# Federal Writers' Project – Life Histories/2021/Spring/105/Section 88/Lizzie Mercer
## Overview

Lizzie Mercer, an unemployed African American woman, was interviewed by Annie A. Rose in association with the Federal Writers' Project. The interview took place on May 1, 1939 in Macon, Georgia.

## Biography

Mercer was an unemployed African American born around the 1880s who lived in Macon, Georgia. Though she wished she had, Mercer never learned to read or write. Because of this, she and her husband insisted that all of their children receive an education. In her adult years, a disease called pellagra caused her body to become sore and inflamed in many places. Mercer’s condition, along with her inability to read and write, prevented her from working. Her lack of income and inability to access adequate health care caused her to become dependent on her husband—who died around the onset of the Great Depression—and children—which of the seven, only two were employed—for support financially. Mercer’s husband had been a Methodist preacher, who raised his children in the fear of the Lord, but after his death they strayed from that path and hardly ever went to church. All of the members of their household were “firm believers in the wisdom of insurance,” though. Mercer belonged to an insurance group called “The Daughters of Jerusalem,” from which she received a dollar a week when she was sick in bed. Besides paying dues of 25 cents every three months, the group also served as a burial society and required members to attend the various funerals of other members or pay a fine. Mercer did not mind attending these services; rather, one of her dreams as she suffered from pellagra was that one day she would have a fine funeral like those she had to attend.

## Social and Economic Context
### Inequality of Health Care for African Americans

The major cause of health care inequality in the United States has been—and still is—structural racism. Health disparities are closely linked with social, economic, and environmental disadvantages and negatively affect groups of people who have experienced racial or ethnic exclusion or discrimination, like African Americans. These groups of people have, therefore, faced greater challenges regarding their health and well-being because they cannot access adequate health care. In the 1900s, exclusionary policies such as redlining caused African Americans to be denied financial services, which consequently decreased property values, reduced the quality of local schools, and limited access to equitable health care. In addition to discriminatory policies, “pseudoscientific racist principles, derogatory racial character references, and pronouncements of impending black racial extinction” were woven into medical textbooks and journals during the late 19th and early 20th centuries. Oftentimes blacks were hardly even “conceptualized as normal human beings” except for in post-Civil War black medical schools and the few black hospitals and clinics. Examples of systematic racism such as those mentioned were especially apparent in the South. Because medical facilities and resources were (and in some cases still are) not equally available to people of all races, poor African Americans have had the worst health care, health statuses, and health outcomes out of any racial or ethnic group in America.

#### Pellagra During the Early 20th Century

Pellagra is a disease caused by a lack of the vitamin niacin (vitamin B3) which led to thousands of deaths in the South during the early 1900s. Symptoms of the disease include “the four D’s”: diarrhea, dermatitis, dementia, and death. Pellagra deaths were reported in every state in the Union during the first half of the twentieth century; however, the disease was much more prominent in the South because the diet for poor whites and blacks mainly consisted of foods with very little niacin, such as salt pork, molasses, and corn. People who could afford to eat foods with sufficient niacin, like potatoes, eggs, and milk, were able to avoid contracting the disease. In 1928 the pellagra epidemic reached its peak in the American South, with an estimated 230,000 cases and over 7,000 deaths per year. After a range of theories among physicians and public health workers over the years, Conrad Elvehjem conclusively proved that pellagra is a nutrition related disease caused by insufficient niacin consumption in 1937. After this discovery, states throughout the country passed laws requiring niacin to be added to bread, flour, and corn products. In the United States today, pellagra is largely unknown, with the exception of homeless people and those living in extreme poverty who cannot afford a proper diet to prevent the disease.

### Impact of the Great Depression on African Americans

The Great Depression, which lasted from 1929 to 1939, was the worst economic collapse ever experienced by the industrialized world. It left millions of Americans unemployed and hit minority groups, such as blacks, especially hard. With few jobs up for grabs, many black Americans attempted to migrate North, only to discover that these jobs were given to white workers or were gotten rid of altogether. Relief programs were available to blacks on paper; however, most relief programs were filled with discrimination in practice since all relief programs were administered locally. Furthermore, beyond the difficulty of finding employment, discrimination in income meant that black workers’ efforts to provide for their families were greatly hindered. Even when African American households were able to hold onto jobs, the low level of wages ensured that many lived in poverty.