Racialization and Reproduction: Asian Immigrants and California's Twentieth-Century Eugenic Sterilization Program.

During the twentieth century, state health authorities in California recommended sterilization for over 20,000 individuals held in state institutions. Asian immigrants occupied a marginalized position in racial, gender, and class hierarchies in California at the height of its eugenic sterilization program. Scholars have documented the disproportionate sterilization of other racialized groups, but little research exists connecting the racist, gendered implementation of Asian immigration restriction to the racism and sexism inherent in eugenics. This study examines patterns of coercive sterilization in Asian immigrants in California, hypothesizing higher institutionalization and sterilization rates among Asian-born compared with other foreign- and US-born individuals. We used complete count census microdata from 1910 to 1940 and digitized sterilization recommendation forms from 1920 to 1945 to model relative institutionalization and sterilization rates of Asian-born, other foreign-born, and US-born populations, stratified by gender. Other foreign-born men and women had the highest institutionalization rates in all four census years. Sterilization rates were higher for Asian-born women compared with US-born [Incidence Rate Ratio (IRR) = 2.00 (95% CI: 1.61, 2.48)] and other foreign-born women (p < 0.001) across the entire study period. Sterilization rates for Asian-born men were not significantly higher than those of US-born men [IRR 0.95 (95% CI 0.83, 1.10). However, an inflection point model incorporating the year of sterilization found higher sterilization rates for Asian-born men than for US-born men prior to 1933 [IRR 1.31 (95% CI 1.09, 1.59)]. This original quantitative analysis contributes to the literature demonstrating the health impact of discrimination on Asian-Americans and the disproportionate sterilization of racial minorities under state eugenics programs.

Operationalizing racialized exposures in historical research on anti-Asian racism and health: a comparison of two methods.

Background: Addressing contemporary anti-Asian racism and its impacts on health requires understanding its historical roots, including discriminatory restrictions on immigration, citizenship, and land ownership. Archival secondary data such as historical census records provide opportunities to quantitatively analyze structural dynamics that affect the health of Asian immigrants and Asian Americans. Census data overcome weaknesses of other data sources, such as small sample size and aggregation of Asian subgroups. This article explores the strengths and limitations of early twentieth-century census data for understanding Asian Americans and structural racism. Methods: We used California census data from three decennial census spanning 1920-1940 to compare two criteria for identifying Asian Americans: census racial categories and Asian surname lists (Chinese, Indian, Japanese, Korean, and Filipino) that have been validated in contemporary population data. This paper examines the sensitivity and specificity of surname classification compared to census-designated "color or race" at the population level. Results: Surname criteria were found to be highly specific, with each of the five surname lists having a specificity of over 99% for all three census years. The Chinese surname list had the highest sensitivity (ranging from 0.60-0.67 across census years), followed by the Indian (0.54-0.61) and Japanese (0.51-0.62) surname lists. Sensitivity was much lower for Korean (0.40-0.45) and Filipino (0.10-0.21) surnames. With the exception of Indian surnames, the sensitivity values of surname criteria were lower for the 1920-1940 census data than those reported for the 1990 census. The extent of the difference in sensitivity and trends across census years vary by subgroup. Discussion: Surname criteria may have lower sensitivity in detecting Asian subgroups in historical data as opposed to contemporary data as enumeration procedures for Asians have changed across time. We examine how the conflation of race, ethnicity, and nationality in the census could contribute to low sensitivity of surname classification compared to census-designated "color or race." These results can guide decisions when operationalizing race in the context of specific research questions, thus promoting historical quantitative study of Asian American experiences. Furthermore, these results stress the need to situate measures of race and racism in their specific historical context.

Entanglements of Eugenics, Public Health, and Academic Medicine: Reckoning with the Life and Legacies of Victor C. Vaughan.

Victor C. Vaughan (1851-1929) was a noted medical educator, microbiologist, and active proponent for the idea of eugenics. Vaughan spent his career at the University of Michigan, where he served as Medical School Dean for many years. He lectured widely on the importance of "race betterment" and actively supported passage of state legislation that led to over 3,000 sterilizations in the state of Michigan. After his death, Vaughan's name was applied to student organizations, endowed chairs, buildings, and more. This paper considers how the use of Vaughan's name not only reflected Vaughan's support of eugenics but also gendered and racialized ideas about what it means to be a physician. We conclude that the use of any name from the past carries meanings about what our values are in the present and that, if there was ever a moment to celebrate the life of Victor Vaughan, that moment has passed.

Cautions About Medicalized Dehumanization.

Critical lessons can be gleaned by examining 2 of the most salient relationships between racism and medicine during the Holocaust: (1) connections between racism and dehumanization that have immediate, lethal, deleterious, longer-term consequences and (2) intersections of racism and other forms of hatred and bigotry, including discrimination against people with disabilities; lesbian, gay, bisexual, transgender, and queer people; and social and religious minorities. When considered in the US context, these lessons amplify need for reflection about the history of eugenics and human experimentation and about the persistence of racism and ableism in health care.

Disproportionate Sterilization of Latinos Under California's Eugenic Sterilization Program, 1920-1945.

OBJECTIVES: To compare population-based sterilization rates between Latinas/os and non-Latinas/os sterilized under California's eugenics law. METHODS: We used data from 17 362 forms recommending institutionalized patients for sterilization between 1920 and 1945. We abstracted patient gender, age, and institution of residence into a data set. We extracted data on institution populations from US Census microdata from 1920, 1930, and 1940 and interpolated between census years. We used Spanish surnames to identify Latinas/os in the absence of data on race/ethnicity. We used Poisson regression with a random effect for each patient's institution of residence to estimate incidence rate ratios (IRRs) and compare sterilization rates between Latinas/os and non-Latinas/os, stratifying on gender and adjusting for differences in age and year of sterilization. RESULTS: Latino men were more likely to be sterilized than were non-Latino men (IRR = 1.23; 95% confidence interval [CI] = 1.15, 1.31), and Latina women experienced an even more disproportionate risk of sterilization relative to non-Latinas (IRR = 1.59; 95% CI = 1.48, 1.70). CONCLUSIONS: Eugenic sterilization laws were disproportionately applied to Latina/o patients, particularly Latina women and girls. Understanding historical injustices in public health can inform contemporary public health practice.

Shadows of doubt: the uneasy incorporation of identification science into legal determination of paternity in Brazil.

The arrival of DNA paternity testing in the 1980s was met with great enthusiasm in the Brazilian courts. Yet, over the past two decades, Brazilian legal doctrine and jurisprudence have increasingly rejected DNA proof as the sine qua non for paternity cases. Instead, DNA paternity testing has generated mountains of litigation, as biological proof has been challenged by the argument that paternity is primarily "socio-affective". Leading family law specialists describe this new conception of paternity as an outcome of the "revolutionary" provisions of the 1988 Constitution, which recognizes the "pluralism" of family forms in modern society and guarantees equal family rights for all children. Without denying the significance of the constitution's dignitary framework, we show that new legal understandings of paternity represent less a paradigm shift than a continuation of longstanding historical tensions between biological and socio-cultural understandings of family and identity. In this article, we explore the development of biological and eventually genetic typing in Brazil, both of which had ties to the fields of criminology and race science. Our review suggests that techniques of biological identification, no matter how sophisticated or precise, were ineffective means for establishing identity, whether of individual personhood, as in the case of paternity, or national make-up. Instead, they became incorporated as supplemental methods into complex legal, social, and cultural decision-making around families.

California's Sterilization Survivors: An Estimate and Call for Redress.

From 1919 to 1952, approximately 20 000 individuals were sterilized in California's state institutions on the basis of eugenic laws that sought to control the reproductive capacity of people labeled unfit and defective. Using data from more than 19 000 sterilization recommendations processed by state institutions over this 33-year period, we provide the most accurate estimate of living sterilization survivors. As of 2016, we estimate that as many as 831 individuals, with an average age of 87.9 years, are alive. We suggest that California emulate North Carolina and Virginia, states that maintained similar sterilization programs and recently have approved monetary compensation for victims. We discuss the societal obligation for redress of this historical injustice and recommend that California seriously consider reparations and full accountability.

Eugenics, sterilization, and historical memory in the United States / Eugenia, esterilização e memória histórica nos EUA

Abstract From the 1920s to the 1950s, California sterilized approximately 20,000 people in state homes and hospitals based on a eugenic law that authorized medical superintendents to perform reproductive surgeries on patients deemed unfit and “suffering from a mental affliction likely to be inherited.” Working with a unique resource – a dataset created from 19,000 sterilization recommendations – my team and I have reconstructed patterns and experiences of institutionalization of sterilizations. This article presents several of our important initial findings related to ethnic and gender bias in sterilization policies, and reflects on the relevance of the history for contemporary issues in genomics and social justice.

Resumo Da década de 1920 até a de 1950, o estado da Califórnia esterilizou aproximadamente vinte mil pessoas em abrigos e hospitais públicos com base em uma lei eugênica que autorizava as autoridades médicas a esterilizar pacientes considerados incapazes e portadores de “transtorno mental possivelmente hereditário”. Trabalhando com uma fonte singular – um conjunto de dados contendo 19 mil recomendações para esterilização –, minha equipe e eu reconstruímos padrões e experiências que concorreram para a institucionalização das esterilizações. Este artigo apresenta importantes achados iniciais relacionados ao viés étnico e de gênero nas políticas de esterilização, e reflete sobre a relevância da história para questões contemporâneas como genômica e justiça social.

Eugenics, sterilization, and historical memory in the United States.

From the 1920s to the 1950s, California sterilized approximately 20,000 people in state homes and hospitals based on a eugenic law that authorized medical superintendents to perform reproductive surgeries on patients deemed unfit and "suffering from a mental affliction likely to be inherited." Working with a unique resource - a dataset created from 19,000 sterilization recommendations - my team and I have reconstructed patterns and experiences of institutionalization of sterilizations. This article presents several of our important initial findings related to ethnic and gender bias in sterilization policies, and reflects on the relevance of the history for contemporary issues in genomics and social justice.

Assessing Argentina's response to H1N1 in austral winter 2009: from presidential lethargy to local ingenuity.

Argentina experienced a heavy burden of novel H1N1 influenza in austral winter 2009. In early July 2009, Argentina reported more than 1,500 cases and was confronting the highest per capita H1N1 mortality rate in the world. By September 2009, more than 500 people had died of H1N1 in Argentina. Unlike sister countries Chile and Mexico, Argentina's national authorities did not respond by implementing mitigation measures such as public gathering bans and school closures or by issuing broad-based messages about personal hygiene and disease prevention. Around the globe, many observers expressed dismay at this inaction. For example, The Economist scolded the country's leadership for its halting response and seeming apathy to an escalating health crisis. Why did Argentina, a middle-income country with a developed and, in many respects, sophisticated system of health and education, fall short in enacting a national pandemic plan during the 2009 H1N1 outbreak? What can we learn from Argentina's experiences about obstacles and opportunities during a pandemic crisis? This article, based on extensive qualitative research, including document capture, media analysis, and oral history interviews, assesses Argentina's mixed response to H1N1 during austral winter 2009, and adds to a growing body of studies focused on how governments and health systems in the Americas performed during the 2009-2010 H1N1 pandemic. When the first cases of novel H1N1 influenza were identified by the U.S. Centers for Disease Control and Prevention (CDC) in mid-April 2009, Argentina's national health ministry appeared to be prepared. Starting in 2002, primarily in response to the prospect of avian influenza, the health ministry had formulated a preparedness plan and, beginning in 2005, had conducted at least five pandemic simulation exercises. In April 2009, Argentina's health ministry activated its pandemic response plan, triggering the establishment of an executive-level situation room equipped with rapid communications and computer surveillance to track events as they unfolded. In addition, several expert committees were assembled to assess the situation and solicit input from health practitioners, academics, hospital staff, and allied professionals.

“The Hour of Eugenics” in Veracruz, Mexico: radical politics, public health,and Latin America’s only sterilization law

In 1932, the Mexican state of Veracruz passed Latin America's only eugenic sterilization law. Building on the foundational scholarship of Nancy Leys Stepan, this article critically examines Veracruz's eugenics movement, exploring how it intersected with public health, antivice campaigns, and radical agrarian and labor politics. I pay particular attention to Governor Adalberto Tejeda, who, during his second term in office (1928 – 1932) incorporated a zealous version of Latin eugenics into state laws and policies. This article suggests that Veracruz's experiment with eugenics, especially the state's sterilization statute, was intimately connected to concerns about prostitution, sexual health, and working-class vigor. This article highlights an unexplored dimension of society and medicine in Latin America and raises questions about the orientation and limits of preventive eugenics in Mexico, and about the homologies among eugenics movements in the Americas and across the globe in the twentieth century. (AU)

Lucien Howe, hereditary blindness, and the eugenics movement.

Ophthalmologists admire Lucien Howe, MD (1848-1928) (Figure 1), for his leadership and philanthropy. During his presidency of the American Ophthalmological Society (AOS), the organization established an award for contributions to ophthalmology, now known as the Howe Medal (Figure 2), one of the highest honors in the specialty. In addition, there are 2 other Howe Medals and a Howe Award, each of which is given at irregular intervals. The American Medical Association's Lucien Howe Prize Medal in Ophthalmology was first given in 1926. The University of Buffalo (The State University of New York) and the Buffalo Ophthalmological Society have given a Lucien Howe Medal in Ophthalmology since 1928. The Medical Society of the State of New York's Lucien Howe Award was established in 1906.

"Better off in school": School medical inspection as a public health strategy during the 1918-1919 influenza pandemic in the United States.

During the 1918-1919 influenza pandemic in the United States, most cities responded by implementing community mitigation strategies, such as school closure. However, three cities--New York City, Chicago, and New Haven, Connecticut--diverged from the dominant pattern by keeping their public schools open while the pandemic raged. This article situates the experiences of these three cities in the broader context of the Progressive era, when officials and experts put great faith in expanding public programs in health and education. It adds an important dimension to the historical understanding of the 1918-1919 influenza pandemic and offers lessons for public health practitioners and policymakers today who might face difficult decisions about how to respond to the 2009 H1N1 influenza pandemic.

A quiet revolution: the birth of the genetic counselor at Sarah Lawrence College, 1969.

In 1969 Melissa Richter founded the first master's degree genetic counseling program in the country at Sarah Lawrence College in Bronxville, New York. This article examines the myriad factors that contributed to the birth of the genetic counselor and situates this historical watershed in its social, cultural, academic, and medical context. This article highlights Richter's prescience and path-breaking vision, evaluates the Sarah Lawrence program during the years of her directorship (1969-1972), and explores how this early foundation subsequently shaped the field of genetic counseling. Close attention is paid to the ethical issues that concerned Richter and their ongoing relevance to genetic health professionals today. This article is based on historical research in archives, consultation of primary sources, and oral history interviews with genetic counselors, geneticists, and allied professionals.