The Eighteen of 1918-1919: Black Nurses and the Great Flu Pandemic in the United States

Am J Public Health. 2019 Jun;109(6):877-884. doi: 10.2105/AJPH.2019.305003. Epub 2019 Apr 18.


This article examines the role of Black American nurses during the 1918-1919 influenza pandemic and the aftermath of World War I. The pandemic caused at least 50 million deaths worldwide and 675 000 in the United States. It occurred during a period of pervasive segregation and racial violence, in which Black Americans were routinely denied access to health, educational, and political institutions. We discuss how an unsuccessful campaign by Black leaders for admission of Black nurses to the Red Cross, the Army Nurse Corps, and the Navy Nurse Corps during World War I eventually created opportunities for 18 Black nurses to serve in the army during the pandemic and the war's aftermath. Analyzing archival sources, news reports, and published materials, we examine these events in the context of nursing and early civil rights history. This analysis demonstrates that the pandemic incrementally advanced civil rights in the Army Nurse Corps and Red Cross, while providing ephemeral opportunities for Black nurses overall. This case study reframes the response to epidemics and other public health emergencies as potential opportunities to advance health equity.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Black or African American / history*
  • Female
  • History of Nursing*
  • History, 20th Century
  • Humans
  • Influenza, Human / history*
  • Military Personnel / history*
  • Pandemics / history*
  • Public Health / history
  • Social Segregation / history
  • World War I