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This chapter discusses the sociological, literary and cultural aspects of life that African American, British West Indian, and Southern Italian women encountered and created after coming to New York City. These women often had parallel and overlapping reasons for their migrations and competed for housing, services, and even prospective sexual mates. In addition, the chapter reconstructs how these poor and working-class women dealt with the vagaries of daily urban living—abandonment, poor health, caring for their children, work, and abandonment—by using census and sociological data from the 1910s and 1920s and Community Organization Society social work interviews of women who lived in Columbus Hill and the Mulberry District.

This introductory chapter discusses the main topic of the book: infant and maternal health care created for impoverished women in the turn-of-the-twentieth-century New York City. In particular, the text compares the health outcomes of three different groups of poor and working-class women whose stories of infant and maternal health care are linked by New York City's first citywide mortality study in 1915. Poor and working-class African American, British West Indian, and southern Italian women received some of the nation's best health care, albeit shrouded in racially gendered and classed misconceptions and stereotypes of their supposed inferiority. In relation to this, numerous historians of public health have shown that socioeconomic factors and cultural traditions have influenced how client communities have responded to the health care they received.

The chapter examines the crucial strikes in the National Health Service (NHS) during the Winter of Discontent and contextualizes them within historic currents in the health service since its foundation. The chapter describes how acute staff shortages, combined with the Government’s need for cheap labour created low-paid, working-class vocations within the NHS and how three major groups were recruited: men left redundant from de-industrialization; white working- class women who were primary and/or essential breadwinners, and overseas workers, particularly from the West Indies, restricted to such work partly by racism. The chapter details how the National Union of Public Employees (NUPE) harnessed workers’ dissatisfaction with low pay and the political energy of a new generation of local male and female activists like Celia Newman, Lorraine Donovan, and Robert Gregory during the disputes of 1978-1979. The chapter ends with the Prime Minister James Callaghan’s dramatic defeat in March 1979 with the Conservative Party’s call for a vote of no confidence in the Labour Government and the commencement of the General Election of 1979.