Spring 2008 - "Public Health in the City"

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Editorial Introduction

Michael E. Mercier
David Wright
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An Epidemic without Enmity: Explaining the Missing Ethnic Tensions in New Haven’s 1918 Influenza Epidemic

Julia Irwin


Although much of the historiography of urban public health documents scapegoating of immigrant and working- class civilians during onsets of epidemic disease, the 1918 influenza epidemic in New Haven, Connecticut, suggests a very different story. A large number of industrial working-class Italians made up a significant proportion of the city’s population. During the epidemic, Italians succumbed to influenza at nearly twice the rate of other residents. But, contrary to historiographic expectations, the New Haven story is one narrated by piercing silences and a distinct lack of hostility towards the immigrant community. These silences must be understood as a product of the period’s political and social context. Influenza struck New Haven during the closing months of the First World War, a period marked by calls for unity, cooperation, and fierce patriotism. As Anglo citizens emphasized Americanism and assimilation, the Italian community’s middle- class leadership largely acquiesced. Italian editors, physicians, business-owners, and other professionals used the epidemic period to construct a new public face of the Italian community as a modernized, patriotic, and responsible ethnic group. Simultaneously, New Haven’s nationally renowned public health officials embraced a wartime vocabulary of voluntarism and civic obligation to alter civilian behaviours. They encouraged education and gentle persuasion in hygiene over more forceful coercion. Together, these community responses to influenza helped to quell potential hostilities. However, they also masked persistent inequalities in Italian health and limited the potential for real urban reforms of immigrant housing and health. Italian- and English-language publications demonstrate the diverse meanings of the influenza epidemic for different groups within the city. They also illustrate the many ways these groups used the epidemic to construct new definitions of citizenship and proper behaviour.
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Public Health, Yellow Fever, and the Making of Modern Tampico

Glen Kuecker


This essay uses the Mexican port city of Tampico as a case study of the relationship between nation-state formation, urban transformation, and public health policy during the late nineteenth century. It examines a virulent yellow fever epidemic in 1898 to illustrate how Tampico’s urban transformation generated conditions for the epidemic, and how public health officials addressed the challenge of combating the epidemic. Special emphasis is placed on how officials used quarantines in a failed attempt to contain the problem. As a result of its limitations, national authorities came to perceive quarantines as antithetical to the project of the modern nation-state, leading them to adopt urban sanitation projects as substitute. Local and state authorities, however, retained their faith in the quarantine, often out of a desperate need to protect their populations and commerce. The battle against yellow fever constituted part of an important shift in public health authority from the control of local officials to national authorities, which further consolidated the power of the nation-state. The essay concludes with consideration of the implications of Tampico’s 1898 epidemic for a history of circum-Caribbean port cities.
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Preparing for the Pandemic: City Boards of Health and the Arrival of Cholera in Montreal, New York, and Philadelphia

John B. Osborne


This paper compares the responses of city officials in Montreal, New York, and Philadelphia to the cholera epidemic of 1832. In the absence of a medical consensus on the cause or contagious nature of the disease, physicians recommended a variety of preventive/protective measures ranging from quarantine to isolation hospitals to city sanitation. Significantly, prejudices toward immigrants, the working class, and particular ethnic groups influenced the city leaders’ response to the epidemic as much as the opinion of medical experts. Of the three cities, Philadelphia experienced the lowest death rate during the epidemic—a success that contemporaries attributed to the city’s hygienic/sanitation program but was due to the clean supply of drinking water from the city’s state-of-the-art waterworks.
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A Janus-Like Asylum: The City and the Institutional Confinement of the Mentally Ill in Victorian Ontario

Shawn Day
Nathan Flis
Jessica Smith
David Wright


This paper examines several aspects of the complex relationship between the city and the Victorian lunatic asylum. The first part of the paper demonstrates that the urban-ness of the public mental hospital has been a point of some degree of ambiguity. Mental hospitals were Janus-like—looking forward to the emerging urban world and yet, at the same time, looking back to a romanticized, rustic past. The second part of the paper adopts a quantitative approach and reveals that, far from the receptacle of strictly urban dwellers, the mental hospitals received a remarkable number of mentally ill from rural regions of the province. This finding, derived from one of the largest database studies of mental hospital patients ever undertaken, revises an important and longstanding argument in the historiography of the North American mental hospital.

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