African Americans and Spiritual Care
African American spirituality is shaped by a unique historical, social, and theological journey that uniquely dictates how care is given, received, and trusted. It was born in oppression, not privilege, and one must truly understand that it did not emerge in hospitals. It emerged in cotton fields, tobacco plantations, chains, hush harbors, jail cells, and at gravesites. African American spirituality was forged under enslavement, racial terror, segregation, and systemic exclusion. Therefore, faith was not optional—it was necessary for survival. Because of who they were and where they were, enslaved people relied on preachers, elders, family members, and community faith leaders for care and guidance, and without a doubt, their God. The core of African American spirituality is deeply communal, not primarily individualistic. We survived together with a faith shared through testimony, call-and-response worship practices, collective prayer, and church as an extended family.
Henry McNeal Turner was the first African American chaplain commissioned in the Union Army in 1862. Rev. Jeremiah Asher wrote to President Lincoln in 1863, asking for Black ministers to serve as chaplains, and he became one of only fourteen in the entire Union Army, dying in service in 1865. Prior to the mid-20th century, most hospital chaplains in the U.S. were White. That changed in 1935 when the Rev. A.C. Garner was appointed the first Black chaplain at Harlem Hospital.
Unfortunately, the very systems that should have provided spiritual care—hospitals, the government, the medical system, academic institutions, and dominant religious structures—did not. These systems often caused harm and exclusion, breeding deep distrust that began in slavery. Case in point: the Tuskegee Airmen. In 1941, these Airmen became the first African American military aviators. Their skill and courage challenged racist assumptions and helped pave the way for the desegregation of the U.S. Armed Forces. This accomplishment was met with pride, honor, and hope among African Americans. However, that hope of change was quickly extinguished and reinforced by events such as the Tuskegee Syphilis Experiment, as well as the revelation to the public. From 1932 until 1972, the U.S. Public Health and the Centers for Disease Control and Prevention conducted the Tuskegee Syphilis Study which experimented on 600 African American men, mostly poor sharecroppers, from Macon County, Alabama. The men were already diagnosed with syphilis but deliberately were never given effective medicine—even after penicillin became available. This experiment deeply damaged an already fragile trust among African Americans, eroding confidence in doctors, medical institutions, and anyone or anything connected to the healthcare system.
That breach of trust did not end with the study itself: it was passed down through generations, shaping how African American communities approach medicine, hospitals, and systems of care to this day. As African Americans gained access to doctors and hospitals, it did not automatically close the door of distrust, nor did it open the door of trust. Access did not equal safety, and presence did not guarantee care. Consequently, when a chaplain enters the African American patient’s room, there is often an unspoken wall already standing—not built from disrespect, but from history. Conversation may be warm, polite, even cordial, yet it frequently remains guarded and surface-level, offering only what is necessary. Beneath the courtesy lies caution, shaped by generations of experiences where vulnerability was costly and trust was not protected.
So how does a chaplain (especially a White chaplain) provide authentic spiritual care for an African American patient? First, not by pretending history doesn’t exist and not by rushing toward prayer as a shortcut to trust. Spiritual care is more than words spoken over someone: it is presence that stays, advocacy that speaks up, and the courage to acknowledge trauma without trying to fix it away. It recognizes past wounds, names them with reverence, and commits to supporting the whole person’s healing—mind, body, and spirit.
This kind of care listens deeply to experiences of mistrust, whether they are openly shared or quietly implied. It affirms dignity in every care decision and honors the patient’s right to feel cautious. When a chaplain shows up consistently, listens without defense, and stands with the patient rather than over them, walls begin to soften. Trust may not come quickly, but healing begins the moment the patient feels seen, listened to, safe, and respected. That is the sacred work of spiritual care and is how bridges are built where history once placed barriers.
Ultimately, the history of African American spirituality teaches us this: faith survived not because suffering ended, but because God was found in the middle of it. May we as chaplains provide spiritual support to our African American sisters and brothers mindfully and with sensitivity—joining God who is already present in that hospital room.
