WALD, LILLIAN D. 1867-1940

Public health nurse

A Baptism of Fire

Lillian D. Wald is regarded as the founder of what is now called public health or community nursing, and she was known for her contributions to school nursing and child welfare. Wald was born to a wealthy family in Cincinnati, Ohio, and raised in Rochester, New York. Educated at Miss Crittenden's English and French Boarding and Day School for Young Ladies and Little Girls, she was encouraged by her physician relatives to become a nurse. She spent a year nursing at the New York Juvenile Asylum and then entered Woman's Medical College in New York. During medical school Wald was asked to go to New York's Lower East Side to instruct immigrant mothers on the care of the sick. Like Margaret Sanger, she was shocked by what she saw there. One day, as she was teaching a hygiene lesson in the slum, a little girl approached her for help. The child led her through filthy, crowded tenements to where her mother lay untended in a bed soiled with the hemorrhage of childbirth. Wald referred to that morning's experience as her "baptism of fire." Never returning to medical school, she began her career in public health nursing and her battle against poverty and disease.

The House on Henry Street

In 1893 Wald persuaded a classmate to go into the tenement district with her to live and work. Their house on Henry Street eventually became the Henry Street Visiting Nurse Service. She fought for legislative reforms, coining the phrase "public health nursing," and served on the New York State Immigration Commission. In addition to the creation of the United States Children's Bureau in 1912, she established the Rural Nursing Service of the American Red Cross in the same year. In 1912 she also became the first president of the National Organization for Public Health Nursing, the nation's third national nursing association. By 1913 she and Mary Adelaide Nutting had established an educational program in public health nursing in which nurses would receive theoretical course work at Teachers College and Columbia University and practical experience at the Henry Street Settlement.

The U.S. Children's Bureau

The history of pediatrics is closely associated with the history of public health. In the first two decades of the twentieth century infant mortality fell dramatically as public health workers turned their attention to prevention as a key to saving babies' lives. In 1908 New York City set up the first division of child hygiene in the world with astounding results. Twelve hundred fewer deaths were recorded from one year to the next as new mothers were identified and visited by public health nurses who taught them how to care for their babies. The New York experience inspired others and led to Congress's creation in 1912 of the U.S. Children's Bureau, the brainchild of Wald and fellow health activist Florence Kelley. The bureau specialized in prenatal and maternal care, and its 1913 pamphlet on prenatal care became one of the government's most popular publications.

World War I

After the United States entered World War I, Wald joined in a powerful nursing triumvirate with Mary Adelaide Nutting and Annie Goodrich to form the National Emergency Committee on Nursing. Fearing that the war's acute need for nurses would force nursing schools to lower admission and graduation requirements, the committee stated that its purpose was to develop "the wisest methods of meeting the present problems connected with the care of the sick and injured in hospitals and homes; the educational problems of nursing; and the extraordinary emergencies as they arise." Wald's social vision, initiative, and skill in acquiring support for new ideas and new plans made her one of the most influential health workers of her day.

Sources:

M. Patricia Donahue, Nursing, The Finest Art (Saint Louis: C. V. Mosby Company, 1985);

Lillian Wald, The House on Henry Street (New York: Holt, 1915);

Wald, Windows on Henry Street (Boston: Little, Brown, 1934).

Lillian Wald

Lillian Wald (1867-1940), American social worker, nurse, pacifist, and reformer, founded one of the first great American settlement houses.

Lillian Wald was born on March 10, 1867, in Cincinnati. Her father, a dealer in optical goods, moved often, but she thought of Rochester, N.Y., where she was privately educated, as her hometown. In 1891 she graduated from the School of Nursing at Bellevue Hospital in New York City. After a year's work in a juvenile asylum, she entered the Women's Medical College. While a medical student she was asked to teach home nursing in New York City's East Side, then the most congested residential area in the world. The need of the immigrants living there was so great and the medical care available to them so slight that Wald abandoned her career and with another student took up residence on the East Side in 1893. Their tenement flat was the place from which both the Henry Street Settlement and the New York public health nursing service grew.

There were no city public health nurses in New York when Wald began her work. A score of agencies—most of them private, sectarian, charitable bodies—provided visiting nurses. Wald early resolved that the Henry Street nurses would be nonsectarian and would charge fees only to those who could pay. The service rapidly expanded, and 100 nurses were working out of what was then called the Nurses' Settlement by 1914. They treated more patients than the three largest city hospitals combined. The Henry Street Settlement also grew into a great neighborhood center. By 1913 it owned nine houses, seven vacation homes in the country, and three stores used as stock rooms, milk stations, clinics, and the like. The settlement enrolled 3,000 people in its clubs and classes and offered many cultural activities.

Wald also helped organize the first public school nursing services in New York City, as well as Lincoln House, one of the first settlements with an African American clientele. She was a founding member of the National Association for the Advancement of Colored People. She helped create the New York State Bureau of Industries and Immigration and the Federal Children's Bureau.

Like other settlement leaders, Wald was a pacifist, and, also like them, she found World War I to be the gravest challenge of her career. She was chairman of the American Union against Militarism (AUAM), which had helped prevent a war with Mexico in 1916. Regarding American entry into the Great War, some members wished to concentrate chiefly on combating militarism, others to defend civil liberties. A third group, to which she belonged, hoped to devise alternatives to war without pitting themselves directly against the government. The struggle led to her resignation as chairman in 1917, after which the AUAM took a more radical line. Though it later dissolved, it helped father the American Civil Liberties Union and the Foreign Policy Association, a study group interested in promoting a just and durable peace. This was the approach she found most congenial.

In later years Wald became more involved in partisan politics. She supported Governor Al Smith, a good friend of social welfare, and later Franklin Roosevelt, an even better one. She died on Sept. 1, 1940, in Westport, Conn.

Further Reading

Wald wrote two books about her work: The House on Henry Street (1915) and Windows on Henry Street (1934). Her biographers are Robert L. Duffus, Lillian Wald: Neighbor and Crusader (1938), and Beryl Epstein, Lillian Wald: Angel of Henry Street (1948). □

Lillian D. Wald , 1867–1940, American social worker and pioneer in public health nursing. In 1893 she organized a visiting nurse service, which became the nucleus of the noted Henry Street Settlement in New York City. The U.S. Children's Bureau (founded 1912) was suggested by her, as were other public health services and social reforms.

Bibliography: See her autobiographical books The House on Henry Street (1915) and Windows on Henry Street (1934, 4th ed. 1937); biographies by R. L. Duffus (1938) and B. W. Epstein (1960).