Report of the Committee on Municipal Health Department Practice

Applying Health Services Research to Public Health Practice: An Emerging Priority

“…During that decade the American Medical Association took on the responsibility for assessing and comparing state public health agencies to ascertain their structure and operations and make recommendations for improving their services (Turnock and Handler 1997). Responsibility for conducting these types of studies, and companion research that focused on local public health agencies, was subsequently assumed by the American Public Health Association (APHA) and its Committee on Administrative Practices, which continued in some form into the 1950s (APHA, Committee on Municipal Health Department Practice 1922a, b; Armstrong et al 1924). The culmination of this effort was Haven Emerson's report on the organizational structures and human resources needed by local health departments to perform a set of six basic public health functions, including communicable disease control, maternal and child health, vital statistics registration, public health laboratory provision, environmental health, and health education (Emerson 1948).…”

City health departments, public health expenditures, and urban mortality over 1910–1940

“…Larger cities had the capacity to fund and operate a full‐time health department, where smaller cities did not. In a formal survey of health department activities from the 1920s, the authors note that majority of notable public health efforts occurred in urban areas with more than 100,000 inhabitants (Armstrong et al., 1924). 8…”

“…Other documents, such as the survey of health departments cited above, also note the limited standardization of health departments (Armstrong et al., 1924). Armstrong et al.…”

“…Armstrong et al. (1924) describes, “It is generally known that a great variety of procedures are in effect; that the organization of the health departments differs in different communities; that the amounts spent per capita for any branch of health service vary considerably and that, in other respects, few standards are available to health officers who would pattern their departments after those which predominate in American practice or achieve most satisfactory results” (p. 7). Overall, it appears that city health departments organized gradually over time, adding different functions at different times without necessarily following clear guidelines or settled norms for public health practice.…”

“…The handling of milk went further than just local milk regulation and extended into public health education of mothers, with information on the proper storage and heating of milk for infants. Cities targeted infant health directly by providing public health nurses, with many cities setting up home visits for infants, providing prenatal care, and organizing infant welfare stations (Armstrong et al., 1924; Ravenel, 1921).…”