Access Denied: African Americans and Access to End-of-Life Care in Nineteenth-Century Washington, D.C.

In 1959, construction workers uncovered skeletal remains associated with two 19th-century African American and Quaker cemeteries in Washington, D.C. Thirty years later, biological anthropologists at the Smithsonian Institution analyzed a small sample of the remains and concluded that “the overall health pattern of this group [from the Mt. Pleasant Plains Cemetery] was one of good health in comparison to other blacks and many whites of the time” (Mann and Krakker 1989:21). However, recognizing the limitation of small sample size for bioarchaeological study (MNI=14), researchers were unable to make general inferences about African American mortality and morbidity in the District of Columbia. Building upon this earlier bioarchaeological analysis, this study uses demographic data from the death records of 7,237 individuals interred at the Mt. Pleasant Plains Cemetery between 1874 and 1890 to infer variability in access to healthcare amongst African Americans in the late 19th century. The results demonstrate that, for African American women, access to end-of-life care (EoLC) in hospitals was in part contingent upon employment. Thus, young African American women less than 16 years of age represent one of the most vulnerable populations in 19th-century Washington, D.C., as they lacked general access to EoLC in hospitals. In addition to exploring this gendered component to healthcare, this study also demonstrates the diverse health experiences of African Americans and argues that archaeologists can adhere to ethical principles that discourage archaeological excavations while still addressing important research questions.