Author ORCID Identifier
https://orcid.org/0000-0002-4972-335
Date Available
5-13-2027
Year of Publication
2025
Document Type
Doctoral Dissertation
Degree Name
Doctor of Philosophy (PhD)
College
Arts and Sciences
Department/School/Program
History
Faculty
Kathryn Newfont
Faculty
Claire Clark
Faculty
Hilary Jones
Abstract
This dissertation analyzes the history of public health and the violence of white supremacy through the lens of smallpox, arguing that the disease became a weapon for Kentucky’s municipal governments to reinforce existing racial hierarchies through the discriminatory application of compulsory public health measures. From the advent of emancipation to the end of the First World War, smallpox disproportionately harmed Black Kentuckians. Newly free people perished from smallpox and found themselves only imperfectly protected by federal officials. By the end of the nineteenth century, they found themselves the target of public health measures enforced at the point of a gun. In both cases, white Kentuckians blamed them for the disease and framed them as its agents rather than its victims. The fact that people could be protected from smallpox by vaccination gave public health officials the tools to contain the disease. They exercised these with increasing authority over the course of the late nineteenth and early twentieth century. By employing tactics such as compulsory vaccination, isolation, and disinfection, white public health officials were able to claim authority over Black Kentuckians’ bodies, imprison them without due process, enter their homes without permission, and publicly destroy their possessions. Smallpox allowed public health officials to claim that they were protecting the public health while mostly sparing white Kentuckians the burdens of this protection. It also enabled them to intimidate and dispossess Black Kentuckians without this being explicitly named as a form of racially motivated violence that would have violated Kentucky’s claims to a milder form of racism than that of states further South. In some cases, Black Kentuckians were able to construct parallel health institutions, but because they did not have access to power in city governments, beyond being vaccinated they did not have the ability to respond effectively to smallpox outbreaks. At the same time, many distrusted health officials who might have administered vaccines due to negative experiences with white physicians. Most white citizens were also not able to protect themselves from smallpox, but they were more likely to be insulated from its worst effects by the structures of white supremacy. Racial segregation created fundamental inequalities for Kentucky’s citizens, and therefore smallpox, a virus with no decision-making power beyond the most basic elements of survival, was transformed into a tool of white supremacy.
Digital Object Identifier (DOI)
https://doi.org/10.13023/etd.2025.159
Funding Information
Graduate Student Pilot Grant for the College of Arts and Sciences, Center for Health Equity Transformation, University of Kentucky, 2023
Dorothy Leathers and George Herring Graduate Fellowship, History Department, University of Kentucky, 2024
Leslee K. Gilbert and Daniel E. Crowe Fellowship, 2024
Recommended Citation
Stephens, Abigail Katharine, "Public Health and Racial Violence: Smallpox in Kentucky's Urban Black Communities, 1865-1918" (2025). Theses and Dissertations--History. 91.
https://uknowledge.uky.edu/history_etds/91
Included in
History of Science, Technology, and Medicine Commons, Other History Commons, Social History Commons, United States History Commons
