The Tuskegee Syphilis Study

In 1932, in Macon County, Alabama, the U.S. Public Health Service ran out of money. A Rosenwald Fund program had been treating rural Black Alabamians for syphilis through the early Depression years, but the funding collapsed. Rather than let the survey data go to waste, PHS officers redirected it into something new: a long-term observation of untreated late-stage syphilis. They chose Macon County partly because earlier testing there had found roughly 35 percent of residents infected, and partly because the county's population, about 27,000 people and roughly 82 percent Black, offered a large pool of potential subjects. For credibility and access, the PHS partnered with the historically Black Tuskegee Institute, founded by Booker T. Washington, and hired a local nurse named Eunice Rivers to serve as the study's day-to-day link to participants. The PHS decided to enroll only men, reasoning it would ease tracking of symptoms and avoid the complication of pregnancy, and set the minimum age at 25. The plan on paper was modest: six to eight months of observation, then a report. Nobody involved in that first year imagined nurse Rivers would still be signing men in four decades later, or that the six-month plan would stretch across the rest of most of their lives.