The Price of the Ticket: Race, Clinics and the Keywords of Cross-Border Citizenship in the Cold War

Abstract

In 1940, the United States started registering and drafting men over 18. Two years later, the Bracero program started re-connecting rural Mexico to fields, factories and railways in the United States. Between 1940 and 1980, American health care institutions and ideologies struggled to keep up with the changing affiliations and desires that migrants and conscripts carried along in their cross-border journeys. This panel uses tensions in health care industries and ideologies shaping Cold War ‘migrants,’ be they conscripts, braceros or people working in their institutional aftermath, to address the use of health as a pathway to democracy for people of color. All these terms are keywords – contested terrain for cold war governance at the edges of the U.S. empire. The participants in this roundtable will examine the medical factors shaping the ‘contested terrain’ that made this Cold War conjuncture.

Family Practice: Cold War Medical Expansion, Pro-Natalism and the Burdens of Latino Migrant Physicians, 1945–1965

World War II inaugurated a period of grand institutional expansion, political incorporation, and new forms of exclusion. The federal strengthening of domestic institutions under the Cold War led more Latinos and Latin Americans into American medicine and brought more Latinos into contact with American medical institutions. Hospitals, for their part, started recruiting across the world to find professionals to help them meet the needs of growing numbers of people with access to medical services in the United States. As white Americans abandoned cities for the promise of the suburbs, rural Puerto Rican and Latin American labor migrants moved in alongside black Southerners to cities like Chicago, and New York, while Mexicans and other Latin Americans moved to cities like Los Angeles, San Francisco, and Houston. Latino doctors emerged, seizing on the increasing investment in public education by the states and the federal government to obtain medical degrees and build careers unimaginable in the 1930s. This paper explores the ways Latino doctors trained in Puerto Rico, Mexico, and Texas negotiated the tensions of the 1950s. Rejecting the endless commodity promise of the 50s and troubled by the narrowing political horizon established by the domestic culture of the Cold War and the creation of the Commonwealth of Puerto Rico, many Latino physicians committed to expanding access to medical care, while leaving workplace conditions outside the parameters of their work. This paper will treat doctors as high-status participants in the politics of the Second Great Migration.

Presented By
John Mckiernan-Gonzalez, Texas State University, Center for the Study of the Southwest

The Railroad Bracero Program and the Struggle for Health Citizenship in the U.S. Workplace, 1943–1945

Focusing on the railroad bracero program, this presentation will examine how the debates over Mexican guest worker health shaped the twentieth century struggle for health citizenship in the U.S. During World War II an estimated 135,000 Mexican men participated in the railroad bracero program, a guest worker program co-sponsored by the U.S. and Mexican governments, as temporary track maintenance workers to alleviate the labor shortage and support war transportation. When a railroad bracero experienced injury and/or illness, the Mexican state, together with the railroad bracero, filed health claims on the force of the labor contract demanding U.S. employers rectify workplace safety and health issues, and provide full-coverage of medical bills. The labor contract entitled railroad braceros to a comprehensive form of health citizenship: hygienic housing, food, a safe work environment, access to medical care, and injury compensation. Yet these promises often went unfulfilled. The result was a debate over bracero health inequity and the meaning of health citizenship in the U.S. more broadly. Indeed, the configuration of health citizenship—the scope of health protections, and the parameters defining who had access to health rights—was ambiguous during World War II. The railroad bracero program had, in effect, brought to center stage the question of alienage—what are the limits of non-citizen rights?—in defining the boundaries of health citizenship.

Presented By
Chantel Rodriguez, University of Maryland

Democracy Ends at the Clinic Door: Black Soldiers, Europe, and the Sexual Scripts of Military Citizenship, 1915–1950

The movement of black troops beyond the borders of the U.S. nation state did enable them to map the contours of a global color line; and though subordinated through hierarchies of race, class, and gender, African American soldiers wielded a certain amount of agency—often manifested in their contacts with black, brown, and yellow peoples during World War I and World War II—owing to America’s military and economic power. Combining art, propaganda, and diplomatic sources treating WWI France and Allied-Occupied Berlin, this paper argues that the U.S. military used VD clinics to stage its progress through black soldiers. In WWI France, the experimental salvarsan treatment clinics stood in opposition to the intimacies and aesthetics linking wartime France to black soldiers. Alongside its efforts to re-educate the German people through official policies of “denazification” in post-World II Berlin, the army deployed racial and sexual discourses so as to institute a de facto regime of heroic white American masculinity in occupied Germany. In the arena of public health these discursive signs achieved visualization and dissemination in anti-venereal disease posters that depicted white American male bodies under attack from German women and the sexually transmitted infections they allegedly carried. Meeting transcripts noting the Kommandatura’s efforts to stem the spread of sexually transmitted infections through increased policing of German women and displaced persons bespeak profound racial and sexual anxieties among the American military elite—namely, that African American soldiers, circulating overseas through quartermaster and trucking companies, bore disproportionate responsibility for high rates of venereal diseases in Berlin and beyond, jeopardizing America’s standing among the occupying powers. All this anxiety highlighted the ways black soldiers had crafted a desired and desiring identity through WWII in these cold-war contact zones.

Presented By
Khary O. Polk, Amherst College

Claiming Access: The Chicano Movement and Health on the U.S.-Mexico Borderlands

This paper charts the development of healthcare and the Chicano Movement in the Imperial-Mexicali borderlands. Situated on the U.S.-Mexico borderlands and at the intersection of social movements and labor, this paper demonstrates the push for access to low-cost healthcare rooted in ideas of self-determination and the welfare state. In particular, the paper reveals the financial and social frustrations of politicians and medical organizations as Chicanas/os demanded a health delivery system that was culturally attuned to their needs. As will be shown, the success of the clinic required negotiation with federal and local officials. More importantly, it also required active engagement with peoples on the ground and organizing beyond borders or citizenship.

Presented By
Michael Damien Aguirre, Harvard University

History in the Unraveling Hispanic Paradox: Structure, Politics and Latinx Men’s Health Disparities

Although disparities exist across the spectrum of health for Latino men, much of the current research has focused on a handful of health conditions. In the United States, public health approaches to health disparities are typically driven by biomedical theories and frameworks (Glanz & Bishop, 2010; Glanz, Rimer, & Viswanath, 2008). Yet, these approaches have failed to adequately address disparities experienced by Latino men. This failure is partly due to an emphasis in public health theory on intra- and interpersonal levels of the Social Ecological Model, rather than factors at the organizational, community, and policy levels (Abraido-Lanza, Echeverria, & Florez, 2016). Additionally, and although often ignored, the history of racism and gender socialization is critical to understanding and addressing health disparities among Latino men. The purpose of this paper is to describe patterns of health and mortality among Latino men and the cultural, social, and historical factors that lead to health disparities.

Presented By
Jason Daniel-Ulloa, University of Washington Bothell

Chair and Commentator: Beatrix Hoffman, Northern Illinois University
Beatrix Hoffman, professor of history at Northern Illinois University, is a historian of American health care. She first became fascinated by differences in national health care systems while studying abroad in England, where she was surprised to find that patients never receive a hospital or doctor’s bill. While pursuing a PhD in US History at Rutgers University, she focused her studies on the earliest attempts by reformers in the United States to establish a system of state-sponsored health insurance for workers in the 1910s. Her dissertation on this topic was published in 2001 as a book, The Wages of Sickness: The Politics of Health Insurance in Progressive America.

Professor Hoffman next began a study of the history of the right to health care. Her research on how health care rights have been both implemented and limited in the United States led to publications on rights to care in the emergency room, the exclusion of undocumented immigrants from access, and the history of deductibles and copayments in US health insurance.

Hoffman’s most recent book is Health Care for Some: Rights and Rationing in the United States since 1930, published in 2012. This book argues that the United States has a history of rationing health care in a uniquely American way. This system of rationing awards or denies care based not on medical need but on numerous other factors such as race, residency, employment status, type of health insurance, income, and even age. Health Care for Some argues that Americans must openly discuss our continuing tradition of rationing in order to more productively debate ways to improve the health care system today.

Her work has been supported by awards from the Robert Wood Johnson Foundation, the National Endowment for the Humanities, the Association for Healthcare Research and Quality, and the American Council of Learned Societies.

Presenter: Michael Damien Aguirre, Harvard University
Michael Aguirre is a postdoctoral fellow with the Inequality in America Initiative at Harvard University. He received his PhD in history at the University of Washington, Seattle in June 2019. His dissertation, “The Wages of Borders: Political Economy, Labor Activism, and Racial Formation in the Imperial-Mexicali Borderlands, 1937-1979,” won the distinguished dissertation award from the Graduate School at the University of Washington. Aguirre’s work is featured in the groundbreaking volume, Chicana Movidas: New Narratives of Activism and Feminism in the Movement Era, edited by Maylei Blackwell, Maria Cotera, and Dionne Espinoza, published by UT Press in 2018. In addition, his forthcoming article on labor and citizenship will be part of a special issue of the Southern California Quarterly. Aguirre is also a fellow with the World Economic Forum’s Council on the New Equality and Inclusion Agenda, where he serves as the qualitative and historical voice to issues in the fourth industrial revolution. His research has received funding from the Center for Engaged Scholarship, the Harry Bridges Center for Labor Studies, the Hoover Institution at Stanford University, and the Walter Reuther Library.

Presenter: Jason Daniel-Ulloa, University of Washington Bothell
Jason Daniel-Ulloa earned an MPH in Health Promotion and a PhD in Health Behavior Science at San Diego State University. Then as a postdoc with UNC Chapel Hill, Wake Forest University and then the University of Iowa, he trained to apply principles of Community Based Participatory Research into research and practice with rural Latinx. He started teaching at San Diego Mesa College and San Diego State University as a PhD student and has since taught at University of Iowa in the College of Public Health and the Department of Gender, Women and Sexuality Studies and recently at UW for Health Services (Seattle) and Education (Tacoma).

Jason’s scholarship is guided by principles of community based participatory research and social justice, especially as they apply to the study of health in Latinx peoples. His current work is focused on the health and well-being of Latino men, ways in which concepts of masculinity, class and race promote and impede health individually and collectively. He has experience applying both qualitative and quantitative methods to these issues. He also has experience working in HIV and STI prevention, cancer prevention, physical activity promotion and exploring issues in reproductive health and patterns of alcohol and other drugs use and abuse.

Presenter: John Mckiernan-Gonzalez, Texas State University, Center for the Study of the Southwest
John Mckiernan-González is the Director of the Center for the Study of the Southwest, the Jerome and Catherine Supple Professor of Southwestern Studies, and an Associate Professor of History at Texas State University. His first book, Fevered Measures: Public Health and Race at the Texas-Mexico Border, 1848-1942 (Duke, 2012), treats the multi-ethnic making of a U.S. medical border in the Mexico-Texas borderlands. He co-edited the volume, Precarious Prescriptions: Contested Histories of Race and Health in North America (University of Minnesota, 2013) which examines the contradictions and complexities tying medical history and communities of color together. His broad takes on Latina/os in U.S. medical history can be found in American Latinos in the Making of the United States and in Keywords in Latina/o Studies (NYU, 2017). His next project, Working Conditions: Medical Authority and Latino Civil Rights tracks the changing place of medicine in Latina/o/x struggles for equality. Born in the U.S., he grew up in Colombia, Mexico, and the U.S. South and brings a migrant eye and experience to his projects in public history, medical history, and Latino studies.

Presenter: Khary O. Polk, Amherst College
Khary Polk is an Associate Professor of Black Studies & Sexuality, Women’s and Gender Studies at Amherst College. He attended Oberlin College as an undergraduate, where he majored in English with a concentration in Creative Writing, and received his Ph.D. in American Studies from New York University. Polk has written for the Studio Museum of Harlem, The Journal of Negro History, Women’s Studies Quarterly, Gawker, the journal Biography, and has contributed essays to a number of queer of color anthologies, including Why Are Faggots So Afraid of Faggots?: Flaming Challenges to Masculinity Objectification, and the Desire to Conform, If We Have To Take Tomorrow, Corpus, and Think Again. His forthcoming book, Contagions of Empire: Scientific Racism, Sexuality, and Black Military Workers Abroad, 189-1948, will be published by University of North Carolina Press in Spring 2020.

Presenter: Chantel Rodriguez, University of Maryland
Professor Chantel Rodríguez received her Ph.D. in History from the University of Minnesota in 2013 with a specialization in twentieth-century transnational U.S. history. Her areas of research interest are U.S.-Mexico labor relations, political economy, occupational health, and citizenship.

Her book manuscript, Health on the Line: The Railroad Bracero Program and the Struggle for Health Citizenship during World War II, examines the debates over the health rights of Mexican guest workers laboring on American railroads in order to show that the railroad bracero program played a crucial and under-examined role in shaping the larger twentieth struggle for health citizenship.

Before joining the History faculty at the University of Maryland, Professor Rodríguez was a Smithsonian Latino Studies Fellow in 2012 and spent the 2013-2015 academic years as the Miller Postdoctoral Fellow at the University of Maryland.