Public Health Projects (1933)

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Public Health Projects (1933)

There was no single public health program of the New Deal, but many varied public health projects across different federal agencies. Hence, New Deal public health impacts, while significant, are often overlooked by historians. Nevertheless, they had many benefits, some long-lasting and still benefiting us today. The projects can be placed into four broad categories: construction, direct services, research assistance, and public information.

All across the country, the New Deal’s Public Works Administration (PWA) provided major funding for the construction of hundreds of new hospitals that dramatically increased America’s bed capacity; hundreds of new water mains and water treatment facilities that provided clean drinking water; and hundreds of new sewer lines and waste disposal plants that reduced pollution in rivers and creeks [1]. The PWA noted the obvious but often forgotten fact that clean water and proper sanitation are vital to health: “Water is life” [2].

The Works Progress Administration (WPA) engaged in similar projects as the PWA, though usually on smaller-sized facilities, and it also built 2.3 million sanitary privies (“outhouses”) in rural areas. Though ridiculed by critics of the New Deal, the privies proved to be instrumental in fighting disease. For example, in 1939 the U.S. Surgeon General credited the privies with large reductions of illness and death from typhoid fever, hookworm, and dysentery in Mississippi, Tennessee, and West Virginia [3]. The WPA also drained swamps and fought mosquitoes, and these projects greatly contributed to the virtual eradication of malaria from the U.S. [4].

The direct health services of the New Deal, largely provided by WPA workers, were massive and reached every corner of the nation. Thousands of WPA nurses and housekeeping assistants visited the homes of Americans who had fallen ill. Tens of thousands of immunizations were administered, saving countless lives. In 1936, for instance, the WPA administered immunizations to 17,000 children in Cleveland, a 66 percent increase from the year before, resulting in a record low number of deaths from diphtheria [5]. The WPA also staffed hospitals, clinics, and laboratories; operated mobile dental clinics; provided health check-ups at its nursery schools; tested older schoolchildren for vision, hearing, and heart problems; and served 1.3 billion nutrition-based school lunches [6]. Other New Deal agencies, such as the National Youth Administration and Farm Security Administration, provided similar public health services.

In the area of medical research, the most prominent New Deal project was the National Cancer Institute, created by Congress and FDR in 1937. Today, it is a multi-billion dollar program that conducts in-house studies and awards grants to outside research institutions [7]. The New Deal also hired jobless workers with scientific backgrounds to aid in research. For example, WPA project number 65-3-575 helped scientists at the University of California, Berkeley in their study, “The Blood Lipids of Diabetic Children” [8]. Other New Deal-assisted research included, “Pregnancy and Tuberculosis” (WPA), “Pulmonary Embolism Following Trauma” (Civil Works Administration) and “The Course of Rheumatic Heart Disease in Adults” (Federal Emergency Relief Administration) [9].

To improve national awareness and information on health issues, several thousand WPA workers conducted the National Health Survey, interviewing 800,000 families (2.8 million total people) in 19 states [10]. It was the first national survey “to study the extent and nature of disability in the general population, with special reference to chronic disease and physical impairment” [11]. The survey aroused in Americans a great interest in the overall health of the nation, shaping public policy discussions about treatment and care for years thereafter. It influenced the creation of Medicaid to aid the poor and resonates with the National Institutes of Health’s ongoing focus on chronic health problems [12].

WPA posters informed the public, too, by promoting workplace safety, good nutrition, and proper hygiene; advertising free health classes; encouraging testing and vaccination; and highlighting the value of early detection and treatment. A colorful WPA poster with a crowing rooster declared, “Early is the watchword for cancer control. Early diagnosis, early treatment, will save many lives” [13]. Another poster listed available cancer treatments: surgery, x-rays, and radium [14], all of which are still utilized today [15].

The health projects of the New Deal, and the optimistic and proactive nature of the New Deal itself, improved not just physical health but also mental health. For example, it has been estimated that “every $100 in New Deal spending per capita was associated with… a drop in suicides of 4 per 100,000 people” [16].

Finally, it is important to note that the New Deal helped minority groups that had often received little or no professional healthcare. On American Indian reservations, the PWA and the Office of Indian Affairs built new hospitals and clinics [17]. In Puerto Rico, the School of Tropical Medicine was expanded and at least 88 health clinics were established by the New Deal’s Puerto Rico Reconstruction Administration [18]. African Americans, meanwhile, benefited from improved sanitation; better reproductive healthcare; and more effective treatment of syphilis (in contrast to the disgraceful Tuskegee Syphilis Study occurring at the same time). Across the Jim Crow South, where 80% of African Americans lived at the time, federally-funded hospitals brought much better professional care for Black patients while increasing the access of Black doctors and nurses to modern equipment and interaction with White colleagues, even in segregated facilities [19].

Sources

(1) Public Works Administration, America Builds: The Record of PWA, Washington, DC: U.S. Government Printing Office, 1939, pp. 141-178, 269-271, 288, 290. (2) Ibid., p. 169 (also see p. 156). (3) Annual Report of the Surgeon General of the Public Health Service of the United States, Washington, DC: U.S. Government Printing Office, 1939, pp. 41-42. (4) See, Carl Kitchens, “The effects of the Works Progress Administration’s anti-malaria programs in Georgia 1932–1947,”Explorations in Economic History, Volume 50, Issue 4 (October 2013), pp. 567-581, and Federal Works Agency, Work Projects Administration, Public Health and the WPA (foldout brochure), Washington, DC: U.S. Government Printing Office, 1940. (5) “Boondoggle?” The Post-Register (Idaho Falls, Idaho), January 21, 1937, p. 4. (6) Federal Works Agency, Final Report on the WPA Program, 1935-43, Washington, DC: U.S. Government Printing Office, 1947, pp. 61-62, 68-70; and Public Health and the WPA (see note 4). (7) For more information, see our summary, “National Cancer Institute Act (1937).” (8) Works Progress Administration, Index of Research Projects, Volume III, 1939, p. 28. (9) Ibid., pp. 27-31. (10) George Weisz, “Epidemiology and Health Care Reform: The National Health Survey of 1935-1936,” American Journal of Public Health,” Volume 101, Issue 3 (March 2011), pp. 438-447 (also see Public Health and the WPA, note 4 above). (11) Ibid., quoting Hugh S. Cumming, U.S. Surgeon General, 1920-1936, and citing: H. S. Cumming, “Chronic Disease as a Public Health Problem,” Milbank Memorial Fund Quarterly 14, no. 2 (1936), pp. 125–131, 127. (12) Ibid., generally; and also see, e.g., “For rural people with chronic diseases, poverty and depression go hand in hand,” National Institute on Minority Health and Health Disparities, National Institutes of Health, August 2, 2017 (accessed January 16, 2024). (13) “Early is the watchword…,” Library of Congress Prints and Photographs Division (accessed December 25, 2023). (14) “The only safe weapons against cancer…,” Library of Congress Prints and Photographs Division (accessed December 25, 2023). (15) Surgery, of course, is routinely performed to remove cancerous masses; x-rays are still the primary form of radiation therapy (Mayo Clinic); and radium-223 dichloride, an isotope of radium, is used to treat prostate cancer that has spread to the bones and, as of December 2023, is being put through clinical trials for potential treatment of other types of cancer (National Cancer Institute). (16) “How Austerity Kills,” New York Times, David Stuckler and Sanjay Basu, May 12, 2013 (accessed December 25, 2023). (17) These projects are documented in various issues of Indians at Work, a newsletter published by the U.S. Office of Indian Affairs, 1933-1945. (18) Puerto Rico Reconstruction Administration, Rehabilitation in Puerto Rico, San Juan, Puerto Rico: Imprenta Venezuela, 1939 (unpaged). (19) Karen Kruse Thomas, Deluxe Jim Crow: Civil Rights and American Health Policy, 1935-1954, Athens, GA: The University of Georgia Press, 2011, pp. 45-75.

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The 2023 New Deal Book Award

The winning titles and authors have been announced. The 2023 Award, with a prize of $1,000, will be presented at the Franklin D. Roosevelt Presidential Library June 22, 2024.

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