Segregation is the separation of people based on race, religion, ethnic group, sex, or social class. In the United States, racial segregation has been the most prevalent and visible form. After the abolition of slavery in 1865, laws, known as Jim Crow laws, were passed in most southern states. The term "Jim Crow" referred to an African-American character in a popular song composed in the 1830s, and these laws, already introduced after that time were designed to enforce racial separation. Segregation was not only enforced by law, but also by various forms of physical violence. African Americans were forced to sit only in the back of buses and trains, use "black only" water fountains, and enter through the back doors of hotels and restaurants—if allowed to enter at all. Laws forced blacks to live only in certain sections of a town or city, be educated in separate schools, and obtain health care in separate hospitals or wards. They were also excluded from some governmental jobs.
Segregation not only limited black people physically, but also economically and socially, by blocking access to schooling and jobs. It also served as a form of humiliation and degradation. The Supreme Court, however, upheld segregation laws as late as 1896, in Plessy v. Ferguson, ruling that "separate but equal" facilities were constitutional. This concept was argued against strongly by both African Americans and whites throughout the United States. Eventually, arguments by Thurgood Marshall before the Supreme Court in Brown v. Board of Education of Topeka in 1954 led the Court to declare school segregation unconstitutional. This started a series of legal battles, lobbying efforts, boycotts, and protests, which eventually brought an end to de jure, or legal, segregation and discrimination. Even so, de facto segregation, or segregation in fact, continues, and is evident in housing, education, and a number of other areas. Integration remains a continuous process in the United States.
The long-term impact of years of racial segregation persists even to this day. African Americans continue to live in the sections of cities and towns where they were initially forced to live, and they continue to suffer from a lack of economic and educational opportunities. The long and difficult experience of segregation has also resulted in deep mistrust of whites by African Americans. This has, at least in part, contributed to the noticeable disparities in health status and access to health services. In particular, African Americans appear to be more hesitant to seek medical attention. There are many potential reasons, such as previous bad experiences with white health care providers as well as the fact that they may not be as aware of their health problems as whites because of disparities in the provision of health education. Even after becoming aware of their need for services, however, African Americans may experience many barriers to accessing services (i.e., lack of insurance, transportation). They are also more likely to obtain inadequate care even after overcoming these barriers. These discrepancies are extensively documented in the health-services research literature.
(SEE ALSO: African Americans; Asian Americans; Cultural Appropriateness,; Cultural Identity; Ethnicity and Health; Ethnocentrism; Hispanic Cultures; Inequalities in Health; Prejudice; Race and Ethnicity)
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