Children’s Health Issues in Historical Perspective (review)

We have a voice but sometimes don’t know how to get it out to everyone. Please help us speak out,” says a fourteen-year-old girl from Burnaby, British Columbia (3). Cheryl Krasnick Warsh and Veronica Strong-Boag have successfully responded to the plea of this girl by compiling a comprehensive collection of essays on the medical history of children and childhood. Their work explores the varied and complex issues of this field of inquiry under five main headings: politics, nutrition, racial and ethnic dimensions, experts, and institutions. The volume presents a “contradictory history” of child health issues in the past by refusing to overlook glaring inconsistencies. Although it works principally in the North American context, it aims to aid policy-makers, professionals, and citizens as they “think more critically about how to improve the health and well-being of all children” (15). The essays in the collection challenge existing theories and ideas about children in the past and should be seen as a call to all medical historians, and historians of children and childhood, to further research in this discipline.

The section on politics highlights the nationalistic rhetoric often employed by politicians in the past to further children-oriented initiatives. Through the lenses of imperialism and heightened political tension, this section explores how and why governments chose to implement child health policy. The underlying theme of child-rearing as a mirror of nation building is consistent in all three chapters despite the diverse geographical differences of the papers.

A second theme running throughout the volume is the idea of infants as human capital. This is most prevalent in the section on nutrition, which explores the mother-doctor conflict and the medicalization of infant care in the twentieth century. The papers in this section highlight the contradictions and confusion spawned by prescriptive literature for mothers and further explores how medical professionals sought to place the blame for persistently high infant mortality rates on “ignorant” mothers and poor parenting. Linking with the previous section, Judith Sealander’s essay, “Diet, Health and America’s Young in the Twentieth Century,” illuminates the economic agenda of governments that provided advice to mothers on breastfeeding versus cow’s milk.

Furthering the poor parenting thesis, the third section of this volume (racial and ethnic dimensions) is dedicated to understanding the top-down views and policies imposed on immigrant, under-served, and colonial parents throughout the twentieth century, and the subsequent impact on child health. Margaret Tennant and Myra Rutherdale, for example, each employ religion, empire, scientific medicine, and local customs as tools for analyzing infant and child health in colonial Vietnam and Northern Canada, respectively. Most historians of childhood focus on adult perspectives and interventions. Mona Gleason’s unique contribution to this volume, however, attempts to illustrate the thoughts and perceptions of immigrant children and parents. If the academic community truly wishes to revive the voice of the child, as demanded by the young girl at the start of the review, then research like Gleason’s needs to be highlighted and, where possible, replicated.

Despite active health care interventions targeting children for nearly three centuries, pediatrics only became a recognized medical specialty in the closing decades of the nineteenth century. Pediatricians, especially in America, struggled for legitimacy, status, and recognition. All of the essays in this section demonstrate how patriarchal, professional imperatives generally dominated the individual rights of children, especially concerning the child body. Hughes Evans clearly demonstrates this tension using sexual abuse and physician denial as an example, arguing that “twentieth century physicians, for the most part, have shirked, bypassed, or otherwise failed to fulfill their responsibilities toward young children with gonorrhea” (327). Sub-disciplines of pediatrics, like child psychology, further medicalized the opening decades of life, which can be seen in Cynthia Commacchio’s essay, “Adolescent Health Care in English Canada, 1920–1970.” Commacchio advances notions raised by Gleason and Tennant concerning the role of race, gender, and class...