More Than Medicine. Jennifer Nelson
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Group” at Aradia to discuss racism in the Women’s Liberation movement. These efforts contradict popular notions that white middle-class feminists focused exclusively on their own political demands without considering the different needs of women of color or poor women. Many white feminists were concerned about race and wanted to address their own racist impulses.
In chapter 4 I turn to the Atlanta Feminist Women’s Health Center, which opened in 1977. Like Aradia feminists, founders of the Atlanta Feminist Women’s Health Center (FWHC) hoped to provide feminist and woman-controlled health services in a compassionate atmosphere. They provided forums in which women could learn about their bodies and discuss the relationship among body knowledge, sexuality, and health. Yet, unlike Aradia feminists in the first half of the 1970s, Atlanta feminists quickly encountered opposition from the anti-abortion movement. The Atlanta FWHC, like its predecessor the Los Angeles FWHC, provided abortions in addition to comprehensive gynecological services. (Aradia did not provide abortions until the 1980s.) Despite their attention to self-knowledge and collaborations among women to promote understanding of the body and sexuality, health centers associated with the Federation of FWHCs, such as the Atlanta clinic, also instituted a more structured system of providing medical care that included fixed fees and medical hierarchy.
Atlanta FWHC faced significant challenges from the anti-abortion movement just two years after opening their doors. A close look at anti-abortion movement confrontations in Atlanta helps us to better understand why feminists often made abortion central to their politics in the 1980s. It also sheds light on the strategies used by the anti-abortion movement: legislative and direct action tactics. Both legislative techniques and direct action campaigns took a significant toll on the Atlanta FWHC, making abortion provision more expensive and thus absorbing scarce resources that could have been spent on other women’s health problems. Threats of clinic bombings, harassment, and arson also had a psychologically draining effect on clinic workers. Still, Atlanta FWHC continued to provide abortions and other health services throughout the most intense periods of anti-abortion protest, including during the 1988 Democratic National Convention. HIV testing, in particular, was an important service offered by Atlanta FWHC. In 1987 they expanded their HIV work with the Women with AIDS Partnership Project, which targeted African American and poor women for testing, education, and health services since these groups of women were most vulnerable to HIV transmission and had less access to comprehensive health services.
The Atlanta FWHC struggled with a perception that they largely served the interests of white women, despite their attention to HIV/AIDS and its impact on women of color. Many women of color believed that the Atlanta FWHC and other majority-white feminist organizations displayed subtle forms of racial bias and even racism. In chapter 5, I spotlight the work of Loretta Ross within the National Organization of Women (NOW) in order to explore conversations about race and racism within majority-white feminist organizations focused on reproductive politics and abortion rights. As the director of Women of Color Programs, Ross worked to build coalitions between NOW and women of color organizations. She met with mixed success but eventually left NOW to work with Byllye Avery and the National Black Women’s Health Project. Ross believed that NOW continued to marginalize women of color, so, like other women of color activists interested in issues of women’s health and reproductive politics, she shifted her focus to independent women of color organizing.
Chapter 6, the concluding chapter of this book, details the creation of a reproductive justice movement among women of color. Critical of the dominant abortion rights discourse about reproductive “choice,” they used human rights as their frame for building a movement that focused on transforming the broad social and economic context that they believed was fundamental to achieving reproductive justice for all women. Distancing themselves from a medical model of health care activism, women of color feminists like Loretta Ross, Dázon Dixon Diallo, and Luz Rodriguez argued that fundamental needs—ending poverty, gaining access to jobs and quality housing, and acquiring education—all needed to be met in order to guarantee reproductive justice. Since poor women and women of color had the most trouble satisfying these most basic needs, they suffered compromised reproductive health and control over their reproductive choices. Thus, like the civil rights activists who insisted that economics and access to food were essential to health, women of color activists also insisted that when people are hungry, health care is food, jobs, and community empowerment. Demands to satisfy basic needs cannot be separated from reproductive politics, because a right to reproductive control is hollow without a right to live free of hunger, racism, and violence and without the dignity that facilitates real choices for one’s own future and community.
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“Medicine May Be the Way We Got in the Door”
Social Justice and Community Health in the Mid-1960s
The women’s health movement of the 1970s emerged from an earlier movement focused on the use of health care to end poverty in the United States. Health care reform activists of the 1960s, some of whom joined the feminist health reform movement in the 1970s, forged what they believed would be a comprehensive and community-based solution to poverty eradication. Although the implementation of their solutions was never quite as sweeping as some activists wanted, they successfully garnered substantial federal dollars for their programs. These activists intended to use Neighborhood Health Centers (NHCs) to eradicate poverty and to restructure the social hierarchies that ensured certain groups’ “generational poverty” by providing health care, linked social services, and economic supports necessary to ensure individual and community health. As Dr. Harry P. Elam, codirector of Mile Square Health Center in Chicago, asserted, “In the ghetto, you cannot separate the delivery of family medical care from housing problems, underemployment, culture, traditions, and mores. Although this concept is not part of traditional medicine, it is the new focus needed in working with the poor today.”1
One of the key concepts behind the NHCs was that real health could only be achieved if medical care addressed the socioeconomic roots of ill health. This idea influenced medical delivery and training in subsequent decades. H. Jack Geiger, one of the founders of the movement, noted the extent to which changed definitions of health and health care influenced young medical students and doctors by 1972, less than a decade after the creation of the first NHCs: “Substantial numbers of physicians were trying to learn something about the economics of medical care . . . and trying to bring new kinds of medical care services into being instead of perpetuating the old.” He argued that these young physicians understood that there was “something wrong with the social order . . . to the extent it makes large numbers of people sick by condemning them to miserable housing, hunger, joblessness, social and biological and environmental stress.”2 Feminist activists of the 1970s employed a similar concept of comprehensive health care that addressed medical care as well as its social context; they developed a broad critique of gender oppression and sex inequality promoted by medical institutions.
This chapter tells the story of the evolution of the NHCs and these new understandings of health care and what it meant to be healthy. NHCs were founded during a grassroots initiative that partly grew out of the civil rights and New Left movement calls for greater “participatory democracy” among those without access to social power or economic resources. NHCs flourished in the 1960s with support from the Johnson administration’s War on Poverty spending linked to the Office of Economic Opportunity (OEO). The successes of the NHCs helped perpetuate the notion that real health required broad socioeconomic solutions that targeted and empowered residents of local neighborhoods and communities. NHC planners chose to locate health centers within neighborhoods because residents of neighborhoods faced similar health and socioeconomic problems. Residents also often shared extended family, ethnic or racial ties, and other social connections that could facilitate finding solutions to these problems. Neighborhood affiliation, perhaps most importantly, also encouraged consumers of health care to feel that the health center belonged to them, particularly if they worked there or sat on a community board for the center. Rather than foster feelings of inferiority or exclusion—as many hospitals had done in the past—NHC organizers wanted to empower community residents to make decisions about their own medical care, theorizing that involvement would encourage people to access health resources more readily.
Ideas about community empowerment in the 1960s originated with the civil