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Fourteen women posing as a group, one holding a baby and one with a child in front.

Greenwich Mothers’ Club of the Henry Street Settlement, Lower East Side, New York City, ca. 1932

Courtesy U.S. National Library of Medicine

The Henry Street Visiting Nurse Service organized Mothers’ Clubs to educate expectant mothers with a course of talks and demonstrations on maintaining healthy pregnancies.

A uniformed, white, female nurse standing next to a table with an audience of seated women in front of her.

“Fordham Hospital Mothers’ Club. Mrs. Jeffrey teaches a lesson,” New York, 1930s

Courtesy U.S. National Library of Medicine

In an effort to reduce the high infant mortality rate in immigrant neighborhoods, Henry Street nurses led “mothers’ clubs” to educate women about prenatal and baby care.

A uniformed, white, female nurse tending to a child in a crib.

“Miss Kramer takes care of a very sick baby with pneumonia,” New York City, 1930s

Courtesy U.S. National Library of Medicine

A Henry Street nurse cares for a baby with pneumonia, one of the most common diseases and a frequent cause of death in New York City in the first half of the 20th century.

White, female nurse with a Chinese-American family comprised of a mother and seven children.

“Miss Pearson with a Chinese family,” Bronx, New York, 1930s

Courtesy U.S. National Library of Medicine

Italian-American family, mother with five children.

“Mrs. De Santis and children,” Bronx, New York, 1930s

Courtesy U.S. National Library of Medicine

The oldest daughter (not pictured) was suffering from tuberculosis and Henry Street nurses instructed the rest of the family on methods of avoiding the disease. Tuberculosis was a major cause of death in immigrant and poor communities. Henry Street developed a “system of care for tuberculosis patients and instruction for their families” years before New York City created its own program.

Smiling white woman holding newborn baby outside.

“Mrs. Pallone is happy over the new baby even tho’ her husband has been injured and cannot work for some time.” Bronx, New York, 1930s

Courtesy U.S. National Library of Medicine

Lillian Wald emphasized that social conditions, such as dangerous workplaces, affected immigrants’ health. She wrote, “[w]hile the district nurse is laboring with the individual she should also contribute her knowledge toward the study of the large general conditions of which her poor patient may be the victim.”

Woman sitting with a child in a cluttered room with laundry hanging from the ceiling and kitchenware scattered.

A mother and child in a New York City tenement kitchen, ca. 1910

Courtesy U.S. National Library of Medicine

Immigrant families crowded into apartments and workplaces that lacked ventilation and sanitation. These conditions contributed to high sickness and mortality rates in New York’s immigrant neighborhoods.

Map showing the Bronx and Staten Island covered in dots.

“Visiting Nurse Service: Visits for One Day—1925,”
Report of the Henry Street Settlement, May 1926

Courtesy U.S. National Library of Medicine

Each dot on this Henry Street Visiting Nurse Service map from 1925 represents two nursing visits.

Page from a book showing the items visiting nurses were expected to carry with them.

Visiting Nurse Service: Administered by the Henry Street Settlement, Bulletin of Instruction, revised edition, 1933

Courtesy U.S. National Library of Medicine

The Henry Street Visiting Nurse Service Bulletin of Instruction lists some of the items nurses were expected to carry with them. The list includes a guide book of New York City and the contents of the medical bag issued to each nurse. Medical bags included items for sterilizing instruments, patient examinations, childbirth and baby care, and record keeping.

Front page of the book review section of a nursing service quarterly with text and an image of a white woman.

Quarterly of the Henry Street Visiting Nurse Service, Vol. 1, No. 1, March 1930

Courtesy U.S. National Library of Medicine

The Quarterly of the Henry Street Visiting Nurse Service documented the impact of the visiting nurses in the communities they served. News clips covered administrative business and inspirational stories about nurses in the field. Henry Street Visiting Nurses attended to the social as well as the physical and mental welfare of their patients.

Cover of a news bulletin with text and a profile view portrait of a white, female nurse.

The Quarterly Bulletin for Metropolitan Nurses, Metropolitan Life Insurance Company, October 1940

Courtesy U.S. National Library of Medicine

In 1909, Henry Street nurses began providing health visits to the policyholders of the Metropolitan Life Insurance Company, who were mostly working-class immigrants. The nurses were so successful in improving clients’ health that MetLife established its own visiting nurse service modeled on Henry Street. This edition commemorates the life of Lilian Wald, founder of the Henry Street Settlement.

Drawing of a white man and white woman in hats holding a baby with others looking at them.

“Immigrant Inspection Service,” Harper’s Weekly, W.A. Rogers, February 10, 1883

Courtesy U.S. National Library of Medicine

Health officials working on trains conducted inspections and vaccinations for smallpox for immigrants settling in the Midwest and West.

Side view of a uniformed, female, white nurse picking through the long curly hair of a woman.

Inspection of hair for lice at Ellis Island Immigration Station, New York, early 20th century

Courtesy U.S. National Library of Medicine

At Ellis Island, immigrants’ hair was inspected for lice, which could spread typhus and other dangerous diseases. Only steerage (third- and fourth-class) passengers were transferred to the island for inspection. Passengers who could afford cabins were inspected onboard and were allowed to disembark without passing through Ellis Island.

Asian men with bare chests lined up, waiting for inspection by two male medical professionals in white gowns.

U.S. Public Health Service physician inspects Asian immigrants for trachoma at the Angel Island Immigration Station, California, 1910s

Courtesy U.S. National Library of Medicine

The examination for trachoma, an infectious eye disease, was quick but extremely uncomfortable: inspectors used a metal hook to turn the eyelid inside out. These immigrants at the Angel Island port of entry in San Francisco, California await their trachoma screening.

White woman in a headscarf completes a puzzle while seated. Two examiners and six women watch.

A female immigrant piecing together a wooden puzzle as part of an examination, early 20th century

Courtesy U.S. National Library of Medicine

A puzzle was used as part of the examination to identify and exclude immigrants with so-called “mental deficiencies.” Health officials believed that people with intellectual disabilities would not be fit to work and could become dependent on charity or welfare.

Four uniformed men inspecting two Cuban children’s arms for vaccination marks. Three women appear in background.

Quarantine inspectors checking children for vaccination marks, photograph by Black-Baker Photographers for U.S Public Health Service, 1965

Courtesy U.S. National Library of Medicine

As new vaccines developed throughout the 20th century, increased numbers of immunizations were required for immigration. These Cuban refugee children were examined for smallpox vaccination marks upon their arrival in the United States in 1965. Today, the majority of immigrants come from countries that have vaccination rates similar to, or even higher than, the United States.

Uniformed white man pointing to an x-ray of a chest next to an elderly white woman in a headscarf.

A newly arrived immigrant views her chest X-ray with a U.S. Public Health Service physician at Kennedy International Airport in New York, photograph by Esther Bubley, ca. 1960

Courtesy U.S. National Library of Medicine

Three skeleton-faced ghosts with one word—“malarium,” “small-pox” or “leprosy”—on their robes, floating above San Francisco churches, buildings, and waterways.

“San Francisco’s Three Graces,” illustration by George Frederick Keller for The Wasp, May 26, 1882

Courtesy Billy Ireland Cartoon Library and Museum, The Ohio State University Libraries

San Francisco authorities, believing that epidemics of smallpox and plague originated in the city’s Chinatown, passed quarantine and vaccination laws that applied only to people of Chinese origin. In 1900, the U.S. Supreme Court ruled that such ethnically-based quarantines violated the Constitution.

Street view of buildings on fire with people standing in the street and horse drawn carriages.

A street view of the city fires to control the bubonic plague, Honolulu, Hawaii, 1900

Courtesy Hawaii State Archives

During the 1900 plague epidemic in Honolulu, the city government set fire to allegedly-contaminated buildings and garbage piles in Chinatown. Some of the fires burned out of control and destroyed 4,000 homes.

Asian women and babies sit on benches in a detention area with one white woman.

Women and children held in a detention pen with a social worker at Angel Island Immigration Station, San Francisco, early 20th century

Courtesy U.S. National Library of Medicine

Angel Island was the West Coast counterpart to Ellis Island, but it was dedicated to restricting rather than welcoming immigrants. Following the Chinese Exclusion Act of 1882, Asian immigrants had to prove family connections to enter the United States, and all Asians trying to enter through Angel Island were subject to weeks of detention, questioning, inspections, and quarantine (in contrast to days or hours at Ellis Island).

Ten men standing behind a chain-link fence with two uniformed men on the opposite side.

Detention pen at the Ellis Island immigration station, New York, 1902

Courtesy U.S. National Library of Medicine

Steerage passengers who failed medical inspection were held in quarantine before either being deported or allowed to continue on their journeys. Steerage passengers were usually poor and from immigrant groups seen as racially distinctive, such as Italians and Jews.

The Ellis Island quarantine facility was designed to hold 1,800 detainees, but was usually at several hundred over capacity. Overcrowding increased the possibility that contagious disease would spread among detainees.

White man sitting in a prison cell wearing striped clothing reading a newspaper.

An immigrant held in medical quarantine detention on Ellis Island, New York, ca. 1930

Courtesy U.S. National Library of Medicine

Mexicans of mixed ages wearing hats waiting in a line between a house and a bridge.

Mexicans wait to be bathed and deloused at the El Paso Disinfection Station at International Bridge, Records of the Public Health Service, 1917

Courtesy National Archives and Records Administration

All workers who commuted daily from Juarez, Mexico to El Paso, Texas were forced to strip naked, bathe, and then be sprayed with gasoline and other pesticides to kill lice.

Old newspaper with typed text and the headline “Order to Bathe Starts Near Riot Among Juarez Women”.

“Order to Bathe Starts Near Riot among Juarez Women,” El Paso Morning Times, January 29, 1917

Courtesy University of North Texas Libraries

A group of domestic workers led by 17-year-old Carmelita Torres—referred to in the newspaper as the “auburn-haired Amazon”— refused to submit to the humiliating and dangerous delousing procedure. Their protest failed, and the bathing requirement continued for decades, despite lack of evidence of typhus danger from Mexico. The incident became known as the El Paso Bath Riots.

A boy being sprayed with pesticide by a uniformed woman.

Bracero workers being fumigated at Hidalgo Processing Center, photograph by Leonard Nadel, Texas, 1956

Courtesy Leonard Nadel Photographs and Scrapbooks, Archives Center, National Museum of American History, Smithsonian Institution

Because of a shortage of agricultural labor, the United States created the Bracero (temporary guest worker) program, which brought over 4.5 million people from Mexico to work on U.S. farms and in other industries between 1942 and 1964. “Braceros” crossing the U.S.-Mexico border were required to undergo fumigation for lice with harsh pesticides, such as DDT and lindane. The treatment could make people sick, and in the 1970s, these substances were banned for causing cancer and neurological problems. Pesticide poisoning continues to be a hazard to farm workers exposed to chemicals on the job.

Face of a West African man behind a chain-link, barb wired fence, with poster text.

I am not a disease: learn the facts about Ebola, design by Joe Scorsone and Alice Drueding for Posters Against Ebola, 2014

Courtesy U.S. National Library of Medicine

Although past practices that targeted people for their ethnicity have been discredited, the fear that newcomers will bring epidemics can still grip the national imagination. This powerful poster, produced during the 2014 Ebola scare, urges viewers to reject the unscientific linkage between diseases and specific ethnic or national groups.

Sky view of street with a large crowd of people gathered in NYC.

Protest over U.S. Food and Drug Administration ban on Haitian blood donations, Brooklyn, New York, April 20, 1990

Courtesy AP/Gerald Herbert

In 1990, Haitian-American organizations led a march of tens of thousands of people to protest the stigma and discrimination caused when the U.S. government wrongly labeled Haitian national origin as a risk factor for HIV infection.

Typed text with an illustration of a Victorian-style hospital.

Emigrants’ Hospital for sick and destitute immigrants, Ward’s Island, New York, engraving by Lossing & Barritt, ca. 1868

Courtesy U.S. National Library of Medicine

White female nurse in uniform consulting a notebook while in a patient’s home.

Health aide Dorothy Press visits a migrant family in a migrant workers’ camp outside Nassawadox, Virginia, photograph by Janet Ochs for Public Health Service World, 1966

Courtesy U.S. National Library of Medicine

U.S. agriculture has depended on migrant labor for over a century. Whether workers are citizens, temporary migrants, or immigrants, most face low wages, dangerous health conditions, and a lack of medical care.

A white, female, uniformed nurse walking into a run-down wooden structure or home.

Health aide enters a home in a migrant workers’ camp near Nassawadox, Virginia, photograph by Janet Ochs for Public Health Service World, 1966

Courtesy U.S. National Library of Medicine

A public health nurse visits migrants in their temporary homes in a camp for agricultural workers on Virginia’s Eastern Shore. After decades of neglect of migrant workers’ health conditions, Congress passed the Migrant Health Act in 1962. It provides federal grants for delivery of basic preventive care to migrant workers, such as visits from a nurse.

Typed advertisement for Partners for Health showing two men shaking hands, and a drawing of medicines and forms.

Partners for Health: iCompañeros en la Salud! Migrant Clinicians Network, Austin, Texas, late 20th century

Courtesy U.S. National Library of Medicine

Migrant workers and their families, who live on the move, face many obstacles to obtaining care. In 1985, nurses and physicians dedicated to improving health care for migrant farmers formed the grassroots-based Migrant Clinicians Network.

Interior view of shop with tall drawers, chandelier, Chinese writing and vase. Chinese-American man sitting in chair.

“A Chinese drugstore in Chinatown, San Francisco,” 1800s

Courtesy U.S. National Library of Medicine

Dispensaries sold herbs and traditional remedies in communities that lacked other health services. Some evolved into modern clinics and hospitals that still serve patients today, providing both Western and non-Western medical care.

Typed note of Staff Seminar meeting reminder.

Postcard announcing a seminar for physicians at Philadelphia’s Jewish Hospital, 1938

Courtesy U.S. National Library of Medicine

The Jewish Hospital for the Aged, Infirm, and Destitute, opened in 1866, was one of hundreds of ethnic and religious hospitals organized by immigrant groups. It served both Jewish and non-Jewish residents of Philadelphia. In 1952, it merged with two other hospitals to form Einstein Medical Center.

International Ladies’ Garment Workers Union Health Center Building entrance drawing on cover of a report.

Triennial Report: 1947–1949, Union Health Center, New York, ca. 1950

Courtesy U.S. National Library of Medicine

The Union Health Center was opened in 1913 by the International Ladies’ Garment Workers’ Union to serve its mostly Jewish and Italian immigrant membership. Like Henry Street, the UHC believed that workers’ rights included a right to medical care and safe working conditions. It is still in operation today.

A Hispanic male in a farmer’s hat, an African American male, and a White male doctor in a lab coat.

“Dr. Caleb Foote greets new patients in the waiting room of the Terronez Clinic,” Delano, California, 1975

Courtesy Peter Rudd

In the 1960s and 1970s, the United Farm Workers, the most influential organization of migrant workers in history, recruited volunteer physicians and nurses, and opened health clinics for its members. For many farm workers, this was the first time they’d had access to the care they needed.

Typed pamphlet with text and an image of two men working in a garden.

“Prepare for Medical School, La Raza Needs You,” National Chicano Health Organization, Los Angeles, 1970s

Courtesy University of New Mexico, Center for Southwest Research, Frank I. Sanchez Papers

In the 1970s, the National Chicano Health Organization created a campaign to encourage more Mexican-Americans to attend medical school. Health professionals from diverse backgrounds are crucial in expanding access to care for underserved communities. “La Raza” refers to both recent immigrants and people of Mexican heritage whose families have been in the U.S. for generations.

Young Asian woman seated at a table outdoors conducting a blood pressure test on an Asian woman with two Asian men standing behind her.

A volunteer from the Chinatown Health Clinic takes a resident’s blood pressure at the Chinatown Health Fair, photograph by Corky Lee, New York City, 1973

Courtesy Corky Lee

Neighborhood clinics and health centers are important sources of care for immigrant communities. Starting as immigrant self-help efforts in the early twentieth century, many facilities have continued to operate since the 1960s with support from federal and local governments.

People protesting in the street with banners in English and Chinese.

Health care march in New York City’s Chinatown, photograph by Corky Lee, 1973

Courtesy Corky Lee

Residents of New York City’s Chinatown organized, in the 1970s, against the proposed closing of a local hospital. They also pushed for the hiring of bilingual physicians, including speakers of Chinese, Italian, and Spanish.

Sign on wall in English and Chinese language declaring workers must speak Chinese.

“1/4 of the workers at the new Gouverneur must speak Chinese!” photograph by Corky Lee, Chinatown, New York City, 1973

Courtesy Corky Lee

Residents of New York City’s Chinatown organized, in the 1970s, against the proposed closing of a local hospital. They also pushed for the hiring of bilingual physicians, including speakers of Chinese, Italian, and Spanish.

Typed advertisement with an image of three Cambodian-American adults and three Cambodian-American children posing as a happy group, and text in Khmer.

“Stay Healthy – Use Condoms: Make Our Future Free of AIDS,” Center for Southeast Asian Refugee Resettlement, 1993

Courtesy U.S. National Library of Medicine

The Center for Southeast Asian Refugee Resettlement, a San Francisco organization led by Southeast Asian refugees and immigrants, created this HIV-prevention campaign directed at the Cambodian community.

A smiling woman and man looking at a flyer in a hospital setting.

Gouverneur clinic in New York City provides multi-lingual health care information and services, 2017

Courtesy NYC Health + Hospitals

Years of action and pressure from immigrant rights groups have led the medical community to recognize the necessity of multilingual health education and services. In the 21st century, more multilingual medical practitioners and educators are needed in order to ensure better health for all.

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