Department of Maternal and Child Health

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MCH/Public HealthMilestonesPart VI 1940-1959
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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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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
Childrens 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
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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.

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Expectant Mother
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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.

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1941 U.S. enters World War II
Children at Auschwitz
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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

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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.

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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.

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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.

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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.

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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.

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 1946 Childrens Bureau Placed in Federal
Security Agency

• In 1946, the Childrens Bureau was placed in
  the Federal Security Agency.

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President Harry Truman
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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.

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School Children
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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.

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Leonard Goldenson, founder of UCP
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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.

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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.

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Infant Formula Production
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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.

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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 Courts opinion in Brown versus the Board
  of Education (see 1954, Brown v. The Board of
  Education.

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Banning of Segregation in Schools
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1951 National Childrens 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

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Martha May Eliot
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1952 National Association of Retarded Children

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

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National Association of Retarded Children
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1953 Department of HEW

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

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President Dwight Eisenhower
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1954 Brown v. Board of Education

• The Supreme Courts 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.

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Polio Vaccine Developed

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

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Polio Vaccine Field Trials
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Polio Vaccine Development

• In 1954, an inactivated vaccine was developed
  by Dr. Jonas Salk.
• Two years later, Dr. Albert Sabin perfected a
  live attenuated vaccine.

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Albert Sabin
Jonas Salk
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1957 MCH-MR Demonstration Clinical Programs

• 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.

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1958 Full-time Working Mothers

• 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 Childrens Bureau survey found that 400,000
  of these children had no adult supervision during
  the day.

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Working Mothers
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Special Projects for Retarded Children

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

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Maternal and Child Health/Public Health
Milestones 1940-1959Photo 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 Childrens 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/steine
  rt/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

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Maternal and Child Health/Public Health
Milestones 1940-1959Photo 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

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Maternal and Child Health/Public Health
Milestones 1940-1959Photo 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 OConnor 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/19
  57.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 Childrens 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.

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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.