Public Health Nurse

Public health History

In 1900, the crude mortality rate was about 1700 deaths per 100,000 and the life expectancy at birth was 47 years.  Between 1900 and 2000, the crude mortality rate was cut nearly in half to 872 per 100,000 and life expectancy at birth rose to 77 years.The decline in mortality rates and increase in life span experienced in the 20th century was due to the implementation of effective public health practices that we continue to use today.

The immigration law of 1891 made it mandatory that all immigrants coming into the U.S. be given a health inspection by the Public Health Service physicians.  Physicians looking at the eyes for signs of trachoma. *

The nineteenth century witnessed a wave of industrialization and immigration which led to overcrowded and unsanitary living conditions.  People were forced to live in tight quarters usually with inadequate or nonexistent public water supply and waste disposal systems.  Such living conditions led to outbreaks of cholera, dysentery, TB, typhoid fever, influenza, smallpox, yellow fever, and malaria.

The late nineteenth century and early twentieth century brought with it advances in public health and clinical medicine.  In 1850, Lemuel Shattuck developed the first “blueprint” of a public health system that called for the establishment of state and local health departments.  Shattuck reasoned that health departments were needed to implement and control sanitary efforts and communicable disease.  During and after the 1870s, many technological and scientific advances occurred that enabled scientists to discover disease causing bacteria and parasites.  The advancement in science led to the development of public health programs that implemented sewage systems in cities to prevent contamination of water supplies, rodent control programs, vaccination  programs, and housing regulations in order to control the spread of infectious disease.

Tremendous growth in local and state health departments continued into the 1900s.  As public health policies were passed and programs enforced, fewer individuals died in childhood and early adulthood from infectious diseases. People today are living much longer and are experiencing diseases related to the aging process, such as heart disease, cancer, diabetes, emphysema, arteriosclerosis, and kidney disease.  The challenge for public health workers today is to combat the chronic and degenerative diseases that have become the major causes of death in advanced societies.

Typhoid fever, attributable to poor sanitary living conditions, was a major cause of illness in the U.S. during the 19th and early 20th centuries, especially in the rural areas.  The picture above shows an entire family receiving inoculations against typhoid fever in the early 20th century.*

If you are interested in learning more about the history of public health, additional information can be found at the following website: