Neighbours on notice: national and imperialist interests in the American Public Health Association, 1872-1921

Since its founding in 1872, the American Public Health Association (APHA) has devoted its energies to influencing the US's federal, state, and local governments to support public health. But within a few years of its establishment, the APHA expanded its interests beyond US borders; Canada joined the organization in 1884, and Mexico and Cuba became members in 1892 and 1902, respectively. The organization acknowledged a name change to reflect its new membership--the American, Canadian, Mexican and Cuban Public Health Association. However, official control of the organization remained in US hands. This article explores the APHA's national and imperialist interests and the involvement of Canadian, Cuban, and Mexican public health professionals in the association. We seek to understand the economic, political, and medical factors that motivated the APHA to go beyond US borders and induced Canada, Mexico, and Cuba to join the organization. We examine the scope and limits of the APHA's success in obtaining first-hand information concerning epidemic and endemic diseases in each of its member countries and in imposing measures to prevent the spread of disease from one nation to another. We also discuss the impact of the APHA in urging the four countries to pass sanitary codes and establish active national departments of health. Finally, we analyze the role of Canadian, Mexican, and Cuban public health efforts in shaping the APHA and helping the organization understand the importance of reciprocity in international public health.