Malicious Intent: Murder and the Perpetuation of Jim Crow Health Care

Do we want to perpetuate a Jim Crow health system?" A brilliant, idealistic physician asked that question in Alabama in 1966. Her answer was no—it led to her murder. Unearthing the truth of Jean Cowsert's life and death is a central concern of David Barton Smith's Race, Murder, and Medicine. Unearthing the grim history of our healthcare system is another. Race-related disparities in American death rates, exacerbated once again by the Covid-19 pandemic, have persisted since the birth of the modern U.S. medical system a century ago. A unique but fundamentally racist history has prevented the United States from providing the kind of healthcare assurances that are taken for granted in other industrialized nations. The underlying story is one of political, medical, and bureaucratic machinations, all motivated by a deliberate, racist design. In Race, Murder, and Medicine, David Barton Smith traces the Jean Cowsert story and the cold case of her death as a through line to explain the construction and fulfillment of an unequal healthcare system that would rather sacrifice many than provide for Black Americans. Cowsert's suspicious death came at a key moment in the struggle for universal healthcare in the wealthiest country on earth. Race, Murder, and Medicine is a history of those failed efforts, and a story of selective amnesia about one doctor's death and the movement she died for.

Table of Contents:
Preface Part I. Race and Recovery of Memory 1. A Forgotten Death 2. Jim Crow Medicine 3. Death of Universal Healthcare Part II. Mobile 4. Old Wounds 5. Civil Rights Struggles 6. Local Medicine Part III. Jean Cowsert, M.D. 7. Preparation 8. An Irresistible Force Meets an Immovable Object 9. Eliminating the Jim Crow Cages Acknowledgments Notes Bibliography Index

About the Author :
David Barton Smith, Professor Emeritus in Health Administration at Temple University, is the author of Reinventing Care: Assisted Living in New York City (also published by Vanderbilt University Press) and Health Care Divided: Race and Healing a Nation. He is assisting in the production of a companion documentary supported by the National Endowment for the Humanities.

Review :
Malicious Intent investigates two mysteries: what caused the 1967 death of Jean Cowsert, a courageous physician in Mobile, and why extreme health disparities persist in the United States. David Barton Smith finds the solution of both in the history of racism in America, of which he is a foremost chronicler."—Timothy Stoltzfus Jost, author of Health Affairs' Following the Affordable Care Act blog (2010-2017) ​"David Barton Smith sees health care reform as having been stifled by racism, and in that sense Dr. Cowsert's death serves as a metaphor—a way to humanize and personalize the struggles and costs of health reform."—Keith Wailoo, author of How Cancer Crossed the Color Line “Dr. Smith’s work represents a significant contribution to the literature on structural racism and the history of healthcare, providing important context to much-needed contemporary discussions of the subject.”—Stuart Wexler, author of America's Secret Jihad: The Hidden History of Religious Terrorism in the United States