Speaker 1: Welcome to the ASHP Official podcast, your guide to issues related to medication use, public health, and the profession of pharmacy.
Gregory Bond: Thank you for joining us for today's podcast about the role of historically black colleges and university pharmacy schools in U.S. healthcare. One quick note before we begin, historically black colleges and universities are otherwise known by the acronym HBCU, which we'll be using a lot throughout today's conversation.
Gregory Bond: Our discussion for this podcast will recount the history of HBCU pharmacy schools and the education of African American pharmacists. We'll also explore how the social and the political environment, and the lack of access to healthcare influenced the history of HBCU pharmacy schools, both those that closed in the early 20th Century and those that, today, continue to educate African American pharmacists.
Gregory Bond: My name is Dr. Gregory Bond, and I'm the assistant director of the American Institute of the History of Pharmacy, located at the University of Wisconsin-Madison School of Pharmacy. I'm also the senior editor of Pharmacy in History, the institute's scholarly journal. I'll be your host today for today's interview about this important research as we celebrate Black History Month for 2020.
Gregory Bond: With me today is Dr. John Clark, who is a man of many titles. He's an assistant professor, the director of experiential education, and the director of pharmacy residency programs in the Department of Pharmacotherapeutics and Clinical Research at the College of Pharmacy at the University of South Florida. Thanks for joining us today, Dr. Clark.
John Clark: Thank you for having me.
Gregory Bond: Yep. Thanks for being here. Let's get started talking about today's topic on the role of historically black colleges and university pharmacy schools in U.S. Healthcare. Now, Dr. Clark, I've also researched and written about this history of African Americans and pharmacy a little bit, and I've followed your research about this important topic with much interest. I've always been impressed by the depths of your investigations and the amount of time you've committed to this important project. Can you describe for our listeners the scope of your research and what inspired this undertaking?
John Clark: Yes. Well, because you know the interest in research, and education, science has been at the forefront of history in the U.S. While there has been some attention given to African Americans, physicians, nurses, and chemists and even scientists, less a focus have been on the history of African American pharmacists, and almost no attention on things like the curriculum, the faculty, and the students that were from segregated, defunct African American pharmacy schools.
John Clark: There seemed to be a lack of interest and, in some cases, maybe a disregard for the information, but for me, it became very interesting. One of the things that piqued my interest to it was an article I read by Dr. Todd Savage from East Carolina University Medical School. The article was entitled Poor African American Proprietor Medical College. As I read the article, he mentioned several times about pharmacy schools. I was not aware of these schools, so I began to look for more information about it, and I also called them on the phone. His conversation that I had led to my motivation in this project.
John Clark: Little did I know the effort that it took to kind of put this all together and learn more about it. It required that I look at a number of sources over time. I had to research annual catalogs, newsletters, newspapers, digital tools, digital libraries, electronic yearbooks, as well as ancestral websites to find information that related to several questions that I had in mind: when they were founded, where they were located, the admission requirements, the graduation requirements, the number of students that may have become pharmacists from those programs, and as much as I could find on the characteristics or the faculty.
John Clark: The research, its sort expanded from about 1868 up until around 1936, and we'll talk about that a little later as to how that time period came about. But the goal was to sort of look at the evolution of the African American pharmacy schools, as well as identify some of the challenges that they faced during the time when they were being developed.
Gregory Bond: Great. That's very interesting. I love hearing about some of your research techniques. I know I've borrowed some from yours, some of the digital libraries you've used. I've also used to good effect after you informed me about them, so I really love hearing about your research and how you've tracked down some of this information, which can be very hard to find.
Gregory Bond: Now, for our listeners, Dr. Clark, who might not know a lot about the history of HBCUs, can you briefly talk about the evolution of HBCUs and the schools of pharmacies you studied, and maybe tell us which schools no longer exist and which HBCUs continue today to educate pharmacists?
John Clark: Yes. The HBCU started after the Civil War, and there were eight pharmacy schools that were formed that are now defunct. Those were Meharry Pharmaceutical College, which started in 1890, and it closed around 1936. Sean Leonard School of Pharmacy from Raleigh, North Carolina, it was opened in 1890, and it closed in 1918. The University of West Tennessee College of Pharmacy opened around 1900 and closed in 1923. There was also the New Orleans University College of Pharmacy of the Flint Medical College in New Orleans. It opened in 1900, and it closed in 1915.
John Clark: One of the others that I looked at was the Louisville National Medical College Pharmacy Department, which opened in 1902 and closed in 1912. And there was one that I could not find enough information on to include in research, and that was Washington College of Pharmacy in Washington, D.C. It opened in 1922, and closed in 1926. By 1937, six of those schools had closed, and the only one that was still open was Howard University and Xavier College of Pharmacy started in 1927.
John Clark: Today, the schools that produce some of the largest number of African American pharmacists includes Howard University, which started in 1868. Xavier University of New Orleans, which started in 1927, and Texas Southern University, which started in 1948, Florida A&M University College of Pharmacy started in 1951, Hampton University, which started in 1897, and the Chicago State University started 1998, and then the University of Maryland Eastern shores, which many people don't realize is an HBCU. It started in 2010.
John Clark: Now, we have approximately about nine HBCUs that exist today, and in the past, there was at least six that are closed.
Gregory Bond: All right, it's very interesting to learn about the schools that didn't make it, and some of the schools that are still around educating African American pharmacists. Jumping off on that topic, from your research, Dr. Clark, can you discuss some of the important or seminal events and perhaps some of the important people who have influenced or perhaps have demonstrated the growth and the importance of these HBCU schools of pharmacy over the years?
John Clark: One of the most striking events that sort of caught my attention had to do with the Flexner Report that came out around 1910. The report was endorsed by the American Medical Association, and the recommendation came through the Carnegie Foundation. By 1923, five of seven of the African American medical schools were forced to close. Now, they weren't the only one. At that time, there was a movement going on to reform medical education. So in total, there was about 43 medical schools that were closed. There was seven African American schools, and five of that seven were also forced to close as well.
John Clark: The decision for those schools had a profound impact on African American opportunities for medical education, and on their healthcare communities. Years later, as the number of African American physicians began to decrease because of that decision and lagged far behind the population growth that was occurring in the African American community, there was not enough African American physicians available to treat the patients that needed it most, which were these African Americans located mostly in the South.
John Clark: What I became unaware of and learned from this report was that there were a number of other health care providers that was also affected by that decision, and that includes nurses, dentists, and pharmacists, which I was not aware of at the time. It's been suggested that these closings had an effect on health disparities that we see today, and also on the communities of those people of color that was affected by it after the war.
John Clark: Because of that, the other finding that was interesting that I found was that there was a trend towards a declining number of African American pharmacists that went on for several decades, and those decreases in numbers played a part in the formation of the new African American schools that came up around 1949 up until the current time period.
John Clark: Some of the people that I found interesting that came from this mostly were from the Meharry Medical College that I was able to learn a lot about. One is Dr. Wally C. Base. He was a graduate from the University of Minnesota in the 1921 class. He became the first head of the pharmacy division at the Meharry Pharmaceutical College. Some of the other people from Meharry that I found interesting was J.B. Martin. He was a pharmacist that graduated around 1897 from the school and became an owner of some professional baseball teams.
John Clark: He owned the Memphis Red Sox along with his brothers, the Martin brothers, and that was a bit of interesting people found. But one of their other interesting finds was the women that graduated from the class. Matilda Lloyd was one of the first females to graduate from the class. She graduated in 1894 with a Ph.G. degree. And those-
Gregory Bond: What does Ph.G. stand for our listeners who may not know?
John Clark: Thank you for asking. That was a graduate in pharmacy degree with a two-year degree program that is no longer being given as a degree at this time. But that was the norm during that time period. So Matilda Lloyd was in the class with two other women. Ella Coleman was one, and I forget the third one, but all three of the women in the same class.
Gregory Bond: Margret Miller, I believe.
John Clark: Yes. Margaret. That's correct. That was the first time in history that three women had graduated out of the same class, so that was an interesting note to the history of that.
Gregory Bond: Also, correct me if I'm wrong. They're among the first known African American female graduates of any college of pharmacy in the country, correct?
John Clark: That's correct. That's correct.
Gregory Bond: Very interesting.
John Clark: That's correct. Which is a question that comes up quite often as to who were there first, so those were the first known African American female graduates.
Gregory Bond: Just to clarify, for our listeners, Meharry Medical College is in Nashville, Tennessee, and while the pharmacy school closed in 1936 or so, the medical school is still there, correct?
John Clark: That's correct. The medical school and the dental school. Since that time, they've added healthcare policy programs as well as dental assistant programs-
Gregory Bond: Interesting.
John Clark: ... that weren't in existence during the time of the pharmaceutical college.
Gregory Bond: I know you love researching the early female graduates of schools of pharmacy, John, so I was wondering if there are any others you want to talk about before we move on, early, female, African American pharmacy graduates.
John Clark: Yeah, yeah. There was two others. The Sean Leonard School of Pharmacy graduated two females in its existence. It closed in 1918, and, at that point, there was only two females that had graduated. Pearl Wasson was one, and Shelly Brown was the other. That was interesting to note that they were some of the first African American female graduates from that school.
John Clark: Also, the University of West Tennessee graduated Bebe Stevens-Lakes. She was the wife of the founder, which was Miles Lakes, and that was a unique bit of history in that the husband and wife actually financially formed that school. They didn't legally charter it, but they were the one who organized the entire programs that were seen in the school. Bebe Stevens-Lakes was promoted by her husband to be the dean of the school, and that little historical note occurred around ... When it occurred, I'm not exactly sure, but when the school closed in 1923, she was still listed as the dean of the College of Pharmacy.
John Clark: Now, when that started, I'm not exactly sure, but there was no women that had held the position of dean at that time, So she is believed to be the first, although there is more research that we have to look at to confirm that. But she may be the first female to serve as dean of a college of pharmacy.
Gregory Bond: That's very interesting, and that's the first female, African American or white, correct?
John Clark: That's correct. That's correct, so that was a very interesting find.
Gregory Bond: Yeah, an important find.
John Clark: Exactly. So the New Orleans College of Pharmacy, there were two other women that graduated there in the first class. One was Camille Green. She was in the 1903 class, and right after graduation, she became a professor of pharmacy at the college. Now, she was not alone. Bebe Stevens-Lakes, I forgot to mention, also became professor of pharmacy at the University of West Tennessee College of Pharmacy, so those two women became the first African American females to serve on a faculty.
John Clark: That again, is ongoing research because I have been unable to find any other women who may have served on the faculty during that time that were African American. So they appear to be the first two women to serve on the faculty of a pharmacy college, and that was in 1903. Those are two significant findings that I thought that I found doing my research.
Gregory Bond: Absolutely. Very important history that deserves to be better known, which is why I was so happy you're doing this important research. Now, we've heard a little bit about the histories of these early HBCU schools of pharmacy. Thinking particularly about the years after the Civil War into the 20th Century, can you talk a little bit, Dr. Clark, about how HBCU pharmacy schools have influenced the education, the graduation rates, the professional preparation, basically development and the graduating of African Americans for careers in pharmacy since the late 19th Century?
John Clark: Well, what I learned that the schools emerged in the healthcare crisis that occurred after the Civil War, there were a number of African Americans that had left the confines of a slave plantation that did not have the ability to get care. So there was a number of epidemic diseases occurring as well as over-crowdedness from the poverty that led to other diseases. These things occurred at the same time when the pharmacy and medical schools started to be developed.
John Clark: When the schools were formed, their graduation rates during that time were very low. The numbers that were being graduated was also very low. In some cases, there were no more than one pharmacist that may have graduated out of one class. Meharry probably had the largest graduation class of 1922, which was 43 pharmacists in that class, and that was the largest in the history of the country at the time.
John Clark: The graduation rates continue to be very low. They were ranging between 27 to 35% of the classes were graduating. That's a strong research course to continue to look at. One that I had an interest in, but have not had the time to try to understand why. We know that it had a lot to do with economics where many of their parents were coming from slavery who had not worked, or had any means or educational skills to be able to provide the financial support to pay for tuition for students. So that could have been a factor, but again, that may need further research as well.
John Clark: Those rates continue today, even with some of the other HBCUs. May not necessarily be in the pharmacy college, but some of the other programs where the rates are running around 35% for graduation. That started as early as the late 19th Century, so it continues today.
Gregory Bond: I think that shows some importance of this history. If we can research and try to figure out what led to some of these low graduation rates in an earlier time period, perhaps we can use that information to improve the graduation rates at contemporary HBCUs. I think this is one example of the perhaps very important contemporary importance of this type of research you're doing.
John Clark: Right.
Gregory Bond: As we're thinking about these HBCUs, you've been talking a lot about the ones that have closed or closed by the early 20th Century. What impact do you think the closing of these HBCU schools of pharmacy like Meharry and Leonard had on African American healthcare or the provision of African American pharmacists?
John Clark: That's a good question. It's difficult to determine the real impact. Some of the impact is sort of speculation, but it seems very practical. Again, I'm thinking of the pharmaceutical services that they needed during that time period. Many of the African American patients could not get adequate pharmaceutical services from the then predominantly white drug stores. They were prohibited in some cases to enter the stores, and definitely prohibited from using lunch counters and soda fountains. That, in itself, made services more limited.
John Clark: When the schools closed, it only makes sense that the number of pharmacists that were graduating throughout the country would have fallen, would have gone down. When they would go down, that means less ownership of the drug stores and less services being provided to the community. I've been unable to confirm that exactly, but there has been only one report that I've seen that sort of shed some light on that. That was done out of the state of North Carolina, where 3% of the drug stores started to close in that state right after the Civil War.
John Clark: That was somewhat of a confirmation of what was happening as an impact of the closing of those schools. It only makes sense the community would have been affected by these changes, although measuring that impact has been somewhat difficult. Again, this is one of those other areas that I think opens the door for more research to be done in that regard.
Gregory Bond: Sure. Absolutely. I think it just stands to reason that if you're graduating fewer African American pharmacists, then you'll have few African American pharmacists to serve the black community in these segregated towns, both North and South. Whether the color line is by law or by custom, fewer African American pharmacists will certainly increase the health disparities between perhaps the white community and the black community.
Gregory Bond: As we're speaking of these health disparities, this is obviously still a vitally important topic as we consider things going on in contemporary United States. As we're coming to the end of this podcast, Dr. Clark, do you have a call for action for our listeners today based on this history
John Clark: Well, yes, I do. I think one of the main things we should look at is making people more aware of some of the history itself that has been overlooked in some cases and may not have been known, which is understandable. So the call would be to share the information with others and make sure that when we are talking about pharmacy history, it also includes the African American history in pharmacy, and it all becomes American history for everyone.
Gregory Bond: Absolutely. Absolutely. I couldn't agree more. I think that's all the time we have for today. I want to thank Dr. Clark again for joining us to discuss this very interesting, very important topic on the role of historically black colleges and university pharmacy schools in U.S. healthcare. Thanks for listening.
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