Children growing up in Indian slums: Challenges and opportunities for new urban imaginations. Girls as young as 5 carried infants and toddlers on their hip and moved around freely in the narrow pedestrian bylanes of the village, visiting shops for sweets and the houses of friends down the street.

1. Families Of The Slums Pdf Online
2. Families Of The Slums Pdf Download
3. Slums Pdf Spanish
4. Families Of The Slums Pdf

Abstract

We studied historical materials to examine the conditions that gave rise to California's rural slums, the consequences of their emergence, and how interpretations of housing, health, and welfare policies by government officials, and public health officials in particular, produced health inequities for residents of these communities. For more than a century, successive groups of immigrants and domestic migrant laborers have worked on California's farms and faced numerous challenges, among them a lack of safe and affordable housing, poor working conditions, and denial of public services. Although these experiences are not new, nor are they unique to agricultural workers, they illustrate a longer history in which inequities and injustices have been rooted in the exploitation and disposability of labor. Ameliorating or even redressing inequities will require understanding the social determinants of health through ecological approaches that can overcome the historical, social, and political causes of inequity.

1. Nina Tumosa, Professor of Internal Medicine at Saint Louis University, gave me different versions of the Saint Louis University Mental Status exam (SLUMS), each in a different language. I converted the files into pdf documents available for download. Unfamiliar with the SLUMS exam? Read about it here.
2. Slums represent the worst of urban poverty and inequality. Yet the world has the resources, knowhow and power to. May include broken families, unemployment and economic, physical and social.
3. Families of the slums an exploration of their structure and treatment Published 1967 by Basic Books in New York.
4. Families Of The Slums [Salvador Minuchin, Braulio Montalvo, Bernard G. Guerney Jr., Bernice L. Rosman, Florence Schumer] on Amazon.com. *FREE* shipping on qualifying offers. A study by psychiatrists, psychologists, and social workers which examines the problems of poor urban families and assesses measures for their treatment.

FOR MORE THAN A CENTURY, waves of immigrants, predominantly non-White, have composed the agricultural workforce in California.1 By the early twentieth century, public health played a significant role in reinforcing constructions of race and class, particularly regarding immigrant populations.2 Nativist rhetoric often intertwined diseases with immigrants and reinforced the idea that immigrants threatened the health of the United States. In some cases, immigrants were excluded or were denied access to general assistance and health care services. In other cases, immigrants refused these services for fear of being deemed a public charge and running the risk of deportation.

Although the 1937 California Welfare and Institutions Code formalized an obligation for local counties to provide access for general assistance and medical care for the indigent, regardless of an individual's migration status, use of these services required proof of residency, which was at times an insurmountable burden for immigrants and domestic migrant agricultural workers who followed the crops.3 These requirements affected and depended on the ability to establish formal residency as well as where such residency was established.

Rather than focusing on the history of immigration and public health in urban communities, we examined the impact of health and housing policies on populations in rural California.4 By documenting this history, particularly regarding housing and formal residency for agricultural laborers in rural areas in the post–World War II period, we sought to address an important gap at the intersection of labor and public health history and illustrate how the inequities agricultural workers experienced were embedded in differential treatment toward immigrants and the disposability of labor. Government officials and public health officials, in particular, participated in worsening the inequities through their application and interpretation of health and welfare policies.

RISE OF THE RURAL SLUM

Farmers and agricultural interests often used employer-provided housing as an incentive to recruit workers, because they recognized that “good housing mean[t] contented workmen; contented employees mean[t] better work and better returns to the farmer.”5 This was not a new strategy; in fact, some of the largest farms had historically provided dormitory-style labor camps as an incentive to attract and retain a stable workforce. However, in most cases the shelter provided was meant to be temporary. As early as 1935, federal and state agencies established a precedent for temporary housing when they sponsored one of the most successful housing procurement programs.6 Agencies such as the Farm Security Administration built temporary units in unincorporated regions of heavily agricultural counties to address the problem of squatters’ camps that arose with Depression-era migration. Guidelines prohibited workers from staying past camp closure dates except at the request of local growers. Such arrangements illustrate the treatment of agricultural workers as a source of cheap labor, allowed to stay only as long as they were needed.

World War II and its aftermath complicated the housing situation for agricultural workers in California. Internal migrations afforded the movement, primarily of White agricultural migrants, out of agricultural labor and into defense industries. Concerns over wartime agricultural labor shortages stimulated the American government to formalize importation of Mexican nationals under what became known as the Bracero Program.7 From 1942 until 1964, the Bracero Program brought more than 4 million men into the United States to fill labor shortages in agriculture and other industries. This cooperative labor agreement allowed for relaxed regulations on housing, wages, and board for braceros, demonstrating the state's willingness to acquiesce to agricultural producers while subordinating labor.8 Agricultural interests, which had thus gained a stable pool of cheap labor, also attempted to exercise greater control over living conditions for other agricultural workers by removing existing public housing programs from the purview of the Farm Security Administration. In keeping with the mission of supplying a readily available labor force, the camps, once known as migratory labor camps, now became farm labor supply centers. Some of the centers eventually housed braceros in abominable living conditions.9 As many as 1843 centers housed braceros in the San Joaquin Valley alone. Although advocates of the Bracero Program argued that braceros could fill labor shortages but should not displace domestic agricultural workers, their presence in California had an impact on the living and working conditions of other agricultural workers across the state.10

After World War II, the San Joaquin Valley also experienced rapid population growth similar to the increases seen in the state's urban areas. Between 1940 and 1960, California's population grew by almost 9 million residents. Migration accounted for most of this growth, contributing approximately 5.9 million new residents, half of whom arrived in California between 1941 and 1944 (Table 1). Housing resources, scarce everywhere in California, became scarcer for low-income agricultural workers in the San Joaquin Valley, where the population increased 85% between 1940 and 1960 (Table 2).

TABLE 1—

Estimated Population Growth in California, 1940-1960

Source. California Department of Finance, Demographic Research Unit.11

TABLE 2—

Population Growth in California and the San Joaquin Valley, 1940-1960

Source. University of Virginia, Geospatial and Statistical Data Center.12

By 1950, the farm labor supply centers were brought up to local housing codes, and responsibility for them was transferred to county housing authorities.Even with some farm labor housing under public control, safe and affordable dwellings remained scarce. Local growers continued to offer better housing mostly to what they considered a permanent class of employee, which left many agricultural workers struggling to find housing and unable to meet formal local residency requirements to access health and welfare services.13 Agricultural workers did not refuse to establish permanent homes; on the contrary, many agricultural workers had internalized home establishment as the embodiment of the American

“Housing resources, scarce everywhere in California, became scarcer for low-income agricultural workers in the San Joaquin Valley, where population increased 85% between 1940 and 1950.”

dream.14 Throughout the 1950s, service agencies such as the National Farm Workers Ministry, the American Friends Service Committee, and the National Girl Scout Organization responded to local governmental exclusions of agricultural workers living in unincorporated areas by reinforcing these dreams of a permanent home and providing children of agricultural workers with a sense of belonging, community integration, and preparation for citizenship.15

Despite the desire of formerly migrant agricultural workers for stability, many city and county officials prevented them from establishing permanent homes by making housing scarcer.16 During the early 1950s one Tulare County city declined to build new housing on the grounds that there was no need for additional public housing.17 Although red scare fears are thought to have contributed to a decline in public housing in other regions of California, no historical evidence suggests that they contributed to such a decline in the San Joaquin Valley.18 Agricultural interests, on the other hand, sought to control labor through the control of housing. Consequently, the fear of unionization may have posed a greater threat to public housing than did the red scare.

Although agricultural workers had previously been criticized for their rootlessness, their efforts to independently establish permanent homes were not looked on favorably. In response to the lack of housing in the San Joaquin Valley, landowners and speculators spurred the creation of communities on what many considered cheap, unproductive lands. As a result, agricultural workers had the opportunity to purchase small inexpensive plots of land, dubbed working men's tracts, for as little as a $500 down payment and $10 to $25 a month.19 Workers erected their dwellings with salvaged packing cases, discarded lumber, burlap, and cardboard. In other cases, workers imported labor camp shanties to the new communities and leaned them together to make two-room homes set up in rows to approximate streets. 20 Often these informal communities were a mix of tents, shacks, and small homes that existed on the fringes of cities or in unincorporated areas outside cities. Local media, labor advocates, and White residents characterized these communities as jim towns, jungles, rural fringes, colonias [colonies], or no man's lands, and as bearing a distinct similarity to a New York tenement.21

Most of these communities shared common deficiencies: lack of community centers, no centralized formal government, no recreational activities for children, inadequate housing, no sewage, no running water, and limited job opportunities.22 Yet they offered residents proximity to work and affordable home ownership, particularly for the African American and Mexican agricultural workers who had been denied housing in established cities in the San Joaquin Valley.23 The region acquired a reputation as the “longest rural slum” in the world (neither the largest nor the oldest slum, but the longest one, spanning the entire San Joaquin Valley), and even allies of agricultural workers began to regard it that way.24 Some researchers have categorized these disenfranchised communities as immigrant gateways. Such descriptions suggest a temporary transition or imply opportunity for upward social mobility, leading to a tendency to blame members of these communities for the never-ending cycle of poverty in which they became trapped, rather than holding state and local institutions responsible for their collusion with industry and their participation in the subordination of labor and creation of a disenfranchised underclass.25

The rural slum and the urban slum, although they had different origins, were similar because both were byproducts of labor and industrial demands in the region. Post–World War II slums, as many scholars have noted, were largely seen as an urban problem emerging from an influx of Black residents and simultaneous White flight.26 However, by the early 1950s, the rural slums of the San Joaquin Valley had become permanent communities, geographical spaces where poverty, race, and labor intersected.27 Some local White residents acknowledged the similarity, stating that the unincorporated rural slums were “quite similar to the fringe areas and the slums of any city that is caused by industry.”28 Ultimately, agricultural labor needs produced one type of slum and industrial labor needs the other.29

HOUSING STANDARDS ENFORCEMENT

White residents often saw rural slums as uncontrollable “places of disease, crime, corruption, vice and destruction” that bred blighted living conditions and drove the need for county services.30 These troubling housing conditions had already gained the attention of the California Department of Industrial Relations Division of Housing, which in 1950 set out to identify and enumerate the housing units where agricultural workers lived. The survey found that some housing units were hidden away from highways or county roads and required housing officials to trek through desolate regions to uncover and inspect blighted communities of labor camps, auto courts, motels, and trailer parks. As part of the investigation (i.e., the enumeration of housing units and the survey), housing officials discovered deteriorated motels in areas with low tourist activity that had been converted into housing facilities for farm labor. The quality and type of labor camp available for workers varied by the intense harvesting requirement of a particular seasonal crop as well as by who managed the operation (farmers, grower associations, or labor contractors).

Lack of coordination between state and local authorities produced lax housing enforcement and inadequate community development for inhabitants of many rural areas. The Labor Camp Act, originally enacted in 1913 and amended continuously until 1947, was the central law overseeing labor camps.31 It authorized the Division of Housing to be the sole enforcer of its provisions. The Labor Camp Act defined camps as any living quarters, dwellings, boardinghouses, tents, bunkhouses, trailers, or other housing accommodations that housed five or more employees and was established, operated, or maintained in connection with any work. In parallel with housing legislation, however, the California State Housing Act designated both county officials and the state as the agents of enforcement. Which agency assumed the actual authority depended on the physical location of a particular community. For example, within city boundaries, county building departments had sole jurisdiction over construction, alteration, and repair of housing facilities. In unincorporated areas, county building departments shared enforcement duties with the state Division of Housing only for apartments and motels.

Although dwellings within the State of California were subject to the State Housing Act, those enforcing the act applied it only to dwellings located within city boundaries, resulting in a complete lack of enforcement in unincorporated areas. Although building codes prevented new slum developments, they did little to bring existing dwellings and communities into compliance.32 Consequently, when the Division of Housing undertook the 1950 housing survey, it used the standards of the Labor Camp Act as the measure of compliance. According to those standards, only 40% of the 703 labor camps inspected between September 1949 and October 1950 passed muster. The remaining camps—the majority—were determined to be substandard and to jeopardize the health and safety of agricultural workers who lived there.33

Thus, the rural slum did not arise solely from the actions of workers; institutional disregard toward unincorporated communities also helped create the slums. Because it was not always clear which institutions were responsible for enforcement and regulation, substandard housing cropped up with little interference in unincorporated areas, which lacked the infrastructure common to cities, such as paved streets, sewers, utilities, and water.34 Lax regulation meant that agricultural workers found opportunities to establish homes within unrecognized communities, but the lack of regulation and enforcement contributed to the institutionally created marginalization experienced by agricultural workers, who were often barred from living within city limits. When these workers attempted to establish permanent homes, they were less likely to find safe, healthy, and sanitary environments or to win political recognition from local officials.

Many local White residents and officials contended that improvements in slum communities were unnecessary because they were convinced that agricultural workers were to blame for conditions in the slums. In Fresno County, for example, representatives of local agricultural interests insisted that agricultural workers were the best paid and the best housed in the United States; their behaviors and goals were said to be the only true obstacles preventing them from gaining access to the “finer things in life.”35 Despite findings from community surveys that as many as 39% of agricultural workers in unincorporated communities of Tulare County had lived there as long as five years, many local White residents remained convinced that agricultural workers were temporary migrants.36

Local policies contributed to confining and concentrating agricultural laborers in economically impoverished, unsafe, and isolated areas. Even where agricultural workers and their allies attempted to improve these unincorporated communities, they faced local resistance when they sought equitable provision of services. The annexation of unincorporated communities offered one solution, but annexing the slums, according to some local city officials, would spread health menaces, fire hazards, and other problems into the city proper.37 These officials therefore denied annexation pleas by citing the exorbitant costs the city would incur if it annexed the unincorporated areas.38 Instead, government officials looked toward a future in which these unincorporated areas would “be completely eradicated.”39

THE IMPACT OF URBAN RENEWAL IN RURAL AREAS

Communities in unincorporated areas of the San Joaquin Valley did not cease to exist; instead, residents sought the annexation into incorporated cities to gain much-needed public and health services.40 Local organizations such as the Community Service Organization (CSO), a civil rights–civic action movement, became the state's leading Mexican American political organization after World War II. The CSO built advocacy partnerships with political organizations such as the California Democratic Council, a statewide liberal coalition that strongly advocated on behalf of the housing concerns of agricultural workers.41 Local CSO chapters turned their attention to community development, education, and health; they also fought racial discrimination, resisted police and government abuses, worked to institute better municipal services, and demanded broader economic and political reform for disenfranchised communities.42 In the San Joaquin Valley, local chapters sought the annexation of unincorporated fringe areas, insisting that annexation would give residents the opportunity to apply for home improvement loans and urban renewal programs.43

By the time the CSO began promoting annexation of fringe communities, state and national organizations were already raising awareness about the relationships between housing, health, and poverty.44 State public health officials were convinced that preserving health required cooperative relationships with community-wide participation and attention to the ecological context of disease. Environmental sanitation, as Malcolm Merrill, director of the Department of Public Health, called it,

may be said to have as a primary purpose the prevention of communicable diseases, [yet] the implications are much broader. A clean, wholesome atmosphere; clean, wholesome lakes, beaches, streams, and recreation areas; light, well-ventilated, clean houses; and rodent- and insect-free communities all contribute to health in a positive way beyond the prevention of communicable disease.46

Additional articles published in the state Department of Public Health's journal emphasized the importance of collaborative relationships between the health department, government, and civic agencies in enforcing housing laws that could prevent disease and support the health of the community.47 These efforts stood in contrast with the work of most postwar public health professionals, who had moved away from environmental causes of disease and environmental reform toward so-called magic bullets and a focus on individual responsibility in amelioration of disease.48 Yet even as the mission of public health was changing, many who recognized the importance of the relationship between housing and health overlooked the conditions in rural slums. Newly developed housing policies did little to correct the neglect that allowed these conditions to exist.

As with other progressive legislation, California was at the forefront of urban renewal and redevelopment. The California Community Redevelopment Act (1945) authorized the establishment of county redevelopment agencies to address blight; it set the precedent for the Federal Housing Act of 1949.49 This federal legislation specifically sought to eliminate blight and slum conditions through urban renewal. The California act also gave the local redevelopment agencies (mostly county housing authorities) the ability to acquire land, create public housing, demolish existing substandard properties, and relocate residents under the auspices of urban renewal. Subsequent modifications to the Federal Housing Act required communities engaged in urban redevelopment to adopt code enforcement, relocation, and other measures to curtail the spread of urban blight. In addition, the state act provided financial assistance for conservation, rehabilitation, and redevelopment, contingent on county governments’ comprehensive plan for renewal, inspection, improvement, and planning.50

Although urban renewal projects were designed to improve housing for the poor, local CSO chapters and other advocates working on behalf of agricultural workers found that communities in unincorporated areas throughout the San Joaquin Valley faced overwhelming obstacles. To qualify for urban renewal funds, local county jurisdictions had to institute planning commissions; counties without a satisfactory housing inspection, improvement, and planning commission were not eligible for federal funds.51 Most San Joaquin Valley communities, even some incorporated cities, failed to meet the federal mandates and standards and were unable to access these federal funds. Although the urban renewal plans for the City of Fresno met the minimum standards of the California State Housing Act, these plans were not sufficient to meet federal urban renewal guidelines.52 The Fresno building code prevented new slum development, but officials did not enforce housing standards for preexisting dwellings. Of the eight San Joaquin Valley counties, Tulare County's building department was the only one that met the prerequisites for federal aid.53 Inadequate local government capacity, coupled with a lack of organizational infrastructure among the planning departments in the San Joaquin Valley, was a problem not just for workers, but for all the valley's rural residents.

Urban renewal projects that did take place frequently increased obstacles and placed undue economic hardships on low-income and agricultural worker families.54 In the San Joaquin Valley, county building departments dutifully condemned dwellings that did not comply with basic measures of sanitation and safety, but often refused the owners of such dwellings the necessary permits to bring their homes up to code.55 County governments did little to help people displaced by urban renewal projects. Although the Redevelopment Act stipulated that displaced individuals were to be relocated into areas with conditions equal to if not better than their blighted communities, counties found such relocation efforts challenging and unrealistic. Health departments were unable to certify that relocation housing met minimum standards. Moreover, urban renewal demolition and relocation were generally slow processes, but orders for displacement and removal happened quickly, often without any provision of adequate and affordable relocation housing.56 With few resources to defend themselves against land loss, low-income residents were sometimes displaced by county government planning departments from their existing communities and forced into even more blighted areas. Worse, some county governments also attached the full cost of previously received welfare benefits and health services to a property's deed, thereby reducing the cash realized on homes forcibly sold under renewal programs and in many cases leaving families with even fewer financial resources.57

In the absence of a supportive local county government, residents of unincorporated areas had difficulty qualifying for any renewal funds that could improve conditions in their communities. Moreover, urban renewal funds more often went to infrastructure development, such as transportation, water, and sewage, for new suburban development within cities rather than in unincorporated communities. The built environments that replaced blighted neighborhoods within cities were problematic: new suburbs were distant from downtown centers, provided poor street connectivity, and increased reliance on cars, all features that are now known to be associated with decreased physical activity, social isolation, and poor access to healthy foods. Residents of unincorporated rural fringes, whose communities did not meet the criteria for urban renewal funds and who could not afford suburban housing, continued to live in dilapidated dwellings that exposed them to numerous health and safety violations.

One farm labor advocate overheard someone describe the problem of rural fringe communities as being “so big and so complicated that the growers and the laborers have come to a mutual understanding that they will ignore its very existence.”58

THE FARM WORKER HEALTH SERVICE

By the time Governor Edmund G. Brown Sr requested that the state Department of Public Health undertake a new study on the health conditions of and services for agricultural workers in 1960, it was no surprise to learn that agricultural workers needed better housing, better sanitation, cleaner surroundings, and improved access to health care. Bruce Jessup, MD, lead investigator on the report, wrote that the failure in meeting the health problems of agricultural workers represented a failure in the definition of community medical care. The overreliance on “orthodox approaches” such as urban-oriented standards of child care, limited clinic hours, and unaccessible clinic locations put together for middle class families, “despite their demonstrated failure,” Jessup noted, were severe limitations for health care programs intended to serve agricultural workers.59 Jessup insisted that orthodox or urban models would inevitably fail. Instead, he advocated for equal services for agricultural workers.

The Jessup report prompted the governor to initiate the first-ever scientific study of agricultural workers residing in unincorporated or fringe urban areas of the San Joaquin Valley. The study found striking disparities in living conditions (all previous scientific studies of housing among agricultural workers in California dealt mostly or exclusively with employer-provided or labor camp housing). More than 80% of agricultural workers and their families lived in dwellings that violated standards of health, safety, and comfort; nearly 65% of the dwellings occupied by general fieldworkers were dilapidated or deteriorated.60 The permanent homes and communities of agricultural workers in marginalized unincorporated areas, ignored by county governments, did not fulfill the requirements for residency. Consequently, access to clinical services, like other health and welfare concerns such as child care centers and housing, was based on criteria established for urban populations and never adapted for agricultural workers or other rural families.61

The Jessup report also provided the legislative impetus for the department to take a more active role in the health of farm workers and eventually led to the establishment of the Farm Worker Health Service (FWHS) in 1961.62 From its inception, the FWHS concerned itself with broad environmental, economic, and social issues that affected the health status of agricultural workers. This broad view of public health “beyond a mere concern with disease,” espoused by the FWHS and other advocates, was often criticized by local medical practitioners and medical societies63:

They tell me that people interested in migrant health should confine themselves to health education and nursing and not attend themselves into housing, education, etc… . I think we have a little bit of a battle looming about what is the proper sphere of operation.64

In fact, prominent medical leaders such as the president of the American Medical Association, Milford O. Rouse, MD, insisted that comprehensive projects were “bad because they were set up without the consultation with local doctors and because slum health problems can be met under already existing programs.”65 But for Paul O'Rourke, MD, chief medical officer of the FWHS, to overlook the ecological approach was simply ridiculous.

Within a few short years, staff members of the FWHS began working with the state Office of Economic Opportunity, a counterpart to national antipoverty efforts. However, this renewed focus on poverty and health for agricultural workers met with resistance from local officials in the San Joaquin Valley. County health officials questioned the need for comprehensive public policy or health and welfare plans. Instead, they maintained that agricultural workers were migratory and consequently not the responsibility of county jurisdictions. Many local officials seemed unwilling to recognize postwar demographic changes in which a great many previously migratory workers had established permanent homes in their counties. These arguments about the supposed temporariness of workers reaffirmed local health officials' views which classified agricultural workers as an ever-mobile, disposable group of migrant labor.66 An outraged Ralph V. Gunderson, sanitarian to the FWHS, responded:

[Agricultural workers] are living on ditch banks, in orchards, and along roadsides… . These people were living from their cars, and when I speak of “them” I mean family groups… . They are easily accounted for: you can count the number of cars, plot them on a map and the next evening you can talk to the people… . If the staff members [of the local health department] are willing to work, (and I'm sure they know the geography of their county), they can find these people.67

Gunderson spoke from experience. As a former Tulare County sanitarian, he was familiar with local geography and policies. In addition, as a participant in the FWHS field survey he had identified detailed housing locations and substandard housing conditions throughout the valley. O'Rourke insisted that the conditions documented in the FWHS survey showed that agricultural workers were in a state of unrecognized chronic disaster. “If this were a situation that had arisen as a result of flood or some other natural catastrophe,” he complained, “nobody would stand by” and allow the conditions to persist.68

Through their work, Gunderson, O'Rourke, and others at the FWHS attempted to broaden the mission of public health by bringing attention to the social and ecological context that shaped health conditions for agricultural workers. For these advocates, poverty itself was not a menace but rather an issue of social justice. Addressing poverty was an ecological approach that could transcend weak policies and institutional barriers while also recognizing the social, economic, and human value of agricultural workers. They highlighted the dysfunction of local (mostly city or county) officials and institutions that created needless obstacles to addressing the health and welfare of agricultural workers. The definitions, categories, and classifications under which institutions operated and determined eligibility for services had material adverse consequences for agricultural workers and for other rural Californians who were excluded.

Although the FWHS used its housing research to determine the location of greatest need for agricultural communities, they were unable to overcome local challenges.69 Locally enforced formal residency requirements continued to produce medical segregation. To many county officials, addressing the health problems of the poor required additional resources and services, such as safe housing, improved education, and higher incomes, that were beyond the scope of medical care. Comprehensive programs for agricultural workers challenged the institutional boundaries of medical professionals, who considered comprehensive public health projects to be outside the scope of medicine or an unnecessary duplication of existing resources.70 Seeking approval for such projects resurrected questions about the role of public health and debates over the treatment and prevention of illness. County health officers were frequently unwilling to rock the boat in their own jurisdictions.71 Instead, it became easier for some health officers to deny the presence of workers within their county boundaries or to incorrectly report to their Board of Supervisors that the needs of agricultural workers were being met.72

The FWHS instituted a demonstration project in 14 counties in 1961; this grew by 1966 to 24 federal–state–local projects operated in 18 different counties, some year round and some seasonal.73 All of the local demonstration projects addressed one of four health needs for agricultural workers: development of decentralized clinics, improvement of sanitation for housing in labor camps and rural fringe areas, establishment of health education programs, and extension of public health nurse services in homes, clinics, and hospitals. Not all counties identified as major agricultural areas cooperated with the FWHS; Tulare and Kings counties, both known for their intensive use of agricultural labor and for the poor health of their agricultural workers, failed to establish the FWHS comprehensive agricultural labor programs (Figure 1). Despite its best efforts, the FWHS was unable to overcome local institutional barriers to ameliorate the patterns of inequities experienced by agricultural workers and other rural residents in the San Joaquin Valley.

FWHS map for 1966–1967 showing major agricultural areas, such as Madera, Tulare, and Kings counties, that did not collaborate with the FWHS to become migrant service areas.

Note. FWHS = Farm Worker Health Service.Source. FWHS Annual Report.74

CONCLUSIONS

The systematic exclusions and marginalization of rural residents within unincorporated communities had enduring consequences that continue to this day. The experiences of agricultural workers in the San Joaquin Valley typify a long history of exploitation of immigrants as cheap sources of labor and document the roots of the injustices visited on agricultural workers in their exploitation and disposability. Rural slums did not result solely from poor planning and disinterest, as many claimed; responsibility also rested with institutions and government officials and how they chose to interpret and enforce particular laws. Moreover, this history reveals that involvement by public health advocates in housing and development policies and projects has had mixed results.75

The systematic denial of public services and the institutionally ignored health needs of agricultural workers that occurred within many rural and incorporated communities of the San Joaquin Valley occurred because agricultural workers did not have equal access to housing, much less a healthy community. Over the past century, public health advocates have attempted to address inequities and disparities through various political innovations (e.g., the New Deal, the Office of Economic Opportunity), yet the fundamental barriers persist. As public health once again focuses on ways to create healthy communities through policy, systems, and environmental change, new programs and policies are being proposed to address the nonmedical, social, economic, political, and environmental factors that influence the distribution of health and illness in the population.

In addressing these social determinants of health, we must remember that even the most progressive and radical policies may cluster social, economic, and environmental health inequities in low-income and non-White communities and constrain opportunities for people residing in those communities. The interpretation, enforcement, and application of policies by local officials in California historically did not favor equity. At every level of government, the root causes of health disparities were often overlooked or denied. As we move forward in advocating for policy and systems change, equity concerns should be addressed in all policies. We must be aware of which social groups, communities, and regions emerging policies exclude and where funding for policy and systems change is concentrated. A focus on health equity calls for fully integrating diverse communities, particularly those that have been marginalized and excluded in research and practice. If we miss these opportunities to address inequities, we run the risk of exacerbating them. ■

Acknowledgments

We thank Anne-Emanuelle Birn and the three anonymous reviewers for their incisive comments and suggestions.

Endnotes

Families Of The Slums Pdf Online

Families Of The Slums Pdf Download

Slums Pdf Spanish

Families Of The Slums Pdf