As in previous years, a "Case of the Month" from United States history is presented to celebrate the 4th!

At the turn of the twentieth century the United States South was still recovering from the Civil War. Although the "New South" had been proclaimed, the region in general contained areas of severe poverty and remained dependent upon agriculture. Southern agriculture, unfortunately, was the least productive in the United States. Public health and public education resources were weak to non-existant across the region.

Both black and white races suffered but blacks particularly so. In its 1896 ruling Plessy v Ferguson the United States Supreme Court codified "separate but equal" accomodations on railroad cars. In practice with a variety of "Jim Crow" laws, southern states applied these segregation practices to all aspects of public life. In part for these reasons illiteracy was particularly prevalent among southern blacks (50% vs 12% for whites). Beyond black poverty, illiteracy, and disenfranchisement there also existed the grim image of the white "cracker," - individuals with sallow skin, bare feet, scrawny necks, protuberant abdomens, retarded intelligence, and shiftless habits.

Within the South itself, one region suffered in even more desperate poverty than others. On the southern coastal plain, a region of sandy soils created by the remnants of an ancient sea, people lived in shanties, without sanitation, and existed by subsistence farming.

Children growing up on the southern coastal plain seemed particularly listless and apathetic, sallow of complexion, of stunted growth and intellectually dull. Performance and attendance at school could be poor. Observers from outside the region were apt to attribute some sort of innate laziness and ignorance to the region's population.

Public health authorities, however, came to suspect a medical etiology for the physical and intellectual deficiencies that could be observed in many of those in the region.