcrowding that led to the spread of disease. The treatment of Japanese Americans during World War 2 also features. A drawing of barracks at an internment camp in New Mexico reminds the viewer how, in the name of national defence, a 1942 Presidential Executive Order mandated detainment of more than 100 000 people. Most were American citizens, and over half were children, and many suffered physical and psychological stress as a result. This was also a time when race and power dynamics influenced the health of Mexican Americans. The 1942 “El Bracero” programme allowed Mexican workers to enter the USA temporarily to meet labour needs, but ultimately led to widespread discrimination along with poor living and working conditions. There is a disturbing image of Mexican men being sprayed with DDT by Department of Agriculture personnel upon entering the USA. I felt a personal connection to the exhibits that address the legacy of racism and discrimination experienced by African Americans. Stark images from the period of segregation under the “Jim Crow” laws line the walls and fill the display cases—I found pictures of a midwife in a poor rural town and of conditions in schools particularly affecting. These images evoked vivid memories of times spent in my grandparents’ home beside those railroad tracks—a home filled with love but no running water and no heat. My grandparents were smart, proud, and hardworking but had little more than a grade school education, all that was afforded to them in this segregated Georgia town. With limited financial resources, low health literacy, and some distrust of the health-care system, my grandfather died on the job from a massive myocardial infarction, while my grandmother died of advanced breast cancer that was bleeding and ulcerated at the time of diagnosis. My grandparents’ premature deaths from preventable diseases provide the basis for my real-world understanding of the health impact of social determinants. These memories brought the museum exhibits to life. But the exhibition also reveals more than just a painful past. Works on display about civil rights activist W E B Du Bois (1868–1963) are inspirational. He was one of the first to suggest that social conditions and not inherent traits led to health differences between blacks and whites. Armed with Du Bois’ insights, I walked away with a newfound passion to educate tomorrow’s health-care providers. Through this exhibition, I am reminded that many complex social determinants have a role in health and wellbeing. To have the broadest impact on health, clinicians should understand the complexity and impact of race and other social determinants of health and endeavour to find ways to connect community public service and advocacy with their clinical work. Jada Bussey-Jones [email protected] Health is a Human Right: Race and Place in America David J Sencer CDC Museum, Centers for Disease Control and Prevention, Atlanta, GA, USA, until Feb 28, 2014 http://www.cdc.gov/museum/ exhibits/health.htm “My grandparents’ premature deaths from preventable diseases provide the basis for my real-world understanding of the health impact of social determinants.” Visionary sociologist and civil rights activist W E B Du Bois in his Atlanta University office, 1909 Courtesy of Special Collections and University Archives, University of Massachusetts Amherst Libraries
