Introduction: Searching for a Golden Age

Welcome to the Golden Age of American medicine. This website was developed to encourage the exploration of American health history during the middle years of the 20th century, the 1930s, 1940s and 1950s. During these years the experience and the practice of medicine changed dramatically in the United States, as did the structure of the health care delivery system. Our goal is to arouse your curiosity about some of these changes, so that you will be motivated to investigate how and why they took place.

The materials selected for inclusion reflect only a small portion of the resources available for studying this era of American health and medical history. Chosen for their ability to evoke important aspects of a past time, the wide variety of images, documents, tables and graphs presented here require close scrutiny. The questions and writing exercises that accompany this material were designed to aid you in this process. Navigating these web units is an experience that is part guided tour and part do-it-yourself project.

WHY A GOLDEN AGE?

The middle of the 20th century has often been described as a golden age of scientific advancement and miraculous medical breakthroughs, as well as an era in which the medical profession and the institutions it controlled enjoyed especially high public regard. Observers as varied as science writer and journalist Paul de Kruif, AMA spokesperson Morris Fishbein, film maker Hal Wallis, medical sociologist Eliot Freidson, and historian John Burnham have been intrigued by this golden era. They and the scores of others who have written about and analyzed the different aspects of American health culture during this era did not always agree on the exact parameters of this age of miracles. Some would have it begin as early as the bacteriological revolution of the late 19th century. Others look to the flowering of scientific research and pharmaceutical development that is associated with World War I, and still others point to the changes in medical education and public health often associated with the Progressive era. Similarly, there is a lack of agreement about a suitable end point for the Golden Age, although there is a fairly widespread consensus that it is over by the late 1960s and early 1970s. The passage of Medicare & Medicaid legislation over the strenuous opposition of the medical profession, as well as the changing nature of the medical market place and the increasing chorus of scholarly, journalistic, and consumer-oriented critiques of the medicine signal the end of an era for most observers. Taking these variations into account, we have focused our attention on the 3 decades at the core of most accounts of the golden age: the 1930s, the 1940s and the 1950s.

Differences over the exact chronological parameters of the golden age resonate with the wide variation this era’s observers give to the question: what made it a golden age? The varying answers to this question depend substantially on the kind of evidence the observer favored. The more demographically inclined point to the declining mortality rate for infectious disease or to the increase in the average American’s life span. Others more concerned with the issue of the medical practitioner’s high social status point to the consistently high ratings that physicians and scientists received from their fellow citizens in opinion polls. Or they emphasize the popular culture image of doctors, nurses and medical scientists found in novels and movies which often cast them in a heroic light. More economically minded analysts of the golden age have pointed to the slow but steady rise in physicians’ incomes and the expanding role of costly hospital care as evidence for their arguments. Another set of criteria used to judge this a golden age are accounts of this era’s medical wonders – sulfa, blood typing, the polio vaccine, penicillin, etc. For interested mid-twentieth century observers, there was no lack of evidence to support a characterization of their time as one of medical triumph and advancement in American health.

For many this was an era in which no problem seemed unsolvable. There were no diseases that science could not ultimately defeat, no surgical procedure or medical product that could not be mastered, and no technology that could not be harnessed. And yet, this was the period in American health history rocked by some dramatic medical scandals, such as the 1937 sulfanilamide poisoning, which cost the lives of nearly a hundred citizens. This was also an era in which hospitals and the latest technology remained clustered in the larger urban areas, while many of the poorer and more rural parts of the country were facing shortages in medical basics, including doctors and nurses. During the same years, cancer, heart disease and a host of other chronic health conditions remained significant problems for the American health care system with its hospital based, acute care orientation. Rising costs of many kinds of medical care and the economic disruptions of a devastating economic depression and a world war further complicated the health lives of many Americans. How could the years of the Great Depression and the Second World War be part of a golden age in American health history??

In the following sections of our website you will find materials that will help you explore these questions and other aspects of American health culture in the 1930s,1940s and 1950s. Please feel free to indulge your own curiosity, but be aware that we have focused our attention on the following questions: