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MCH/Public Health Milestones Part VI: 1940-1959 Greg R. Alexander, MPH, ScD Cathy Chadwick, MPH Donna J. Petersen, MHS, ScD MaryAnn Pass, MD, MPH Martha Slay, MPH Nicole Shumpert, BS Department of Maternal and Child Health The MCH Leadership Skills Training Institute

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MCH/Public HealthMilestonesPart VI: 1940-1959

Department of Maternal and Child Health

University of Alabama at Birmingham


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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

Department of Maternal and Child Health

University of Alabama at Birmingham


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Acknowledgement

Supported by funding from the Maternal and Child Health Bureau

Department of Maternal and Child Health

University of Alabama at Birmingham


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1940

White House Conference on Children in a Democracy

U.S. Involvement in World War II begins

Antibiotics used to reduce mortality due to

infectious diseases

Emergency Maternity Infant Care Program

Children’s Bureau placed in Social Security Administration

School Lunch Program begins

Formation of United Cerebral Palsy

Brown vs. Board of Education ends segregated schools

Polio vaccine developed

Increasing awareness and provisions for children with

mental disabilities

1959

Department of Maternal and Child Health

University of Alabama at Birmingham


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1940: White House Conference on Children in a Democracy

  • The White House Conference on Children in a Democracy addressed the problems concerning malnutrition.

  • It also focused attention on discrimination on the basis of race or creed, and urged the elimination of such practices.

  • Another result of the conference was a proposal for a national program on maternity care.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Expectant Mother

Department of Maternal and Child Health

University of Alabama at Birmingham


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1940s

  • In the years during and following World War II, a number of demographic changes impacted upon the health care delivery system.

  • The population explosion during these years, in addition to increasing demands on the health care delivery system and changes in medical education, resulted in a shortage of physicians and other health care professionals who provided primary care services.

Department of Maternal and Child Health

University of Alabama at Birmingham


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1941: U.S. enters World War II

Children at Auschwitz

Department of Maternal and Child Health

University of Alabama at Birmingham


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1940s

  • The migration from small and rural communities, and the growth in the population of urban areas, also contributed to an increasing mal-distribution of health resources.

  • These problems were compounded by health care financing difficulties

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health

University of Alabama at Birmingham


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1943: Emergency Maternity Infant Care Program (1943-1948)

  • The Emergency Maternity and Infant Care Program (EMIC), passed by Congress in 1943, provided funds for maternity and infant care for the wives and infants of servicemen in the four lower pay grades.

  • Medical, nursing, and hospital services for the prenatal period, as well as delivery and six weeks postpartum care, were provided to these families at no charge.

  • In addition, complete care was provided for infants less than one year old.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health

University of Alabama at Birmingham


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Emergency Maternity Infant Care Program (1943-1948)

  • The program continued until mid-1948.

  • It was the largest public medical care program undertaken in the United States up to that time.

  • Because it was closely identified with the war effort, Congress and the Executive branch strongly supported this program.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health

University of Alabama at Birmingham


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1940s-1950s

  • The United States experienced significant advances in medicine and public health during these years and technical developments in the health field continued to grow and expand at a rapid pace.

  • Antibiotics, such as penicillin, streptomycin, and tetracycline, discovered during this period, reduced morbidity and mortality caused by pneumonia, meningitis, dysentery, and other bacterial infections.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health

University of Alabama at Birmingham


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Antibiotics Introduced

  • Antibiotics, known as “miracle drugs,” provided enormous benefits to adults and children.

  • These drugs significantly reduced child mortality rates due to pneumonia, meningitis, and dysentery, as well as other diseases caused by bacteria.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health

University of Alabama at Birmingham


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1940s-1950s

  • There was rapid progress in the knowledge of nutrition and vitamins, as well as in emerging medical fields, such as pediatric surgery.

  • Health care professionals devoted increasing attention to the physical, mental, and emotional development of the child.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health

University of Alabama at Birmingham


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1946: Children’s Bureau Placed in Federal Security Agency

  • In 1946, the Children’s Bureau was placed in the Federal Security Agency.

Department of Maternal and Child Health

University of Alabama at Birmingham


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President Harry Truman

Department of Maternal and Child Health

University of Alabama at Birmingham


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School Lunch Act

  • The National School Lunch Act was passed in 1946 as a measure to“secure the well-being and health of children as well as to encourage consumption of local food.”

Department of Maternal and Child Health

University of Alabama at Birmingham


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School Children

Department of Maternal and Child Health

University of Alabama at Birmingham


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1949: Formation of United Cerebral Palsy

  • Leonard and Isabelle Goldenson worked to help establish the National Institute of Neurological Diseases and Stroke, part of the National Institutes of Health.

  • The recruitment of parents of children with cerebral palsy interested in improving services for their kids in New York City and the surrounding area gave rise to the National Foundation for Cerebral Palsy.

  • In 1949,the name of the organization was changed to United Cerebral Palsy and affiliates across the nation were formed.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Leonard Goldenson, founder of UCP

Department of Maternal and Child Health

University of Alabama at Birmingham


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1950s

  • In spite of these advances during the 1940s, the 1950s were years of stagnation for child health.

  • Infant mortality ceased to decline, and the maternal mortality rate remained high for certain subgroups.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health

University of Alabama at Birmingham


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1950s

  • An increasing number of new mothers chose to bottle feed their infants.

  • Additionally, large numbers of children in low-income families received no medical or dental care.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Infant Formula Production

Department of Maternal and Child Health

University of Alabama at Birmingham


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1950: Mid-century White House Conference on Children and Youth

  • The Mid-century White House Conference focused on the mental and emotional development of the child with the theme of the “total well-being of children.”

  • Issues regarding the needs of retarded children also were considered in the conference.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health Youth

University of Alabama at Birmingham


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1950: Mid-century White House Conference on Children and Youth

  • In addition, the conference addressed the problems of racially segregated public schools, and commissioned Kenneth Clark to write “Prejudice and Your Child.”

  • In 1954, this document became part of the U.S. Supreme Court’s opinion in Brown versus the Board of Education (see 1954, Brown v. The Board of Education.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Banning of Segregation in Schools Youth

Department of Maternal and Child Health

University of Alabama at Birmingham


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1951: National Children’s Bureau Division of Child and Maternal Health

  • Martha May Eliot, a pediatrician, was instrumental in many postwar programs for maternal and child health

  • In 1951, she became Bureau Chief of the National Children's Bureau Division of Child and Maternal Health

Department of Maternal and Child Health

University of Alabama at Birmingham


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Martha May Eliot Maternal Health

Department of Maternal and Child Health

University of Alabama at Birmingham


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1952: National Association of Retarded Children Maternal Health

  • As a result of the Mid-century White House Conference, the National Association for Retarded Children was formed.

Department of Maternal and Child Health

University of Alabama at Birmingham


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National Association of Retarded Children Maternal Health

Department of Maternal and Child Health

University of Alabama at Birmingham


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1953: Department of HEW Maternal Health

  • The Federal Security Agency became known as the Department of Health, Education and Welfare (HEW) in 1953, under the leadership of President Dwight Eisenhower.

Department of Maternal and Child Health

University of Alabama at Birmingham


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President Dwight Eisenhower Maternal Health

Department of Maternal and Child Health

University of Alabama at Birmingham


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1954: Brown v. Board of Education Maternal Health

  • The Supreme Court’s decision in Brown v. The Board of Education had a significant impact on the future course of special education.

  • This decision challenged the long held opinion that “separate but equal” was legally and socially acceptable.

  • This same ruling was used in Utah in 1969 to support the decision requiring fair and equal education for mentally retarded students.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health Maternal Health

University of Alabama at Birmingham


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Polio Vaccine Developed Maternal Health

  • Three immunologically distinct polio viruses were established as causative agents of poliomyelitis during the 1940s.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Polio Vaccine Field Trials Maternal Health

Department of Maternal and Child Health

University of Alabama at Birmingham


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Polio Vaccine Development Maternal Health

  • In 1954, an inactivated vaccine was developed by Dr. Jonas Salk.

  • Two years later, Dr. Albert Sabin perfected a live attenuated vaccine.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Albert Sabin Maternal Health

Jonas Salk

Department of Maternal and Child Health

University of Alabama at Birmingham


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1957: MCH-MR Demonstration Clinical Programs Maternal Health

  • Increased appropriations for Maternal and Child Health programs was authorized by Congress in 1957.

  • One million dollars was earmarked for demonstration clinical programs for mentally retarded children.

  • The response was so prompt and organized, that new diagnostic, consultative, and educational clinics rapidly were established nationwide.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health Maternal Health

University of Alabama at Birmingham


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1958: Full-time Working Mothers Maternal Health

  • By 1958, women were entering the job market in greater numbers than ever before.

  • It was estimated that 4,037,000 children under age 12 lived in families in which the mother worked full time.

  • A Children’s Bureau survey found that 400,000 of these children had no adult supervision during the day.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Working Mothers Maternal Health

Department of Maternal and Child Health

University of Alabama at Birmingham


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Special Projects for Retarded Children Maternal Health

  • Special programs for retarded children existed in 44 states by 1958.

Department of Maternal and Child Health

University of Alabama at Birmingham


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Department of Maternal and Child Health Maternal Health

University of Alabama at Birmingham


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Maternal and Child Health/Public Health Milestones Maternal Health1940-1959Photo Acknowledgements

Slide 6: Pregnant migrant woman living in California squatter camp. Kern County. Lange, Dorothea, photographer. memory.loc.gov

Slide 8: Photograph from the Main Commission for the Investigation of Nazi War Crimes, courtesy of USHMM Photo Archives. Polish children imprisoned in Auschwitz look out from behind the barbed wire fence. (July 1944) history1900s.about.com/

Slide 10: Children playing, Shafter Migrant Camp, Shafter, CA, March 1940. Arthur Rothstein, photographer. www.newdeal.org

Slide 12: The Children’s Bureau. DHEW book

Slide 14: Nacogdoches County, Texas. Mother and child. Vachon, John, 1914-1975, photographer. 1943 Apr. memory.loc.gov

Slide 16: History of World War II Medicine. Schenley Labs Advertisement. home.att.net/~steinert/wwii.htm

Slide 18: Pneumonia was a serious concern of the Public Health Service in the early decades. Together with influenza, it was the leading cause of death in the 1900s. National Library of Medicine. www.nlm.nih.gov

Slide 20: Throat examination. Wisconsin Health Clinics. www.newdeal.org

Slide 22: Harry S. Truman, 33rd president of the United States, assumed office when Franklin D. Roosevelt died, on April 12, 1945. Within the first weeks of his presidency, the Allies had won the war in Europe. Truman then made the most difficult decision that ever faced any president, choosing to use the new atomic bomb against Japan to end World War II. www.encarta.com

Department of Maternal and Child Health

University of Alabama at Birmingham


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Maternal and Child Health/Public Health Milestones Maternal Health1940-1959Photo Acknowledgements

Slide 24: memory.loc.gov Holton Arms School. Children holding hands in a circle at Holton Arms School. Theodor Horydczak. 1920-1950.

Slide 26: www.nbcnet.org

Slide 28: Public Health Service photo. PHS book

Slide 30: www.promom.org

Slide 32: “Class of convalescents”, Charity Hospital, New Orleans, LA. www.newdeal.org

Slide 34: www.seattletimes.org

Slide 36: www.cdc.gov

Slide 38: www.thearc.org

Slide 40: Dwight D. Eisenhower parlayed his great success as supreme Allied commander during World War II into two terms as the 34th president of the United States.Hulton Getty Picture Collection. www.encarta.com

Slide 42: inst.augie.edu/%7Ecebenson/brown.html

Department of Maternal and Child Health

University of Alabama at Birmingham


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Maternal and Child Health/Public Health Milestones Maternal Health1940-1959Photo Acknowledgements

Slide 44: Public School 61, New York, New York, participating in nationwide Salk polio vaccine trials, organized and sponsored by National Foundation for Infantile Paralysis. Dr. Emanuel Dubow gives injection to Jeffrey Coles, as New York Health Commissioner Dr. Leona Baumgartner, NFIP Medical Director Dr. Hart E. Van Riper and NFIP president Basil O’Connor look on. April 27, 1954. www.nycarchivists.org/

Slide 46: Salk: The first effective vaccine used as a preventative against poliomyelitis was developed in 1952 by Jonas Salk. Salk's earlier work on an anti-influenza vaccine during the 1940s led to his discovery. By the mid-1950s, the vaccine had been widely distributed in the United States, greatly reducing the domestic incidence of polio. Culver Pictures. www.encarta.com .

Sabin: www.pbs.org/storyofpolio/polio/timeline/1957.html Dr. Albert Sabin begins field trials in USSR and Eastern Europe in 1957. Sabin is shown in this photograph standing in front of one of the many roller-drums that helped to cultivate the virus used in his experiments on the live-virus vaccine.

Slide 48: Physician and nurse with a Downs’ Syndrome child. Courtesy of National Library of Medicine. www.nlm.nih.gov.

Slide 50: After America's entrance into World War II, military production in the United States increased severalfold. Many women took jobs or volunteered in staffing weapons factories, earning the nickname of "Rosie the Riveter." Intense rationing efforts of certain foods and materials, such as rubber and metals, were also enacted to feed America's war machine. Culver pictures. www.encarta.com

Slide 52: The Children’s Bureau photo by Esther Bubley in DHEW book

PHS Book: Mullan, F. Plagues and Politics: The Story of the U.S. Public Health Service. New York: Basic Books. 1989

DHEW book: U.S. Department of Health, Education, and Welfare, Public Health Service, Health Services Administration. Child Health in American. DHEW Publication No. (HAS) 76-5015. 1976.

Department of Maternal and Child Health

University of Alabama at Birmingham


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CREDITS Maternal Health

  • 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.

Department of Maternal and Child Health

University of Alabama at Birmingham


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