Department of Maternal and Child Health

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MCH/Public HealthMilestonesPart III
1910-1919
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Greg R. Alexander, MPH, ScDCathy Chadwick, MPH
Donna J. Petersen, MHS, ScDMaryAnn Pass, MD,
MPH Martha Slay, MPHNicole Shumpert, BS

• Department of Maternal and Child Health
• The MCH Leadership Skills Training Institute
• University of Alabama at Birmingham

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Acknowledgement

• Supported by funding from the Maternal and Child
  Health Bureau

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1910
Flexner Report
Pasteurization
Beginning of mandatory school health inspection
Childrens Bureau established
National Organization of Public Health Nursing
Baby-Saving Campaigns
National Birth Registry developed
World War I
American Child Hygiene Association established
White House Conference on Standards of Child
Welfare
1919
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1910 Flexner Report

• The present educational requirements for
  physicians is largely based on the Flexner
  Report.
• The report criticized many of the medical
  schools of that time.
• The reports author, Abraham Flexner, was not a
  physician.

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Abraham Flexner
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Pasteurization

• By 1910, pasteurization was recognized as the
  best way to ensure that infants and the general
  population in the United States were provided
  with safe milk .

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Pasteurization Inspection by Public Health Nurse
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1911 Mandatory School Health Inspection

• By 1911, nine states had mandatory school
  health inspection laws.
• Approximately 400 cities had adopted a system
  of medical inspection.

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School Health Inspection
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1912 U.S. Public Health Service

• Marine Hospital Service was renamed the U.S.
  Public Health Service and given increased
  responsibility for health investigation and
  environmental sanitation.

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U.S. Public Health Service
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1912 Childrens Bureau April 9, 1912

• The Childrens Bureau was established under
  President Taft on April 9, 1912 as a result of a
  recommendation from the First White House
  Conference on Children in 1909.
• Julia C. Lathrop, the 1st woman to be selected
  by a president to head a Federal statutory
  agency, was appointed chief of the new bureau and
  held that position for nine years.

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Julia C. Lathrop
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1912 Childrens Bureau

• The Bureaus mission was to ...investigate
  and report upon matters pertaining to the welfare
  of children and child life among all classes of
  people...
• Such involvement on the part of the Federal
  government was controversial at the time
  however, the legislation on creating the Bureau
  was enacted through the active support of
  President Taft and other key individuals.

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President William Taft
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National Organization of Public Health Nursing

• The National Association of Public Health
  Nursing was organized in 1912.

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National Organization of Public Health Nursing
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1914 Pamphlet on Infant Care

• As a result of the Childrens Bureau studies on
  infant and maternal mortality and morbidity, a
  pamphlet on Infant Care was published in 1914.
• A total of 45 million copies of the pamphlet
  were distributed during the next 50 years.
• This 1st edition focused on the average U.S.
  mother, providing a detailed section on feeding
  infants and older children.

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Baby-Saving Campaigns

• An early activity of the Childrens Bureau was
  a 1914 report which proposed model MCH programs.
• Recommendations in this report included
  complete birth registration, the provision of
  prenatal care, appropriate care at birth, support
  of breast-feeding, medical supervision of
  children, and an available clean milk supply.

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Early Incubator
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1915 National Birth Registry

• The National Birth Registry, proposed by the
  Childrens Bureau, was established in 1915.
• This was a response to past efforts to improve
  collection of vital statistics data.

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Birth Certificate
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1917 World War I (1917-1918)
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American Nurses walking through trenches in WWI
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1918 Childrens Year

• The Childrens Year (1918) and Baby Week Campaign
  (1917) led to an increased awareness among states
  and local health agencies of the importance of
  maternal and child health issues.
• It also helped to create support for the
  Sheppard-Towner Act.

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1918 Childrens Year

• A speech by President Wilson announcing the
  Baby Week Campaign demonstrated his support by
  saying
• Next to the duty of doing everything
  possible for the soldiers at the front, there
  could be, it seems to me, no more patriotic duty
  than that of protecting the children who
  constitute one-third of our population.

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Woodrow Wilson
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1918 American Child Hygiene Association

• The American Association for the Study and
  Prevention of Infant Mortality changed its name
  to the American Child Hygiene Association,
  reflecting a more inclusive approach to child
  health.

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American Child Health Association
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1918-1919 Influenza Pandemic

• This worldwide influenza epidemic killed 20-40
  million people, more than were killed in World
  War I.
• In many countries, schools were closed, but in
  the U.S., this was not widely accepted or
  practiced.

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1919 White House Conference on Standards of
Child Welfare

• The Second White House Conference, which was
  conducted as a series of eight regional meetings,
  addressed child welfare in terms of the entire
  health and social well-being of the child.
• A report summarizing the conference included a
  series of proposals designed to improve the
  standards of maternal and child health programs.

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Maternal and Child Health/Public Health
Milestones 1910-1919Photo AcknowledgementsSli
de 6 wwwihm.nlm.nih.gov. Courtesy of the
National Library of MedicineSlide 8 Supervision
of pasteurization by a public health nurse.
wwwihm.nlm.nih.gov. Courtesy of the National
Library of Medicine.Slide 10 National Archives
photo no. 90-G-5-8 in PHS bookSlide 12
www.hhs.gov/pharmacySlide 14 The Childrens
Bureau in DHEW bookSlide 16 William Howard Taft
was the first person to serve as both the
president of the United States (1909-1913) and
chief justice of the Supreme Court (1921-1930).
Taft, who admitted that he never really wanted to
be President, considered his appointment to the
nation's highest court his greatest achievement.
www.encarta.comSlide 18 First Annual meeting of
the National Organization of Public Health
Nurses. www.ihm.nlm.nih.gov. Courtesy of the
National Library of MedicineSlide 22 Byron, The
Byron Collection, Museum of City of New York.
DHEW bookSlide 25 American armored troops going
forward in the Argonne, France, September 26,
1918www.ku.edu/kansite/ww_one/photos/Slide 26
American nurses walk through trenches in France
during World War I. In addition to soldiers, many
other people went to Europe to support the war
effort. The United States declared war against
the Central Powers in 1917. Hulton Getty/Archive
Photos. www.encarta.comSlide 28 The Childrens
Bureau. DHEW bookSlide 30 Woodrow Wilson,
full-length portrait, seated at desk, facing
front. CREATED/PUBLISHED1913(?).
memory.loc.gov (American Memories)Slide 32
Palmer GT, Platt PS, Walker WF, Nicoll AJ,
Jablonower A. A Health Survey of 86 Cities.
1925.Slide 34 American Red Cross photo from
www.stanford.edu/group/virus/uda/fluresponse.html
Slide 36 National Library of Medicine c 1920
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CREDITS

• This work builds upon the earlier efforts of
  Dr. Allan C. Oglesby, Cindy Camberg, EdD, and
  Cathy Chadwick of the Maternal and Child Health
  Institute to Increase Leadership Skills Project,
  San Diego State University, and draws upon their
  Manual of the History and Philosophy of Maternal
  and Child Health as a foundation for this
  multi-volume series.