Employer-based postwar health insurance structurally excluded Black Americans from coverage and care.

Evidence

Employer-based health insurance, which took off in the wake of World War II, put yet another hurdle between African Americans and equitable healthcare. “They were denied most of the jobs that offered coverage,” says David Barton Smith, an emeritus historian of healthcare policy at Temple University. “And even when some of them got health insurance, as the Pullman porters did, they couldn’t make use of white facilities.” White doctors helped widen the gap even further: professional societies like the American Medical Association (AMA) allowed Black doctors to be excluded, medical schools barred Black students, and most hospitals and health clinics segregated Black patients. The cumulative effect of these and other privations was to leave Black Americans with statistically shorter, sicker lives than their white counterparts. — Nikole Hannah-Jones et al., The 1619 Project, 1172

Categorization

• XREF: The pattern of apparently race-neutral institutions (employer-based insurance, the AMA) encoding exclusion echoes the book’s broader reframing thesis about how infrastructure built on slavery’s logic reproduced inequality.