Lessons for us from the Great Depression of the 1930s?
Rational Documentation and Advocacy Practices: Human Relations Leadership for "Accident” Prevention.
(See also: ICEHS Newsletters Archivist’s Attic, Sept and Oct 2002; Feb 2006 and Dec 2007.)
…..
For us historians, one major fallacy is to reflect on the past by using current paradigms. With that caveat, here are some reflections and perhaps some echoes of the past on our present economic downturns.
The time period is the 1930s, the Great Depression, the small part of the corner of the world is our field’s harbingers - the ‘accident’ prevention school.
The first offering is on home accidents. The ICEHS Section appreciates the written permissions from the American Journal of Public Health to have ICEHS reprint the following excerpts from the AJPH archives of 1929-1938, so to fill in some gaps in my commentary.
1. To begin- is this really a false dichotomy on data collection separated from planning, developing organizing initiating injury prevention programs?
“Science is built with facts, as a house is built with stones. But, a collection of facts is no more a science than a heap of stones a house.”
Henri Poincare. La Science et l'hypothese Flammarion, Paris, (1902).
Introduction. In Mark Buchaanan. Nexus. Small Worlds and Groundbreaking Science of Networks.W W Norton &Company, NY, NY. 2002.11
OR
2. There are only a few different letters between change and challenge. In economic downturn it’s a chance- (it was for me over many years in injury control)- for injury control to edit those different letters into written programming programs and on manuscripts for our future history. L.F. (The original source of “challenge and change“ was adapted from Leadership Course at NYS Dept of Health , circa 1990). Moreover, those different letters must be not just framing “Injury Control” but cost savings to society and taxpayers (see ICEHS Newsletter Dec 2007).
The Great Depression period, worldwide and in the USA from 1929 to circa 1939 – with bread lines, home tents camping near the White House, 20 percent unemployment, one out of four banks failing – still continued philosophical or limited programmatic progress on injury prevention. In 1935, innovative national data collection started on the class of child and home injury. Non fatal home accidents were first included in the Nation Health Survey by frequency of disability of one week or more by means and nature of the injury, age, sex, employment, extent of impairment, and persons disabled for the twelve months immediately preceding the day of interview. [i]. By 1936, about 36,500 Americans died in auto accidents and 36,000 in home accidents, a newly recognized growing threat to the public health. (A New York State study showed that by 1940- 1948, home injury deaths in upstate New York had greatly accelerated those of motor vehicles.[ii]) In a plea for state cooperation to reduce motor vehicle related injury to occupants, President Franklin D. Roosevelt, sent in 1936 a letter to the Governor’s of the forty-eight states: his leadership leveraging - in the worse time of our nation’s history - for injury prevention during the Great Depression moved states to establish Governor’s Traffic Safety Committees (and in the early 1940’s he spoke nationwide about more lives being lost on the home front from’ accidents’ and the need for home safety groups to come together ),. [iii] In 1937, leaders of the National Safety Council and the State and Provincial Health Authorities of North America conferred on:” What shall we do about accidents?”[iv]
A follow-up thrust for later planning and development for injury prevention started at the October 23, 1936, Annual APHA Meetings, Vital Statistics Section, in New Orleans. New York State Health Department Commissioner, Edward Godfey, subsequently APHA President, stated his thesis statement that health departments study of "accidents" required an epidemiological approach:
"few, if any health officers or health departments are displaying any interest in prevention of injury and death from accidents. They are content that statistics shall be tabulated and published, leaving prevention entirely to other agencies or the will of God... It is the field of home and public accidents however, that I believe the health department has the greatest responsibility and opportunity."[v]
Godfrey, while offering an agrarian thesis of a rational documenting system for preventing accidental deaths (he offered evidence that injury death were beginning to exceed deaths from the major communicable diseases , and the 1938 APHA Resolutions cited Congressional funding support for accident prevention [vi] [vii] ), would fail to neither develop a program plan nor organize a structure, nor suggest any evaluation approaches. He, instead, proposed collecting of data and vague informational remedies of being safe and careful. He, like Shattuck in Boston or Chadwich in England on rational and on emotive public health leadership for changing poor housing conditions, was unable to directly leverage real change.
And Godfrey's pleas would be on deaf ears as A War had converged on other foci, not unlike today – for our country and the world. WWII end was the ‘mother of returning to prosperity’.
[1]Proceedings of the First Conference on Home Accident Prevention. Ann Arbor: University of Michigan School of Public Health, National Safety Council, USPHS, APHA Committee on Home Accident Prevention,1953.
[2] Brightman IJ, McCaffrey I, Cook LC. Morbidity statistics as a direction finder in home accident prevention. Am J Public Health.1952;24:841.
[3] Inside Cover: Am J Prev Med 2001;21.(thanks to Dave Sleet, CDC, for his research and that offering )
[4] Johnson W., King B., op cite. 7.
[5] Godfrey E. Role of health departments in the prevention of accidents. Am J Public Health. 1937;27:152 - 155.
[6] Year Book . Amer J Public Health .1938;28:34-35. (see also Godfrey’s advocacies on noise conditions and accidents and on his presentations at national meetings, respectively , in: Amer J Pub Health . Year Book Part III .28(2) ;160-161 ( Feb1938); Year Book 1938-39.Part 1. 29 ( Feb 1939) ; and also 29 ( Aug 1939). ( For the last two citations , the pages were not found but search phrases ‘Godfey and accidents’ found at www.ajph.org ,on 8/16/07)
[7] Editorial: The health officer and the accident problem. Am J Pub Health. Dec 1937;27:1290-1291.
There was also Great Depression activity on motor vehicle, suicide, and homicide injury prevention:
-ACCIDENTS (From: AJPH 1929)
PREVENTIVE medicine has been concerned too exclusively with the prevention of disease, the great majority of its devotees still regarding that function as the chief, if not the only province of their profession. Some of the old dictionaries had in their definition of medicine "the remedying, as far as possible, the results of accident and violence." The speed of modern life has forced us to recognize the prevention of accidents as a part of our calling, though a casual survey of books on hygiene and preventive medicine indicates that only those interested in industrial hygiene have given the subject the attention which it deserves.
The 1928 report of the National Safety Council1 arrests one's attention. During 1927, more than 95,000 deaths occurred by accident. If the same rate of increase holds for 1928, approximately 100,000 lives will have been lost. While the year showed a low general death rate, no improvement for accidents is evident. From 1911 to 1928, there was a total decrease in the death rate from accidents of 7.2 per cent, all of which, however, occurred prior to 1921, since which year the death rate has steadily increased. The actual number of deaths per year has increased 20 per cent. The most striking item is that deaths from automobile accidents have increased 1050 per cent during the same period. (bold LF) It is leasing to note the great improvement in deaths from railway and street railway accidents-37 per cent in one case, and 44 per cent in the other. As might be expected, a large number of automobile accidents occur among children, most of them in the 5-9 year period. This rate is exceeded only in the longer 15-24 year period, by approximately 3 per cent. Defects in the vehicle, such as poor brakes, improper lighting, etc., played a comparatively small part in the total number of accidents, there being only 4,969 cases reported in approximately 200,000 vehicles. Intoxication and physical defects were reported in 3,163 cases, 90 per cent of these being the result of intoxication. As far as the responsibility of the driver of the cargoes, the greatest number of accidents occurred through violation of the rules of right of way. Excessive speed, driving on the wrong side of the road, failing to signal and cutting in, come next in order as given. As far as pedestrians injured are concerned, crossing at intersections without a signal was the chief cause of accidents, crossing between intersections coming next, and playing in the street third.
A more recent report from the City of New York,' while not so detailed in character, shows that highway accidents lead as the cause of violent deaths- 1,306 out of 5,902.
The figures taken from these two reports have been selected because, for the most part, they represent the more easily preventable causes of accidents. The railroads and street car lines have adopted very widely the " Safety First " slogan. It is recognized that the great increase in automobile traffic has had a marked influence in decreasing the number of passengers on railways and street cars, especially for the short hauls, but there is little doubt that care of equipment and instructions to operatives have also played a part. It seems time for those interested in hygiene and public health to take a more active part in the education of the public in the prevention of accidents, and for the influence of the vast body of health workers to be exercised, not only for the making of laws, but for the provision of officers to enforce such laws.
REFERENCES
1. Public Safety Series, No. 17, 108 East Ohio 'Street, Chicago, Ill.
2. Weekly Bull., Dec. 1, 1928.
-AJPH 1932:
In 1932,the overall accidental death rate was 70.5 the lowest in the history of the united states except for 1921-22 ( 68.4 and 67.6)..MV accidental deaths declined lowest in history by 13%..'
…the reason for decreased MV accidental deaths was due in part "to safer use of streets and highways" and the lower occupational accidental deaths, … higher unemployment". For MV data, state by state assessments are provided.
LF Note: The above sampled web archive (it also has tasteless racist comments on stats and causes of homicides and suicides ) is from a AJPH published column:
Vital Statistics. Amer. J. Pub Health 23(6): 629. 1933 , courtesy to apha.icehs section for reproduction and use , and also at www.ajph.org:
http://www.ajph.org/cgi/reprint/23/6/620?maxtoshow=&HITS=25&hits=25&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=lower+accidental+deaths&andorexactfulltext=and&searchid=1&FIRSTINDEX=25&sortspec=relevance&resourcetype=HWCIT
- AJPH 1933:
“In its campaign against the eye hazards of industry, the Society cooperates with state labor departments, industrial journals, insurance companies, trade associations, universities and vocational schools, safety engineers, and others professionally concerned with industrial accident and health problems.
During the past year the Society sought, particularly, to arouse the public against dangerous fireworks and toy firearms, which constitute serious hazards to children. A survey conducted by the Society revealed that many children lost their sight as the result of accidents while playing with such toys”.
- AJPH 1933:
“Attention should be called to the rate of fatal automobile accidents, 22.0, the lowest in 4 years, and that of other types of accidents, 47.0, which has never been lower. These figures reflect not only the effect of safety measures, but also of the decrease in the number of automobiles on the highways and machines in operation in factories.
Compared with 1931, cases of sickness from reportable diseases increased by 15,000. More cases of scarlet fever were reported than ever before, the total of 40,000 being greater by 50 per cent than the corresponding figure in 1931. Cases of measles increased by 6,000, whooping cough by 1,500. The number of reported cases of syphilis, almost 60,000, was by far the greatest on record, representing a rise of more than 100 per cent since 1925. Among the favorable events was the drop in cases of poliomyelitis, the total for the year, 333, being a gratifying contrast to the 6,000 or more cases registered during the epidemic of 1931. A new minimum point was reached by diphtheria, with 4,200 cases in the entire state as compared with 11,000 only 4 years ago.-NTew York State Weekly Health News, 10:25-26 (Feb. 13), 1933.”
- AJPH 1933:
“Safety First for Little Folks-By
Lillian M. Waldo. New York:
Scribner, 1933. 165 pp. Price, $64.
That safety education has definitely established its place in the elementary schools is proved by statistics which show a steady increase in fatalities for adults and for children of preschool age, and a marked decrease for children of school age. The story centers around a little girl who dreamed that she took a trip to Danger Land and who tells of her experiences with the crippled children she met there. The safety lessons drawn are correlated with civic instruction to show children what the community is doing for their welfare and how they can cooperate. The book contains a number of illustrations.
A very good book for children of the third, fourth, and fifth grades if studied under the supervision of an understanding teacher. Bess Exton
That Great Depression ‘thunder of history’, ( what we cannot change), we pray, will never be repeated. But in crisis and political changes , comes new opportunities for the safety of consumers . Our history can also show how our leaders in earlier generations coped and moved our injury prevention systems forward. (See www.extranet.icehs.org , Members’ Only for my major surveys and overlays of modern leadership models on our injury control history ) ; also check out some broader overlays on our field : “ A Bookshelf of Change. Essential works that altered America’s thinking “. ( WSJ.Nov 8-9. 2008, W8):; works by David Thoreau, Harrriet Beecher Stowe, Betty Friedan, Mark Twain, and Dr. Benjamin Spock.
My opinions are mine alone.
L Fisher Copyrighted 2009
Les Fisher MPH
Safety/Leadership Consultant,(Archivist, American Public Health Association, Injury Control and Emergency Health Services Section - www.icehs.org - See my monthly newsletter commentaries and monographs at members only, on the history of injury control leadership at extranet.icehs.org ) 97 Union Ave, S. Delmar, NY 12054 USA. 518-439-0326