We cannot verify your location
Browse Book and Journal Content on Project MUSE

Classrooms and Clinics

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

Richard A. Meckel

Publication Year: 2013

Classrooms and Clinics is 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.

Published by: Rutgers University Press

Series: Critical Issues in Health and Medicine

Title Page, Copyright, Dedication

pdf iconDownload PDF
pp. 1-6


pdf iconDownload PDF
pp. vii-viii

read more


pdf iconDownload PDF
pp. ix-xii

For historians, the research and writing of a scholarly monograph is often an intensely solitary endeavor. Yet none of us ever works entirely alone, and thus I would like to use this opportunity to thank those who provided me with sup-port and assistance. Very little of the research for this book could have been done without the invaluable help of the staffs of the Rockefeller, Science, and ...

read more


pdf iconDownload PDF
pp. 1-9

In the fi nal 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 mani-fest by years of research, beginning with studies generated by the War on Pov-...

read more

1. Going to School, Getting Sick: Mass Education and the Construction of School Diseases

pdf iconDownload PDF
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 associa-tion, 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 fi tful, and suffer recurrent head-...

read more

2. Incubators of Epidemics: Contagious Disease and the Origins of Medical Inspection

pdf iconDownload PDF
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 pub-lic health offi cials concerned with the health and survival of children in the nation?s rapidly expanding urban immigrant ghettos. Noting that each fall and ...

read more

3. Defective Children, Defective Students: Medicalizing Academic Failure

pdf iconDownload PDF
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 ...

read more

4. Building Up the Malnourished, the Weakly, and the Vulnerable: Penny Lunches and Open-Air Schools

pdf iconDownload PDF
pp. 100-127

Early medical inspections? revelation that a sizable proportion of urban school-children showed signs of malnutrition and underfeeding did not come as a complete surprise to either school hygienists or the general public. That a signifi cant number of city schoolchildren might be going to school hungry or suffering from the consequences of poor and inadequate nutrition had been ...

read more

5. From Coercion to Clinics The Contested Quest to Ensure Treatment

pdf iconDownload PDF
pp. 128-156

Confl ict 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 med-ical inspection had identifi ed as having remedial defects. As was true with school lunches, a central and contentious issue was the relative responsibili-...

read more

6. The Best of Times, the Worst of Times: Expansion and Reorientation in the Postwar Era

pdf iconDownload PDF
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 ...

read more

Epilogue: Contraction, Reorientation, and Revival

pdf iconDownload PDF
pp. 195-206

Although those involved in school health continued to discuss urban pri-mary schools and schoolchildren, and to offer various proposals for improv-ing 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 physi-...


pdf iconDownload PDF
pp. 207-250


pdf iconDownload PDF
pp. 251-260

read more

About the Author, Further Reading

pdf iconDownload PDF
pp. 273-276

Richard A. Meckel is a professor in the American Studies Department at Brown University. His previous books are Save the Babies: American Public Health Re-form and the Prevention of Infant Mortality, 1850? 1929 and Children and Youth in Sickness and Health, edited with Janet Golden and Heather Munroe Prescott.Available titles in the Critical Issues in Health and Medicine series:...

read more

Image Plates

pdf iconDownload PDF
pp. 277-286

...source: John Shaw Billings, Ventilation and Heating (New York: Engineering Record, 1893), 420.source: Luther Halsey Gulick and Leonard P. Ayres, Medical Inspection of Schools source: Luther Halsey Gulick and Leonard P. Ayres, Medical Inspection of Schools, rev. ed. (New source: Luther Halsey Gulick and Leonard P. Ayres, Medical Inspection of Schools rev. ed. (New source: Ernest Bryant Hoag and Lewis M. Terman, Health Work in the Schools (Boston: Houghton ...

E-ISBN-13: 9780813565408
E-ISBN-10: 0813565405
Print-ISBN-13: 9780813562407

Page Count: 272
Publication Year: 2013

Series Title: Critical Issues in Health and Medicine
Series Editor Byline: Edited by Janet Golden and Rima D. Apple See more Books in this Series

OCLC Number: 863824527
MUSE Marc Record: Download for Classrooms and Clinics

Research Areas


UPCC logo

Subject Headings

  • Children with social disabilities -- United States.
  • Education, Urban -- United States -- Health aspects.
  • City children -- Medicare care -- United States.
  • Child health services -- United States.
  • You have access to this content
  • Free sample
  • Open Access
  • Restricted Access