Documenting Durham's Health History: Understanding the Roots of Health Disparities (2018-2019)

North Carolina’s “City of Medicine” is also a city of great racial and class health disparities. While these inequities have deep historical roots, we know remarkably little about the specific ways by which structural forces, policy decisions and specific group actions have shaped the landscape of health in contemporary Durham. A better understanding of these phenomena requires historical research and engagement that moves beyond the academy to connect with public health departments, community leaders, multidisciplinary researchers and health professionals. A documentary history of health in Durham, and Duke’s relationship to it, has the potential to expand, and even transform, the vision of healthcare of our community.

This Bass Connections project was structured as a social science/humanities lab, involving a team of students, project leaders, faculty and community representatives. In the first year of this project, the team pursued activities in five areas:

Historical overview: Speakers and readings provided background on the history of Durham and its hospitals (Duke, Watts, Lincoln).
Longitudinal data analyses and visualization: Using available vital records, the team described long-term secular trends in morbidity and mortality for Durham County since 1900, focusing on racial disparities. Analyses included mapping and other types of geographic visualization.
Historical case studies: Team members identified a set of case studies focusing on specific epidemics or diseases with significant racial health inequities. These included examples that are historical (e.g., 1918 influenza epidemic, typhoid, tuberculosis, pellagra) and recent (e.g., HIV, obesity, cancer, opiate overuse).
Archival and contemporary research: Team members investigated each case study using various archival and contemporary sources, such as interviews, oral histories, vital records, photographs, maps, newspapers and popular media. Questions included: How did the particular disease affect different communities in Durham? How did any differences relate to broader social and contextual factors (such as housing, employment, education and municipal utilities)? What kind of healthcare was available (both outpatient and hospital), and did economics and racial barriers shape accessibility? How did implicit bias as well as structural racism play out in healthcare?
Exhibition and documentary production: The team developed exhibitions and documentary materials illustrating the findings of the research.

Timing

Fall 2018 – Spring 2019

Team Outputs

Documenting Durham’s Health History: An Exhibition (Trent Semans Center for Health Education, Duke University, April 22, 2019)

Documenting Durham’s Health History: Understanding the Roots of Health Disparities (poster by Jeffrey Baker, Kanav Chhabra, Dan Crair, Chelsea Hamlet, Jessica Hauger, Meghana Sai Iragavarapu, Sujeiry Jimenez, Robert Korstad, Suzanna Larkin, Dillon Leovic, Michelle Li, Melissa Norton, Felicity Palma, Alex Paulenich, Brian Rhee, Bianca Rochelle, Nikki Vangsnes, Katie Waeldner, presented at Bass Connections Showcase, Duke University, April 17, 2019)