Chapter 5 Formations of Racial Health Projects

Epidemics in Colonial Settlements

Treating emerging diseases as racial problems can be traced back to the Spanish conquest. When California transitioned from a Spanish colony to a Mexican republic (1823), the most significant factor in colonial efforts to overcome Indigenous resistance was disease. Epidemics of smallpox, syphilis, diphtheria, chickenpox, and measles caused the suffering and deaths of Indigenous children and adults throughout the territory (E. Castillo, n.d.). The population size was devastated by newly introduced viruses, but hundreds of thousands of the Indigenous people of California sought hiding to regroup while keeping out of sight of new settlers and their ongoing extermination technologies.

Anthropologists often cite that at least three hundred thousand Indigenous people resided in the territory before colonial contact, though Indigenous scholars consider this a low estimate and argue that the size of the population was much larger when considering their expansive networks and the one hundred or more languages spoken among the California natives (Trafzer and Hyer 1999). Colonialism and its introduction of ranching, agriculture, and other economic developments caused a mass decline of the Indigenous population because these developments decimated key resources that were used for sustenance, spiritual and nutritional. Death from epidemics reduced nearly 50 percent of the Indigenous population in California by the time of the American takeover in 1850 (E. Castillo, n.d.). The first recorded epidemic devastated the Santa Clara Valley Costanoan people in 1777. Twenty-five years later, pneumonia and diphtheria spread from Monterey to Los Angeles, primarily killing Indigenous children. In 1806, an outbreak of measles devastated the Central Coast native population from San Francisco to Santa Barbara. More than twenty thousand Central Valley Miwok, Yokuts, Wintun, and Maidu natives perished from malaria, which was carried by fur trappers from Oregon to the Sacramento and San Joaquin River drainages in 1833.

By the start of the California gold rush, the persecution and murder of Indigenous people, especially of women and children, were systematic and institutionalized. Armed military and militia bands were reimbursed for the accrued costs for enslavement and murder by government officials (Trafzer and Hyer 1999; E. Castillo, n.d.). These combined forms of direct violence were catastrophic for the Indigenous population. The greatest loss of life was between 1848 and 1868, when more than one hundred thousand California natives died from malnutrition, enslavement, persecution, and rape and murder (Trafzer and Hyer 1999). Today, the Indigenous population has grown because, after California’s annexation, many survived through hiding, strategic counterattacks, and land negotiations.

The U.S. settlers established themselves as trustees of Indigenous land use. In addition to persecution and murder, white settlers placed native children in boarding schools. The displacement of young children away from their communities resulted in generations of loss of languages, customs, and knowledge about traditional land stewardship practices. These additional forms of genocide institutionalized hunger and the decline of cultural knowledge (Norgaard, Reed, and Van Horn 2011). The first two years of the gold rush were especially brutal due to widespread and random murder of nearly one hundred thousand Indigenous people at the hands of miners and paramilitary groups in California (E. Castillo, n.d.).

The near obliteration of the Indigenous people following the disastrous consequences of seventy years of epidemic outbreaks and disease, along with the tactics of brute force and hunger, attracted the interest of white American physicians, but in ways that reinforced rather than reduced the racial distribution of illnesses. California served as a living laboratory for miasmic studies on the link between the environment and health, the primary approach in medicine of the time (Nash 2007). Physicians and medical researchers noted correctly that different climates create different kinds of disease outcomes, but they concluded incorrectly—and self-servingly—that nonwhite bodies were immune to high temperatures and damp marshes. In a period of profound population changes, physicians argued that the coastal region’s salubrious properties were ideal geographies for the procreation of a “sturdier and more attractive breed” of white settlers (44). See also Thompson 1969. The Central Valley with its record high temperatures and marshes, however, was considered ripe for disease and, thus, unsuitable for white people. By 1877, the California State Board of Health acknowledged that “scarlet fever, measles, diphtheria, influenza, typhoid, phthisis (consumption), and various forms of dysentery and intestinal disease” were part of the Central Valley’s “natural” landscape (Nash 2007, 37). The regional dangers of disease, especially for white settlers, fueled debates about what kinds of transformations were desirable and how to judge their effects. It propelled physicians to recommend dedicating the Central Valley region to farming.

California physicians of the nineteenth century, such as Thomas M. Logan, made it seem possible and desirable to develop the Central Valley using the labor of nonwhite people. They argued that people with Black, Asian, and mixed-race descent were naturally immune to tropical conditions (Nash 2007). When Native Americans showed susceptibility to the kinds of diseases that white people suffered, Logan, like other physicians, argued that it was their “un-civilized” behaviors that would inevitably cause them to perish as California continued to transform and grow. White American physicians became the storytellers of mythical fables about the biological differences of racialized groups in order to reconcile the inherent contradiction in the new frontier. The region was “both an undeveloped resource and a pathogenic place” (Nash 2007, 51). Under this approach to American colonization, white physicians cocreated a narrative with early settlers that saw themselves apart from nonwhite people as paradoxically more vulnerable to certain diseases because of their race yet also singularly destined to enjoy the full fruits and benefits of settlement.

According to these stories, the biology of nonwhite immigrants made them ideally suited for hard labor under dirty and dangerous conditions, for being denied adequate nutrition, and for living in crowded, dark, and damp dwellings that exposed them to the risks of tuberculosis, cholera, and malaria (Shah 2001). These narratives were quickly adopted in San Francisco and other destinations where Chinese immigrants continued to arrive since the gold rush (Shah 2001; Molina, HoSang, and Gutierrez 2018). The most vehement opponents of Chinese immigrants were members of labor unions in San Francisco, as some had been among the early miners migrating from the South (Chen 1980). Other opponents included real estate agents and building owners who collaborated with city officials to hoard resources and opportunities in white neighborhoods of the emerging cities while concentrating housing for nonwhite residents in segregated areas of the city (Shah 2001). They jammed Chinese workers into tiny, dark, and overcrowded dwellings. Slaughterhouses and meat processing factories legitimated dumping their by-products into open ponds near sites where nonwhite immigrants lived. When nonwhite immigrants did contract diseases in large numbers, white people attributed the infirmities to immigrants’ cultural practices and biological deficiencies. Xenophobic residents in San Francisco presented aggressive exploitation and immiserating conditions as a form of self- defense. Segregationists extended the reach of the Jim Crow laws from the South into the Pacific Northwest, citing an international threat from China on the Western horizon.

The Burlingame Treaty of 1868 was a binational agreement that recognized Chinese and white people’s rights to free migration into and out of both countries. It held that they were to be respected as citizen subjects and allowed to travel for “the purpose of curiosity or trade or as permanent residents,” though the United States did not grant naturalization to Chinese immigrants (as cited in Chen 1980, 128). The agreement provided Chinese immigrants access mainly to jobs in the United States with few health protections. Chinese immigrants entered San Francisco’s garment industry. Some established their own businesses and many joined the ranks of the Central Pacific and Transcontinental railroad employees connecting the West and the East (see McCain 1994). In the Central Valley, contractors sought Chinese immigrants as workers to lay down railroad tracks. The growers used their labor for projects diverting water into farms, pulling out brush and trees, and digging canals that would set the stage for industrializing agriculture (Ngai 2004). The foundations of the California agriculture economy were made possible because of Chinese immigrant labor. As a labor force, they reorganized the natural ecologies in ways that made water, land, and sunshine into desirable resources. But unlike the global citizenship stipulated in the binational agreement, Chinese immigrants were offered the lowest wages under far worse conditions than most white working citizens. Their poor health became the currency that subsidized the industry.

In an era when medical racism categorized nonwhite people as contaminated, California physicians treated foul or “bad” odors as causes of diseases, which was a key attribute of the miasmic theory. Notions about what was good or bad air set in motion the development of statewide sanitation programs purported to remedy noxious air and, subsequently, to reduce disease outbreaks (Nash 2007). Physicians collaborated with elected officials to reengineer cities and residential neighborhoods. These environmental changes included building sewer lines, treating drinking water with chloride, sealing trash cans, and paving the streets. The collaboration and comprehensive sanitation efforts were not extended to San Francisco’s Chinatown, however (Trauner 1978). During a congressional investigation of San Francisco’s Chinatown in 1877, Dr. A. B. Stout, a member of the California Board of Health, stated to the committee that “the city authorities undertake to clean the city in other parts, but the Chinese are left to take care of themselves and clean their own quarter at their own expense” (Trauner 1978). Chinese residents became the assumed responsible party for their community’s health, even when the racist and exploitative practices of private and public investors benefited from the very social and ecological conditions causing illness, such as overcrowding, poor sanitation, and toxic hazards.

Germ theory was a central concern in the field of bacteriology in the late nineteenth century but was not widely adopted during the early American takeover of California. The most feared diseases to humankind were isolated as organisms beginning in the 1880s: typhoid fever (1880), tuberculosis (1882), cholera (1883), diphtheria (1883), and bubonic plague (1894) (Trauner 1978). Germ theory should have challenged the racist conceptions of biological risk through its scientific discoveries of zealous microscopic organisms causing deadly ailments. However, germ theory was of little import for public sanitation efforts across nonwhite communities, and it would remain irrelevant during the ethnic succession of farmworkers in the Central Valley. In other words, the era of medical progressivism did not alter long-held views that nonwhite communities were undeserving of disease prevention.

The “hot spots” of illnesses in rural and urban areas that emerged due to uneven development presented miasmic theorists and physicians with a hybrid ideological approach to health: people were the carriers of diseases and environmental conditions would contribute to those ailments. Anti-Black and anti-Indigenous racism and xenophobia blended the emerging germ theory with the managing of environmental conditions through the miasma lens as a central way to address disease outbreaks (Nash 2007). Immigrants, but especially Chinese people, were viewed as the carriers of diseases, giving credence to the social taboo against race mixing as a biological threat to white bodies. State laws prohibiting marriage between white people and Black people or Native Americans were revised in 1905 with the added term “Mongolian” (Karthikeyan and Chin 2002). Chinese residents became medical scapegoats based on a fear of contamination (Trauner 1978). The patterns of exclusion from disease protections were replicated in Chinese communities across the United States.

Narratives about cultural and biological threats have long pervaded the Central Valley. The first group of Chinese immigrants who settled in Fresno County arrived as contracted workers for mining and construction jobs; some arrived to operate their own businesses in the 1850s (Chacon 1988). Many of the workers were housed near Fort Miller, Coarsegold, and Millerton, where there were gold mining operations along the San Joaquin River near a military post that supplied commerce with added security against theft. When Chinese merchants were more successful at selling products to both Chinese and white workers, and outcompeted white merchants, the town’s white leaders discussed the issue and voted to ban all Chinese residents from residing near the white settlers. White miners adopted narratives about the Chinese immigrants’ allegedly unassimilable moral qualities, complaining of workers’ strange nutritional habits, language, religion, and dress, as well as the practices of bathing daily in the river after a twelve-hour workday and not drinking the river water. White settlers feared social and cultural, as much as biological, contamination. They mocked the practices of Chinese immigrants as threats to whiteness and forced them out of view, one mile outside of the Millerton area. These tactics achieved the desired economic outcomes and protections for white settlers. Segregation became an acceptable strategy that was repeated and applied in the growing cities of Stockton, Merced, Fresno, and Bakersfield.

The fear of contamination reemerged when the Central Pacific Railroad hired contracted Chinese workers during the 1870s. Upon completion of the Fresno Station in 1872, many of the workers settled in the growing town (Chacon 1988). Chinese and white workers from the Millerton area flocked to Fresno, drawn by its central geography and the new station that provided access to dispersed regions of the state. By 1874, Fresno had a population of six hundred residents, two hundred of whom were Chinese. Most of the Chinese residents were male workers, and a few of them were merchants with some political influence. The estimated ratio of male to female Chinese immigrants was 20:1, while for white people it was 10:1, a gender imbalance influenced by the Page Act of 1875 (Lee 2003). Fresno’s established Chinese residents served the incoming immigrants as a source of credit, linguistic accessibility, and cultural and religious affirmation, as well as a social network for discussing and securing employment on farms (Chacon 1988). They built on their shared sense of community as immigrants in a place with growing xenophobia.

White segregation in the neighborhoods east of the station’s tracks led to the emergence of Fresno’s Chinatown to the west. Prohibited from expanding, the Chinese residents built in every direction possible in a small section of a few blocks in the still growing town (Chacon 1988). Basements connected through elaborate tunnels linked many of the buildings on the street surface, where storefronts and apartments rose upward. Some of the basements were used to house incoming immigrants. The tunnels were also likely used for more discrete transactions such as sex work, gambling, and hiding from the frequent police raids due to anti-Chinese politics.

Fresno’s Chinatown did not simply serve the large growers’ labor needs, it also created a porous sociocultural border, where white and Chinese workers commingled and cocreated spaces that deepened a shared sense of belonging. It was a time when female companionship was scarce, when anti-Chinese legislation was growing, and when medical debates about white people’s physical acclimatization to the valley was still in question. Upon completion of seasonal farmwork, many laborers could reconnect with friends, form new relationships, and make quick money through gambling in the vibrant social life that Chinatown offered (Chacon 1988). This life contrasted with the isolation and cold tents provided by growers in distant fields.

The surrounding landowners depended on Chinatown becoming the central place to find contractable nonwhite immigrant farm labor. The growers hired immigrant farmworkers at this site for nearly one hundred years, well into the 1960s (Chacon 1988). Chinese laborers, merchants, railroad engineers, and Eastern medicine specialists and doctors established communities throughout the Central Valley. Chinatowns emerged in Stockton (Sun Minnick 2002), Merced (Martinez 2021), Visalia, Hanford (Chen 2021), Bakersfield (Boyd and Ming 2002), and smaller settlements along the Delta and Sierra Nevada foothills.

Disease continued to provoke segregation rather than sanitation. Outbreaks of syphilis in Fresno and other urban areas across the state were viewed as evidence of moral failings stemming from the recreational activities of gambling, opium use, and sex work, though these activities were taking place both inside and outside of the red-lantern districts (Chacon 1988). Dr. H. H. Toland (founder of the Toland Medical College, subsequently the University of California Medical School) testified to a congressional investigation committee in 1877 and claimed that most venereal disease cases in San Francisco could be traced back directly to sex workers. Chinese sex work was viewed as the source of the “most terrible pollution of the blood of the younger and rising generation” (as cited in Trauner 1978, 75). White and Chinese sex workers both suffered from sexual transmittable diseases, but only Asian sex workers were the target of public defamation (Trauner 1978). They were condemned as immoral, suspected of being promiscuous, unvirtuous, and contaminated, and determined to be a threat to the white patriarchal and heteronormative nuclear family (whose husbands’ and fathers’ infidelity was taken for granted and neither policed nor condemned). This rhetorical frame was economically motivated but was depicted as a public health strategy. By morally and spatially containing disease, elected officials protected the economic investments of the state, while public health authorities made it possible to imagine syphilis as a moral vice contained within geographic and biological boundaries and the culturally specific behaviors of aggrieved racialized groups.

In the eyes of most state authorities and medical experts, disease outbreaks in Chinatowns were not simply local concerns but rather a national security problem that hindered colonial projects. The earliest anti-Chinese immigration policy, the Page Act of 1875, was justified by its supporters as a response to the rise of transmittable diseases (Trauner 1978) but was also motivated by concerns with the increased competition facing white immigrant workers. The Workingman’s Party (Lee 2003) organized anti-Chinese mobilizations, pointing to the deplorable conditions in Chinatowns throughout the United States without acknowledging these stemmed from racist ideas about sanitation (Nash 2007). Under the Page Act, all Asian women, but especially Chinese women, were presumed to be sex workers servicing men. This formulation became the rationale for a national politics committed to limiting Asian female immigration. It denied entry of any Chinese woman who was allegedly contracted for “immoral purposes” and required Chinese women to undergo humiliating procedures intended to confirm that they were not entering for sex work (Ming 2010). The authority was given to a consul officer, a white male official stationed in Hong Kong, to permit or deny entry. Many women simply did not show up to undergo the humiliating process, but some did pay bribes to secure passage (Lee 2003). The beliefs about Chinese women’s alleged immorality contributed to an even more skewed male-dominated labor force. In turn, this sparked hopes among some white people that fifty thousand Asian immigrants would return to China. As Shah (2001) demonstrates, however, this policy also produced a gender imbalance in Chinese communities that was then used to argue that they were abnormal, deviant, and unassimilable.

Public officials from California appealed to Congress for broader legislation to protect the privileges of economic and biological whiteness, invoking the Chinese Exclusion Act of 1882. This act absolutely suspended the Chinese immigration of skilled and unskilled workers into the United States for ten consecutive years. Exceptions for entry were reserved for teachers, students, and wealthy Chinese merchants. The act also granted all Chinese residents permanent alien status and thus made them ineligible for citizenship. The Geary Act (1892) extended the exclusion for an additional ten years with the added provision that immigrants were required to carry a certificate of residence, a precursor to the green card. If Chinese immigrants did not present one, they were subject to detention and then deportation. In the 1924 Immigration Reform Act (Johnson-Reed Act), a quota system was created based on the national census data of 1890 (after the ban of 1882) (Haney Lopez 2006). Fifteen pieces of legislation were presented at this heightened period of anti-Chinese xenophobia and violence. Local and national legislation forbid Chinese immigrants to testify in court against white people, own property and land, hold commercial and professional licenses, attend white schools, and marry white people (Ngai 2021; Loh-Hagan et al. 2022).

These new forms of economic and political repression not only mirrored aspects of the Jim Crow laws of the South but also eerily reflected the influence of a distorted representation of germ theory. When epidemics broke out in San Francisco’s Chinatown, such as the case of leprosy in 1875, immigrants were forced to quarantine at the “lepers’ quarters,” a makeshift hospital that served only Chinese residents. The physicians at these quarters collaborated with the port immigration authorities to deport Chinese people who evidenced symptoms of leprosy (Trauner 1978). When a bubonic plague epidemic emerged in the Chinatown of Honolulu, Hawaii, in 1899, public health officials recommended that all the buildings of the Chinese quarters be burned down; forty-five hundred people were displaced into tents because of this order. When cases of bubonic plague were detected in San Francisco’s Chinatown (1900), sanitation officials were sent to disinfect sewers and dwellings with sulfur dioxide, a dangerous gas pollutant formed when burning coal, petroleum, or diesel. Health officials attempted to detain immigrants in a concentrated camp, displacing about seven thousand Chinese people (Trauner 1978). This attempt nearly succeeded but was voided by a circuit court decision. The governor of California, Henry Tifft Gage and his appointees in the State Board of Health “opposed all (bubonic) plague control efforts and refused to allow inspection of other California cities where plague was rumored to exist” due to fears of injuring business investments (Trauner 1978, 79). Two years later, San Francisco health officials ordered the condemnation of all wooden basements, most of which were in Chinatown. At almost every major outbreak of disease, Chinese immigrants faced displacement, detention, or deportation. The collaboration between medical authorities, government officials, and business investors, including land developers, cocreated a social lens for understanding diseases as foreign in origin and almost always a potential threat to whiteness. In the face of disease outbreaks, economic investments could still be made and protected so long as public authorities could treat diseased bodies as segregable and removable.

Despite pervasive exploitation and subordination, Chinese immigrants in the United States rebuilt, reconnected, and reimagined a vibrant political life at every turn. When the wave of anti-Chinese politics took hold nationally, Mexicali (in Baja California, Mexico) became the primary destination for Chinese immigrants. The subterranean cultural hubs of Mexicali’s La Chinesca neighborhood were flourishing in the wake of the passage of the Chinese Exclusion Act (Warren, Yu, and Ruiz y Castello 2015). The U.S.-Mexico border was isolated from the interior regions of Mexico and buffered from national debates by the South. The Colorado River Land Company (CRLC) acquired an expansive amount of territory near the international border of the Mexicali Valley. The CRLC sought Chinese workers from Mexicali because they had valuable knowledge of and experience with farming. Despite the ban on Chinese immigration, Chinese residents were key to developing CRLC lands for the massive production of cotton. The higher wages paid in the United States and a growing sense of community in La Chinesca generated a North Pacific Ocean migration stream that benefited U.S. industries well into the Great Depression. It also, however, led to improvising new ways of living in Mexicali. The numbers of Chinese merchants, distillery dealers during prohibition, Eastern medicine specialists and doctors, and farmers grew in Mexicali. Interracial marriages, diverse family structures, and varied social and political involvement emerged in ways that generated borderland lives in every sense of the word.

Reclaiming a sense of belonging at the U.S.-Mexico border required Chinese residents to craft a safe means of passage. Many built underground tunnels across the border for farmworkers to travel between Mexicali and the Imperial Valley and its growing cotton industry, though many also used aboveground smugglers (Warren, Yu, and Ruiz y Castello 2015). American wages offered by the CRLC and other growers financed remittances to China and provided funds for supporting the growing binational families in Mexicali. These acts of insubordination among Chinese immigrant farmworkers led to a “hardening” of the international U.S.-Mexico border with custom line riders or “Chinese inspectors” patrolling the international line on horseback (68). Nearly forty years after the Chinese Exclusion Act, Mexicali’s census indicated that 44 percent of its population was Chinese, 30 percent Mexican, 20 percent American, and 6 percent Japanese (1921).

At the height of Mexican repatriation from the United States during the Great Depression, the Mexican government introduced land reform policies and seized lands owned by large foreign corporations in 1937. The land reforms sought to resettle Mexican peasants as landowners. Many Chinese farmers and renters were violently forced to leave Mexicali altogether, though many remained in La Chinesca, establishing small businesses, pharmacies, and an enduring Chinese community on the borderland.

Multiracial Farm Labor Resistance

Anti-Asian state and federal legislation profoundly shaped the labor and health practices that subsequent immigrants faced in California. The virulent racism of large growers provoked leftist Japanese labor organizers Tetsugoro Takeuchi and Iwasa Sakutaro to oppose growers’ exploitative behaviors in the Central Valley (Yamazaki 2020). Takeuchi and Sakutaro cofounded the Fresno Federation of Labor in 1907, echoing and amplifying anti-capitalist views and discussions among Japanese American workers and students. They organized Japanese farmworkers’ walkouts, negotiated higher wages, and broke labor contracts when growers changed their conditions of employment. The success of the Fresno Federation of Labor was strengthened by organizing across racial lines, a strategy modeled by the Japanese-Mexican Labor Association farmworker union in Oxnard, California, in 1903 (Almaguer 1984). The multiracial strike in Oxnard by Mexican and Japanese farmworkers was led by Kosaburo Baba, the association president, in response to the replacement of Japanese contractors by the Western Agriculture Contracting Company, which was a coalition among wealthy white bankers, the Oxnard Sugar Beet Company, and sugar beet farmers who imposed depressed wages on workers and secured the profits of labor contracting for the coalition. In Fresno, the Fresno Federation of Labor mobilized over four thousand Mexican, Italian, and Japanese farmworkers in response to decreased wages and similar exploitative arrangements (Yamazaki 2020). The lessons of multiracial organizing equipped farmworkers with knowledge about negotiations and strategies that involved strikes and collective bargaining. Their success reached Japanese and other immigrant farmworkers across the United States, including organizers in Hawaii during the 1920 Oahu sugar strike led by the alliance between the Filipino American Labor Union and the Japanese American Federation of Japanese Labor. The Fresno Federation of Labor leadership was influential in the Los Angeles–based Japanese Workers Association, united under the name of Nihonjin Rodo Kyokai in 1924, which organized a broad constituency of Japanese workers including domestic workers, gardeners, and farmhands. With the growing national strategy to deport Asian immigrants, the Japanese Workers Association founded the International Labor Defense office in Los Angeles (1927) to defend immigrant workers from deportation. Workers across racial groups gained valuable skills to counter the threats of labor exploitation and deportation, which came to characterize nonwhite immigrant farmwork.

The workers’ practices of insubordination included the unification of Japanese families with relatives in the United States, which strengthened the possibilities of acquiring land and using long-term property leases. Japanese families organized farming cooperatives to support new Japanese farmers; some paying for the initial costs of starting the business, as well as providing loans for farm machinery (Yamazaki 2020). Japanese farmers further nourished relationships with local grocers to supply fresh produce, while unsold supplies were sent to distant outdoor markets or swap meets (Historic Research Center, n.d.). In Bakersfield, when a family experienced an economic hardship, the members of the Japanese Buddhist Temple provided mutual aid; sometimes extending support to neighbors who were neither Buddhist nor Japanese. California agricultural landholdings by Japanese and Japanese Americans grew from 61,858 acres in 1905 to 281,687 acres by 1913 (Galarza 1977). Using elaborate cooperatives and deep social connections, Japanese families put 450,000 acres of land into production throughout California by 1920 in diverse sectors of agriculture, though together they accounted for less than 10 percent of the population (Galarza 1977). The Japanese farmers’ success in building up their businesses threatened the boundaries of exclusion that the anti-Chinese legislation had promised to defend. Many of the children of farmers sought careers, bought property, expanded businesses, and moved out of the vicinity of Chinatowns where many were initially forced to reside. Landholdings and successful entrepreneurs became targets for anti-Asian elected officials and competitors threatened by their success. The loud and frequent complaints brought by elected leaders, growers, and business owners were heard by President Theodore Roosevelt who responded by negotiating the Gentlemen’s Agreement (1907). As a binational agreement with Japan, it agreed to restrictions on the distribution of passports to nonlaborers who had established a former address in the United States and to people joining parents, wives, and children living in the U.S. territory. Japanese exclusion was made implicit in the California Alien Land Law of 1913, prohibiting “acquiring, possessing, enjoying, or transferring real property or any interest therein” to people ineligible for naturalized citizenship (Ferguson 1947, 67). These policies were intended to diminish the possession of property by Japanese immigrants and their families (Lyon 2024). The dispossession of Japanese American landholdings was solidified with their displacement and deportation to prison camps during World War II.

The Succession of Ethnic Farmworkers

Small victories were won by labor at the turn of the twentieth century after long and bloody political battles with growers who often secured the support of the police force to squash labor movements into defeat, sometimes resulting in the deaths of workers (Almaguer 1994). Yet, few white workers would accept what were considered publicly “coolie” and later “wetback” wages. By 1905, rural settlements in the Central Valley were marked as nonwhite places, or, as U.S. Senator James Phelan expressed, Japanese farmlands in Merced County had “destroyed the area for white settlement and the desirable element” (as cited in Ngai 2004, 39). The growers deepened the racialization of farmwork and the spatialization of race in rural Central Valley with each new succession of ethnic immigrants, a force of labor that was highly desirable as nonpermanent.

Hiring Japanese, Armenian, Hindu, Portuguese, Yemenite, Filipino, and Mexican immigrants, each with their own language, culture, and reasons for migration, became the preferred strategy to farm the region and manage labor in it (David Weber 1970; Bisharat 1975a). The growers hoped to codify contract labor as a way of controlling production and profiting from it but not acknowledging that workers were humans who had complex and dynamic lives. Language and cultural differences presented farmworkers with challenges in organizing for better working and living conditions.

Mexican immigrant farmworkers are among the longest-lasting labor source for growers, arriving under a binational labor exchange agreement as early as World War I. California growers frequently denied Mexican immigrant workers their wages, relegating many to inhabit segregated, unhealthful, and undignified places (Calavita 1992). A renewed agreement with the Mexican government, including the consulate that leveraged previously reported abuses to require American growers to provide legally bounded contracts to all Mexican nationals, quelled the hysteria of a labor shortage during World War II. The Mexican Farm Labor Program Agreement (Public Law 45), known as the Bracero Program (Devra Weber 1996), required growers to make contracts that would guarantee workers’ wages and schedules. Public Law 45 also required that growers report the number of workers needed to the American Farm Bureau Federation. The American Farm Bureau Federation was prohibited from using federal money for domestic laborers because they were not protected under the international agreement (Calavita 1992). Thus, domestic Mexican American farmworkers could not secure contracts stipulating wages and scheduled workdays.

Despite reporting an estimated twenty-thousand-person labor shortage in the Central Valley, the number of hired braceros was often greater than that needed on the farms, which left many Mexican nationals stationary and without pay (Galarza 1977). Braceros were paid at piece rates for their labor and charged exorbitant costs for room and board regardless of the availability of work. They were segregated in remote sites and in labor camps that “limited the workers’ interactions, physical mobility, visibility, and settlement, allowing the U.S. government to depress wages and repatriate the men upon their contract’s expiration, denying them the right to organize and bargain for fair wages individually and collectively” (Rosas 2014, 7). Owing more to the agricultural companies than they had earned, many braceros sought employment as undocumented workers in cities, while some used the railroad to find new destinations in the Midwest. Altogether, nearly two million Mexican braceros circulated through California between 1942 and 1960 (Galarza 1977).

The historian Christina Morales Guzmán (2012) explains that despite the growers’ efforts to make Mexican immigrants a temporary and mobile workforce, many Mexican families carved out places to call home. Mexicans and Mexican Americans settled throughout the Central Valley in both semiurban and rural areas. In the city of Fresno, they established the first Mexican Baptist church, which was a standing symbol of status and permanence at the edge of Chinatown. Fresno’s Chinatown continued to be the headquarters for contracting farm labor. Outside of Fresno, rural towns were hopeful places for immigrants to establish permanent homes. Land was generally more affordable in rural and semiurban communities than in urban settings, which provided Mexican immigrants with the best opportunity to become landowners (Hymer 1923). Mexican immigrant farmworkers became squatters in unincorporated areas near rivers and canals. Some built homes using scrap materials, cardboard, and salvaged lumber, as well as tarps, tents, or abandoned sheds to house their families (Galarza 1977; see also Galarza et al. 1968; Ibarra and Torres 2017). Few had access to running water, except from ditches, and some had water collected and stored in barrels. The growers who provided labor camps often had running water and roofed housing for workers. These camps offered slightly better amenities than shacks. Yet, they were set up to restrain workers from leaving debt free (Bisharat 1975a). Many workers owed more money than they had earned after being charged high rates for food, rent, and transportation. Unemployment during the winter months left rural Mexican immigrants to rely on fishing and foraging to feed their families (Guzmán 2012). Winter also enabled a pause from following harvests across the state, grounding families in places to create a sense of home and for children to continue their education (Pichardo 1990).

In the developing urban area of Bakersfield, formerly known as Kern City, Mexican immigrants formed voluntary organizations that provided arriving immigrants with access to mutualistas (mutual aid societies) as early as 1895 (Paronyan 2023; Pichardo 1990). Sociedad Juarez among many other voluntary organizations in Bakersfield was critical for absorbing the influx of immigrants, providing community knowledge about safer housing options in redlined districts to new immigrants. Mutualistas engendered familiar language among neighbors, friends, and family and supported the creation of a rich cultural life, which was reinforced with each wave of immigration (Camarillo 1979). Mutualistas provided a regenerative sustenance that fueled local labor movements and, later, the national Chicano movement (Pichardo 1990).

Farm labor camps under the control of growers often faced outbreaks of malaria, tuberculosis, fevers, muscular fibrosis, and other illnesses associated with inadequate living conditions (Nash 2007). Transforming these living laboratories into thriving and healthy communities was not in the plans of growers and agribusinesses, however (Daniel 1982). Nearby white settlements, where health clinics were located, restricted their services to white residents, although some facilities served nonwhite people sparingly (Nash 2007; Abel 2004). Mutualistas connected immigrants to much-needed health care professionals who could treat illnesses, deliver babies, and cure diseases resulting from labor abuses and deplorable housing conditions in labor camps.

Segregated health care services to treat illnesses associated with poverty and unsafe housing along with policies that restricted access to social welfare reflected how Mexican and other nonwhite immigrants were viewed as undeserving individuals who drained social resources from those viewed as deserving (Galarza 1977). Like Asian immigrants, Mexican immigrant farmworkers were portrayed as parasites rather than producers, as sources of contagion, and as displaceable in every sense of the word. This sentiment was further exacerbated by media representations that narrated “illegal” border crossings by Mexicans as a problem of national security, coconstructing the embodiment of illness and illegality as both being threats to whiteness (Molina 2014). They were not expected to receive services or benefit from any of the programs they paid into.

Redlining in Bakersfield and Fresno legitimated residential segregation on the assumptions of risk and land value. Similarly, growers legitimated the undignified housing conditions and disease in racialized labor camps and rural settings with fabricated and inaccurate stories about out-migration after each harvest (Calavita 1992). For the migrants and their children campaigns to desegregate public services, including schools and hospitals, forming a powerful farm labor union, and accessing landownership became essential to their permanence.

Toward a Relational Formation of Racialized Health

The fate of Japanese and Japanese American internees at Gila River sheds light on the crossroads between disease and race. The health of prisoners in detention camps was infused with implicit assumptions about what conditions are suitable for groups of people who are categorized as inherently dangerous and criminal, morally and spatially unassimilable, and contagious. Public authorities charged with protecting the public’s health were in denial about their own contributions to segregation and disease. California growers in the Central Valley would replicate these assumptions with each new ethnic group that harvested their crops. Natalia Molina, Daniel Martinez HoSang, and Ramon Gutierrez (2018) apply a relational formation of race framework that links the experiences of racialized groups vis-à-vis other racialized groups. It is a multidirectional analysis that decenters whiteness by shedding light on how racialization has also led to polylateral relations among the aggrieved racialized groups, which entailed cocreated meanings, experiences, and shared alternative ways of existing across time and space. As a framework, it allows for understanding the utility of racial subordination as a process that enables differently inflected but similar racial projects to be sustained across time. When applied to valley fever, it sheds light both on how racialized meanings about disease travel, not just from one racialized group to another and not just constrained within the same spatial localities, and on how processes that generate immense profits are fluid and unequally distributed. If endemic cases call attention to the rate of infection and scaled geographies, then one will see that risk is persistently located in nonwhite neighborhoods and nonwhite bodies. But relational and racial formations of disease further elucidate how institutions like public health and agribusinesses rely on a long history of naturalizing immiseration, immigrant exploitation, wage theft, toxic uncertainty, and police violence to secure the denial of public support for health and well-being: or, in short—disposability, displaceability, and deportability.

Death by disease among Native Americans in California and the exclusion of Blackness from white spaces were mechanisms easily adopted and applied to Chinese immigrants. The immigration policies of exclusion that were directed at Chinese immigrants were then extended to Japanese and other Asians. Displacement was embedded into anti-Japanese wartime policies and Mexican anti-immigration politics. Agriculture workers landed in communities shaped by exclusion policies, and, as Molina (2014) argues, public health officials did not attend to the health needs of Mexicans because they were not viewed as citizens and deserving of public services. But, like the Native Americans, Black people, and Asians in California, the Mexicans and many succeeding immigrants carved out spaces to live and stay connected.

The long history of racial capitalism in the Central Valley has entailed treating nonwhite laborers and their communities as disposable, deportable, and exploitable, depriving them of health care and healthful conditions, and attributing racially disparate health outcomes to the biological makeup of nonwhite groups rather than to the socioecology that damages them. Nonwhite laborers and their communities have paid a terrible price for these policies over the years while white owners and investors have reaped unearned gains and unfair rewards from them. Yet, these conditions have always provoked oppressed people to forge powerful cultures of opposition, resistance, solidarity, and mutuality as mechanisms for self-defense, self-definition, and self-determination.

For example, in 1967, the young Chicano Ricardo Favela left Dinuba, a farm working community in the heart of the raisin industry in the Central Valley, to begin studies as an undergraduate student at California State University, Sacramento. He went on to become one of the most politicized artists of his time, organizing the Rebel Chicano Art Front collective with other artists, and eventually taking on a role as professor at Sacramento State. Favela’s struggles were as personal as they were political. They stemmed from wrestling with the dangerously racialized agricultural industry, the neglect of the most basic needs for healthy livelihoods because of it, and the straight up denial of the care that nurses, doctors, and hospitals pledged to provide. All these conditions amounted to many moments of injury and loss, including the death of a brother turned away from emergency medical care because of segregation. The dark and messy past of the Central Valley was compounded constantly by the presence of police who threatened to detain friends, neighbors, and extended family. Yet, despite all the deprivation, exploitation, and depression, the people of the Central Valley created and sustained rich resources of mutual recognition and respect, knowledge, and sharp humor that maintained a vibrantly creative political life. Reflecting in 2002 on his development as an artist and activist, Favela recalled:

For the most part, my works and those of the other Chicano/Indio artistas are not what the so-called experts call classic, or even technically brilliant. They are, however, works rooted in our concern for our people and culture, thus giving them a vibrant emotional life. The fact that, as a people, we are tied to the earth by our indigenous heritage and, ironically, by the great US society’s penchant for offering us niño farm worker occupation in our own occupied ancestral lands leads me to strive with my teaching and art to influence and ultimately give consequence to our present educational system, whether inside or outside the mainstream.

Like the artists of the Rebel Chicano Art Front, Ester Hernandez deployed cultural images as provocations for collective identity and solidarity. She portrayed the deadly dangers of harvesting grapes in a poster that parodied the Sun-Maid Raisins logo to convey the deadly harm that pesticides posed to workers and consumers. Hernandez’s screen print positioned a skeleton woman wearing a red bonnet and carrying a basket of grapes with the words printed “Sun Mad.” The poster helped educate a new constituency about the work of Dolores Huerta, Larry Itliong, Cesar Chavez, and many other organizers, who led national boycotts of grapes, helping to win major concessions from growers, as they founded the UFW labor union, which crossed racial lines and geopolitical boundaries. Huerta established an educational foundation in her senior years. In a speech directed at a teachers’ strike in Sacramento, she pointed to the similarities between farmworkers who nourish our bodies and “teachers [who] nourish our minds.” Long before social media, emerging educators established the newspapers La Voz de Aztlan and Sentimientos, where writers celebrated and promoted the resistance cultures of the Central Valley. Chicana/o activists Frances Peña, Tony Garduque, and Manuel Olguin dedicated forty years to the annual Chicana/o Youth Conference at Fresno State, which authored a path to pursue higher education for thousands of people, including returning Vietnam veterans. In all these instances and many others, people found strength through affirmations of self-determination to build a collective mission larger than themselves as individuals.

In this chapter, I have traced the historical background of how disease and race have long intersected. Illnesses require people to search deep within themselves for strength, not only for their personal survival but also to soothe and aid the ones they love. While diseases have no eyes, they can make us see how race, politics, and the environment affect the chances for recovery. Responses to valley fever via community solidarity and mobilization have interrupted and disrupted the capitalist imperatives of agribusiness, at times, while also challenging the inadequacy of the state’s health programs. I discuss this last point in more detail in Chapter 6.