Community Organizing and Health Access in New York City's Chinatown in the 1970s
New York City’s Chinatown is just one of many Chinatowns that exist throughout the United States. Much like other Chinatowns, it is in a dense urban area populated by a vibrant, diverse community. Located on the Lower East Side in between three bridges, Chinatown exists side by side with other historically ethnic enclaves, including Little Italy, nearby. To understand the uniqueness of New York City’s Chinatown, though, it is useful to understand how and why Chinatowns emerged nationally.
Chinese immigration to the West Coast is a fairly well-known historical phenomenon: first seeking work in California’s gold mines, then later railroad and infrastructure construction, many Chinese immigrants made their way to the western United States. There, they faced xenophobic, often-violent hostility from other workers. In response to the rising tensions between white workers’ racial anxieties and Chinese workers attempting to build a new life in America, the government intervened to protect white workers’ belief that Chinese workers were “job stealers.” The Chinese Exclusion Act of 1882 prevented Chinese immigration for 10 years, and set a precedent for dramatically limiting Chinese immigration for decades beyond that. It prevented Chinese people in the United States from becoming citizens, which made building community for Chinese Americans increasingly difficult. The Act also made it near-impossible for women and children to immigrate, making it difficult for Chinese male workers to start families or maintain family ties.
Still, those who stayed in the United States and settled down found community and protection in mono-ethnic areas: what would become known as Chinatowns. These areas were typically in “inner-city areas” where land was less desired. In the “Yellow Peril” era of the late 1800s and early 1900s, and as the neighborhoods became more visible, Chinatowns became a target of discrimination and mob violence. Products from Chinatown in San Francisco had to be labeled as such. In the 1880s, an anti-Chinese riot in Denver led to their Chinatown being erased. And in 1906 in Santa Ana, California, a Chinatown was torched after a man allegedly had leprosy. There were countless more incidents, all of which contributed to an atmosphere of fear and isolation.
The formation of Chinatowns in the northeast, like New York City’s Chinatown, began to expand rapidly following increasing violence on the West Coast in the late 1800s. With the promise of more job opportunities and diversity than areas on the West Coast, many Chinese Americans moved to New York City and began to build a community around Mott Street in the 1870s. Growth slowed following the Chinese Exclusion Act in 1882. However, restaurants in Chinatown continued to grow and flourish on Mott and Pell Street, with non-Chinese New Yorkers enjoying the food as well.
By the passage of the 1965 Immigration and Naturalization Act, with the exclusion laws and immigration quotas lifted, Chinatown and the Chinese American population in New York City began to grow rapidly. With this growth came complications, as well as new forms of community organizing, including increased demand for accessible, bilingual health resources in Chinatown. The 1965 Act prioritized the immigration of “highly skilled” AAPI workers, marking a distinct shift in immigration policy. It made pathways to immigration and citizenship easier and allowed families to immigrate as a unit. But it also perpetuated stereotypes about Asian American immigrants, including the Model Minority Myth. The Model Minority Myth is a stereotype that positions Asian Americans as the “model minority" in comparison to other minority groups, including Black and Hispanic people. It focuses on the success of Asian Americans, removing credit for real accomplishments achieved through merit by Asian Americans as portraying them as "natural.” While masked as a “positive stereotype,” this stereotype overshadows the racism and discrimination that the Asian American community faces. It can also prevent struggles within the Asian American community from being seen, including health disparities.
The Lower East Side, the neighborhood that surrounds Chinatown, has been a diverse immigrant community since the early 19th century. In the mid-19th century, one of the earliest immigrant populations which settled there were Germans. As the German population rose in the city's class and social hierarchy in the late 1800s and began to slowly move uptown, other white ethnic immigrant groups moved in. Eventually, Eastern European Jewish and Italian populations also began to put down roots in the neighborhood in the late 19th and early 20th century. These groups are often overly centered in stories about the neighborhood, particularly when talking about the history of tenements. However, Black, Puerto Rican, and Chinese communities also had — and continue to have — a large presence in the Lower East Side, and have worked together to overcome many financial, health, and legal struggles on the Lower East Side.
Many historic Chinatowns were built in "undesirable" parts of their cities, packing people into buildings with old infrastructure and poor sanitation. This population density and a lack of health insurance meant that health issues and the spread of infectious diseases was and continues to be a prevalent issue in Chinatowns. Large amounts of goods were transported in and out of these neighborhoods to support restaurants, hand laundries, and other businesses, increasing traffic pollution and further exacerbating health and respiratory issues. New York City’s Chinatown featured predominately tenement-style buildings, which often were tightly packed with residents, had poor sanitation and ventilation, and offered little light or clean air. These were ideal conditions for the spread of respiratory diseases, including tuberculosis. Decaying buildings and spotty health services further contributed to the fact that in 1970, New York's Chinatown had one of the highest rates of tuberculosis in the country.
Some key community groups that emerged in the late 1960s, including the Young Lords and I Wor Kuen, would eventually organize around access to TB testing and treatment. These health care-focused initiatives, along with other community issues like education and housing, led to health advocacy becoming a pillar of these groups' missions. Though Chinatown's position in the Lower East Side, surrounded by other immigrant and working-class communities, sometimes led to tensions, it also allowed for the possibility of true community solidarity. These instances are highlighted in the collaboration between the Young Lords and I Wor Kuen in fighting for accessible health care services in Chinatown.
In the larger context of the Civil Rights Movement, the Black liberation movement, and the New Communist Movement of the 1960s, many new revolutionary organizations arose. These included student activist groups, as well as groups organized around particular racial or ethnic identities. These groups included the Black Panthers, the Young Lords, and I Wor Kuen, among others. All three groups emphasized providing direct services to their communities in various ways, including health care. I Wor Kuen, in particular, was an important presence in New York City's Chinatown in the late 1960s and 1970s. It's useful to understand a little more about each group and how they were founded in order to better understand how they shared political ideas and collaborated.
The Black Panthers
Founded in October of 1966 in Oakland, California, the Black Panther Party (BPP) — formally known as the Black Panther Party for Self Defense — critically influenced the work of both the Young Lords and I Wor Kuen (IWK). The BPP had a far reach in many areas: challenging white political power, providing community services or “survival programs”, and protecting Black people from police brutality by all means, including armed self-defense. The party, founded by Huey Newton and Bobby Seale, wanted to go beyond the liberal Civil Rights Movement's demands to integrate Black people into American society. Instead, they called for fundamental changes in society itself: for Black Power, rather than white acceptance. Local chapters organized “survival programs” as community mutual aid, offering free breakfast, sponsoring schools and legal aid offices, and organizing health clinics. Women, although underrepresented in how we commonly think of the Panthers — often as armed, and usually as male — ran most of their survival programs.
The BPP articulated their mission in what was known as their Ten Point Program, a model which was a clear influence on other radical groups' creation of their own ten (or twelve) point programs, including IWK and the Young Lords. Below is "What We Want" — the list of demands initially included in the Black Panther Party’s Ten Point Program.
The Young Lords
The Young Lords were established by José “Cha-Cha” Jiménez in 1968 in Lincoln Park in Chicago, Illinois. Modeled after the Black Panther Party, their members were originally part of a Puerto Rican street gang that morphed into a community-based organization. They advocated for healthcare, education, employment, and housing in minority communities. They also demanded Puerto Rican self-determination and collaborated with other revolutionary nationalist groups, including the BPP and IWK. Eventually, the Young Lords expanded from Chicago to New York City's East Harlem, and grew to be a multi-ethnic and LGBTQ+-inclusive organization. Some initiatives of the Young Lords in both cities included free breakfasts for community members, Puerto Rican community centers, and free health clinics — on which they often collaborated with other groups, including IWK. Like both I Wor Kuen and the Panthers, the Young Lords had monthly newspapers with political editorials and listings of their events and community services, published both in Chicago and New York City. Interest in healthcare advocacy in the Young Lords' New York chapter was especially piqued as Mingo El Loco, who helped organize events for the Young Lords, died of stab wounds after an ambulance took over an hour to arrive to East Harlem. This was an issue of medical racism and city neglect that resonated with several areas in the city, including the Lower East Side.
The Young Lords' focus on health care and hospital access for their community also led to the occupation of the South Bronx's Lincoln Hospital in 1970, a protest meant to disrupt the understaffing and poor treatment that many Puerto Ricans experienced there. Their health activism was summed up in their Ten-Point Health Program:
I Wor Kuen
The last of the three organizations to form, I Wor Kuen (IWK) was a Marxist-Leninist organization formed in New York in 1969, and the primary organization involved in starting the Chinatown Health Fairs. The organization emphasized unity amongst oppressed people and solidarity with other groups, including the Young Lords. IWK was composed of a diverse Asian and Asian-American population: working people, elders, students, and even working-class youth. Their community work consisted of education initiatives and community-based programs, often publicized in Getting Together, the IWK's bilingual newspaper published in both Chinese and English. The newspaper both educated the public on local and global political issues, and also helped organize the public by bringing awareness to community-based initiatives or resources. The IWK eventually expanded to both coasts as a result of a merger with the Red Guard Party in San Francisco, another city with a large AAPI population. Throughout the group's lifespan, it critiqued capitalist society and hoped to bring attention to the injustices and oppression marginalized groups experienced due to U.S. imperialism, including health disparities and poor living conditions. These were issues directly addressed in the services provided at the Health Fairs.
Similar to the Black Panthers and the Young Lords, I Wor Kuen articulated their group's mission statement around a twelve-point program. Point seven, as seen below, highlights health advocacy as part of their goals.
Though there were ideological differences between all three groups, they shared many common political principles and a commitment to taking care of their own communities. Comparing and contrasting their guiding principles — and how they manifested in the local work they did in neighborhoods — may be a helpful way to think about cross-racial solidarity.
The healthcare advocacy of both IWK and the Young Lords occurred in a time period where healthcare globally was rapidly shifting. Post-World War II, changes in the structure of US medical care along with growing instances of documented medical discrimination in the age of civil rights advocacy also stirred growing discontent in many minority communities. Events, including shifting away from the privatization of healthcare in Cuba and rapidly increasing rates of disease in migrant populations, led to demands for improved healthcare, especially in marginalized communities. Veterans returned from war with injuries and disabilities that required longer-term care than the state could provide. And insurance access, particularly for seniors or for low-income communities, was spotty, and the idea of a public safety net (Medicare or Medicaid) was tangled in Cold War-era anxieties over any public services being equivalent to "community" or "socialist" medicine.
By the time Lyndon B. Johnson assumed the American presidency in 1963, some changes were coming. While LBJ's "Great Society" did fund some new community health clinics and finally managed to sign Medicare into law, the 1960s into the 1970s saw small, local medical practices — which often waived or reduced costs for low-income community members — go under, and be replaced by mainstream hospitals and large medical research institutions. Remaining private practices often shifted to offer “luxury healthcare.” Due to the increasingly for-profit-dominated health care system, lower income community members often relied on free city public health resources. These were often not actually concentrated in areas that needed them most, like East Harlem and the Lower East Side pre-1970. In the absence of the city or the state providing the services that people needed, community groups often stepped in to serve their own people. Organizations like the Young Lords, the BPP, and I Wor Kuen all faced similar questions: how could they build community structures that would fill gaps in healthcare, and how would they reach the people who needed them most?
For all three groups, having their own newspapers or newsletters was a key part of directly reaching people. The IWK's Getting Together publication was a tool for strengthening coalitions, both bringing attention to available community services and writing editorial coverage on why they were so needed. As mentioned in the prior section, the bilingual English-Chinese newspaper emphasized language accessibility, and involved young people in the writing and translation of the publication.
In the July 1970 Issue of Getting Together, a newspaper clipping reads:
“I WOR KUEN has increased its efforts to serve the community through TB testing. Door-to-door Tine testings being done twice a week or more, and a survey of community health problems and facilities has been incorporated into the program. I WOR KUEN has also acquired the facilities of the X-RAY truck recently liberated by the Young Lords Organization in New York City, and will be used for follow up of positive Tine tests.”
(Tine tests are now outdated, but at the time of publication, they were one of the most common ways to screen for tuberculosis. The testing mechanism also benefited from being small and relatively portable, meaning that community health groups could easily administer them themselves.)
From this excerpt, we can see that the publication not only hopes to advertise their services to the public, but also to highlight minority community organizations building solidarity and recognizing their shared struggles. While New York had public health services that would come directly to neighborhoods, the trucks that screened for TB would often come unannounced, during hours when working-class community members were busy, or not at all. Often, providing services in one minority community was framed as taking them directly from another. The Young Lords sharing their TB testing resources with the AAPI community on the Lower East Side is a direct argument against that myth. The excerpt in Getting Together explicitly highlights this, combating narratives of anti-Blackness or the model minority myth that attempted to pit minorities against each other. Instead, they proclaimed:
“This is an example of how revolutionary groups of different races can cooperate to together SERVE OUR PEOPLE”.
In August of 1971, the health care services provided by organizations like I Wor Kuen and a desire to mobilize the community through health care advocacy led to the first Chinatown Health Fair. Growing discontent with the few services provided by the city, especially to immigrants, made it deeply significant that the first Chinatown Health Fair provided both bilingual and bicultural services. The Fair was influenced by the larger Civil Rights Movement, and used the gathering as a way to advocate for rights including health care — and beyond. The first Health Fair was a labor of love for community organizing, involving collaboration between I Wor Kuen, Basement Workshop members, local churches, activist and photographer Corky Lee, and more.
It was especially important to I Wor Kuen members that the Health Fair provided bilingual health access. To help, they mobilized bilingual youth — younger, radical Chinese Americans — to help translate and provide services. A New York Times article published on August 1, 1971, reads: “The youths offered their services as interpreters for the non English speaking, to help take the mystery out of modern medicine. The young people feel that often when a person is not given an explanation of a finger‐prick test, for example, he is liable to fear the unfamiliar procedures.” Many youth involved came from Asian student organizations from universities, such as the Chinese Students Association at Columbia University. Similarly to the bilingual articles published in Getting Together, the inaugural Health Fair emphasized the growing importance of language-accessible resources in an era of growing immigration to the United States.
The Health Fair adapted to meet the needs and culture of its surrounding community. They offered services targeting the diseases that were most prevalent in Chinatown: tuberculosis, but also conditions affecting the elderly, families, and smokers, like lung cancer information or blood pressure testing. They aimed to meet language needs, as well as Chinese cultural practices. Booths at the Health Fair didn’t just include Western medicine, but also health care that aligned with Chinese cultures, including a booth where community members could receive herbal medicine treatments and acupuncture. According to Regina Lee, a then-New York University student and an organizer of the Health Fair, “While you're taking this medication, it's probably not advisable to take herbal medicine because they might be contraindicated. We don't tell patients to stop because we respect the culture of Asia. A lot of our providers probably also [use] herbal medicine [themselves].” By offering both herbal medicine and Western treatments without judgment, giving information and allowing community members to make their own choices, the Health Fair, as well as the clinic that arose from it, aimed to respect cultural traditions while providing effective health care to the community.
The Health Fair went beyond just providing health services. It also emphasized educating individuals on their rights beyond a once-yearly community gathering, advocating for community health services, including the Chinatown Health Clinic. The CHC opened the same year as the first Health Fair, founded and run by bilingual volunteers, who were community members, students, doctors, and nurses. The center was part of a larger national community health center movement, with centers opening in Boston, Massachusetts and Mound Bayou, Mississippi in prior years. It was renamed as the Charles B. Wang Community Health Center in 1999, to honor Charles B. Wang, a philanthropist who provided support to the clinic. The center was run originally out of a church on Mott Street, and has since expanded to include locations in Flushing, a permanent location in Chinatown, and more.
While the original 1971 Health Fair emphasized providing preventative health services, including TB testing, blood tests, and X-rays, by 1973, the fair had expanded its mission. While providing the same services, it placed more emphasis on a larger goal of educating community members on all of their rights, including housing and health care access.
The Gouverneur Hospital, which was under a period of construction when the first Health Fair took place, was one of the only city-owned, full-service hospitals serving the Chinatown and Lower East Side communities. Understanding its role in the neighborhood is crucial to understanding the state of health care access in Chinatown in the late 1960s and early 1970s, and the multiracial coalition which came together to advocate for it. Though it was state-of-the-art when it first opened around the turn of the century, by the 1960s, Gouverneur had seen better days. In 1961, its hospital accreditation and ability to provide inpatient service were both removed. Beth Israel, a large city hospital, took over its outpatient services, but their priorities were very different than those of neighborhood activists. The Hospital Council of Greater New York had been attempting to shut down Gouverneur in various forms since the 1950s. Their proposed replacements for the care it provided were nowhere near adequate for the services, both routine and emergency, that a large, diverse neighborhood like the Lower East Side required.
The city's main roadblock in their attempts to close Gouverneur Hospital was the Lower East Side Neighborhood Association (LENA): a coalition of Asian, Black, Hispanic, Italian, and Jewish community members. This coalition represented all the different waves of immigration that Chinatown and the Lower East Side had experienced in the first sixty-odd years of the twentieth century. The LENA coalition focused on the gaps in the hospital's inpatient and outpatient services, the labor conditions at the hospital, and the hospital's lack of translators and bilingual medical staff. These issues were a key factor in the community needs that the Chinatown Community Health Fairs would address.
As seen in the above photograph, which declares that "1/4 of the workers at the new Gouverneur must speak Chinese!", many members of LENA advocated for the city to hire bilingual workers and for the hospital's staff to reflect the neighborhood it served. Many members of LENA went on to found the Lower East Side Health Council South, which continued to take up these issues throughout the 1970s. In the photograph below, Corky Lee, a photographer and neighborhood activist involved in the creation of the Community Health Fair and the Charles B. Wang Community Clinic, documented the protest.
Following the establishment of the “new” Gouverneur hospital in 1972, the hospital began to produce newsletters aimed at educating and engaging the community. Similar to I Wor Kuen’s Getting Together, the paper was bilingual, providing English as well as Mandarin translations of the paper. The paper demonstrates the continued need for communication, and highlights the media as a tool for community-building and creating transparency. These values were key to fostering a service that truly reflected community needs.
In the English-language issue of the Gouverneur Newsletter reprinted above, published within the first nine months of the hospital’s reopening, the writers highlight “community struggle” as key to the creation of the hospital. They emphasize the reliance on community health centers in areas like the Lower East Side. In particular, they discuss a neighborhood health center affiliated with Gouverneur, and the federal requirements that these centers involve community members. These seem to indicate some interest, at least, in a participatory approach to running the health center.
However, the article also mentions tensions between private “medical empires” and community needs, which had led to the closure of health centers in major urban areas, including Los Angeles, Denver, and Boston. They make reference to the struggle in maintaining community needs while dealing with capitalist-driven medical empires, which prioritized profit over people. Truly community-run clinics like the Charles B. Wang Community Health Clinic, previously known as the Chinatown Community Health Clinic, did not face these same challenges. However, the inclusion of this item in the newsletter already demonstrates efforts at transparency and including community voices. Moreover, the article “Health in China” highlights an attempt to incorporate traditional medicine and bicultural health services into city-run hospital services, including acupuncture.
Today, health inequalities still persist in Asian American communities. The intersection between health care access and racism was further highlighted by the outbreak of the COVID-19 pandemic in 2020, which saw shortages in testing access and treatment in public hospitals. This was also accompanied by a spike in anti-Asian hate crimes, particularly in visibly Asian neighborhoods like New York's Chinatown.
During the pandemic, those with insurance, access to private health care, and the ability to shelter at home without losing pay experienced significantly better health outcomes than those who were uninsured or worked outside the home. Even today, those with access to private health care still tend to be wealthy white people. Medical care without insurance is incredibly expensive, and there are barriers outside of cost that keep many from accessing it: language barriers, cultural differences, unfriendly hours, and many more practical considerations. Many of the same issues that prompted I Wor Kuen and other groups to prioritize community-based health still exist today.
The Charles B. Wang Community Health Clinic, which still provides services to Chinatown's community, continues to expand in other Chinese ethnic enclaves, including Flushing. They still host a community health fair every year, demonstrating the same need for community health education, education on rights, and community-oriented public health services. Many city agencies, including the Office of Immigrant Affairs, continue to be involved, and table at the fair. They aim to educate citizens on their rights, connecting to the mission of the fair since 1971. The health fair still relies on bilingual staff and volunteers, embodying their mission of accessible health care that can meet community needs in all forms.
The community health fairs and health advocacy of the 1970s still embody an example of community organizing by the community, for the community. It speaks to the importance of involving community leadership to ensure that culturally reflective services reflect the needs of community members. Solidarity between different communities on the diverse Lower East Side demonstrates that minority communities are able to use collective organizing to strengthen advocacy, ensuring their needs are met and not ignored.
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