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During recent decades, social scientists, particularly anthropologists, sociologists and medical historians, have looked increasingly at how social and cultural factors inform a society's medical community and vice-versa. As Roger Cooter recently stated, " ... medicine is a social phenomenon capable of being properly studied only when treated as a part of its social, political, economic and cultural totality."l In America, a steady flow of medical sociologists-most notably Henry E . Sigerist in the 1940s, Talcott Parsons in the 1950s, David Mechanic in the 1960s and 1970s, and Vern and Bonnie Bullough in the 1980s-contributed numerous empirical 'studies that revealed that the development of American medicine was shaped moreso by its social and cultural context than clinical discoveries.2 These studies have demonstrated conclusively that the American health profession's approaches to disease (etiology and therapy), the institutional structure of medical research and care, and public health care policy all have been deeply influenced by socio­ economic and cultural factors specific to historical epochs of evolving American society. At the same time that the socio-cultural context for medical care is gaining closer examination, social science researchers and health experts are placing greater importance on the ethnic and racial dimensions of health care. They stress that the spread of disease and illness within a society reflect not only economic barriers to medical services, but also ethnic and racial stratification. The mortality and morbidity rates of a society's minority populations, as well as the distribution of medical care and practitioners, mirror closely its ethnic and racial hierarchy. As Richard Cooper stated, "[i]n virtually every multi-racial society consistent patterns of differential mortality have been described."3 This study will present an historical overview of the connection between the social context and the collective perceptions of medical, anthropological, and social policy thinkers in the United States regard-

American Medical and Intellectual Reaction to African Health Issues, 1850-1960: From Racialism to Cross-Cultural Medicine