Classrooms and Clinics
Classrooms and Clinics
Urban Schools and the Protection and Promotion of Child Health, 1870-1930
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.
This book adds an important dimension to our understanding of children’s health and the contested role of the state in providing health services to needy populations. Meckel illuminates the sometimes promising, sometimes disappointing evolution of school health in America during a critical period of growing public institutions, philanthropies, and private entities.
This is the first comprehensive history of public school hygiene in the United States. Meckel skillfully traces the origins and evolution of school health programs and their troubled legacy today.
Meckel demonstrates that government and medical authorities contested the claim that because the state mandates education, it bears a concomitant responsibility for student health. This is an excellent history into herto uncharted territory, accompanied by supurb notes and index. Highly recommended.
Beautifully written and impressively researched, Classrooms and Clinics is a major contribution to the history of education, medicine, and public health policy. It deserves a wide readership as Americans continue to debate public versus private responsibility for health care and the welfare of urban school children.
Historians of children’s health and school hygiene have eagerly awaited this work, and Classrooms and Clinics does not disappoint. Meckel covers a tremendous range of topics, but the narrative is clearly focused and the argument carefully developed. Classrooms and Clinics is sure to stimulate a wealth of new scholarship on the history of schoolchildren’s health.
This detailed, careful, and extensively researched analysis of late nineteenth century and early twentieth century debates related to school hygiene, and the expansion and contraction of school health services that followed them, provides a helpful and arguably essential framework for current debates about the role of the urban schools in the improvement of children’s health (p. 206). Hopefully, the book will find an audience not only within but also beyond academia, among today's child advocates, policy makers, and educators.
Classroom and Clinics reveals how the subtleties of disagreement over issues of individual versus governmental responsibility and the dividing line between preventive and therapeutic services resulted in the abandonment of a movement to put clinics in schools. Meckel’s meticulous research and sophisticated analysis challenges scholars of this period to rethink their characterizations of the contours of reform.
A valuable contribution to the histories of American education, childhood and youth, public health, and the Gilded Age and Progressive Era. By examining the discourse of urban school hygiene, Meckel demonstrates the enduring nature of tensions between the state's obligations to schoolchildren and the rights and responsibilities of parents.
RICHARD A. MECKEL is professor of American studies at Brown University. He is the author of Save the Babies: American Public Health Reform and the Prevention of Infant Mortality, 1850–1929 and coeditor of Children and Youth in Sickness and in Health.
Introduction
1. Going to School, Getting Sick: Mass Education and the Construction of School Diseases
2. Incubators of Epidemics: Contagious Disease and the Origins of Medical Inspection
3. Defective Children, Defective Students: Medicalizing Academic Failure
4. Building Up the Malnourished, the Weakly, and the Vulnerable: Penny Lunches and Open-Air Schools
5. From Coercion to Clinics: The Contested Quest to Ensure Treatment
6. The Best of Times, the Worst of Times: Expansion and Reorientation in the Postwar Era
Epilogue: Contraction, Renovation, and Revival
Notes
Index
