Tag Archives: public health

Public School Pre-Vaccine Public Health Class Circa 1932 – Part 1: Good Citizenship

What did we do to prevent diseases and still carry on with daily life before vaccines existed? Vulnerable populations still existed. Public health measures still existed, even under President Herbert Hoover. So let’s take a gander into the archives of historical texts, starting with my grandmother’s health textbook.

It should be noted, as we are reading a historic text in its context, that my grandmother was a young white woman born in 1925 in Birmingham, Alabama to a doctor that made a point of treating people of all colors. That is not to say this did not occur without discrimination. As I was not alive and never met my great grandfather, I will never know the full story without speculation. My grandmother did explain to me that she attended an all white school. The name of the school her and her brother, William, attended was called “Edgewood” according to her distinctive cursive handwriting on the inside cover. I do not know if this is the same textbook that was used at other schools in the Birmingham area.

Controlling Disease

One distinct aspect of this textbook is the emphasis on good citizenship skills being a necessary requirement for preventing disease. But what is “good citizenship” and how does a health textbook from the 1930s define this?

Earlier in the text, good citizenship is defined as including everything from behavioral expectations and good hygiene to looking out for your fellow man in your daily activities. One prohibition era example of this being moderating consumption of anything that may dull or alter perception, such as alcohol containing medicines. There is an emphasis on “knowing thyself” and having awareness as being an important philosophical concept necessary for good health (see below).

Part of good citizenship seems to be a willingness to understand the concept of doing what is best for the common good, or what is best for maintaining the health and wellbeing of the population at large. This included some rather drastic measures, such as “sanitariums.” I will get to how tuberculosis sanitariums are described in the book in part 2 when we discuss the concept of the common good.

Good Citizenship

What did good citizenship mean? This is discussed throughout the textbook and I have attempted to summarize the concept here. It meant:

  • Not going out in public if you were sick, caring for a sick person at home, or were exposed to someone you later found out was sick until after the isolation period was over. In fact, make a special room in your house that can be converted to a “sick room” to isolate a person if they get sick – make sure it has plenty of windows you can open to keep the room “well-aired” with lots of daylight while it is shut off from the rest of the house.
  • Participating in volunteer groups, such as community service and church groups, that provide resources to keep others from feeling like they can not maintain the actions associated with good citizenship.
  • Keeping yourself clean and encouraging those around you to do the same through regular bathing, hand washing, and laundering of garments. This also included the wearing of aprons and work clothes that would be changed upon entering the home. By changing outfits regularly you kept the “germs” associated with the different parts of your life compartmentalized.
  • During certain times of the year, such as the winter, keep a wash basin by the front door with lye soap for guests and occupants of the home or building.
  • Wearing gloves to keep the hands clean while you are out and about and changing gloves between activities. These should be laundered regularly.
  • Using a handkerchief that is not to be shared for crying, coughing, sneezing, and all other expulsions of bodily fluids from the face. This should be laundered regularly with a disinfectant.
  • Eating healthy, home-cooked food from a clean kitchen, and bringing food of this kind to events. Practicing good hygiene in the kitchen is a must. (There is no mention of hand washing or gloves in the kitchen interestingly, but there is mention of washing vegetables, utensils, plates, and the management of food waste.)
  • Having home activities that keep your family fit and healthy, while bonded together. Suggested sports include examples such as tennis and chopping wood. (I’m not kidding about the chopping wood bit – that’s a sport for family bonding.)
  • Listening to the directions of your public health officials to prevent outbreaks. At the time only one vaccine was available (pertussis), but there were other prevention methods no longer used today.
Chart with information on incubation period and isolation requirements post exposure.

If you were exposed to someone with one of these diseases you had to isolate at home. If you didn’t do that, your parents were being bad citizens.

What is a bad citizen? That’s a more complicated subject and is where we start to delve into problematic areas with how this advice was given. In more modern terms that strip away the problematic content of the past, if you’re actively not helping to keep everyone around you safe and out of harm’s way, you’re a bad citizen.

It’s fascinating how times change. These methods were used to keep schools safe and in session before vaccines (not perfectly – outbreaks definitely still happened).

Anyways, I’ll revisit history again soon. Hope this was as informative for you as it was for me!


If you would like to see more posts like this one, please be sure to like, comment, and/or share this post. This helps me know which posts my readers like the most so I can try and cater my content. As always, thank you for taking the time out of your day to join me.

This post is dedicated to my friend Katrina, and other friends currently dealing with teaching full classrooms over Zoom. Be sure to thank a teacher today.

How Behaviors Impact Coronavirus Spread & Confirmed Case Reporting

Part 1 – Introduction to Issues

This is a pretty loaded topic. Breaking this one up into several parts. In this post I’m addressing limitations to medical accessibility, such as uninsured rates, caregiving, and religious exemption from government advised or required disease control practices, such as social distancing. Let’s talk about human behavior and how that may impact the vulnerability of your location in the United States to coronavirus.

Accessibility, Uninsured Rates, and Alternative Medicine

Source: https://www.census.gov/data-tools/demo/sahie/#/?s_searchtype=s&s_agecat=1&s_statefips= You can play with this viewer too! Go play with census data and learn about the United States.

There are many reasons Americans are uninsured. Being uninsured will ultimately lead to limited access to healthcare. Due to decisions that were made regarding how to implement mandated healthcare, the poor were punished for not being able to afford exorbitantly priced healthcare. I don’t care who you blame for it not working. Point is, it didn’t, and now we’re sunk. You may notice a similarity between the map above and the maps in my previous post on the closure of rural hospitals and poverty. Texas and Oklahoma are currently set up to be the two of the hardest hit states by coronavirus because these are uninsured populations that feel they cannot seek already-limited healthcare (because hospitals closed). This means that they turn to alternative medicine at home and don’t call a doctor due to the cost. Alternative medicine, though potentially complementary (waiting on research), doesn’t involve providing ventilators to people drowning from their own viral lung inflammation. Alternative medicine doesn’t necessarily involve reporting confirmed cases to the state, either.

Luckily, telemedicine is slowly stepping up the game at reducing costs and improving accessibility, but until we have Point of Care testing that allows for mass screening that could be distributed to a population via the health department – good luck. The FDA still strictly prohibits self administered tests. This is one of the major outstanding limitations preventing telemedicine from serving our most underserved and vulnerable populations in the United States during this pandemic.

Religious Exemption

Source: http://childrenshealthcare.org/?page_id=24

Religious exemptions for medical care are a real thing. I know there are people reading this that are going to think, “but no one in their right mind is thinking that now!”

Oh honey, I wish I could say that was so. Let me first introduce you to What’s The Harm. Even without coronavirus, people are and will be dying due to lack of access to medical care in part because their families opt out via religious exemptions. When this is combined with alternative methods gone wrong and cultural factors, the vulnerability of this population is amplified by pre-existing public health issues.

Part of the states’ Stay At Home orders have meant the discontinuation of standard church gatherings and not everyone is taking it so well. Across the United States, churches are challenging these orders by stating that they are restricting freedom of religion. The continued in-person gatherings of worship services and other church functions result in COVID-19 outbreaks within communities. The Palmer Grove Baptist Church in Burke County, Georgia is one example from today, 31 March 2020. Another example: a choir practice when there were no positive cases reported in the county lead to an outbreak due to asymptomatic transmission. In Arkansas, California, Florida, Louisiana, Oklahoma, South Carolina, Tennessee, Texas, Washington, and Wisconsin, churches have risked or spread COVID-19 to members through gatherings or other church related events. As long as church closures are seen as a threat, these communities will be at higher risk for impacts from COVID-19.

I’ll be making a separate post dedicated to addressing the religious exemption issue in a culturally sensitive manner. Stay tuned for part 3.

Home Care For The Sick

One of the most wonderful things about America is that we are a country of caregivers. By acting as a caregivers we enter others’ homes or share homes with them to ensure their wellbeing. Remember that map from this other post on poverty and rural hospital closures?

When we care for the sick at home, a variety of other factors come into play that may delay or prevent access to medical intervention or reporting. Cultural norms around illness, including distrust of the medical system, preference for home care, and family caregiving will play their roles in the spread of COVID-19.

Source: https://www.cdc.gov/aging/caregiving/caregiver-brief.html

This means that children and older family members that do have symptoms may not have access to medical intervention, documentation, advice, or have sufficient care or separation from family members. While these deep-rooted beliefs come from a nurturing and caring place of love, it is important that cases at least be documented. These practices currently put families and communities at high risk of having the virus spread within them. While we do have recommendations for caregivers and home care instructions for coronavirus patients, they are not practical options, nor sufficient for the average family in America.

Home Burials

Source: https://www.romemonuments.com/home-burials – great website. Highly recommend reading more there!

In Part 2 – Home Burials and Funeral Industry

Thank you to anyone reading these commentaries and predictions. Without you I would be shouting into a void.