Stephen Smith (1823–1922): Founder of the American Public Health Association

Abstract

to his lessons of longevity. And justifiably so, since considering that life expectancy at birth was then 41 years, he had already lived two normal lifetimes for his days! He credited his longevity to a lifetime of hard work, beginning as a child on his family farm. Born February 19, 1823, in New York State, the son of a cavalry officer in the Revolutionary War, Smith began his life in the year President James Monroe declared the Monroe Doctrine and the first steamship began to navigate the Mississippi River. He lived through the US Civil War and the closing of the American frontier, and founded the American Public Health Association (APHA) before the patenting of the telephone and radio. Smith trained as a physician at the College of Physicians and Surgeons at Columbia University, and did his residency at Bellevue Hospital. Beyond treating his patients, he recognized that outbreaks of typhus and cholera were related to dreadful environmental conditions in New York City. He knew the city was under the political sway of the notorious Boss Tweed and Tammany Hall cronyism that turned a purposeful blind eye toward public hygiene. During his formative professional years, three characteristics of Smith were always evident: he mobilized and enlightened citizens, researched and backed his sanitary campaigns with evidence, and declared that the public’s health required a wellorganized public health system staffed with well-trained professionals. In 1865, Smith and other dedicated reformers produced the landmark report on the sanitary conditions in the city. 3 Smith’s dogged pursuit of advocacy with his fellow physicians led to the creation of the Metropolitan Health Board for New York City in 1866. Smith was appointed a commissioner of the board and served until 1875. With other visionaries, he saw the need for a national network to engage scientists, enlighten the public, and ignite civic support for public health. This vision came to fruition with the creation of the APHA in 1872. Smith published a retrospective review in 1911 that is tellingly entitled The City That Was. He was not always correct in his portents of the future: for example, he reasoned that the human life span should be 100 years, and that this could be achieved through advances in public health and medicine by the 100th anniversary of APHA. He also predicted that enlightened humankind would eliminate war. His predictions may not yet have been met, but his words and vision resonate, then and now. AT THE AGE OF 98, STEPHEN Smith attended the semicentennial banquet of the American Public Health Association, held in his honor at the Hotel Astor on November 16, 1921. A distinguished audience greeted Smith, and as part of the evening of celebration a medallion was presented to Smith. On the obverse of the Stephen Smith Medallion was