Review of Pathogenic Policing: Immigration Enforcement and Health in the US South by Nolan Kline, New Brunswick, NJ: Rutgers University Press. 2019. pp. 215.

Elizabeth Cartwright

Idaho State University

Nolan Kline’s Pathogenic Policing: Immigration Enforcement and Health in the US South is a detailed ethnographic account of undocumented Latinx individuals living in Atlanta, Georgia, in the mid-2010s. Kline describes the various intersectionalities of race, legal status, and gender as they result in differential access to health and well-being in the Latinx community; many of the problems this community faced were created and exacerbated by the immigration enforcement strategies used by the local police force.

Kline starts his ethnography with a historical review of immigration policy surrounding the various influxes of (mostly) Mexican immigrants coming to work in the United States in agriculture, construction, and other low-paid service sector industries. He theoretically situates his discussion within the Foucauldian notion of biopower, focusing on power and control over groups of people by categorizing them as “illegal” and therefore as not deserving of basic human needs such as adequate nutrition, safety, and medical care. The fear and trauma that result from the enactment of specific laws, like the oppressive HB 87 which was passed in 2011 in Georgia, resulted in a specific constellation of hurts to undocumented individuals living in that state.

The second chapter of the book is an interesting ethnographic look into how protests against HB 87 took place and how the protests were effective in changing some of the most negative aspects of that law. Through an anthropological perspective, we are invited into the world behind the scenes as Kline describes working with grassroots organizations, attending rallies and hearings in the state legislature during its 2013 session. We meet the organizers of these rallies who have years of experience living and working in the United States; some of them have extensive academic backgrounds in Mexico and they all attest to the difficulties of trying to live in Georgia while being targeted by law enforcement officials for such things as traffic stops and other offenses that would normally be considered minor in nature. They are not minor, however, for undocumented people who were at risk for being deported once their immigration status was known to the authorities. This chapter provides a window into the legislative process surrounding HB 87. This political process is tedious and frustrating, and Kline shows what tenacity it took to challenge the system; even to get an interview with some of the lawmakers was impossible. This is an area that warrants more attention by social anthropologists.

In chapters 3 and 4, the focus is more quotidian and some of the most telling ramifications of living in this situation are illustrated here. For instance, Kline takes a detailed look at how the mere act of getting behind the wheel without a US driver’s license created stress and ill health for the individuals with whom he was working. The fear of being deported was constant. The police had control over any driver as they could pull over a vehicle for many reasons; at that point they could ask for a valid driver’s license, which was a proxy for proof of citizenship. The inability to provide that license could start the deportation process. The interviewees told Kline how they changed their driving habits, missed doctor’s appointments, made alternate arrangements for getting to work, and how established provisions for their young children in case they were arrested and subsequently deported, which would leave their kids parentless. Children became pawns in these familial struggles for survival as, oftentimes, they were US citizens while their parents were either undocumented or in other tenuous legal categories like Legal Permanent Residents (LPRs). Children were left behind with extended family members or were placed in foster care in the United States when their parents were deported to Mexico. Immigration status was also shown to be a tool of coercion in situations of domestic discord or violence when one spouse threatened the other with revealing their undocumented status to the authorities to get them arrested and deported. The ramifications of forced deportation, under these conditions, rarely stopped at the border; retributions were sometimes carried out in Mexico, too. The stresses of living in this situation tore at the structure of families in many ways. While some families did persist and thrive in the United States, despite the odds, many families were ripped apart and many individuals turned to negative coping mechanisms.

Pathogenic Policing addresses some broader social issues surrounding immigration enforcement and health in chapters 5 and 6. Here, Klein includes the perspectives of healthcare providers both as individuals and as workers within the US biomedical system. We hear from doctors and nurses as they justified not getting involved in immigration battles for their patients. Whether it was through their refusal to become immigration enforcers by asking their patients for legal documents that could reveal their status or through larger value-driven codes of behavior, such as those embodied by practitioners in faith-based clinics and hospitals, the healthcare providers that Kline interviewed separated their roles as practitioners from immigration law enforcement activities. The final chapter documents immigration reform struggles and protests as they played out at the end of his fieldwork.

Overall, this book is a fine example of a medical ethnography that details the intersectionality of immigration status, policing behaviors, and the well-being of undocumented Latinx immigrants. Ethnographies are of a time and a place and, as such, they often become more important as the years go by. One thing that would have clarified the many judicial nuances described in this work would be the inclusion of some illustrative graphics, such as timelines and additional images, which would create a more precise account of how these interacting processes related to one another.

This book gives us a reference point for the future to question how and why the legal system changes as immigration pressures increase in the United States, including the inevitable increases of immigrants and refugees who will come to the United States as a result of climate change, economic need, and political violence. It will be interesting in 20 or 50 years to look back at laws like HB 87 and see if the United States has moved beyond such oppressive uses of immigration status to control the lives of people who come here to try to make a life for themselves and for their families.