While these topics are usually treated as separate academic inquiries, Loyd persistently and powerfully reveals them to be multiple fronts of state violence. Health Rights Are Civil Rights places “health” at the center of investigation through lively archival engagement with popular struggles...

Introduction

While these topics are usually treated as separate academic inquiries, Loyd persistently and powerfully reveals them to be multiple fronts of state violence. Health Rights Are Civil Rights places “health” at the center of investigation through lively archival engagement with popular struggles for health in Los Angeles in the 1960s and 70’s. Loyd compellingly shows that state violence—spectacular and more indirect forms—is a health problem:

“Health and violence cannot be understood as mutually exclusive issues so long as there is social injustice” (15).

The book is a tightly interwoven yet lucid and inviting account of the vibrant scope of people’s health projects within broader struggles for social change at the beginning and end of a Great Society political era. Loyd excavates layers of war-making and welfare repression in the Southland landscape, and constructs a richly empirical and analytical story of “how Cold War geopolitics became body politics in the space of the clinic, in the streets, and through the urban geopolitics of warfare and welfare” (2). Health Rights Are Civil Rights details the practical-everyday and epistemological efforts of Black freedom, antiwar, welfare rights, and women’s movement activists “to heal, politicize, and prevent the bodily harms of state violence, racism, poverty, and patriarchy” (2). It is a moving portrayal of the “spirit and breadth of health demands that animated these movements”—social welfare, child care, clean air, jobs, peace, housing, justice, dignified medical care, and bodily well-being—as the common ground for alliances, debate, conflict, and solidaritous thinking and action (2).

The commentaries that follow expand on historical, theoretical, methodological, and personal aspects of Health Rights Are Civil Rights. First presented at the 2013 Association of American Geographers meeting in Tampa, FL, this iteration of the book forum includes contributions from Javier Arbona, Paul Jackson, Becky Mansfield, and Katherine McKittrick. The remainder of this introduction provides an overview of the book’s layout and signals a few key contributions—an establishing shot for the subsequent reviews. It is impossible to capture the various ways this book can be read, utilized, and enjoyed; it is a well-crafted assemblage with many possible entries and departures. A second aim of this introduction, then, is to draw out the book’s formal qualities and underscore the social practice of this kind of political history text. Health Rights Are Civil Rights is a call-to-action—not through the conventions of the authorial vanguard but, rather, via Loyd’s careful channeling of other thinkers-in-action and layering of her analytic connections with theirs in the narrative. The book’s form achieves an ethical constellation of archival materials, activist critical practices, and Loyd’s own interventions that re-appraise historical arguments in order to illuminate other legacies of struggle that remain with us. The dynamic text cultivates spatial-intersectional thinking, as central to people-powered projects for justice and bodily well-being in the past and as an imperative today.

Before mapping the general structure and empirical terrain of the book, the formal and methodological politics of Health Rights Are Civil Rights merit further discussion. First, the book constructs political history through an “intersectional archive” that draws correspondences between activist epistemologies (see Jackson review). The text recaptures little-known currents of activism in the 1960s that linked democratic health care to ending militarism, as essential to creating cities of freedom, peace, and social justice. Loyd shows how civil rights, peace and justice activist movements redefined health as a structural issue that could be challenged at multiple scales—most prominently, at the level of everyday needs—a platform from which to build capacities for broader social change. Health Rights Are Civil Rights is essentially a genealogy of unfinished struggle based in Los Angeles, a model terrain of militarized racial economy and policy. The book examines how past social movements made analytic connections between health and violence to challenge ideologies and material geographies of war, racism, and sexism. The failures of postwar political movements, too, are re-visited and assayed in order to foster critical spatial thinking and continue unfinished peace and justice agendas. The revisionist effort of the book should not be underestimated: in reading the text we come to realize that popular understandings of these social movements are limited; they are structured through sexist and racist ideologies of war that falsely separate domestic racial liberation movements from peace, and reproduce discrete understandings of welfare rights and anti-war efforts (18).[2] Loyd elucidates, “Received histories of this era, even some critical ones, have reproduced the militarized ideology of war as external to the United States as a nation. Likewise, the gendering of these histories—namely the masculinist privileging of militancy and direct action antiwar demonstrations over organizing around mundane issues of daily life—has prevented understandings of the full terrain of civil rights, women’s, and antiwar organizing” (107-8). In response, Loyd assembles political geographies of health that move beyond single issues or identity politics to show the historical labors of coalition-building around vital needs, as the means to support larger-scaled transformations. History operates, here, to render the often paralyzing complexity of war-making and violence concrete for action.

Second, Health Rights Are Civil Rights innovatively undertakes health politics as scale politics. Loyd’s methodology starts with an understanding of health as a social spatial relation rather than merely the result of medical practices or individual behaviors. Accordingly:

Health is not simply bodily or biological, but fundamentally social. Health inequalities can be understood as spatial inequalities to the degree that health is shaped by uneven social relations and material environments. This makes the geographic scales at which people understand “health” and “health promotion” prime areas of conflict (16).

Loyd foregrounds the relationship between health and militarization, broadening focus to the direct threats of organized violence and the numerous indirect ways that policies support and augment war-making, thereby creating different life possibilities for different groups of people (7). Loyd queries:

“For whom is war not healthy, and who is made ‘healthy’ from war?”(11; see Mansfield review).

Challenging hegemonic understandings of health that ignore violence and limit our conceptualization of the geographic scales of health, Health Rights Are Civil Rights establishes how “war-making has a domestic geography” that profoundly shapes regional and metropolitan landscapes as well as internal class and social hierarchies and life chances (25). Unhealthiness and “health brutality” are tied to military infrastructures, militarized racial economy, and racialized austerity, all of which embed premature death into the material organization of everyday life  in the U.S. through uneven spatial relations of harm and well-being (13; see McKittrick review). Counteracting the extent to which dominant meanings and geographies of health obscure (state) violence by aligning with the binarism of war/peace, Loyd tracks the continuities of violence and repressive state practices across war and home fronts, revealing the “nationalistic and militarized ideology of a strict separation between the domestic and foreign spheres of government action” (9; see Arbona review). For this pursuit, she compellingly develops the idea of “militarized domesticities” to demonstrate how violence and militarized priorities become naturalized in the interlocking scales of the (white suburban) home and nation, obscuring the military-industrial complex and domestic racism that unevenly structure life on the home front (18; 109).

Two additional inter-scalar analytics largely figure in Health Rights Are Civil Rights, cultivated within the empirical terrain of organized violence in Southern California and efforts to materially link and politicize the connections between war and hunger, war and poverty, war and health. The “warfare-welfare nexus” challenges the ideological and material bounding of inner city and suburb and the repressive treatment of urban crisis as exceptional rather than ordinary and integral to racism and war for the U.S. as a nation. This political geography of the city is crucial to understanding how an “urban-suburban Cold War” defined and played out in the Southland’s racially differentiated residential landscape and defensive posturing toward urban crisis (8). The axis of “Cold War geopolitics—body politics” further articulates the everyday embodied materiality of war’s unhealthiness: the layering of state violence and constitutive links between landscape, infrastructure, such as hospitals, and embodied harms. In Loyd’s words, “Cold War geopolitics were not abstract, distant from everyday life concerns, but were visceral and homely. The body politics of the Cold War reached from the atmosphere and into children’s teeth. They also extended onto the streets where people protested Jim Crow health care and housing, war, and sacrifices for military priorities” (2). Body politics thus provides “a useful lens through which to view how welfare rights, antipoverty, and peace movements struggled to open clinic doors and to create healthy living conditions, which included ending state violence” (15).

Third, Health Rights Are Civil Rights charts a practical utopian relationship between health and freedom that Loyd has described as the collaborative practice of “freedom’s body.” Health “refers to more than an absence of unfreedom but positively animates what we might understand as freedom” (14). Loyd strategically considers health to be a state of being—namely the embodied, lived effects of socially produced harms—and a discourse about people’s desires for well-being and bodily integrity (14). “Health can be understood as the political shaping of biology at the level of scientific understanding and for individual and collective bodily practices” (14). Struggles for health, then, dialectically connect “the necessity of meeting immediate needs and healing with long-term, broadscale organizing efforts to create healthier, freer, and socially just relations and spaces for living”; in other words, health is about individual and collective bodily self-determination (14-15). The book dislodges dominant medical institutions and the focus on the isolated and medicalized individual body—as the singular sites and sources of health. Instead, Loyd theorizes social change as a collective embodied project and, conversely, reconceives the body as a material locus of collective labors (see Jackson review). Loyd explains this pivot around the body and well-being as a site of collaborative action:

“Premature death and health inequalities are bodily expressions of unfreedom at its most intimate and abstract” yet the “visceral quality of unfreedom captured by ideas of structural violence and excess death” is an inverse way of understanding an instinctual basis for freedom (12; 13).[3]

Cautioning against essentialist claims, Loyd gestures toward what might be considered an ontology of rebellion as vital—embodied through practical, experiential, and relational oppositions to war and violence that endeavor to heal bodies and reclaim cities. “Health promotion becomes a project of ending premature death and promoting peace”—defined not only as the cessation of armed conflicts and organized violence but also the flourishing of human capabilities (13). As the layered histories within the book suggest, solidarity is made possible in conditions of war that can work for the futures that war forecloses, but “the project of building common futures must confront the specific ways in which racism and class undercut universalist visions” (179). Health Rights Are Civil Rights persistently uncovers how bodily well-being and healthy living conditions are achieved through building solidarities—through practical resistances and everyday organizing against multiply-scaled violence and inequities that unevenly structure our material realities and impede individual and collective thriving (see McKittrick review). “Freedom’s body” is nothing short of a radical strategy for social justice. It uncompromisingly insists that bodily harms and healing are enmeshed in the material remaking of the city, and diligently nurtures health rights as the collective peace and justice project of an unfinished humanity (2; 247).

The book is arranged into three main sections, with a total of eight chapters, an introduction, and epilogue. The introduction lays out the empirical and conceptual terrain, including key discussions of Cold War American exceptionalism and home front geopolitics, theorization of health and violence (premature death, body politics, social crisis in medicine, etc.), and Loyd’s agenda of tracing alternative geographies of health/violence, peace/war, and freedom/unfreedom. It also sketches an overview of the book’s chapters (17-20; recapped below) that is subsequently supported and advanced by truly insightful segues that mark the end of each chapter and inaugurate the next one.

Chapters One and Two comprise Part I “Desegregating Health, Transforming Health,” which grounds 1960s-70s health activism in the political geographies of white supremacy and militarization of Los Angeles/Southern California. Health discourses reinforced long-established associations between “densely crowded, poor neighborhoods, racial difference, and disease”; dominant geographies of health obfuscated the relations of violence and white property tying the urban poor and suburbs together and “producing unequal neighborhoods and life chances for residents” (47-48). As the inequities of racial segregation deepened through suburbanization, health and civil rights activists took on the spatialization of racial inequity as a health problem (48), shifting the blame of poor health from the people most vulnerable to illness and onto the broader scale social institutions that were responsible (17). Chapter One scrutinizes the militarized political geography of the Southland, revealing how Los Angeles’ defense economy contributed to racial and class exclusivity. Loyd discusses how struggles over segregation—specifically efforts to expand health care and access decent housing—were “met by anti-tax and private property arguments, which built on the sanctity of the white home” (17). A subsection on the intersecting Cotton Curtain and Missile Crescent of the LA landscape includes a devastating appraisal of slum reasoning and the ideologies of equal opportunity and private property. Chapter Two focuses on efforts to launch the War on Poverty in Los Angeles before and after the 1965 Watts uprising and captures the contradictory ideas of community control that hinge around the King-Drew Medical Center and War on Poverty-funded Southcentral Multipurpose Health Center in Watts (17-18). According to Loyd, struggles for access to care were coupled with efforts to change the very practice of health care (52), but community control of health facilities and social programs would be limited by austerity measures (76) and the emergence of poverty as a “racially exclusive problem” removed from “histories of racial discrimination and economic transformation” (59).

The second section (“Part II: Urban Crisis”) delves into 1960s mobilization and the strategies that were implemented to resolve what came to be understood as urban crisis (18). Within the context of what Loyd theorizes as militarized domesticities, activists developed strategies to confront the interrelations of racism, warmaking, economic transformation, and the state’s ready deployment of violence to contain people’s freedom movements (81). Chapter Three navigates the scale of the city and the ways peace and racial liberation movements cultivated a shared political terrain through critical interpretations of and solutions to urban crisis (81). How Black freedom, peace, and welfare rights activists understood the constitutive ties between U.S. warmaking and racism takes center stage—including the colonial occupation of space, domestic economy of warmaking, and continuities of violence across scales. While Loyd observes the failure of these efforts to fully register the degree to which warmaking contributed to urban inequalities, she details how these survival programs and serve-the-people projects necessarily challenged both state violence and the state’s failure to materially remedy racial inequality and poverty. In the process, they exposed the embodied effects of urban crisis and demonstrated different possibilities for living. Chapter Four looks at the coalition between women peace and welfare rights activists that cohered in the 1970s to challenge the ways that warmaking imperiled the home, urban ecologies, and children’s futures. Loyd compellingly argues that the racialized contradictions of Cold War domesticities enabled peace and welfare mothers to coordinate a political formation that she calls “Mothering Underground,” which united around reconstructing the home on a less exclusive basis (109-10). The chapter “highlights the interracial, cross-class tensions of political mothering and the alternative geography of health they nonetheless collectively created” (19). In doing so, they would “come closer to articulating a revolutionary, antiracist perspective on peace and freedom” (104). Rounding out this section, Chapter Five concentrates on the interracial antiracist, antiwar, and anti-austerity coalition that formed around critiques of the continuities of violence between the Vietnam War and domestic oppression (129). According to Loyd, “the language of genocide” became a central way radical people of color linked imperial wars waged abroad “to daily experiences with state violence and racialized poverty on the domestic front” (134) Opposing both fronts of state violence, these activists made crucial connections between police brutality, white supremacy, and welfare oppression. The chapter considers self-defense and revolutionary violence to be related aspects of self-determination, and includes a keen analysis of the ontological reversal of welfare—the life-sustaining objective of income supports—into a war against welfare recipients as enemies of the nation (147).

Part III on “Cold War Body Politics” addresses “the contradictory place of the body and clinic as sites of repression and austerity, liberation and health justice” (19). Chapter Six situates the postwar history of reproductive justice within the context of the welfare rights and peace movements, and within Cold War debates over population, poverty, and revolution (154). Scrutinizing the links between U.S. urban crisis and “population explosion” discourse, the chapter recounts how the international continuity of coercive anti-poor solutions to poverty, such as forced sterilization, galvanized international antiwar solidarity and domestic antiracist struggle (155).[4] Loyd judiciously assays the gains and pitfalls of health and abortion rights activists in this milieu: they achieved some political autonomy through collective knowledge and noncooperation with the state/medicine; however, they were unable to fully account for differential embodied vulnerability, in part because their liberatory visions were tied to the scale of the body—a legacy that remains with us today in the narrow memory of reproductive justice as simply a matter of “life” versus “choice”  (171; see Mansfield review). Chapter Seven deliberates on the place of community clinics in transforming the medical system and the role of doctors in social change during the mounting health care crisis of the late 1960s to early 1970s—an “explosive collision between people’s struggles for health and bodily self-determination and the fiscal and legitimation crises in medicine” (19; 183). Revisiting the organizational reforms advocated by the health-focused left and feminist movements, Loyd explores the contradictions of the community health worker ideal and advocacy capacity of the free clinic and neighborhood health center programs; the cooptation of radical collective self-help into medicine as “self-care”—as a biomedicalized remedy for the fiscal crisis of health care—is one stunning example (193). The chapter ends by querying why proposals for national health insurance failed and the consequences of those failures.

Returning to the militarized grounds of California, Chapter Eight takes stock of welfare and health cuts in the 1970s and positions austerity as an explicit political project that further undermined progressive metropolitanism, entrenched inequalities, and championed property rights over human rights (19). Loyd shrewdly dispels the “backlash thesis” that naturalizes U.S. decline as inevitable, by foregrounding the political maneuvering and geopolitics of urban crisis, corporate tax revolt, the violent suppression of the left, antifeminism, and repression of welfare recipients, and the New Right’s body politics of individual discipline and personal responsibility (209). The latter, bolstered by individualized health discourses in biomedicine, obscured the “widespread bodily harms produced by rampant medical care inflation, associated local fiscal crises, and dismantling of public health infrastructure,” and effectively scapegoated those who were most vulnerable to austerity (236). Loyd speculates on what else might have been done—such as reframing welfare and inflation in terms of urban reconstruction—to launch alternative metropolitan futures rather than the battery of militarized solutions to urban crisis. The epilogue picks up on the ways that metropolitanism still holds possibility as an antiracist strategy for progressive redistribution (235). Briefly profiling current grassroots efforts to tie health rights with myriad other rights (education, housing, employment, safe environment, food sovereignty, dignity, and so forth), Loyd presents hope for rebuilding “the common ground that might unite the poor and middle class around a shared project of economic and urban reconstruction” (237-8).

The fragile gains and losses of the people’s health movements of the 1960s and 1970s, garnered within the pages of Health Rights Are Civil Rights, show us that “the possibilities for peace and freedom remain grounded in articulating claims to the city that challenge declared and undeclared wars” by “connecting the dots among different sectors and developing shared organizing strategies” (20; 245). Loyd brilliantly observes that reversing the displacement of war is “the real battleground for building a people’s city” (237). She urges a cultural project of demilitarization:

“to reshape domestic imaginations of how cities are built, who may live in them, and how they are organized” (246). “This will require coming to terms with the ways in which racism undergirds meanings of home, freedom, and security and informs answers to social and economic crises. It will also mean turning capacities for violence into the grounds for the beautiful, self-determined futures so many people desire” (238).

Loyd vividly illuminates for us a social practice of “author as interlocutor of struggle” and the unassailable necessity and bold promise of health promotion to social change.

‍

Notes

[1] See also Loyd et. al. (2012). This anthology explores the formidable connections between imprisonment and bordering, and ties together prison abolition, no borders, and decolonial theory and practice.[2] These are but two examples of the many binarisms that can be attributed to an imagined geography of war as external to the nation, with peace presumed to be domestic security—all of which obscure broader structural violence and relations.[3] Loyd builds on Avery Gordon’s reading of New Left theorist Herbert Marcuse; “instinctual basis for freedom” is Gordon’s expression for “identifying the longings that already exist—however muted or marginal or extreme—and turning these longing into vital needs, into things we cannot and will no longer live without” (Gordon 2004, page 125).[4] Loyd succinctly captures the injustice of this operation, “U.S. urban crisis and Third World restiveness were conceptually linked through a racialized logic that aimed to prevent upheavals through minimizing threatening numbers rather than rectifying the harms of concentrated wealth” (156).

References

Gordon A F (2004) “Some thoughts on the utopian.” In Keeping Good Time: Reflections on Knowledge, Power, and People. Boulder, CO: Paradigm Publishers.

Loyd J M, M Mitchelson, and A Burridge (2012) Beyond Walls and Cages: Prisons, Borders, and Global Crisis. Athens, GA: University of Georgia Press.

‍

‍Review by Javier Arbona After I read Jenna Loyd’s Health Rights Are Civil Rights: Peace and Justice Activism in Los Angeles, 1963-1978, I couldn’t help but to keep thinking more about John McCone. McCone becomes the subject of discussion in this book for his role as the chair of the “blue ribbon” commission chartered to find the reasons for the Watts uprising of 1965 in Los Angeles, California. The then governor Pat Brown appointed the (predominantly white) members of what came to be commonly called the McCone Commission. It plays a relatively brief—yet crucial—part of the deeper story of Health Rights because the commission “found that the area’s poor health indices and scarce medical facilities contributed to the uprising”...

‍Review by Paul Jackson For full disclosure, I’ve known Jenna Loyd for years. Therefore I can’t divorce my experience of reading of her new book, Health Rights Are Civil Rights from knowing her as both a scholar and a friend. As long as I have known Jenna, she is constantly on the move, intellectually restless, travelling constantly, and always seeking political change. As a practice, Jenna adds a “militant” modifier to this movement, a reminder that everything can be turned into a political moment and open to analysis. When Jenna rolls into town, she gathers together an amazing group of scholar/activist/artists and she is always bringing in new people, forming an ever-increasing constellation of thoughts and actions. How I was brought into her circuit was such an illustrative exchange, indulge me for just a moment because this digression is a good introduction to the book...

‍Review by Becky Mansfield Health Rights Are Civil Rights is a truly wonderful book on bodily harm, state violence, and struggles for justice. Tightly focused on Los Angeles activism in the 1960s and 1970s, it is also sweeping and multi-layered, drawing together seemingly disparate issues such as urban spatial form, geopolitics, and access to medical care. It is not only that we cannot understand these activist movements—their issues, demands, approaches, successes, and failures—without placing them in wider context. Rather, it is by investigating how activists themselves made wide-ranging connections among aspects of life commonly held apart that we gain a better understanding of things like cities, wars, poverty, health, and justice. What makes the book so impressive is that Loyd not only analyzes activist movements, but in so doing she treats these activists as themselves analysts...

‍Review by Katherine McKittrick Jenna Loyd’s Health Rights Are Civil Rights locates the ways in which health, militarization, gender, and race intersect in Los Angeles. The book draws attention to the ways in which the civil rights and other activist movements that began in the 1960s came to understand and articulate how health is a multi-scalar concern—located not only through and within intimate scale of the body, but also connected to the neighborhood, city, region, state, nation, and globe.  More specifically, Loyd’s argument demonstrates, at least for me, the monumental workings of imperialism and white supremacy—for in this book, she carefully outlines how health is tied to a set of social and spatial relations that are bound up in a racial economy of war making. The context allows her to show how war, at home and abroad, nuclear armament, poverty, racism, policing, housing, and labour are interlocking global processes that unfold in Los Angeles in meaningful ways...

‍Response by Jenna M. Loyd I am honored and grateful for the care that Javier Arbona, Paul Jackson, Becky Mansfield, and Katherine McKittrick have taken in their thoughtful responses to Health Rights Are Civil Rights. And my tremendous thanks also to Shiloh Krupar for organizing this review and an author meets critic session at the Association of American Geographers meeting in Tampa in 2014. Theirs is the kind of care and intellectual generosity that sustains academic life, especially in difficult political times. In my essay, I’d like to respond to some of the issues that the reviewers make regarding the double-edgedness of health and the ongoing relevance of histories of 1960s and 1970s health activism to the current moment...

‍