School health is public health: An interview with Richard Meckel

Urban school-based health care is the legacy of a public health crusade that began about 140 years ago, historian Richard Meckel of Brown University writes in his new book. An interview with the author.

by Janet Golden, PhD

Published Sep. 9, 2013, 6:30 a.m. ET

Richard Meckel: It was the product of a school hygiene movement that evolved in four overlapping and cumulative stages. It commenced in the 1870s, when urban public health and medical experts began questioning the health impact of the new mass compulsory education and identified certain "school diseases," which they connected to schools and schooling.

A second stage began in the 1880s, with rising concern that schools could be incubators of epidemic disease. This led to new policies of surveillance, exclusion and compulsory immunization, and brought nurses and physicians into schools.

In the next stage, beginning around 1900, attention turned to identifying and correcting physical defects as a means of improving academic performance and educational efficiency. States passed legislation requiring urban schools to provide regular medical exams and publicly and privately funded dental, ENT, and eye clinics for schoolchildren were established in many cities. Always too few, and opposed as socialistic and a violation of religious freedom, parental rights, and the sanctity of private practice, the clinics experiment was less effective than it could have been. Thus, by the 1920s, school hygienists began emphasizing prevention through health education over the detection and correction of defect.

Janet Golden: What happened in the years after 1930?

Janet Golden: What is the situation today?

Janet Golden, a Rutgers University history professor, specializes in the histories of medicine, childhood and women.

Janet Golden, a Rutgers University history professor, specializes in the histories of medicine, childhood and women.