Posted by BoomerMan (18.12.14.21) on February 04, 2004 at 22:06:50:
In Reply to: Suburbs, Polio epidemic, and Bomb Shelters posted by Megan on January 28, 2004 at 14:33:52:
hi Megan: Here's some interesting readings:
Please do not forget to cite the sources.
Suburbs:
In the booming post-war economy 11 million suburban homes were built between 1948 and 1958; and 83 percent of national population movement and growth during those years flowed to those newly-created communities, most of them generally inhabited by fewer than 50,000 people. Much of the Hill-Burton hospital construction money went to building suburban hospitals.
Suburbanization of America would continue well into the 1980s, and its impact upon public health would be multi-faceted. The suburban communities initially tended to be comprised of highly homogeneous populations because specific housing developments targeted certain buyers: Jewish or WASP buyers, lower or upper middle income, urban commuters or those whose jobs did not require daily travel to the central city. As the middle class tax base allowed better government services such as public schools and top hospitals, and these served as magnets for still more highly-paid suburbanites.
The suburbs were originally populated by young families, particularly World War II and Korean War veterans, and suburbanites soon acquired their own unique, youthful glamor. With images of martinis, cigarettes, frozen TV dinners, aerosolized whipped cream, supermarkets, and fancy new kitchen appliances the advertising world gave the suburbs an aura of convenience and adult fun. A sort of genteel suburban alcoholism, coupled with heavy smoking by both men and women, was the norm. Suburban characters played by Gig Young, Dean Martin, and Doris Day moaned their ways through day-after hangovers on the silver screen; real life housewives greeted their commuting husbands with cocktails and Cheese Whiz.
Suburbs were automobile cultures; air pollution created by millions of commuting cars was the immediate companion of suburbanization. With car culture came a lack of community cohesiveness. Suburban Americans nationwide began to experience what Los Angelenos had long known: social isolation and anonymity. While there might be pressure to keep up with the Jones in a suburban commodities competition, drawn shades, fences, and yards allowed those Jones more privacy than they had had in the city.
The combination of heightened privacy, lack of community cohesiveness, and antipathy towards the cities they had abandoned would make suburbanites uniquely difficult for public health authorities to reach. Indeed, some of the weakest departments of health in the country were in suburbanized counties, reflecting residents’ preference for strictly private health care and preventive health advice.
Abandoned by the White middle class the cities rapidly deteriorated. Without their middle and professional class tax bases, New York, Chicago, Pittsburgh, Detroit, and other large urban centers could no longer maintain their public infrastructures. Within fifteen years of the end of World War II things were visibly, often drastically, falling apart in American cities. The victims included schools, public hospitals, trains, buses, roadways, parks, museums, cultural centers, and government services. The erosion pushed more flight from the cities, expanding and perpetuating suburbanization.
As early as 1949 the impact was shockingly obvious; many American cities suddenly had slums in their downtown cores. Congress saw this and approved funds for construction of 810,000 public housing units to be built in place of the recent urban squalor. But by 1955 less than a quarter of those units had been constructed and many so-called urban renewal projects were turning into eyesores and centers of crime. By the 1960s “the Projects,” as they were called, and degenerated neighborhoods of most U.S. cities would be racially stratified centers of explosive anti-government sentiment, all but impenetrable to public health officials.
But before all of that occurred, urban public health was still to face, and often meet, some of its classic challenges.
Polio epidemic:
Throughout the United States 1948 brought a new polio epidemic, the worst the nation had experienced since the first one in 1916. New York City’s outbreak, with 703 cases and just 26 deaths, was minor. The same year Minnesota, with a statewide population far smaller than that of New York City, suffered 1,236 polio cases and 81 deaths.
In the 1916 epidemic the national polio case rate had reached a high of 41.1 per 100,000 and thereafter generally stayed below 12 per 100,000. In 1948 the polio rate climbed to 18.3 per 100,000 and in 1949 it hit 28.3. By 1950, when about 32,000 people contracted the disease, acute poliomyelitis was the most feared communicable disease in the United States. And in 1952, when the national rate topped 37 per 100,000, more than 58,000 Americans contracted poliomyelitis, which killed 1,400 of them. That most of the paralysis and death occurred among children made polio particularly frightening.
The National Foundation for Infant Paralysis (NFIP), begun by FDR’s friend Basil O’Connor in 1938, waged a March of Dimes campaign in the 1950s to raise funds for polio research. Nearly two-thirds of all people in the country made donations.
The foundation had a public health, not a curative medical, goal. Rather than fund the search for a treatment, O’Connor and his colleagues hoped to eliminate, via development of a vaccine, the threat polio posed to society as a whole.
Prior to 1947 several laboratories had discovered that polio was caused by a virus that existed in three different sub-types, two of which were responsible for most human disease. Other than laboratory-inoculated monkeys, rabbits, and mice, no other species suffered from polio, which offered optimism that, were an effective vaccine discovered and widely used, the disease might disappear.
But the virus was extremely difficult to study. In his University of Pittsburgh laboratory Dr. Jonas Salk had a technique for isolating viruses that required growing the microbes in monkeys. The NFIP estimated in 1948 that it would take 50,000 monkeys to grow enough viruses to make the basis for vaccines sufficient for inoculating all Americans. Bad as polio was, no one relished the idea — or cost — of raising, inoculating, and then killing 50,000 monkeys.
However, during the war microbiologist Albert Sabin had discovered how to grow polio viruses on human nerve cells in his Rockefeller University laboratory in Manhattan. And in 1949 the Harvard Medical School’s Dr. John Enders and two of his former graduate students, Drs. Thomas Weller and Frederick C. Robbins, made a pivotal discovery — by accident. Weller was the first person to figure out how to grow viruses on human fetal tissue cultures — in the primary case, he used mumps viruses. Then he set to work trying to duplicate that effort with chicken pox viruses. He wasn’t having much luck, so Weller pulled some polio samples out of the freezer and put them in his tissue culture tubes.
And the viruses grew and reproduced like crazy. Over subsequent months the Harvard trio perfected the technique, creating a simple way to mass produce polio viruses without having to kill any monkeys. For their efforts the trio was awarded the 1954 Nobel Prize in Medicine and Physiology.
In Pittsburgh Jonas Salk seized on the tissue culture discovery and, supported by charitable funds from local philanthropists and the NFIP, set to work making a polio vaccine. Enders readily shared his work and his advice with Salk. By 1953 Salk had figured out how to use monkey kidneys, rather than human fetal cells, as a tissue culture basis for large-scale production of polio viruses.
The next step was to kill the viruses and make of them an effective vaccine.
And a coincident discovery made in New York City’s Public Health Research Institute turned the then marginal possibility of polio vaccine production into a striking reality. Having obtained samples of Salk’s killed virus vaccine, Dr. Jules Freund added a cocktail he invented, comprised of fats and water. He called the mixture an adjuvant and reasoned that it would stimulate a stronger response in the immune system and up the efficacy of the polio vaccine. In lab animals the effect of Freund’s adjuvant was obvious — so much so that New York City Health Commissioner Dr. Leona Baumgartner announced the discovery to proud New Yorkers in 1953, declaring the City’s intention to be the first test site of large-scale human use of the Salk vaccine. Months earlier Salk had already tried his vaccine — without the critical adjuvant — on children in Pittsburgh’s Watson Home for Crippled Children, a rehabilitation facility for victims of poliomyelitis. And by the end of 1952 Salk had safety data on 161 children who had, with parental approval, taken the experimental vaccine.
In the fall of 1953 more than 80,000 six- to eight-year-old New York City school children rolled up their sleeves for shots of either Salk’s vaccine, or a placebo made of Freund’s adjuvant and a diluent. As word of the New York experiment got out, Salk and the NFIP were deluged with requests: the whole nation wanted the still-experimental vaccine. In 1954 and ‘55 tens of thousands of children nationwide enlisted as Polio Pioneers to serve as willing guinea pigs for the vaccine. And though every aspect of the Salk vaccine effort was mired in politics, ethical debates, and production and distribution snafus, there were never shortages of school children lining up for polio shots. The fear of polio was far greater than any parental concerns about the experimental nature of the vaccine.
Bomb Shelters:
On March 1, 1954 Teller’s first Superbomb was dropped in the middle of the Pacific Ocean on the coral atoll Bikini. It was 750 times more powerful than Fat Man, and it spread radioactive bits of Bikini over a radius of 7,000 square miles.
Ninety miles away from the blast, Aikichi Kuboyama and his fellow fishermen were trawling the Pacific on board the Lucky Dragon. They were showered with radioactive ashes that fell like snow from the sky. And when the crew reached their Japanese home port, every one of them had radiation sickness. Kuboyama died shortly thereafter.
The Lucky Dragon episode received wide publicity and was the basis of sharp diplomatic tension between post-war Japan and the United States. Six months later, the Soviet Union tested its first H-bomb, dropping it — incredibly— on a Russian-inhabited Siberian village called Totskoye located just 600 miles from Moscow.95
Following the Soviet detonation, several U.S. administrations pepetuated a public fantasy of survivable thermonuclear war. School children of the 1950s and ‘60s were taught to “duck and cover.” In this drill, they would get under their desks as soon as teachers gave the signal that a “Soviet hydrogen bomb” had fallen and carefully cover their eyes lest they be blinded. They would sit there with their heads between their knees until someone gave the all-clear signal. Parents were instructed to build bomb shelters similar to those many English families carved out of their basements during the German bombing of London. Inside those shelters, the Atomic Energy Commission (AEC) instructed, should be sufficient provisions for the family for a year.
Pauling and hundreds of other scientists were incredulous. They argued that the radiation in nuclear fallout would make any bomb site unliveable for decades, possibly centuries. And Pauling insisted that the fallout produced by nuclear weapons was, in itself, a risk to public health.
The bomb-makers, of course, knew this to be so, though it would be decades before their views would be made public. In a 1940 internal memo circulated at the Manhattan Project, scientists informed the Roosevelt administration: “Owing to the spreading of radioactive substances with the wind, the bomb could probably not be used without killing large numbers of civilians, and this may make it unsuitable as a weapon for use by this country....”
Seven months after the United States dropped its first H-bomb on Bikini, every scientist’s dream came true for Linus Pauling — he got the proverbial phone call from Stockholm. Awarded the Nobel Prize in chemistry for his pioneering research on protein structure, Pauling suddenly went from three years as a silent social and political pariah to being one of the world’s most celebrated scientists.