A 1940s Red Cross rule, which racially segregated blood, propped up notions of racial difference and Black inferiority.
In the summer of 1941, months before the U.S. officially entered the global conflict that would occupy it for the next four years, the country’s military was already out for blood. That February, the Army and Navy had joined the American Red Cross to establish the National Blood Donor Service — the first nationwide network of blood banks — with an eye toward supplying life-saving donations to wounded service members.
But when Wanda Douglas, an African American worker at the Social Security Board, went with nine White coworkers to give blood at a Baltimore donation center that July, she was turned away. Unknown to her, and to the general public at the time, the Red Cross had decided not to accept blood from Black donors for use in its military program. Officials feared that White servicemen, even with their lives in the balance, would recoil at the prospect of Black blood coursing through their veins. Douglas could donate blood, she was told, but only if she went to a separate location. And the Red Cross policy meant that her donation would never find its way to the battlefield.
Douglas and several of her coworkers left the center in protest. Her story was later picked up by a local Black newspaper, the Baltimore Afro-American. In a nod to the segregation laws that were then rampant in the Southern U.S., the paper dubbed the discriminatory treatment “Red Cross Jim Crow.”
According to historian Thomas Guglielmo, who chronicled this history of the National Blood Donor Service in a 2010 article in the Journal of American History, Douglas may have been the first Black person turned away from a Red Cross blood donation center in such a public manner, but she was by no means the last. Over the months and years that followed, Red Cross donation centers across the country would either reject blood from Black donors outright, or accept donations but store and process them separately, to ensure they never reached the veins of White servicemen. Officials gave no scientific rationale for the policy. Rather, historians say the policy served to placate a sense, especially among White Southerners, that Black blood was inherently different from and inferior to their own.
For Black Americans who were already locked in a battle for dignity and civil rights, the policy was likely a painful reminder that they were second-class citizens — no matter which side of the Mason-Dixon line they were on.
Five months after Douglas left the Baltimore blood donation center in protest, Sylvia Tucker, a Black woman whose son was nearing military service age, was turned away from a center in Detroit. Tucker penned a letter about her experience to first lady Eleanor Roosevelt, writing that she had begged the doctor to “accept my blood and place it in a container and label it ‘Negro Blood’ and after due process, make it available for some Negro mother’s son.” She said she would have even paid for the processing herself, if need be. “The American Red Cross holds the destiny of human being[s] white and black,” she pleaded with Roosevelt. “Make them understand that we are Americans, too.”
The fact that pleas like Tucker’s went unanswered for so long, experts say, served to exacerbate a lingering distrust of the medical establishment, and may have contributed to a disparity in Black blood donor rates that still persists to this day.
A cruel irony of the National Blood Donor Service’s policy of racial discrimination is that the campaign itself may not have been possible but for the contributions of a young Black physician.
Born and raised in a racially diverse section of Washington, D.C., Charles Drew was a star athlete and scholar who decided to pursue medicine after his sister died of tuberculosis. After earning an undergraduate degree from Amherst College and graduating second in his medical school class at McGill University in Montreal, Drew joined the Howard University medical faculty in 1935 and rose to chief surgical resident at the university’s teaching hospital.
At that time, most blood banks were small operations, hampered by the limitations of existing blood storage techniques. At Howard, and also as a Rockefeller Fellow at what is now Columbia University Irving Medical Center, Drew developed methods to separate plasma from blood’s other components, allowing blood to be stored for longer periods of time. The medical advance paved the way for the U.S. government to develop the “Blood for Britain” program in 1940. Led by Drew, the five-month project collected blood from 15,000 donors, including Black Americans, and provided desperately needed plasma to British soldiers at war with Germany. Drew was eventually named medical director of the American Red Cross national blood bank program, a position he was appointed to when the organization launched the National Blood Donor Service in February 1941.
Historians say the policy served to placate a sense, especially among White Southerners, that Black blood was inherently different from and inferior to their own.
Despite Drew’s role at the Red Cross, the National Blood Donor Service refused Black blood from the very start, according to Guglielmo. Individual donation centers set some of their own race rules: Centers in New York and Philadelphia, for instance, accepted Black donors but sent their blood to local hospitals rather than processing it for armed services personnel; Baltimore centers did the same, though they used segregated donation facilities. “But segregated or not,” wrote Guglielmo, “no center sent blood from Black donors to be processed for the American military.”
The policy discriminated against Black donors specifically, Guglielmo noted: Blood from Asian and Mexican-American donors was neither separated nor distinguished in any way from that of White donors.
Ostensibly, the Red Cross policy was predicated on worries that an integrated blood system would alienate White Americans, without whom the donor effort could not survive. This was based on an assumption that White people were uncomfortable with mixing Black and White blood. But in reality, there was little if any evidence that White soldiers cared where their blood transfusions came from, and the military never asked them, said Sarah Chinn, author of “Technology and the Logic of American Racism: A Cultural History of the Body as Evidence.” According to Chinn, it was much more about “anticipated objection.”
The policy was implemented quietly, but it soon came to light. In December 1941, Pearl Harbor was bombed, the U.S. officially entered World War II, and the Red Cross ramped up its blood donation campaign. The same month, an internal memo that outlined the organization’s discriminatory blood donation policy leaked to the press, sparking widespread condemnation.
Among the opponents of the policy was outspoken socialist Vito Anthony Marcantonio, who represented East Harlem in the U.S. Congress for seven terms and had long been a strong advocate of Black civil rights. When he learned that Black people were being turned away from blood donation centers, he led a New York delegation to Red Cross headquarters in protest. Few, if any, other federal elected officials so openly opposed the policy.
Prominent voices in Black media and civil rights circles took up the cause as well, including national and local NAACP presidents, the Detroit Teachers Union, the Communist Party of Cuyahoga County, Ohio, the New Jersey State Legislature, and William H. Hastie, a civilian aide to the U.S. Secretary of War. A Dec. 27, 1941 Chicago Defender headline summed it up: “Red Cross Refuses Blood From Black Donors.”
The following January, under increasing public pressure, the Red Cross and U.S. military announced what it viewed as a compromise: It would accept Black donors' blood for military use but process it separately, “so that those receiving transfusions may be given plasma from blood of their own race.”
In a Jan. 29, 1942 New York Times article, Marcantonio called the new policy an improvement but still deemed it “abhorrent to the principles for which this war is being fought and on which this country was founded.” In a discrimination complaint filed against the Red Cross, James J. McClendon, president of the Detroit branch of the NAACP, echoed the sentiments of many civil rights activists when he called blood segregation “Hitler-like.”
The American Red Cross holds the destiny of human being[s] white and black…Make them understand that we are Americans, too.
But the Red Cross policy had its supporters, particularly in the Deep South. The Baltimore Afro-American reported that Mississippi representative John E. Rankin, a staunch proponent of anti-miscegenation laws, said “there are many Southern White troops with the Allies and I resent having the blood of other races pumped into their veins when they are helpless to do anything about it.”
There was one thing that proponents and opponents of the policy seemed to agree on: Integrating blood banks was a direct challenge to the nation’s deeply entrenched social order — a social order defined by Black-White segregation, even within the ranks of the military service structure itself. When the U.S. entered World War II, about 95 percent of the Army and Navy were White men, and the military as a whole remained segregated. The few Black men who served were relegated to menial service roles and unlikely to see combat. Whereas segregationists seemed to view the equal treatment of Black and White blood as catastrophic, integrationists saw it as a tentative step toward a more equal society.
Over the course of the war, labor unions, religious groups, scientific organizations, nearly every major civil rights organization, and Charles Drew himself threw their weight behind efforts to overturn the Red Cross’s policy, to no avail.
According to Drew’s daughter, neuroscientist and researcher Charlene Drew Jarvis, Drew tried hard to persuade Red Cross and military officials to change course, arguing that an integrated blood supply would have a greater salutary effect on Black morale than anything else. “He said no official department of the federal government should willfully humiliate its citizens and that there was no scientific basis for the order,” recalled Jarvis.
Drew’s arguments failed to bring about a change, and he eventually resigned, later declaring the policy humiliating to Black Americans. In a Sept. 26, 1942 interview with the Chicago Defender, he described the underlying problem as a social one, rather than a medical one. “And like all other social problems where prejudice between races is concerned,” he said, “great difficulties face anyone who attempts to analyze the problems away.”
Throughout American history, the question of who can give blood, and to whom, has often been constrained less by medical limitations than by cultural assumptions and biases. In the 1980s, at the height of the AIDS crisis, the U.S. Food and Drug Administration banned donations from gay and bisexual men, who had the highest HIV infection rates. At the time, scientists still didn’t know much about the virus, and blood banks were limited in their abilities to detect HIV in blood donations. But despite scientific advancements, the prohibition remained in place until 2015, long after it had become clear that the transfusions could be done safely. Even today, the agency requires that men who have sex with men be sexually abstinent for three months prior to donating blood, a restriction that is unsupported by science. The FDA recently signaled that it is poised to remove that restriction, which has already been abolished in other countries.
Similarly, the 1940s treatment of Black blood donations was in many ways emblematic of a country still in the grip of old prejudices and outdated folk wisdom. To Black Americans still fighting for their civil rights, proving their heroism, commitment, and patriotism — whether on the battlefield or in civilian arenas — was a powerful way to make the case for equality and full citizenship. In rejecting Black donors’ sacrifices, the nation seemed to be conspiring to ensure a complete sense of belonging remained out of their reach.
Today, Black Americans donate blood to the Red Cross at disproportionately low rates. Despite making up 13 percent of the national population, they account for less than 3 percent of blood donors. Experts largely attribute the shortfall to mistrust of the medical profession — sowed by a string of injustices, including the Red Cross policy — and to deeply entrenched disparities in access to health care.
To help boost numbers of the Black donors they once shunned, the Red Cross recruited Charles Drew’s daughter, Jarvis. As she explained, they thought that by speaking through her father, she might help with opening doors to African American blood donations. “There was resistance and there still is for a number of reasons,” Jarvis said, adding that the historical mistreatment of Black patients going back to the Tuskegee experiments and beyond has engendered suspicion of the medical establishment. Jarvis said she suspects that the Red Cross blood segregation policy likely also contributed to that distrust.
Although medical professionals generally agree that socially defined racial categories do not reflect inherent differences in blood biology, many are concerned that low Black blood donor rates are making it difficult to precisely match blood types for certain patients who require donor blood with a very specific combination of antigens.
These groups are called minor blood group antigens, and the better matching transfusions are referred to as “precise matches,” Connie Westhoff, executive scientific director of the National Center for Blood Group Genomics at the New York Blood Center, explained an email to Undark. Those minor blood group antigens, which characterize a person’s blood in greater detail than the standard A, B, AB, and O classifications, are inherited and differ between populations and ethnic groups, Westhoff said. She added that people with sickle cell, a blood disorder that in the U.S. disproportionately affects Black Americans, “do much better if they get blood with the same minor blood types,” which are more likely to come from within the same ethnic group. Although sickle cell patients can receive blood donations from a person of any race, health officials say that Black people are 10 times more likely than White people to have a specific blood type that is in high demand for those patients.
Chinn recognizes that calls for blood from particular racial or ethnic groups can be fraught. The British National Health Service faced tremendous pushback following a 2017 tweet that declared they needed Black blood, with critics arguing that such calls perpetuate the notion that race is biological. Yet Chinn supports race-targeted blood drives as a critical way to match rare blood types, and she sees them as a value-free acknowledgement of small statistical biological differences between groups. It’s only when these differences “get interpolated with social value, political value, [and] cultural value that it takes on this more dangerous complexion,” she said. “No pun intended.”
In September 2021, the Red Cross issued a statement calling its World War II era blood segregation policy a “regrettable decision” that accommodated “cultural norms of the time rather than relying on scientifically based facts.”
“In 1948,” the statement read, “the Red Cross discontinued the practice of segregating blood, as we determined that there was no scientific or medical basis to do so.”
According to Chinn, however, the Red Cross likely ended its policy for more practical reasons: because it was expensive and unsustainable. The war had ended. The battlefields had been abandoned. “They just kind of fell away from it,” said Chinn. “I think they realized that it was just really stupid and pointless and really expensive” as well as time-consuming.
Charles Drew, the physician who had transformed blood donation and transfusion died just shy of his 46th birthday of injuries sustained in a car accident on April 1, 1950, the same year the National Blood Donor Service stopped marking racial designations on the medical records of donors. Louisiana did not repeal its longstanding law mandating the segregation of blood until 1972.
Her father, Jarvis said, “lived in an environment in which race led to this diminution of the perceived attributes of people of color.” His “answer to that was excellence of performance.”