Santa Maria, California, United States
Los Angeles, California, United States
|Fig 1. Los Angeles Population Growth shown in a promotional pamphlet from 1915. From: Abbott, James W. Among cities Los Angeles is the world’s greatest wonder–Why?. [Los Angeles, The Cadmus press, 1915] Source: The Library of Congress.|
In early twentieth century Los Angeles, efforts to improve social conditions and meet the needs of the underserved and deprived often sprang from faith-based social organizations. Two notable women pioneers, Mary Julia Workman (1871-1964) and Katherine B. Higgins (1880-1967), strove to elevate the social milieu of the poor and immigrants regardless of the dictates of their differing religious affiliations. Their stories remind us of the long standing relationship between faith and charity. They inspire us to recognize that social and healthcare needs should rise above dogma.
Conditions in early twentieth century Los Angeles
The early twentieth century saw rapid industrialization and urbanization in American cities. Los Angeles (LA) grew from a sleepy frontier town to a regional population center of 567,763 by 1920, and 2.2 million by 1930. [Fig-1] There was a large-scale influx from the eastern United States, Asia, and Mexico, the last, and the largest, caused by the Mexican Revolution.1
Overcrowding, poor sanitation, unfamiliarity with local customs and language, unsafe housing, and crime were emblematic of many urban areas. The LA region was no exception. Employers frequently exploited immigrants, especially children. [Fig 2] In this chaotic mix, the Progressive Era women and men, mostly white, educated, and middle-class, exerted a major but underappreciated influence for the betterment of living conditions for the poor and immigrants. They worked through both faith-based organizations and secular institutions.2
Settlement houses similar to the Hull House of Chicago, started and nurtured by Jane Addams (1860-1935), dotted many American cities. Many women in the LA region, including Mary Workman and Katherine Higgins, played outsized roles in rendering social services to its residents.3
Religious fervor of the times
Religious fervor energized women and men to undertake faith-based initiatives that reached out to immigrants and the underprivileged. Jewish, Catholic, and Protestant organizations, as well as College Women’s Groups established settlement homes, clinics, schools, and outreach programs.4 Among the mostly Anglo-Protestant, middle-class citizenry, the immigrants’ differing faiths, languages, and cultures induced a pervasive opposition to what could “destroy the fabric of” their society. Fears included, strangely, even the practice of midwifery among immigrants. Certain newly emerging forms of religious practice leaned towards “entertainment and sensationalism.” Denominational promotion and a subdued emphasis on proselytization were also part of their agenda.5
|Fig 2. Child labor, Los Angeles version. Barefoot newspaper boys in 1915. Photographer: Hine, Lewis Wickes, 1874-1940 Source: The Library of Congress.|
Workman, Higgins, and others address immediate needs
Existing religious and socioeconomic separations narrowed when social workers, pioneers of an emerging profession, brought discordant human elements together. Indigents’ needs were met with a willingness to give to the poor, agnostics, and the faithful.6 Clinics, churches, schools, and community centers brought them all together. This was the milieu in the early 1900s, in which women excelled in their roles in the social movements for “civic improvements of all kinds.” They were more effective (“deadly”) than men in combating occupational hazards and alcoholism. They ran early free dispensaries, started the first Goodwill Industry in LA, and instituted the district nurses. “LA was the first city to municipalize the district nurse” at the instigation of Mrs. Maude Foster Weston and the College Settlement workers.7
Mary Julia Workman, scion of a prominent California family, graduated from the State Normal School (now the UCLA) in 1901 and taught kindergarten for twenty years in public schools. She drew inspiration from the Protestant settlement workers of that time and founded Brownson House (BH), a Catholic establishment on Jackson Street in LA. [Fig-3] The BH cared for the infirm and the poor through education, employment, housing assistance, and medical help. Catholic-inspired establishments were limited in that period in LA, and the BH was the first one west of the Mississippi. Between 1901 and 1920, there were 210 women and fourteen men volunteers. The Catholic hierarchy was skeptical of lay women engaging in such Protestant work outside of their homes. With rare exceptions, amity between Catholic bishops and the Protestants was unusual.8
Fig 3. Mary Workman (white frame) and volunteers who served all who sought help, in the non-sectarian environment of the Brownson House, 1916. Source: Workman Family Collection, Archives and Special Collections, William H. Hannon Library, Loyola Marymount University, Los Angeles.
Katherine Higgins, English by birth, Methodist by faith, and of modest means, emigrated to Pittsburgh as a child en famille with her widowed mother and siblings. She bloomed into a social reformer of extraordinary caliber in California. Imitating Nobel winner Jane Addams of Chicago’s Hull House, Higgins trained in social work at Chicago Commons and University of Chicago Settlement. She declined a well-paying job offer in Pittsburgh. Instead, her conscience and convictions led her to LA in 1915 to accept an initially unpaid position as a social worker, under the aegis of the Latin American Mission of the Southern California Conference of the Methodist Episcopal Church. In 1905 they had launched the LA-Plaza Community Center (LA-PCC), which had evolved by 1916 into a non-profit agency. Higgins founded the Goodwill Industries of Southern California in 1916. She served until 1949 by managing, teaching, writing for, and nurturing the PCC, and later continued her social work in other capacities.9 [Fig-4]
As in our times, underprivileged citizens of LA lacked healthcare, education, and employment. Both Workman and Higgins confronted these adversities. The BH provided comprehensive orthopedic rehabilitative services including orthotics, joint manipulations, body jackets, and complex surgeries such as Lorenz acetabular refashioning. The medical staff strove to correct congenital foot, ankle, hip, and spinal deformities with an ultimate goal of employment. At-cost hardware, radiologic tests, and even a dedicated free hospital bed were available.10
Higgins’ services, rendered from within her Methodist church, the affiliated LA-PCC, and the clinic on Bloom Street, were more comprehensive but with less of a focus on orthopedic rehabilitation.11 For example, in 1921 her clinic served 12,640 outpatients, provided 950 treatments, and gave 200 referrals. Medical, dental, pediatric and ENT specialists consulted, mostly for free. She and Workman concentrated their energies on civic improvement, refraining from negative comments in their writings about the prevailing tensions and fears between the Methodists and Catholics.
Language classes, maternal and perinatal education, employment in-loco or nearby, legal counseling, home visits, jail visitations, full-time schooling, and transportation were all part of the assistance programs rendered for free or at minimal charge. Opposing the then-popular pseudoscience of eugenics, Higgins and Workman served those from every background with respect for all beliefs and with no compulsion to convert. They took in abandoned children regardless of their color or race. “Nothing obligatory . . . and no proselytizing” was the operating credo at the PCC; Bible reading was not required. Both establishments catered to the needs of poor and immigrant Angelinos in and near the Plaza area. Although they came from different faith traditions, their endeavors were aligned, respectful, mutually sympathetic, and nurturing. Even as the Mexican population swelled, neither establishment left to serve more economically privileged loci, but stayed in the community.8.9
Fig 4. Katherine Higgins and her admiring pupils, circa 1920. Source: Courtesy and kind permission from Rev. Jennifer Gutierrez, Executive Director, Museum of Social Justice, and the Museum’s Collection, at The Tom & Ethel Bradley Center, California State University, Northridge.
Though primarily a Catholic enterprise, the BH served “all who come of every race and creed” without compromising “anyone’s religious conviction.”12 Workman and her Catholic middle-class staff borrowed organizational models from other successful Protestant progressives. Narrow ecclesiastical inflexibility and rigidity of faith-centered edicts did not stand in the way of cooperation and adoption of “non-Catholic” ideas. Catholic lay women excelled in delivering social services independent of hierarchical male church leadership. LA Bishop John J. Cantwell (1917-1947), in contrast, believed in centralized, clerical control of Catholic charities. Workman, however, emphasized individual initiative, local flexibility, and demonstrated success in her endeavors. This led to ideological divisions and eventually en masse staff resignations in 1920. After this departure, Workman stayed active in civic reform work, Democratic politics, and defense of Japanese Americans.
Similarities to current times
Illness and wellness have both biomolecular and social roots of equal depth; however, funding priorities have privileged the former. An overdue realization that social conditions contribute to health has reemerged after almost a century of dormancy. The “golden age” of medicine in the mid-to-late twentieth century diverted our attention from awareness of societal imbalances. This trend has been reversing in the last two decades.13 Religion and health, however, have had a more balanced nexus of beneficial associations. This has been especially true when one does not “prescribe” religion or view illness as an inculpating moral failure.14 In the early twentieth century, without federal funding and with scientific medicine in its infancy, faith-based organizations bore the onus of improving social conditions.
Differing ethical and moral underpinnings of religion-based traditions could hold back consensus and limit the potential for positive effects on health. Evidence of such differences in the operating credo was noticeably absent in the actions and writings of Higgins and Workman. Care of the indigent transcended edicts and dogmas. The driving force was the pressing needs of their citizenry, leaving no time for unproductive ideological analyses of the effects of particular religions on health. Infusing “spiritual joys” in the face of hunger and poverty was not a priority. The humanitarian “duty to respond to the needs of the poor and marginalized” was their mandate, as has always been the case for believers of diverse faiths.15 Even today, most patients assign a low priority to the religious affiliations of healthcare institutions when seeking medical relief.16 Social bonds can generate a positive effect,17 and Workman, Higgins, and their peers promoted social bonding without a strict tether to religious affiliation. Their work inspires us because they wove together caring and religion, a difficult task, with grace and success.18
- Figures are for LA County. US Census Bureau, “1930 Census: Volume 1. Population, Number and Distribution,” https://www.census.gov/library/publications/1931/dec/1930a-vol-01-population.html. Promoters boosted an inflow of middle-class, white Easterners and Midwesterners to the LA area. Books and pamphlets started “selling” sunshine, sea, lifestyle, mountains, and fruit. Contemporaneously, a large influx of Mexicans fleeing the Revolution (1910-1920) also swelled the region’s population. This demographic mix, with its diverging expectations, realistic and otherwise, are well documented by: Elias, Judith W. “The Selling of a Myth: Los Angeles Promotional Literature, 1885-1915.” 1979; and Abel, Emily. Suffering in the Land of Sunshine: A Los Angeles Illness Narrative. Rutgers University Press, 2006.
- Copious scholarship exists about the squalid living circumstances, neglectful treatments, and dismissive attitudes towards impoverished immigrants and non-white residents during the Progressive Era (1890-1920) in Southern California. Deverell, William Francis. Whitewashed Adobe : The Rise of Los Angeles and the Remaking of Its Mexican Past. Berkeley: Univ. of California Press, 2005; Molina, Natalia. Fit to Be Citizens?: Public Health and Race in Los Angeles, 1879-1939. Berkeley: University of California Press, 2006; Nayan Shah, Contagious Divides: Epidemics and Race in San Francisco’s Chinatown. Berkeley: University of California Press, 2001; Sanchez, George J. Becoming Mexican American: Ethnicity, Culture, and Identity in Chicano Los Angeles, 1900-1945. Oxford: Oxford University Press, USA, 1993; Abel, Emily K. “‘Only the Best Class of Immigration’: Public Health Policy toward Mexicans and Filipinos in Los Angeles, 1910-1940.” American Journal of Public Health 94, no. 6 (June 2004): 932–39; Beard, Mary Ritter. Woman’s Work in Municipalities. New York, Appleton, 1915.
- The LA Plaza area corresponds to the current El Pueblo de Los Angeles historical monument area adjacent to the Union Station, and about a mile around it. The organizations we describe here all operated in this region. See Estrada for a detailed account of the history of the Plaza.
- Estrada, William D. The Los Angeles Plaza: Sacred and Contested Space. Austin: University of Texas Press, 2008.
- Koslow, Jennifer. “Delivering the City’s Children: Municipal Programs and Midwifery in Los Angeles.” Canadian Bulletin of Medical History 19, no. 2 (2002): 399–430. Brass bands, visual aids, concerts, clubs, and amusements to “fill every pew” were part of the competition, sensationalism, and entertainment that were frowned upon by traditional adherents. “Competition in Religion: Sensationalism that has Degraded the Pulpit.” Los Angeles Times June 16, 1907, sec. Business and Finance.
- Several authors have traced the contributions of social workers to overall wellness and public health of societies. Woods, Robert Archey and Albert Joseph Kennedy. Handbook of Settlements. Charities Publication Committee, 1911; Cabot, Richard C. Social Work; Essays on the Meeting-Ground of Doctor and Social Worker, Boston and New York, 1919; Lathrop, Breanna. “Nursing Leadership in Addressing the Social Determinants of Health.” Policy, Politics, & Nursing Practice 14, no. 1 (2013): 41–47; Ruth, Betty J. and Jamie Wyatt Marshall. “A History of Social Work in Public Health.” American Journal of Public Health 107, no. S3 (December 1, 2017): S236–42.
- Pioneering efforts by Alice Hamilton, MD led to recognition of occupational hazards and improvement in industrial safety. Jacobson, Anne. “Alice Hamilton: Physician and Scientist of the Dangerous Trades.” Hektoen International, Winter 2019. https://hekint.org/2019/03/08/alice-hamilton-physician-and-scientist-of-the-dangerous-trades/?highlight=alice%20hamilton. Women were described as being “more deadly than men” in combating “common enemies of man woman.” These and other women’s contributions are elaborated in: Beard, Mary Ritter. Woman’s Work in Municipalities. New York, Appleton, 1915; “One Woman’s Good Work: Mrs. Bradley Reports on Benefits of Bethlehem Free Dispensary, a Boon to the Poor.” Los Angeles Times; Los Angeles, Calif. May 27, 1911, sec. Editorial.
- Published and archival literature about Workman is available through: Engh, M. E. “Mary Julia Workman, the Catholic Conscience of Los Angeles.” California History California History 72, no. 1 (1993): 2–19; Engh, Michael E. “Female, Catholic, and Progressive: The Women of the Brownson Settlement House of Los Angeles, 1901-1920.” Records of the American Catholic Historical Society of Philadelphia 109, no. 1/2 (1998): 113–26; Workman Family Papers, CSLA-9, Archives and Special Collections, William H. Hannon Library, Loyola Marymount University, Los Angeles; Workman and Temple Homestead Museum, City of Industry, CA https://www.homesteadmuseum.org/.
- Satya-Murti, Saty and Jennifer Gutierrez. “Addressing the Social Determinants of Health: A Los Angeles Community Center’s Narrative from 1913 to 1925.” Southern California Quarterly 101, no. 4 (November 1, 2019): 357–95; Edward Williams, “Katherine Banfield Higgins: The Good Angel of the Plaza.” (Unpublished Biography, available from the Museum of Social Justice, Los Angeles, CA; El Mexicano, a quarterly newsletter (1913-25) of the Latin American Mission of the Methodist Episcopal Church in Southern California, published Higgins’ thoughts, reports, and news dispatches. They are available as digitized archives from the Museum of Social Justice in Los Angeles < https://www.museumofsocialjustice.org/>, through their Tom and Ethel Bradley Center, California State University.
- Bradford, Edward H. “Lorenz’s Operation in Congenital Dislocation of the Hip.” The Boston Medical and Surgical Journal 135, no. 9 (1896): 205–7.
- “MEDICINE OR ADVICE: Plaza Center Assists When Problems Arise.” Los Angeles Times, Los Angeles, Calif. October 28, 1949; The Los Angeles Times covered Higgins’ retirement with a four-column report by Norma H. Goodhue, its long-time women’s club editor. Goodhue, N. H. (1949, Oct 23). “Founder of Plaza Center Paid Tribute.” Los Angeles Times, October 23, 1949.
- Workman, “Brownson House, Los Angeles, Calif., A Catholic Social Settlement,” St. Vincent de Paul Quarterly, 20 August, 1915), 175; and “Brownson House to Seek Funds,” Los Angeles Times, October 15, 1916; “Brownson House to Seek Funds,” Los Angeles Times, October 15, 1916.
- Social Determinants of Health (SDH) stress the importance of environmental and living conditions for a balanced, flourishing, and healthy society. Biomedicine, consisting of clinical intervention in symptomatic disease, does not alone correct long-standing causal inequities in social conditions. This topic has received overdue attention in recent decades. See Link, Bruce G., and Jo Phelan. “Social Conditions as Fundamental Causes of Disease.” Journal of Health and Social Behavior, 1995, 80–94; Brandt, A M, and M Gardner. “Antagonism and Accommodation: Interpreting the Relationship between Public Health and Medicine in the United States during the 20th Century.” American Journal of Public Health 90, no. 5 (May 2000): 707–15; Marmot, Michael. “Historical Perspective: The Social Determinants of Disease–Some Blossoms.” Epidemiologic Perspectives & Innovations 2, no. 1 (2005): 4; Kaplan, Robert M. More than Medicine: The Broken Promise of American Health. Harvard University Press, 2019; O’Mahony, Seamus. Can Medicine Be Cured?: The Corruption of a Profession. London, England: Head of Zeus Ltd, 2019; Armstrong, Katrina, and David A. Asch. “Bridging Polarization in Medicine — From Biology to Social Causes.” New England Journal of Medicine, March 4, 2020:888-89.
- For a hope-filled perspective on religion, spirituality, and health, see DeHaven, Mark J., Irby B. Hunter, Laura Wilder, James W. Walton, and Jarett Berry. “Health Programs in Faith-Based Organizations: Are They Effective?” American Journal of Public Health; Washington 94, no. 6 (June 2004): 1030–36; VanderWeele, Tyler J. “Religion and Health: A Synthesis.,” 2017; Levin, Jeff. “Faith-Based Partnerships for Population Health: Challenges, Initiatives, and Prospects.” Public Health Reports 129, no. 2 (March 1, 2014): 127–31; Levin, Jeff. “Partnerships between the Faith-Based and Medical Sectors: Implications for Preventive Medicine and Public Health.” Preventive Medicine Reports 4 (December 1, 2016): 344–50. There were several prescriptive practitioners of “Healing Ministry” in the country and in LA. Aimee Semple McPherson was a popular faith healer in the early 1900s in LA. Epstein, Daniel Mark. Sister Aimee: The Life of Aimee Semple McPherson. Houghton Mifflin Harcourt, 1994.
- Ferris, Elizabeth. “Faith-Based and Secular Humanitarian Organizations.” International Review of the Red Cross 87, no. 858 (2005): 311–25; Guinan, Patrick. “Is It Ethical to Bring Religion into Medicine?” Hektoen International: A Journal of Medical Humanities. 2, no. 1 (2010).
- Guiahi, Maryam, Patricia E. Helbin, Stephanie B. Teal, Debra Stulberg, and Jeanelle Sheeder. “Patient Views on Religious Institutional Health Care.” JAMA Network Open 2, no. 12 (December 2, 2019): e1917008–e1917008; Fuchs, Joseph Robert, Jeffrey William Fuchs, Joshua M. Hauser, and Marilyn E. Coors. “Patient Perspectives on Religiously Affiliated Care in Rural and Urban Colorado.” Journal of Primary Care & Community Health 12 (January 2021): 215013272110121.
- Charles, Sarah J., Valerie van Mulukom, Jennifer E. Brown, Fraser Watts, Robin I. M. Dunbar, and Miguel Farias. “United on Sunday: The Effects of Secular Rituals on Social Bonding and Affect.” PLOS ONE 16, no. 1 (January 27, 2021): e0242546.
- We could find no evidence that Workman and Higgins specifically collaborated, even though their efforts clearly overlapped. The PCC still operates as a non-profit childcare center for low-income Latino families, independent of the Methodist church; its clinic ceased operations in 2000 for lack of funding. The Associated Catholic Charities incorporated the BH into its operations sometime after Workman’s departure in 1920 and operates it in Boyle Heights to this day.
SATY SATYA-MURTI, MD., FAAN, is a clinical neurologist and health policy consultant. Following retirement, Saty has spent time researching cognitive biases, the social underpinnings of clinical medicine, Progressive Era medicine, and forensic sciences. He enjoys grandparenting, solar cooking, and volunteering.
MICHAEL ENGH, Ph.D., S.J., is a historian and an academic with an interest in the history of Los Angeles and the role of religion in the American West. He was the immediate past President of Santa Clara University in Santa Clara, California, and now is the Chancellor of Loyola Marymount University in Los Angeles, CA.