Enslaved Health and Healing in An American Health Dilemma: A Retrospective Review

In An American Health Dilemma (2000), W. Michael Byrd and Linda A. Clayton synthesized historical scholarship to trace the devastating health impacts of chattel slavery, White supremacy, and racial science. Their study exposed disparate levels of death and illness experienced by generations of enslaved African Americans. My retrospective review of An American Health Dilemma demonstrates how subsequent scholarship has reinforced Byrd and Clayton's analysis of the roots of African American health disparities but also illuminated some of the limitations of the authors' physician perspectives. By decentering biomedical frameworks and introducing new interdisciplinary approaches, historians of enslaved health and healing complicate the authors' conceptualization of the "slave health deficit" and challenge their assumptions about the "slave health subsystem." New studies of slavery and capitalism, gender, reproduction, and disability expand the account of slavery's full impact on African American health. Furthermore, rather than viewing enslaved healers as members of a subsystem of superior Euro-American professional training, a new body of literature today explores the spiritual and intellectual worlds of Black healers grounded in Black mobility and the cultures of the African diaspora. (Am J Public Health. 2026;116(5):649-656. https://doi.org/10.2105/AJPH.2026.308422).