History of public health in the United States
When epidemics or pandemics took place the movement focused on minimizing the disaster, as well as sponsoring long-term statistical and scientific research into finding ways to cure or prevent such dangerous diseases as smallpox, malaria, cholera.
Special emphasis was given to expensive sanitation programs to remove masses of dirt, dung and outhouse production from the fast-growing cities or (after1900) mosquitos in rural areas.
Since the mid-19th century there has been an emphasis on laboratory science and training professional medical and nursing personnel to handle public health roles, and setting up city, state and federal agencies.
The 20th century saw efforts to reach out widely to convince citizens to support public health initiatives and replace old folk remedies.
In the late 20th century anxious popular environmentalism led to an urgency in removing pollutants like DDT or harmful chemicals in the water and the air.
Localistic community-oriented care was typical, with families and neighbors providing assistance to the sick using traditional remedies and herbs.
During the Revolution General George Washington insisted his soldiers get inoculated else his forces might get decimated or the British try to use smallpox as a weapon.
Due to the high mortality rates and unbalanced sex ratio, traditional family structures were difficult to maintain.
[9][10][11] Lemuel Shattuck (1793-1859) of Boston promoted legislation that required a better statewide system for the local registration of vital information on births and deaths.
He specified the need for precise details on age, sex, race, and occupation, as well as standard terminology for diseases and cause of death.
[13] It explained how to remove the giant mounds of dirt, horse dung, and outhouse production that were overwhelming the neighborhoods of fast growing cities.
[16][17] The Rockefeller Sanitary Commission in 1910 discovered that nearly half the farm people, white and Black, in the poorest parts of the South were infected with hookworms.
[18][19][20] In the Southern states 1890s to 1930s, Jim Crow virtually dictated inferior medical care for the large, very poor African American minority.
It was conducted between 1932 and 1972 by two federal agencies, the United States Public Health Service (PHS) and the Centers for Disease Control and Prevention (CDC) on a group of 399 African American men with syphilis.
They were not asked to give permission, were not told their medical condition, and when penicillin became available in the mid 1940s it was deliberately not given them so the researchers could discover what happens to untreated men.
As a result, the program was terminated, a lawsuit brought those men affected $9 million, and Congress created a commission empowered to write regulations to deter such abuses from occurring in the future.
[28] In retrospect the Tuskegee experiment caused deep distrust on the part of the African American community, and apparently reduced Black reliance on public health agencies.
One research study in 2018 estimated that the negative response caused the average life expectancy at age 45 for all Black men to fall by up to 1.5 years.
[33][34] Historian Nancy Bristow has argued that the great 1918 flu pandemic contributed to the success of women in the field of nursing.
[35] During the Great Depression in the 1930s, federal relief agencies funded many large-scale public health programs in every state, some of which became permanent.
The programs expanding job opportunities for nurses, especially the private duty RNs who suffered high unemployment rates.
[36][37] A leader was Dr. Sara Josephine Baker who established many programs to help the poor in New York City keep their infants healthy, leading teams of nurses into the crowded neighborhoods of Hell's Kitchen and teaching mothers how to dress, feed, and bathe their babies.
Field nurses targeted native women for health education, emphasizing personal hygiene, and infant care and nutrition.
These programs have addressed key issues such as infant mortality, disease prevention, and access to local healthcare for mothers and their babies.
Its major initiatives included the Campaign for Better Babies (1915), to educate mothers, reduce infant mortality, and identify threats to children's health.
