Malicious Intent

Murder and the Perpetuation of Jim Crow Health Care

By: David Barton Smith

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Paperback | 15 October 2023

At a Glance

Paperback
290 Pages

Dimensions(cm)
22.86 x 15.24 x 1.65

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"Do we want to perpetuate a Jim Crow health system?" A brilliant, idealistic physician named Jean Cowsert asked that question in Alabama in 1966. Her answer was no-and soon after, she died under suspicious circumstances. Unearthing the truth of Cowsert's life and death is a central concern of David Barton Smith's Malicious Intent. Unearthing the grim history of our health care system is another.

Race-related disparities in American death rates, exacerbated once again by the COVID-19 pandemic, have persisted since the birth of the modern US medical system a century ago. A unique but perpetually unequal history has prevented the United States from providing the kind of health care assurances that are taken for granted in other industrialized nations. The underlying story is one of political, medical, and bureaucratic machinations, all motivated by a deliberate Jim Crow systemic design. In Malicious Intent, David Barton Smith traces the Jean Cowsert story and the cold case of her death as a through line to explain the construction and fulfillment of an unequal health care system that would rather sacrifice many than provide for Black Americans.

Cowsert's suspicious death came at a key moment in the struggle for universal health care in the wealthiest country on earth. Malicious Intent is a history of those failed efforts and a story of selective amnesia about one doctor's death and the movement she fought for.

Industry Reviews

Malicious Intent investigates two mysteries: what caused the 1967 death of Jean Cowsert, a courageous physician in Mobile, and why extreme health disparities persist in the United States. David Barton Smith finds the solution of both in the history of racism in America, of which he is a foremost chronicler."-Timothy Stoltzfus Jost, author of Health Affairs' Following the Affordable Care Act blog (2010-2017)

?"David Barton Smith sees health care reform as having been stifled by racism, and in that sense Dr. Cowsert's death serves as a metaphor-a way to humanize and personalize the struggles and costs of health reform."-Keith Wailoo, author of How Cancer Crossed the Color Line

"Dr. Smith's work represents a significant contribution to the literature on structural racism and the history of healthcare, providing important context to much-needed contemporary discussions of the subject."-Stuart Wexler, author of America's Secret Jihad: The Hidden History of Religious Terrorism in the United States

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