Fit To Be Citizens? Public Health and Race in Los Angeles, 1879–1939 (review)

This masterful account helps to introduce readers to the history of public health in Los Angeles, a major metropolis too long ignored by members of this profession. Natalia Molina discusses early efforts to control Chinese laundries, as well as the official neglect of the serious health problems besetting the Japanese community. In the bulk of the book she examines the public health campaign directed toward the many Mexican workers who poured into Los Angeles during the 1910s and especially during the 1920s. Their arrival coincided with the development of the Los Angeles County Health Department; Director John L. Pomeroy helped to craft the anti-immigrant discourse by relentlessly portraying Mexicans as a dangerous group who imported dread diseases into the country, took few preventive steps, and refused to abide by public health advice.

When typhus fever struck a Mexican community in 1917, Pomeroy blamed the uncleanliness of the sufferers and their tendency to spread disease among themselves. Seven years later, plague visited Los Angeles, killing more than thirty people, 90 percent of whom were Mexican. This time the authorities were dealing with not just a virulent and frightening epidemic, but one that struck close to downtown, arousing fears that infection would spread to whites and that bad publicity would undermine the tourist industry. Both city and state officials joined the campaign to eradicate the disease. The severity of some of their measures stemmed not only from contemporary scientific knowledge but also from the belief that Mexicans lacked knowledge about sanitation and could not be trusted to obey public health regulations. Both state and local officials also took part in efforts to tighten the border between Mexico and the United States: after the Immigration Act of 1924 instituted numerical quotas for European immigrants, officials testified in the hearings organized by Representative John C. Box on a bill to extend the law to those from the Western Hemisphere. During the 1930s, public health leaders were important players in the drive to expel Mexicans from Los Angeles.

A particularly impressive feature of this book is the emphasis on the protests launched by Mexicans during the 1930s. A major organization was the National Congress of Spanish Speaking Peoples, which was especially prominent in Los Angeles. Although previous historians have associated the group primarily with labor struggles and political protest, Molina demonstrates that it also agitated for better health and housing.

My one criticism is that, by focusing exclusively on the issue of race, Molina slights the topic of class. The Los Angeles elite during the late nineteenth and early twentieth centuries assumed the dominance not only of whites but also of the middle class. The metropolis first withdrew its welcome of health seekers not after the onset of the Great Depression, as Molina suggests (p. 128), but during the late 1890s, when reports of high rates of disease among "tramps" from the East led to an exclusionary campaign against them. I also disagree that white refugees from the Dust Bowl during the 1930s "evoked a generally sympathetic institutional response to their plight" (p. 162): the tenor of most comments by both state and local officials leaves little doubt that their primary objective was to repel the migrants. Many migrants who applied for financial assistance from either the California State Relief Administration or the Los Angeles County Department of Charities were offered only transportation home. Those who were sick or disabled were especially likely to be encouraged to depart.

Nevertheless, the merits of this book far outweigh any deficiencies. This well-written and well-researched study deserves a wide audience.