Out of Breath: Toward a New Origin Story of Public Health.

This article examines the historical and ongoing impact of medical racism on Black Americans, focusing on the critical issue of ventilation and the struggle to breathe from the transatlantic slave trade through the twentieth century to the COVID-19 pandemic. It highlights how overcrowded and poorly ventilated conditions—beginning with slave ships and continuing in urban housing and medical institutions—have contributed to disproportionate health crises such as tuberculosis and asthma in Black communities. The article also emphasizes the agency of Black reformers, physicians, and activists, including W.E.B. DuBois and organizations behind National Negro Health Week, who advocated for improved public health measures centered on fresh air and sanitation. Furthermore, it connects historical medical biases, such as flawed assessments of Black lung capacity, to contemporary disparities in healthcare technologies and outcomes. The narrative situates Black health struggles as central, rather than peripheral, to the history of public health in the United States.