Slavery, Health, and Medicine

by

Stephen C. Kenny

• LAST REVIEWED: 27 November 2023
• LAST MODIFIED: 15 January 2015
• DOI: 10.1093/obo/9780199730414-0256

Introduction

Considerations of health and well-being as fundamental human rights have always been at the heart of serious attempts to understand the experience and history of enslavement in the Atlantic world. As a profoundly oppressive, destabilizing, and deeply exploitative social system—and a toxic method of utilizing human labor—slavery in the Americas guaranteed negative health outcomes and enduring health problems in all of its geopolitical and historical contexts. Breaking down core elements of the enslavement process and the oppressive governance and exploitation of slave life and labor highlights how the system relentlessly undermined physical, psychological, and emotional health. The initial acts of capture, incarceration, human commodification, and forced transportation all weakened health. So too did the separation of families and disruption of communities and being held in captivity under constant surveillance, with labor coerced and closely supervised. Indeed, the health of the enslaved was constantly threatened by the rigid regulation of all aspects of daily life. Slave health was also vulnerable to the use and constant threat of violent punishment, dangerous and debilitating occupations, as well as environmental exposure. Sexual interference and abuse were major assaults on slave health. Poor housing and sanitation and inadequate food, water, and clothing also put enslaved people at risk of a range of debilitating diseases. Throughout the history of their enslavement, however, Africans and their New World descendants vigorously resisted the destructive effects of oppression and pursued a struggle for health reliant upon their own knowledge, practices, and resources, absorbing new ways of healing through encounters and cross-cultural exchanges with white Europeans and the indigenous peoples of the Americas. Eighteenth- and nineteenth-century abolitionist activists recognized slavery’s dire health impact, which they brought to light in their campaigns and writings. Late-20th-century public health discourse encouraged policymakers, governments, and health professionals to consider a broader range of determinants beyond the role of individual behaviors and the health-care system—especially structural, material, and psycho-social factors—in an effort to fully evaluate and improve the health status of population groups. Historians of slavery in the Americas have adopted innovative and interdisciplinary approaches in exploring the health histories of enslaved peoples, with increased availability of sources in the digital age and new collaborations all promising ever more robust, holistic, and systemic analyses. This article examines key features of the rich and diverse historiography of slavery, health, and medicine in the contexts of the Transatlantic slave trade and in North America, where the literature is particularly strong. The article then turns attention to studies of slave health and medicine in the Caribbean and Brazil, before concluding with consideration of slavery’s impact on emotional, psychological, and environmental health.

General Overviews and Edited Collections

Scholarship on this subject is developing rapidly for Northern and Southern Atlantic slave regimes and in all time periods, with an especially noticeable upsurge in studies of slavery, health, and medicine for Brazil and the Caribbean. The first major wave of interest in the subject of slavery, health, and medicine resulted in a number of useful edited collections and bibliographic essays, such as Kiple 1984, Numbers and Savitt 1989, and Beckles and Shepherd 1991, foregrounding current debates and compiling key research on the topic but also highlighting methodological approaches and providing helpful guides to manuscript collections. Byrd and Clayton 2000 offers an overview of the black experience of health care under North American slavery, highlighting various forms of medical racism—including stereotyping, neglect, abuse, and differential treatment. Porto 2006 signals an exciting stage in the development of the literature on this topic in the Brazilian context. In the Oxford Handbook of Slavery in the Americas (Paquette and Smith 2010), the challenge and significance of defining and determining the well-being of enslaved peoples is reflected in the fact that health issues are dealt with across a number of essays, including Steckel’s overview of “Demography and Slavery” and Kiple’s contribution on “Biology and African Slavery.” Volume 22 of The New Encyclopedia of Southern Culture: Science and Medicine (Thomas and Wilson 2012) is a thematic textbook focused on the US South and offering a wide range of essays on established and emerging topics.

• Beckles, Hilary, and Verene Shepherd, eds. Caribbean Slave Society and Economy: A Student Reader. Kingston, Jamaica: Ian Randle, 1991.

  An anthology including essays by Michael Craton, Barry Higman, Kenneth and Virginia Kiple, and Richard Sheridan on the topics of health, diet, disease, mortality, reproduction and medical treatment in the British West Indies.

• Byrd, W. Michael, and Linda A. Clayton. An American Health Dilemma. Vol. 1, A Medical History of African Americans and the Problem of Race: Beginnings to 1900. New York: Routledge, 2000.

  Byrd and Clayton provide a detailed survey of the numerous social injustices and inequalities that have shaped the history of the black health-care experience in North America. They also consider how white Western biomedicine reinforced negative health outcomes for black Americans and contributed to their racialization, by generating stereotypes, manufacturing differences, and erecting racial barriers.

• De Barros, Juanita, Steven Palmer, and David Wright, eds. Health and Medicine in the circum-Caribbean, 1800–1968. New York: Routledge, 2009.

  The introductory essay examines the subject of slave health within a broader consideration of the Caribbean’s medical historiography. Individual essays examine topics including slave midwives, the development of professional medicine, and the issue of race.

• Kiple, Kenneth F. “Bibliographic Essay.” In The Caribbean Slave: A Biological History. Edited by Kenneth F. Kiple, 259–265. Cambridge, UK: Cambridge University Press, 1984.

  This essay offers a useful overview of archival sources and key medical and biological studies of slavery in the Americas.

• Numbers, Ronald L., and Todd L. Savitt, eds. Science and Medicine in the Old South. Baton Rouge: Louisiana State University Press, 1989.

  All nine essays included in Part II of this collection (“Medicine in the Old South”) have some bearing on the subject of slave health and medicine in this region, with individual contributions examining ecology, public health, mental health, folk beliefs, and black health on the plantation.

• Paquette, Robert L., and Mark M. Smith, eds. The Oxford Handbook of Slavery in the Americas. Oxford: Oxford University Press, 2010.

  DOI: 10.1093/oxfordhb/9780199227990.013.0001

  See Kenneth Kiple’s “Biology and African Slavery,” Richard Steckel’s “Demography and Slavery,” and Theresa Singleton’s “Archaeology and Slavery”—though the volume’s index finds no place for general terms such as “health,” “medicine,” or “slave health” or “slave healers.”

• Porto, Ângela. “O sistema de saúde do escravo no Brasil do século XIX: Doenças, instituições e práticas terapêuticas.” História, Ciências, Saúde-Manguinhos 13.4 (2006): 1019–1027.

  DOI: 10.1590/S0104-59702006000400013

  Porto offers a short “state of the field” overview—useful in highlighting sources, emerging themes, and new approaches, as well as drawing attention to gaps and opportunities.

• Thomas, James G., Jr., and Charles Reagan Wilson, eds. The New Encyclopedia of Southern Culture. Vol. 22: Science and Medicine. Chapel Hill: University of North Carolina Press, 2012.

  This edited collection considers questions of slave health and medical care from a regional perspective. Contains thematic essays on a wide range of topics, such as “Civil War Medicine,” “Folk Medicine,” “Racialized Medicine,” “Slavery and Medicine,” and “Slaves in Medical Education and Research.”