Contagious Divides: Epidemics and Race in San Francisco's Chinatown (review)

This informative book illuminates an important chapter in the history of American culture. As the author explains, a society on the path to modernity engages in a process of standardization and the setting of norms that guide its governance and policies—including the adjudication of what constitutes true citizenship. To illuminate this process, Nayan Shah analyzes in great detail the construction of racism toward the Chinese in San Francisco from the Gold Rush to the middle of the twentieth century. In an extensive introduction, he explains his thesis: after being branded aberrant because of their deplorable housing conditions, lifestyles, and domestic arrangements, the inhabitants of Chinatown became gradually educated and socialized in American values. From its earlier nineteenth-century characterization as a threat to the Caucasian majority in the city, Chinatown was eventually incorporated into American society following World War I thanks to the efforts of a second generation of acculturated Chinese Americans. In Shah's view, the Chinese community—having improved their homes, changed their living conditions, and adopted the prevailing forms of domesticity—finally achieved access to the privileges and opportunities of "civilized" citizenship previously denied to them. Since then, and in spite of lingering racism, they have become a model minority engaged in all aspects of American society.

Not surprisingly, health and cleanliness were key factors in that transformation, and the author therefore focuses on public health discourses and policies, employing them as a convenient and often revealing window into the complex processes in the construction of racism. For Shah, race is not a biological fact but a social and political category, its meanings capable of explaining behaviors as well as intellectual and physical traits. The stage is set in the first chapter, in which he reviews half a century of efforts to "demonize" San Francisco's "Mongolian settlement" (p. 43), portrayed as a hotbed of disease, notably during successive smallpox epidemics. This is followed by an excellent discussion of efforts in American cities to promote a salubrious environment through public sewerage and health regulations. In San Francisco, the population crammed into Chinatown became a convenient foil for the creation of containment strategies, as well as fumigation and constant surveillance. Shah also eloquently describes the perceived threat to American domesticity and mores by the Chinese, with their gambling and opium-smoking bachelor society, prostitution, and the dangers of disseminating syphilis. Another chapter deals with the main events of the 1900 plague epidemic, stressing the growing Chinese resistance to the public health measures advocated by municipal and federal health authorities.

By 1904, however, a sanitary surveillance program sought to create better living conditions in the district, and following the 1906 earthquake and second plague outbreak, cooperation with public health measures set the stage for Chinatown's full incorporation into the city. After detailing the racism surrounding Chinese labor in San Francisco and the ordeals of immigration through Angel Island, Shah discusses the establishment of new institutions in Chinatown. These included schools, a hospital, and a chamber of commerce, as well as YMCA and YWCA branches that in the Progressive Era brokered the necessary cultural accommodation of the Chinese to American middle-class values of sanitation and health.

Shah's work reflects meticulous scholarship. The book contains seventy-two dense pages of notes, an extensive bibliography of primary and secondary sources, and a useful index. Gone is the celebratory historiography of public health focused on progressive scientific achievements. However, its contemporary replacement with far more sophisticated and nuanced accounts featuring racism and ethnic discrimination sometimes tends to omit or downplay the cultural impact of new scientific insights and discoveries. In the case of plague, for example, public health efforts in time shifted from pathologized Chinese bodies...