Over three days in the spring of 1972, the Black Panther Party, the radical political organization that had emerged in Oakland, California, almost six years prior, held a Black Community Survival Conference—a gathering that combined elements of a rally, a street fair, and a block party—in that city’s De Fremery Park.1 On March 27, standing before a large banner carrying the slogan “Serve the People Body and Soul,” the Party’s chairman and cofounder Bobby Seale spoke on a public address system to the assembled mass of Panther loyalists, political allies, locals, police, and passers-by about the organization’s slate of free community service programs. These “survival programs” were established partly to help poor blacks cope with the surveillance and harassment they experienced at the hands of agents of a mounting “law-and-order” state. These programs were also intended as a stopgap solution to the diminished provision of social services by a shrinking welfare state.
Against a backdrop of barbecuing; children’s presentations on black and radical history; speeches by members of other activist groups, such as Johnnie Tillman of the National Welfare Rights Organization; a performance by the pioneering a cappella group the Persuasions, and other entertainment, Party cadre and volunteers distributed information about more than a dozen no-cost community service initiatives, including escorts for senior citizens to medical appointments, free elementary education at their school, and a bus service to prisons for visits with incarcerated friends and family.2 Concurrently, Party rank and file showed Seale’s words in action, handing out bags of free food and clothing to an appreciative crowd.3
On this same weekend, the Party also held a voter registration drive in anticipation of its May 1972 announcement of Seale’s and Minister of Information Elaine Brown’s respective candidacies for mayor and Sixth District city council seat—on a “Community Survival ticket”—in upcoming Oakland elections.4 Accordingly, some scholars have interpreted this gathering and the subsequent survival conferences that occurred that year as marking the Party’s “deradicalization”—a shift in the organization from revolutionist to reformist principles and from radical militarist tactics to mainstream electoral politics.5 Less remarked on, however, is the fact that this episode was also a signpost of the Party’s health politics.6
At this event, the breadth of the Party’s health-focused activism was evident: Party members publicized the activities of the People’s Free Medical Clinics. Party cadre touted grocery giveaways as ameliorating the malnutrition that often accompanied poverty and thus as contributing to community members’ healthfulness. Working with their collaborators and also with volunteers, the activists reportedly screened thousands for sickle cell anemia—a genetic disease that predominates in persons of African descent. Moreover, in this same month, Party cofounder Huey P. Newton and Brown, the group’s chairwoman, amended the organization’s founding ten-point platform to include a revised point 6, a demand for “COMPLETELY FREE HEALTH CARE FOR ALL BLACK AND OPPRESSED PEOPLE.” The extent of these activities confirms that the provision and politicization of medicine was a significantly developed feature of the Party’s broader mission. By spring of 1972, Party health activism was full-fledged.7
This community survival conference illustrated in microcosm the scope and ambition of the Black Panthers’ health politics. Given the extent of these efforts, it is surprising that the Party’s health initiatives have received mostly passing mention in both scholarly analysis and popular recollection and have been overtaken in popular memory by the penumbra of debates about whether the Party’s primary aim and lasting bequest was social disorder or social transformation. Indeed, the Party’s community service programs have become ready ammunition in the so-called culture wars of recent decades. An unfortunate consequence of the tendency to either pillory or valorize the Party’s activities in a zero-sum manner is that scant attention has been paid to its considerable engagement with medical and health concerns. Bellicose critics of the Party’s survival programs dismiss them merely as attempts by the activists to downplay the organization’s promotion of violence and shore up its credibility after run-ins with law enforcement decimated its membership and eroded its public support.8 Equally pugnacious champions of the Party, including several former members turned memoirists, by contrast, invoke these programs as reflecting the activists’ true mission and as counterpoints to claims that the organization comprised nothing more than an assortment of aimless youth with violent tendencies.9 The historical truth, of course, lies somewhere between and also beyond these characterizations.
In the mid-1960s the eye of the civil rights storm set course for “freedom North.”10 To be sure, African American equality struggles had always been waged both below and above the Mason-Dixon Line. In this period, however, the spotlight of public attention that had since the 1950s shone brightest on civil rights activism centered on the South—exemplified by events like the Montgomery, Alabama, bus boycott and the Student Nonviolent Coordinating Committee’s (SNCC) Freedom Summer project—shifted to urban centers in the West, Midwest, East, and North. In these latter settings, resistance to racial and economic oppression was often more stridently projected, as exemplified by the militant radicalism of the Black Panthers and the scores of urban rebellions that punctuated the “long hot summer” of 1967.11 The moral authority that was accorded to opponents of antiblack southern racism derived in large measure from the Christian principles that undergirded their nonviolent tactics.12 In the mid-1960s, when black radicals employed “un-civil” tactics such as armed confrontation with state authorities and denunciations of state-sanctioned institutional racism, the issue of health imparted another moral mantle to their efforts.13
Health was a powerful and elastic political lexicon that could signify many ideals simultaneously. In settings where racial oppression was more commonly advanced through social abandon (e.g., nonexistent or insufficient social welfare programs) and social control (e.g., police harassment, medical mistreatment) than through staunch Jim Crow practices, health was a site where the stakes of injustice could be exposed and a prism through which struggles for equality could be refracted. Health could also connote inalienable human attributes and freedoms. Martin Luther King Jr., for example, invoked the idea of health as both a fundamental and a paramount property of human life during an address before the Medical Committee for Human Rights (MCHR) in 1966. “Of all forms of inequality, injustice in healthcare is the most shocking and inhumane,” King proclaimed.14 The Black Panthers translated the poly-valence of “health” into practical social programs and political ideology. Body and Soul is an exploration of why and how health issues, broadly understood, came to be an indispensible element of the Party’s politics. As is described here, ideological foundations, historical continuities, and tactical exigencies precipitated the Party’s commitment to these concerns.
The Long Medical Civil Rights Movement
Seale and Newton established the Black Panther organization in October 1966 to afford protection for poor blacks from police brutality and to offer varied other services to these same communities. In ensuing years, as the Party’s ranks quickly swelled in Oakland and beyond, Party headquarters instituted guidelines for new chapters and members that specified, among other procedures and practices, the establishment of no-cost community-based medical clinics (or PFMCs). Mandated by the Party leadership, but not funded by it, the operation of the clinics depended on the ingenuity of the Panther rank and file and members’ abilities to mobilize local resources. At the PFMCs, Panther cadre worked with both lay and trusted-expert volunteers—including nurses, doctors, and students in the health professions—to administer basic preventive care, diagnostic testing for lead poisoning and hypertension and other conditions, and, in some instances, ambulance services, dentistry, and referrals to other facilities for more extensive treatment. At the free clinics, the Party also administered extramedical patient advocacy; Black Panthers and volunteers helped clinic clients to navigate housing, employment, social welfare programs, and similar matters. Party health politics also ranged beyond the physical site of the PFMCs in many ways: the activists conducted health services, outreach, and education in homes, parks, churches, and other venues. They used vans and ambulances to take healthcare services out into poor communities.15 The Black Panther leadership also engaged in public debates about the significance of race for healthfulness and medical care via its newspaper, interactions with the mainstream media, and the legislative process.
A novel interpretation of the Black Panthers’ mission, trajectory, and impact becomes available when we shift the focus to their broad health-focused activities. The fact of Party health politics contravenes accepted wisdom that neither black activists’ express participation nor their particular perspectives contributed to the development of the health political landscape of the late 1960s and early 1970s. Suggestive of this tendency is a claim ventured by the sociologist Paul Starr in his monumental work, The Social Transformation of American Medicine. Starr writes that
the civil rights struggle lost its momentum as a protest movement in the seventies, but it set the example for dozens of other movements of similar purpose. Instead of marching through the streets, they marched through the courts. And instead of a single movement centered on blacks, the new movements advocated the rights of women, children, prisoners, students, tenants, gays, Chicanos, Native Americans, and welfare clients. The catalogue of groups and rights entitled to them was immensely expanded in both variety and detail. Medical care figured prominently in this generalization of rights, particularly as a concern of the women’s movement and in the new movements specifically for patient’s rights and for the rights of the handicapped, the mentally ill, the retarded, and the subjects of medical research.16
Here Starr suggests that the civil rights and health rights activism of this period were effectively detached from each other.
Yet African American activism of import did not fade from the political scene in the 1970s, and black activists of this decade did not precipitate the degeneration of civil rights struggles. A recent significant wave of research pioneered by the historian Jacqueline Dowd Hall and taken up by numerous others has generated a fuller accounting of African Americans’ battles for equality and has recast standard narratives that draw hard distinctions between the civil rights and black power movements. This school of thinking highlights the “long civil rights movement” by recalibrating the temporality, geography, and scale of the twentieth-century black protest tradition.17 The civil rights movement did not first emerge after World War II; it was inaugurated at least several decades earlier through the actions of not only large social movement organizations like the National Association for the Advancement of Colored People but also local communities’ specific political struggles in both the southern and the northern United States.18 While the regional, thematic, and tactical focuses of the black freedom struggle may have evolved over its longue durée, the movement continued through the 1970s and endures today.
Moreover, “race” was not the wholesale political “metalanguage” of late twentieth-century civil rights activism, to rework the historian Evelyn Brooks Higginbotham’s important observation about the hierarchization of social categories.19 Civil rights activists’ bailiwick included, to varied degrees, class inequality, fair employment, gender equality, health rights, and opposition to the Vietnam War. Ella Baker, A. Phillip Randolph, and the Black Panthers, to name but a few examples, fervently articulated that economic oppression and racism together placed limited horizons on blacks’ life chances.20 Similarly attuned to overlapping vectors of inequality, King Jr., in his capacity as a leader of the Southern Christian Leadership Conference, in 1967 began planning the Poor People’s Campaign, an innovative “interracial alliance” aimed at declaring “‘final victory over racism and poverty.’”21 Fannie Lou Hamer, the iconic vice chair of the Mississippi Freedom Democratic Party’s efforts to unseat that state’s exclusively white, pro–Jim Crow delegation to the 1964 Democratic National Convention, was drawn into activism as a way to overturn the intersecting system of racial, gender, class, and health inequality that characterized her experience in the South. She famously used the phrase “Mississippi appendectomy” to describe the medical oppression of poor black women who, like her, were surreptitiously sterilized while seeking treatment for other matters by abusive physicians.22 Activists from Randolph to Hamer to the Black Panther Party addressed the many sources of racial injustice. Health politics therefore must be understood as an important feature of a broader conceptualization of the civil rights movement.23
Pace Starr, the battle against Jim Crow was not merely a faded object lesson for the Party and its health activist contemporaries. Rather, the struggles for health access and for just distribution of both the benefits and the harms of biomedicine were a protraction of civil rights struggles in at least two ways. First, the Black Panthers’ health activism was a signpost in the long civil rights movement as well as a manifestation of an established tradition of African American health politics. This legacy was evident in the Party’s own tactical repertoire that drew on the example of black communities’ prior responses to health inequality and medical mistreatment. Health activism was (and remains) a prominent facet of black political culture. The Party was firmly rooted in a tradition that had developed during slavery in interface with how bondage, racism, and segregation affected the well-being of black communities. During the twentieth century, black health activists fought for access to humane and equitable medical treatment, from the Progressive Era during which black leaders endeavored to dispense healthcare services for their communities in the face of institutionalized Jim Crow by establishing hospitals that, like disease, did not abide a “color line,” to the 1950s and 1960s during which reformers staged a “medical civil rights movement” to desegregate medical schools and workplaces.24 The Party drew practically on the influence of these prior health activists. For example, although the Panthers’ establishment of independent health clinics was in keeping with the community control and self-determinist ethics of 1970s black nationalism (and New Left health activists), this alternative institution building harked back as well to early-twentieth-century endeavors, such as the “black hospital movement.”25 In these ways, the Black Panthers employed tactics that were demonstrably derived from a line of African American health advocacy that had developed in response to racially segregated medical institutions and health professions.
Black Panther health politics represented a continuation of civil rights struggles in a second significant way. Actors and organizations involved in Party health politics bridged civil rights and health rights endeavors. This is particularly apparent in the cross-fertilization between the Panthers, SNCC, and the MCHR. The MCHR, a group of doctors, nurses, students of the health professions, and others, first came together as medical support for SNCC’s 1964 Freedom Summer campaign. At this time, the SNCC leadership included H. Rap Brown, Stokely Carmichael, and Kathleen Cleaver, who would be among the earliest members of the Panther organization. As described in chapter 1, the Party’s health work extended directly from the efforts of the SNCC organization. Moreover, members of the MCHR worked closely with the Party on its health projects in Los Angeles, Chicago, and other locations to establish and run community-based health clinics not unlike ones started by SNCC. From an organizational perspective as well then, the founding of the Party did not mark the conclusion of the civil rights era but rather its extension. As Elaine Brown described, the Party did not discriminate between phases of the black freedom struggle and, indeed, appreciated its continuity: “We never called it the ‘civil rights movement.’ It was just ‘the movement.’ . . . Everybody called it ‘the movement.’ Everybody would tell you that. . . . We never really distinguished ourselves from Martin Luther King; we thought he was a great hero as we did with Malcolm X, of course.”26
Civil Rights, Health Rights
“A poor man has no medical or legal rights,” a member of the Party lamented in an issue of the group’s newspaper: “He is a colonized man.”27 As this quote suggests, while Black Panther health activism did not indicate the twilight of civil rights struggles, it was certainly a referendum on contemporary social issues. Indeed, the organization’s emergence responded to the profound dissatisfaction still felt by many African Americans despite the fact that their civic membership in the United States had been fortified anew in the Civil Rights Act of 1964 and the Voting Rights Act of 1965. For the Party, the reality of urban poverty and structural racism showed recent civil rights strides at their limits. Moreover, the persistence of health inequality despite recent improvements only highlighted the indefatigableness of the systematic social and economic exclusion of blacks.
The Panther activists apprehended that the provenance of birth was no guarantee of citizenship, especially for the poor. Despite dramatic legislative transformation and changes in social mores, citizenship could remain tenuous for members of marginalized groups. Some recent observations by theorists of citizenship are instructive for understanding the dynamics that conditioned this exclusion. For example, the historian Alice Kessler-Harris and the sociologist Margaret Somers, drawing on the works of T. H. Marshall and Hannah Arendt, have underscored the fact that holding civil rights neither guarantees social rights nor precludes economic oppression, despite legislation or expectation.28 In the twentieth-century United States, social rights typically emanated from civil rights, so that individuals could, for example, expect to receive health benefits through their place of employment. Yet this course of social inclusion has been unreliable for individuals who are more likely to be under- or unemployed or whose labor has not traditionally been remunerated (e.g., stay-at-home mothers and caregivers, “surplus” labor). Kessler-Harris explains that the provision of rights has “rested on sometimes hidden, normative assumptions about who ‘cares’ and who ‘works’; who deserves what sorts of rights; and who required protection from the market,” or, to use Somers’s words, on ideas about who has the “right to have rights.”29 This gap between civil rights and social benefits, or this citizenship contradiction, as I call it, has been especially acute for women and African Americans, who consequently may be relegated to incomplete and “problematic form[s]” of citizenship.30 In such instances, individuals are dependent on powerful institutions, organizations, and others to secure their rights. Alternately, members of these groups may possess an emaciated citizenship that may be “conditional on political whim” or the vagaries of the market.31 Returning to the Black Panthers with Kessler-Harris’s and Somers’s analyses in mind, we can understand the organization’s health politics as an effort to provide resources to poor blacks who formally held civil rights, but who by virtue of their degraded social status and social value lacked social and economic citizenship and thus the privileges that accrue to these, including access to medical care. Through its activism, the Black Panthers intended to fulfill a most basic human need (i.e., medical treatment) while insisting on a full measure of social inclusion for the black urban poor.
In the late 1960s, with social citizenship decoupled from civil rights, despite recent changes in U.S. political culture, the Party exposed the citizenship contradiction facing poor black communities and demanded rights on their behalf. The Panthers regarded healthcare as “a right and not a privilege,” as did many other health radicals of this period and as had prior reformers and activists.32 More proximate to the Black Panthers was the capacious idea of a right to health elaborated in the 1948 constitution of the World Health Organization, underlain by the United Nations Universal Declaration of Rights formalized in the same year, which affirmed the “inherent dignity” and “inalienable rights” of all human beings.33 The WHO, the UN entity tasked with coordinating global health issues, advanced a robust definition of health as both a basic and a universal right: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity . . . health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”34
In developing its health politics, the Party borrowed liberally from the WHO charter. Given that in the Party’s original ten-point platform of 1966, the activists requested assistance from the UN to create an autonomous political community, or “plebiscite,” it is perhaps unsurprising that the Party’s expansive definition of health would be appreciably indebted to that of the WHO. In an article in its newspaper touting the group’s free medical services, for example, the Panthers declared that it is “the government’s responsibility to provide its people with this right [to health] and other basic human rights.”35 Also following the UN body, the activists defined health as “a state of physical, social and mental wellbeing” and “one of the most basic human rights of all human beings.”36 Holding a conception of health that included many registers of wellbeing, the Black Panthers were understandably disaffected by recent narrow civil rights gains.
Building on the WHO’s assertion of health as a universal right as well as traditions in both African American culture and leftist thinking that drew together iatric and social well-being, the Party developed a distinctive perspective and approach that I term “social health.”37 With the phrase “social health” I mean to characterize the activists’ efforts on the terrain of health and biomedicine as being oriented by an outlook on well-being that scaled from the individual, corporeal body to the body politic in such a way that therapeutic matters were inextricably articulated to social justice ones.38 The Party’s social health position reflected its particular understanding of the history of racial subjugation and its commitment to social equality combined with a Marxist-Leninist critique of the “medical–industrial complex”—health radicals’ term for the confluence of business interests, the medical profession, the insurance industry, and pharmaceutical companies that drove the commodification of healthcare.39
The Party’s social health “frame” was also distinctly elastic.40 In addition to allowing the fashioning of metonymy between individual illness and social dis-ease, the elasticity of the social health perspective allowed the Party to advance alternatives to mainstream explanations for why certain diseases, like sickle cell anemia, persisted among black populations and to suggest why these communities were disproportionately depicted by biomedical researchers as the loci of disease and pathology. As a praxis, social health linked medical services to a program of societal transformation. The Panthers’ clinics, for example, were imagined as sites of social change where preventive medicine was dispensed alongside both extramedical services (e.g., food banks and employment assistance) and ideology via the Party’s political education (PE) classes. Reflecting many influences, social health was the frame for the Panthers’ engagements with biomedical knowledge and a guiding principle for the group’s health initiatives. It was an articulation of the Party’s unique critical discourse of citizenship and health rights.
The Party’s focus on health and medicine was impelled by several factors, described in the chapters to follow, including its founding political ideology, the influence of prior African American health activism, internal organization dynamics, and state repression. The Party’s activism was also notably au courant. Its health politics intensified at a time when healthcare was at the forefront of political and policy debates in the United States (alongside desegregation and the implementation of recently passed civil rights legislation, President Lyndon B. Johnson’s War on Poverty, and the failing Vietnam War). In the late 1960s and early 1970s, there was general agreement in the United States that the country was in the midst of a healthcare “crisis.”41 During this time, crisis discourse was taken up by austerity hawks who complained that state-sponsored healthcare coverage strained the federal government’s resources to the limit, and by welfare statists on the left, who pointed to the exigencies of a profit-driven medical system as the culprits. The Party also took up this health crisis rhetoric. For the Panther organization, and other health radicals, the emergency lay at the nexus of rising health inequality, deficient medical care, and waning confidence in a medical profession that was unaccountable to its patients. Moreover, for the Panthers, the crisis was also due to the fact that blacks disproportionately suffered ill health and poor medical treatment. These realities, the activists insisted, were corporeal manifestations of the vicissitudes of urban poverty in the United States.
As I detail below, varied political camps—including two presidential administrations, professional associations, and health activists—advanced diverse diagnoses of and remedies for the crisis. In 1965 President Johnson established Medicare and Medicaid—government health insurance for the elderly and the disabled and the poor, respectively—when he signed into law the Social Security Act of 1965, as a cornerstone of his Great Society model, which enlarged the federal government’s role in healthcare and other social welfare programs. In this same year, partly following the example of Freedom Summer—SNCC’s and the Council of Federated Organizations’ two-month campaign to register and empower black voters, during which “Freedom Schools” and “Freedom Clinics” were also established in Jim Crow Mississippi—the Johnson administration began a community clinic program in an effort to provide healthcare to the poor.42 This initiative, funded by the Office of Economic Opportunity, mandated the “maximum feasible participation” of local communities in administering the clinics.43
Within a few years of the passage of the Social Security Act, there were pitched battles over proposals to federally fund universal healthcare coverage that pitted the conservative President Richard Nixon, the American Medical Association, and other medical industry lobbyists against the health reformer and Democratic senator Edward M. Kennedy, labor unions, and health activists of mixed political provenance. Healthcare for workers was fundamentally transformed when Nixon signed into law the Health Maintenance Organization Act of 1973. A centerpiece of his administration’s national health strategy, this legislation required businesses with more than twenty-five employees to supply both indemnity and healthcare insurance coverage to their workers and primed the pump of the managed care system by supplying government-backed grants and loans to qualified health maintenance organizations.44 Moreover, with this plan the Nixon administration could appear to respond to calls for medical care in the United States to be made more affordable and accessible, without acceding to demands for state-sponsored universal healthcare that surpassed the coverage provided by Medicaid and Medicare.
Activists, too, were conversant in the political rhetoric of the health crisis.45 In diametric contrast with the Nixon administration and healthcare lobbyists who were committed to the continued commodification of medical care, health radicals—a coterie that included the Black Panther Party, health workers such as the MCHR and the Student Health Organization (SHO), and the New Left–oriented Health Policy Advisory Center (or Health/PAC)—understood the most acute aspect of the crisis to be the proliferation of a capitalist medical system that produced and exacerbated inequality. The Chicago Black Panther Party minister of health Ronald “Doc” Satchel’s complaint in the pages of the Black Panther that “the medical profession within this capitalist society . . . is composed generally of people working for their own benefit and advancement rather than the humane aspects of medical care” typified this activist argument.46 The health Left often parted ways with liberal reformers, such as Senator Kennedy, who believed that mainstream medicine could be made more equitable. For these radicals, a for-profit healthcare system was fundamentally and inherently flawed. Accordingly, they took no succor in the proliferation of the medical–industrial complex—even in a liberal guise.
Health activists, moreover, pointed to the consequences of the skewed health status quo as further evidence of the crisis: legions of people suffered medical neglect, they declaimed. Healthcare options available to the poor were often either deficient or too expensive and thus inaccessible. The elderly and impoverished people who received federal healthcare assistance in the form of Medicare and Medicaid, activists protested, were too frequently subject to substandard care. What is more, persons without any insurance coverage whatsoever might receive slipshod treatment in the emergency rooms of large, often dilapidated, public medical facilities. Writing on behalf of the Party, Elaine Brown voiced this objection in a 1974 dossier describing the organization’s service programs. “Private hospitals and doctors charge fees more expensive than poor people can afford,” Brown declared, “while public hospitals and clinics are so overcrowded and understaffed that their services are almost totally inadequate.”47
Those with access to healthcare often experienced the medical encounter as coercive and authoritarian, especially if they were poor, female, institutionalized, or members of minority groups. Disproportionately incarcerated blacks and Latinos were subject to medical abuse and experimentation, perhaps most notoriously at Pennsylvania’s Holmesburg Prison from the early 1950s to the early 1970s.48 Further, the circulation of prisoners’ and patients’ accounts of “being ‘treated like animals’”49 at these “butcher shops”50 and “butcher houses”51 —some actual, many apocryphal—eroded public faith in mainstream medicine.52 As a June 1970 newsletter published by the Los Angeles–based, Southern California chapter of the Black Panther Party put it, “Poor people in general and black people in particular are not given the best care available. Our people are treated like animals, experimented on and made to wait long hours in waiting rooms.”53 That this accusation was warranted was confirmed for many skeptics after the New York Times’s disclosure in 1972 of the four-decades-long Tuskegee syphilis study in which close to four hundred African American men were left untreated for the disease so researchers could observe its ravages on the human body.54 This controversy generated considerable public outrage and distrust on the part of poor and minority communities as well as the larger population.55 From politicians, to the Party, to the general public, there was acute awareness of the health crisis of the late 1960s and early 1970s.
The Chapters Ahead
The Panthers were heirs to a mostly uncharted tradition of African American health politics. In chapter 1 I draw out this tradition from the long civil rights movement. I demonstrate and argue that health advocacy, variously conceived, has been a deep-rooted concern of black political culture, across the range of institutions, community organizations, and social movements that constitute this protest tradition. Spanning the period from 1880 to 1965, the chapter links up the Party’s efforts with a line of health advocacy that was the necessary response of black communities to the myriad forms of health inequality to which they were subject for generations, including lack of access to healthcare resources; exclusion from whites-only hospitals; refusal of admission to professional schools, associations, and organizations; subpar medical care; and, in some instances, deliberate neglect and medical abuse. The Party’s social health approach was indebted to an earlier “relationist” paradigm through which “clinical and socioeconomic factors . . . explain[ed] . . . sickness in the individual black [person] as well as the black community generally.”56 In addition to this relative definition of well-being that went beyond strictly biological concerns, Panther health activism shared with prior efforts a critical engagement with the construction of race in medicine, or what the historian David McBride terms “sociomedical racialism.”57 The Panthers were also bequeathed a legacy of tactical responses to racialized health inequality, including institution building, integrationism (or antisegregationism), and the “politics of knowledge.”58
Party health activism was, at the same time, characteristic of the milieu of the late 1960s and early 1970s; it was an outgrowth of contemporary political currents and of its own organizational evolution. How and why the survival or “serve the people” programs came to play a central role in the Panther organization is explored in chapter 2, focusing in particular on a confluence of factors that precipitated the evolution of its health politics. Attention to community service was an expression of Party founders’ initial commitment to the dual deployment of theory and practice in response to their frustration with what they deemed black cultural nationalists’ preoccupation with rhetoric and the limitations of War on Poverty programs. The Party’s community service orientation was thus forged between and in reaction to what the activists regarded as ineffective rhetoric, on the one hand, and paternalistic social initiatives, on the other.
Serving the people was also a pragmatic matter for the Party by 1968. Between January 1968 and December 1969, at least twenty-eight Panthers were murdered in confrontations with police.59 Within the first few years of the Party’s emergence, it became subject to repressive police power that decimated its membership with fatalities and incarceration and jeopardized its popular support.60 The ideas of Ernesto “Che” Guevara, Mao Zedong, and Frantz Fanon provided a conceptual bridge between the Party’s political philosophy, its community service ethos, and its health politics. These theorists’ influence could be seen in how the Party afforded an integral role to medicine in its imagination of a “robust” social body: in its valorization of lay expertise, in its critique of “bourgeois” healthcare and medical power, and in its aim to foster medicine for and by “the people.”61
The administration of the Party’s locally controlled, alternative health clinics, including how they were staffed, supplied, and operated, is the focus of the third chapter. “Serve the people body and soul” was a familiar Black Panther aphorism, one that lyrically signaled the group’s total dedication to its constituencies. This saying took on a decidedly literal meaning after the Party leadership’s 1970 mandate that all current and future chapters institute health clinics.62 Although concern for the health of poor and black communities was intrinsic to the Party’s founding principles, and several chapters, including those in Chicago, Seattle, and Los Angeles, had already established PFMCs, this directive marked the beginning of a more coordinated effort.
The Party was not only a standard-bearer of the black power movement. It was also a significant “health social movement”—that is, an organization that challenged health inequality, in this case, by supplying access to medical services, contesting biomedical authority, and asserting healthcare as a right.63 The Panthers were indeed a significant faction in the radical health movement of its era. As health activists in the late 1960s and early 1970s, Party members labored alongside feminist groups; hippie counterculturalists; leftists such as Students for a Democratic Society and Health/PAC; politicized medical professionals and students, including the SHO and the MCHR; and the Party’s allies in the “rainbow coalition,” most notably the Young Lords Party.64 This multifaceted community—the radical health movement—was a decentralized aggregate of groups, collectives, and organizations with distinct missions that sought to transform medicine, institutionally and interpersonally.
These collaborations were critical to the functioning of the Party’s clinics. In keeping with the era’s DIY spirit, the activists enacted the better world they imagined by establishing their own independent healthcare initiatives and institutions. The radical health movement modeled practices that, in the words of some Bay Area radicals, valued “Health Care for People Not Profit.”65 This mission was frequently manifested in activist-run no-cost or low-cost clinics, such as the PFMCs established by the Panthers. Consistent with the period’s antiauthoritarian zeitgeist, at these alternative institutions the activists empowered patients to have a voice in the medical encounter and encouraged laypeople to claim the mantle of expertise by taking a hand in their healthcare—and, sometimes, in producing medical knowledge as well. The democratization of both medical practice and knowledge in the clinic setting was a tactical cornerstone of the Party’s health politics.
In addition to being brick-and-mortar embodiments of the Party’s health politics, these clinics were sites where the Party’s political ideals were translated into social practice by providing free basic care and advocating on behalf of patients. The Party provided healthcare services to populations who lacked them. The clinics addressed local needs, reflected local priorities, and drew on and mobilized local resources. The work of these chapter-based institutions did not end with providing health services. The clinics were exemplars of the Party’s commitment to the total well-being of its constituents. A person entering a Party clinic might also receive help from a “patient advocate” with paying bills or dealing with a problematic landlord; this individual might also be encouraged to attend a political education class in which writings by Fanon and other theorists were discussed. In this way, the PFMCs were sites for social change.66
The Panthers’ health clinics were also bases of operation for its sickle cell anemia campaign. Chapter 4 details the Party’s efforts to highlight the problem of this disease, an incurable genetic condition. Its campaign, launched in 1971, was both practical and ideological. In response to what they perceived as deliberate and pernicious neglect of African American citizens by the healthcare state, the Panthers established their own genetic screening programs. The Party also initiated health education outreach and disseminated information about the disease to black communities via the Black Panther and other media outlets, pamphlets, and public events. In this process, medical jargon about sickling was translated into terms comprehensible to a general audience. It was also translated into political analysis. Framed in a social health perspective, the Party explanation for the disease’s persistence emphasized the history of racial slavery, contemporary racism, and the inadequacies of profit-driven healthcare.
With its clinic network and the sickle cell anemia initiative, the Party worked to ensure the health of black communities by providing needed services. In another initiative, described in chapter 5, Newton led the Party and a coalition of activists to shield the impoverished, the incarcerated, and otherwise vulnerable populations from becoming biomedical research subjects. In 1972 and 1973 Newton, working with the progressive attorney Fred J. Hiestand and allied activists drawn from the civil rights, women’s, and labor movements, successfully challenged the establishment of the proposed Center for the Study and Reduction of Violence at the University of California at Los Angeles. The center was planned with a multidisciplinary slate of research programs that were variously dedicated to investigating the origins of violent behavior, including a highly controversial project that hypothesized individual diseased brains as the source of violence and proposed invasive surgery as a method of behavior modification. This chapter describes the Party’s manifold arguments against the center, particularly its opposition to the biologization of violence that it believed would inevitably result from research linking behavior with race and disease. In keeping with its social health perspective, the Panthers articulated an alternative etiology of violence that privileged social causation (e.g., racial oppression, poverty, reaction to state aggression) and defined violence as a social phenomenon rather than a biomedical one.
In the conclusion, I summarize the scope of the Party’s activism and consider its implications for how we historicize and theorize health inequality. The Party attended to how poor black communities were both underserved by and overexposed to the medical system. Accordingly, its health politics displayed two interrelated emphases: demands for healthcare access and for emancipation from “medical apartheid.”67 The Panthers and their allies endeavored to remedy the lack of access to medical services for members of marginalized groups by supplying basic preventive care at its free clinics. The Party additionally sought to shield these same communities from the excesses of biomedical power, such as the clinical research and medical experimentation described in recent poignant books by Rebecca Skloot and Harriet Washington.68 With its initiatives and interventions, the Party endeavored to provide a check on the healthcare state, protecting poor and black communities from neglect owing to a lack of access to healthcare services and from potential abuse from exposure to biomedical power. Importantly, vocal as they were in bringing attention to the potential for discrimination and abuse in medicine, the Panthers’ own foray into providing healthcare and health advocacy reveals that the group, while skeptical of mainstream medicine, was not antimedicine. The activists appreciated that biomedicine was necessary and could be put to useful purposes if it was loosed from market imperatives and carried out by trusted experts.
The Party enacted a calculated politics of health and race in which theories of human difference were strategically jettisoned and espoused toward select ideological ends. In some instances, the Panthers strategically deployed scientific claims about African Americans and black bodies to support their larger ideological aims. For example, with its sickle cell anemia campaign, the Party repurposed evolutionary theory to argue that this genetic disease was an embodied vestige of slavery and colonialism. At other times, the activists rejected biological theories about race and the “nature” of communities of color as they did in their campaign to put down UCLA’s planned “violence center.” Thus squarely at the center of the Panthers’ health politics were claims about the scientific, medical, and political significance of blackness and racism, about how and when the concept of race could be legitimately deployed.
In this way, the Party’s activities offer some possibilities for thinking anew about contemporary debates over issues of health inequality. This account of the Party offers insight into how black communities sought health rights and attempted to challenge invidious forms of biomedical racialization; it also foreshadows contemporary debates about racial health disparities and links between genetics and disease identity.
The Black Panthers’ health politics suggests why today some African Americans hold a complex and critical perspective that recognizes the particular vulnerability of blacks as patients and research subjects yet still demand participation in the healthcare system. We can see the beginnings of what the sociologist Steven Epstein describes as the “inclusion-and-difference paradigm” emerging in the 1970s.69 For Epstein, this paradigm partly reflects the outcome of women’s and minorities’ successful campaigns for access to biomedicine’s beneficial possibilities at the expense of acquiescence to categorical (read: racial) claims about human difference. Epstein demonstrates that civil rights discourse and affirmative action rhetoric were important to this transition. The Party story detailed here, in highlighting how health rights claims of the late 1960s and early 1970s were an extension of proximate black freedom struggles, suggests how civil rights discourse (if not civil rights themselves) would and could be an essential avenue through which many African Americans were incorporated into mainstream medicine.
At the same time, by illuminating the interdependency between civil rights activism and health social movements, this book deepens our understanding of collective action more generally. The account of the Party’s activism detailed here is of consequence for how we understand “health social movements” and their burgeoning in the last three decades of the twentieth century. Black health activism in this period did not necessarily augur the emergence of “new social movements” or mark the decline of more recent antiracist activism. To the contrary, it represented an evolution of the civil rights movement. Consistent with sociological scholarship on “social movement spillover,” the Party’s influences and collaborations suggest how civil rights and health rights claims were mutually constituted (and how health activism proliferated with a civil rights frame).70 More particularly, health rights activism of the 1960s and 1970s was an extension of the push for equal liberties and an effort to bridge the stubborn gap that separated civil and social citizenship.
Between its founding in 1966 and its formal end in 1980 (on the occasion of the closing of its Oakland elementary school), the Party blazed a distinctive trail in U.S. political culture, linking health to its vision of the good society. Its lasting significance is perhaps most robustly manifest in Panther iconography—in the symbol of the black panther borrowed from civil rights activists in Lowndes County, Alabama; in Minister of Culture Emory Douglas’s idiosyncratic political art; in the graphic identity the organization established with its newspaper; and the many photographs that captured the countenance and posture of its fresh-faced yet knowing leaders. Although the Panthers’ politics of health and race is a seemingly more ephemeral legacy, it endures in the commitment of health activists today, both former Party members and those inspired by them; in the persistence of community-based healthcare in the face of medical inequality; and the idealism that a right to health might be assured.