Cover

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Title Page, Copyright

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pp. i-iv

Contents

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pp. v-vi

Illustrations

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pp. vii-viii

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Acknowledgments

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pp. ix-xii

Many people read all or part of the manuscript, including Rick Abel, Karen Brodkin, Janet Brodie, Amy Fairchild, Sharla Fett, Janet Golden, Rachel Lee, Natalia Molina, Doreen Valentine, Devra Weber, and Alice Wexler. Douglas Flamming directed me to relevant documents. Sabah Uddin and Ellie Hickerson provided research assistance. Archivists who rendered essential help included Robert G. Marshall of the Urban Archives Center, California State University, Northridge; Katharine E. S. Donahue, Teresa G. Johnson, and Russell A. Johnson, all of the History Division, UCLA Louise M. Darling Biomedical Library; Dace...

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Introduction

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pp. 1-4

Arriving in Los Angeles in the early 1930s, “noir” writer Louis Adamic found sickness everywhere. Unlike his native Slovenia, where “good health was the rule, rather than the exception...and so there was little interest in it,” the Southern California city had so many invalids that health was “the leading topic of conversation.”1 Adamic’s primary goal was to debunk the myths circulated by city boosters. Although notorious for its polluted air today, Los Angeles once billed itself as a health resort, especially for people with “lung troubles.” Soon after the arrival of the transcontinental railroad in 1876, publicists had...

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Chapter 1: Pestilence in the Promised Land

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pp. 5-28

Nineteenth-century Americans considered themselves a uniquely blessed people, exempt from the normal vicissitudes of life. Alexis de Tocqueville famously found the country “a course almost without limits, a field without horizon,” a place where “the human spirit rushes forward...in every direction.”1 And the West was the epitome of American promise, the destination of all easterners in search of regeneration and renewal. Consumptives figured prominently among those travelers. Since ancient times, it had been widely believed that certain air, soil, and water could promote health. Westward journeys in search of cures for lung...

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Chapter 2: Strategies of Exclusion

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pp. 29-38

As the new century opened, the booster enterprise increasingly met opposition. The primary critics were public health officials, who argued that the welfare of Los Angeles required exclusion, not unlimited expansion, and proposed various measures to seal the borders. Growing concerns about germs bolstered the public health campaign. In California, as in the rest of the nation, health officials and advocates launched a massive educational campaign in the 1890s. A broad array of films, posters, exhibits, and lectures gradually convinced the public that tuberculosis was a communicable, not a hereditary, disease and that even casual...

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Chapter 3: Creating a Tuberculosis Program

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pp. 39-60

The campaign to establish free and low-cost services in Los Angeles both reflected and reinforced the growing hostility surrounding poor people affected by the disease. A key argument for creating hospitals and sanatoriums was that they promoted public safety by segregating the patients most likely to spread germs.1 But all institutions soon had long waiting lists; many people urged to accept placement either refused to do so or fled soon after arriving; and restrictive residence requirements disqualified some patients considered especially threatening. Far from increasing support for hospitals and sanatoriums, statements about the need...

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Chapter 4: “Outsiders”

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pp. 61-76

White Americans at the turn of the twentieth century took as a matter of faith that physical strength and vigor underlay their social and political supremacy. Photographs of muscular, healthy soldiers justified the nation’s first foray into imperialism.1 Feminist writer Charlotte Perkins Gilman sought to advance women’s position by declaring that “the dominant soul—the clear strong accurate brain, the perfect service of a health body” belonged not just to one gender but to the entire race.2 The heavy-weight boxing victory of African American Jack Johnson over white Jim Jeffries shocked primarily by upsetting cherished...

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Chapter 5: Slashing Services in the Great Depression

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pp. 77-85

Ever anxious to portray Los Angeles as uniquely favored, both the boosters and the local press initially claimed that the metropolis was exempt from the worst ravages of the Great Depression. By late 1931, however, few could deny that the cataclysm had struck Los Angeles as swiftly and severely as the rest of the country. Manufacturing output had dropped by 38 percent while business failures and unemployment had soared.1

But if the boosters no longer could ignore the depression, they could try to use it to stimulate tourism. The publicity literature urged easterners beset by financial...

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Chapter 6: Expelling Mexicans and Filipinos

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pp. 86-107

The most searing event in the early life of Mary Helen Ponce, the daughter of Mexican immigrants in the San Fernando Valley, was the death of her brother Rito. Rito had joined the Civilian Conservation Corps as a teenager in the late 1930s but returned home when he was diagnosed with tuberculosis and died just before the outbreak of World War II. Mary Helen had only fleeting memories of him—his sadness, his blue-green eyes, the gentle touch of his thin fingers when he combed her tangled hair, and the blue cotton pajamas he wore as a patient at Olive View Sanatorium. But she vividly remembered the...

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Chapter 7: “Agitation over the Migrant Issue”

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pp. 108-124

Rafael Garcia must have been desperate by the time he applied for help from a Los Angeles office of the State Relief Administration (SRA) on November 20, 1936.1 Two of his five children, sixteen-year-old Enrique and thirteen-year-old Maria, were in the tuberculosis ward of Los Angeles General Hospital. His wife, Gloria, was pregnant. And the money he had earned picking fruit during the summer was completely gone.2 But the SRA had little to offer. According to the case file, Rafael’s legal residence was Globe, Arizona, where he had worked as recently as June, and the...

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Chapter 8: Fighting TB in Black Los Angeles

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pp. 125-136

Unlike Mexicans, Filipinos, and “inter-state migrants,” African Americans could neither be barred from California nor sent home. But they resembled the groups targeted by the early twentieth-century campaign of exclusion in two critical ways. Like Mexicans, African Americans were assumed to have an innate predisposition to tuberculosis. And if they could not be expelled, they could be subjected to various forms of “social exclusion”— the denial of access to a community’s major institutions.1 As an unwanted ethnic minority, black Los Angelenos suffered severely after the 1929 stock market crash. Despite...

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Epilogue

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pp. 137-140

Tuberculosis is again on the rise. Worldwide, two billion people are infected with the tubercle bacillus each year; nine million of them develop active disease.1 Although the 1946 introduction of streptomycin made TB cures possible, some new strains resist all drugs in the medical armamentarium.2 The disease continues to impoverish households and devastate quality of life. In India, more than 30,000 children annually withdraw from school because their parents suffer from tuberculosis, and approximately 100,000 affected women are abandoned by their families.3 The great majority of cases occur in the global South, especially where HIV leaves the population vulnerable to other afflictions. “We cannot win the...

Notes

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pp. 141-178

Index

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pp. 179-188

About the Author

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pp. 189-190