The early twentieth and twenty-first centuries are equally times of unprecedented interconnectedness that present a variety of public health issues. This paper presents an historical examination of one way that public health’s role in American society was imagined at its genesis, and its continued relevance. From its broadest perspective, my research examines public health’s role as one of the earliest institutionalized examples of a practical application of scientific knowledge to the wellbeing of the public. Since its beginning as a profession in the early twentieth century, public health maintains a dynamic tension among its component parts: medical experts, government bureaucracy, and citizen participation. Research for a race and ethnicity seminar into the case of Mary Mallon (“Typhoid Mary”), an Irish immigrant cook and suspected typhoid carrier in early-twentieth-century New York, is what led me to examine how these three disparate but equally necessary components of a public health system came together in the United States, and the narratives that first united them.
An effective narrative to describe the need for public health in American society was key as it became a professionalized field. The authority of New York City’s Department of Health was largely established by its ability to identify and contain contagious disease at the turn of the twentieth century. Priscilla Wald notes that outbreak narratives were key to establishing public acceptance of the need for medical experts to become involved in both the public and private lives of citizens.[1] During a time of unprecedented immigration through New York City, outbreak narratives told by experts informed the public of the contagious dangers of increasing urban interconnectedness. As a single immigrant woman who moved from cooking job to cooking job, Mary Mallon was unwittingly perfectly positioned to become the subject of a disease outbreak narrative when it was discovered that several of her employers were sickened with typhoid because she was likely a “healthy carrier.”
At the time, two fairly new scientific concepts – healthy carriers and germ theory – were still being disseminated among medical experts, but increased urban population density and high rates of immigration to American cities demanded that public health officials effectively educate the general public about these concepts as well. Unfortunately for Mary, her case became a symbolic example of how urban interconnectedness and immigration could lead to the spread of contagious disease, and her identity as Mary Mallon became swallowed by her symbolic identity as “Typhoid Mary.” An outbreak narrative overshadowed her private life until her death in quarantine on North Brother Island.
My research by no means disputes the fact that Mary’s position as an immigrant made her vulnerable to labeling and persecution. My focus rests on only one of the many reasons why it was so easy for medical experts and government officials to label her as dangerous: she refused to learn and acknowledge the science. However, when Mary Mallon was suddenly thrust into a situation where an understanding of germ theory was key to her survival in 1907, there were physicians all over the world who were still ignorant of it. The science was incredibly new, and no one was used to what Wald calls “new models of being in the world,”[2] involving dangerous organisms too tiny to see.
There is no such excuse for ignorance now, as authority figures continue to use narratives linking immigrants with disease as an argument to keep them from the United States. As Dave Levitan notes, “moving backward through history, we can see that politicians have repeated, time and again, the idea that immigrants are bringing over every disease that happens to be in the news.”[3] Ignorance of the basic science behind contagious disease transmission is no longer an excuse for the association that continues to be made between immigrants and disease.
I’m presently exploring how ignorance, and in some cases willful ignorance, of science continues to facilitate prejudice against immigrants. Of particular interest to me in Mary’s case is the potential for other narratives. Sara Josephine Baker, a public health official who twice apprehended Mary to be tested for typhoid, is the lens through which I have conducted my research. Public health, for Baker, told what I call a “narrative of life,” in which government, medical expert, and citizen together claimed responsibility for individual and societal wellbeing. Most simply, Baker’s work demonstrated that scientific knowledge belongs to everyone, and that it takes the understanding and engagement of everyone involved in public health to truly promote individual and societal wellbeing.
[1] Priscilla Wald, Contagious: Cultures, Carriers, and the Outbreak Narrative (Durham: Duke University Press, 2008), 70-71.
[2] Wald, Contagious, 70.
[3] Dave Levitan, “When politicians link immigrants to disease, the science just doesn’t add up,” Popular Science, April 19, 2017, accessed May 7, 2018 https://www.popsci.com/politician-science-immigration#page-3.
— Rebecca Johnson
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