Professionalization of Public Health
“…a general health law should be considered and enacted by you, so that should epidemics of contagious diseases threaten us, some protection may be afforded our people.”
– Governor George E. Chamberlain, Inaugural Address to Oregon Legislature, 1903
The organization of the American Public Health Association (APHA) in 1872 marked the professionalization of public health in the United States. In one of its first actions, APHA sent a public health survey to every town in the country with a population greater than 5,000. The survey covered such topics as vital statistics, water supply, sewer systems, ventilation in public buildings, and other aspects related to community health. By the turn of the century, public health had emerged as a medical specialty and APHA worked to establish standards for degrees in the new specialty.
A New Medical Specialty
As public health continued to professionalize, it became evident that specialized training was needed. Starting in the 1870s, several medical schools across the nation offered lectures in hygiene. By the late nineteenth century, there was a national movement to teach hygiene and sanitation in public schools, which added to the demand for university level courses on the subject. In 1900 APHA began work to establish standards for degrees in public health and a decade later, more than a dozen universities offered certificates or degrees in public health. It was the Johns Hopkins School of Hygiene and Public Health, the first permanent school of public health in the United States, that set the precedent for public health education when it opened in 1916. It provided critically needed training, as revealed by a 1922 United States Public Health Service survey which found that less than 10 percent of health department administrators in the seventy-two cities it surveyed had public health training of any kind.
In Oregon, lectures in public health were integral to the training at the University of Oregon Medical Department from its earliest years. In 1887, A. J. Giesy, M.D. taught hygiene, which was originally offered alongside dermatology. A. E. Mackay, M.D. established a laboratory course in bacteriology in 1889. A decade later, Cortes H. Wheeler, M.D. oversaw a course on preventive medicine and sanitary science. He was replaced by Calvin S. White, M.D. in 1911, who had recently been appointed state health officer, and the course was renamed Hygiene and Sanitation. Offered in the Department of Medicine, the curriculum focused on municipal sanitation, food safety, waste management, and how these topics related to public health. The course moved to the newly formed Department of Bacteriology in 1918, with Harry J. Sears, M.D. as chair. During the 1930s, his students conducted public health surveys of communities across Oregon. The surveys are similarly organized and provide such information as: descriptive data about the community, organization of the local health department, vital statistics, communicable diseases, venereal diseases, control of milk and food, sanitation, and recommendations to improve public health. The Public Health in Oregon collection includes several of these surveys. Throughout the 1920s and 1930s, public health courses at the medical school were taught by city or state appointed health officers. In 1942, the university established the Division of Public Health and Preventative Medicine and appointed Adolph Weinzirl, M.D. as chair.
Medical Societies and Journals
Further adding to the professionalization of public health was the publication of books relating to the field, the proliferation of medical journals, and the increasing dedication of medical societies to educating their members about public health matters.
In nineteenth-century Oregon, health professionals began communicating their findings to one another through periodicals such as the Proceedings of the Oregon State Medical Society. Papers relating to public health topics were presented at the Oregon State Medical Society’s annual meetings, like Dr. Horace Carpenter's 1875 talk on “Climatology and Epidemics of Oregon.” That same year, medical society members proposed the creation of a state board of health. Using the Board of Health of California, which had been established five years earlier, as a model, the society intended to submit a bill to the Oregon legislature. Repeated appeals to the legislature to form a board of health were ignored until the early twentieth century.
An 1876 issue of the journal contains case studies, reports, essays, announcements, and even poetry. Most of the information is anecdotal. Scientific publications did not necessarily contain the wealth of data and statistics expected by readers today. Data, when provided by the authors, was usually unstructured, mentioned in longer text passages that make it difficult to extract and compare with other data.
Harry J. Sears Public Health Survey Records, Collection Number 2004-025, Historical Collections & Archives, Oregon Health & Science University.
Larsell, Olof, and Oregon Historical Society. The Doctor in Oregon; a Medical History. Portland, Or.: Pub. by Binfords & Mort for the Oregon Historical Society, 1947.
Marion County Medical Society. Oregon Medical Journal, Vol. 1, No. 2. 1876.
Oregon State Medical Society. Proceedings of the Annual Meetings.
Rosen, George. A History of Public Health. Revised Expanded ed. Baltimore: Johns Hopkins University Press, 2015.