Bad Health in a Good Retreat: Working-Class Immigrants, the State, and the Built Environment in São Paulo, 1860-2020

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“Bad Health in a Good Retreat “examines the often-competing visions of wellbeing among immigrants and representatives of the state like health professionals and policymakers. The book will analyze how rigid social structures and misattributed understandings of cause (culture) and effect (disease) often lead to enduring health issues. It treats health and care (broadly defined) as windows into the connected systems of the built environment, public health laws and practices, and citizenship. My research will demonstrate how federal, state, and municipal health and immigration legislation (from about 1850 to present) engender continuity by triangulating the history of Brazilian public health research, laws and policies, and globally dominant ideas about disease and other health issues. My diverse approaches, sources, and methods allow me to explore the interactions between health, immigration, and physical structures such as workplaces and living spaces. “Bad Health in a Good Retreat” asks how health is created by state-built environments ranging from health clinics and hospitals to sidewalks and streets.

Unlike traditional ethnic histories that often focus on single immigrant groups and their relationship with the state, “Bad Health” uses a multi-ethnic neighborhood to analyze how the state and its representatives often flatten cultural differences and why immigrants, despite different historical and cultural trajectories, often generate similar responses to policies. In addition to archival and literary research, the Lesser Research Collective has been constructing an interactive cartographic platform of Bom Retiro and conducting research in the Bom Retiro Basic Health Clinic to explore long-term continuities in the relationship between health professionals and the public.

I have chosen the neighborhood-focused approach for many reasons. First, my observation of the medical team allows me access to buildings and inhabitants, including sweatshops, unregulated multi-family housing settlements, and formal and informal businesses. Bom Retiro also contains two important institutions related to public health and the public’s health. One is the Central Disenfectory, built in 1893 built over Brazil’s first immigrant hostel (think Ellis Island), is today operated by the São Paulo Secretary of Health as a museum/archive and as a medical warehouse. Across the street, the Public Health Clinic sits on a lot that has housed a leprosy treatment center, a pro-natalist education site for expectant mothers, and a sexual health inspectory. 

“Bad Health in a Good Retreat” has been funded by a Fulbright Senior Research Fellowship, the University of São Paulo’s Institute for Advanced Study, the São Paulo State Research Foundation (FAPESP), the Emory University Research Council, and the Emory College of Arts and Sciences Interdisciplinary Faculty Fellowship.

Lesser Research Collective members Dr. Emily Pingel, Alexandra Llovet, Dr. Fernando Cosentino, and I recently published “Committing to Continuity: Primary Care Practices During COVID-19 in an Urban Brazilian Neighborhood” in Health Education & Behavior (a legally shareable, accepted version is here). Another article related to the project, that I co-authored with Dr. Uriel Kitron, is entitled “The Social Geography of Zika in Brazil” [in English in the NACLA Report on the Americas  and in Portuguese in Estudos Avançados]. 

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