In the history of American social welfare there are many instances where social reformers were intimately involved in efforts to improve health care, prevent disease, treat the sick and protect the frail and disabled.  The entries below are representative of some of these efforts.

  • American Social Health AssociationAt the beginning of the twentieth century venereal disease was a prevalent concern for social health organizations. Diseases such a syphilis and gonorrhea affected many people and the social stigma attached to sexually transmitted disease prevented most people from discussing or addressing means of treatment for venereal disease. In 1913, at a conference in Buffalo, New York, several organizations dedicated to fighting prostitution and venereal disease joined together to form the American Social Hygiene Association (ASHA).
  • American Social Hygiene Association History and a ForecastAt the beginning of the twentieth century venereal disease was a prevalent concern for social health organizations. Diseases such a syphilis and gonorrhea affected many people and the social stigma attached to sexually transmitted disease prevented most people from discussing or addressing means of treatment for venereal disease. In 1913, at a conference in Buffalo, New York, several organizations dedicated to fighting prostitution and venereal disease joined together to form the American Social Hygiene Association (ASHA).
  • American Social Hygiene Association Posters for BoysDuring the 1920s, ASHA served as a central coordinator for the local or regional committees, doctors, public health officials, and social welfare agencies that were combating venereal disease and vice. In addition to the continued fight against venereal disease and prostitution, ASHA published the Journal of Social Hygiene and the Social Hygiene Bulletin. The organization also promoted character and sex education as a means of preventing the spread of venereal disease. The ASHA educational program emphasized preparation for a wholesome family life, avoiding venereal disease, and physical as well as moral fitness. Below are selected "Keep Fit" posters designed to educate young males.
  • American Social Hygiene Association Posters for GirlsAt the beginning of the twentieth century venereal disease was a prevalent concern for social health organizations. Diseases such a syphilis and gonorrhea affected many people and the social stigma attached to sexually transmitted disease prevented most people from discussing or addressing means of treatment for venereal disease. In 1913, at a conference in Buffalo, New York, several organizations dedicated to fighting prostitution and venereal disease joined together to form the American Social Hygiene Association (ASHA).
  • American Social Hygiene Association Relationship to Community WelfareProgress in social welfare has not been spontaneous. If it is desired to correct or improve a social condition by the formulation of a law, something more must be done that the mere enactment thereof. Laws will not enforce themselves. If a cure is discovered for a disease, something more must be done than its inscription in a medical textbook to make it a factor in the improvements of public health. The same may be said of other social activities. In order to secure effective progress, activities or private and voluntary groups are necessary to supplement and fill in the gaps left by official agencies. The American Social Hygiene Association is organized and equipped to do just this. It is apparent that the activities of the American Social Hygiene Association toward the conservation and protection of the family as a basic social unit is of vital importance to the welfare of any community.
  • American Social Hygiene Association: 1946Incorporation of the American Social Hygiene Association as “a national voluntary non-profit membership organization” took place under the laws of the State of New York in March, 1914. The Constitution adopted at that time reflected the far-seeing vision of the men and women who framed it. Consisting of only two Articles, this documents so broadly and competently stated the problem and opportunities ahead, that no change has ever been found necessary. The purpose of this Association shall be to acquire and diffuse knowledge of this established principles and practices and of any new methods which promote, or give assurance of promoting, social health; to advocate the highest standards of private and public morality; to suppress commercialized vice, to organize the defense of the community by every available means, educational, sanitary or legislative, against the disease of vice; to conduct on request inquiries into the present condition of prostitution and the venereal disease in American towns and cities; and to secure mutual acquaintance and sympathy and cooperation among the local societies for these or similar purposes.
  • American Social Hygiene Association: Keeping Fit Posters I (1919)"Keeping Fit" was a 48-poster series produced by the American Social Hygiene Association in collaboration with the U.S. Public Health Service and the YMCA in 1919. It was designed to educate teenage boys and young men about the dangers of sexual promiscuity and urged them to embrace moral and physical fitness. A parallel series, "Youth and Life" was designed for girls and young women.
  • American Social Hygiene Association: Keeping Fit Posters II (1919)"Keeping Fit" was a 48-poster series produced by the American Social Hygiene Association in collaboration with the U.S. Public Health Service and the YMCA in 1919. It was designed to educate teenage boys and young men about the dangers of sexual promiscuity and urged them to embrace moral and physical fitness. A parallel series, "Youth and Life" was designed for girls and young women.
  • American Social Hygiene Association: Youth and Life Posters (1922)"Youth and Life" was a 48-poster series, designed to educate teenage girls and young women about the dangers of sexual promiscuity and urged them to embrace moral and physical fitness. It was adapted in 1922 by the American Social Hygiene Association from "Keeping Fit,", similar series for boys and young men produced in cooperation with the U.S. Public Health Department and the YMCA.
  • Are We Checking the Great Plague?Four years ago in a historic article published simultaneously in Survey Graphic and Readers Digest, Surgeon General Parran launched a vast drive against syphilis. To what extent have we checked the spread of the disease and provided for its treatment? Here is a progress report by the assistant surgeon general of the U.S. Public Health Service, who sounds a twenty-year challenge.
  • Assistance for the Disabled"...People know well that restoring one of us cripples--because as some of you know, I walk around with a cane and with the aid of somebody's arm myself--to useful occupation costs money. Being crippled is not like many other diseases, contagious and otherwise, where the cure can be made in a comparatively short time; not like the medical operation where one goes to the hospital and at the end of a few weeks goes out made over again and ready to resume life. People who are crippled take a long time to be put back on their feet--sometimes years, as we all know...."
  • Baker, JosephineWhen Sara Josephine Baker's father died suddenly when she was sixteen, she gave up a Vassar scholarship to go to medical school to train for a secure career as a physician. Despite the opposition of family members who were skeptical of women physicians, Baker persuaded her mother that she was making the right decision. She was the first woman to earn a doctorate in public health from the New York University and Bellevue Hospital Medical College (later the New York University School of Medicine).
  • Birth Control WinsTwo events which occurred at the end of 1936 may signify a turning-point in the birth-control movement in America. Together they denote the closing of one era—the era of pioneering, of preparation, of laying the foundation—and the beginning of another—an era of extensive research and clinical accomplishments.
  • Carry On: Magazine on the Reconstruction of Disabled Soldiers and SailorsIN the first number of this magazine, June 1918, Surgeon General Gorgas promised that "the Medical Department of the Army will 'Carry On' in the medical and training treatment of the disabled soldier until he is cured or as nearly cured as his disabilities permit." Today I can assure you that the Medical Department of the Army has Carried On. Over there, amid the dangers at the front and in the aero-bombed districts in the rear, our doctors and nurses strove day and night to cure the disabled and return them as rapidly as possible to the fight -- eighty per cent, of the wounded went back to the front within six weeks. The remainder, as soon as able and travel was available, were returned to this country where, under more normal conditions, proper care could be administered.
  • City Diets and DemocracyThe proportion of our children who are found in families without adequate nutrition should be a matter of grave concern to all of us. A Bureau of Labor Statistics' study of employed wage earners and clerical workers shows that more than 40 percent of the children in this relatively favored group live in families whose incomes are below the level necessary to provide adequate food, as well as suitable housing, clothing, medical care, personal care, union dues, carfare, newspapers, and the other sorts of recreation for which city families must pay in dollars and cents.
  • City Diets and Democracy: 1941In developing an educational program for improving nutrition, it is important to keep in mind the importance of custom in our food habits. The Labor Department's recent studies of food consumption show the remarkable persistence of the food preferences of earlier generations in the localities studied. The tables of New Orleans still remind one of the fish, the chicken, the salads, and the greens of the French; the Bostonians still eat more beans and drink more tea than families in most other cities. In Cleveland and Milwaukee they eat more rye bread and cheese and apples and coffee. A national nutrition policy should plan to change food consumption habits only insofar as it is absolutely necessary to do so to provide all the nutrients necessary for health, efficiency, and the full enjoyment of life.
  • Food, Farmers, and Fundamentals: 1941Thanks to the ever-normal granary and the efficiency of modern farm production, we can approach the problem of nutrition more constructively than during the last war. There seems little likelihood that we shall have meatless days, or days without sugar. The problem today is to use our soil, our farmers, our processors, our distributors, and our knowledge to produce the maximum of abounding health and spirits—a broad foundation on which we can build all the rest of our hemispheric defense.
  • Franciscan Sisters of MarySister Antona was a pioneer who advocated for peace and justice between groups who were divided in healthcare work, yet the best example of her excellence in social action is outside of the healthcare setting in 1965. Answering the call for an inter-faith demonstration, she was selected to represent the SSMs in Selma, Alabama for a march to support black voting rights. When the nuns present became the vanguard of the group, she received media attention and became the voice of the demonstrators: "I am here because I am a Negro, a nun, a Catholic, and because I want to bear witness."
  • Free African SocietyThe Free African Society’s legacy is acknowledged in Philadelphia at the site of the original Mother Bethel African Methodist Episcopal Church as “the forerunner of the first African-American churches in this city”. The contributions of the group during the yellow fever outbreak in 1793, as well as the racially charged dialogue that followed, acknowledge both the willingness of free blacks to serve the larger community and the difficulty in assuaging bigoted fears and suspicions at that time. Finally, the Free African Society provided the valuable social services of looking after the sick, the poor, the dead, the widowed, and the orphaned of their marginalized membership.
  • Hammond, Dr. William A.In 1878 a bill was submitted to Congress authorizing the President to review the proceedings of the court-martial which convicted Dr. Hammond, and, if justice demanded, to reinstate him. This measure was passed almost unanimously by the House and Senate. In August, 1879, it was approved by President Hayes, and, after inquiry, he restored Dr. Hammond to his place on the rolls of the army as Surgeon General and Brigadier General on the retired list.
  • Health Conservation and the WPAThe Works Progress Administration (WPA) was created by Executive Order #7034 on May 6, 1935. President Roosevelt had the authority for this Executive Order via the Emergency Relief Appropriation Act of 1935. The WPA was created to offer direct government employment to the jobless. The unemployment rate was about 20% at the time the WPA was created. The WPA lasted until June 30, 1943. The unemployment rate then was possibly below 2%, with many Americans working in the armed services, defense industries, etc. The WPA–during it’s 8 years of existence–employed over 8.5 million different Americans, and reached peak employment of over 3.3 million in late 1938.
  • Health Conservation and WPAThe essence of the WPA program is cooperation. It is ready with the workers to help public-spirited citizens make their communities better places to live in. People in this country do not need to take their desires for better sanitation out in merely wishing. They can help turn the hopes and dreams of sanitary engineers into realities. They do not need merely to wish that it were unnecessary for thousands of cases of serious illness to remain untreated. They can and should see that medical and nursing services are extended to a larger number of people who cannot pay for them. The National Health Survey, one of our greatest WPA projects sponsored by the United States Public Health Service, revealed that every year some 2 million cases of serious illness go entirely without medical treatment. That is why the WPA maintains and assists clinics in most of our cities. That is why it sends nurses into the homes of the poor. That is why it builds hospitals and provides medical and dental treatment for people who could not receive such treatment otherwise.
  • Health Work For Negro Children-- 1925There are too many deaths among Negro children today, for the good of the Negro race and for the good of the country as a whole. The Negro race needs a stronger and more healthy younger generation to help it combat successfully the many obstacles which it must meet. In addition to the normal struggle for existence, the black man in America must endure a number of handicaps. He must make his living by means of the lowest-paid and most unhealthful jobs in industry, though this condition is improving somewhat in certain sections of the country. He must struggle for life itself against unfavorable environments in the form of the least healthful neighborhoods and the oldest and most unsanitary houses.
  • Hot Lunches for a Million School ChildrenOne million undernourished children have benefited by the Works Progress Administration's school lunch program. In the past year and a half 80,000,000 hot well-balanced meals have been served at the rate of 500,000 daily in 10,000 schools throughout the country.
  • Influence Of The Medical Setting On Social Case Work Services 1940 The great complexity of the modern medical institution, the extreme development of specialization, the multiple details required by clinic and ward administration, all combine to create a certain inevitable amount of confusion, overlapping, and delay. Where there are several professions working together, there are unavoidable duplications, gaps, and conflicts. Division of labor in the hospital has been carried to a degree where many of the activities have assumed an impersonal character, until the patient as an individual is lost to sight. Mechanical procedures and rigidities may develop until the very concept of the hospital's purpose itself becomes narrowed. This means that it is at the same time both more important and more difficult for social case work to find and hold its own purpose in such a setting.
  • Medicaid Program (circ. 1980)Medicaid (Title XIX of the Social Security Act) was created with little debate in 1965. Its purpose was to provide federal financial assistance (FFP) to states in providing health care for public welfare recipients. Similar to other state-federal public welfare program, states had to choose whether or not to participate in the Medicaid program.
  • Mental Health America - OriginsIn 1908, Clifford Whittingham Beers published his autobiography “A Mind That Found Itself.” The publication chronicled his struggle with mental illness and the shameful state of mental health care in America. In the first page of his book, Beers reveals why he wrote the book: "...I am not telling the story of my life just to write a book. I tell it because it seems my plain duty to do so. A narrow escape from death and a seemingly miraculous return to health after an apparently fatal illness are enough to make a man ask himself: For what purpose was my life spared? That question I have asked myself, and this book is, in part, an answer...."
  • Milestones in Social HygieneThrough the consolidation of the American Federation for Sex Hygiene, the American Vigilance Association (which was the later name for the American Vigilance Committee) the American Purity Alliance, and other agencies for social service, the present American Social Hygiene Association came into existence in 1914, with Charles W. Eliot as President and James Bronson Reynolds and William F. Snow as the executive officers.
  • Mobilize for Total Nutrition!Very many families are unable to secure enough "protective foods." Milk, meat, eggs, fresh vegetables, and fruits are relatively expensive. Whole wheat bread and other whole grain cereals are perishable—a factor which adds to the cost of their distribution. The farmer in most cases can keep a cow and have a garden and an orchard; but on some poor lands, this is impossible. The city dweller is always dependent on the market for the variety of foods available to him and the amounts which his dollar will purchase. Families with incomes below a certain level must have assistance in tangible form if they are to secure the foods which provide an adequate diet. Assistance may take the form of a money dole, or it may involve the direct distribution of food.
  • Nurses In "Settlement" WorkWe are about to move from the tenement into a house near it, that an opening may be made for other nurses to share the privileges of living among the people. The house is given to us to use for the purpose of a nurses' settlement; and we hope zealous women, who have added the nurses' training to their other preparations for usefulness, will realize the privilege of joining our family. The plan of the house is as follows: One room is to be reserved for a dispensary for small nursing cases, such as come to us in great numbers to be treated. A physician comes at regular periods for such special cases as do not require treatment in the large regular dispensaries. Classes in nursing, making of poultices, care of bed patients, elementary first aid to the injured, household hygiene, and care of children, will be held for the mothers and the girls and boys of the tenements.
  • Sanger, MargaretMargaret (nee: Higgins) Sanger risked scandal, danger, and imprisonment to challenge the legal and cultural obstacles that made controlling fertility difficult and illegal. Ms. Sanger viewed birth control as a woman's issue and she was prepared to take on the medical establishment, the churches, the legislatures, and the courts. She was persuasive, tireless, single-minded, and unafraid of a fight. On October 16,1916 she opened a birth control clinic in Brooklyn, was arrested, and served thirty days for distributing information about contraceptives. From that experience, Sanger moved on to assume leadership of the struggle for free access to birth control. In 1921 she founded the American Birth Control League, the precursor to the Planned Parenthood Federation, and spent her next three decades campaigning to bring safe and effective birth control into the American mainstream.
  • Sisters of Charity of Cincinnati, OHSystemic bias was also present in Cincinnati in the early 1840’s and played a significant part in the financial difficulties of the sisters’ ministries. While funding was allotted by the Ohio legislature to support Protestant asylums, the sisters’ petition was denied because they were considered a sectarian group. Still, the sisters’ ministries continued to expand, and in 1844 a boys’ orphanage was opened stemming from their previous ministry of placing male orphans, mostly Catholic, into community families. By 1847, St. Peter’s orphanage had outgrown its facility twice, and new facility construction projects proved helpful in caring for the nearly 150 orphans who needed services, many whose parents had passed away in another cholera outbreak.
  • Sisters of Charity of Nazareth, KYWhen the cholera outbreak hit Louisville in 1832, the sisters nursed many to full recoveries. In addition, many of the children who lost their parents in the outbreak were placed in St. Vincent’s orphanage. Those sisters who were teaching had dropped everything in lieu of the crisis, and three SCNs died during this episode of the infectious disease. After the epidemic subsided, the sisters opened St. Joseph Infirmary, which treated all classes of people according to medical records, including some slaves. In Nashville, TN, the SCNs had a similar experience with cholera. Classes were temporarily cancelled, and orphans who were under the guardianship of the sisters, some who likely lost their parents to cholera, became assistants to the sister-nurses.
  • Social Unit PlanThe social unit plan aims to bring about a genuine and efficient democracy by showing the rank and file how to secure for themselves a clear idea of their own needs and by helping them to organize for the satisfaction of those needs the best skill and the wisest advice available. Practical health work is the point of attack because it is one of the sorest immediate needs and the one of which people are most conscious. The laboratory chosen for the working out of this new concept of democracy is a typical district of Cincinnati containing approximately fifteen thousand people. In this district, under the control of the citizens who reside in it and with the co-operation of citizens throughout the entire city as well as of the city government, it is planned to develop an organization which, if successful, may later, with minor modifications, be capable of application in other sections of the city and in cities throughout the country.
  • Social Work At Massachusetts General Hospital: 1908Ida Maud Cannon was responsible for developing the first social work department in a hospital in the United States. Convinced that medical practice could not be effective without examining the link between illness and the social conditions of the patient Cannon diligently worked at creating the field of medical social work. During her long career, she worked as a nurse, a social worker, Chair of Social Services at Massachusetts General Hospital, author of a seminal book in the medical social work field, organizer of the American Association of Hospital Social Workers, consultant to hospitals and city administrations throughout the United States, professor and designer of a training curriculum for medical social workers.
  • The Daughters of Charity of St. Vincent De PaulFrom 1832-1834, they were responsive to community needs for nursing in a variety of locations across the United states during the cholera and yellow fever outbreaks. Many nurses and others in charge of caring for the sick were fearful of catching the disease and left the job rather than risking infection. While anti-Catholic attitudes were strong in early America, the work of the sisters had a good reputation, and their vows, especially of celibacy, gave them clarity of purpose and intention in their roles.
  • The Eugenic Value of Birth Control PropagandaWe have come to the conclusion, based on widespread investigation and experience, that this education for parenthood must be based upon the needs and demands of the people themselves. An idealistic code of sexual ethics, imposed from above, a set of rules devised by high-minded theorists who fail to take into account the living conditions and desires of the submerged masses, can never be of the slightest value in effecting any changes in the mores of the people. Such systems have in the past revealed their woeful inability to prevent the sexual and racial chaos into which the world has today drifted.
  • The First Step Toward FitnessWhen America began to recover from the Great Depression, it began to take stock of its human resources. We found that a large minority of our population did not get enough to eat. These people who did not get enough to at were below par in health. They were below par in initiative and alertness.
  • The Job AheadA call to action—and a program. An epochal statement.—by the Surgeon General, United States Public Health Service in July 1941.
  • The Lesson of Selective Service: 1941Out of a million men examined by Selective Service and about 560,000 excepted by the army, a total of 380,000 have been found unfit for general military service. It has been estimated that perhaps one third of the rejections were due either directly or indirectly to nutritional deficiencies. In terms of men, the army today has been deprived of 150,000 who should be able to do duty as soldiers. This is 15 percent of the total number physically examined by the Selective Service System
  • The March Against Commercialized Prostitution: 1886-19491910: United States Congress adopts Mann Act (prohibiting interstate and international traffic in women) and Bennet Act (penalizing those who import aliens for immoral purposes, and providing for deportation of aliens engaging in the business of prostitution).
  • The Place Of Social Work In Public Health-- 1926The influence of social work on public health administration is found in the development of every branch of that service in the past fifty years. The recreation movement, the child welfare movement, and such special developments as workingmen's compensation in the industrial field have all been influenced by the humanitarian interests of the forces interested in social work, and each of these has had a direct bearing upon the health of the several communities in this country.
  • The Relation Of Hospital Social Service To Child Health Work: 1921The term hospital social service is unfortunately not a very specific term, as it has come to be used to include a great variety of extra-mural service to hospital and dispensary patients. It has been used to designate such a variety of functions as a simple follow-up system to keep track of patients' attendance at clinics, friendly visiting in the wards, various phases of public health nursing, a variety of administrative functions at admission desks and in the clinics, and medical-social case work. The fact is that all these various types of service are coming to be recognized as necessary to the improvement of hospital and dispensary service. All of them recognize the necessity of individualizing the patients and taking into account some of the social elements in the patients' situation. Before we can discuss hospital social work intelligently, we need more specific terminology and definition. I shall not attempt that now but shall choose for discussion the contribution that was made to the efficiency of medical treatment by the introduction of the trained social worker into the staff of hospitals and dispensaries. Visiting nursing in the homes of dispensary patients antedated the present hospital social work movement by several years and still remains in many cities the long arm of the hospital extending skilled nursing service and hygiene teaching to the patients discharged from the hospital or under supervision of the dispensary. Such service has long been recognized as essential to baby welfare and tuberculosis clinics and has stimulated the development of public health nursing organization in most of our cities.
  • The Sisters of Charity of New YorkAs Catholic immigrants arrived in poverty during the 19th century, the sisters became known for accepting newborns at the doorsteps of the convent. The work of the SCNYs in education, health care, and other social services for all faiths and races continues today throughout the city and beyond.
  • U.S. Public Health ServiceEfforts were made during the early decades of the 20th century by both political parties and by people inside and outside of government concerned with the nation's health to combine public health-related work being done by various Federal agencies, but they were unsuccessful in Congress. On August 14, 1912 the name of the PHMHS was changed to the Public Health Service (PHS) and further broadened its powers by authorizing investigations into human diseases (such as, tuberculosis, hookworm, malaria, and leprosy), sanitation, water supplies and sewage disposal, but went no further.
  • U.S. Public Health ServiceThe PHS grew out of a need for healthy seamen in our infant republic, which relied so much on the sea for trade and security. These seamen traveled widely, often became sick at sea, and then, away from their homes and families, could not find adequate health care in the port cities they visited or would overburden the meager public hospitals then in existence. Since they came from all the new states and former colonies, and could get sick anywhere, their health care became a national or Federal problem.
  • U.S. Sanitary Commission: 1861The object of the Sanitary Commission was to do what the Government could not. The Government undertook, of course, to provide all that was necessary for the soldier, . . . but, from the very nature of things, this was not possible. . . . The methods of the commission were so elastic, and so arranged to meet every emergency, that it was able to make provision for any need, seeking always to supplement, and never to supplant, the Government.
  • Visiting Nurse Service Administered by the Henry Street SettlementIn 1935, the staff of the 264 Henry Street Visiting Nurses gave care to 99,362 patients in the boroughs of Manhattan, Bronx and Queen. To these people they made 517,016 visits. In ten years the service has increased by 170,00 visits--in thirty years it has increased by 475,000. Dr. S.S. Goldwater, Commissioner of Hospitals in New York, has said, “The chronic diseases constitute the major health problems of today.” The interpretation of this statement and its tragic significance can readily be seen by a glance at the chart on the opposite page [Six Chief Causes of Death] which shows that five of the major causes of death are due to chronic diseases and one, the sixth, pneumonia. No effort has been made, even in symbol, to soften the shock which its study brings.
  • What Is The Public Practice Of Medicine? -- 1926Freedom from political domination is perhaps responsible more than any other single factor for the public health progress in Cincinnati. This change was brought about in I910, and with it came a reorganization of the health department, until now it parallels an ideal organization recommended by Dr. C. E. A. Winslow, chairman of the Committee on Municipal Health Department Practice of the American Public Health Association. The fact that the members of the Cincinnati Board of Health are appointed for ten years, and that only one member retires every two years, guarantees continuity of program and policy. This is a wise provision of our charter. All members of the health department are civil service appointees and devote their full time to public service.