Untold thousands of black North Carolinians suffered or died during the Jim Crow era because they were denied admittance to white-only hospitals. With little money, scant opportunities for professional education and few white allies, African American physicians, nurses and other community leaders created their own hospitals, schools of nursing and public health outreach efforts. The author chronicles the important but largely unknown histories of more than 35 hospitals, the Leonard Medical School and 11 hospital-based schools of nursing established in North Carolina, and recounts the decades-long struggle for equal access to care and equal opportunities for African American health care professionals.

Few career opportunities were available to minority women in Appalachia in the first half of the 20th century. Nursing offered them a respected, relatively well paid profession and--as few physicians or hospitals would treat people of color--their work was important in challenging health care inequities in the region. Working in both modern surgical suites and tumble-down cabins, these women created unprecedented networks of care, managed nursing schools and built professional nursing organizations while navigating discrimination in the workplace. Focusing on the careers and contributions of dozens of African American and Eastern Band Cherokee registered nurses, this first comprehensive study of minority nurses in Appalachia documents the quality of health care for minorities in the region during the Jim Crow era. Racial segregation in health care and education and state and federal policies affecting health care for Native Americans are examined in depth.

Drawing on a variety of sources from oral histories to the records of professional organizations, Thomas J. Ward, Jr. examines the development of the African American medical profession in the South. Illuminating the contradictions of race and class, this research provides valuable new insight into class divisions within African American communities in the era of segregation.

During its 1874-1875 session, the North Carolina General Assembly founded two new public asylums to address overcrowding in its only mental health care facility in Raleigh (Dorothea Dix Hospital). The first, in Morganton (Broughton Hospital), was intended to serve the white citizens of the state in addition to the Raleigh hospital. The second new facility in Goldsboro (Cherry Hospital) was intended to serve all the African American mentally ill of the state. This thesis explores the creation of this asylum system from the opening of the Raleigh facility in 1856 to the deaths of superintendents Patrick Murphy (Morganton), and J. F. Miller (Goldsboro). It examines the contradictions in the founding and running of the Goldsboro asylum. North Carolina differed from southern states such as South Carolina by creating a separate facility for African Americans, as had been pioneered by Virginia and Tennessee. This thesis argues that while the North Carolina General Assembly passed the act that founded the asylum, the lack of support and funding they provided prevented the asylum's ability to offer the same quality of care its white counterparts could provide to theirs. The General Assembly prioritized the all-white Morganton and Raleigh asylums over its only African American mental health care facility from its beginnings because of the race and the triumph of Jim Crow.

Lincoln Hospital opened in Durham in 1901 to serve the community's African Americans as a center for patient care and medical education. With the onset of the Civil Rights Movement, however, Lincoln's competition increased, and it closed in 1976. Still, the hospital is remembered today through the Lincoln Community Health Center and in the hearts and minds of those who contributed to its history.