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Philadelphia Health
Philadelphia's
Early History of Public Health
The
history of public health in Philadelphia is almost as old
as the city itself. The Philadelphia Almshouse, established
in 1729, was the first institution in the American Colonies
to provide hospitalized care for the poor. In 1794, the city
established a health office that was one of the first in the
nation. It also created the Municipal Hospital for Contagious
Diseases and a quarantine hospital for the Port of Philadelphia
called the Lazaretto. All were managed by 24 health inspectors.
In 1804, their control was placed under an independent Board
of Health also charged with removing all nuisances prejudicial
to public health.
Beginning in 1818, Board of Health members were elected by
the City Council and the Commissioners of the Districts and
Townships. By 1855, the Board was clearly designated a branch
of the City Government. Gradually the Board's responsibilities
increased to include protection of the city's water supply,
public vaccinations, keeping vital statistics, licensing of
midwives and ridding the city of public nuisances.
The
Bullitt Bill of 1887 placed the Board of Health under the
control of the newly created Department of Public Safety.
In 1899, the Board was reduced to three mayoral appointees
and the Bureau of Health was officially organized. At that
time the Board of Health became an advisory and policy-making
body - the role it still continues today. The Bureau of Health
was placed under the Department of Public Health and Charities
in 1903. After restructuring in 1919, that Department became
known as the Department of Public Health.
The
Philadelphia Almshouse
The
Philadelphia Almshouse, built in 1732, was the first American
institution to provide hospitalized care for the poor. Initially
located at Third and Pine Streets, the Almshouse was managed
by the City's Overseers of the Poor, later called the Guardians
of the Poor. The Almshouse also provided housing for the indigent.
In 1767, the Almshouse moved to larger quarters at Tenth and
Spruce Streets.
Yellow
Fever Epidemic
In
the summer of 1793, Philadelphia was struck by a yellow fever
epidemic that killed 1/10 of the city's population (almost
5,000 persons) in less than five months. It is considered
one of the worst epidemics to ever hit an American city. Over
one-third of the inhabitants fled the city leaving only a
courageous few behind who were willing to risk their lives
to help the sick and the dying. Dr. Benjamin Rush, one of
Philadelphia's most prominent physicians, was one of them.
Rush served on a temporary Board of Health established to
enforce sanitary regulations. The Board worked with the Guardians
of the Poor to set up a hospital beyond the city limits to
quarantine the victims. During the epidemic Philadelphia Mayor
Matthew Clarkson asked for additional volunteers to help with
the care of the sick. Two of the few who stepped forward were
African-American clergymen Richard Allen and Absalom Jones.
Most of the 2,500 African Americans living in the city were
free. Through the Free African Society Allen and Jones recruited
volunteers to bring the sick to the quarantine hospital, serve
as nurses in the infected areas and help bury the dead. At
the time of the epidemic many believed blacks were immune
to it. In the end, they were proved wrong as more than 300
African Americans perished.
The
Guardians of the Orphan Children was created in 1794 specifically
to care for the orphaned children of victims of the yellow
fever epidemic the year before. A city appropriation was made
to provide suitable clothing, food, education, and employment
and housing arrangements for the children.
Vital
Statistics
The
development of effective public health policies and programs
requires accurate and complete data on births and deaths.
In 1819, the Legislature of Pennsylvania passed an act requiring
all physicians to register the births that took place under
their care. In Philadelphia these Returns of Births were submitted
directly to the Board of Health. The City passed a law in
1860 that called for the quick and exact recording of all
city births, marriages and deaths in a systematic and continuing
manner by the Board. The Civil War brought a significant increase
in the number of requests to the Board for certified birth
certificates. Widows and families were compelled to make such
requests to obtain pensions due from the federal government.
Philadelphia's rich religious and cultural diversity was reflected
in the Board of Health's 1868 vital statistics report on marriages
which noted no less than 21 different religious ceremonies
were employed in the city. The Board worked diligently to
ensure the accuracy of all vital statistics records until
the state Registration Act of 1915 transferred the recording
of births and deaths to State Bureau of Vital Statistics.
Fairmount
Water Works
Considered
a universal marvel, the Fairmount Water Works, completed in
1820, was an early achievement of the Board of Health in its
advocacy for a clean municipal water supply to improve public
health and prevent epidemics. It would take almost another
100 years to build a complete citywide filtered water and
sewage system. Chlorination of the water supply began in 1912;
fluoridation in 1954.
Today
and Tomorrow
Over
the past two centuries the Philadelphia Department of Public
Health has stood as the bulwark of defense against hazards
threatening the wellbeing of all Philadelphians. Today, the
Department of Public Health still works to maintain core public
health services despite reductions in funding. It strives
to continue to provide improved quality health care in an
efficient manner while meeting the challenge of the increased
demand for services by the under- and uninsured.
The Philadelphia Department of Public Health remains at the
forefront of public health developments on a national scale
in an environment where traditional roles are continuing to
shift in the delivery of health care services. New Department
initiatives include establishing a task force to review youth
fatalities, coordinating surveillance of emerging infectious
diseases, monitoring the threat of bio-terrorism, and continuously
studying the dangers of environmental exposure to public health.
New
health care challenges and risks will continue to emerge in
the future. The Philadelphia Department of Public Health and
its employees remain dedicated to ensuring that the citizens
of the City of Philadelphia can live and work in a safe, healthy
and disease-free environment in the 21st Century.
Source
of Article:
Philadelphia
Department of Public Health. (2008). History. Retrieved
June 5, 2008 from http://www.phila.gov/Health/Commissioner/HistoryInto.html
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