Federal Direction + Local Implementation as a Strategy for Improving Infant Health: The Founding and Evolution of the Infant Welfare Society of Evanston.

Abstract

While the role of the US federal government in improving Maternal and Child Health (MCH) is often seen as a history of opportunities and tensions between the federal bureaucracy and state implementation, less is known about how federal governmental policies to improve MCH have been implemented at the local level, and the nature of the dynamic between local implementation and federal adoption of locally generated strategies. By describing the emergence of the Infant Welfare Society of Evanston in the first part of the 20th century and describing its evolution until 1971, we showcase the forces that shaped the emergence of an MCH institution at the local level in the early part of the history of MCH in the US. This article highlights the interaction of a progressive maternalistic frame and the growth of local public health infrastructure as fundamental to the basis of action to address infant health during this period. However, this history also highlights the complex relationship of institutions dominated by White women and their relationship to the populations served in the development of the field of MCH and elucidates the need for more explicit attention to understanding the role of Black social institutions in the development of the field of MCH.