Conventional wisdom concerning labor migration in Southern Africa holds that cheap, migratory labor was necessary for the extraction of base metals and the profitability of colonial mining. The different geologic, political, economic, labor and domestic conditions of mines across the region has, as a result, been obscured. The deterministic view of labor migration within “cheap-labor theory” does not consider the individual reasons why workers and other migrants chose to migrate. As self-perception has become embedded in ideas of work-membership, able-bodiedness, and gender, specific historical analysis of urbanization in different contexts has become necessary. Using health data, colonial and mining company records, and anthropological accounts, along with secondary scholarship, this study addresses dependency relationships between urban black populations, native leaders and colonial and mining authorities. The hypothesis is that relationships of dependence may have translated into forms of citizenship that were not institutionally recognized or that may be antithetical to Western, liberal ideas of freedom. Assessing these relationships in the context of health offers an understanding for how individuals navigated issues of social and political change that are important for decision making in the fields of global and public health, and urban planning. Structural and institutional inequalities created by historical circumstances have resulted in the different quality of state membership experienced by marginalized communities. Understanding how membership and self-perception has been historically created is an essential element for deconstructing institutional and social barriers that contribute to global health inequalities in crucial ways.