Fit to be Citizens? Public Health and Race in Los Angeles,1879–1930 (review)

When plague broke out in a Mexican immigrant neighborhood in downtown Los Angeles (LA) in 1924, the neighborhood was placed under strict quarantine, with LA’s young public health department and eager public health officials flexing their muscles against this immigrant community. The stringent “no entry/no exit” policy applied to everyone in the seven-block region where disease was “hidden,” with one notable exception: laborers (83–85).

Natalia Molina’s monograph vividly details how public health institutions, officials, and discourses shaped the anti-immigrant ethos of Los Angeles during the period of its growth into a modern metropolis. In this well-constructed and thoroughly researched work, Molina argues that public health officials operationalized and thereby encoded discriminatory public images of non-white Angelinos. Through its chronological chapters on the influx and treatment of Chinese, Japanese, and Mexican immigrants into LA, her book concretizes how the physical body served as a site for racialization within the larger narrative of LA’s urban expansion.

Molina sets the experience of Mexicans and Mexican Americans against that of prior Asian immigrants to LA. Beginning in the first chapter on Chinese immigrants, who worked mostly as peddlers and launderers, and proceeding through subsequent chapters on Japanese and Mexican laborers, Molina shows how city officials increasingly harnessed public health, home ownership, and other urban planning regulations to impose discriminatory ideologies on these groups. Her narrative of the labor and housing experience of these immigrants in LA becomes a microcosm of broader trends in immigration restriction and discrimination, which culminated in the 1882 Chinese Exclusion Act and the 1907–08 Gentleman’s Agreement, restricting Asian immigration. The third and fourth chapters document how Mexican Americans, no longer imagined as birds of passage but rather understood as the permanent residents of LA that they were, became subject to a newly institutionalized public health infrastructure, designed to residentially segregate and gradually acculturate these Angelinos to white norms of housing, childbirth, and healthcare.

Molina demonstrates that despite the differences among immigrant groups’ experiences, white city leaders imagined immigrant communities, from Chinese launderers to Mexican railway laborers, as sickly, contagious, and socially menacing. Public health officials and the public simultaneously blamed immigrants for their poor health while providing grossly inadequate public health facilities and permitting blatantly unhealthful working and living conditions for immigrant laborers.

Molina interweaves various fascinating narratives that contribute to this story of race and public health in LA. One key protagonist is John Pomeroy, LA’s first full-time health officer, who grew the department to 600 employees and who became nationally prominent as a public health innovator. Efforts to lower the birthrates of Mexican Americans, short-lived sterilization campaigns, deportation drives, and legal efforts to prohibit Chinese launderers from residing in the same building as their businesses all reflected white social anxieties about the growing presence and worrisome health outcomes of the immigrant poor. Molina’s book shows how moneyed white Angelinos were conflicted by their desire for cheap non-white labor and their discomfort about how the visible, growing, and increasingly permanent slums of non-white immigrants undermined the imagined purity and healthfulness of their city.

Molina takes the story of public health and immigrant racialization in a new direction through her chapter on Mexican American activism around public health and housing. Mexican activists in the 1930s called upon local government to make good on promises for the provision of adequate public health care and improvement in public housing. The language of this activist movement summoned notions of democracy and citizenship as part of these families’ claim to improved conditions. Activists called attention to LA’s contradictory reliance on immigrant labor and its consistent neglect of immigrant neighborhoods. This chapter recommends future research that incorporates health-related activism as part of how scholars envision the social history of the patient. In light of the current debates on immigration...