Addressing racism as a clinical competence: Robert Wilson, Jr. (1867-1946).

Charles S Bryan; Mason J Schroeder

doi:10.1016/j.amjmed.2026.04.030

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Addressing racism as a clinical competence: Robert Wilson, Jr. (1867-1946).

Charles S Bryan·Mason J Schroeder

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Abstract

Addressing health inequity is now recognized as a clinical competency in medical education. We examined the career and writings of Robert Wilson Jr. (1867-1946), longtime dean of the Medical College of the State of South Carolina during the Jim Crow Era, using primary and secondary sources within the context of systemic and structural racism, particularly in South Carolina. Wilson used public health data to refute the "Black Extinction Hypothesis" rooted in social Darwinism. He challenged assumptions of inherent Black susceptibility to tuberculosis, linking disease instead to social determinants of health. He also identified disproportionate mortality from kidney and cardiovascular disease among Black populations, anticipating modern health disparities research. Wilson further acknowledged systemic injustice and implicated structural conditions, including housing, in shaping outcomes. In an era of continuing health inequity and racial health disparities, Wilson applied empirical evidence to reject biological determinism, identify outcomes disparities, and advocate for racial justice.

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History, 20th Century Racism Humans History, 19th Century South Carolina Education, Medical Black or African American Health Status Disparities Addressing racism Outcomes disparities Social determinants of health Tuberculosis Journal Article Historical Article Review

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Charles S Bryan, Mason J Schroeder. 2026-05-04. Addressing racism as a clinical competence: Robert Wilson, Jr. (1867-1946).. https://doi.org/10.1016/j.amjmed.2026.04.030

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