Women’s Health Protective Associations in the United States

Women’s Health Protective Associations in the United States
Amelia Bonea, Tokyo University of Foreign Studies

Women’s or Ladies’ Health Protective Associations were reform groups organized in various parts of the United States from the last decades of the nineteenth century with the aim of improving public health. During a time when women were yet to gain recognition as full-fledged citizens of their country, collective action in the form of associations, leagues and clubs proved to be a popular and efficient form of intervention not only in the field of public health, but also in the public arena in general.

The establishment of these organizations was prompted by the development of a new concept of “public health,” one that emphasized the role of civic engagement in addressing a variety of health-related issues which confronted communities across the United States. The Ladies’ Health Protective Association of New York, the first of its kind, was established in November 1884 with the aim of eradicating the “foul odors” produced by a nearby manure yard. Despite a prolonged and difficult struggle in the course of which the women had to battle not only entrenched gender stereotypes, but also the antagonism of various political bodies, the Association was eventually successful in its pursuit and managed to set an example for other American women.

Similar organizations were soon established in Brooklyn, Philadelphia, Pittsburg and even in smaller towns such as Yakima, Washington. As The Outlook reported, these associations, whose membership consisted entirely of women, had become common throughout the United States by the 1890s. Some of them were set up in response to the imminent threat of contagious diseases such as cholera and typhoid fever. This was the case with the Woman’s Health Protective Association of Philadelphia, which was formed in 1892 to fight the occasional outbursts of cholera which threatened the life of many Philadelphians. The supply of clean water remained for many years a high priority on the agenda of this organization, as an article published in the September 1897 issue of The Forum suggests. But the Health Protective Associations were involved in a much wider sphere of activities which included street cleaning, supervision of garbage disposal, children’s aid, the construction of playgrounds, enforcement of sanitary measures in schools, the monitoring of food production and storage, protests against smoke emissions, as well as fighting against expectoration in public spaces.

The American periodical press of the late nineteenth century provides fascinating insights into the history of the Women’s Health Protective Associations and, by extension, their important contribution to the development of public health in the United States. The press offered women the opportunity to access and shape public opinion by popularizing their efforts to improve public health. The accounts suggest that the increased engagement of women in the field of public health during the second half of the nineteenth century was the result of a number of factors. One was a gradual shift in medical thinking, from a system of medical practice which emphasized the cure of diseases to one that recognized more and more the benefits of preventive action. As The Outlook declared in 1894, “Much of our public discomfort is traceable to individual carelessness or ignorance.” In this context, women came to acquire a reputation as efficient supervisors of sanitation enforcement agents. In 1897, for example, The Outlook praised Mrs. Paul and Mrs. Kinniccutt of Chicago and New York, respectively, for their successful attempts to clean the streets in their towns.

Another important development which enabled women to participate actively in public health initiatives was their increased access to specialized medical knowledge. Following the pioneering example of Elizabeth Blackwell, the first woman to obtain a medical degree in the United States in 1849, more and more women turned towards the medical profession and sought to acquire formal training in institutions of higher education. In 1897, Edith Parker Thomson revealingly wrote that women had come a long way from the time when “They were supposed to ‘know it all [i.e. medicine] by instinct, like a bird’.”

Yet the periodical press of the time also suggests that the work of such reform-oriented groups could not be separated from the age-old rhetoric of domesticity. The household was conceived of as “the realm of women” exclusively and it was argued that many of the ills they sought to redress in the public domain had the potential to affect, in equal measure, the health of their own households. As mothers and sisters, women were expected to tend to public sanitation and order in the same way they tended to their own “homes.” In fact, as The Outlook unambiguously declared, women’s successful activity in the field of public health gave “new emphasis to the axiom that good municipal economy is good housekeeping.” The Women’s Health Protective Associations were thus a form of “city housekeeping.” This analogy between the home and the city made women particularly suitable for public health work. The accounts published by the periodical press are particularly intriguing as they document the ways in which women claimed a place in the public arena by virtue of a type of work which was described simultaneously as “public” and “domestic.”

The Health Protective Associations empowered women by giving them a voice in the administration of their respective communities. They were an avenue through which they pressed for legislative changes and for official recognition from the Boards of Health attached to the municipal governments, but also built their confidence as responsible and capable citizens. Given the role of the Women’s Health Protective Associations in enabling an important part of the American population to carve a niche for themselves in the public domain, these organizations deserve to have their own Wikipedia entry.


Elizabeth Blackwell, Pioneer Work in Opening the Medical Profession to Women (London and New York: Longmans, Green, and Co., 1895).

Nicholas Casner, “’Do It Now!’ Yakima, Wash, and the Campaign against Rural Typhoid,” American Journal of Public Health vol. 91, no. 11, 2001, pp. 1768-75.

Mary E. Mumford, “The Place of Women in Municipal Reform,” The Outlook, March 31, 1894, pp. 587-88.

“Public-school Sanitation,” The Outlook, May 29, 1897, pp. 239-40.

“On the Opening of the John Hopkins Medical School to Women,” The Century Magazine, February 1891, pp. 632-36.

Mrs. John H. Scribner, “The Relation between Woman’s Health Protective Associations and the Public Health,” in American Public Health Association, Public Health: Papers and Reports, vol. XXIII, Concord: The Rumford Press, 1898, pp. 413-21.

Edith Parker Thomson, “What Women Have Done for the Public Health,” The Forum, September 1897, pp. 46-55.

“A Woman Inspector of Street-Cleaning,” The Outlook, October 9, 1897, pp. 351-52.

“Women’s Health Protective Association,” The Outlook, May 19, 1894, p. 870.

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