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Contagious diseases have long posed a public health challenge for cities, going back to the ancient world. Diseases traveled over trade routes from one city to another. Cities were also crowded and often dirty, ideal conditions for the transmission of infectious disease. The Europeans who settled North America quickly established cities, especially seaports, and contagious diseases soon followed. By the late 17th century, ports like Boston, New York, and Philadelphia experienced occasional epidemics, especially smallpox and yellow fever, usually introduced from incoming ships. Public health officials tried to prevent contagious diseases from entering the ports, most often by establishing a quarantine. These quarantines were occasionally effective, but more often the disease escaped into the cities. By the 18th century, city officials recognized an association between dirty cities and epidemic diseases. The appearance of a contagious disease usually occasioned a concerted effort to clean streets and remove garbage. These efforts by the early 19th century gave rise to sanitary reform to prevent infectious diseases. Sanitary reform went beyond cleaning streets and removing garbage, to ensuring clean water supplies and effective sewage removal. By the end of the century, sanitary reform had done much to clean the cities and reduce the incidence of contagious disease. In the 20th century, public health programs introduced two new tools to public health: vaccination and antibiotics. First used against smallpox, scientists developed vaccinations against numerous other infectious viral diseases and reduced their incidence substantially. Finally, the development of antibiotics against bacterial infections in the mid-20th century enabled physicians to cure infected individuals. Contagious disease remains a problem—witness AIDS—and public health authorities still rely on quarantine, sanitary reform, vaccination, and antibiotics to keep urban populations healthy.

Article

Death is universal yet is experienced in culturally specific ways. Because of this, when individuals in colonial North America encountered others from different cultural backgrounds, they were curious about how unfamiliar mortuary practices resembled and differed from their own. This curiosity spawned communication across cultural boundaries. The resulting knowledge sometimes facilitated peaceful relations between groups, while at other times it helped one group dominate another. Colonial North Americans endured disastrously high mortality rates caused by disease, warfare, and labor exploitation. At the same time, death was central to the religions of all residents: Indians, Africans, and Europeans. Deathways thus offer an unmatched way to understand the colonial encounter from the participants’ perspectives.

Article

David S. Jones

Few developments in human history match the demographic consequences of the arrival of Europeans in the Americas. Between 1500 and 1900 the human populations of the Americas were traBnsformed. Countless American Indians died as Europeans established themselves, and imported Africans as slaves, in the Americas. Much of the mortality came from epidemics that swept through Indian country. The historical record is full of dramatic stories of smallpox, measles, influenza, and acute contagious diseases striking American Indian communities, causing untold suffering and facilitating European conquest. Some scholars have gone so far as to invoke the irresistible power of natural selection to explain what happened. They argue that the long isolation of Native Americans from other human populations left them uniquely susceptible to the Eurasian pathogens that accompanied European explorers and settlers; nothing could have been done to prevent the inevitable decimation of American Indians. The reality, however, is more complex. Scientists have not found convincing evidence that American Indians had a genetic susceptibility to infectious diseases. Meanwhile, it is clear that the conditions of life before and after colonization could have left Indians vulnerable to a host of diseases. Many American populations had been struggling to subsist, with declining populations, before Europeans arrived; the chaos, warfare, and demoralization that accompanied colonization made things worse. Seen from this perspective, the devastating mortality was not the result of the forces of evolution and natural selection but rather stemmed from social, economic, and political forces at work during encounter and colonization. Getting the story correct is essential. American Indians in the United States, and indigenous populations worldwide, still suffer dire health inequalities. Although smallpox is gone and many of the old infections are well controlled, new diseases have risen to prominence, especially heart disease, diabetes, cancer, substance abuse, and mental illness. The stories we tell about the history of epidemics in Indian country influence the policies we pursue to alleviate them today.

Article

The issue of genocide and American Indian history has been contentious. Many writers see the massive depopulation of the indigenous population of the Americas after 1492 as a clear-cut case of the genocide. Other writers, however, contend that European and U.S. actions toward Indians were deplorable but were rarely if ever genocidal. To a significant extent, disagreements about the pervasiveness of genocide in the history of the post-Columbian Western Hemisphere, in general, and U.S. history, in particular, pivot on definitions of genocide. Conservative definitions emphasize intentional actions and policies of governments that result in very large population losses, usually from direct killing. More liberal definitions call for less stringent criteria for intent, focusing more on outcomes. They do not necessarily require direct sanction by state authorities; rather, they identify societal forces and actors. They also allow for several intersecting forces of destruction, including dispossession and disease. Because debates about genocide easily devolve into quarrels about definitions, an open-ended approach to the question of genocide that explores several phases and events provides the possibility of moving beyond the present stalemate. However one resolves the question of genocide in American Indian history, it is important to recognize that European and U.S. settler colonial projects unleashed massively destructive forces on Native peoples and communities. These include violence resulting directly from settler expansion, intertribal violence (frequently aggravated by colonial intrusions), enslavement, disease, alcohol, loss of land and resources, forced removals, and assaults on tribal religion, culture, and language. The configuration and impact of these forces varied considerably in different times and places according to the goals of particular colonial projects and the capacities of colonial societies and institutions to pursue them. The capacity of Native people and communities to directly resist, blunt, or evade colonial invasions proved equally important.