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Excerpt from Oral History Interview with James Slade, February 23, 1997. Interview R-0019. Southern Oral History Program Collection (#4007) See Entire Interview >>

The health impacts of racism and poverty

Slade remembers his public health clinic practice, serving poor residents and migrants. He began serving only black patients, but desegregation made it more acceptable for whites to seek treatment there. Slade also remembers migrants' unique set of medical needs that were tied to their socioeconomic status: they sought treatment for diabetes, hypertension, and ulcers, for example.

Citing this Excerpt

Oral History Interview with James Slade, February 23, 1997. Interview R-0019. Southern Oral History Program Collection (#4007) in the Southern Oral History Program Collection, Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.

Full Text of the Excerpt

KAREN KRUSE THOMAS:
One thing we haven't covered is your public health experience. What was it like to practice in those public health clinics when you first started in '66?
JAMES SLADE:
Initially, when we began to do those public health clinics, they were state-funded. Now they pay you something like $20 an hour. Initially, we saw fairly sick children. Many times, I would have to refer a child from the clinic to the hospital. One thing I always tried to do was not refer them to myself. But a lot of times they wound up seeing meߞif they come to you, you have no choice. We tried to be careful not to refer patients to yourself. Initially, practically 100 percent of the children we saw were black. With the advent of Medicaid, and the passage of time, we began to see more white children come into the clinics. Now, it's still more black than white, but it's not unusual to have white children in the clinics these days.
KAREN KRUSE THOMAS:
Why do you think that changed?
JAMES SLADE:
I suspect part of it was because of school desegregation, since they had to go to school together.
KAREN KRUSE THOMAS:
So you think it became more acceptable to go to a public health clinic after school desegregation?
JAMES SLADE:
I think so, because it's not that there weren't poor whites, but they either did without care or some of the white doctors saw them. As time went on, it became no longer a problem. Even in the public health clinics, though, you had very few black nurses. I can only remember one or two. The children who come are less ill. You very seldom see a premature baby in the clinics anymore. I have seen babies around three pounds in public health clinicsߞyou don't see that anymore. I think again, it's because hospitalization is not a problem for these children. The midwives were very active in those early years, and they're not that active now.
CATHERINE SLADE:
Also, they have programs in the health departments now where they provide formula.
KAREN KRUSE THOMAS:
When did that start?
JAMES SLADE:
It probably began in the early '70s. We used to have milk and formula in the office. In addition to the public health clinics, I also work in the migrant clinics. It's still through the public health department, but it's a different division.
KAREN KRUSE THOMAS:
When did this area start getting a lot of migrants in, and when did those clinics start?
JAMES SLADE:
It might have started before my time. It was well established in '66 when we started going over there. They would have probably 500 migrants or more in the area.
KAREN KRUSE THOMAS:
Were those migrants African American at that time?
JAMES SLADE:
Yes. No Hispanics back in the late '60s, early '70s. Occasionally you would see a Caucasian, not very often but once in a while. Most of the clinics were held in Pasquotank County, we'd have to drive over there. A lot of times, they were busy. There were two physicians when I started, one other physician and myself, and sometimes my wife would work with us. We would both work until one or two o'clock in the morning before we got through, and we weren't just sitting around chatting, either.
KAREN KRUSE THOMAS:
What were some of the problems that y'all saw that were specific to migrants?
JAMES SLADE:
A lot of epilepsy. Occasionally, we'd find tuberculosis. Part of the epilepsy problem was due to lifestyle. There's a lot of alcohol consumed among the migrants, I guess that's part of the socio-economic status, and the pressures and all that. Hypertension, diabetes, although not necessarily insulin-dependent. A lot of rashes. With the diabetics, a lot of times you'd see foot ulcers. Occasionally, you may run into someone with a cardiac problem, but hypertension was the biggest thing. Sometimes some of the ladies would be pregnant and we'd take care of the newborns. That's what I'd like, when we had a baby to look after. Makes you feel more at home.