Precarious Prescriptions: Contested Histories of Race and Health in North America ed. by Laurie B. Green, John Mckiernan-González, and Martin Summers (review)

If we want to understand the complex intersections of race and medicine in the United States, our perspective is greatly enriched by paying attention to the borderlands. Race and medicine are unstable objects that change over time and, reading Precarious Prescriptions, I was struck by how much it matters that “the United States” is a moving target as well. Starting with its first substantive chapter, on native healing practices in 1830s Texas, this collection highlights how much not only the notion of being American but also the political entity of the United States is a work in progress in the nineteenth and twentieth centuries. Medicine and public health are part of nation building practices at its borders, and attending to this provides insights for understanding race, medicine, and public health more broadly.

Precarious Prescriptions emerged out of a conference at the University of Texas at Austin (p. viii), and this location may have contributed to the particular regional strength of the book. Although the book’s title promises to tell “contested histories of race and health in North America,” the coverage of the continent is not comprehensive. A more accurate and intellectually exciting articulation of its scope comes in the introduction: “a more complex portrait of the intertwined histories of race, medicine, and public health in the United States and its borderlands” (p. viii). A significant emphasis is on the Southern border of the United States, on the borderlands with Mexico, which is the subject of five of the twelve chapters. One chapter considers the borderlands with Canada; another is about Hawai’i. None consider the urban centers of the East Coast or Midwest. This is atypical of edited collections on race and medicine in the United States and distinguishes this volume. Its strong colonial and borderlands element might make this book particularly appealing to different audiences than other readers on race and medicine, such as students, scholars, and those interested in global health.

Having multiple Latino and indigenous-focused chapters highlights the diversity within those spheres. Two chapters highlight colonial encounters, one in Texas and the other in Puget Sound. Two chapters focus on practitioners in the borderlands, including one on midwives in New Mexico just after statehood, and another on nurses in colonial Hawai’i. Two more chapters focus on Mexican migrant workers in the United States as objects of public health campaigns. Importantly, the book’s attention to the borderlands and Latino and indigenous communities does not supplant or replace its attention to African Americans. There are two chapters focused on African-American physicians, including a particularly fascinating one that profiles individual practitioners in the years just after the Civil War. There are also two chapters focused on the mass media phenomena that traffic in imagery and stereotypes of African Americans: a beautiful chapter on 1960s mass media on “Hunger in America,” and an incisive one on the 1980s panic about “crack babies.” There is also the obligatory chapter on the Tuskegee Syphilis Study. One outstanding chapter explicitly focuses on African Americans and the borderlands: “At the Nation’s Edge: African American Migrants and Smallpox in the Late-Nineteenth Century Mexican-American Borderlands.” The volume as a whole demonstrates the analytical value of reading African American history and borderlands history together, for the field of history of medicine and beyond.

Another distinctive aspect of the collection is that many chapters focus on racialized patients and publics, others specifically on medical practitioners of color. This highlights intracommunity differences and complicates what might otherwise come across as simple stories of oppression. The practitioners—variously doctors, nurses, midwives—are betwixt and between, both suffering from racist exclusions and wielding considerable power.

A third and related distinctive element of the book is underscored by the word “precarious” in the title: the essays...