Public Health: What It Is and How It Works, 2nd Edition
HISTORY OF SELECTED PUBLIC HEALTH
EVENTS IN CHICAGO, 1834-1999
|
1834 |
A
temporary board of health was formed to fight the threat of cholera. |
|
1835 |
Chicago
Board of Health established by the state legislature to secure the general
health of the inhabitants because of the threat of cholera epidemic.
Chicago, then a town, had an estimated 3,265 residents. |
|
1837 |
Chicago
incorporated as a city of 4,170 residents. Three health commissioners and
a health officer named to inspect market places, prepare death
certificates, construct a pesthouse, visit persons suffering from
infectious diseases in their homes, and board vessels in the harbor to
check on the health of crews. |
|
1841 |
Vital
statistics start in a limited way with collection of data (age, sex,
disease) related to deaths; an ordinance requiring reports of death was
passed but not enforced for several years. |
|
1846 |
A
committee of the Chicago Medical Society reported the mortality rates
through 1850. |
|
1848 |
First
cooperative effort of the medical profession and city officials to prevent
the spread of smallpox as physicians volunteer to vaccinate the poor
without charge. |
|
1849 |
Cholera
brought to Chicago by the emigrant boat John Drew from New Orleans,
killing one in 36 of the entire population. A district health officer was
appointed for each city block. |
|
1851 |
A
new city charter provided greater powers in health matters to the City
Council. In the mid-1850's, with the city free from smallpox and cholera,
the powers of the Board of Health were reduced accordingly. |
|
1855 |
Sewerage
became an issue; Board of Sewerage Commissioners was appointed and the
first sewers were constructed the following year. The quarantine placard
introduced with signs reading "Smallpox Here" after 30 die of
the disease. |
|
1857 |
The
financial depression of 1857 caused the Board of Health to be viewed as a
luxury; it was abolished and its duties were transferred to the Police
Department. New permanent City Hospital completed at cost of $75,000.
(Later taken over by Cook County Hospital as one of its earlier
buildings.) |
|
1862 |
Smallpox
outbreak caused the City Council to appoint a Health Officer to work with
the Police Department, but severely circumscribed tenure and duties
rendered the position meaningless. |
|
1867 |
A
new Board of Health was established in response to the 1866 cholera
outbreak with authority independent of the City Council and Police
Department. |
|
1868 |
Meat
inspection initiated at Union Stock Yards. |
|
1869 |
The
Board of Health required vaccination of all children. |
|
1870 |
First
milk ordinance making it illegal to sell skim milk unless so labeled.. |
|
1871 |
Help
given to refugees of Chicago Fire; camps of homeless inspected; and
controls initiated for food supply and epidemic prevention. Birth and
death records lost in the fire. |
|
1872 |
In
aftermath of the Great Fire, death rate increased 32.6 percent to 27.6
deaths per 1,000 persons. Smallpox attacked 2,382 and killed 655.
Fatalities among children under five were the highest ever recorded. (For
the period 1843 to 1872, children under five accounted for half of all
deaths occurring in the city.) |
|
1876 |
The
health functions of city government were reorganized under a department of
health, and a commissioner of health position was established. |
|
1877 |
Commissioner
of Health required the reporting of contagious diseases by physicians, a
move opposed by many physicians. |
|
1885 |
A
cholera and typhoid epidemic kills 90,000 Chicagoans when a heavy storm
washes sewage into Lake Michigan, the city's source of drinking water. |
|
1888 |
Chicago
Visiting Nurse Association was founded. |
|
1889 |
Drainage
and plumbing regulations issued, and five women inspectors of tenements
appointed. |
|
1890 |
Garbage
disposal was placed under the direction of a general sanitary officer in
the health department. |
|
1892 |
Full
milk inspection starts. Laws requiring reporting of communicable diseases
existed; however, doctors argued they should receive payments for
reporting as they received under state law for reporting births. Without
this reimbursement, many physicians refused to comply and were prosecuted. |
|
1893 |
Bacteriological
laboratory opens to conduct microscopic examinations of milk samples and
examine throat cultures for diphtheria. A "Boil the Water"
crusade against typhoid was conducted. |
|
1893/94 |
Last
smallpox epidemic to cause great loss of life (1,033 died in its second
year). Vigorous vaccination efforts (1,084,500 given) result in a
reduction of cases to seven in 1897. During this period, the department
was the first to proclaim the superiority of hermetically sealed
glycerinated vaccine. Circulars distributed on hot weather care of babies
in one of the first public education efforts. The Health Department began
publishing a Monthly Statement of Mortality. |
|
1895 |
The
first diphtheria antitoxin issued, and a corps of antitoxin administrators
appointed. Daily analysis of water supply inaugurated. |
|
1896 |
Medical
school inspections inaugurated---the second city in the U.S. to do so.
Rules regulating the practice of midwifery were promulgated. |
|
1899 |
Campaign
against infant mortality enlists support of a voluntary corps of 73
physicians. |
|
1900 |
Sanitary
engineers reverse the flow of the Chicago River to prevent a recurrence of
epidemics, giving the city the world's only river that runs backward.
Department publishes a study reporting that the average span of life in
Chicago more than doubled in a generation. |
|
1901 |
Ordinance
passed prohibiting spitting in public places. The Health Department began
publishing State of the City's Health every week in the newspapers;
Monthly Statement of Mortality was discontinued. |
|
1902 |
Milk
Commission of Chicago was established to ensure pasteurized milk was made
available for needy children; diary inspections were started with the
salaries of two dairy inspectors initially paid for by the Chicago Civic
Federation. Fourth of July "Don’ts" were first promulgated to
prevent accidents. |
|
1903 |
A
Tuberculosis Committee of the Visiting Nurse Association was established;
it reorganized in 1906 as the Chicago Tuberculosis Institute. |
|
1905 |
The
39th Street intercepting sewer opens, resulting in a marked
decrease in typhoid deaths. |
|
1906 |
City
Council passed an ordinance providing for the licensing and control of
restaurants. |
|
1907 |
Chicago
Tuberculosis Institute opened dispensaries for the diagnosis and treatment
of TB cases. |
|
1908 |
Full
communicable disease program inaugurated, and 100 physicians sent to
congested districts during July and August to instruct mothers in baby
care. Forty nurses loaned to the department by the Visiting Nurses
Association of Chicago to help in a scarlet fever epidemic. They were so
effective that the City Council appropriated funds to hire the
department’s first nurses to work in maternal and child welfare and
communicable and venereal diseases. |
|
1909 |
Chicago
became first city in the United States to adopt a compulsory milk
pasteurization ordinance. Public health nurses from the Board of Health,
Visiting Nurse Association, and United Charities collaborate to become
"finders of sick infants" and refereed these babies and their
mothers to tent camps where treatment was provided and hygiene classes
held. |
|
1910 |
Municipal
Social Hygiene Clinic established, and dispensaries required to report
venereal diseases. New milk standards applied to ice cream. Health
Department nurses were assigned to conduct intensive follow-up on babies
in hospital wards where infant death rates were high; the Infant Welfare
Society was organized as the successor to the Milk Commission. |
|
1911 |
Common
drinking cups and common roller towels prohibited by ordinance. |
|
1912 |
Sterilization
of Chicago’s water begins, and within four years the entire supply is
being treated, causing a dramatic decline in the city’s typhoid fever
rate---from second highest among the 20 largest U.S. cities in 1881 to the
lowest by 1917. |
|
1915 |
The
Eastland, a lake excursion boat docked at the Clark Street bridge, rolls
over while loaded with passengers; 812 die, 300 more than the Titanic.
Dental services provided in Chicago public schools following a three-year
introductory pilot program funded by a local philanthropist The Municipal
Tuberculosis Sanitarium opened. |
|
1916 |
Policy
initiated to hospitalize all cases of infantile paralysis (polio) after 34
patients died out of 254 afflicted. |
|
1917 |
Municipal
Contagious Disease Hospital established. New health ordinances range from
requiring the reporting and treatment of venereal diseases to requiring
the screening of residence, stables and barns against fleas. Immunization
against diphtheria with von Behring’s toxin-antitoxin starts in public
schools and institutions. |
|
1918 |
Influenza
becomes a reportable disease with the pandemic of influenza reaching
Chicago, to cause 381 deaths on one day (October 17) alone. |
|
1919 |
Department
wins its first case in the prosecution of landlords for failure to provide
sufficient heat to tenants. |
|
1920 |
The
right of the department to quarantine carriers of contagion was upheld in
the Superior Court of Cook County. |
|
1922 |
New
Health Commissioner began a campaign against venereal disease, proposing
education and distribution of prophylactic outfits in brothels; opposition
from medical profession was based more on moral than medical grounds. |
|
1923 |
Committee
appointed on prenatal care in the first concerted effort to coordinate the
activities of all agencies doing prenatal work in the city. Inspection of
summer camps for children inaugurated. Venereal disease clinics were
established at the Cook County Jail and House of Correction. |
|
1924 |
Venereal
disease prevention literature distributed to 500,000 homes in Chicago. |
|
1925 |
Department
institutes a regular schedule of home visits by nurses during the first
six months of an infant’s life. Conferences inaugurated for care of
preschool children. Order installation of sanitary types of drinking
fountains. |
|
1927 |
Health
Commissioner was forced to resign when mayor directs that the Health
Department include political literature with information about baby care
being distributed to all Chicago mothers. |
|
1930 |
Intensive
campaign against diphtheria results in 400,219 injections being given in
three months. |
|
1932 |
Staff
or 300 nurses carried throughout the city on buses to give diphtheria
inoculations. Physicians sent to the homes of mothers unable to take
children to welfare stations for shots. After campaign, cases drop to 154
with nine deaths, compared to 1,266 cases with 68 deaths the previous
year. |
|
1933 |
Outbreak
of amebic dysentery among out-of-town guests who came to the Century of
Progress (1,409 cases and 98 deaths scattered in 43 states, the Territory
of Hawaii, and three Canadian provinces) in the first recognized
water-borne epidemic of he disease in a civilian population. Cause traced
to water contamination through faulty plumbing. |
|
1934 |
A
plumbing survey for cross-connections in hotels and mercantile buildings
begun to prevent future amebic dysentery outbreaks. As a result of
drinking from contaminated water supply at the Union Stock Yards fire on
May 19, 69 persons contract typhoid fever, 11 of whom die. |
|
1935 |
Ordinance
passed requiring that only Grade A milk and milk products can be sold in
Chicago. A premature-infant welfare program initiated. A mother’s milk
station starts operating to supply breast milk to premature, sick, or
debilitated infants whose parents could not afford this expense. |
|
1936 |
Summer
brings 210 deaths from sunstroke and exhaustion compared to 11 from the
same cause in 1935. With 1,000 premature infants under supervision, two
additional premature stations open, making 31 conferences available each
week. |
|
1937 |
Chicago
public schools open three weeks late because of a polio scare. Chicago
Syphilis Control Project established with the emphasis on breaking the
chain of infection. |
|
1942 |
Chicago
Intensive Treatment Center for venereal disease launches an effort so
successful that it wins a War Department commendation in 1943 and records
a declining VD rate following World War II demobilization, in contrast to
soaring rates in other large cities. |
|
1946 |
Chicago-Cook
County health survey undertaken by US Public Health Service, including an
audit of all city and county facilities conducted by outside experts.
Various recommendations made, including more food inspection staff,
establishment of district health centers, restructuring of the Board of
Health with an executive director and deputies in charge of engineering,
preventive medicine, and district health services. |
|
1947 |
Mental
Health section for Health Department was approved. |
|
1948 |
A
federal grant of $46,270 is made available through the State to subsidize
a psychiatric program. Comprehensive food ordinance adopted by the City
Council. |
|
1952 |
Chicago
counts 1,203 cases of polio, including 82 deaths and hundreds of persons
with paralysis. Frightened parents keep their youngsters out of movies and
swimming pools. Beaches close. Insect and rodent control program starts. |
|
1955 |
Chicago
is one of the first cities in the U.S. to introduce Salk vaccine after it
is pronounced safe and effective against the polio virus on April 12. |
|
1956 |
With
warning signs of an approaching polio epidemic, mass inoculations of Salk
vaccine given in all parts of the city with department staff working in
vacant stores, garages, street corners, from the backs of trucks, and in
park fieldhouses. Chicago takes the lead among major American cities in
introducing a water fluoridation program, which reduces tooth decay among
children. |
|
1957 |
Nursing
Home Section and Hospital Inspection Unit initiated. |
|
1958 |
A
section for chronic illness is activated, with mental health as one of its
activities. |
|
1959 |
First
Community Mental Health Center started on South Side. |
|
1960 |
Bureau
of Institutional Care consolidates nursing home and hospital inspection
services. |
|
1961 |
Division
of Adult Health and Aging begins consolidating activities of chronic
diseases, cardiovascular diseases, diabetes, cervical cancer, rheumatic
heart fever, and nutrition. A lead poison survey begins on Chicago’s
West Side. |
|
1962 |
Mental
Health division, with more than 15 community-based mental health centers,
is established in the Health Department. |
|
1965 |
Family
planning initiated in limited number of clinics. |
|
1966 |
Testing
for sickle cell initiated; citywide lead poisoning screening and treatment
began. |
|
1968 |
Planning
for Comprehensive Neighborhood Health Centers in 4 areas began in
cooperation with Chicago Model Cities program. |
|
1970 |
First
Model Cities Neighborhood Health Center opened in Uptown. A record 1.2
million inoculations were provided for Chicago children in immunization
drive. |
|
1973 |
Englewood
Neighborhood Health Center opened. 40 hospitals approved as trauma centers
in accordance with state statute on emergency medical services. |
|
1974 |
Women,
Infant and Children (WIC) supplemental nutrition program initiated. Senior
citizen clinic and new hypertension center open while plans were unveiled
to phase out the TB Sanitarium. |
|
1975 |
City
Council revised the municipal code to delineate the duties of the 9-member
Board of Health as a policy making body and the Department of Health as
the agency administering health programs and enforcing regulations.
Outpatient TB services were decentralized to 5 health centers. |
|
1976 |
Health
Department formed interdisciplinary committee on child abuse with
representatives from health, law enforcement, and welfare agencies. |
|
1981 |
Chicago
Alcohol Treatment Center comes under jurisdiction of Health Department
only to be closed several years later with its funding used to support
community-based providers of substance abuse treatment services. Refugee
health program was initiated. |
|
1983 |
Chicago
Area AIDS Task Force was established and the Health Department creates an
AIDS Activity Office. |
|
1984 |
Partnerships
in Health program was initiated with hospitals to assure continuity of
care for Health Department patients. |
|
1985 |
Health
Department sponsors city's first major pastoral conference on religion and
health. |
|
1986 |
Infant
mortality reduction strategic plan developed. |
|
1987 |
The
first child lead poisoning death in nearly a decade leads to the
establishment of the Mayor's Task Force on Lead Poisoning. |
|
1989 |
Health
Department coordinates development of Chicago AIDS Strategic Plan through
a multidisciplinary advisory council of 125 individuals. |
|
1990 |
Chicago/Cook
County Health Care Summit produces plan to improve local delivery of
health services, calling for ambulatory care reforms, restructuring of
inpatient care, and changes in system financing. As a result, the Chicago
and Cook County Ambulatory Care Council is established to assess health
needs and undertake initiatives. |
|
1991 |
Epidemiology
Office is established in the Health Department. |
|
1995 |
Extreme
heat conditions in Chicago during July result in 514 heat-related deaths.
Violence Prevention Office is established. |
|
1997 |
City
Council passes Managed Care Consumer Protection ordinance, calling for the
Health Department to created an Office of Managed Care---the nation's
first municipal effort to monitor the managed care industry. |
|
1998 |
Health
Department coordinates development of Chicago Violence Prevention
Strategic Plan, developed by more than 150 participants. |
|
1999 |
Chicago
Turning Point Partnership convenes to develop a plan to strengthen the
public health infrastructure in Chicago. |
Sources:
150 Years of Municipal Health
Care in the City of Chicago: Board of Health, Department of Health 1835-1985.
Chicago Department of Health; 1985.
Medicine in Chicago: 1850-1950;
chapter in The Social and Scientific Development of a City; TN Bonner.
The Rise and Fall of Disease in Illinois; Illinois Department of Public Health, 1927.