Tuberculosis and the Politics of Exclusion: Los Angeles, 1880-1940

Although tuberculosis has received enormous attention from U.S. medical and public health historians, most focus on the east coast, especially on New York City. This paper, by contrast, examines the public health response to the disease in Los Angeles at the turn of the twentieth century. Officials emphasized the prevalence of the disease among immigrants, depicted them as agents rather than victims of disease, and called for border control. Nevertheless, the tuberculosis story unfolded differently in Los Angeles for several reasons. First, although notorious for its polluted air today, the metropolis once billed itself as a health resort. Members of the white elite were especially ready to embrace an exclusionary strategy because they viewed themselves as a uniquely blessed people. They could sustain an illusion of invulnerability only by banishing anyone identified with weakness and danger. Second, migrants poured into Los Angeles not only from other countries but also from the eastern United States. The identification of tuberculosis with “tramps” during the 1890s and “inter-state migrants” during the 1930s provoked exclusionary measures against both groups. Third, the major immigrant group to California came from Mexico rather than eastern and southern Europe. Most arrived during the 1920s, by which time immigration from Europe had greatly diminished. Because many Mexicans worked in agriculture rather than in industry, they were assumed to pose a grave threat to the food supply. They also encountered uncompromising discrimination. The identification of tuberculosis with Mexicans during the 1920s hardened the perception that they did not belong in Los Angeles. Many public health officials were convinced that Mexicans had an innate susceptibility to the disease. Concerns about the cost of supporting tubercular Mexicans figured prominently in efforts to restrict their immigration in the 1920s and in the deportation and repatriation drives of the 1930s. As a result of those drives, the Mexican population of Los Angeles declined by a third.