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344 An American Dilemma
discrimination. The trend seems to be in the direction of decreasing discrim-
ination in the distribution of federal aid, and the increasing weight of the
Negro vote in the North is strengthening this trend.^° In spite bf all, there-
fore, we believe that the Negro cannot fail to gain if the federal govern-
ment should start giving aid on a permanent basis even to the main body
of American educational institutions. Some further observations on the
problem of federal aid to education will be made in the last section of
Chapter 41.
4. Public Health
Mortality in all age groups is much higher among Negroes than among
whites.® Negroes suffer more from nearly all sorts of illnesses. We have
shown that at least the major part of these differentials is not due to greater
susceptibility on the part of Negroes*^ but to the impact of economic, educa-
tional, and cultural handicaps, directly or indirectly imposed upon Negroes
by discrimination.*^ The fact that Negroes are in greater need of health
facilities than are whites, and that discrimination in providing them health
facilities hurts the whites themselves, is gradually becoming realized.
The Negroes^ need for public health services is higher also because
poverty, in conjunction with segregation, prevents them from utilizing
private health facilities to the same extent as do whites. Negro families
(not on relief) spend only one-third or one-half as much for medical
services as do white families (not on relief).®^ Although federal, state, and
local governments nowadays carry about half the financial burden for all
hospitalization,^“ private hospitals and clinics continue to play a larger role
in this country, proportionately, than in most European countries. Even
in the North there are many private hospitals which do not accept Negro
patients. True, there are several private all-Negro hospitals, both North
and South,^® but they are usually small and qualitatively inferior.
In spite of the greater need for public health services and the interest
of the whole society that this need be filled, the pattern of public hospital-
ization is about the same as that for public instruction. The general level is
comparatively high in the North, and there Negroes are seldom discrim-
inated against.*^ The general standard of public hospitalization is much
lower in the South.®^ Although no comprehensive data seem to be avail-
able on the total number of beds (private as well as public) available to
* See Chapter 7.
See Chapter 6.
® For example, Negro sections of Southern cities have less adequate street cleaning and
garbage removal services than white sections. These things are related to disease.
® We have already cited one case of discrimination in the North, that of Detroit, where
public subsidies have been given to a second-rate Negro hospital so as to exclude Negroes
from the ordinary public hospitals.
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