Science  /  Antecedent

America’s Medicalized Borders: Past, Present, and Possible Future

Undoing the politics of fear will require us to reckon with the legacies of nativism that divert our attention from the greatest threats to our health.

The notion that immigrants are sources of disease and racial degradation has been a foundational element of US national discourse for generations. Though the two statements above are separated by nearly 100 years, their stunning similarities demonstrate an ideological continuity running through this country’s history. Yet while much has been made of former President Trump’s echoing of fascist rhetoric in the vein of Adolf Hitler, news media has done little to reflect on the profoundly American origins of his recent statements.

If we intend to understand the continued salience of such views, it’s necessary to excavate their sordid roots, particularly on this year’s centenary of the Immigration Act of 1924—a law that was the culmination of years of anti-immigrant pathologization. Reflecting on the past and present manifestations of “border medicalization”—the process by which immigrants are stigmatized and treated as inordinate bearers of dangerous diseases—is necessary for recognizing and resisting its new and emerging forms.

The Past

In the late 19th century, new bacteriological understandings of disease transmission emerged. These, in turn, fused with a new xenophobic panic, which responded to the growing arrival of immigrants from eastern and southern Europe and Asia.

These new immigrants became widely viewed as carriers of the most pernicious infectious diseases ravaging the United States at the time, such as cholera, syphilis, smallpox, typhus, and trachoma. Such diseases were already prevalent in many parts of the US, and there was little evidence that immigrants were a significant source of contagion. Still, prominent medical and political leaders played an important role in portraying stigmatized foreigners as uniquely pathogenic.

In his 1876 official address as president of the American Medical Association, J. Marion Sims proclaimed that “Chinese syphilis” had reached epidemic proportions in California because of the arrival of Chinese women whose “presence necessarily breeds moral and physical pestilence.” Such malevolent depictions of Chinese women, who were assumed to be imported sex workers, were critical in building political support for the 1875 Page Act, the first federal law to restrict immigration into the United States.