The 1930s Medicine and Health: Overview

Major developments in the field of medicine and health occurred during the 1930s. Scientists developed vaccines for crippling diseases like poliomyelitis (commonly known as polio), while new "sulfa" drugs promised therapy for a wide range of infections. New anesthetics made surgery safer and less painful. What stood in the way of dramatic improvements in public health was the Depression. By the mid-1930s, the average national income in the United States was half that of 1929. With nearly 40 percent of some states' populations on government relief, fewer patients could afford to pay for medical care. Physicians earned less as a result, but many continued to treat charity cases for free. Hospitals had similar problems. In the absence of modern drug therapies, the average hospital stay in 1933 was two weeks. Many patients could not afford to pay, so beds remained empty while people suffered at home.

Large increases in deaths from cancer, respiratory diseases, and heart attacks occurred during the Depression. Syphilis, a sexually transmitted disease, affected as many as 10 percent of Americans, a rate higher than that in any other industrialized nation with records. The main causes of death in the early 1930s, in order of risk, were: heart disease, cancer, pneumonia, and infections and parasitic disorders. This last group included influenza (flu), tuberculosis, and syphilis.

Polio was a serious problem in the 1930s. In 1931 there was a large outbreak that spread across the Northeast. In 1932, Philadelphia was hit, and in 1934 Los Angeles was affected. The year 1939 saw outbreaks in South Carolina, Buffalo, and New York. Many Americans did not realize that their president, Franklin D. Roosevelt, had been crippled by poliomyelitis (polio) in 1921. Although he wore leg braces and moved around in a wheelchair, this was not generally reported in the news. On the rare occasions he stood at a public event, his legs were hidden from view.

Little was known about how the disease was transmitted or how it could be stopped. Vaccines were being developed, but before the Food, Drug, and Cosmetic Act was amended in 1938, vaccines did not have to be tested or licensed by the U.S. Public Health Service. It is estimated that as many as one in every thousand cases of polio in 1935 was actually caused by trials of vaccines. Such failures were a serious blow to research. In the midst of the Depression, money for research was scarce. Roosevelt used his influence to help create the March of Dimes campaign, one of America's most successful fundraisers.

Despite their difficulties in containing some diseases, scientists made great strides in understanding the body and curing disease during the decade. Karl Landsteiner won America's second Nobel Prize for medicine in 1930 for his work identifying the blood groups. Other winners in the 1930s included Thomas Hunt Morgan for research in genetics and George R. Minot, William P. Murphy, and G. H. Whipple for their work on the blood disease pernicious anemia. In 1936, five years after Austrian researchers discovered two strains of poliovirus, Albert B. Sabin managed to grow the virus in the laboratory. This would pave the way for effective vaccines in the future. Other advances included faster, cheaper X-ray machines, better blood transfusions, and the widespread use of hormones, vitamins, and insulin in therapy.

President Roosevelt's social reform program, called the New Deal, marked the first time the federal government addressed the nation's health. From plans to provide better housing to the Farm Security Administration (FSA), New Deal agencies provided medical insurance, childcare, help for the disabled, and boosts in public health campaigns. The Food, Drug, and Cosmetic Act of 1938 protected the public from quack doctors and dangerous drugs or procedures.

Although Congress debated the idea of a national health insurance program, attempts to establish one failed. Instead, voluntary health insurance became more widespread in the 1930s. First, the American Hospital Association (AHA) created the Blue Cross plan in 1933 to pay for hospital costs. Then in 1939, Blue Shield was put in place to cover other medical costs. Doctors objected to government involvement in health care, but three quarters of Americans approved of government help with paying for health care. By the 1930s the fee-for-service system of paying for medical services was not working. Reform began with the New Deal. But the issue of who should pay for health care was still being argued in the twenty-first century.