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The workers should not serve two races at once. Both races are also not allowed in the same room. The colored people usually had to enter from the back doors, and also had designated seats.

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The whites and the colored people have different entrances into the hospital. They would let colored people in the hospital entrances only if they were prepared. Nurses would refuse to help a colored patient.

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Jim Crow may have been legally outlawed in 1964, but many of its health effects may only now be emerging for black Americans who lived under its racist rule in their early childhoods.

That's the conclusion of epidemiologists and economists who have studied the impact of Jim Crow laws, first adopted as racist backlash in the decade after emancipation-and its abolition by the 1964 Civil Rights Act-on infant health, infant mortality, life expectancy, and premature mortality.

What researchers increasingly believe is that "health in adulthood is shaped by the environment experience early on in life," says Douglas Almond, an economist at Columbia University who has studied the under-provision of basic medical care due to segregation in Southern hospitals.

Though legally blessed overt racism may seem distant, researchers are quick to remind us that black Americans born when Jim Crow was in effect in 21 states and DC are as young as 53 years old.

We will never know the full extent of the destructive health effects of Jim Crow in its time, because data on racial disparities was not collected until the first National Health Interview Survey in 1958. What we do know is that it was perfectly legal for white nurses to refuse to treat black patients and integrated rooms in mental health facilities were against the law. Segregation also existed in the blood supply. Hospitals that treated black patients may have been far from the people who needed them; only six hospitals in Mississippi would treat black patients in 1929 and none were in the Delta. No wonder, by 1946, fewer than 10 percent of all births of black children in Mississippi took place in a hospital compared with nearly 70 percent of white births.

When black Americans made their way to a white doctor, it did not mean they were treated as full human beings. W. E. B. Du Bois, one of the great sociologists of the twentieth century, lost his two-year old son to a treatable infection because "no White physicians [were] willing to treat a Black child," a story that he recounts in his classic The Souls of Black Folk. Even in cases of child rape, many white doctors refused to examine black girls, as Ruth Thompson-Miller and Leslie H. Picca have shown.

While a 1963 Supreme Court decision made segregation illegal in hospitals, and the Civil Rights Act the next year outlawed Jim Crow altogether, the damage may have already worked its way into the bodies of those forced to live under its racist rule. As Almond indicated, since our health as adults is shaped, in part, by early experiences in life, we may only now be seeing the effects of the state-sanctioned racism in the 1960s and earlier. "That history is alive now in people's bodies," says Nancy Krieger, a professor of social epidemiology at the Harvard T.H. Chan School of Public Health who has been at the forefront of this research.

A new study on the connection between breast cancer and Jim Crow adds to this growing body of literature. Krieger and her colleagues found black women born before 1965 in Jim Crow states were more likely to have estrogen-receptor-negative breast cancer, which tends to be more aggressive and more difficult to treat. But black women born after the abolition of Jim Crow showed no such Jim Crow effect, a finding that suggests the racial disparity in more aggressive breast cancer is the product of racism. "The history of Jim Crow in the USA is not remote," the study authors write, "but instead remains embodied, within and across generations."

The Jim Crow health effect harms not only individuals, but also their children, as the infants of black women born in the late 1960s have a much lower risk of low birth weight than the infants of black women born in the early 1960s. That is a clear example of how the effects of structural racism pass between generations. "We're seeing the legacy of early-life exposure to Jim Crow and compromised childhood health," says Almond, an author of the study.

Though researchers place a bold asterisk on any suggestion that the abolition of Jim Crow vanished racial health disparities altogether, their work repeatedly shows a connection between the abolition of the racist laws and improved health for black Americans, a finding that suggests the promise of addressing structural determinants of racial health disparities. "Understanding health in the United States requires grappling with the history of the country," Krieger says. "You carry your history with you in your body."

Today, we know that de facto segregation is very much alive and has serious health consequences-hospitals are more likely to close in segregated areas, pharmacy deserts are more likely to exist, and living in certain neighborhoods is associated with having your life cut short by more than a decade. And yet research funding continues to prioritize the search for the cause of racial disparities in the genome rather than the environment. "There has been a lot of time and a lot of public resources spent on researching racial differences as though they have any weight in comparison to structural inequality," says Samuel Roberts, director of Columbia's Institute for Research in African American Studies and author of Infectious Fear: Politics, Disease, and the Health Effects of Segregation.

Why black Americans are more likely to die in childbirth or from infectious diseases has long been explained with biological theories rather than social ones, a way of thinking that underpinned Jim Crow policies of higher insurance rates for black people and racial miscegenation laws. The American tradition of blaming black people for having something wrong with them, rather than something wrong with society, may go all the way back to religious explanations for why different races exist and how that reasoning worked its way into scientific racism, according to Terence Keel's work of intellectual history, Divine Variations: How Christian Thought Became Racial Science. But what the Jim Crow health effect shows is that black Americans do not suffer from worse health outcomes because of race, but because of racism.

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Jim Crow Laws Are Gone But They're Still Making Black People Sick

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Jim Crow may have been legally outlawed in 1964, but many of its health effects may only now be emerging for black Americans who lived under its racist rule in their early childhoods.

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Black and White students were conducted  separately. Some have schools a place for white and colored people would go to a different place.

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The KKK was an organization that is an American white supremacist hate group whose targets were mostly African American etc. The KKK was dedicated to an underground campaign of violence against blacks and white to reverse the policies of Radical Reconstruction.

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Black Codes were strict local and state laws that were made to limit the freedom of African Americans. Detailed when, where, and how enslaved people work, to take voting rights away, control where people live, etc.

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When slavery ended in the United States, freedom still eluded African Americans who were contending with the repressive set of laws known as the black codes. Widely enacted throughout the South following the Civil War-a period called Reconstruction -these laws both limited the rights of Black people and exploited them as a labor source.

In fact, life after bondage didn't differ much from life during bondage for the African Americans subjected to the black codes. This was by design, as slavery had been a multi-billion dollar enterprise, and the former Confederate states sought a way to continue this system of subjugation.

"They may have lost the war, but they're not going to lose power civically and socially," says M. Keith Claybrook Jr., an assistant professor in the Department of Africana Studies at California State University, Long Beach. "So, the black codes were an attempt to restrict and limit freedom."

Losing the Civil War meant the South had little choice but to recognize the Reconstruction-era policies that abolished slavery. By using the law to deny African Americans the opportunities and privileges that white people enjoyed, however, the one-time Confederacy could keep these newly liberated Americans in virtual bondage.

A Loophole in the 13th Amendment

White planters in these states denied Black people the chance to rent or buy land and paid them a pittance. The 1865 ratification of the 13th Amendment prohibited slavery and servitude in all circumstances " except as a punishment for crime." This loophole resulted in Southern states passing the black codes to criminalize activities that would make it easy to imprison African Americans, and effectively force them into servitude once more.

First enacted in 1865 in states such as South Carolina and Mississippi, the black codes varied slightly from place to place but were generally very similar. They prohibited "loitering, vagrancy," Claybrook says. "The idea was that if you're going to be free, you should be working. If you had three or four Black people standing around talking, they were actually vagrant and could be convicted of a crime and sent to jail."

In addition to criminalizing joblessness for African Americans, the codes required Black people to sign annual labor contracts that ensured they received the lowest pay possible for their work. The codes contained anti-enticement measures to prevent prospective employers from paying Black workers higher wages than their current employers paid them. Failing to sign a labor contract could result in the offender being arrested, sentenced to unpaid labor or fined.

Enslavement by Debt

Fees were the easiest way to reinstitute servitude, as African Americans earned so little that paying a steep fine was out of the question for most of them. Failure to pay fines allowed the state to order them to work off their balances, a system called debt peonage. Typically this work was agricultural in nature, just as Black Americans had performed while enslaved.

Black children were not spared from forced labor. If their "parents were seen to be unfit or weren't around, the state received these children as orphans, and they would be put into apprenticeships," Claybrook says. "Again, they are doing work without compensation."

The black codes not only forced African Americans to work for free but also essentially placed them under surveillance. Their comings and goings, meetings and church services were all monitored by the authorities and local officials. Black people needed passes and white sponsors to move from place to place or to leave town. Collectively, these regulations codified a permanent underclass status for African Americans.

After the black codes had been enacted throughout the South in 1865, Congress passed the Civil Rights Act of 1866 to give African Americans more rights-to a degree. This legislation allowed Black people to rent or own property, enter contracts and bring cases before courts (against fellow African Americans). Moreover, it allowed individuals who infringed upon their rights to be sued.

Progress With the 14th and 15th Amendments

The passing of the 14th and 15th amendments gave African Americans some hope for the future. Ratified in 1868, the 14th Amendment granted citizenship and "equal protection of the laws" to Black people, while the 15th Amendment, ratified in 1870, barred states from depriving citizens the right to vote based on race. In the end, the South rescinded the black codes, but the repeal of these restrictions didn't significantly improve life for African Americans.

"With the passage of the 14th and 15th amendments, there was a shift over to Jim Crow laws, which were kind of a perpetuation of the black codes," says Connie Hassett-Walker, an assistant professor of justice studies and sociology at Norwich University in Vermont. "You don't just flip the switch and all that structural discrimination and hatred just turns off. It kept going."

And Black Americans weren't "separate but equal," as the states enforcing Jim Crow laws claimed. Instead, their communities had fewer resources than white communities, and white supremacist groups like the Ku Klux Klan terrorized them.

The Ku Klux Klan and Lynchings Terrorize Black Americans

"You start to see the rise of lynching, and lynchings were really about the message sent to the living people," Hassett-Walker says. "It might have been about punishing that individual person, but it was done to keep the other people in line, to say, 'See, this could happen to you.'"

Simply exercising one's right to vote could lead to a visit from the Klan, and employment options for Black Americans remained limited. They largely worked as sharecroppers, which entailed working the land of others (typically white people) for a fraction of the worth of any crops grown.

To say that sharecropping paid poorly would be an understatement, and impoverished African Americans racked up debts in shops that charged them high interest rates on the supplies they needed as tenant farmers.

Those who couldn't pay their debts risked incarceration or forced labor, much like they faced during the black codes. The debt peonage system robbed them of income and locked them into servitude once again. Additionally, the police imprisoned them for minor offenses that whites weren't jailed for in equal numbers, if at all. In prison, Black Americans-men, women and children-provided free labor.

The black codes may have been repealed, but African Americans continued to face a series of regulations that reduced them to second-class citizens well into the 20th century. It would take the activism of civil rights leaders, and the Civil Rights Act of 1964, to see this legislation overturned.

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How the Black Codes Limited African American Progress After the Civil War | HISTORY

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The black codes effectively continued enslavement for African Americans by restricting their rights and exploiting their labor.

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Jim Crow Laws were a state and local statutes collection that enforced racial segregation.