William Augustus Evans (1865–1948): Public Health Leader at a Critical Time

Abstract

THE REPORT EXCERPTED HERE was produced by committees of the American Public Health Association (APHA), each made up of experts on different aspects of the influenza pandemic of 1918–1919. These experts were attempting to contend with a terrifying global pandemic that would cause approximately 40 million deaths worldwide, 550 000 of them in the United States.1 The APHA's intention was to provide health officers with an authoritative guide to what we would today call “best practices.” Overall, the recommendations were quite astute, especially those in Section D3 (“Closings”), D5 (“Isolation”), and D7 (“Hospitalization”). A recent retrospective analysis of the impact of the 1918–1919 pandemic on US cities has concluded that those cities which implemented these “social distancing” procedures early and in a layered and sustained way definitively mitigated the impact of the pandemic.2 The several shorter reports produced were combined into one by an editorial committee chaired by William A. Evans. Evans was no doubt chosen for this position because, in addition to being an internationally known physician and public health leader, he was a skilled writer and served as health editor of the Chicago Tribune from 1911 to 1914. In the latter capacity, he wrote a regular column in which he would answer questions submitted by readers.3 These columns were reprinted under the title “How to Keep Well” in numerous newspapers in the United States and abroad, making Evans the first syndicated health columnist in the United States.4 Sears and Roebuck later gathered his columns together and republished them as a book.5 Evans was born in Alabama and grew up in Mississippi, where his family owned a plantation. He attended the Mississippi Agricultural and Mechanical College and then earned his degree in medicine from Tulane University in 1885. He completed his postgraduate studies at the Pasteur Institute in Paris, France. On his return to the United States, he moved to Chicago, Illinois, to become the pathology demonstrator at the University of Chicago Medical School. No doubt an impressive personality, he was elected President of the Chicago Medical Society (and served from 1902 to 1903) and in 1907, he became Chicago's first Commissioner of Health, a position he held for the next 20 years. He also served as Professor of Preventive Medicine at Northwest University Medical School from 1908 to 1948. In 1917, Evans became President of the American Public Health Association (APHA). He served on the General Medical Board of the Medical Section of the Advisory Council of National Defense and was chairman of a subcommittee on the Health of Workers. In this capacity, he asked about 50 members of the Industrial Hygiene Section of APHA to draft reports for the Department of Labor on such matters as the hazards of working in munitions plants and how to best protect the health of enlisted men. For his 1917 presidential address, Evans gave a presentation on the war experience from a public health perspective, noting the successes (control of enteric diseases, especially typhoid, paratyphoid, cholera, and typhus) and the problems still to be solved (tuberculosis, trench fever, trench jaundice, war nephritis, shell shock, and gas poisoning).6 He ended his speech with a ringing and optimistic prediction of APHA's future: The opportunity of the American Public Health Association is at hand. If we carefully analyze the trend of events, if we carefully study the history of other organizations and if we plan on the basis of these analyses to properly serve the interests of the people, of public health and our profession … we should be able to build up an organization quite as strong in numbers and in influence as those which draw their membership from other professions or those which are supported by the practitioners of curative medicine.6(p918)