From the Environment to Education: AICP Nurses and the Narrowing of Reform

Abstract

This paper argues that early-twentieth-century public health efforts witnessed a "medicalization of reform." It traces the changing role of public health nurses in the Association for Improving the Condition of the Poor (AICP), a prominent Progressive social service agency in New York City. At the turn of the twentieth century, AICP infant health programs reflected an environmental understanding of health and poverty that labeled the city itself as "unhealthy." By the 1920s, however, this discourse shifted: new AICP programs sent nurses to individual homes, where they met with mothers and educated them in a variety of practices understood to improve infant health. This transition in the role of public health nurses represents a larger shift in urban reform. Infant health, once a poverty problem, was now primarily a medical problem. In some ways, this medicalization of reform provided a new sense of hope: perhaps even the poorest families, with the right training, could raise healthy children. At the same time, it also encouraged reformers to narrow their scope and to adopt a much more limited understanding of reform.