Naida García-Crespo on Beatrix Hoffman’s *Borders of Care: Immigrants, Migrants, and the Fight for Healthcare in the United States*

Beatrix Hoffman’s Borders of Care: Immigrants, Migrants, and the Fight for Healthcare in the United States offers a rich history of the struggle for medical care in the United States of not just migrant and immigrants but of the general United States population. The book covers an extensive period, analyzing healthcare access from the nineteenth century all the way to present day. Geographically speaking, the book focuses mostly on the southern border, with some brief discussions of metropolitan areas like New York City and Chicago. Furthermore, while the book does provide limited discussions of European, Asian, Central American, and Caribbean populations, it focuses primarily on Mexican immigrants. Overall, the book thoroughly argues that “fights to expand health rights for immigrants and migrants created modest but meaningful improvements in the [healthcare] system as a whole” (210).

To support her argument, Hoffman offers a comprehensive history of healthcare access, particularly among non-white populations and mostly among southern-border states, that showcases how discursively political actors transformed immigrants into a health threat in the popular American imaginary. From the creation of ethnic hospital, to labor organizing, to the establishment of the Community Health Center program, Hoffman convincingly explains how the exclusion of immigrants from health services perhaps inadvertently made evident the flaws in the American healthcare system, which in turn transformed the fight for immigrants’ access to healthcare into a national struggle for every citizen’s right to adequate healthcare.

I found particularly strong the book’s fourth chapter, “From Access to Rights,” in which Hoffman discusses how 1960s and 1970s racially conscious political, labor, and social movements in both rural and urban settings positively influenced health reform across the United States. More specifically, in this chapter, Hoffman analyzes how two immigrant-centered judicial cases Madrigal v. Quilligan and Memorial v. Maricopa set the precedent for every American to have the right to informed consent, and to receive healthcare despite the duration of their residency in a particular place. Additionally, the chapter offers a thought-provoking discussion of how, historically, documented and undocumented migrants have been pitted against each other in national discourses that transform rights into a zero-sum-game among different communities.

Overall, Borders of Care, with its impressively extensive bibliography, offers a methodically documented history of how immigration and healthcare access have been rhetorically linked in the United States. As Hoffman argues, by placing unwarranted blame on a vulnerable population, politicians managed to (and still continue to) obscure systemic flaws in how healthcare is delivered/accessed by American citizens. This book is a great reference for anyone interested in cultural studies, public health, rhetoric, and/or political science.