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Progress update: I'm done, I think. Comments and suggestions from all quarters welcome.
Also classmates: if you have time on your hands, would you be able to help me out with some research tips for students doing this kind of work in the future? http://emoglen.law.columbia.edu/twiki/bin/view/AmLegalHist/ResearchHelp |
| | Timeline with linked sources
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The public, we may almost now say national health, is too vast and important a concern to be entrusted to inefficient boards of health and spasmodic Congressional legislation (Report to Congress in the wake of the 1878 yellow fever epidemic from the Commission as to the Causes and Prevention of Yellow Fever. Link here.)
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< | On 2 June 1879, the Act creating the National Board of Health came into effect, accompanied by a very large appropriation of $50,000. |
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> | On 2 June 1879, the Act creating the National Board of Health came into effect, accompanied by a very large appropriation of $50,000. Section 10 of this Act was a 'sunset clause', providing that the Act would expire four years after the date of its approval (June 2 1883). |
| | State Boards of Health and the National Board's operation
Section 3 of the 1879 Act creating the National Board of Health (the 'founding Act') set out a two-step process. First, it encouraged the co-operation of the National Board with the State Boards of Health and their regulations. Second, it allowed the Board to displace these rules with Presidential approval. A fair analytical conclusion is that this two-step process, and the Presidential approval requirement, constituted an attempt to secure State support for the Bill and the possibility of diminution of State authority. |
| | The Supreme Court in Dunwoody v United States 138 U.S. 578 (1892) held that Mr Dunwoody, the chief clerk and sometime Secretary of the National Board of Health, could not recover money from the federal government for services he had performed for the Board in the absence of specific Congressional grants for this purpose. This case was brought several years after the Board had ceased to exist. It contains a very clear timeline of Congressional appropriations, a clear ruling that Mr Dunwoody was not entitled to the funds he claimed, and no description at all of anything outside the legal skeleton of the Board's history. |
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< | Even though the Board was passed with an initially large appropriation, not all this money was spent. Instead, Congress passed a series of subsequent appropriation Bills for smaller amounts, and in one included a clause stating that no money other than these new appropriations was to be spent on the Board's activities. Clashes over funding also existed prior to 1893: in 1881, the annual report reveals that the Board received only one third of the funds it wanted to build new quarantine stations in Virginia, Georgia and Texas (link). |
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> | Even though the Board was passed with an initially large appropriation, not all this money was spent. Instead, Congress passed a series of subsequent appropriation Bills for smaller amounts, and in one included a clause stating that no money other than these new appropriations was to be spent on the Board's activities. Clashes over funding existed from the early days of the Board: in 1881, the annual report reveals that the Board received only one third of the funds it wanted to build new quarantine stations in Virginia, Georgia and Texas (link).
As discussed above, the Act creating the Board expired on June 2, 1883. There was clearly some movement to continue the Board with expanded powers, given its positive early activities (reference link). In 1883 there was a Bill drafted to expand the Board's powers and repeal the sunset clause, but it was never passed (the full text of the Bill can be found in the Board's annual report for 1884, at p 16). Instead of passing this Bill, Congress chose to pass diminishing appropriations, with the result that the 1884 and 1885 Board annual reports devote a large amount of time lamenting the activities the Board had been forced to curtail due to lack of funding. Eventually no more Congressional funding was forthcoming, and the Board ceased all activities. Its final meeting was in November 1884, and final annual report was for 1885. |
| | The historical documents are largely silent as to the motives behind the Board's slow death due to underfunding. My conclusion is that it was controversial. The address of the President of the American Public Health Organization in 1887 (reported in Science, Vol X No. 251, link here) notes that: It is unnecessary for me to refer to the various circumstances that conspired to paralyze the effective energy of this Board. Unhappily it is a thing of the past, and the hopes which we had founded on this our bantling are but a thing of the past. |
| | The annual reports, however, also reveal instances of close and mutually beneficial cooperation with numerous State Boards of Health, and demonstrate a genuine-seeming interest in strengthening State sanitary legal infrastructure (for example, State legislation). I think the better view is that State resistance to the National Board's efforts probably did not originate specifically in the State Boards of Health, but was a reflection of more general attitudes and trends. There is also some evidence of some State-level authorities preferring their autochthonous regulatory infrastructure and quarantine procedures: see e.g. The Daily Picayune, (New Orleans) 1-17-1884 'The Defunct National Board of Health' p 4. |
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< | Overall, I think the federalist analysis is the best lens through which to analyze the decline of the Board. In 1893 the centralizing forces, which had peaked in response to the chaos of the 1879 yellow fever epidemic, were outweighed by the interests of local and regional autonomy. In the slightly longer term, however, countervailing forces meant that many of the National Board's core functions were returned to a national level after its demise. |
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> | Overall, I think the federalist analysis is the best lens through which to analyze the decline of the Board. In 1883 the centralizing forces, which had peaked in response to the chaos of the 1879 yellow fever epidemic, were outweighed by the interests of local and regional autonomy. In the slightly longer term, however, countervailing forces meant that many of the National Board's core functions were returned to a national level after its demise. |
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After the Board |
| | The creation of the National Board of Health, even if it ultimately failed, was a significant step in creating uniformity of quarantine standards and broader public health measures more generally. In some ways it is surprising that a national response to foreign-originated epidemics and quarantine took so long to formulate. Even before the Supreme Court's expansive reading of the commerce clause in the 1930s, it was relatively uncontroversial that the federal government had the power to regulate quarantine measures under this clause. My best guess as to why this is the case is the politically sensitive nature of quarantine regulations that could have a potentially significant effect on trade between States as the Louisiana v Texas case demonstrates. Also, the broad swathe of topics that were regarded as relating to 'health' was probably threatening to many States' sense of sovereignty without a tightly-focused mandate, which the Board had in its theoretical statutory functions but not in its operational practice. Even today, with the federal government exercising power that was not contemplated in the nineteenth century, it is by no means uncontested that a national response to health and safety regulation (beyond the specific issue of immigrant quarantine and epidemic management) is most efficiently done at a federal rather than State level. The nature of federalism involves weighing State autonomy and ability to tailor regulation to local circumstances on the one hand, and the potential for national coordination, economies of scale and (relative) neutrality of regulation on the other. The rise and fall of the National Board of Health should be seen in the light of these competing forces, as an aspect of broader federal tensions inherent in the nature of the American political system. |
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< | An even more important historical lesson from studying the Board, however, is its function signaling a national commitment to both preventative medicine and medical research. In a short span of years, both would take root in America on a scale to match even the optimistic predictions of the people involved in the Board's administration. Moreover the National Board of Health, even during the twilight of its chronically underfunded life, was instrumental in sparking and encouraging a layered regulatory commitment to public health measures. Its efforts and the ripple effects of these efforts undoubtedly saved many thousands of lives, and improved sanitary conditions for most Americans far beyond the levels they had been at when the Board came into existence. The many advocates of the National Board of Health and its work may have lost a battle for its renewal in 1893, but they went on to secure many more significant victories in the war for the health of Americans. |
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> | An even more important historical lesson from studying the Board, however, is its function signaling a national commitment to both preventative medicine and medical research. In a short span of years, both would take root in America on a scale to match even the optimistic predictions of the people involved in the Board's administration. Moreover the National Board of Health, even during the twilight of its chronically underfunded life, was instrumental in sparking and encouraging a layered regulatory commitment to public health measures. Its efforts and the ripple effects of these efforts undoubtedly saved many thousands of lives, and improved sanitary conditions for most Americans far beyond the levels they had been at when the Board came into existence. The many advocates of the National Board of Health and its work may have lost a battle for its renewal in 1883, but they went on to secure many more significant victories in the war for the health of Americans. |
| | Table of quarantine Acts |
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| META FILEATTACHMENT | attachment="Forty_fifth_congress_Ch_202_1879_Establishing_National_Board_of_Health.pdf" attr="" comment="The principal 1879 Act" date="1262566994" name="Forty_fifth_congress_Ch_202_1879_Establishing_National_Board_of_Health.pdf" path="Forty fifth congress Ch 202 1879 Establishing National Board of Health.pdf" size="506682" stream="Forty fifth congress Ch 202 1879 Establishing National Board of Health.pdf" user="Main.EmilyByrne" version="1" |
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| META FILEATTACHMENT | attachment="Ohio_fail.pdf" attr="" comment="The Cincinnati Commercial, 02-08-1879 Vol XXXIX Issue 149 p 3" date="1264616807" name="Ohio_fail.pdf" path="Ohio fail.pdf" size="138532" stream="Ohio fail.pdf" user="Main.EmilyByrne" version="1" |
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