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The Immigration Act includes physical and mental health exclusions.

Date: 1891

The Story of Marine Health
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The first statutory health exclusion is added to federal immigration policy, barring “persons suffering from a loathsome or a dangerous contagious disease.” The law places responsibility on steamship companies to “vaccinate, disinfect, and medically examine emigrants to certify their health prior to departure.” The Marine Hospital Service is made responsible for screening all immigrants arriving at Ellis Island, which includes both mental and medical inspections. “The purpose of our mental measuring scale at Ellis Island is the sorting out of those immigrants who may, because of their mental make-up, become a burden to the State or who may produce offspring that will require care in prisons, asylums, or other institutions" (Schlenoff, 2015).