Nursing with a Message: Public Health Demonstration Projects in New York City (Critical Issues in Health and Medicine)

Mandated by the Affordable Care Act, public health demonstration projects have been touted as an innovative solution to the nation's health care crisis. Yet, such projects actually have a long but little-known history, dating back to the 1920s. This groundbreaking new book reveals the key role that these local health programs—and the nurses who ran them—influenced how Americans perceived both their personal health choices and the well-being of their communities. Nursing with a Message transports readers to New York City in the 1920s and 1930s, charting the rise and fall of two community health centers, in the neighborhoods of East Harlem and Bellevue-Yorkville. Award-winning historian Patricia D'Antonio examines the day-to-day operations of these clinics, as well as the community outreach work done by nurses who visited schools, churches, and homes encouraging neighborhood residents to adopt healthier lifestyles, engage with preventive physical exams, and see to the health of their preschool children. As she reveals, these programs relied upon an often-contentious and fragile alliance between various healthcare providers, educators, social workers, and funding agencies, both public and private. Assessing both the successes and failures of these public health demonstration projects, D'Antonio also traces their legacy in shaping both the best and worst elements of today's primary care system. This book is also freely available online as an open access digital edition. Download the open access ebook here. Mandated By The Affordable Care Act, Public Health Demonstration Projects Have Been Touted As An Innovative Solution To The Nation's Health Care Crisis. Yet, Such Projects Actually Have A Long But Little-known History, Dating Back To The 1920s. This Groundbreaking New Book Reveals The Key Role That These Local Health Programs--and The Nurses Who Ran Them--influenced How Americans Perceived Both Their Personal Health Choices And The Well-being Of Their Communities. Nursing With A Message Transports Readers To New York City In The 1920s And 1930s, Charting The Rise And Fall Of Two Community Health Centers, In The Neighborhoods Of East Harlem And Bellevue-yorkville. Award-winning Historian Patricia D'antonio Examines The Day-to-day Operations Of These Clinics, As Well As The Community Outreach Work Done By Nurses Who Visited Schools, Churches, And Homes Encouraging Neighborhood Residents To Adopt Healthier Lifestyles, Engage With Preventive Physical Exams, And See To The Health Of Their Preschool Children. As She Reveals, These Programs Relied Upon An Often-contentious And Fragile Alliance Between Various Healthcare Providers, Educators, Social Workers, And Funding Agencies, Both Public And Private. Assessing Both The Successes And Failures Of These Public Health Demonstration Projects, D'antonio Also Traces Their Legacy In Shaping Both The Best And Worst Elements Of Today's Primary Care System-- Focuses On Demonstration Projects And Health Centers In New York City In The Interwar Years. One Of The Clear Strengths Of The Movement Was Its Acknowledged Dependence On Nurses - Especially Public Health Nurses - To Visit Family After Family, Neighborhood After Neighborhood, School After School, And Church After Church To Encourage The Adoption Of Healthier Lifestyles, Preventive Physical Exams, Well Child Care, And Routine Dental Care. Their Work Established The Norms Of Primary Care Now Practiced In Today's Primary Care Centers. But Their Work Was Highly Labor Intensive And Depended On The Breakdown Of Disciplinary Boundaries Among Nurses, Physicians, And Social Workers That Had Been Painstakingly Created In The Decades Before The War. This Almost Happened - Until The Ravages Of The Great Depression Of The 1930s Forced Retrenchments That Stifled Continued Innovation. Nursing With A Message Explores The Day-to-day Processes Involved In The Coming Together And Moving Apart Of Different Organizations, Disciplinary Interests, Knowledge Domains, And Spheres Of Public And Private Responsibilities Involved In Caring For Those In Need At The Point Of Delivery Of Service. More Specifically, It Uses The Public Health Nurses Involved In New York City Health Demonstration Projects As A Case Study Of Disciplinary Tensions Inherent In Projects With Multiple Constituents And Invested In Multiple, And Sometimes Contradictory Outcomes. It Shows How One Central Public Health Discipline Searched For Better Ways To Care For The People It Served Even As It Attended To Its Own Advancement, Place, And Power In A Very Complicated Space Of Ideas, Practice, Action, And Actors. But The Prerogatives Of Gender, Class, Race, And Disciplinary Interests Shaped Their Implementation-- Introduction -- Medicine And A Message -- The Houses That Health Built -- Practicing Nursing Knowledge -- Shuttering The Service -- Not Enough To Be A Messenger -- Notes -- Bibliography -- Index. Patricia D'antonio. Includes Bibliographical References (pages 131-134) And Index. "Focuses on demonstration projects and health centers in New York City in the interwar years. One of the clear strengths of the movement was its acknowledged dependence on nurses - especially public health nurses - to visit family after family, neighborhood after neighborhood, school after school, and church after church to encourage the adoption of healthier lifestyles, preventive physical exams, well child care, and routine dental care. Their work established the norms of primary care now practiced in today's primary care centers. But their work was highly labor intensive and depended on the breakdown of disciplinary boundaries among nurses, physicians, and social workers that had been painstakingly created in the decades before the War. This almost happened - until the ravages of the Great Depression of the 1930s forced retrenchments that stifled continued innovation. Nursing with a Message explores the day-to-day processes involved in the coming together and moving apart of different organizations, disciplinary interests, knowledge domains, and spheres of public and private responsibilities involved in caring for those in need at the point of delivery of service. More specifically, it uses the public health nurses involved in New York City health demonstration projects as a case study of disciplinary tensions inherent in projects with multiple constituents and invested in multiple, and sometimes contradictory outcomes. It shows how one central public health discipline searched for better ways to care for the people it served even as it attended to its own advancement, place, and power in a very complicated space of ideas, practice, action, and actors. But the prerogatives of gender, class, race, and disciplinary interests shaped their implementation"-- Provided by publisher Cover......Page 1 Series......Page 3 Title......Page 4 Copyright......Page 5 Dedication......Page 6 Contents......Page 8 Illustrations......Page 10 Acknowledgments......Page 12 Abbreviations......Page 16 Introduction......Page 20 Chapter 1. Medicine and a Message......Page 32 Chapter 2. The Houses That Health Built......Page 54 Chapter 3. Practicing Nursing Knowledge......Page 76 Chapter 4. Shuttering the Service......Page 98 Chapter 5. Not Enough to Be a Messenger......Page 120 Notes......Page 132 Bibliography......Page 150 Index......Page 154 About the Author......Page 166 Series Page......Page 168