User note: Boldfaced terms within paragraphs deliver search results.

Heaven sent! Is that too strong a descriptor to use? That, at least, is what Public Health in Modern America (PHMA) affords students, researchers, and faculty across multiple disciplines. It is an enormously useful digital library for the discovery of primary source materials on hundreds of topics related to the history of public health as practiced in the United States.

As a public historian and health sciences librarian, I regularly answer reference questions on the history of the health sciences, prepare public exhibits on the history of medicine, and work in concert with faculty, undergraduate and graduate students associated with the University of Wisconsin in Madison’s Department of Medical History and Bioethics.

Such work with students and faculty includes targeted resource workshops that incorporate the rich primary print collections within the Rare Books and Special Collections division of the University of Wisconsin’s Ebling Library, as well as the fine-tuning of their navigation skills with our campus’s primary and secondary full-text databases. It is not uncommon to provide resource instruction that has been heavily informed by the syllabi of requesting faculty members, who routinely ask their students to investigate the development of public health in America. Course work then will focus on studying the clinical and ethical issues, as well as gender and race concerns characteristic of the evolution of medical, pharmaceutical, and health care enterprises as we know them today.

Students produce research papers on complementary subjects, regularly incorporating primary documents into their research. Along the way, students meet with me, one on one, for tips on which print and online resources to use, how to optimize the available databases, and how to uncover the unheard “voices,” so often difficult to locate in conventional sources.

Based on the collection of materials that it brings together in one place, Public Health in Modern America widens the door for these students by delivering access to previously hard-to-find resources and presenting full-text searchable content not available anywhere outside of a small handful of institutions.  The breadth and depth of the collection is represented through the four thoughtfully indexed digital collections that have been brought together:

  • the records of the U.S. Children's Bureau, with its focus on maternal and child health from the years 1912 to 1969;
  • the work of the Committee on Public Health of the New York Academy of Medicine, and its dedicated collection of correspondence and reports;
  • the remarkable Library of Social and Economic Aspects of Medicine from Michael M. Davis, a lifelong public health researcher, advocate and collector, who had been intimately involved in the campaign for a national health care plan;
  • and a selection of publications on public health—all rare pamphlets unavailable from another digital source—from the New York Academy of Medicine.

 

In my own review of the four collections, my search on the role of race and public health made clear right away that there was not to be any sort of pre-designed subset on the topic—not as a eugenically informed ideal or as a collection of content amassed specifically around the issue of patients and practitioners of color and their relationship to the delivery of health care services, disease occurrence and treatment, or preventive care. Nor did any of the collections specifically supply a dedicated subset on gender and its relationship (whether as practitioner or patient) to health care or disease occurrence.

Counterintuitively, the very fact that such subsets are not so readily found is exactly what makes Public Health in Modern America so valuable. An essay prepared for the Ebling Library’s exhibit Staggering Losses: World War 1 and the Influenza Pandemic of 1918 notes how commonly surveys of U.S. history skip over the involvement, the contributions, or concerns of people of color or women. Over the last 40 years, historical treatments have included the unheralded, unacknowledged, oppressed, or maligned place of people of color and women in the making of a modern America. The occurrence of provocative topics like eugenics and racially informed health care decision-making are evident throughout the digitized resources assembled in Public Health in Modern America.

Within this digital archive, one can experience a far more representative version of the historical place of marginalized groups. It offers a more complete narrative, one that points out the marginalization or disenfranchisement of women even as it highlights the influential contributions people of color and women nonetheless made as patients and professionals

Through vigorous indexing and the power of the platform’s search engine, it is far easier to look up heretofore hidden subjects and themes, even when those subjects are not immediately evident from the title of the resource. Researchers and students can pose questions—and get answers—about people of color and health care delivery, from public health education within the African American community to disease demographics with respect to America’s many communities of color.

So for a study of the prevention of tuberculosis among African Americans, a long list of results appears when a search is properly run. Doing so requires using the advanced search and entering the period-specific term colored (or negro) and tuberculosis. Public Health in America will retrieve over 200 “monograph” publication (all rare pamphlets) result and 806 “manuscript” (each one a folder’s worth of content) results. Among the monographs—all from the sub-collection “Selected Publications on Public Health from the New York Academy of Medicine”—the first title The Movement against Tuberculosis in Washington, D.C. (1907) includes no mention of people of color in the pamphlet title.  But a search within the document on the word “colored” delivers 10 relevant page results. Of particular interest on page 14 (“relevant page 16” in the digitized version) are the lectures that the Associated Charities presented on tuberculosis prevention to both white and black teachers. Here is the paragraph in full:

 

Lectures.—These have been found especially effective in this field. During the first season forty-four public meetings were held, at most of which the subject was illustrated by stereopticon views, besides forty meetings in connection with the Associated Charities, through all of which more than 20,000 people received some knowledge of the nature of tuberculosis. Similar courses have been kept up since, though there has seemed to be less demand for them this last season; and talks on the subject have also been given to all teachers, both white and colored, as well as in all the high schools, and to labor organizations, one of which showed its appreciation by sending the Committee a substantial check. [Italics added.]

 

This 1907 publication by William H. Baldwin (and published by the Journal of the Outdoor Life) is not available from the Ebling Library or elsewhere at the University of Wisconsin, Madison. In fact, only two copies are available in the United States (one of them the copy from the New York Academy of Medicine digitized here). The work does not appear on Google Books, the Hathi Trust Digital Library, or the Internet Archive.  Without this digital copy, there is no knowing if such is even worth the obtaining through interlibrary loan, if available at all by that means. And even if available, why run the risk of handling a potentially fragile document when it is already part of the Public Health in America?

But leaving questions of access aside, the uncovering of this document—and even the topic within it—is no small matter. This little, but not insignificant paragraph, helps me and my students identify one publication, with one entity (Associated Charities) from which they can start to build a historical inquiry.

Once they have such an inquiry in hand, they can then proceed to other monographs or manuscripts within PHMA, looking for additional mentions of Associated Charities (29 monographs; 40 manuscripts), other incidences of adopting teachers within a public health movement (school teachers delivers 108 monograph and 426 manuscript results), other public health initiatives with black patients (negro patients provides 11 monograph and 108 manuscript results) to educate them about any number of topics, including tuberculosis prevention (a search on negroes and spitting offers 9 monograph and 28 manuscript results, many related to preventing tuberculosis within the Black community).  Public Health in Modern America can thus serve as a springboard as students look further afield among other sources like contemporary newspapers, education journals, social hygiene publications—all from the unearthing made possible by the small mention in a previously obscure publication.

But let’s change gears. After recent work assembling an exhibit at the Ebling Library on World War I, I decided to pursue the topic of women health care providers. A search on women and physicians produced 800 monograph and over 2,000 manuscript items. I then narrowed the search to dates of publication to the years when World War I raged from 1914 to 1918 (even though America’s direct participation would not occur until April 1917).  Once filtered down to 98 monograph and 47 manuscript results, I then scrolled the list of available titles, each more thought-provoking than the next. Consider An Appeal to the Men and Women Engaged in Medical Practice and the Advancement of Medical Sciences (1915) from the Medical Brotherhood, just five years after the “Flexner Report” on medical education by Abraham Flexner (researchers can find a 33-page folder devoted to Abraham Flexner in the Michael Davis collection) and the eventual closing of many women’s medical colleges. Would this document mention Flexner’s report? Might it address the many physicians then heading to Europe to help in the war effort and the women who remained behind to take care of patients?

While neither subject is directly addressed, this appeal nonetheless offers a fascinating glimpse into wartime sentiment regarding medical men and women (physicians, nurses, researchers) and their role as stalwart, upstanding volunteers. It includes a call for them to be part of “The Medical Brotherhood for the Furtherance of International Morality” and “to sign their names as (moral) humanitarians.” Women as part of the Brotherhood?  How unusual!  And then there are the several notable women medical doctors whose names appear among the committees presumably affiliated with the Brotherhood. From here, one might begin to research those women and their roles. They include, for example, S. Josephine Baker (11 monograph and 27 manuscript results) and Alice Hamilton (14 monograph and 108 manuscript results).

Those of us who have worked as librarians and historians for decades have seen the pendulum swing from print to online in ways that can sometimes seem alarming. Limiting one’s research in print, particularly within a single institution, may see pivotal primary materials missed. On the other hand, sticking to just online resources can prove as limiting. Responsible researchers ideally use print and online resources in concert to craft definitive arguments, especially in previously unmined territory.

In either case, the goal is to have access to resources—those documents with their tables, images, footnotes, references, and names of pivotal players in the public health arena—that can provide scholars with hints and clues for further research. This domino effect in the gathering of evidence for any study, whether an article intended for publication or a term paper, is what makes searchable digital primary source collections like Public Health in Modern America so valuable. The “rabbit holes” that graduate students so often worry about are often what shine a light on new corners of research.  Such necessary rabbit holes are spread throughout Public Health in Modern America, making the possibilities for research in the history of public health endless.

CITATION

Sullivan-Fowler , Micaela: “Public Health in Modern America: A Research Experience”, Public Health Archives: Gale, a Cengage Company (2021)

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Any views and opinions expressed in these essays are those of the author in question, and any views or opinions from the original source material are those of the publication in question. Gale, part of Cengage Group, provides facsimile reproductions of original sources and do not endorse or dispute the content contained in them. Author affiliation and information within them are correct as of the original publication date.