Emancipated from slavery, former bondspeople entered into an environment in which more soldiers died from disease than from battle. This talk explores the high rate of illness and mortality that devastated formerly enslaved people during the Civil War and Reconstruction. In particular, it provides the first analysis of the smallpox epidemic that began in Washington, DC in 1862 and then spread to the Lower South in 1863 and Mississippi Valley in 1864-65. By 1865, the epidemic plagued the entire South and began to move west and infected Native Americans on reservations.
Due to the unexpected and inordinate mortality, the federal government in an unprecedented move established the first-ever system of national health care in the South–establishing over 40 hospitals, employing over 120 physicians and treating well-over one million freedpeople.