Child Health in the United States
Useful Info: Docs for Tots
Doctors began to specialize in the care of children in 1860. Before that, nurses or general doctors treated older children. Midwives or obstetricians treated children under 2.
Dr. Abraham Jacobi was the first physician in the United States to devote himself to the care of children. He is considered the father of pediatrics in America. In 1860 in New York, he established the first outpatient clinic for children.
Two years later in Paris, Dr. Pierre Budin, a French obstetrician, set up the first clinic for newborns. In addition to instructing parents in feeding and nutrition, he weighed and measured newborns – almost all of whom were born at home. Dr. Budin also established a nursery to care for sick newborn and premature babies.
Useful Info: Show Time
In Paris, Dr. Budin became known for saving the lives of premature infants. One of the secrets of his success was to make sure the babies were kept comfortably warm. To provide warmth, Dr. Budin designed a simple machine called an incubator.
Hoping to interest the public in this new way to care for babies, Dr. Budin sent his student, Martin Couney, to the 1896 Berlin World Exposition with five premature infants, five incubators, and five nurses. People were very interested – up to 3,000 visitors a day filed by the tiny babies in their "human hatcheries!"
After Berlin, Couney traveled to various countries, including the United States, setting up his baby exhibits. As recently as 1939, the exhibit could be viewed at the New York World Fair.
Useful Info: Lessons from the Past
A century ago, milk sold at the local store was dipped from an unrefrigerated five-gallon can. Very likely, molasses, chalk, or even plaster of Paris had been added to improve its taste or appearance. Infants and young children often became ill from the germs that thrived in the warm milk, especially in the summer months. At the time, infectious diseases were the leading cause of death, and contaminated milk was a leading source of infection. The first major victory in the fight to save the lives of young children was won by setting standards for the safe handling of milks. "Milk stations" were set up where parents could get fresh milk from "certified" suppliers.
The next battle was fought against the killer diseases like diphtheria, tetanus, and pertussis (whooping cough). In the 1800s, these diseases filled graveyards with their tiny victims. Parents watched over their children as the disease ran its course to recovery or death. Doctors, called late in the disease when death was close, faced desperate situations. During his years of practice, Dr. Abraham Jacobi, the nation's first doctor for children, performed emergency surgery on more than 2,500 children dying of a blocked windpipe, the deadly complication of diphtheria. Though his heroic actions saved many children, tragically he was unable to save his own son. When the diphtheria vaccine became available, parents celebrated the chance to protect their children.
Development of the vaccine to prevent diphtheria was followed by vaccines for pertussis, tetanus, polio, measles, mumps – the list goes on to include more than a dozen childhood diseases that can be prevented by immunization. A parent of the 1800s would love to trade places with you. By having your child immunized, you can protect your child from diseases that once killed thousands of children.
Useful Info: Live Healthier, Live Longer
A child born in the year 2000 can expect to live to age 76. A child born in 1900 could have expected to live to age 50. Immunizations have made a major contribution to this gift of 26 extra years of life.
Children who are immunized on schedule receive the maximum benefit from vaccines. In 1998, the immunization rate for young children 19 to 35 months of age was the highest ever recorded. Even so, 1 in every 4 children remains unprotected or only partially protected.
Source: U.S. Department of Health and Human Services.
Useful Info: Things Change
The 1800s were years of tremendous change in the United States. Thousands of families moved from small towns and farms to cities where factories offered employment. Factory-made clothing, furniture, and household items like soap and candles replaced handmade items. Middle-class women who could afford to purchase the factory-made goods had time available to spend with their children. Influenced by new ideas on childhood from Europe, these mothers directed their attention to educating their children using a far more gentle approach to parenting than past generations.
While children of middle- and upper-class families benefited from their parents' changing views on childhood, the children of the poor had no such advantage. Children as young as 7 worked long hours in low-paying jobs and were unable to take advantage of public education. The children in factories were not alone in their misfortune. The living conditions of orphanages were so terrible that only 1 of every 10 children placed in an orphanage was likely to survive. All children suffered from the problems of infectious disease and poor sanitation.
As the public became aware of the unhealthy and miserable conditions existing for children, public interest began to grow in the federal government's role in improving the welfare of children. In 1909, the first White House Conference on Children brought together social leaders, educators, doctors, and civic-minded citizens, all of whom were concerned with children's issues. Largely because of their recommendations, in 1912 Congress passed an act creating the Children's Bureau, a federal agency whose purpose was to investigate and report on the problems of children. The creation of the Children's Bureau is an important milestone in the history of child health and welfare.
Useful Info: Today's Diseases - Today's Docs - Today's Kids
…and the terrible epidemics ended and the killer diseases disappeared. The children grew strong and healthy, and families rejoiced, and everyone lived happily ever after. The end.
The "happily-ever-after" ending can be found in children's bedtime stories but rarely in real life. Nevertheless, it's true that the terrible epidemics of diphtheria, measles, and pertussis have ended. And that for the most part, the killer diseases are gone. But there are new threats to our children – substance abuse, eating disorders, teen pregnancy, and more. Yesterday's answers won't always solve today's problems.
New diseases require new approaches. Since many of today's health problems have their roots in emotional and social stresses in the home, school, and community, partnerships between parents, doctors, and schools are increasingly necessary. The new goal for child health care is health promotion – "not just preventing or treating illness or injury, but actively promoting the physical, emotional, mental, and social well-being of children, adolescents, and their families."
Source: Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 2nd edition.
Useful Info: A Safety Net for Children
The Great Depression of 1929 forced 40 percent of the people of the United States into poverty. The Social Security Act of 1935 created an important safety net for many of those most at risk – the elderly, the disabled, pregnant women, and children.
Title 5 of the Social Security Act created the Maternal and Child Health Services Programs to improve services for the health of mothers and children; children with disabling conditions; homeless, neglected, and delinquent children; and rehabilitation for the physically disabled.
In 1965, Congress passed Title 19 of the Social Security Act and established Medicaid. Medicaid is a health insurance program for low-income mothers and children, the disabled, and the elderly who meet eligibility requirements. Eligibility varies considerably from state to state. The federal government provides partial funding with states providing matching money. For an eligible child under 21, Medicaid covers all basic medical services, including hospital care, office visits, immunizations, dental care, screening, diagnostic and treatment services.
Children's Health Insurance Program
In 1997, a major new source of funding for uninsured children was created when Congress passed Title 21 of the Social Security Act. Title 21, the state Children's Health Insurance Program (CHIP), is expected to provide coverage for 10 million uninsured children. For more information, call Hoosier Healthwise at 1-877-KIDS-NOW.
Useful Info: Riley Hospital for Children
Built to honor the memory of the famous Hoosier poet, James Whitcomb Riley, Riley Hospital for Children opened its doors in October 1924. In the years since, the doctors at Riley have cared for many children with many diseases.
Never were Riley's wards more crowded than during the polio epidemics of 1949 and 1951. The iron lung, one of the earliest "breathing machines," kept paralyzed patients alive until they could breathe on their own.
Today Riley is one of the 10 largest children's hospitals in the nation. The building, the patients, the equipment, and the doctors have all changed, but the reason for Riley remains the same – to bring the best that medicine has to offer to the children and families of Indiana.