Overcoming disparities: highlights from our past

December 13, 2006
Dr. Milton Rosenau, Founding Dean

Dr. Milton Rosenau, Founding Dean

Dr. Milton Rosenau, the UNC School of Public Health’s first dean, believed that every person deserved sufficient education and resources to “meet the needs of his body and the demands of his health.”

From its inception, the UNC School of Public Health followed his lead in working diligently to improve the public’s health through cutting-edge research, innovative program development, and high-quality public health education and health services delivery. Faculty and students worked with communities around the world, especially African-American communities throughout the U.S. South, whose quality of life was compromised by poverty, disease and limited educational opportunities.

The School’s community and human rights focus in the United States set it apart from more clinically-oriented public health schools at Harvard and Johns Hopkins universities.

From the start, the School at UNC had an independent, reform-minded spirit, resulting in an unprecedented number of women faculty members and students, groundbreaking development of multiracial teams working with North Carolina communities as early as the 1940s, and social activism beginning in the ’60s.

The School’s early history, according to UNC Kenan Professor Emeritus Dr. John Hatch, was driven by “decent people, in the right place at the same time, all trying to do the right thing.” Their work has set the pace for research, teaching and practice being done now to reduce health disparities. Here, we look briefly at two examples of the School’s commitment — Dr. Lucy Morgan’s pioneering collaboration in the 1940s with the North Carolina College for Negroes (now North Carolina Central University) and the establishment of the Minority Student Caucus in 1976. Along with the timeline below, we highlight the roots of the School’s commitment to overcoming racial and ethnic disparities in health and education.

Dr. Lucy Morgan: “A revolutionary, in the best sense of the word”

By all accounts, Dr. Lucy Shields Morgan was a powerhouse. As the founding chair of the UNC School of Public Health’s Department of Public Health Education — the first of its kind in the country — she was both pioneering and revolutionary.

Morgan’s father was president of the University of Tennessee and director of the Tennessee Valley Authority (TVA). Harcourt Morgan valued the TVA’s ability to make the lives of ordinary citizens more efficient and comfortable so that the larger community could thrive. “Man’s greatest need in the distraction of the age,” he noted, “is to see the unity that runs through diversity. No two people are alike, yet we are all brothers.”

Having adopted her father’s ideology, Morgan earned her doctorate from Yale in 1938 and founded a community health program in Hartford, Conn., which included African- Americans among its administrators and served as a model for similar programs around the country. In 1941, she joined the U.S. Public Health Service and was sent to Fort Bragg, N.C., to study the rise of prostitution at the military base. Almost as soon as she arrived in North Carolina, she was invited by Dean Rosenau to develop a curriculum in Public Health Education at Carolina’s new School of Public Health.

At that time, Dr. James Shepard, president of the North Carolina College for Negroes (NCC) in Durham, N.C., had been negotiating with the General Education Board to create graduate-level training in public health for African-American students. His vision was to establish a master’s degree program in health education at NCC. Morgan was asked to explore the feasibility of developing such a program, and she quickly determined that a need existed.

NCC faculty, however, had not yet been trained in public health education. Given the still-segregated campus at UNC at Chapel Hill, Morgan led her faculty to NCC’s campus in Durham to teach master’s level courses in public health education. Morgan often held joint classes for NCC and UNC students in her home.

Her strategy for field work was radical in the segregated South. Pairing white and African-American students, she sent two-person teams into rural communities where health education and health services were most needed. “They had to be introduced to each other,” she recounted in Robert Korstad’s Dreaming of a Time, a history of the School’s first 50 years. “They had never done that before. At that time, [whites] were not supposed to eat with Blacks, so we always had refreshments at the meetings. We had open houses when people came in from the field, Black and white together. Then it got bitter for awhile, and we used to pull down the shades sometimes when we had meetings in Chapel Hill.”

Morgan’s contribution to the health education program was incalculable.

African-American graduates of the program became faculty — both at NCC (including Dr. Howard Fitts, who chaired NCC’s Department of Health Education and later served on the Durham County Board of Health) and at UNC (including Dr. Howard Barnhill, who also served in the N.C. General Assembly). Morgan helped grow the health education department into the largest of its kind at a school of public health in the country, and oversaw, during the 1950s and ’60s, the training of almost half the country’s health educators.

UNC President Emeritus William C. Friday, whose wife, Ida, studied with Morgan in the master of public health education program and later taught there, called Morgan a “pioneering integrationist with a depth of soul that was instructive and remarkable; a revolutionary, in the best sense of that word.”

Public health as a movement: Minority Student Caucus evolves from grassroots efforts

1984 Minority Health Conference

1984 Minority Health Conference

In his laboratory work, UNC School of Public Health Epidemiology Professor and South African expatriate Dr. John Cassel found that disruption of “society” in a community of rats caused disorientation, stress and illness. He observed similar patterns in his work providing medical care to the poor in South Africa. People in difficult situations, Cassel found, coped better if they could depend on others to understand and support them. He further posited that even when one could not intervene with money or services to improve the well-being of a community, one could at least work to create a more psychologically supportive environment.

Such revelations were applicable in the late 1960s on the Chapel Hill campus. Black students, new to campus and in an environment of upheaval, faced the stresses of isolation and of faculty and programs that did not always understand or meet their needs. Many minority students working toward master’s degrees had been in the work force for years before returning to school. They wanted more opportunities to discuss career goals and challenges specific to minority public health professionals.

African-American graduate students began meeting informally in the early ’70s for support and to exchange ideas. Dr. John Hatch, an African-American, was among this group. Hatch came to UNC in 1971 as a doctoral student teaching at the School of Public Health. Ultimately, he became a Kenan Professor in the School’s Department of Health Behavior and Health Education, retiring in 1995.

In 1971, Dr. Fred Mayes, the School’s third dean, appointed William T. “Bill” Small, himself African-American, to become a full-time minority recruiter at the School to ensure that potential minority students were identified, encouraged to apply and assured of help with financial aid if accepted.

Small — who ultimately became associate dean and senior advisor for multicultural affairs, retiring in 1999 — had many contacts among African-American public health professionals in North Carolina communities and health departments and created much interest in the program. As minority student enrollment doubled that year, the Black Student Caucus came into being to support the needs and goals of this growing population. It also served as a vehicle for bringing concerns to the attention of the School’s administration.

In 1976, graduate students Eugenia Eng, a Chinese American, Victoria Washington, an African-American, and Cherry Beasley, a Lumbee Indian, advocated that the Caucus be inclusive of students from all racial and ethnic groups, so that their unique strengths, needs and concerns could be addressed. That year, by unanimous vote of the membership, the Black Student Caucus became the Minority Student Caucus of the School of Public Health.

In 1977, the Caucus organized its first annual Minority Health Conference — a day-long event highlighting health issues of concern for people of color. Designed to attract students interested in minority health to the School, the event featured Keynote Speaker Floyd McKissick, a lawyer and civil rights activist in North Carolina.

The Conference — now in its 28th year — has become an important educational event, attracting more than 400 public health practitioners, human services professionals, research staff, students and faculty from all over the country each year.

In 1999, Dean William Roper permanently named the conference’s keynote lecture for Small, recognizing his essential role in recruiting and mentoring minority students to the School for more than a quarter of a century.

The Minority Student Caucus continues to be a strong force at the School, uniting students and serving as a vehicle for bringing the concerns of minority students to the forefront. The Caucus also works with the School’s administration on Project Reach to link to the Historically Black Colleges and Universities, especially in North Carolina, and to institutions serving other minority groups.

– by Linda Kastleman

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