City of Plagues : Disease, Poverty, and Deviance in San Francisco

Disease may not discriminate, but it helps those who do. When smallpox struck many areas of San Francisco during the nineteenth century, the Chinese were only one of the populations affected, yet they were blamed for its spread. Tuberculosis in the early twentieth century disproportionately affected poor immigrants, but it also negatively informed social policy about poverty and poor neighborhoods. Addressing these diseases meant undertaking social, physical, and symbolic realignments of the city, processes that come into sharp relief in City of Plagues, an absorbing look at the role of disease and health policy in the construction of race, gender, and class, and in urban development in nineteenth- and twentieth-century San Francisco.Because of its association with medicine, health policy is generally perceived as objective. Yet, as this book demonstrates, its interpretive responses to disease have determined the social location and material reality of those groups at real or perceived risk. Focusing on San Francisco between 1860 and 1940, Susan Craddock considers tuberculosis, plague, smallpox, and syphilis as diseases whose devastations were derived in part from their use as political tools and disciplinary mechanisms. She shows how health policy, by concentrating its responses to smallpox and plague on Chinatown and the Chinese, profoundly influenced the physical look and social location of the Chinese community. She also reveals how the city's antituberculosis campaign, while leaving the disease's root causes untouched, promoted social and domestic restructuring, particularly in its emphasis on women's roles as "health-gatekeepers", maintainers of the values of hygiene,nutrition, and sanitation. Recent instances of AIDS in San Francisco and tuberculosis in New York suggest that little has changed -- and that, as Craddock argues, unless health policies begin to address economic inequity, poor housing, and racial and gender discrimination, then disease will continue to characterize and shape urban society.