“We must operate with the urgency of now. Oppression, exclusion, and racism harm and kill, sapping our society of its full potential in all corners, and especially in health.”
The AMA Center for Health Equity
In the 1960s, Johan Galtung, a Norwegian sociologist, coined the term “structural violence.” While we sometimes think of violence as a physical action, structural violence describes social structures that stop individuals, groups, and societies from reaching their full potential. These social structures can be economic, political, legal, religious, and cultural. Paul Farmer, doctor and medical anthropologist at Harvard Medical School, further explains that these structures are embedded in our social world. They are violent because they cause injuries; injuries that are often detrimental to our health and wellbeing.
If you are a person of color, an immigrant, LGBTQ+ and/or from a low-income background, chances are you have been a victim of structural violence due to being part of a marginalized group in U.S. society. Although many are not familiar with the exact term, structural violence’s existence is undeniable, and many that are affected by structural violence are no doubt aware to some degree of the structures that have caused them harm. Unfortunately, many experience and/or perpetuate structural violence without understanding its existence or their role in the structures that cause harm to others.
This was made abundantly clear when the Journal of the American Medical Association (JAMA) posted a podcast in February 2021 in which Ed Livingston, JAMA’s deputy editor for clinical content, denied structural racism. As anthropologist Lance Gravlee stated “Locating white supremacy in individuals, rather than in structures, is how the shared commitment to white ignorance preserves one’s sense of self while allowing oppressive structures to persist.”
Acknowledgment of these harmful structures is integral in necessary change. In response to the errors and harm the podcast illuminated, Livingston was asked to resign and the AMA's Center for Health Equity published an Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity. This 86-page document shed light on important topics, such as the center’s vision for equity and justice in medicine, the AMA’s history, strategic approaches, and structural violence in a multitude of oppressed communities.
This document’s deep-rooted truths and honesty regarding harmful dynamics that have normalized a hierarchy based in white supremacist and colonization educate us while validating our experiences as Latinx and Afro-Latinx in medicine.
The document also addresses the fruitless reality of treating the oppressed equally with the privileged. This “equal treatment” does not address the generations of deprivation and trauma that was falsely depicted as being caused by inferiority and/or culture. Instead, this treatment further cases injury and suffering. We encourage you to read this impressive feat in all its glory. However, we’re here to highlight structural violence pertinent to the Latinx community.
Inspired by a timeline in this document, we have expanded the information provided with details regarding crucial events in U.S. history that have harmed and killed those in the Latinx community. These laws, policies, and social interactions have caused stress and trauma that has been literally embodied by Black and brown bodies since the conception of this country, often resulting in poor health outcomes. The removal of rights and land, unconstitutional deportations, lynchings and race-based killings, and forced sterilizations have also led to a lack of generational wealth with an abundance of generational, inherited trauma.
For instance, in 1982, in the court case, Pyler v. Doe, the Supreme Court found that states cannot constitutionally deny students a free public education on account of their immigration status. But in 2011, the state of Alabama enacted a law requiring school administrators to determine the immigration status of newly enrolling students. This resulted in markedly higher rates of absenteeism for Latinx school children and caused much fear and confusion. Without an education, job prospects are narrowed with serious consequences pertaining to social determinants of health. The spiral of structural violence is born. Many similar examples are listed below in our AMA-inspired timeline.
Structural Violence and the Latinx Community Timeline
1598-1868 - Disenfranchisement
Between the late 16th and late 19th century, the United States deprived Latinx populations of rights and privileges.
1598 - Spanish Settlement of New Mexico
Conquistador, Juan de Oñate, arrived from Mexico with 500 Spanish settlers and soldiers and thousands of livestock, founding the first Spanish settlement in New Mexico.
1848 - Treaty of Guadalupe Hidalgo
This treaty brought an official end to the Mexican-American War and granted federal citizenship to thousands of Mexicans through the admission of the various previously-Mexican states.
1851 - California Land Act of 1851
This act established a Public Land Commission to determine the validity of prior Spanish and Mexican land grants. Landowners who claimed title under the Mexican government had to prove their title.
1862 - Homestead Act
This act took land that belonged to Mexicans and gave it to Americans that applied for Western land in exchange for farming on it.
1868 - 14th Constitutional Amendment
This amendment was written to counteract Dred Scott, which denied citizenship and Constitutional rights to slaves and their descendants. In its Equal Protection Clause, the Court rejected claims that discrimination could or should be defined solely in black-white terms.
1848-1928 - Juan Crow, Lynching of Mexican Americans
1889 - Botiller v. Dominguez
The Court held that Spanish or Mexican land grants were not valid and needed to be confirmed by an American board of land commissioners.
1898 - Treaty of Peace
This treaty officially ended the Spanish-American War. In the treaty, the Phillipines came into the possession of the U.S. as well as the islands of Puerto Rico and Guam.
1901 - Insular Cases
The Insular Cases are a series of opinions by the U.S. Supreme Court about the territories acquired by the U.S. in the Spanish–American War. These cases emphasize the idea that white Americans are superior to non-white Americans or Americans in U.S. territories. The ideas behind these cases were echoed in racist and paternalistic laws passed throughout the 20th century that did not permit full citizenship and equal rights to citizens in U.S. territories.
1902 - Reclamation Act
This act contributed to a boom in Mexicans migrating to the U.S. as it provided federal funding for irrigation projects in the Southwest. However, this migration led to a surge in xenophobia.
1910 - La Matanza “The Slaughter” 1910-1920
La Matanza, which translates to "The Massacre" or "The Slaughter", was a period of anti-Mexican violence in Texas. This time period included lynchings and massacres committed by Anglo-Texan vigilantes, and law enforcement justified by racism.
1917 - Jones-Shafroth Act
The act granted U.S. citizenship to anyone born in Puerto Rico. It also created the Senate of Puerto Rico, established a bill of rights, and authorized the election of a Resident Commissioner to a four-year term.
1930s - Repatriation - Unconstitutional deportations included American citizens
During the Great Depression, the U.S. deported almost 2 million Mexicans, of which more than half were U.S. citizens.
1918 - Porvenir Massacre
After a Brite Ranch raid, Texas Rangers were sent to the Porvenir area to stop banditry. Although there was no evidence that anyone from Porvenir was involved, the Rangers separated fifteen men and boys from the rest of the village and shot them.
1922 - Balzac v. Puerto Rico
After Jesús M. Balzac was denied a trial by jury in Puerto Rico, he declared that his rights had been violated under the Sixth Amendment. The Supreme Court held that certain provisions of the U.S. Constitution did not apply to territories not incorporated into the union, emphasizing the unequal treatment of individuals living in U.S. territories.
1947 - Mendez v. Westminster
After an all-white school district in Orange County rejected nine-year-old Sylvia Mendez and her brothers because of their Mexican appearance and ancestry, the Ninth Circuit Court of Appeals ruled that it was unconstitutional and unlawful to forcibly segregate Mexican-American students by focusing on Mexican ancestry, skin color, and the Spanish language.
1954 - Hernandez v. Texas
Despite more than 100 years of citizenship rights under the Treaty of Guadalupe Hidalgo, Mexicans Americans in Texas endured segregation in systemic jury discrimination. In 1951, Pete Hernandez, a young Mexican-American, was charged with life imprisonment by an all Anglo-Saxon jury in Edna, Texas. The Supreme Court unanimously ruled that the 14th Amendment protects those beyond the members of the “two class theory”. The Court recognized that Latinos were subject to discrimination based on their ethnicity despite being considered “white” under Jim Crow regimes.
1954 - Operation W*tback
Operation W*tback was an immigration law enforcement initiative between the U.S. Immigration and Naturalization Service (INS) and the Mexican government that used military-style tactics to remove Mexican immigrants (even American citizens) from the U.S.
1964 - Civil Rights Act
This act ended segregation in public places and banned employment discrimination on the basis of race, color, religion, sex or national origin.
1966 - Miranda v. Arizona
The Supreme Court’s decision on this case addressed four different cases that all involved custodial interrogations. In each of these cases, the defendant was questioned while cut off from the outside world, was not given a full and effective warning of his rights at the outset of the interrogation process and admission of guilt was elicited after questioning.
1940s to 1970s - Chicano Civil Rights Movement
This movement was both social and political. It was largely inspired by prior acts of resistance among people of Mexican descent that worked to embrace a Chicano identity.
1930s to 1970s - Sterilizations
During a span of 40 years, about a third of the female population of Puerto Rico was sterilized. This is the highest rate of sterilization in the world. Forced sterilizations targeting Latinas were also common in California. After multiple Latinas at the Los Angeles County USC Medical Center were sterilized, the judge ruled it was a “misunderstanding'' due to the women primarily speaking Spanish. The judge even blamed their distress from being sterilized on their cultural ideas of worth.
1968 - Bilingual Education Act
This act was the first federal legislation that recognized the needs of limited English speaking ability students in the U.S.
1970 - Young Lords occupy Lincoln Hospital
The Young Lords, a Puerto Rican group similar to the Black Panthers, responded to New York City’s indifference to the health needs of Puerto Ricans and African Americans in the South Bronx, specifically the deplorable conditions of healthcare delivery at Lincoln Hospital.
1973 - San Antonio ISD v. Rodriguez
Protesting a lack of resources and adequate teachers due to the area's socio-economic status, 400 high school students, mostly of Mexician origin, in San Antonio held a walkout and demonstration, marching to the district administration office. The Supreme Court stated that the system of school finance did not violate the federal constitution and that the issue should be resolved by the state of Texas. It also held that the state would not be required to subsidize poorer school districts, producing additional legal barriers to equalization.
1975 - United States v. Brignoni-Ponce
During this case, the Supreme Court determined it was a violation of the Fourth Amendment for a roving patrol car to stop a vehicle solely on the basis of the driver appearing to be of Mexican descent.
1982 - Pyler v. Doe
The Supreme Court found that states cannot constitutionally deny students a free public education on account of their immigration status. The Court determined that any resources which might be saved from excluding undocumented children from public schools were far outweighed by the harms imposed on society at large from denying them an education.
1982 - INS v. Cardoza-Fonseca
Luz Maria Cardoza-Fronseca, a Nicaraguan, entered the U.S. in 1979 on a non-immigrant permit and overstayed her visit. After actions were taken to deport her, the Supreme Court broadened the definition for the word “refugee”.
1986 - IRCA
The Immigration Reform and Control Act amended the Immigration and Nationality Act forcing employers to verify the work status of their employees before hiring, recruiting or referring for a fee. Employers must first verify work status. It also made it illegal to continue to employ someone with an unauthorized work status.
1992 - Johnson v. DeGandy
Hispanic and Black voters, along with the Federal Government, claimed that Florida's reapportionment plan for the State's single-member Senate and House districts unlawfully diluted the voting strength of Hispanic and Black Americans in the Dade County area. The court found that voting proceeded largely along racial lines, causing there to be an unlawful lack of majority Hispanic and Black House districts, imposing a remedial plan.
1992 - Alexander v. Sandoval
After Alabama added an amendment to its state constitution making English the state's official language, the Director of the Alabama Department of Public Safety ordered that driver’s license tests would be given only in English. After Martha Sandoval sued due to this discrimination, the district court agreed that Alabama's policy was discriminatory and enjoined the policy.
1994 - Three Strikes Law
This law required that anyone convicted of a felony, having already been convicted of a serious felony, be sentenced to state prison for twice the term otherwise provided for the crime, specifically targeting and terrorizing Black and Latinx communities due to unequal contact with police and the justice system. The law permitted the use of the death penalty for 60 new federal offenses, including certain drug offenses, and expanded the school-to-prison pipeline. Many states followed suit and the incarceration rate for Black and Latinx Americans boomed, causing it to be referred to as a “direct descendant of lynching.”
2012 - DACA
President Barack Obama established the Deferred Action for Childhood Arrivals (DACA) policy by executive action which deferred the removal of individuals brought to the U.S. as children.
2016 - PROMESA
PROMESA stands for the Puerto Rico Oversight, Management, and Economic Stability Act that is intended to help address the fiscal crisis in Puerto Rico.
2018 - Family Separation Policy
Under the Trump administration, the U.S. had a "zero tolerance" approach that was intended to deter illegal immigration and encourage tougher legislation at the US–Mexico border. Under the policy, federal authorities separated children and infants from parents or guardians with whom they had entered the US.
There are still many major and minor events not listed in this timeline but we hope the ones above add perspective to the structural violence the Latinx community has endured. Unfortunately, this violence continues to create barriers to education, cause health issues, and even kill Latinx individuals. Equity can only be assured when the structures in place causing this violence are demolished. For more information on health equity and structural violence, please read the AMA”s Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity.