Building a Healthy Black Harlem: Health Politics in Harlem, New York, from the Jazz Age to the Great Depression.

Dorman, Jacob S.

Building a Healthy Black Harlem: Health Politics in Harlem, New York, from the Jazz Age to the Great Depression. By Jamie I Wilson. Amherst, New York: Cambria Press, 2009. xii + .206 pp. $104.99 hardcover; $26.99 Kindle.

In Building a Healthy Black Harlem, Jamie J. Wilson shows that residents of Harlem, New York City in the 1920s faced severe overcrowding that caused numerous health problems. Residents met these challenges by frequenting magico-religious workers and conventional doctors alike. Campaigns to improve care and desegregate the medical staff of Harlem Hospital ultimately resulted in the hiring of Black nurses and doctors by the early 1930s, but Harlem remained one of the unhealthiest neighborhoods in New York. Wilson's argument is that poor housing conditions, lack of access to health care, and racial discrimination in the 1920s and 1930s "encouraged not only personal and organizational pursuits for health services, but also political organization with the community in order to demand health options from medical and political leaders..."(2).

Wilson views the struggle for health and wellness in Harlem as not just one of many struggles waged in those tumultuous decades, but as the principal struggle waged by Black residents of Harlem in those years. Wilson uses the census to paint a meticulous social history portrait of life in one Harlem tenement, while drawing from The New York Amsterdam News, and from the poetry and fiction of Claude McKay, Rudolph Fisher, Langston Hughes. He also relies on reports from New York governmental agencies as well as prior scholarship, especially the work of Cheryl Greenberg, Or Does It Explode? Black Harlem in the Great Depression (New York: Oxford University Press, 1991). For Wilson as for Greenberg and other scholars of Harlem, the neighborhood's health woes began with the racial discrimination that burdened Harlem residents with high rents and low wages, forcing overcrowding and breeding the highest rates of disease in New York City. Wilson's account is especially innovative in depicting magico-religious workers, whose advertisements are ubiquitous in Harlem newspapers of this era, as frontline healthcare workers practicing forms of root work and conjure with roots in hoodoo and African modes of healing. Taking for granted that these spiritualists, "professors," and healers provided a valuable service, Wilson argues that their arrests and criminalization "reduced the quality of wellness care by limiting overall healing options in the community," (58).

Wilson also gives the best and most extensive account of the struggles to integrate the medical staff of Harlem Hospital and to improve the quality of care at that troubled institution. Savvy Black political pressure on New York's Tammany Hall machine eventually brought the reorganization of Harlem Hospital and the hiring of five Black physicians in 1925 and twenty-five more in 1930. The battle for the reform of Harlem Hospital pitted Adam Clayton Powell, Sr.'s Abyssinian Baptist Church and the Communist Party against the NAACP, whose board of directors included Louis T. Wright, a hospital administrator.

Community-based organizations such as the African American women's Utopia Club created the Utopia Children's House with funding from John D. Rockefeller and provided preschool, before and after school programs, lunches, clothing, medical and dental care, and enrichment classes. Private efforts and New Deal programs such as the Harlem River Houses were never enough to ameliorate the squalid living conditions and attendant health problems of Harlem as a whole. But Wilson wants to push our attention away from the overarching ghetto synthesis model of authors such as Gilbert Osofsky and instead blame Harlem's continued health woes on "changing economic circumstances, technological innovations, reliance on government support, the political strength of the American Medical Association, the monopoly of the pharmaceutical companies, and the transformation of cultural values during the post-civil rights era..." (131).

Wilson's book is a valuable contribution to our knowledge of a place and time better known for its famous writers and artists than for the quotidian struggles of its workers facing racism and the structural economic trap of high rents and low wages. It demonstrates that Harlem residents struggled to battle racism and improve health and wellness even when the decks were stacked against them. Wilson's book is an impressive achievement that updates social history with fresh material and perspectives and makes important interventions in the literature on African American urbanization.

Jacob S. Dorman Assistant Professor The University of Kansas