Wald, Lillian D. (1867–1940)

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Wald, Lillian D. (1867–1940)

American public health nurse, social reformer, settlement house leader, and feminist who worked to improve the health and welfare of women and children . Born Lillian D. Wald (the initial does not stand for anything) on March 10, 1867, in Cincinnati, Ohio; died on September 1, 1940, in Westport, Connecticut, after a long illness brought on by a cerebral hemorrhage; daughter of Max D. Wald (an optical goods dealer) and Minnie (Schwartz) Wald; attended various private schools, including Miss Martha Cruttenden's English and French Boarding and Day School for Young Ladies and Little Girls in Rochester, New York, until the age of 16; granted nursing diploma, New York Hospital Training School for Nurses, 1891; attended Woman's Medical College of New York, 1892–93; never married; no children.

Founded the Henry Street Settlement and organized the Henry Street Visiting Nurse Service (1893); founded the National Child Labor Committee (1904); helped establish a department of nursing and health at Teachers College (Columbia University, 1910); elected first president of the National Organization for Public Health Nursing (1912); helped establish the Children's Bureau (1912); awarded gold medal of the National Institute of Social Sciences (1912); headed Committee on Home Nursing, Council of National Defense (1917–19); founded League of Free Nations Association (1919); retired as head of Henry Street Settlement (1933); was co-chair, Good Neighbor League (1936); awarded the New York City Distinguished Service Award (1937).

Selected works:

The House on Henry Street (Henry Holt, 1915); Windows on Henry Street (Little, Brown, 1934).

In 1893, a young medical student named Lillian D. Wald was teaching a course in hygiene and home nursing to a group of immigrant women from the Lower East Side of Manhattan. One day, a child came to Wald's classroom and asked her to look in on her sick mother, who was a student in Wald's class. Wald, who had completed nurses' training before entering medical school, agreed to look in on the patient. On the way to the child's home, she encountered a street environment she described in her autobiography, The House on Henry Street:

Over broken asphalt, over dirty mattresses and heaps of refuse we went. The tall houses reeked with rubbish. … I will not attempt to describe the place, the filth, the smell, or the sanitary conditions, which were too foul for words. … There were two rooms and a family of seven not only lived here but shared their quarters with boarders.

In the late 19th century, such conditions were in fact not unusual for impoverished areas of New York City and other large cities, but for Wald, like many middle-class women of her time, such a degree of poverty and misery was beyond her ken. Arriving at the flat, she did her best to tidy up the meager surroundings and make her student comfortable, and when she was finished, "that poor woman kissed my hands." Recalling that the moment left her "ashamed of being part of a society that permitted such conditions to exist," Wald wrote, "that morning's experience was my baptism of fire. That day I left the laboratory and the [medical] college. What I had seen had shown me where my path lay."

Wald herself came from a background far removed from the squalor of Manhattan's Lower East Side. Born in 1867 in Cincinnati, Ohio, she was the second daughter and third of four children of Max D. Wald and Minnie Schwartz Wald . Both the Wald and Schwartz families were descended from a long line of rabbis, merchants, and professional men from Poland and Germany, and there was even a legendary ancestor said to have been the king of Poland for a day. Like many immigrants, the Walds and the Schwartzes had come to America hoping to find greater economic opportunity and political and social freedom than were available in their own countries, and their hopes were soon fulfilled. Max Wald prospered as a dealer in optical goods, and was able to provide his four children—Alfred, Julia , Lillian, and Gus—with a carefree and luxurious childhood. Lillian described herself as a "spoiled child" who was seldom punished, and who was showered with expensive gifts and treated to luxurious excursions by her parents and her indulgent paternal grandfather, Goodman Schwartz. The Walds and the Schwartzes were also avid connoisseurs of fine literature, music, and art. Lillian recalled her mother Minnie as a woman who was both "beautiful and loved beauty" in her surroundings, and taught all of her children to appreciate "good works, good books, and good talk."

Max Wald's business eventually took the family from Cincinnati to Dayton and finally to Rochester, New York, which Lillian regarded as her hometown long after she had moved on to her life's work in Manhattan. In Rochester, the Walds joined a prominent German-Jewish community that enjoyed a lavish social life and tended to be conservative in its politics and attitudes toward social reform. Like other rapidly growing industrial cities of the time, Rochester had its share of working-class families who suffered from the deleterious effects of low wages, long working hours, poor nutrition, and a bad living environment, but there is no indication that Lillian was aware of their plight. Her parents appear to have been equally unconcerned with the situation of the poor. Although they occasionally performed private acts of charity, they were not involved in social causes of any kind, and devoted most of their time to ensuring their place among Rochester's elite professional class.

Like most young women of her social standing, Wald was not expected to earn wages outside the home or to be educated in preparation for a professional career. Instead, she was sent to private "finishing" schools that would give her the skills and manners expected for marriage, in particular Miss Martha Cruttenden 's English and French Boarding and Day School for Young Ladies and Little Girls. Although the school aimed to "make scholarly women and womanly scholars," and included standard college preparatory courses, such as languages, trigonometry, astronomy, physics, and chemistry, it did not actually intend to prepare students for either college or career. Instead, Miss Cruttenden hoped to transform the students into "elegant young ladies" suitable for marriage to equally well-mannered young gentlemen.

Although Lillian appreciated the social advantages of the school, she gradually became dissatisfied with the quality of education offered there. At age 16, when Lillian decided to apply to Vassar College in Poughkeepsie, New York, her parents, who held somewhat stereotypical ideas about women's education, were surprised but allowed her to proceed with the application. After the president of Vassar decided that Lillian was too young to enter the college then, and suggested that she reapply in a few years, Wald reluctantly returned to her studies at Miss Cruttenden's, and entered into the stylish social life of Rochester with the intention of finding a wealthy husband.

Although Lillian enjoyed wearing pretty clothes and attracting male attention, she quickly grew bored with the social whirl of Rochester, and began to search for something more interesting to do with her life. Her options were limited, as young women of her background did not work for wages or leave their childhood homes before marriage; she could have gone to Vassar or some other women's college eventually, but her initial rejection seems to have quelled that ambition. When her father helped her obtain a respectable clerical job that she could perform at home, she found the opportunity uninspiring. In 1889, while visiting her pregnant older sister Julia, she began to find her direction. During the visit, Julia became ill and needed the care of a trained nurse; the woman assigned to her was a graduate of the Bellevue nursing school, then one of the best programs in the country. She was the first member of the nursing profession whom Wald had ever met, and the experience, according to Lillian, was "the opening of a window on a new world." On her application to nursing school, Wald expressed her reasons for wanting to enter:

My life hitherto has been—I presume—a type of modern American young womanhood, days devoted to society, study, and housekeeping duties. … This does not satis fy me now, I feel the need of serious, definite work. A need perhaps more apparent since the desire to become a professional nurse has had birth. I choose this profession because I feel a natural aptitude for it and because it has … appeared to me womanly, congenial work, work that I love and which I think I could do well.

When Wald entered the New York Hospital Training School in 1889, her family did not entirely approve. Nursing was regarded by many as little more than specialized domestic service, and an unsuitable occupation for well-bred ladies. Seeing that her heart was set on this career, however, and being the indulgent parents that they were, the Walds had grudgingly allowed Lillian to attend. After graduating in 1891, she took a nursing job at the Juvenile Asylum, an orphanage in New York City. She found the institutional treatment of children to be appalling, and left the position after only a year.

In 1892, Wald decided to supplement her nursing training and enrolled in the Woman's Medical College in New York, an institution she described as "one of those schools founded in protest against the exclusive attitude adopted by the men's colleges." A year later, she agreed to organize home nursing classes at a school for immigrant women on the Lower East Side, and there underwent the experience that changed her life. After her firsthand look at living conditions of the urban poor, Wald decided to leave medical school to do something to help.

Wald's reform activities were strongly influenced by the work of the settlement house movement then under way, in which young, college-educated women and men lived among the urban poor to teach them job skills, money-saving strategies, cooking and cleaning methods, and other ways of improving their daily lives. Educated women found settlement work especially attractive, for it provided one of the few alternatives to marriage and motherhood at the time.

A major source of Wald's inspiration was the College Settlement Association, founded in 1887 by seven Smith College graduates who were dismayed by the lack of professional opportunities available to college-educated women, and sought to help the poor while providing themselves with independent, meaningful careers. In 1889, the Association set up the College Settlement at 95 Rivington Street in Manhattan, which Wald visited several times during her early forays into the Lower East Side. Together with Mary Brewster , a friend from nurses' training school, Wald decided in 1893 to create a "Nurses' Settlement," which would provide inhabitants of a poor neighborhood with nursing care and teach them the rudiments of healthy living.

During the first few years, Wald and Brewster worked out of makeshift quarters in the College Settlement and a tenement building on Jefferson Street. Eventually the generous contributions of Jacob H. Schiff, a wealthy New York banker, allowed Wald and Brewster to acquire a permanent home at 265 Henry Street. The two nurses were soon joined by nine other residents, many of whom were also trained nurses. By 1913, Wald had a thriving Visiting Nurses' Service consisting of 92 nurses who made more than 200,000 visits per year from the Henry Street headquarters and branch settlements in upper Manhattan and the Bronx. The service provided low-cost home health care for invalids, first aid stations, convalescent facilities, and follow-up care for patients recently released from the hospital.

Wald's nursing activities soon moved beyond Henry Street as she became involved in a nationwide movement to reform American nursing. For centuries, nursing had been a lowly occupation that was usually performed by women in charitable religious orders, or by untrained women in hospitals, many of whom were former prostitutes and/or recently recovered patients. Nurses typically had no control over their work environment, and were entirely subservient to physicians and hospital administrators, almost all of whom were men. Consequently, nurses were viewed by most people as little more than housemaids, and in need of little if any training.

By the late 19th century, however, nurses and their supporters were dissatisfied with the lowly status of their work. To many of these women, their situation was a microcosm of women's subordinate status in American society in general, and they identified the uplifting of nursing with the aims of the larger feminist movement then under way to grant women full equality with men. In her memoirs, Wald recalled that she and many of her colleagues regarded nursing as "a gauge and an inseparable part" of the "eternal woman movement." One of their major goals, therefore, was to free nursing from the domination of male physicians and hospital administrators, and give nurses themselves full control over educational standards, licensing, and the nature of their work. Wald's visiting nursing service at Henry Street was a particularly important advance in this area, for the visiting nurse worked independently of the controlling influence of physicians.

The Henry Street model of nursing care spread rapidly beyond New York City as similar programs were set up across the country and around the world, culminating in the birth of a new profession that Wald called public health nursing. Central to Wald's concept of public health nursing was the idea that the nurse should do more than simply care for sick patients, by working to prevent illness before it starts through improvement of the clients' environment and their education in the principles of a healthy lifestyle.

In addition to the Henry Street Visiting Nurse program, Wald helped to create a number of institutions that extended the concepts of public health nursing beyond the settlement movement. In 1902, she convinced the New York City Board of Health to establish the first public-school nursing program in the United States. In 1909, Wald persuaded the Metropolitan Life Insurance to adopt a public health program for industrial workers to prevent these clients from succumbing to premature death or disability.

Three years later, with the help of the American Red Cross, she set up a Town and Country Nursing Service, which gave individuals in rural and suburban areas access to visiting nurse services. That same year, Wald was recognized for her pioneering efforts in this new profession, and was named the first president of the National Organization of Public Health Nursing.

Wald's accomplishments in the area of social reform were equally impressive, and a logical extension of her activities in public health. Although Henry Street had begun as a nursing settlement, Wald soon realized that her clients needed more than good nursing care; in order to remain healthy, they also needed good jobs, decent wages, safe housing, and clean physical surroundings. Through a variety of civic campaigns, Wald became involved in providing the poor with improved housing, sanitary drinking water and bathroom facilities, and parks and playgrounds for their children. She was also an avid supporter of the organized labor movement, offering rooms at Henry Street for labor union meetings, and became a major ally of the Women's Trade Union League.

Wald was especially concerned with abolishing child labor, which she saw as not only causing ill health among the young, but also reducing the wages of working women who competed with children for jobs. Wald was a lifelong member of the New York Child Labor Committee and the National Child Labor Committee, both of which pushed for legislation to outlaw child labor. Her work in this area convinced her of the need for a federal governmental agency to protect the health and welfare of the nation's children. She first recommended such a national agency to President Theodore Roosevelt in 1905, bitterly noting that there was a bureau to investigate the state of the nation's crops and livestock but none to preserve the well-being of American children. In 1912, her campaign resulted in the creation of the federal Children's Bureau, with fellow children's rights leader Julia Lathrop as the agency's first chief.

Throughout the 1910s and 1920s, Wald's political activism broadened. In 1909, she was a key figure in the establishment of the National Association for the Advancement of Colored People (NAACP). In 1914, she and other settlement leaders protested the "hideous wrong" as World War I got under way when they founded the American Union against Militarism with Wald as its first president. After the U.S. became a combatant in the war, Wald served as head of the committee on home nursing of the Council of National Defense, and enlisted her Henry Street nurses to care for wartime victims of contagious diseases. Her service was especially valuable during the influenza pandemic of 1918, when she served as the chair of the Nurses' Emergency Council. When the war ended, she continued her pacifism and concern for civilian victims of war by founding the League of Free Nations Association as successor to her anti-militarist union.

Wald's main passion during this time, however, was the battle for woman's suffrage. From 1909 to 1917, she served as honorary vice chair of the New York State Woman Suffrage Party, which succeeded in winning the vote for New York women in 1917. Upon hearing the news that women had finally received the right to vote, Wald wrote to her friend and fellow settlement leader Jane Addams , "We are nearly bursting over our citizenship. … I had no idea that I could thrill over the right to vote."

With the suffrage victory in hand, Wald and her associates at Henry Street worked hard to educate women in the socially responsible use of their new political power. One major accomplishment often attributed to the women's vote was the passage in 1921 of the Sheppard-Towner Maternity Bill, which offered federal matching funds for maternal and infant health care. Wald and other reform leaders were faced with a conservative political climate during the 1920s, however, and were disappointed to discover that many women did not share their liberal views. The Sheppard-Towner Bill was overturned in the late 1920s, and Wald and her associates found it increasingly difficult to drum up popular support for other reform causes.

By the mid-1920s, Wald was approaching age 60, and deteriorating health forced her to cut back on many activities, both at Henry Street and in national politics. In 1933, a debilitating heart attack and stroke forced her to resign from Henry Street altogether, and she retired to her country home in Westport, Connecticut. Even in retirement, she maintained her enthusiasm for political causes and was a major ally of Franklin Delano Roosevelt and the New Deal.

Despite her frail condition, she served as chair of the Good Neighbor League in 1936, and helped persuade independent voters to join the Democratic Party. She also continued to back nurses' struggle for professional autonomy. When the visiting nurses at Henry Street balked at her successor, who was not a trained nurse, Wald supported their decision to secede from the settlement house, saying that the "nurses must speak for themselves" if they were to have full control of their profession. Wald even found the energy to pen Windows on Henry Street (1934), a sequel to her much-acclaimed autobiography, The House on Henry Street (1915).

On March 10, 1937, Lillian Wald made one of her few trips outside Westport to attend a celebration in New York in honor of her 70th birthday. Thousands of well wishers attended joint ceremonies at Henry Street and in Westport, and Wald received hundreds of gifts, cards, and letters from around the world congratulating her on her lifetime accomplishments. Her highest acclaim came from New York City Mayor Fiorello La Guardia, who awarded her the city's Distinguished Service Award.

Later that year, Wald suffered another heart attack and stroke, which confined her to Westport for the remainder of her life. She died in September 1940, and her ashes were buried in her family's plot in Rochester. In November of that year, 2,500 people attended a memorial service in her honor held at Carnegie Hall in New York City. President Roosevelt sent a telegram praising her for her "discernment and vision, a heart overflowing with compassion … [and] indefatigable industry. She did her great work without thought of self. The Henry Street Settlement with its superb record in bringing light to dark places and joy to the hearts that had known only sorrow is her true monument."

sources:

Coss, Clare, ed. Lillian D. Wald: Progressive Activist. NY: Feminist Press, 1989.

Daniels, Doris Groshen. Always a Sister: The Feminism of Lillian D. Wald. NY: Feminist Press, 1989.

Duffus, Robert L. Lillian Wald: Neighbor and Crusader. NY: Macmillan, 1938.

Rogow, Sally M. Lillian Wald: The Nurse in Blue. Philadelphia, PA: Jewish Publication Society of America, 1966.

Wald, Lillian. The House on Henry Street. NY: Henry Holt, 1915.

——. Windows on Henry Street. Boston, MA: Little, Brown, 1934.

suggested reading:

Davis, Allen. Spearheads for Reform. NY: Oxford University Press, 1967.

Melosh, Barbara. "The Physicians' Hand": Work Culture and Conflict in American Nursing. Philadelphia, PA: Temple University Press, 1982.

Muncy, Robyn L. Creating a Female Dominion in American Reform, 1890–1930. NY: Oxford University Press, 1991.

Reverby, Susan M. Ordered to Care: The Dilemma of American Nursing, 1850–1945. NY: Cambridge University Press, 1987.

collections:

Lillian D. Wald Papers, Rare Book and Manuscript Library, Columbia University; Lillian D. Wald Papers, Manuscript and Archives Division, New York Public Library; Archives of the Visiting Nurse Service of New York (all New York City).

related collections:

Jane Addams Papers, Peace Collection, Swarthmore College.

Florence Kelley Papers, Rare Book and Manuscript Library, Columbia University.

M. Adelaide Nutting Papers, Nursing Archives in Special Collections, Milbank Memorial Library of Teachers College, Columbia University.

Heather Munro Prescott , Associate Professor of History, Central Connecticut State University, New Britain, Connecticut