Public Health Policies and the Role of the State in Latin America: Workers’ Housing Projects in Chile and Peru (1880-1940)

The debates regarding the impact and costs of public and private health, and the responsibility of the State to offer access to healthcare are ongoing discussions in Latin American countries. This paper discusses the relationship between State formation and public health in Latin America, using case studies from Chile and Peru from the late 19th-to mid-20th centuries. In this period, public health was a determining factor in State consolidation. Multiple sectors debated and pushed the State to embrace public health as a national issue and provide healthcare as a citizens’ right. We focus on the efforts of an elite group led by doctors, hygienists, and politicians to place the relationships between healthcare, urban living conditions, and demographic crises on the political and media agenda. Following these efforts, in the early 20th century governments in both countries established public health as a major concern, understanding the issue as synonymous with modernity and progress. In the context of urban and industrial growth, the inadequate sanitary conditions of lower-class housing were considered the main factor in the spread of contagious infections. Legislation transformed the nascent issue of worker housing into a State obligation, while access to sanitary housing became a cornerstone of healthcare and, in turn, one of the earliest public health policies. Given this context, we trace the evolution of housing policies in the two countries through primary sources such as presidential speeches and legislative debates, newspapers, and medical essays and reports.