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 an historical research and engagement strategy that moves beyond the academy to engage 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.

Project Description

This Bass Connections project will be 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 will pursue activities in five areas:

  • Historical overview: Speakers and readings will provide background on the history of Durham and its hospitals (Duke, Watts, Lincoln).
  • Longitudinal data analyses and visualization: Using available vital records, the team will describe long-term secular trends in morbidity and mortality for Durham County since 1900, focusing on racial disparities. Analyses may include mapping and other types of geographic visualization.
  • Historical case studies: Team members will identify a set of case studies focusing on specific epidemics or diseases with significant racial health inequities. These will include 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 will investigate each case study using various archival and contemporary sources, such as interviews, oral histories, vital records, photographs, maps, newspapers and popular media. Questions to be explored include: 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 will develop exhibitions and documentary materials illustrating the findings of the research.

Anticipated Outcomes

Case histories providing a more nuanced picture of the origins of health disparities and how they have changed over time; set of exhibitions depicting how historical understanding can shed light on racial and class health disparities in Durham today, displayed at a public event; set of short documentary products (photographs, short films, audio recordings) addressing health disparities in Durham; possible future academic articles, websites


Fall 2018 – Spring 2019  

  • Fall 2018: Begin with weekly meetings, background talks and readings on history of Durham; participate in one-day documentary and oral history intensive training; identify case studies and divide into teams of three, connect to mentors, begin research
  • Spring 2019: Complete research; develop exhibition products and documentaries; hold formal event with presentation of exhibit materials in April; post selective material on existing websites (Bull City 150, Trent Center); potentially develop separate website in future

Team Outcomes to Date

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)

    Watts Hospital in Durham

    Team Leaders

    • Jeffrey Baker, School of Medicine-Pediatrics
    • Robert Korstad, Sanford School of Public Policy

    /graduate Team Members

    • Jessica Hauger, History-PHD
    • Felicity Palma, MFA/Experimental and Doc Arts

    /undergraduate Team Members

    • Kanav Chhabra, Neuroscience (BS)
    • Daniel Crair, Cultural Anthropology (AB)
    • Chelsea Hamlet, Public Policy Studies (AB)
    • Meghana Iragavarapu, Program II (AB)
    • Sujeiry Jimenez, Public Policy Studies (AB), Global Health (AB2)
    • Suzanna Larkin
    • Dillon Leovic, Int Comparative Studies (AB)
    • Michelle Li, Public Policy Studies (AB)
    • Alexandra Paulenich, Biology (BS), Global Health (AB2)
    • Brian Rhee, Interdept Biology/Sociol (BS)
    • Bianca Rochelle, Psychology (AB)
    • Kathleen Waeldner, Cultural Anthropology (AB)

    /yfaculty/staff Team Members

    • John Moses, School of Medicine-Pediatrics: Primary Care Pediatrics
    • Melissa Norton, Samuel Dubois Center on Social Equity
    • Nikki Vangsnes, School of Medicine
    • Rebecca Williams, Medical Center Library-Archives

    /zcommunity Team Members

    • Marissa Mortiboy, Partnership for a Healthy Durham