By Marian Ryan
(Emancipation Day, Freedom Day, Juneteenth Independence Day)
President Joe Biden signed legislation on June 17, 2021, proclaiming Juneteenth (June 19) a federal paid holiday. IHA recognizes Juneteenth as an important day in our history and an important one for working toward equity — especially health equity — by committing to continued research into inclusive best practices in health literacy and facilitating policies to promote their implementation.
Juneteenth is the oldest known celebration commemorating the end of slavery in the United States. However, the actual proclamation was declared 2½ years earlier. President Abraham Lincoln issued the Emancipation Proclamation on January 1, 1863:
“That on the first day of January, in the year of our Lord one thousand eight hundred and sixty-three, all persons held as slaves within any State or designated part of a State . . . shall be then, thenceforward, and forever free.”1
It took 2½ years for this proclamation to reach Texas (the furthest west region of the Confederate States). Major General Granger of the U.S. Army went to Galveston, took control of the American Army troops,2 and ended the Civil War. On June 19, 1865, he issued General Order Number 3, which informed the people of Texas that all enslaved people were now free: “This involves an absolute equality of personal rights and the rights of property between former masters and slaves.”3
Most states had recognized Juneteenth as either a holiday observance or an official state holiday prior to President Biden’s signing the bill. Juneteenth commemorates the day 250,000 slaves in Texas were finally told they were free. Communities since that day celebrate African American history, culture, and strengths.
“Although it marks a day of family, food, and fun, it’s also critically important that Juneteenth is a tribute to the legacy and power of a people who endured and overcame the most unimaginable conditions,” says Professor of African American studies Anthony Greene.4
The period of Reconstruction following the abolition of slavery in the United States was aimed at improving the lives and liberties of freedmen. Although Reconstruction is considered a failure by most historians, a positive outcome was the building of schools to educate freed Blacks.5 “Adults sat in classrooms with children all eager to learn to read and write.”6 Literacy had been forcibly and legally withheld from slaves after the slave revolt of 1831 in all but one of the Confederate States as a means of keeping Blacks enslaved.7
Implications for health equity
As Juneteenth is celebrated across the country and in recognition of this important day in history, we have an opportunity to embrace, understand, read about, and be inspired by the courageous men and women of their time (Sojourner Truth, Frederick Douglass, Harriet Tubman, Frances Ellen Watkins Harper, and so many others) and continue the work for equality and personal freedom for everyone.
As health professionals, we are dedicated to achieving health equity and reducing known health disparities. We recognize the well-established connection among literacy, health literacy, and the other social determinants of health that result in negative outcomes for so many. The last 2½ years have illuminated the failure of our healthcare system and public health to keep people safe from COVID-19 — with the greatest morbidity and mortality borne by racial and ethnic minorities and other disadvantaged groups.
As a health literacy community, we must work collectively to advocate for and, in some cases, institute organizational and local policies that promote organizational and personal health literacy. For instance:
- We can conduct translational research on best practices in health literacy to ensure resources are understandable and relevant to all people in our service areas.
- We can co-design new resources with people living in the community, rather than simply asking them to review our products after we, “the experts,” have developed them.
- Most importantly, we can be part of the solution by ensuring inclusiveness in all of our work.
The story of Juneteenth is not my family’s story, but it is an important part of history and needs to be recognized, studied, and shared. The slaves in the Confederate States toiled under grueling conditions in the cotton fields and plantation owners’ homes, were beaten and forbidden to learn to read or write and suffered so many other atrocities. Following President Lincoln’s Emancipation Proclamation, hundreds of thousands joined the Union Army and fought for the freedom of all people. They fought for the same life most of us desire — freedom of choice, a home, paid work, a partner, and maybe children.
“There can be no reconciliation or healing without truth. The horrifying truth about slavery and its historical and ongoing violations of people’s rights must be told.”8
Committing to a health literacy agenda may be a first step of dismantling structural racism in your organization. Organizational failure to optimally address health literacy is a sizable component of systemic racism in healthcare.
1 National Archives.
2 Gordon-Reed A. On Juneteenth. New York: Liveright Publishing, 2021.
3 National Archives.
4 Kerr A. African Studies Professor Explains History of Juneteenth (6/18/2018).
5 Gordon-Reed A. On Juneteenth.
7 Smithsonian Art Museum, Literacy as Freedom.
8 Braveman PA, Arkin E, Proctor D, Kauh T, Holm N. Systemic and Structural Racism: Definitions, Examples, Health Damages, and Approaches To Dismantling. Health Aff (Millwood). 2022 Feb;41(2):171-178.
About the Author
Marian Ryan, Ph.D., MA, MPH joined IHA as Chief Policy and Research Officer in March 2020. Her previous healthcare and public health experience include: direct clinical care, staff training, patient education and health literacy, health program development and evaluation, and performance improvement ─ working with both payer and provider sectors caring for vulnerable populations. Mid-career, she resigned from a healthcare leadership position and earned her Ph.D. in Social Policy (with a concentration in health policy and health services research) at Brandeis University as an AHRQ pre-doctoral fellow. In her position with IHA Dr. Ryan seeks to bridge research, policy, and practice with the goals of improving the accessibility and effectiveness of healthcare services and reducing health disparities.