Studying america’s eugenics era through an elsi lens: Mixed methods study design and public health relevance

Nicole Novak, PhD, MSc1, Alexandra Stern, PhD2, Kate O'Connor, MPH, PhD(c), Project Manager of the Sterilization and Social Justice Lab at the University of Michigan2, Natalie Lira, PhD3, Siobán Harlow, PhD2, Sharon L.R. Kardia, PhD4 and Johanna Schoen, PhD5
(1)University of Iowa, College of Public Health, Prevention Research Center, Iowa City, IA, (2)University of Michigan, Ann Arbor, MI, (3)University of Illinois at Urbana/Champaign, Urbana, IL, (4)University of Michigan School of Public Health, Ann Arbor, MI, (5)Rutgers University, New Brunswick, NJ

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From the passage of the first US state sterilization law in Indiana in 1907 until the 1970s, approximately 60,000 people were sterilized based on eugenic criteria designed to prevent the reproduction of the “unfit”. We present the study design and findings from a mixed-methods study of eugenic sterilization in four US states. Our interdisciplinary collaboration between historians and epidemiologists integrates quantitative and qualitative analysis of over 30,000 sterilization requests from California, Iowa, North Carolina and Michigan to capture a multiregional and layered understanding of eugenic sterilization in the United States in the 20th century. We produced de-identified eugenic sterilization datasets for each state, including data on the gender, age, race, ethnicity, nationality, diagnosis, and institutional home of patients considered for sterilization. We analyze eugenic sterilization datasets in conjunction with individual-level Census microdata to estimate and calculate population-based sterilization rates. We integrate quantitative findings with in-depth qualitative analysis of notes on patient forms to generate a richer understanding of the experiences of people sterilized during the eugenics era. This study provides new scholarly knowledge about the ways in which a particular variant of genetic determinism resulted in the widespread state-mandated deprivation of reproductive capacity. Eugenic stereotypes about race and ethnicity, gender, sexuality, and intellectual disability influenced state intervention into the reproductive lives of institutionalized and vulnerable persons. Our findings can serve as a backdrop for contemporary conversations about the extent to which concepts of normality, disability, and genetic stigmatization can insinuate themselves into the norms of disease prevention and human improvement.

Epidemiology Ethics, professional and legal requirements Public health or related laws, regulations, standards, or guidelines Social and behavioral sciences