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Public Health and Ethnicity Contagious Divides: Epidemics and Race in San Francisco's Chinatown

JAMA. 2002;288(1):103. doi:10.1001/jama.288.1.103.
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Nayan Shah's book is a nuanced, lucidly written and well-researched account of the public health assimilation of Asians, above all Chinese, in the Bay Area during the late 19th and early 20th centuries. Shah documents the way in which the Chinese went from being regarded as dangerous outsiders in epidemiological and sexual terms to the position they hold today as consummate members of the mainstream.

Starting in the mid-1900s, Chinese immigrants were regarded as importers of epidemic diseases, such as smallpox, cholera, tuberculosis, and typhoid fever, and their neighborhoods and living conditions were seen as a menace to other parts of San Francisco. Their domestic habits, above all the prevalence of men unaccompanied by spouses who lived in various forms of temporary housing and allegedly provided a steady demand for prostitution, were thought to undermine the dictates of white bourgeois society. They were also the victims of campaigns promoted by trade unions, which sought to persuade consumers to eschew cheaper goods made by Chinese labor because of their alleged threat to health.


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