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UBC Theses and Dissertations

Pestilential policy and migratory maladies : the American state, epidemic disease policy, and migration, 1890–1915 Louie, Naomi Jane Linthwaite


This thesis examines the development of American public health institutions and public health policy during the Progressive Era through the interplay of the twin issues of anti-epidemic disease policy and immigration and rethinks the relationship between race, migration, policy, and public health. It investigates three disease epidemics that occurred during the late nineteenth and early twentieth centuries, in which migrants figured prominently: the 1892 cholera outbreak in New York City, the 1900 plague epidemic in San Francisco, and the typhoid fever outbreaks started by the woman who came to be known as Typhoid Mary. Through these three case studies, this thesis argues that though American public health institutions greatly expanded their reach in this period as the central state took on the primary responsibility for protecting the nation’s health, these institutions remained shakier and more vulnerable to challenges than the secondary literature has appreciated. I demonstrate this trend by studying the perspectives of both the pub-lic health officials implementing anti-epidemic policies and the migrants caught up in these poli-cies, highlighting the roles played by challengers to public health policy. These “resisters,” as I term them, were a broad group of disparate individuals ranging from the political and racial elite, to racially and politically marginalized migrants; their resistance constrained public health offi-cials’ actions and the range of policy tools wielded by public health agencies. Finally, in light of this pattern, this thesis draws a comparison between public health in the Progressive era and the Covid-19 pandemic in twenty-first century America. I suggest that the vulnerabilities in the pub-lic health system exposed by the Covid-19 pandemic are part of a much longer history, and arose in part because America’s system of public health sits atop institutional foundations that were never particularly sturdy even at the time they were built.

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