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Classrooms and Clinics

Classrooms and Clinics: Urban Schools and the Protection and Promotion of Child Health, 1870-1930

Richard A. Meckel
Copyright Date: 2013
Published by: Rutgers University Press
Pages: 272
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  • Book Info
    Classrooms and Clinics
    Book Description:

    Classrooms and Clinicsis the first book-length assessment of the development of public school health policies from the late nineteenth century through the early years of the Great Depression. Richard A. Meckel examines the efforts of early twentieth-century child health care advocates and reformers to utilize urban schools to deliver health care services to socioeconomically disadvantaged and medically underserved children in the primary grades. Their goal, Meckel shows, was to improve the children's health and thereby improve their academic performance.

    Meckel situates these efforts within a larger late nineteenth- and early twentieth-century public discourse relating schools and schooling, especially in cities and towns, to child health. He describes and explains how that discourse and the school hygiene movement it inspired served as critical sites for the constructive negotiation of the nature and extent of the public school's-and by extension the state's-responsibility for protecting and promoting the physical and mental health of the children for whom it was providing a compulsory education.

    Tracing the evolution of that negotiation through four overlapping stages, Meckel shows how, why, and by whom the health of schoolchildren was discursively constructed as a sociomedical problem and charts and explains the changes that construction underwent over time. He also connects the changes in problem construction to the design and implementation of various interventions and services and evaluates how that design and implementation were affected by the response of the civic, parental, professional, educational, public health, and social welfare groups that considered themselves stakeholders and took part in the discourse. And, most significantly, he examines the responses called forth by the question at the heart of the negotiations: what services are necessitated by the state's and school's taking responsibility for protecting and promoting the health and physical and mental development of schoolchildren. He concludes that the negotiations resulted both in the partial medicalization of American primary education and in the articulation and adoption of a school health policy that accepted the school's responsibility for protecting and promoting the health of its students while largely limiting the services called for to the preventive and educational.

    eISBN: 978-0-8135-6540-8
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-xii)
  4. Introduction
    (pp. 1-9)

    In the final decades of the twentieth century, American child health advocates and activist child healthcare providers rediscovered the urban public school as a potentially promising site for clinics that could deliver primary healthcare to city schoolchildren and youth. The need for such clinics had been made manifest by years of research, beginning with studies generated by the War on Poverty, demonstrating that economically disadvantaged inner-city children and youth received shockingly little basic medical and dental care or counseling and thus were very likely to have untreated conditions and defects or be at risk for developing them. Moreover, the logic...

  5. Chapter 1 Going to School, Getting Sick: Mass Education and the Construction of School Diseases
    (pp. 10-37)

    In his opening address to the 1884 annual meeting of the American Public Health Association, Albert Gihon, newly elected as president of the association, observed that he was occasionally approached by parents who wanted to know why as each fall progressed into winter at least one of their children would lose his or her appetite, grow pale and fitful, and suffer recurrent headaches and general lassitude. Gihon explained that his response was always the same: he told the parents to visit the child’s school. Once they had done that, he declared, once they had “breathed the vitiated air it breathes,...

  6. Chapter 2 Incubators of Epidemics: Contagious Disease and the Origins of Medical Inspection
    (pp. 38-66)

    In an 1895 article, Henry Dwight Chapin, a young New York pediatrician and volunteer at a charity clinic, sounded what was becoming a familiar theme in the written and oral comments of American clinicians, nurses, and public health officials concerned with the health and survival of children in the nation’s rapidly expanding urban immigrant ghettos. Noting that each fall and winter epidemics of scarlet fever, diphtheria, measles, mumps, and a host of other contagious diseases flashed through the tenement districts of New York and other large American cities, Chapin suggested that even more than the crowded and often filthy housing...

  7. Chapter 3 Defective Children, Defective Students: Medicalizing Academic Failure
    (pp. 67-99)

    The examinations that medical inspectors gave to schoolchildren showing symptoms of disease revealed not only an urban student body plagued with minor contagious skin and eye conditions, but also one in which physical defects were almost universal. Although not charged with detecting such defects, medical inspectors could not help noting them. As they looked for evidence of infection in students’ throats, they were all too often confronted with mouthfuls of carious teeth and swollen gums. As they watched students make their way around their school, inspectors saw some with obvious signs of heart diseases and others with bodies bent or...

  8. Chapter 4 Building Up the Malnourished, the Weakly, and the Vulnerable: Penny Lunches and Open-Air Schools
    (pp. 100-127)

    Early medical inspections’ revelation that a sizable proportion of urban schoolchildren showed signs of malnutrition and underfeeding did not come as a complete surprise to either school hygienists or the general public. That a significant number of city schoolchildren might be going to school hungry or suffering from the consequences of poor and inadequate nutrition had been the object of public discussion since at least 1904, when a muckraking moderate socialist and former Hull House worker named Robert Hunter ventured inPoverty, his influential survey of the extent, nature, causes, and consequences of poverty in the United States, that “there...

  9. Chapter 5 From Coercion to Clinics: The Contested Quest to Ensure Treatment
    (pp. 128-156)

    Conflict and controversy similar to that surrounding the efforts of school hygienists to combat malnutrition by establishing school feeding programs attended their efforts to facilitate the corrective treatment of those whom medical inspection had identified as having remedial defects. As was true with school lunches, a central and contentious issue was the relative responsibilities of the school and the family in guaranteeing that children received the treatment they needed. Like those opposing subsidized school lunches, opponents of schools’ playing more than a diagnostic and advisory role in securing treatment for children raised concerns about publicly funded education exceeding its mandate...

  10. [Illustrations]
    (pp. None)
  11. Chapter 6 The Best of Times, the Worst of Times: Expansion and Reorientation in the Postwar Era
    (pp. 157-194)

    For urban primary school health programs—the main focus of school hygiene discourse and activity since the 1870s—the period between the end of World War I and the Depression was one of contradiction. In many respects, it was a time of unprecedented expansion. It was during these years that school-based detection and correction services reached the apex of their development as they grew in number and type in most of the cities that had begun them in the first two decades of the twentieth century and were initiated in many other cities, including some in the South, which had...

  12. Epilogue: Contraction, Reorientation, and Revival
    (pp. 195-206)

    Although those involved in school health continued to discuss urban primary schools and schoolchildren, and to offer various proposals for improving the organization and operation of city school health programs, the shift in emphasis during the 1920s from detection and correction to prevention through education—along with the concomitant decentering of the physically defective urban schoolchild within the school hygiene gaze—effectively brought to an end the intense discursive negotiation, begun some six decades earlier, of the urban school’s relationship to the health of its pupils. At least a half-century would pass before child and adolescent health advocates would again...

  13. Notes
    (pp. 207-250)
  14. Index
    (pp. 251-260)
  15. Back Matter
    (pp. 261-264)