Children and adults alike suffered from illness and disease in the late nineteenth century and early twentieth century. Communicable diseases were caught and spread easily due to harsh living conditions, poor nutrition, and lack of sanitation. Cholera, typhus, polio, and tuberculosis were all prevalent. A lack of health education in both rural and urban communities also contributed to the problem.
Maternal and infant health was of great concern to public health workers. With a lack of health services and proper sanitation, pregnant mothers and infants of the working poor were at risk for disease and infection, especially in the summer because of dehydration.
Early public health initiatives sought to prevent childhood disease, especially among the urban poor. Lillian Wald, a pioneer of public health, founded the Henry Street Settlement in 1893 in the immigrant-populated Lower East Side neighborhood of New York City. The organization provided much-needed health and social services for the neighborhood, including maternity and infant care. A strong advocate for child welfare, Wald helped to found the National Organization for Public Health Nursing and the Child Labor Committee, which later became the National Child Labor Committee.