Health System Pharmacy and African Americans
by John E. Clark
African American pharmacists turned to professional associations for the same reasons as white pharmacists. They sought to participate in organizations where they felt welcome, could be given opportunity for leadership, and where their issues and voices would be heard. In the pre- and post-Civil War period, membership inclusion of African Americans in national, state, and local professional pharmacy associations was slow, minimal, and non-existent in some states. In part due to a desire for exclusion by some members and a cautiousness and reluctance by others due to socio-political pressures during the times.
In the early formation of professional pharmacy associations, there was never any collective movement by pharmacists to address the issues of inclusion and discrimination of African American in the professional organizations. As a result, African American pharmacists joined national advocacy groups, the African American medical associations, and formed their own professional pharmacy associations. In 1947, the National Pharmaceutical Association (NPhA) was formed, which is the first national organization created by African American pharmacists to provide a network and forum with an emphasis on issues of importance to African American pharmacists and healthcare in minority communities.
The second national professional association formed by African American pharmacists was the Association of Black Health-system Pharmacists (ABHP, formerly the Association of Black Hospital Pharmacists), which was first established in December 1978 in San Antonio, Texas. The ABHP has a long, rich and outstanding history that is not well known or documented in the pages of pharmacy history records. Key activities and events created by the ABHP during the period of 1978-2012 are considered very historic. Significant accomplishments continue to be made today as with the American Society of Health system Pharmacists (ASHP) and other healthcare organizations.
As painfully uncomfortable as it is to remember, racial segregation in hospitals was commonplace well into the 20th century and it manifested itself in various forms. Not only were African American patients denied admission to most hospital up until the early twentieth century, but African American physicians were also denied medical privileges to treat or admit patients. When patients were admitted, they would be house in segregated sections of the hospital. Babies were segregated in the nurseries, and blood transfusions of blood belonging to African Americans were prohibited. Some African American nurses and pharmacists were restricted by different forms of discriminatory practices as well. Even though they may have been equally qualified and educated or even have a higher degree of education, they were not allowed to supervise their white counterpart.
In the pre- and post-Civil War period, work in hospital pharmacy was not considered a strong career option. This was especially the case for African Americans for many socio-political reasons, but also because hospital pharmacy was not a well-recognized and accepted component of the profession. In those hospitals that had dispensary rooms for dispensing and preparing medications, African American pharmacists were not routinely utilized, except in African American run hospitals. Some of the most recognized early African American hospital pharmacists were women. Julia Pearl Hughes had gained work experience at the Freedman’s Hospital (later became the Howard University Hospital) in Washington, D.C. as a student and a graduate pharmacist in 1897 before moving to Philadelphia, PA and working at the Frederick Douglas Memorial Hospital in 1899. Prior to leaving the hospital to start her own business, she was promoted to pharmacy manager at the hospital and may have become one of the first African American females to work in that capacity.
Chester Dillard Dean worked at the Garretson Hospital dispensary in Philadelphia as a student around 1911 but did not finish her work experience there to get her pharmacy license on account of her gender and race. In 1912, she was able to purchase her own drug store with money borrowed from her sister. She was later cited as the only African American female drug store owner in the city of Philadelphia.
Ella Phillips Stewart was the first African American female to graduate from the University of Pittsburgh School of Pharmacy in 1916. After graduation, she also became a part of the small number of African American pharmacists hired to work in hospital pharmacy. She worked in the General Hospital in Braddock, Pennsylvania around 1916 and later at the Youngstown City Hospital in Youngstown, Pennsylvania. Because of the social constructs in the country around race, Ella Phillips Stewart and other African American pharmacists sometimes found themselves working in hospitals where African American patients were not allowed. As changes were made in the Civil Rights Act, in Medicare and Medicaid requirements, and the passage of the Hill-Burton Act, racial segregation practices were gradually abandoned in hospitals throughout most of the country up until the 1960s, with exceptions in some southern states.
Prior to the 1930s, there was no professional organizations representing pharmacists working in hospital settings. The American Society of Hospital Pharmacists (ASHP) started from a subsection of the APhA in 1936. In 1947, it evolved into a separate independent organization from the APhA with the goal of representing hospital pharmacists on a national level. Since that time, its membership has grown from 153 charter members to over 45,000 members nationwide today. It is not certain when African Americans started to join the ASHP. It appears that their membership also started slowly, may have been very rare to non-existent in some states, and gradually increased over time. One of the first African American to become active in state and national hospital pharmacy associations was Wendell T. Hill, Jr., Pharm.D. Dr. Hill received his BS degree from Drake University School of Pharmacy in 1950, about three years after the formation of the ASHP. He later received the Doctor of Pharmacy (Pharm.D.) degree from the University of Southern California in 1970. He completed a Hospital Pharmacy Residency in 1954 at the Veterans Administration (VA) Hospital in Los Angeles, California and is believed to be the first known African American pharmacists in the country to do so. He later served as Chief Pharmacist at the VA Hospital in Los Angeles. He was appointed Chief Pharmacist of Orange County Medical Center in Orange, California in 1957 and served as Director of Pharmaceutical Services at Detroit General Hospital from 1970-1977, where he also established the hospital’s first ASHP-Accredited Residency in Hospital Pharmacy. His active involvement in hospital pharmacy led to his election as one of the first African-American presidents of a state professional pharmacy association when he was elected President of the California Council of Hospital Pharmacists in the late 1960s. In 1971, ASHP made history by electing Wendell T. Hill as its first African American President, amidst very low historical participation by African Americans. Dr. Hill served as President and member of the Board of Directors from 1972-1973. In 1989, he became the first African American to receive the ASHP Harvey A. K. Whitney Lecture Award, “health-system pharmacy’s highest honor.” He was also one of the first African American health-system pharmacists to hold the door open for others to follow. As membership and state affiliate participation slowly increased among African Americans, Bruce E. Scott became the second African American to be elected President of ASHP in 1998.
Today, racial, ethnic, gender diversity, and inclusion in pharmacy education and practice are goals and expectations. In 2005, the American Society of Health-System Pharmacists (ASHP), through its Ad Hoc Committee on Ethnic and Diversity and Cultural Competence, became one of the first pharmacy associations to address the changing trends in ethnic and racial diversity in the profession and recommend ways to improve and foster inclusion within the ASHP membership, Board of Directors, its councils, committees, commissions, and other component groups, including its staff. In 2007, the ASHP Task Force on Pharmacy’s Changing Demographics recommended ways that hospital and health-system pharmacy practice can capitalize on the evolving racial, ethnic, and gender demography in pharmacy to improve the profession’s contribution to health care. In 2007, Janet Mighty became the first African American female pharmacist to serve on the ASHP Board of Directors and the first to run for the President in 2012.
There were several contributing factors associated with the ASHP’s position on racial and ethnic diversity, which included the changing demographics within the profession and within the ASHP; the forward-thinking leadership within the ASHP, which started with Dr. Joseph Oddis and continued with Dr. Henri Manassee and Dr. Paul Abramowitz; and the partnership and relationship with the Association of Black Health-system Pharmacists (ABHP).