| This dissertation is a study of the impact of political considerations on public health efforts in Chicago to control epidemic diseases. Often, political considerations have a negative impact on public health outcomes, but not always. The study focuses on the municipal institutions managing these epidemics, with particular attention paid to efforts to control the influenza epidemic of 1918, the various political pressures placed upon those institutions in the city of Chicago, and the effort after 1918 to attempt to restrict the growing authority of the Health Commissioner to shape and direct public health policy in the city.;Chicago suffered from recurrent epidemics of cholera and smallpox in the nineteenth century. The effort to control these epidemics led to the establishment of a professional Department of Health with a sizeable bureaucracy and budget. The growth of the Department led various politicians in the city to attempt to assert control over the Department's budget for use as political patronage. Conflict between the Commissioners of Health and city politicians and other elites hampered efforts to improve the public health of the city's residents. Then in 1918, when the influenza epidemic of that year reached Chicago, Health Commissioner John Dill Robertson pursued a policy of cooperation with the various political, business and religious leaders in the community. This cooperation resulted in a lower mortality rate from influenza than many cities, such as Philadelphia, experienced in 1918. Still, the growth of the Commissioner's authority and prestige provoked a backlash.;In the 1920s the courts ruled the Health Commissioner exceeded his authority and compelled a reorganization of the Department of Health, which subsequently shut down in 1930-1931. The City Council reorganized the Department, establishing a Board of Health to determine public health policy and not a Commissioner of Health. However, the newly established President of the Board of Health, by following a policy of cooperation with various interests, came to dominate public health decision-making in Chicago just as the Commissioner of Health had. This study suggests the best public health outcomes result from efforts by public health officials to cooperate with rather than combat political interests. |
