Julius Rosenwald & Rosenwald Schools National Historical Park Campaign

FACT SHEET

Julius Rosenwald Fund African American Health and Medical Service Program:
Syphilis Control Studies

The mission of the Rosenwald Park Campaign (Campaign) is to create the multisite Julius Rosenwald & Rosenwald Schools National Historical Park with a visitor center in Chicago and a small number of Rosenwald Schools in various southern states.

This Fact Sheet will first provide background on the education and health and medical services programs of the Julius Rosenwald Fund (Fund). The specific focus is the six U.S. Public Health Service (PHS) syphilis incidence and treatment demonstration projects for African Americans in the South supported by the Fund between 1929 – 1931. These projects showed that the incidence of syphilis among African American communities varied based mainly upon socioeconomic differences and that available medications for syphilis could be administered to rural underserved populations. In 1932 the Fund decided to discontinue further research on treatment of syphilis. In 1937 the Fund supported a recheck on the status of participants in the prior syphilis control demonstration project in Macon County, AL.

Future Fact Sheets may address other aspects of the overall Programs of the Fund.

The Julius Rosenwald Fund: Education and Health and Medical Services Programs

In 1928, Julius Rosenwald hired Edwin Embree, a Vice President at the Rockefeller Foundation, to be President of the Fund, which he had founded in 1917 for the well-being of mankind. The main thrust of the Fund before 1928 was the Rosenwald Schools Building Program. Between 1912 and 1932, first Julius Rosenwald individually and then the Fund partnered with nearly 5,000 African American communities in 15 southern states to help build schools that provided the education for their children that was either non-existent or greatly lacking even though they paid taxes. A total of 5,357 schools, teacher homes and shop buildings were constructed. Nearly one-third of African American children in the Jim Crow South attended these schools and had the better lives so ardently desired by their parents. Many Rosenwald School alumni joined the Civil Rights Movement, most notably Congressman John Lewis and poet Maya Angelou.

With Rosenwald’s approval, Embree added fellowship and health and medical services programs to the education program in 1928. Under the fellowship program, which lasted from 1928 to 1948, nearly 900 highly talented people, most of whom were in the early stages of their careers, received awards; two-thirds were African Americans. Luminaries included Ralph Bunche, Dr. Charles Drew, Marian Anderson, W.E.B. DuBois, Langston Hughes, John Hope Franklin, Kenneth and Mamie Phipps Clark, James Baldwin Zora Neale Hurston and Ralph Ellison. The Fund also supported early NAACP legal cases and contributed to a number of Historically Black Colleges and Universities, including Tuskegee, Fisk, Dillard and Howard Universities and Morehouse College.

The health and medical services program focused on improving the health of African Americans through more accessible and better hospitals and clinics for them and providing better training for African American doctors, nurses and midwives. It also included public health projects to demonstrate the feasibility of controlling the infectious diseases syphilis and tuberculosis and of reducing the rates of maternal and infant mortality among African Americans. Total expenditures over the life of this program were $3.02 million, the equivalent of nearly $68.8 million in 2022.

The Julius Rosenwald Fund expended a total of $22.2 million from its inception in 1917 until its termination in 1948 in accordance with dictates of Julius Rosenwald that the Fund end within 25 years of his death. About $19 million went to improve African American education and healthcare and to seek better race relations, the equivalent of about a $433 million in 2022 dollars.

Fund Syphilis Incidence and Treatment Demonstration Projects

The syphilis demonstration program began in 1929 after Dr. Thomas Parran, then US Assistant Surgeon General, approached Dr. Michael Davis, general director of the Fund’s medical program. Dr Parran suggested that a joint project be undertaken by the PHS and the Fund to demonstrate the possibility of mass control of syphilis among southern African Americans. The PHS had just completed a survey of syphilis incidence in more than 2,000 African Americans employed by the Delta and Pine Land Co. in Mississippi, in which nearly one-fourth of the employees had tested positive. The PHS requested $10,000 from the Fund for a one-year demonstration project “to give adequate treatment for syphilis for this group.” The Fund agreed to the project, which started in late summer 1929.

The Fund also approved a new program in November 1929 for calendar year 1930 for “demonstrations of the control of venereal disease in the rural south, in cooperation with the PHS and with state and local authorities.” Five counties, in addition to the work continued in Mississippi, were selected for the demonstrations: Macon County, AL; Glynn County, GA; Pitt County, NC; Tipton County, TN, and Albemarle County, VA. The selected sites were chosen specifically to be dissimilar from one another both geographically and economically, in order to develop information to address the occurrence of syphilis under a variety of circumstances.

The six demonstration projects showed that the incidence of syphilis among African American communities varied based mainly upon socioeconomic differences. In Macon County, AL, where there was extreme poverty, high illiteracy and a lack of medical and educational facilities, the rate was the highest, more than four times higher than in Albemarle County, VA, where the general economic status, schools and medical care were significantly better.

The demonstration projects also showed that the medications for syphilis available at that time could be administered to rural underserved populations. Those medications included bismuth and neoarsphenamine injections and mercury ointments administered on the skin, the accepted treatments of choice during that time period. It was the medical establishment’s conclusion at the time that long-term treatment was needed for this deadly disease, even though treatment could produce serious side effects.

Syphilis has three stages, and is mainly just contagious in the first two. Although penicillin was discovered in 1928, the pure compound was not isolated until 1940, and its effectiveness in treating early syphilis was first shown on a small scale in 1943. Availability of the drug for widespread treatment of syphilis and other bacterial infections did not occur until after World War II.

In their 1949 book Investment in People: The Story of the Julius Rosenwald Fund, authors Embree and Waxman stated with respect to the six demonstration projects, “While treatment had not been extensive enough to effect the cure of all patients, it had rendered most cases noninfectious and reduced suffering and disability.”

The Rosenwald Fund monitored the demonstration project in Macon County closely. H. L. Harris, Jr., an African American physician working for the Fund, made two site visits to Macon County during the course of the project. Following his second visit in the fall of 1930, he submitted a report questioning the feasibility of attempting to cure syphilis in the county until overall health and socioeconomic conditions were improved, noting that the community desperately needed a comprehensive health and social welfare program. He concluded that the syphilis demonstration project in Macon County had “accomplished all that can be hoped from it” and should not be extended.

Shortly thereafter, the Fund hired Dr. Charles S. Johnson, Chair of the Department of Social Science at Fisk University and later the University’s President, to perform a sociological study of 612 African American families from eight settlements in Macon County, AL. A large number of these families had participated in the 1930 demonstration project. In his 1934 book on that study, Shadow of the Plantation, Johnson wrote that the demonstration project in Macon County made some social discoveries vital to health issues beyond the control of syphilis. These occurred because the treatment of syphilis required preliminary general physical examinations, which revealed the large incidence of other disabilities among the study participants. He stated:

“Some 7,500 blood examinations and 3,200 urine analyses were made on those under treatment, and a total of 2,042 prescriptions dispensed during the first year. Apart from this, however, 3,500 typhoid inoculations were given, and 600 children immunized against diphtheria, and 200 vaccinated against smallpox. This altogether, with the Red Cross distribution of seeds for gardens and yeast to be used in combating pellagra, constituted one of the most intense concentrations upon a reconstructive health campaign of any rural section in the South.”

At its spring 1932 meeting, the trustees of the Rosenwald Fund voted to discontinue projects with the PHS on syphilis incidence and treatment. The dramatic decline in public revenue in the South due to the Great Depression precluded meaningful governmental and philanthropic participation in syphilis control work. The Fund was experiencing financial difficulties of its own due to the stock market crash. Moreover, the report from Dr. Harris, advising against an extension of the study in Macon County, was available to them.

The Fund’s financial contribution to the six syphilis incidence and treatment demonstration projects was $72,900, equivalent to $1.73 million in 2022.

Tuskegee Syphilis Study

A new large scale research program related to syphilis known as the Tuskegee Syphilis Study was undertaken in the fall of 1932 by the PHS with participation by the Tuskegee Institute. The program lasted until 1972. The Rosenwald Fund did not contribute funds to the Tuskegee Syphilis Study. Its Trustees had voted to discontinue further syphilis control studies with the PHS in the spring of 1932.

The infamous Tuskegee Syphilis Study followed a group of African American men with demonstrated, supposedly late, non-contagious, syphilis who were not informed that they had the disease and were not given treatment for the disease—even after penicillin was demonstrated to be curative for this stage of the disease by the mid 1950s. Instead, they were subjected to ongoing medical observation, told the aspirins, iron tonics and vitamins given them were treatment, and even the diagnostic spinal taps were a “special treatment.” They were intentionally followed until their deaths, and money from the Milbank Memorial Fund, a New York based public health foundation, made autopsies possible for about half the men who died by giving money for their burials. A separate group of African American men without syphilis served as the control group. Few of the men with syphilis in the experiment had been part of the prior Rosenwald Fund control demonstration project in Macon County because those men had received short-term treatments for syphilis.

Other Rosenwald Fund Syphilis Treatment Program

In 1937 the Rosenwald Fund decided to renew its support of syphilis control programs by conducting a recheck of participants in the syphilis control demonstration project in Macon County, AL. The recheck showed a reduction in the syphilis rate. The Fund sent African American physician Dr. William E. Perry, of the Harvard School of Public Health, to Macon County. The PHS took steps to help assure that none of the men being studied in the Tuskegee Syphilis Study were included in the Rosenwald Fund syphilis control program, although how or if they did it has been disputed by some of the providers in this program.

The Rosenwald Fund provided support to the John A. Andrew Memorial Hospital on the campus of the Tuskegee Institute. The Fund’s contributions to this hospital totaled $64,500 (equivalent to $1.47 million in 2022) for experiments on a county-wide basis in venereal disease control, the training of midwives and the establishment of a nurses’ training course.

In the late 1930s, the US government launched a nationwide syphilis control program that included mass testing for the disease and nationwide mobile treatment clinics for both Whites and African Americans. The techniques utilized in the six Fund-supported demonstration projects contributed to the development and success of the program, which helped contain this dreaded disease.

Input from Dr. James H. Jones and Dr. Susan M. Reverby

As part of its review of the six syphilis control demonstration projects, the Campaign interviewed Dr. James H. Jones, author of “Bad Blood: the Tuskegee Syphilis Experiment,” and Dr. Susan M. Reverby, author of “Examining Tuskegee: The Infamous Syphilis Study and Its Legacy.” Both Dr. Jones and Dr. Reverby reviewed the draft version of this paper and stated that the six demonstration projects supported by the Rosenwald Fund provided treatment to people diagnosed as having syphilis. Both authorized the Campaign to use their names in this regard. They also stated that the Rosenwald Fund did not support the Tuskegee Syphilis Experiment.

Summary

As part of its mission to improve the well-being of mankind and its commitment to significantly enhance the education and health of African Americans, the Julius Rosenwald Fund contributed to six PHS demonstration projects on the incidence and treatment of syphilis among African Americans in six counties of southern states between 1929-1931. One of the counties was Macon County, AL. These studies showed that socioeconomic conditions contributed significantly to the incidence of syphilis within populations and that underserved rural populations could be treated for syphilis. The Rosenwald Fund trustees voted in the spring of 1932 to discontinue its syphilis control program with the PHS. The Fund did NOT contribute to the large-scale Tuskegee Syphilis Study, conducted between 1932 and 1972, which intentionally did not provide treatment to the participating men with syphilis. In 1937, the Fund performed a recheck of participants in its prior syphilis control demonstration project in Macon County. The nationwide PHS syphilis control program initiated in the late 1930s benefitted from the six Fund-supported syphilis incidence and treatment demonstration projects.

References:

Embree, E.R. Julius Rosenwald Fund: Review of Two Decades 1917-1936. Chicago.1936.

Embree, E.R., and Waxman, J. Investment in People: The Story of the Julius Rosenwald Fund. Harper & Brothers, Publishers, New York, NY. 1949.

Gray, F.D. The Tuskegee Syphilis Study: An insider’s account of the shocking medical experiment conducted by government doctors against African American men. New South Books. Montgomery, AL. 1998, 2013.

Johnson, C.S. Shadow of the Plantation. The University of Chicago Press. Chicago, IL. 1934.

Jones, J.H. Bad Blood: The Tuskegee Syphilis Experiment - A Tragedy of Race and Medicine. The Free Press, New York, NY. 1981, 1993.

Jones, J.H. Personal communication with D. Canter, September 22, 2022.

Jones, J.H. Email to D. Canter, October 12, 2022.

National Register of Historic Places Multiple Property Documentation Form. The U.S. Public Health Service Syphilis Study, Macon County, Alabama, 1932-1973 (reference number 64501070). Received April 2, 2010 (Accessed at https://catalog.archives.gov/id/77835306).

Reverby, S.M. Examining Tuskegee: The Infamous Syphilis Study and Its Legacy. The University of North Carolina Press. Chapel Hill, NC. 2009.

Reverby, S.M. Personal communication with D. Canter. September 12, 2022.

Reverby, S.M. Email to D. Canter, September 12, 2022.

Reverby, S.M. Email to D. Canter, October 7, 2022.

Thomas, S.B. and Quinn, S.C. The Tuskegee Syphilis Study , 1932-1972: Implications for HIV Education and AIDS Risk Education Programs in the Black Community. Public Health Then and Now. 1991;81(11):1498-1505.

University of Maryland, Baltimore County. James Jones: The Tuskegee Syphilis Experiment: A Tragedy of Race and Public Health. University Center: Ballroom. March 27, 2017. Accessed on September 21, 2022 at https://www.youtube.com/watch?v=f95S2UNVXn0.

Washington, H.A. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. First Anchor Books. New York , NY. 2006.

Attachment
Timeline: Julius Rosenwald Fund African American Health and Medical Service Program
Syphilis Control Studies

NOTE:  The infamous PHS Tuskegee Syphilis Study of African American men with diagnosed syphilis who intentionally were not treated for the disease and were followed until their deaths, was initiated in October 1932 and continued until 1972. The Rosenwald Fund did NOT contribute to the Tuskegee Syphilis Study.

November 21 , 2022