How Lupus Crossed the Color Line: Chronic Illness and the Reproduction of Racism in Health Care




Marshall, Najha

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The treatment of lupus speaks to the transformation of health care through civil rights and the ongoing indifference to Black pain. In one sense, the documented history of lupus dates to 400 BC, where skin diseases were commonly grouped together. In another sense, as research techniques changed, so did the understanding of the conditions that created lupus. Lupus and tuberculosis were thought to be of the same origin until antibiotics were discovered, curing TB but not lupus. Moreover, it took till the 1950s for researchers to investigate the epidemiology of this non-communicable disease. When they did, their research upended the assumption that middle-class white women were the most susceptible to this skin-disease. With the transformations that came with the Great Migration and the Medical Civil Rights Movement, Black people started getting more access to medical facilities that were previously “white only.” Now that Blacks had access to more equitable healthcare, awareness of Black health and Black illness grew. By the 1980s, researchers and clinicians started associating lupus with African Americans, effectively demonstrating how lupus had crossed the color line and become a civil rights issue. Today Black women are three times more likely to develop and be diagnosed with lupus than white women. Although some researchers have tried to attribute these staggering differences to genetic differences, this disproportionality can be better explained by the effects of structural racism. Overall, white Americans have higher socioeconomic status, live in better environments, and have better access to healthcare than Black Americans. By failing to address the systemic causes which have caused Black women to have the highest incidence of lupus, the healthcare system reproduces racism.



lupus, epidemiology, Black women, racism, health care, Honors College


Marshall, N. (2020). How lupus crossed the color line: Chronic illness and the reproduction of racism in health care (Unpublished thesis). Texas State University, San Marcos, Texas.


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