Classrooms and clinics: urban schools and the protection and promotion of child health, 1870-1930

Abstract

During the last decades of the 20th century the potential was rediscovered by American child health advocates and activists for child healthcare providers for public schools in the United States to function as clinics to deliver primary healthcare to students. This initiative is far from the first attempt to provide healthcare to children through their schools, and Richard A. Meckel gives a retrospective assessment of earlier efforts in the United States to use schools as healthcare providers. Meckel argues there is a gap in scholarly work concerning the origin and evolution of school hygiene, the original term used for healthcare, in the United States, and his book endeavours to fill this gap by examining when, how, and why the health of schoolchildren was initially thought of as a sociomedical problem needing to be addressed. The overarching aim of the study is to provide a comprehensive history of the “sociomedical and educational discourse” (p. 2) regarding American schools and healthcare during the late-19th and early-20th centuries. The introduction proposes the book will connect changes in the construction and implementation of various interventions and services and examine the arguments surrounding what services governments and schools must provide when they take on the responsibility for the healthy development of schoolchildren. To focus his discussion, Meckel concentrates his study from 1870 to 1930 on American urban public primary schools, leaving rural schools and older children largely out of the study. Meckel first raises an intriguing question that largely drives his study. In chapter 1, Going to School, Getting Sick, he asks, if parents are legally obligated to send their children to school, does the school then have a “legal and moral duty” (p. 13) to guarantee children are not being made sick from simply attending? From 1880 to 1890, there were fears that both the places and practices of schools were dangerous to the health of students. The poor conditions of school buildings, and learning practices believed to be overdeveloping the brain and stunting the body, were argued to be at fault for the deteriorating health of students. Schools were originally housed in remodeled or rented buildings never intended to function as a school. For example, in Knoxville, Tennessee, one school was housed in an abandoned hotel, packing over 500 children into 11, 28 by 63 foot rooms. In response to concerns over the physical spaces of schools affecting the health of schoolchildren, buildings began to be specifically constructed to function as schools with better air quality and new ventilation systems, but not all changes were successful. In one New York City, New York, school none of the costly heating and ventilation