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Progress update: Still under construction. But the work feels like it is reaching an analytical plateau, I think I'll be able to call this finished (pending comments) within the next week or so - 01/27/10. |
| | Timeline with linked sources |
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| | State Boards of Health and the National Board's operation
Section 3 of the 1879 Act creating the National Board of Health (the 'founding Act') sets out a two-step process. First, it encourages the co-operation of the National Board with the State Boards of Health and their regulations. Second, it allows the Board to displace these rules with Presidential approval. It seems reasonable to assume that this two-step process, and the Presidential approval requirement, was an attempt to secure State support for the Bill and the possibility of diminution of State authority. |
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< | State Boards of health had been in operation for decades in the largest States. New York was the first State with such a Board. It had a State Board of health since 1805, and one fully independent from the Legislature since 1866 (reference link). Massachusetts had a well-organized State Board of Health since 1869 (reference link). In these States, and presumably others where the historical records are more scarce, the functions of the Boards of Health were broader than we would associate with 'health' today, including such functions as the supervision of abattoirs, building codes and prostitution, as well as disease prevention, statistical analysis and providing a forum to produce and disseminate research and learning about medicine and diseases. 'Public health has a vast deal to do with public morals, and immorality is the most fatal blow struck at the public health' noted a report on the convention establishing the National Board of Health in Virginia, just as the yellow fever epidemic of 1878 struck Galveston News, Galveston Texas, 11-25-1878, p 2 'The National Board of Health'. |
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> | State boards of health had been in operation for decades in the largest States. New York was the first State with such a board. It had a State Board of Health since 1805, and one fully independent from the Legislature since 1866 (reference link). Massachusetts had a well-organized State Board of Health since 1869 (reference link). In these States, and presumably others where the historical records are more scarce, the functions of the Boards of Health were broader than we would associate with 'health' today, including such functions as the supervision of abattoirs, building codes and prostitution, as well as disease prevention, statistical analysis and providing a forum to produce and disseminate research and learning about medicine and diseases. 'Public health has a vast deal to do with public morals, and immorality is the most fatal blow struck at the public health' noted a report on the convention establishing the National Board of Health in Virginia, just as the yellow fever epidemic of 1878 struck Galveston News, Galveston Texas, 11-25-1878, p 2 'The National Board of Health'. |
| | The National Board of Health was modeled on the existing State Boards. Its statutory functions include making regular assessments of the conditions of foreign ports, and receiving weekly reports of the conditions of domestic ports. Note that in practice it appears that the functions of the Board in relation to foreign ports were only partially carried out, if at all (link). The founding Act for the Board requires it to publish weekly summaries of the information it receives for the benefit of the Marine Hospital Service, and State and municipal Boards of Health. The inclusion of municipal boards of health is an important reminder that not all parts of the founding Act fit into a simplistic dualist 'federal vs state' regulatory model. These municipal boards were also an important (and in some places long established) part of the regulatory infrastructure for disease prevention and public health (reference link).
The Board was composed of one medical officer from the Army; one from the Navy; one from the Marine Hospital Service. There were also seven members appointed by the President and confirmed by the Senate, not more than one from any State. |
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> | It is clear that the early efforts of the Board had a significant effect on the yellow fever ********** [http://moglen.law.columbia.edu/twiki/pub/AmLegalHist/EmilyProject/Repeal_of_sunset_clause_extension_of_Board_1882.pdf][Committee report discussing repeal of sunset clause 1883]; annual report for 1884 |
| | De-funding, and motives |
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> | The Supreme Court in Dunwoody v United States 138 U.S. 578 (1892) held that Mr Dunwoody, the chief clerk and sometime Secretary of the National Board of Health, could not recover money from the federal government in the absence of specific grants payable to the Board. This case was brought several years after the Board had ceased to exist. It contains a very clear timeline of Congressional appropriations, a clear ruling that Mr Dunwoody was not entitled to the funds he claimed, and no description at all of anything outside the legal skeleton of the Board's history. |
| | Clashes over funding were ongoing. In 1881, the annual report reveals that the Board received only one third of the funds it wanted to build new quarantine stations in Virginia, Georgia and Texas (link).
The historical documents are largely silent as to the motives behind the Board's slow death due to underfunding. My conclusion is that it was controversial. The address of the President of the American Public Health Organization in 1887 (reported in Science, Vol X No. 251, link here) notes that: It is unnecessary for me to refer to the various circumstances that conspired to paralyze the effective energy of this Board. Unhappily it is a thing of the past, and the hopes which we had founded on this our bantling are but a thing of the past. |
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Court Response |
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< | Dunwoody v United States 138 U.S. 578 (1892) held that Mr Dunwoody, the chief clerk and sometime secretary of the National Board of Health, could not recover money from the federal government in the absence of specific grants payable to the Board. |
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| | Louisiana v Texas 176 US 1 (1900) held that there was no interstate federal jurisdiction merely because the quarantine actions of one state (Texas) hurt those of another (Louisiana). The facts of the case concerned the Texan embargo on interstate trade during the yellow fever outbreak in 1899. The Supreme Court point-blank refused to get involved. |