Term Paper: American Urban History

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American Urban History-Public Health

Public Health System Examination

An in-depth look at American urban history as it pertains to Public Health concerns between the Civil War and World War II

Flow of Information

The Past

New York City

Chicago

Newark

Seattle

America boasts a relatively healthy society. Its medical advances and abilities are second to none and people come from all over the world to see American specialists and surgeons that can save their lives or cure their medical problems.

Through recent advances in medical technology Americans live longer today than ever before and with that longer life comes a high standard of living.

Though the nation is relatively young when compared to many of its world wide peers, it has an excellent public health system in place that provides Americans with peace of mind with regard to national health issues.

One of the more significant factors in the strong public health system currently in place, is the focus that major cities have historically placed on water systems, waste systems and public education when it comes to public health.

Following the Civil War, while the nation was still in its relative infancy and medical science had not yet discovered antibiotics, there were many health concerns in urban areas. Whether it was a Yellow Fever scare, a Diphtheria epidemic or another public health problem, major cities across the nation worked hard to eradicate germs, filth and contaminated water supplies in the effort to provide a safe living environment for their residents.

The efforts paid off and America now has one of the safest public health systems worldwide.

The Past

While America currently has one of the best public health systems on earth, there was a time in the nation's history when battling disease and filth was a constant problem.

Major cities across the nation had to deal with waste and water issues and try to prevent disease epidemics from destroying their areas (Savannah, 1/1/1826, Dengue fever (http://www.geocities.com/Heartland/Plains/3959/Plagstate).

Following the Civil War, many large cities in America had outbreaks of disease that killed hundreds of thousands of residents as the disease took hold.

In 1847, for example, New Orleans had a Yellow Fever outbreak that took its toll only to have to happen again in 1852. In Hawaii in the late 1800's there was a small pox outbreak, in 1888, New York had a serious and deadly Measles outbreak and in 1863 the same city was hit with Cholera (Savannah, 1/1/1826, Dengue fever (http://www.geocities.com/Heartland/Plains/3959/Plagstate).

Throughout the history of America, there have been health issues in metropolitan areas but during the period between the Civil War and World War II American cities began to tackle some of the larger issues surrounding public health.

Following the Civil War

Until the Civil War, most of America was at the mercy of whatever health crisis besieged its residents (Public Health (http://www.nlm.nih.gov/hmd/pdf/modern.pdf).While science had begun to pinpoint key elements that could help change the way public health was viewed, it was not yet accepted that water, waste and environmental factors play such an important overall part in the health of urban populations.

It was after the Civil War ended that the emergence of modern medical care began in the United States, including childcare (Public Health (http://www.nlm.nih.gov/hmd/pdf/modern.pdf).

Until the latter half of the nineteenth century there was no distinction in the medical care for the adult or the child. Children were treated as small adults (Public Health (http://www.nlm.nih.gov/hmd/pdf/modern.pdf).Only with the advent of modern medicine did pediatric theory and therapeutics come into being (Public Health (http://www.nlm.nih.gov/hmd/pdf/modern.pdf).During the nation's colonial era the high number of births was balanced by a devastating mortality rate among children. Two epidemic diseases which took a particularly high toll were small-pox and diphtheria (Public Health (http://www.nlm.nih.gov/hmd/pdf/modern.pdf)."

Two things that contributed to the disease death rate were unsanitary living conditions and bad diets.

Prior to the Civil War one out of every two children died before their 10th birthday.

While the general state of medicine in America changed little from the early eighteenth century through the first part of the nineteenth, some advances were made. By 1820 the United States had a number of medical schools and hospitals (Public Health (http://www.nlm.nih.gov/hmd/pdf/modern.pdf)."

However, it was not until the Civil War that urban areas began seeing a connection that was undeniable between water supplies, waste management and the management of public health.

The development of American public health has traceable roots dating back to the Civil War era. It was public health that changed the face of medicine and was ultimately responsible for the proactive instead of reactive mindset of today (Erlen, (http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/20011-21001/20181.ppt).

One of the significant factors in public health issues prior to the Civil War was that before the war, most of America was still very rural. This meant that there were not large numbers of people in close contact with each other, nor was there a need for shared water supplies or waste management. People lived on farms or in spread out areas and rarely had to be confined to urban living situations.

Even given the lack of crowded living conditions, disease and epidemics still managed to find their way to American populations.

When urban areas began to become more popular, it introduced several new elements to the mix, including waste management issues and water supply contamination problems.

In the small towns there were only spotty efforts to collect garbage and dispose of sewage, 2 major public health concerns which remained of primary importance until the start of the 20th century (Erlen, (http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/20011-21001/20181.ppt)."

Prior to the Civil War the main focus of public health in America was dealing with epidemics, while following the Civil War and leading to World War II other issues began to emerge as ways to prevent epidemics from returning.

The major impetus for 19th century public health reforms came from the general public's fear of and reactions to the various epidemics which periodically struck America's rapidly growing cities. While the public came to accept the public health problems of high infant mortality, polluted water, foul smelling air, and overcrowding as everyday factors of life, the sudden appearance of an epidemic, which produced tremendous losses both in terms of life and of economic losses, created a strong demand for direct governmental public health responses (Erlen, (http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/20011-21001/20181.ppt)."

After the Civil War, American residents could begin to focus on other life aspects and attention soon turned to reports from Britain about its new public health system. The reports boasted successful public health reforms with regard to sanitary living conditions of the working class.

The American population was still riding high on its crusade success having recently defeated slavery, and it quickly began to pick up the cause of public health as its next project to tackle.

There were two significant breakthroughs in the first five years after the Civil War ended. It was during this time that New York City was seeing many issues related to public health and crowded urban development. The city was arguably one of the worst public health hazards in the nation with regard to living conditions and sanitary needs (Erlen, (http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/20011-21001/20181.ppt).

By 1850 there were are reported 20,000 city residents living in underground cellars, with no running water, or air circulation. It set the stage for germs and filth to spread disease throughout the city.

Any efforts to correct the problems were halted by the sheer immensity of the situation. In addition there was political corruption throughout the city at that time and the politicians had no concerns about immediate public health.

The second break through happened in Massachusetts around the same time when that state took the opposite approach from New York City and created the first state board of health in the nation (Erlen, (http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/20011-21001/20181.ppt).

By 1890 there were 28 state boards of health patterned after Massachusetts' model. Thus by 1870 the appropriate state and local public health administrative machinery had been created and would quickly be copied throughout the United States. What remained was for national level public health organizations to be created, and this would be the success and failure of the 1870's public health efforts (Erlen, (http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/20011-21001/20181.ppt)."

The urban population increased explosively, from 23 million in 1850 to 106 million by 1920, an increases of 357%(Erlen, (http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/20011-21001/20181.ppt).This tremendous growth came from 2 sources: immigration from abroad, and the influx of rural population into the cities seeking jobs, as between 1880 and 1920 figures showed 15 million people moving into cities from the country (Erlen, (http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/20011-21001/20181.ppt).This influx of humanity made American cities the most crowded in the world i.e.: in 1894 N.Y.C. there were 986.4 persons/acre as compared to 759.7 persons/acre in Bombay, India at that time. Infant mortality in N.Y.C. was 65% higher in 1870 than it had been in 1810. By 1900 infant mortality had reached as high as 317/1000 in sections of some American cities (Erlen, (http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/20011-21001/20181.ppt)."

The big cities had to contend with public health hazards stemming from horse drawn transportation in crowded city streets. Each horse typically excreted several gallons… [END OF PREVIEW]

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