Nursing

By: Darlene Clark Hine

Source:

 Black Women in America, Second Edition

Nursing

The history of the development of the nursing profession is the story of the struggle of a group of women to overcome social and economic adversities. Within this history, however, is another, almost parallel chronicle of the effort of black women to acquire nursing education, to end economic discrimination, and to win professional acceptance from their white counterparts.

The Professionalization of Nursing

During the formative phases of the nursing profession in America, a plethora of concerns riveted the attention of most white nurse leaders: the exploitation of student nurses in hospital training schools, limited employment opportunities for graduate nurses exacerbated by competition from untrained women, the absence of certification or licensing boards, and the need to develop collegiate nursing programs while raising the low social status and esteem accorded to nurses.

Good Samaritan Hospital Nurse Training School.  A graduating class, probably in the late 1920s.

Richard S. Roberts Collection

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The first three American nurse training schools were established in 1873. These early schools operated within hospitals, but in keeping with traditions initiated in Florence Nightingale's movement in 1850s Britain to establish an organized system for training nurses, they were characterized by a degree of faculty autonomy, a separate funding apparatus, and the use of women as nurse supervisors. However, insufficient capital and endowment and the demand for more scientific-based instruction determined that this type of relatively autonomous nurse training school was soon eclipsed by hospitals, which came to dominate nursing education.

There were fifteen hospital nurse training schools in 1880 and 431 schools twenty years later. The number of graduates increased from 157 to 3,456 within this time. The proliferation of nurse training schools continued as hospitals garnered increased respectability from the public, which began to accept them as places of good care, not dens of death. By 1926 there were 2,150 schools with 17,000 graduates, virtually all of which excluded black women.

As hospital nurse training schools mushroomed on the educational landscape, nurse leaders questioned the instructional quality and low admission standards. The inadequate, random instruction provided at the hospitals, the exploitation of student nurses, and the general low status accorded to even trained nurses motivated nurse leaders to organize what would be renamed, in 1911, the American Nurses' Association (ANA). Its official organ, the American Journal of Nursing, had commenced publication in 1901. The National League of Nursing Education, the ANA, and the many other emergent national societies struggled to upgrade the status of and to professionalize nursing.

Training for Black Nurses

The professionalization of nursing had a negative effect on black nurses. Black women had long worked as nurses on slave plantations and, after emancipation, in the homes of white southerners. However, as the number of nurse training schools grew and nursing became another way out of domestic service for thousands of European immigrant and poor white women, black women were increasingly denied the opportunity to acquire this training. Mary Eliza Mahoney, a black 1879 graduate of the New England Hospital for Women and Children in Boston, was an exception to this rule of exclusion. Left with little alternative, African Americans founded their own network of nursing schools and hospitals.

In 1886, John D. Rockefeller contributed the funds for the establishment of a school of nursing at the Atlanta Baptist Seminary, later Spelman College, a school for black women. This was the first school of nursing established within an academic institution in the country. The earliest black hospital nursing schools came into existence in the 1890s, established mostly by black physicians and black women's clubs. In 1891, Daniel Hale Williams, the famed open-heart surgeon, founded Provident Hospital and Nurse Training School in Chicago. He was also instrumental, in 1894, in creating the Freedmen's Hospital and Nurse Training School in Washington, DC. Under the aegis of Booker T. Washington, the Tuskegee Institute School of Nurse Training in Alabama came into existence in 1892. In the same year, the Hampton Nurse Training School at Dixie Hospital in Hampton, Virginia, began accepting students. In October 1896, the black women of the Phillis Wheatley Club founded the only black hospital and nurse training school in New Orleans. The Phillis Wheatley Sanitarium and Training School for Nurses began rather inauspiciously in a private residence consisting of seven beds and five patients. This institution was later renamed the Flint Goodridge Hospital and Nurse Training School. Finally, on 4 October 1897, Alonzo Clifton McClennan, an 1880 graduate of the Howard University Medical School, founded the Hospital and Nursing Training School in Charleston, South Carolina. Anna De Costa Banks, one of the first graduates of the Dixie Hospital School of Nursing, became the first head nurse of the South Carolina institution. By 1920 there were thirty-six black nurse training schools.

The impetus leading to the founding of black schools of nursing was an effort to respond to an array of perceived and real needs of black Americans. Providing adequate training and educational opportunities for black women was only one of many motivational factors. McClennan, for example, was angered by the stubborn refusal of the white municipal hospital administrators in Charleston to allow black physicians to attend their patients, even in segregated wards. He and his black colleagues initially created their hospital in order to advance their practices and to care for their patients. They added the nursing school in order to acquire help in the delivery of medical care to the hordes of poor, superstitious African Americans of Charleston and surrounding counties who sought their services. The black women of the Phillis Wheatley Club were inspired to establish a nursing school after observing the poor quality of health and the high mortality rates of African Americans in New Orleans. Between 1890 and 1900, the overall death rate in New Orleans dropped from 25.4 to 23.8 per thousand, while that of the city's black population increased from 36.6 to 42.4 per thousand. These conditions were similar in cities both above and below the Mason-Dixon line. The lack of adequate hospital facilities and black health care professionals lessened the already slim chances of survival for African Americans. The establishment of the Phillis Wheatley Sanitarium and Nurse Training School marked the first attempt by African Americans to improve black health care in the city.

Other founders and heads of black nursing schools articulated different reasons for their actions. Alice Bacon, the white founder of the Hampton Nurse Training School at Dixie Hospital, justified the establishment of the school as a means to retain “in the hands of trained colored women a profession for which, even without training, the Negro women have always shown themselves especially adapted.” She declared that black women had “to take up the work laid down by the home trained women of the old days, and to hold for their race throughout the South a profession that has always been theirs.” Likewise, Booker T. Washington declared, “Colored women have always made good nurses. They have, I believe, a natural aptitude for that sort of work.”

These early black nursing schools were, for the most part, as deficient in quality and standards as were many of their white counterparts. In keeping with prevailing practices, student nurses were exploited as an unpaid labor force. In every institution, they performed the domestic and maintenance drudgery, attended the patients, and dispensed medicine. Many student nurses at Tuskegee Institute required extended leaves of absence to recover from damage done to their health while working in the hospital. It was not inconsequential that one of the early Tuskegee catalogs noted that the major admission requirement into the nursing program consisted of a strong physique and stamina to endure hardship.

The most oppressive aspect of black nursing training at some of these early schools, notably at Tuskegee and Charleston's Nursing Training School, involved the hiring out of student nurses to supplement a hospital's income. In the Charleston school, the student nurses were required to turn over to the hospital the dollar a day they earned on private cases. These nurses also managed the hospital's poultry operation, tended the vegetable gardens, and organized public fund-raising activities. In spite of the attendant hardship and the mediocre instruction, hundreds of black women graduated from these segregated hospital nursing programs and went on to render invaluable service to black patients.

World War I

A little-noted aspect of America's involvement in World War I was the struggle of black women nurses to serve in the U.S. Army Nurse Corps. Although this particular quest for unfettered access to professional opportunities proved futile, it is nevertheless a revealing case study in both the military history of America and in the history of black women. An examination of the nature and extent of the U.S. government's staunch resistance to the inclusion of black women nurses in “the fight to make the world safe for democracy” illuminates some of the implications of armed forces interracial relations and policies.

More than 367,000 black men were called into service during World War I, and, following an effective black protest campaign and lobbying effort, the U.S. Congress authorized the establishment of a separate reserve officers' training camp for black soldiers. Though African Americans were barred altogether from the marines and the pilot section of the aviation corps, they were permitted to serve in almost every branch of the army and in menial jobs in the navy. Yet black women who fervently desired to use their professional talents and expertise to aid their country were consistently denied the right to serve in the Nurse Corps.

Black Americans had been understandably cautious when, in 1914, Woodrow Wilson, a southerner, became president of the United States. However, in spite of their already low expectations of his administration insofar as black rights were concerned, even the most cynical African Americans were shocked by the depth of Wilson's apparent commitment to racial segregation and discrimination. Wilson had not been in office long, for instance, before he issued an executive order establishing separate eating and restroom facilities in government buildings; other laws segregated and eliminated large numbers of African Americans from civil service jobs. With Wilson's reelection to the presidency came America's plunge into World War I. Black Americans immediately offered their services in the armed forces. Even radicals such as W. E. B. Du Bois and several leaders of the National Association for the Advancement of Colored People urged black men to volunteer for the army. Ironically, confronted with the warm response of African Americans to the draft, the U.S. Congress continued to debate legislation for the drafting and training of African Americans in separate military units.

Of all black professionals, women nurses needed no special persuasion to volunteer their services to aid and care for their wounded countrymen. The advent of World War I helped to raise their expectations and excite their professional dreams. Black women nurses had long despaired over their status as professional outcasts. They could not attend the better-equipped and -managed nurse training schools, were denied individual membership in the American Nurses' Association (ANA), and were denied supervisory or administrative positions in hospitals, nurse training schools, and public health agencies and bureaus. At every level of employment, they earned lower salaries than white nurses. Furthermore, the general low regard and esteem they possessed in the public mind exacerbated their unfair treatment.

In the prewar years, black women nurses had engaged in a number of largely unsuccessful activities designed to improve their position within the ranks of organized nursing. In 1908, they had founded their own professional body, the National Association of Colored Graduate Nurses, to better structure and intensify their struggle to win membership and integration into the ANA. Yet professional equality eluded them. Thus, black women nurses desired to seize the opportunity created by the war emergency to accomplish these objectives.

Although the first wave of black women nurses who attempted to enlist in the U.S. Army Nurse Corps expected to encounter racism, they were not prepared for the total rejection of their services during one of America's greatest crises. Disillusioned and hurt, black women nurses focused their anger initially on the American Red Cross, reorganized and incorporated by an act of Congress on 5 January 1905. The Red Cross, an auxiliary of the U.S. Army Nurse Corps, recruited and enrolled nurses, then classified them as First Reserve nurses or Second Reserve nurses. The First Reserve was composed of nurses with the educational, moral, and professional qualifications required by the military Nurse Corps. The Second Reserve consisted of nurses available for critical civilian nursing who, because of some technicality, such as being over forty years old, were not eligible for the First Reserve. In effect, the American Red Cross enjoyed quasi-governmental status, particularly within the Army nursing group. Indeed, the second superintendent of the Nurse Corps, Jane Delano, served simultaneously as head of the Red Cross Nursing Service.

Black nurses demanded to know why so few of them were called or enrolled into either the First or Second Reserve. Delano's response to their inquiries was both evasive and defensive: “We are enrolling colored nurses at the present time,” she explained, “and shall continue to do so in order that they may be available if at any time there is an opportunity to assign them to duty in military hospitals.” That time and opportunity never seemed to come, and most black nurses waited in vain for the call. Later, criticized for their failure to enroll black nurses, Red Cross leaders shifted blame to the office of the surgeon general, who, they insisted, had simply not called for black nurses. Red Cross officials further asserted that many black nurses had not met the Red Cross prerequisite of graduation from a fifty-bed-hospital nurse training school. The Red Cross also steadfastly insisted that it had given black nurses who lacked the necessary credentials a provisional enrollment until they registered or acquired additional training.

Unconvinced by these rationalizations and evasions, black nurses in particular and black Americans in general felt the injustice deeply. Black criticism of the Red Cross increased as the war continued. The army was markedly reluctant to tap the nursing services of black women, and the navy refused even to consider the matter. As black pressure and anger mounted, the Red Cross belatedly prepared a list of black nurses to serve in a proposed segregated hospital to be established in Des Moines, Iowa. The signing of the armistice on 11 November 1918, and the end of the war, however, aborted the proposed installation. A month before the war's end, though, two dozen black nurses were called for service at Camp Sherman, Ohio; Camp Grant, Illinois; and Camp Sevier, South Carolina. This number represented only a fraction of the 21,000 white women who had been given the opportunity to serve their country as nurses. Commensurately, as the status of the white nursing profession skyrocketed in the aftermath of the war emergency, that of black nurses plummeted. Because black nurses had not served their country, they apparently bore no claim to a share of nursing's newly earned public esteem.

Black educators and leaders such as Robert R. Moton, successor to Booker T. Washington as president of Tuskegee Institute, and Emmett J. Scott, special assistant for Negro Affairs in the War Department, had joined the chorus of protests against the exclusion of black women nurses from service in the Nurse Corps. Moton and Scott informed the secretary of war and the surgeon general of the widespread dissatisfaction of African Americans with the war effort, emphasizing that they were particularly disillusioned with the American Red Cross. Moton wrote, “The Red Cross's exclusion of colored nurses…results in a certain sort of indifference on the part of colored people which ought not to be when the country needs every ounce of effort along every available line.” In the face of the war emergency, some African Americans had accommodated themselves to the exclusion and segregation practiced by the U.S. War Department, convinced that it was temporarily important to do so given the worldwide threat to democracy. The discrimination practiced by the Red Cross was a different matter, however, because that institution symbolized humanitarianism in its most pure form. Black nurses especially believed that the Red Cross had not vigorously pushed for their entry into the Nurse Corps and had failed to uphold its democratic principles.

The intransigence of the Nurse Corps and the inertia of the Red Cross had motivated some black nurse leaders and liberal white allies to take matters into their own hands. In a fashion reminiscent of Booker T. Washington's emphasis on racial solidarity and self-help, an interracial group of some of New York City's most prominent, wealthy, and influential citizens met on 2 November 1917, to launch the black or, more precisely, the interracial counterpart of the American Red Cross. The new organization, incorporated as the Circle for Negro War Relief, was structured similarly to the Red Cross. Officers of the Circle were Emilie Bigelow Hapgood, president; George Foster Peabody, treasurer; and Grace Neil (Mrs. James Weldon) Johnson, secretary. The vice presidents were former governor Charles S. Whitman, W. E. B. Du Bois, Robert R. Moton, Charles Young, and Ray Stannard Baker. Other members of the board of directors included Gertrude Pinchot, Arthur B. Spingarn, Edward Sheldon, R. J. Coady, and Russell Janney.

The primary objectives of the Circle included the promotion of the interests and improvement in the conditions of black soldiers and sailors at home and abroad. Beyond this, Circle members pledged to aid those people related to or dependent upon black servicemen. Within two years, the Circle had fifty-three local chapters in seventeen states and boasted a membership of more than three thousand. Circle committees on the local levels initiated many activities designed to help black servicemen and their families. Committee members sewed, knitted, baked, and collected supplies to send to servicemen via channels established by the American Red Cross. This sharing of Red Cross information and a transfer network was the extent of the cooperation between the Circle and the Red Cross throughout the war years. The Circle also raised money for black soldiers who returned from the war penniless and for those discharged from hospitals without money. In such cases, government funds were, more often than not, both late and inadequate.

The successful execution of all Circle work depended largely on Blue Circle nurses. Through arrangements similar to those of Red Cross nurses, Blue Circle nurses provided relief to needy black families. Furthermore, they instructed many poor rural African Americans on the importance of sanitation, proper diet, and adequate clothing. The nurses also maintained necessary contact with city, county, and state health officials, often alerting them to serious community health problems.

After the war ended, the board of directors voted to continue a revised program of the Circle's work. On 19 May 1919, the board changed the name of the organization to the Circle for Negro Relief, dropping “War” from its title. Circle leaders then turned their attention to seeking funds and developing a new peacetime program. In an effort to raise money, Circle leaders submitted grant proposals to the heads of the major white philanthropic foundations, but with discouraging results. Edwin Embree of the Rockefeller Foundation assured the Circle of the foundation's sympathy and commitment to improving the health of black people but denied its request for funds. In a private memorandum, Embree observed that as far as he could determine, most of the Circle's meager resources were used to cover overhead expenses. More important, however, he maintained that it was against the Rockefeller Foundation's policy to contribute to private voluntary health agencies.

Circle leaders thus drafted a new program, this time with more success. They attempted to construct a national plan that included raising scholarship funds to train and pay part of the salaries of black visiting Circle nurses in southern communities. Their new peacetime program also called for the creation of day nurseries and kindergartens and for providing financial assistance to small community hospitals. Under the new Circle program, each local Circle committee was instructed to organize a County Health Club and to appeal to its respective county Board of Health for financial support to pay half of the salary of a Blue Circle public health nurse. Will W. Alexander of the Commission on Interracial Cooperation in Atlanta attested to the feasibility of the county health plan in a wire to Circle headquarters on 15 January 1921. He enthusiastically claimed that the Board of Health of South Carolina was “greatly interested” in public health nursing for African Americans and would look upon the Circle's plan with favor. Circle leaders justified their plan by noting that the white nursing services such as the Red Cross devoted little attention and meager resources to addressing the health needs of African Americans, especially in the South. They argued that the new Circle plan would improve general black health care, help the families of poor black servicemen, and provide more employment for black women nurses. The Circle for Negro Relief continued throughout the 1920s until the Great Depression.

Black women nurses had looked to the war crisis and the peacetime need for trained nurses to allow them a chance to serve their country, demonstrate their usefulness and value, and enhance their image in the American mind. But they soon discovered that not even a war could give them that stature. Although they were able to provide some service in the Circle, American racism emerged from World War I unscathed and more entrenched than ever. The integration of black women into the Army and Navy Nurse Corps would have to await another crisis: the coming of World War II.

Graduate Nurses

Although, with financial assistance from wealthy philanthropists, African Americans had, by 1928, fashioned an extensive nursing training school network, the process of becoming a respected member of the nursing profession involved more than the acquisition of basic training and a diploma. Access to specialized training or graduate education was of equal importance. Black women desiring to secure graduate education or specialized training, however, were consistently denied admission into many of the country's leading graduate nursing programs.

At every juncture in their quest for professional acceptance and advancement, black nurses encountered entrenched racist attitudes. Challenging career opportunities such as employment in hospitals, visiting nurse associations, and municipal departments of health proved to be as elusive as sympathetic work environments that held out possibilities for promotion to supervisory or administrative positions. In fact, the vast majority of black graduate nurses, like their untrained predecessors, worked in private-duty jobs, where they frequently were expected to perform domestic chores in addition to providing nursing care. When asked about the absence of black women in supervisory positions at her hospital, the white superintendent of nurses at the Lincoln Hospital in New York asserted that “colored” head nurses did not have the capacity to fill positions that entailed heavy responsibility and that discipline could not be maintained unless there was firm, competent white direction. As bleak as the situation was in the North, the advancement opportunities for black graduate nurses were even more limited in the South. Almost all black graduate nurses in the South worked for lower wages than their white colleagues.

Besides the injustice of unequal pay, black women graduate nurses considered the denial of membership in the American Nurses' Association the most visible and demeaning manifestation of professional ostracism. Barred from membership in local and state ANA affiliates, the majority of black women nurses could not participate in the largest professional association of nurses. The only significant number of black women in the ANA had become members when the Alumnae Association of the Freedmen's Hospital in Washington, DC, had merged with the ANA in 1911.

The ANA's exclusionary practices motivated Martha Franklin, a black graduate of the Women's Hospital in Philadelphia, to launch a separate black nursing organization. Beginning in 1906–1907, Franklin mailed over two thousand inquiries to black graduate nurses, superintendents of nursing schools, and nursing organizations to determine whether interest existed for a separate black society. Her letters struck a responsive chord among the members and leadership of the Lincoln Hospital nursing school. Adah Belle Thoms, president of the Lincoln School of Nursing Alumnae Association, arranged a meeting. In August 1908, fifty-two nurses convened at St. Mark's Episcopal Church in New York City to found the National Association of Colored Graduate Nurses (NACGN). In 1912, the NACGN members numbered 125, and by 1920 it boasted a membership of 500.

Under the leadership of two of its more forceful presidents, Adah B. Thoms (1915–1920) and Carrie E. Bullock (1927–1930), the NACGN accomplished much. It secured a temporary headquarters in 1918, which consisted of a room in New York City's Young Women's Christian Association's 137th Street Branch. In 1920, Thoms filed the NACGN incorporation papers and established a national registry of black graduate nurses to assist them in finding employment. Bullock, a 1909 graduate of the Provident Hospital School of Nursing, was supervisor of black nurses at the Chicago Visiting Nurses Association during her presidency. She focused on two key issues during her tenure. In 1928, to facilitate communication and to foster a greater sense of professional involvement among black nurses, Bullock founded and edited the organization's official organ, the National News Bulletin. Second, to encourage black women nurses to pursue postgraduate education, Bullock secured the support of managers of the Julius Rosenwald Fund for the establishment of a Rosenwald fellowship program for black graduate nurses.

In spite of these accomplishments, problems remained. Salary inequities in hospitals and public health agencies persisted; the multiplication of unaccredited black hospital nurse training schools that grossly exploited their students and produced poorly trained nurses continued; and white nurses remained unresponsive to the entreaties of black women for recognition and acceptance within the nursing profession. Under the auspices of the Hospital Library and Service Bureau, Donelda Hamlin, in 1925, conducted a survey of state board of health officials and visiting nurse association heads to determine their evaluation and perceptions of black women public health nurses. In her subsequent report, Hamlin emphasized, as representative of the overall response, the comments of the superintendent of the Public Health Nursing Association in the Louisville, Kentucky. The respondent reported that the type of training the average colored nurse received in the Louisville area was far inferior to white nurses' training and that the best training for colored nurses barely equated to the poorest training given to white nurses. The respondent added, “From another standpoint, their educational background is not so good. Therefore I think the type of service rendered would necessarily be of lower grade than under other circumstances.”

In late 1925, the Rockefeller Foundation employed Ethel Johns to examine the status of black women in the nursing profession. Johns visited twenty-three hospitals and nurse training schools for black women during a four-month period. In Chicago, Johns interviewed the chief nurse of the city's health department, which employed ten black graduate nurses and 154 white nurses. She asserted that black nurses' “technique is inferior to that of the white nurses, they are not punctual, and are incapable of analyzing a social situation.” She maintained that there was a marked tendency among them “to organize against authority” and “to engage in political intrigue.” Not surprisingly, Johns ended her report on a discouraging if understated note. She wrote, “Negro nurses in every part of the country feel very keenly that they are debarred from qualifying themselves for leadership and it is true that most doors are closed to them.”

Black graduate nurses and the NACGN made the opening of doors to their profession a top priority. It would take twenty years, the emergence of a cadre of resourceful black nurse leaders, and a world war crisis for them to break through the negative attitudinal barriers, gain entry into the ANA, and win acceptance as full members in the profession of nursing. In the mid-1930s the NACGN's situation improved when grants from the General Education Board of the Rockefeller Foundation and from the Julius Rosenwald Fund made it possible for the NACGN to employ Mabel K. Staupers as executive secretary and to move into permanent headquarters at Rockefeller Center in New York City, where all the major national nursing organizations had offices. Following a long and relent-less struggle, Staupers and the NACGN president Estelle Massey Osborne succeeded in winning recognition and acceptance for black nurses.

Staupers's fight to eliminate quotas established by the U.S. Army Nurse Corps constitutes one of the finest periods in NACGN history. Although many black nurses volunteered their services during World War II, they were refused admittance into the navy, and the army allowed only a limited number to serve. In 1943, although the navy had notified Staupers that it had decided to place the induction of black nurses under consideration and the army had raised its quota of black nurses to 160, the situation had not greatly improved. In an effort to draw attention to the unfairness of quotas, Staupers requested a meeting with Eleanor Roosevelt. In November 1944, the First Lady and Staupers met, and Staupers described in detail black nurses' troubled relationship with the armed forces. In January 1945, when Norman T. Kirk announced the possibility of a draft to remedy a nursing shortage within the armed forces, Staupers made a well-publicized response, “If nurses are needed so desperately why isn't the Army using colored nurses?” Afterward she encouraged nursing groups of all races to write letters and send telegrams protesting the discrimination against black nurses in the Army and Navy Nurse Corps. The groundswell of public support for the removal of quotas on the number of black nurses in the Nurse Corps proved effective.

Buried beneath an avalanche of telegrams from an inflamed public, Kirk, Rear Admiral W. J. C. Agnew, and the War Department declared an end to quotas and exclusion. On 20 January 1945, Kirk stated that nurses would be accepted into the Army Nurse Corps without regard to race, and five days later Agnew announced that the Navy Nurse Corps was open to black women. Within a few weeks, Phyllis Daley became the first black woman to break the color barrier and receive induction into the corps.

The end of discriminatory practices by a key American institution helped to erode entrenched beliefs about the alleged inferiority of black health care professionals and paved the way for the integration of the American Nurses' Association. In 1948, the ANA opened the gates to black membership, appointed a black nurse as assistant executive secretary in its national headquarters, and elected Estelle Osborne to the board of directors. The decision to grant individual memberships to black nurses barred from state associations in Georgia, Louisiana, South Carolina, Texas, Virginia, Arkansas, Alabama, and the District of Columbia was followed by the adoption of a resolution to establish biracial committees in district and state associations to implement educational programs and promote development of harmonious intergroup relations.

With the removal of the overtly discriminatory barriers to membership in the ANA, members of the NACGN recognized that their needs would now be served by the ANA, which agreed to take over the functions of the NACGN and to continue to award the Mary Mahoney Medal honoring individuals for their contributions to interracial understanding. Thus, during the NACGN's 1949 convention, the members voted the organization out of existence, and the following year, Staupers, then president, presided over its formal dissolution.

See also Health; Staupers, Mabel Keaton; World War I; and World War II.

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