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And so began what became a long tradition among city health officials of tracing any blemish on the pristine image of Los Angeles-including all forms of disease and any manner of disorder-to the city's marginalized communities. As the chapters that follow will show, between 1879 and 1939, areas hometo L.A.'s Chinese, Japanese, and Mexican populations were separately and serially targeted as "rotten spots." Armed with institutional power buttressed and legitimated by the language of "scientific objectivity," public health officials developed discourses that attributed the serious health problems confronting these minorities to purported deficiencies in the groups' biological capacities and cultural practices. Thus, from the start, Los Angeles health officials' efforts to promote the reputation of the city as modern and healthful were interwoven with their role as local arbiters of the meanings of race and racial identities.
Portraying people of Chinese, Mexican, and Japanese ancestry in Los Angeles as threats to public health and civic well-being obscured the real causes of communicable disease and illness-inadequate medical care, exposure to raw sewage, and malnutrition. Misled by their own racial assumptions, health officials betrayed their institution's mission. They devoted inordinate attention and disproportionate effort toward policing racial groups while neglecting the dangers posed by the incidence of communicable disease among the rest of the city's residents. Issues of race, class, and gender were considered in all aspects of health officials' work, from identifying and defining problems, to developing preventative health care programs, to handling disease outbreaks. Disease itself was defined as much by sociocultural beliefs in the inherent uncleanliness of immigrants and nonwhites as by biological explanations. Such definitions effectively stigmatized entire populations of already-marginalized groups in the city.
Perhaps most important in the long term was the public health department's gatekeeper role. Indeed, health and hygiene norms increasingly became standards for "Americanness," and health officers helped determine who was considered part of the body politic. They had the power to restrict people's sense of social membership and shape their relationship to the nation-state. As the historian Suellen Hoy argues, "leanliness became something more than a way to prevent epidemics and make cities livable-it became a route to citizenship, to becoming American. It was, in fact, confrontation with racial and cultural outsiders that transformed cleanliness from a public health concern into a moral and patriotic one." It was health officers, for example, who had responsibility for deciding who was healthy enough to work or attend public school. Public health ordinances dictated where Chinese fruit and vegetable vendors could establish businesses and even prescribed the architectural style of the produce markets. They determined when Mexican railroad laborers could leave their work camps and where Japanese residents could seek institutionalized health care. They approached these communities, which they considered a "menace," with the attitude that they needed to "safeguard the public" against them.
City and county public health officials in Los Angeles consistently failed to distinguish between U.S.-born and foreign-born individuals in the Chinese, Japanese, and Mexican communities (even Californios, those Mexicans who had lived in California when it was still Mexico), thus marking all members of these groups as permanently "foreign." Suspended indefinitely in this "not-yet-American" state, Japanese, Chinese, and Mexican residents of Los Angeles were excluded from the benefits of full social participation in the life of their city. Social membership is usually equated with citizenship status, but it is important also to investigate how those who are not citizens negotiate a sense of national identity, calibrating notions of citizenship and democracy in the process. By shifting the focus to the local level, one can see the ways in which social membership is negotiated every day. In this study, examining local institutions, particularly those whose mission was to promote public health, is crucial to demonstrating how institutional policies affected a sense of social membership. As an institution, the department of public health regulated immigrants' everyday life practices. Moreover, the city and county health departments' official standards, guidelines, and recommendations were routinely evoked by the city council and others to prevent Chinese, Japanese, and Mexican residents from bargaining freely over wages and working conditions; from owning land or accumulating other assets that might appreciate in value and be passed on to subsequent generations; and even from moving freely about the city in search of housing, employment, and business opportunities.
The growth of Los Angeles and the increasing national recognition of public health as a prominent profession in the nation and important institution in the city were closely entwined. Just as demographic growth and increased immigration warranted the attention of government legislators and private investors, so too they demanded the attention of health officials. Sanitation and good health were central to the image of Los Angeles, and public health officials remained thoroughly committed to promoting the reputation of the burgeoning city. The many connections between the health departments and the broader municipal infrastructure challenge the idea of public health as being driven by pure principles of "scientific objectivity." Overarching social and political issues of the time played essential roles in the development of the city and county health departments, determining where clinics were established and what types of programs were offered to whom.
Health officials not only incorporated their racially charged visions into policies and ordinances that targeted ethnic communities but also helped shape the ways mainstream populations perceived ethnic peoples. Moreover, people operating at various levels of power, in and out of government, routinely appropriated public health discourses to advance goals of their own, including the shaping of racial categories and meanings. "Experts" from the fields of public health, public service, law, and social work reinforced each other's ideas, thereby increasing the legitimacy that the general public accorded to their claims. The process by which public health as an institution and a discourse evolved into a key site of racialization in late-nineteenth- through mid-twentieth-century Los Angeles-how it came to exert an influence that extended far beyond the realm of health-is the central question this book addresses.
REFINING THE RACIAL HIERARCHY
In 1875, the Southern Pacific Railroad extended its line from San Francisco to Los Angeles. Additional connections to railroad lines during the 1880s made Los Angeles the terminus of two cross-continental railroads. Each new link precipitated another, larger jump in the size of the city. Census data place the total population of the city in 1880 at slightly over eleven thousand. By 1900, Los Angeles claimed a population of more than one hundred thousand within city limits and an additional seventy thousand residents in the county. But in Los Angeles, unlike comparable cities in the Midwest and East, population density grew only modestly. As a result, the city and county developed into a sprawling metropolis with a much higher ratio of land per capita than was common elsewhere.
If L.A.'s geographical limits seemed infinitely expandable, its social boundaries did not. The city and surrounding county were the site of persistent struggles between the white elite and the racially diverse remainder of the population. Sparring matches over politics, civil rights, housing, employment, and the distribution of city and county services occurred regularly, increasing social polarization throughout the city. These conditions made having a stake in assigning L.A.'s ethnic groups their proper place in the city's racial order especially important. Public and private discussions of the need for maintaining a high standard of public health were laced with references to the perils presented by the city's immigrant minorities. Health officials recorded their racial concerns in quarterly and annual reports, in internal memos, in their correspondence with other health and government officials, and in the press. The multiethnic population of Los Angeles preoccupied public health officials because of a widespread perception that immigrants threatened the health of the nation in both a real and a metaphorical sense.
From the late nineteenth to the early twentieth century, Americans across the country struggled to adapt to the broad changes that accompanied industrialization. Large numbers of people moved from rural to urban areas, and major sites of labor shifted from the fields to the factories. The composition of immigration changed as well. In most cities, southern European newcomers replaced earlier Irish and German populations as the largest immigrant groups. Public dissatisfaction and calls for reforms in various arenas, from business to social welfare programs, accompanied these sociopolitical and cultural transformations. As the country embarked on a "search for order" that would calm growing fears of chaos, public health, which emerged as a field toward the end of the nineteenth century, seemed an ideal solution. With its promise of "scientific objectivity" and its embodiment of many of the values championed by the Progressives, it was an institution well suited to the era.
On the East Coast and in the Midwest, health workers and social reformers directed their efforts at the newly arriving white immigrants from southern Europe, whom they attempted to assimilate into American culture. In Los Angeles, the situation was more complicated. Los Angeles health officials dealt only infrequently with the city's ethnic white (southern and eastern European) immigrants. Their main concerns, instead, were the health issues posed by Chinese, Japanese, and Mexican residents. Asians and Mexicans were not easily classified into racial categories. They were neither white nor black. What position should they occupy in the racial order? The highest levels of government determined legal citizenship, but institutions, such as public health departments, determined who had access to social membership. Public health officials were able to inject new concepts and ideas into delineation processes that are usually informal and carried out at a much lower level (such as a city or even a neighborhood), marking some people as worthy, capable, and deserving members of society and others as correspondingly unworthy and incapable of participation. What degree of social membership and/or legal citizenship should be extended to which groups? Public health officials, with their standards and guidelines, programs and policies, helped answer and institutionalize responses to these questions. I argue that by examining public health as a site of racialization, we will see how public health workers at the local level contributed to the construction of racial categories. In Los Angeles County, the earliest interactions between public health officials and Mexican and Japanese immigrants reveal how race relations in this area differed from those in the rest of the nation.
DEVELOPING A REGIONAL RACIAL LEXICON
In the country as a whole, race was commonly perceived in dichotomous terms as the categories of "white" and "black." The general public identified other major "races" as Slavs, Hebrews, and Mediterraneans. Los Angeles had its share of these groups, but they were rarely mentioned as racially distinct. The black/white imagery that dominated conceptions of race elsewhere gave way in Los Angeles to a notion of race as a graded continuum shading from white, at the top, downward through various forms of "nonwhite," represented by the city's Chinese, Japanese, and Mexican populations. In Los Angeles, people "saw" race differently. The numerically small size of the African American population, combined with the fact that Asians and then, later, Mexicans were highly sought after as laborers, displaced the prejudices usually reserved for African Americans onto these three groups (table 1).
The history of the development of the nonwhite category in contrast to the widely accepted black-white paradigm highlights the fluidity of racial understandings and the many ways in which racial categories evolved. In the wake of the major changes nationwide brought about by large-scale immigration and industrialization, the notion of "an unquestioned hegemony of a unified race of 'white persons'" broke down. Poor and ethnic whites continually needed to define themselves against the "other," most often African Americans, in order to establish their racial privilege. The fervor with which whites guarded their racial privilege is not surprising. Whites' position at the top of the racial order resulted in heightened access to institutionalized power. By definition, racialized populations, since they were constructed in structural opposition to whites, had limited access to institutional power.
The ambiguity that resulted from retooling racial categories also meant that people who were neither white nor black had no clearly defined position in the racial hierarchy. The "nonwhite" category helped stabilize the new racial order. Like whiteness, nonwhiteness was neither a monolithic nor a static category; it incorporated degrees of access to privilege, and its composition changed in response to national factors (e.g., labor needs, immigration laws, and economic cycles) and more regional pressures (e.g., the presence or absence of other marginalized populations). The racial ordering within the category of "non-white" also was affected by the process of racialization itself. As Tomás Almaguer has shown, in nineteenth-century California, groups were racialized in relation to one another, falling into different places along a graded continuum that began with whites, who were followed by Mexicans, African Americans, Asians, and, finally, Native Americans. As Claire Jean Kim has pointed out, the racial order is not a "single-scale hierarchy (A over B over C), but a field structured by at least two axes: that of superior/inferior and that of insider /foreigner. Blacks and whites constitute the major anchors (bottom and top respectively) of this order, and incoming immigrants and other groups get positioned relative to these two loci." In Los Angeles, Mexicans were positioned above the city's Chinese and Japanese residents in many respects. For example, until the Depression, health officials extended Americanization programs to Mexicans. Asians, meanwhile, remained labeled as outsiders, a threatening "yellow peril," simultaneously inferior and alien.
Mexicans' higher status relative to Asians, however, did not enhance their position vis-à-vis the city's white population. They continued to be regarded as subordinate, foreign, and disease ridden. This racialized view had significant and direct consequences for public health in Los Angeles and equally important indirect effects on the city's social structure. During the 1916 typhus epidemic and the 1924 plague, for instance, public health officials focused on "reforming" Mexicans, whom they "knew" to be naturally dirty and inherently too ignorant to rectify their unsanitary living conditions. Because medical discourse had the power to naturalize racial categories, it also had the effect of naturalizing societal inequalities. Rather than addressing the structural inequality that produced the unhealthy environments that hosted virulent diseases, public health departments consistently identified the root problem as racialized people who were in need of reform. By shaping racial categories and infusing them with meaning, health officials helped define racialized people's place in society.
Excerpted from Fit To Be Citizens? by Natalia Molina Copyright © 2006 by The Regents of the University of California. Excerpted by permission.
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