This essay discusses the history of 20th century black migration to Harlem, New York and the utilization of Harlem Hospital. This examination is based on New York newspaper articles in the 1920’s. They tell the story, from a journalist’s perspective, of the challenges African Americans experienced in their interactions with Harlem Hospital. The implicit communication of segregation of Harlem Hospital at that time is connected to the development of patient navigation in the 1970’s. The creation of patient navigation will be discussed in the context of historical health disparities that are increasingly manifested today.