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APHA, Neighbours on Notice

APHA, Neighbours on Notice

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Published by Jose Oquendo
History of APHA, precursor of PAHO
History of APHA, precursor of PAHO

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Categories:Types, Research, History
Published by: Jose Oquendo on Sep 28, 2010
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02/02/2013

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Author, position
CBMH/BCHM / Volume 25:1 2008 / p. ?? - ??
Neighbours on Notice: National
and Imperialist Interests in the
American Public Health
Association, 1872-1921
ANA MARÍA CARRILLO
ANNE-EMANUELLE BIRN
Abstract.Since its founding in 1872, the American Public Health Association

(APHA) has devoted its energies to influencing the US’s federal, state, and local governments to support public health. But within a few years of its establish- ment, the APHA expanded its interests beyond US borders; Canada joined the organization in 1884, and Mexico and Cuba became members in 1892 and 1902, respectively. The organization acknowledged a name change to reflect its new membership—the American, Canadian, Mexican and Cuban Public Health Association. However, official control of the organization remained in US hands. This article explores the APHA’s national and imperialist interests and the involvement of Canadian, Cuban, and Mexican public health professionals in the association. We seek to understand the economic, political, and medical factors that motivated the APHA to go beyond US borders and induced Canada, Mexico, and Cuba to join the organization. We examine the scope and limits of the APHA’s success in obtaining first-hand information concerning epidemic and endemic diseases in each of its member countries and in imposing measures to prevent the spread of disease from one nation to another. We also discuss the impact of the APHA in urging the four countries to pass sanitary codes and establish active national departments of health. Finally, we analyze the role of Canadian, Mexican, and Cuban public health efforts in shaping the APHA and helping the organization understand the importance of reciprocity in interna- tional public health.

Ana María Carrillo, Research Professor, Faculty of Medicine of the National Autonomous
University of Mexico.
Anne-Emanuelle Birn, Canada Research Chair in International Health, University of Toronto.
CBMH/BCHM / Volume 25:1 2008 / p. 225-254
Résumé.Depuis sa fondation en 1872, l’Association Américaine de Santé

Publique (APHA) a employé son énergie en vue d’influencer les gouverne- ments, des États-Unis au niveau fédéral, au niveau des États et dans le soutien de la santé publique. Mais quelques années après sa fondation, l’APHA a étendu ses intérêts au-delà des frontières américaines : le Canada a rejoint l’organisation en 1884, puis le Mexique et Cuba sont devenus membres en 1892 et 1902, respec- tivement. L’organisation a changer son nom pour reéfléter ses nouvelles adhé- sions – L’Association Américaine, Canadienne, Mexicaine et Cubaine de Santé Publique. Cependant, le contrôle officiel de l’organisation est resté entre les mains Américains. Cet article explore les intérêts nationaux et impérialistes de l’APHA, ainsi que la participation des professionnels de santé publique cana- diens, cubains et mexicains dans l’Association. Nous examinons la portée et les limites du succès de l’APHA dans l’obtention d’informations immédiates con- cernant les maladies épidémiques et endémiques dans chacun de ses Etats membres et dans l’imposition de mesures pour empêcher la diffusion de ma- ladies d’une nation à une autre. Nous discutons aussi de l’impact de l’APHA dans l’incitation des quatre pays à voter des codes sanitaires et à établir des ministères de la Santé au niveau national actifs. Finalement, nous analysons le rôle des Canadiens, des Mexicains et des Cubains dans la formation de l’APHA et dans la compréhension de l’importance de la réciprocité dans la santé publique internationale.

Resumen.Desde su creación en 1872, la Asociación Americana de Salud Pública

(APHA) centró sus esfuerzos en influir en los gobiernos locales, estatales y federal de los Estados Unidos, para que éstos apoyaran a la salud pública. Sin embargo, poco tiempo después de su creación buscó, asimismo, traspasar sus fronteras: en 1884, Canadá se unió a la organización, y México y Cuba se convirtieron en miembros de la misma en 1892 y 1902, respectivamente. Desde entonces, se le llamó Asociación Americana, Canadiense, Mexicana y Cubana de Salud Pública, si bien los estadounidenses tuvieron siempre el control de la misma. Este artículo explora los intereses nacionales e imperialistas de la APHA, así como la partici- pación de profesionales de la salud pública canadienses, mexicanos y cubanos en la asociación. Intentamos entender los factores médicos, económicos y políticos que motivaron que la APHA traspasara los límites de los Estados Unidos, y per- suadiera a Canadá, México y Cuba de afiliarse a la organización. Estudiamos los alcances y límites que tuvo la APHA en la obtención de información de primera mano sobre las enfermedades epidémicas y endémicas de cada uno de los países miembros, y en la imposición de medidas para evitar la introducción de las enfermedades de un país a otro. Discutimos también la influencia que tuvo la APHA al interior de lo cuatro países para poner en vigor códigos sani- tarios y organizar enérgicos departamentos de salubridad. Finalmente, anal- izamos el papel que desempeñaron los avances sanitarios de Canadá, México y Cuba en la configuración de la APHA, y en ayudar a la organización a entender la importancia de la reciprocidad en la salud pública internacional.

During the last two decades of the 19th century, public health profes- sionals from North and Latin America began to meet at periodic Pan- American Medical Congresses and created ties that would prove instru- mental in the establishment of the region’s (indeed the world’s) first international health organization in 1902: the International Sanitary

226
ANA MARÍA CARRILLO and ANNE-EMANUELLE BIRN

Office (ISO)—later the Pan American Sanitary Bureau (PASB) and now the Pan-American Health Organization (PAHO)—based in Washington, D.C. With its early focus on sanitary treaties and the protection of com- merce, the ISO served as a beacon of international health priorities, from surveillance, standards, and information exchange to a subsequent emphasis on technical co-operation and the development of public health legislation, policies, and principles.1

The ISO, however, was not the first organization to forge formal rela- tionships between the United States and its neighbours in the Americas. The American Public Health Association (APHA), founded in 1872, invited Canada to join in 1884 and began to seek Latin American part- ners five years later. Though the call was heeded only by Mexico, which joined APHA as a regular member in 1892, and Cuba, which in 1902 was emerging from three and a half years of US occupation, the APHA became an important venue for exchange and interaction among the four countries, particularly in the decades preceding World War I.

The US had a longstanding, often problematic, political and public health relationship with many Latin American countries, while Canada’s relations with its Latin American counterparts were more circumscribed, involving limited trade and investment concerns and representing British imperial interests in the Caribbean.2 Overshadowed by, and reluc- tant to disrupt, US dominance in the region, and bearing an allegiance to Great Britain and Commonwealth countries until well after World War II, Canada joined PAHO only in 1971 and the Organization of American States as late as 1990.3 As such, until the 1970s the APHA was virtually the only organization through which Canadian public health profes- sionals engaged directly with Latin American colleagues,4 and the APHA served as the venue for the initial public health relationship between Canada and the republics of Mexico and Cuba.

This article explores the APHA’s nationalist and imperialist interests and the involvement of Canadian, Cuban, and Mexican public health professionals in the organization. We seek to understand why the APHA, which was, after all, a national organization created to shape and influ- ence federal and local public health policymaking, sought the member- ship of other countries of the Americas in the Association; what were the economic, political, and medical factors that motivated its activities beyond US borders; why Canada, Mexico, and Cuba decided to join the APHA; and what was the impact of APHA membership in advancing public health in these countries. Although the interactions and contra- dictions between the US and each of the other three countries will be the primary focus of this study, we will also touch upon public health rela- tions among Canada, Mexico and Cuba.

This analysis focuses on the period from 1872 until 1921, when the
APHA celebrated its 50th anniversary. Although Mexico and Canada
Neighbours on Notice
227

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