When asked on national television on Nov. 29 why the Latino population in El Paso faced a major health crisis, Republican Mayor Dee Margo, said Hispanic people were hospitalized more for covid-19 than “normal White Caucasians.” He failed to address the city’s large number of low-wage essential workers and his own refusal to support a lockdown to curb the spread of coronavirus.

Such racial inferiority-based explanations for disproportionately high rates of infection and death in the Latino population have long been used by regional political elites to evade accountability during health crises. They also distract from the underlying structural causes of widespread sickness and death: negligent leadership and political, economic and health care systems shaped by over a century of anti-Mexican racism.

The racist politics of this crisis have been made visible in the actions of predominantly White state and local politicians, in addition to local business owners, who repeatedly blocked Mexican American County Judge Ricardo Samaniego’s lockdown orders issued when infection rates spiked in October. Texas Gov. Greg Abbott (R) called Samaniego (D) a “tyrant” and Texas Attorney General Ken Paxton (R) used the courts to block public health measures. Siding with state officials, the mayor sought to further evade accountability by resorting to the language of personal responsibility, saying “we can control this spike with our personal actions.”

Yet the pictures of tent-filled hospital parking lots, inmates loading bodies onto refrigerated trucks, and reports of patients left to die without adequate care — many of them Latino — tell another story. It’s a story that bears a striking resemblance to a situation that El Pasoans faced a century ago.

During the early 20th century, tuberculosis exposed the white supremacist ideologies and practices that made the region’s Latinx population so vulnerable to massive death. Introduced into the region by thousands of predominantly White sufferers of the disease who hoped to recover in the warm, dry desert climate, tuberculosis quickly spread to the working-class Mexican community. Health officials noted Mexican women suffered from especially high infection rates as they were employed in large numbers to care for White “health seekers” in sanitariums and private homes.

In June 1910, Mexican physician José A. Samaniego, great-uncle of current County Judge Samaniego, addressed a large crowd in the Mutualista Hall about the growing number of Mexican deaths from tuberculosis, as well as high infant mortality. Prevention was critical, he argued, and city leaders had failed to take actions to contain the spread. Low wages, and unsanitary and overcrowded living conditions imposed on the Mexican community made them particularly vulnerable to exposure, infection and death. Noting all “efforts are almost useless if they do not remove the cause,” the physician concluded, “[c]ould the people in the Anglo-Saxon residential section tolerate … for a moment such [conditions]?”

Rather than enact public health measures that would mitigate the crisis, however, White health officials and politicians blamed the devastation felt disproportionately by Mexicans and Mexican Americans on their purported biological inferiority and culture. U.S. Public Health Service officer Ernest Sweet, for example, claimed working-class Mexicans in El Paso died of tuberculosis in high numbers because they were a “primitive people” with a “large admixture of Indian blood.” In this way he borrowed from well-established, but since debunked, beliefs surrounding Native Americans’ susceptibility to disease to shut down reports of Whites infecting Mexicans.

Political leaders further insisted the Mexican infant mortality rate, at one point 10 times that of the city’s “American babies,” resulted from “dirty” midwives and “ignorant” mothers feeding their babies watermelon and coffee. They overlooked the low wages employers paid their parents and the lack of sanitation services in their neighborhoods. Shifting blame to Mexican Americans and Mexican immigrant residents for high mortality rates, government officials diverted attention from their own policies, which limited Mexican Americans’ political power and access to fair wages, adequate health care and safe living and working conditions.

These racist ideas of biological and cultural inferiority persisted long after the health crisis fell from view, sharpening as the city underwent demographic change. Beginning in 1910, thousands of Mexicans fleeing the violence of the Mexican Revolution — some of whose early battles were fought just yards away in Ciudad Juárez, Mexico, in 1911 — sought refuge in the city. By 1917, the former White-majority town was declared America’s “most Mexican city,” with a population 55 percent of Mexican origin. Local Whites bristled at the trend, with one man writing a letter to the El Paso Herald in 1926 lamenting the city’s “vanishing white race.” The editor, however, reassured the writer that[a]lthough the “Mexicans” bring more babies into the world, they also lose more of them from disease [and] malnutrition.” In other words, the elevated Mexican infant mortality rate, like high mortality from epidemics, functioned as an effective check on the growth of a Mexican American citizenry.

Fears of a growing Mexican American population also resulted in an inadequate health care system. In 1930, despite the persistence of high mortality rates that kept El Paso in the national news, the White community successfully blocked a bond that would have funded the expansion of the general hospital, whose conditions an American Medical Association inspector called the most “primitive” he had ever seen. Opponents of the bond argued the hospital was “filled with Mexicans,” although hospital administrator S.H. Newman, of mixed Anglo-Mexican descent, reported “Americans” made up 45 percent of the patients treated.

Opponents were particularly fixated on denying Mexican American women access to hospital-based maternity care, arguing their bodies were ideal for giving birth at home “on dirt floors.” The inadequacy of the city’s health care infrastructure, despite widespread poverty, abysmal provider-to-patient ratios and a large uninsured population, would persist into the 21st century. Furthermore, a diverse set of providers — from midwives Felicitas Provencio, Rosa Martin and Teru Kurita, to White public health nurse H. Grace Franklin, to African American physician Lawrence A. Nixon, and White pediatrician Junius A. Rawlings — worked tirelessly to fill the void of care for Mexican and Mexican American families in those first decades of the 20th century.

Anxieties surrounding the growth of the Latinx population, coveted by business leaders for low-wage labor but deemed unfit as citizens, is important context for understanding current racial disparities in covid-19 related deaths. Official neglect for Mexican lives during today’s pandemic persists because many in the business sector and the government continue to see Latinx people as a temporary workforce — not equal citizens.

It is important to recognize it has been the strength of El Paso families, so often pathologized by politicians during this crisis as a reason for viral spread, that is helping this community through this terrible crisis. While not yet reported, anecdotal evidence suggests some of those who have died became infected as a result of taking responsibility for the care of others who, due to inadequate social services, were otherwise without care. They died as a result of their acceptance of responsibility for other people’s well-being, not the selfish act of refusal to sacrifice for the common good.

The massive loss of lives to covid-19 this year is but one recent result of the long history of public health and inequality in the region and the racist ideas that continue to shape public policy. As Mexican physician José A. Samaniego warned in 1910, it’s time to address the root causes of these issues and place the blame exactly where it belongs: structural racism that has fueled health disparities in the city of El Paso and beyond.