Modern Mothers in Progress in Illinois, 1900-1930 (review)

Lynne Curry. Modern Mothers in the Heartland: Gender, Health, and Progress in Illinois, 1900-1930. Women and Health: Cultural and Social Perspectives. Columbus: Ohio State University Press, 1999. x + 206 pp. $40.00 (cloth), $18.50 (paperbound).

Illinois is an unusual state, which makes Lynne Curry's study of "the historical intersections of progressivism, maternalism, and health reform" (p. 6) in early-twentieth-century Illinois especially useful and interesting for historians of American medicine. The state's heterogeneity challenged reformers to address a single sociomedical issue--the health needs of infants and mothers--in several very different contexts at once. In Chicago, for instance, reformers faced poor hygienic conditions in the city's diverse immigrant communities and growing African-American community. In the classically "Midwestern" farm regions of the state's northern and central section, native-born, relatively prosperous white families were more able and willing to "purchase" public health. The southern third of the state, meanwhile, had more in common with the impoverished South than with the rest of Illinois: its tenant farms housed very poor white and African-American families in conditions that were unhealthful at best. Curry makes this diversity of concerns and conditions her focus, taking the questions other scholars have asked about the politics and practice of child and maternal health programs at the national level and posing them at the state and local levels.

In five chapters, Curry introduces us to the Progressive Era reform climate in Illinois; Chicago reformers' attempts to "Americanize" immigrant mothers through hygiene teaching; the efforts of downstate public health nurses, home economists, and farm women's clubs to facilitate modernization through health reform; reformers' and health experts' use of new media and of the wartime emphasis on conservation to make infant and maternal health a civic issue; and the state battle over Sheppard-Towner funding that, Curry argues, both presaged and helped cause the national rejection of this federal program of preventive health services. The most original portions of her account come when she describes the everyday negotiations around health reform and policymaking. For instance, she reminds us that rural women, like most groups of Americans, were far from uniform in their response to expert advice. The women of the Illinois Farmers' Institute found a university home economist's advice to be theoretical, impractical, and thus irrelevant to their own work, and, Curry tells us, they "nearly forced her resignation" (p. 86); the more prosperous, progressive women served by Smith-Lever-funded Home Bureaus, however, seem to have embraced the message that agents preached about hygienic modernization through the acquisition of household technology. Likewise, Curry's account of the machinations surrounding the Illinois General Assembly's deliberations over accepting Sheppard-Towner funds adds dimension to our understanding of the intense political battles around preventive health services in the 1920s.

My only major criticism of Curry's book is essentially a compliment. I wanted to hear even more about these everyday negotiations and conflicts, about the personalities involved in promoting reform and the mothers who benefited from it. We learn, for instance, that some immigrant mothers, especially Italian and Polish women, forced health reformers to adapt their clinics to address mothers' concerns. But were there any cases where differences among ethnic groups in urban areas shaped how women of different backgrounds interacted with the experts and middle-class volunteers who delivered preventive advice? Similarly, Curry is careful to note that the Illinois State Medical Society's intense opposition to Sheppard-Towner did not necessarily reflect all Illinois physicians' views on the subject. This raises a larger, very difficult question that historians of American medicine need to consider in more detail: to what extent did organized medicine in its local, state, and national manifestations speak for everyday physicians? Yet overall, Curry's succinct case study provides a good introduction to the...