1. The enduring pattern of health inequities among Black communities has been captured in the work of a number of historians from the 19th and early 20th centuries. For more on the history of illness among Blacks, see: McBride David From TB to AIDS: Epidemics among Urban Blacks Since 1900. New York: University of New York Press; 1989. Wailoo Keith Dying While in the City. Chapel Hill: University of North Carolina Press; 2001. Gamble Vanessa Germs Have No Color Lines: Blacks and American Medicine 1900–1940. New York: Garland Publishing; 1989. Roberts Samuel Kelton, Jr Infectious Fear: Politics, Disease, and the Health Effects of Segregation. Chapel Hill: University of North Carolina Press; 2001.
2. The poor health of Blacks during the early 20th century captured the attention of a wide range of scholars and public health commentators. See: Dubois WEB The Philadelphia Negro: A Social Study. Philadelphia: University of Pennsylvania Press; 1899. The Health of Negroes; pp. 147–63.Grandy CR Virginia Medical Monthly. Vol. 54. 1927. The Control of Tuberculosis in the Negro; pp. 566–71.Guild C Journal of Negro Education. Jul, 1937. A Five Year Study of Tuberculosis among Negroes; pp. 548–52.Landis Henry RM A Report of the Tuberculosis Problem and the Negro. 10a. Philadelphia: Henry Phipps Institute; 1923. table 7.
3. Hoy Suellen M. ‘Municipal Housekeeping’: The Role of Women in Improving Urban Sanitation Practices, 1880–1917. In: Melosi MV, editor. Population and Reform in American Cities, 1870–1930. Austin: University of Texas Press; 1980. pp. 173–98.
4. Smith Susan L Sick and Tired of Being Sick and Tired: Black Women’s Health Activism in America, 1890–1950. Philadelphia: University of Pennsylvania Press; 1995. p. 32.See also: Hine Darlene Clark, Thompson Kathleen A Shining Thread of Hope: The History of Black Women in America. New York: Broadway Books; 1998.
5. The formation of Black churches and other social and benevolent societies represented an important antidote to anti-Black sentiment, social isolation, and prejudice. Philadelphia’s Free African Society, established in 1787 by Richard Allen and Absolam Jones, is an example of such an organization. For further reading on benevolent societies, see Hine, Thompson A Shining Thread of Hope. Vol. 39
6. US Bureau of the Census. Negro Population in the United States, 1790–1915. Washington, DC: Government Printing Office; 1968. pp. 350–51.Davis Allen F The Peoples of Philadelphia: A History of Ethnic Groups and Lower Class Life, 1790–1940. Philadelphia: Temple University Press; 1973. For more on the migration patterns of Blacks entering Philadelphia, see: Armstrong Association. mimeograph, Armstrong Association Papers. Urban Archives, Temple University Libraries; 1927. Report of Negro Population and Industries in Philadelphia.
7. Mossell Sadie T. The Standard of Living among One Hundred Negro Migrant Families in Philadelphia. Annals of the American Academy of Political and Social Science. 1921;98:174–75.
8. Franklin VP The Education of Black Philadelphia: The Social and Educational History of a Minority Community, 1900–1950. Philadelphia: University of Pennsylvania Press; 1979. pp. 7–32.See also: DuBois The Philadelphia Negro. p. 357.Katz Michael B In the Shadow of the Poorhouse: A Social History of Welfare in America. New York, NY: Basic Books; 1986.
9. “Starr Centre Historical Information Sheet,” p. 2, Starr Centre Collection, Barbara Bates Center for the Study of the History of Nursing, University of Pennsylvania. See also: Franklin VP . Operation Street Corner: The Wharton Centre and the Juvenile Gang Problem in Philadelphia, 1945–1958. In: Katz Michael, Sugrue Thomas J, editors. WEB DuBois, Race and the City: The Philadelphia Negro and Its Legacy. Philadelphia: University of Pennsylvania Press; 2000. p. 97.Beardsley EJG The Value of the Intelligent Direction of the Sick Poor - A Story of The Starr Centre Association of Philadelphia. Therapeutic Gazette. 1911 June;:2.
10. Beardsley The Value of the Intelligent Direction of the Sick Poor,” 2; “Starr Centre Historical Information Sheet. Starr Centre Collection. :2.
11. Starr Centre Association. Charter and Bylaws of the Starr Centre Association. Starr Centre Collection; Jun 2, 1905. p. 4. box 9, folder 105.
12. Beardsley The Value of the Intelligent Direction of the Sick Poor. :1–11.
13. Starr Centre. A Few Facts About the Starr Centre. Starr Centre Collection; 1905. MC 9, series IV, folder 105.Starr Centre Association. Milk and Medical Department. Starr Centre Collection; 1911. MC 9, series IV, folder 104.
14. Starr Centre Association. untitled pamphlet. Starr Centre Collection; 1907. box 9, folder 105.
15. Wharton Susan P. Starr Centre First Annual Report. Starr Centre Collection; 1903.
16. Starr Centre Association. untitled pamphlet. Starr Centre Collection; 1907. box 9, folder 105.
17. Starr Centre Association. board of directors meeting minutes; July 13, 1911; Starr Centre Collection;
18. It is important to note that intraracial tensions were not uncommon among Black civic association members because of differences in class standing and religious affiliation. In her historical account of health promotion in the rural south, historian Susan Smith uncovers evidence of such tensions in her examination of the Tuskegee Woman’s Club. The club women were all Black, educated, and well off, and they believed it their “calling” to improve the physical, spiritual, moral, and educational lives of rural Blacks. Middle-class Black women asserted that their class, as well as their gender, made them uniquely fit to bring about the salvation of the race. These assumptions often led to tension between middle-class and poor club members. See: Smith Sick and Tired of Being Sick and Tired. :18–21.
19. Wharton Susan P. Negro Branch of the Starr Centre. Starr Centre Collection; 1909.
20. Starr Centre Association. Annual Report. Vol. 7. Starr Centre Collection; 1911.
21. Starr Centre Association. board of directors meeting minutes; July 13, 1911; Starr Centre Collection;
22. Starr Centre Association. Annual Report. Starr Centre Collection; 1911. p. 10.
23. Wharton Negro Branch of the Starr Centre. Starr Centre Collection; p. 16.
24. Mossell Sadie T. A Study of the Negro Tuberculosis Problem in Philadelphia. Vol. 18. Starr Centre Collection; 1923.
25. Whittier Centre. Annual Report. Vol. 7. Wharton Center Collection; Urban Archives, Temple University Libraries; 1917. URB 30, series I, box 1.
26. Wharton Negro Branch of the Starr Centre. Vol. 4. Starr Centre Collection; 1909.
29. Starr Centre Association. Annual Report. Vol. 7. Starr Centre Collection; 1911.
30. Starr Centre Association. Annual Report. Starr Centre Collection; 1909. pp. 4–5.
32. For further reading on interracial and class tensions, see: Lerner Gerda Early Community Work of Black Club Women. Journal of Negro History. 1974;59(2):158–97.
33. Starr Centre Association. board of directors meeting minutes; May 28, 1912; Starr Centre Collection; p. 1. Wharton’s full plan for expanding services for Black club members included the establishment of a separate neighborhood house for Blacks, with the addition of a head social worker to coordinate services. The board considered whether it would continue its work with Blacks should Wharton depart; they decided instead to allow Wharton to assume responsibility for all services provided to the Starr Centre’s Black club members.
34. Starr Centre Association. board of directors meeting minutes; June 11, 1912; Starr Centre Collection; p. 2.
35. It remains a mystery why, after so many years of work with the Black community, the Starr Centre Association jettisoned those relationships and handed them to Wharton. I suspect that the needs of the community were outpacing the Starr Centre’s capacity. Also, the Black community’s growth was so tremendous that the Starr Centre may have been increasingly regarded as an “organization for Blacks,” which might have reduced its viability for other needy sections of the community. These thoughts, however, are purely conjecture; the historical record is silent about the real motives behind the center’s resistance to expansion of services targeted toward Blacks.
36. Whittier Centre. Annual Report. Center Collection Wharton; 1914. One of the Whittier Centre’s earliest collaborations was with the Philadelphia Housing Commission, a privately funded association working toward housing reform. In 1914 the commission conducted a study on the housing conditions of the city’s Black residents, and the Whittier Centre offered the services of its visiting staff to collect data for the study. Data collectors visited 1158 homes, where 4891 Blacks lived. The results of this study were published in the Whittier Centre’s “Annual Report” (1914) and summarized by Bernard J. Newman, executive secretary of the Philadelphia Housing Commission.
37. Henry R.M. Landis was a key figure during the Phipps Institute’s first three decades of operation. Born in 1872, Landis was a leading clinician and researcher in the field of TB and was personally chosen by renowned TB specialist Lawrence Flick to work at the institute. After graduating with an AB from Amherst College in 1894 and completing medical school at Jefferson Medical College in Philadelphia in 1897, Landis embarked upon a career specializing in the treatment of TB. Landis was renowned both nationally and locally, serving as the founder of the National Tuberculosis Association and presiding over the Pennsylvania Tuberculosis Society from 1928 to 1932. While at Phipps he functioned as an assistant professor of medicine and director of the Clinical and Sociological Departments, and he served as visiting physician to the Commonwealth of Pennsylvania’s White Haven Sanatorium. He was also connected clinically with Philadelphia General Hospital until 1909.
38. Whittier Centre. Annual Report. Wharton Center Collection; 1914.
40. By 1914, half of the former responsibilities of the Starr Centre rested with the Whittier Centre Whittier Centre. Annual Report. Vol. 4. Wharton Center Collection; 1915.
41. Whittier Centre. Annual Report. Wharton Center Collection; 1917. pp. 7–8.
42. Landis Henry RM. Whittier Centre. Annual Report. Wharton Center Collection; 1916. p. 2.
43. First annual message of John Reyburn. City Archives; Philadelphia: 1908. p. 96.
44. Bureau of Health. Annual Report. City Archives; Philadelphia: 1918.
45. Mossell A Study of the Negro Tuberculosis Problem in Philadelphia. p. 18.
46. Bates Barbara. Bargaining for Life: A Social History of Tuberculosis, 1876–1938. Philadelphia: University of Pennsylvania Press; 1992. P.S. I Am . . . Colored; pp. 288–310.
47. Landis A Report of the Tuberculosis Problem and the Negro. p. 1.See also: Henry Phipps Institute. Fifth Annual Report. Vol. 10. Philadelphia College of Physicians; 1909. p. 19. In his annual report to the Phipps Institute, Lawrence Flick, head of the institute’s Clinical and Sociological Departments, noted the low percentage of Blacks treated at the institute since its inception. Blacks represented 6.63% of the total percentage of Phipps patients during its first year (1904), 5.65% in 1905, 5.96% in 1906, 9.83% in 1907, and 7.68% in 1908. He further reported that Blacks held nearly the highest rates of single visits with no return follow-up, compared with other racial/ethnic groups.Flick Lawrence Phipps Institute Reports. Van Pelt Library, University of Pennsylvania; 1909. Clinical and Sociological Report.
48. Whittier Centre. executive board meeting minutes. Vol. 1. Wharton Center Collection; 1913.
51. Tyler’s work as a public health nurse is consistent with the efforts of her peers in the profession during this period. For further reading on Black public health nurses, see: Pitts Mosely Marie O Satisfied to Carry the Bag: Three Black Community Health Nurses; Contributions to Health Care Reform, 1900–1937. Nursing History Review. 1996;4:65–82. [PubMed]Also, on Black hospital nurses, see: Hines Darlene Clark Black Women In White: Racial Conflict and Cooperation in the Nursing Profession, 1890–1950. Bloomington: Indiana University Press; 1989.
52. Flick Lawrence Report of the Henry Phipps Institute. 1904. pp. 4–5.Gazette. Mar 5, 1926. The Phipps Gift.“Dedication of the Phipps Institute,” news clipping, December 1909. All items in Information Files Collection, UPF 8.51, University of Pennsylvania Archives. See also: Bates Bargaining for Life.
53. Bates Bargaining for Life. Vol. 108
54. Whittier Centre. Annual Report. Housing Association of the Delaware Valley (HADV) Collection, Urban Archives, Temple University Libraries; 1915. pp. 4–5.
55. Whittier Centre. Annual Report. Vol. 2. HADV Collection; 1916.
56. Whittier Centre. Annual Report. Vol. 13. HADV Collection; 1924. It is worth noting that the local health interventions of the Whittier Centre and the Phipps Institute were not isolated initiatives to improve health in Black communities; they in fact ran parallel to national efforts such as National Negro Health Week, which Booker T. Washington launched in 1915 to increase health awareness among Blacks.
57. The Starr Centre and Whittier Centre represent just two examples of interracial cooperatives run collaboratively by Blacks and Whites. Other historical examples reveal the importance of building trust and improving communication across race and class lines to address health and social inequities. In Chicago, for instance, White settlement workers joined Black reformers in founding the Frederick Douglass Center, an interracial settlement that campaigned for equal treatment for Blacks. For further reading on interracial coalitions in Chicago, see: Diner Steven J Chicago Social Workers and Blacks in the Progressive Era. Social Service Review. 1970;44(4):393–410.Interracial cooperation also emerged through evangelical and religious efforts, such as the Young Women’s Christian Association (YWCA). The YWCA experienced both interracial discord and cooperation, but it remains an illustrative example of the triumphs and complexities of building community networks. For further readings on the history of the YWCA, see: Robertson Nancy Marie . Kindness or Justice? Women’s Associations and the Politics of Race and History. In: Powell Walter W, Clemens Elisabeth Stephanie, editors. Private Action and the Public Good. New Haven, CT: Yale University Press; 1998. pp. 193–96.
58. Wallerstein Nina, Duran Bonnie. Community-Based Participatory Research Contributions to Intervention Research: The Intersection of Science and Practice to Improve Health Equity. American Journal of Public Health. 2010;100(S1):S40–S46. [PubMed]