Trusted Messengers: Public Health Education and Advocacy in 20th Century Black American Newspapers

Abstract

For much of the 20th century, Black readers turned to Black newspapers for health information and advice. The messages reached hundreds of thousands across the United States during a period when the nation’s racially separate and unequal health care system limited the ability of Black communities to access vital resources, including public health education. This article, based on an analysis of several hundred health columns published between the 1910s and 1970, traces the origins and evolving role Black newspapers played as trusted messengers of health information. In doing so, it details the strategic ways Black health professionals as well as readers leveraged this form of media to promote health knowledge, address the prevention needs in Black communities, and advocate for better care. (Am J Public Health. 2025;115(3):326–332. https://doi.org/10.2105/AJPH.2024.307897)

From 1920 to 1927, Mrs N, a Black middle-aged woman, suffered from irregular bleeding and worried it might be a symptom of “cancer in womb.”¹ The doctors she consulted with examined her “very roughly” and insisted she needed an operation, but Mrs N was wary of physicians who seemed “eager” to operate on her. Determined to find a treatment plan she felt comfortable with, she wrote to Albert Wilberforce Williams, MD, editor of a weekly health column in the Chicago Defender, the largest Black-run newspaper at the time. “Tell me what you think will help me,” she pleaded. “These doctors I have here are white doctors and I want advice from some of my own doctors.” In his published reply, Williams condemned the clinicians who treated her poorly and encouraged her to continue searching for a physician with good bedside manner. He went on to explain that her symptom history, indeed, suggested she had uterine cancer and if the condition proved inoperable, advised that radium therapy might “afford you much comfort and may prolong your life.” Having responded to her concerns, Williams then used Mrs N’s case to emphasize to readers the importance of being proactive and informed about one’s health to avoid “an early grave.”

Through the early to mid-20th century, Black newspapers were a main channel through which Black medical professionals communicated information about health and disease, and readers across the country sought advice on health issues. The messages reached hundreds of thousands each week at a time when the nation’s racially separate and unequal health care system restricted Black Americans’ access to public health resources, including educational materials. As one White federal official acknowledged in 1929, “the colored people do not have the same opportunities for knowing … literature from Government sources because not so much work has been done by the State and Federal agencies with the negroes as with the white people.”² For Roscoe Brown, the Black health official who headed the Office of Negro Health Work at the US Public Health Service, the consequences of the government’s neglect was dire, as he wrote in 1949, “the Negro people of the nation have suffered greatly from the lack of effective health education.”³ To remedy this situation, Black health leaders and lay people built institutions, nationwide campaigns, and local initiatives that brought health resources directly into their communities.

This article highlights the key role Black newspapers played as a trusted source of health information, drawing on an analysis of several hundred health columns published between the 1910s and 1970, as well as government reports and archival sources. As contemporary studies have shown, collaborating with trusted messengers is an effective strategy for promoting public health.⁴ Cancer prevention campaigns, for example, have involved partnerships with Black newspapers, beauty salons, and barbershops to increase disease awareness and early screening, leveraging the longstanding roles these institutions have held as spaces for exchanging information.⁵ During the COVID-19 pandemic, public health campaigns that engaged community-based organizations proved essential to improving testing rates, reducing structural barriers to vaccination, and combatting misinformation.⁶ This article provides historical context that deepens understanding of these approaches, while also offering a longer perspective on the roles of race and racism, trust, and media in public health. In doing so, it argues for the need to look beyond formal health care settings to recognize the strategies Black Americans have developed to protect their health and advocate for better care in their communities.

THE RISE OF BLACK NEWSPAPERS AND THEIR HEALTH COLUMNS

From their origins in the 1820s, Black newspapers have centered the achievements, concerns, and injustices facing Black Americans, issues that historically have received less attention in White media outlets.⁷ The opening decades of the 20th century witnessed the rising influence of Black newspapers as technological innovations in printing and the migration of millions of Black Southerners facilitated the distribution of newspapers into more communities.⁸ At its height in the 1920s, the Chicago Defender sold 230 000 copies a week. Actual circulation was much higher as copies of the paper were passed along from person to person and read aloud in public areas: waiting rooms, train cars, street corners, and following church services.⁹ By the late 1930s, the Pittsburgh Courier boasted a readership of a quarter million, relying on similar routes of formal and informal distribution.¹⁰ Through migratory routes and in spaces of communal gathering, Black Americans across geographical regions, class backgrounds, and reading abilities gained regular access to the news.

In 1914, Chicago Defender’s editor Robert S. Abbott encouraged readers to turn to the paper not just for news updates but also for health information, writing, “Consult our legal and health editors. Their advice is free. Bring your troubles to us!”¹¹ Abbott’s appeal was more than an effort to boost readership; it anticipated Black newspapers as uniquely positioned to address a growing disparity in public health campaigns. That same year, at the 42nd annual meeting of the American Public Health Association (APHA), a Georgia physician argued that when it came to improving hygiene and health in Black communities, health professionals “might as well try to teach sanitation to mules as to try to teach it to the negroes.”¹² Such dehumanizing analogies, rooted in racist cultural stereotypes, served to rationalize and perpetuate health inequities even as some officials recognized that tackling major issues like communicable disease required working across the color line.¹³

With the 1913 debut of “Keep Healthy” in the Chicago Defender, Williams aimed to enhance public health awareness in Black communities and disprove claims of Black indifference. He was well-positioned to lead this effort, leveraging his professional reputation and experience treating patients at a municipal tuberculosis sanatorium as well as at Provident Hospital, the first Black-controlled hospital in the United States.¹⁴ A 1887 graduate of Lincoln Institute in Missouri (a historically Black university) Williams earned a medical degree from Northwestern University Medical College in 1894 as well as a certificate in sales from Sheldon Business School in Chicago, Illinois.¹⁵ He drew on his business acumen and medical knowledge to promote his newspaper column as “a weekly talk on preventative measures, first aid remedies, hygienics, sanitation.” Emphasizing “no prescriptions given,” he sought to dissuade readers from seeking magic bullet solutions to their ailments and placing “too much faith in medicine.”¹⁶ Instead he stressed the value of reforming daily habits and home environments to prevent the spread of deadly germs.

By the late 1930s, all of the major Black newspapers debuted health advice columns, following the Defender’s lead. Some features ran for only a few editions while others lasted for years and decades including “Keeping Fit” in the New York Amsterdam News, “Afro Health Talk,” in the Baltimore Afro-American, “That Vital Thing Called Health” in the Philadelphia Tribune, and others in Pittsburgh Courier, New Journal and Guide, and Broad Ax. With a combined weekly circulation of 1.1 million subscribed readers, Black physicians had built up a significant platform to amplify their health messages.¹⁷ Columnists focused on the leading causes of morbidity and mortality facing their readers: features that ran in the 1910s and 1920s underscored the importance of childhood vaccination and infectious disease control, especially tuberculosis, pneumonia, and venereal diseases. Though they encouraged open discussions on sexual health, medical columnists also adopted a moralizing tone, especially toward unmarried women and Southern migrants, whom they saw as most in need of guidance. Later columns published in the 1930s and 1940s paid growing attention to cancer and chronic conditions.

ESTABLISHING HEALTH COLUMNS AS TRUSTWORTHY SOURCES

Despite the proliferation of health advice columns, Black physicians took on professional risk in communicating to the public through newspapers. Dating back to the 19th century, this form of print media held a reputation as a source of medical misinformation; a platform primarily used by quack doctors to sell patent medicines.¹⁸ During a period when the lack of licensing laws meant anyone could claim to be a doctor, such deceptive marketing tactics, combined with the crowded layout of newspaper pages, made it difficult for even the savviest of readers to differentiate misleading advertisements from messages intended for the public good.¹⁹ But with rising acceptance of the germ theory of disease at the turn of the 20th century, combined with increased federal regulations over drug advertising, many health professionals began to see newspapers in a different light: no longer as platforms for medical quacks to spread misinformation but as tools that modern physicians could use to enlighten the public.

Still, for Black physicians who remained marginalized within the medical profession, dispensing health advice in a newspaper continued to raise questions about their intentions.²⁰ In an effort to dispel criticism that their columns were just another form of advertising (albeit one that aimed to draw patients to their practice rather than promote a product), Black medical writers emphasized their commitment to public health, that they upheld a professional duty “to sell health and the prevention of disease, instead of sickness or curing disease.”²¹ The Philadelphia Tribune drew a sharp distinction between the health advice provided in its pages from the guidance obtained through face-to-face consultations with a doctor. “It is not the purpose of the articles to take the place of medical examination nor the place of the family physician, but rather to deal with the primary laws of hygiene and right living.”²² Here, too, the editors framed health education and moral instruction as interconnected goals.

To further establish the columnists as trustworthy, newspaper editors highlighted the professional credentials of their medical writers and their experience working to improve health outcomes in Black communities. The 1924 debut of Charles A. Lewis’s column in the Philadelphia Tribune came with the announcement that the physician “of merit … exhibited special interest in the health of his people.”²³ A proud graduate of Lincoln University (class of 1905) and the University of Pennsylvania Medical School (1910), Lewis conducted antituberculosis work with Philadelphia, Pennsylvania’s Bureau of Public Health and the Henry Phipps Institute, including a detailed survey of the environmental and economic factors that drove higher tuberculosis rates in Black neighborhoods.²⁴ Other columnists treated patients at Black-serving hospitals, trained and taught at Black universities, held leadership positions in civil rights organizations, and maintained memberships in civic clubs.²⁵

Through these community-based and professional ties, Black health writers and their columns contributed to wider social efforts to improve health and living conditions. In health sermons they delivered in Black churches and radio addresses they gave that were broadcast during annual campaigns like National Negro Health Week that ran from 1915 to 1951, health professionals extended the reach of their printed messages to engage audiences across rural and urban locales. In Northern cities, the Urban League and National Association of Colored Women made “a special effort” to get health resources into the hands of newly arriving migrants and new mothers, distributing literature at train stations and community centers, and directing those in need of professional care to Black-serving facilities.²⁶ The dissemination of health advice in Black newspapers existed within this network of racial uplift work that flourished during the long Jim Crow era.

Across the different modes of outreach, historical survey data indicate that, by the late 1920s, newspapers had become the preferred source of health information in Black households. A national study carried out under the auspices of the 1930 White House Conference on Child Health and Protection, a decennial gathering of child health and welfare leaders, found that for Black parents, newspapers, more so than any other written source (including magazines, pamphlets, and books) served as the primary resource for children’s health and infant care. Twenty-seven percent of Black mothers relied exclusively on newspaper advice, compared with 8% of White mothers.²⁷ The trend was similar for fathers. Writing for the New York Amsterdam News in 1928, the Harlem-based physician Lucien Brown observed that through “the medium of the newspaper,” Black doctors had found an effective channel to “help thousands.”²⁸ By the time the surgeon Ulysses Dailey launched his “Until the Doctor Comes” column at the Chicago Defender in 1940, taking over from Williams, he felt confident to declare that “the medical column as a medium of health education has come to stay, having won the sanction of the medical profession and the interest of the reading public.”²⁹

FOSTERING READER ENGAGEMENT

Inviting readers to ask questions proved a vital strategy for health columnists seeking to engage and build their readership. This newspaper feature first appeared in the Chicago Tribune, the city’s daily paper with a largely White audience, where William A. Evans, Chicago’s first health commissioner (and future APHA president) briefly responded to readers’ questions. Evans saw the question-and-answer format as a valuable strategy for public engagement. Such exchanges, he believed, enabled health professionals to address the concerns of the “average” person, to “know them just as they are and to appeal to them in terms of their daily experiences.”³⁰ Black health writers quickly recognized the potential of this communication strategy, with some, like Algernon Brashear Jackson at the Baltimore Afro-American, even listing their home address at the top of their weekly columns to encourage readers to write directly for advice.

Responses published in Black newspapers could be quite detailed, as Black physicians made it a key part of their public engagement to discredit scientific theories about racial susceptibility to disease. When in 1923 Ms. A. L. learned she had a fibroid “the size of a walnut,” she wrote to the Chicago Defender to learn more about her condition. “Is it true that Negro women are afflicted with fibroid tumors more than women of other races? What causes fibroid tumors?”³¹ In answering her questions, Williams first explained that physicians classified fibroids based on their uterine location and that the etiology of the condition “is not known to the medical world.” Having established the state of medical knowledge at the time, he turned to address the “speculation and conjecture” that Black women were innately predisposed to fibroids. Such claims, he argued, lacked rigorous data and causal explanation even as they continued to be propagated in medical textbooks and professional articles.

Ms. A. L. was one of hundreds of female and male readers who wrote to Black newspapers with health questions and, in doing so, sent a clear signal that they were not passive recipients of medical advice but actively seeking information that could improve their lives and assessing the merits of such information. At the same time, in replying and publishing many of the letters they received, columnists gave correspondents a degree of agency in shaping public conversations about race and disease that further established health columns as participatory and trustworthy forums.

Some readers also saw value in the columns as a space where they could bare their frustrations over the challenges of accessing quality care. One Cleveland, Ohio, reader recounted the humiliation of traveling to Buffalo, New York, for a surgical procedure only to realize he was admitted to the hospital solely “as an experiment by the young doctors there who had more than a barrel of fun” and discharged him soon after without being fully treated.³² Another, writing from Mississippi, sought recommendations for treating a painful anal fistula that had swollen in size and was causing “a great deal of trouble.”³³ A local physician recommended an operation, but the letter-writer was reluctant to undergo the procedure, explaining, “I am here in the South and the chances are very poor for proper treatment.” Many Black women wrote in expressing their reluctance to have reproductive surgeries, fearing the likelihood they would lose the ability to bear children. Their concerns tragically illuminate how Black women understood their vulnerability at a time when eugenic sterilizations were prevalent and how the threat of such harm deterred women from getting care they critically needed. In describing their fears, past medical ordeals, and hopes for “proper treatment,” Black readers turned to health columns not just as a repository of expert advice but also a place where they believed they would be listened to and their pain would be taken seriously—not dismissed, ridiculed, or further exploited.

GENDER, RACE, AND PUBLIC HEALTH AUTHORITY

Initially, all of the health columnists who wrote for Black newspapers were men, but by the mid-20th century, some Black women broke through the gendered ranks. Flemmie Pansy Kittrell penned one of the longest-running features, which ran from 1936 to 1944, a column geared specifically to poor and working-class readers of the New Journal and Guide, those who “rent houses and work on weekly wages” as she explained.³⁴ Trained in nutrition science as well as home economics, Kittrell earned her graduate degrees from Cornell University (MA in 1930, PhD in 1936), and over the course of her career taught at leading Black institutions: Bennett College, Hampton Institute, and Howard University.³⁵ Her columns offered advice that was both scientifically grounded and resourceful, emphasizing the importance of proper nutrition in promoting children’s healthy development and including tips on preparing low-cost foods into nutritious meals. As World War II rations made it harder for families to secure basic staples, Kittrell’s recommendations became a crucial resource for those confronting food scarcity and insecurity. By 1946, the State Department also sought out Kittrell’s expertise, sending her abroad to survey health education and nutritional needs in Liberia.³⁶

When Dorothy Boulding Ferebee launched her 1950 column “Women Looking Forward” in the Afro-American, she noted with irony that Black women still needed an “invitation” from male news editors to have a space to speak on a national platform.³⁷ One of the most prominent Black physicians of her generation and president of the National Council of Negro Women, Ferebee recognized the obstacles Black women continued to face to secure positions of leadership despite the fact that Black women carried out the bulk of public health work through their roles as nurses, educators, caregivers, and community organizers. From 1934 to 1942, Ferebee served as medical director of the ακα’s annual Mississippi Health Project, guiding her sorority sisters to the Mississippi Delta each summer to provide much-needed preventive services and care to more than 15 000 poor Black families.³⁸ With her news column, she focused on women’s politics, framing the fight for better health care within larger struggles for improving economic and social conditions domestically and globally. One reader found Ferebee’s column and its emphasis on Black women’s political action, “a source of inspiration.”³⁹ And as the civil rights movement gained momentum in the 1950s and 1960s, more Black health leaders turned to newspapers, alongside magazines and professional journals, to mobilize opposition against health care discrimination and social injustices.

HEALTH ADVOCACY IN BLACK NEWSPAPERS AND IN THE APHA

Within a month of being elected APHA’s first Black president in 1969, Paul Bertau Cornely launched the column “Health in Action” that ran in the seven largest Black newspapers based out of Chicago; Philadelphia; Cleveland; Baltimore, Maryland; New York, New York; Pittsburgh, Pennsylvania; and Norfolk, Virginia.⁴⁰ The weekly installment had a considerable audience as by the mid-1960s Black newspaper readership approached 10 million.⁴¹ Cornely’s editorial carried many of the hallmarks of the earlier generation of health columns. The Guadeloupe, French West Indies‒born physician was a widely recognized public health authority having earned three degrees from the University of Michigan (a BA in 1928, MD in 1931, and DrPH in 1934) and spearheaded Howard University’s department of preventive medicine and public health. Deeply involved in the civil rights struggle, he co-organized the Imhotep National Conferences on Hospital Integration that brought together physicians working to desegregate health care, and he served as the medical coordinator for the March on Washington for Jobs and Freedom in 1963, among other roles.⁴² Cornely’s decision to write a news column while holding one of the highest positions of public health leadership signaled that Black health professionals continued to view newspapers as an essential channel for providing health information and promoting community engagement.

Shifting away from previous columns that offered advice on individual health concerns, Cornely announced “Health in Action” would, instead, concentrate on “the ills of the community.”⁴³ He still encouraged readers to write to him, and often referred to questions he received, but kept the focus of his weekly messages on societal-level interventions. For those unsure whether the APHA would advocate for their needs, Cornely emphasized that the association, especially while under his leadership, would be at the forefront on issues that impacted impoverished and disadvantaged communities. Fighting hunger, expanding women’s access to abortion services, and regulating environmental hazards like lead exposure marked key policy areas for the organization in the 1960s and 1970s.⁴⁴

As the title of his column underscored, Cornely believed everyone had a responsibility and role to play in advancing the public’s health. Laypeople should hold their elected representatives accountable on policy matters, he argued. At the same time, he regularly profiled radical, grassroots efforts to transform health care in underserved areas, including the free medical clinics organized by the Black Panther Party.⁴⁵ Cornely brought his call to action to the APHA as well. At the 1970 annual meeting in Houston, Texas, he named racism as a public health “enemy” and urged the organization’s 25 000 members to join him in health advocacy, to “come out of their sterile and scientific atmosphere and jump in the polluted waters of the real world where action is the basis for survival.”⁴⁶ Commitments to advancing health equity, education, and advocacy anchored his leadership vision for the APHA, helping to bring about the creation of the association’s Action Board for coordinating grassroots advocacy.

Cornely’s column, which ended in 1970, in many ways marked the culmination of Black newspapers as a leading voice on public health in their communities. Subsequent years witnessed declining readership and circulation of Black newspapers because of changes that came with the desegregation of the broader newspaper industry as well as a media landscape that was expanding into television programming. Yet, even as the national prominence of Black newspapers waned, the commitment among Black health professionals to partner with community-based organizations endured. Even today, Black physicians remain more likely than others in their profession to work with local groups and institutions to advocate for the health issues facing the populations they serve.⁴⁷

ADDRESSING HEALTH INEQUITIES AND MISINFORMATION TODAY

Through much of the 20th century, Black newspapers provided a central platform that brought health professionals and everyday people together in their efforts to protect and promote the health of Black communities. The guiding values of education and advocacy resonated deeply with newspaper readers who faced formidable obstacles to accessing health resources. The robust discussions that took place in health education columns, many of them driven by ordinary people’s questions, point to the value and continued need to involve and amplify different voices in public health dialogues.

With the 21st-century shift to digital news platforms and social media, public health leaders have sounded alarms that individuals are now exposed to health information that deliberately misleads and undermines public health goals.⁴⁸ This situation demands innovative solutions to rebuild trust in public health leadership. Still as this historical case demonstrates, concerns over the harms posed by media are not new. Black communities have long been engaged in combatting false ideas about race and disease and have strategically leveraged media channels to identify, disseminate, and amplify trustworthy information. Ongoing efforts to advance the public’s health, especially among those historically underserved, must look to these past efforts as a guide and support institutions that are trusted in their communities.