Iowa Public Health Association 

Public Health History: Local Health Units for the Nation

13 Sep 2018 4:53 PM | Anonymous member

By: Dr. Ron Eckoff

“Whereas, a major inadequacy in the civilian health protection in war as in peace time exists consequent upon the failure of many states and of not less than half the counties in the states to provide even minimum necessary sanitary and other preventive services for health by full time professionally trained medical and auxiliary personnel on a merit system basis, supported by adequate tax funds from local and state, and, where necessary, from federal sources: therefore be it RESOLVED, That the Trustees of the American Medical Association be urged to use all appropriate resources and influences of the Association to the end that at the earliest possible date complete coverage of the nation’s area and population by local, county, district or regional full time modern health services be achieved.”  American Medical Association, House of Delegates, June 10, 1942.

A similar resolution was passed by the American Public Health Association and the State and Provincial Health Authorities of North America.  The Subcommittee on Local Health Units of the American Public Health Association, with support from the Commonwealth Fund, undertook a study and published a report in August 1945. 

The committee first analyzed the status of local public health services in the nation and then developed the principles to use in designing proposed services.  The goal of the committee was “the creation of such number and boundaries of area of local health jurisdiction in every state in the Union as will bring within the reach of every person and family the benefits of modern sanitation, personal hygiene, and the guidance and protection of trained professional and accessory personnel employed on a full time basis at public expense, selected and retained on a merit or civil service basis, and free from disturbance by the influence of partisan politics.”

The committee then presented a proposal for each state using the same format.  The narrative proposal for Iowa is presented on the Iowa Public Health Association’s Public Health History in Iowa web page.  The proposal begins with background information about the state and a description of the current public health services.  It then outlines a plan for 27 local health units for Iowa.  Tables with the specifics regarding the grouping of counties, the existing expenditures and service and the proposed staffing and budget for each local health jurisdiction are available from Ronald Eckoff,  There is also considerable background discussion regarding the development of the report available.

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