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Commentary |

Pediatrics, Public Health, and Infant Mortality in the Early 20th Century

Janet Golden, PhD
Arch Pediatr Adolesc Med. 2011;165(2):102-103. doi:10.1001/archpediatrics.2010.280.
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When S. Josephine Baker's article “The Reduction of Infant Mortality in New York City”1 appeared in American Journal of Diseases of Children in 1913, it contained an important claim: “infant mortality is a public health problem.” In retrospect, it seems obvious; at the time, it signaled a new approach to saving the lives of America's most vulnerable. Under Baker's leadership, the Bureau of Child Hygiene of the New York City health department worked with private philanthropists to provide clean milk in poor neighborhoods, arranged for nurses to visit the homes of newborns and educate mothers about their care, and established a program to train girls to tend to their younger siblings. The effort reduced deaths, and the program became a national model. Public health work shifted from infrastructure programs aimed at sanitation and quarantine, such as the building of sewer systems and tuberculosis sanatoria, to medical, legal, and welfare efforts that yielded educational programs for mothers, milk stations, child health clinics, and pasteurization laws.2(pp236-254),3 The link between poverty and illness was clear, but the focus was on eradicating the latter rather than fully addressing the former.

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