Public Services

Keeping the Children Well


Today we take the school nurse for granted. Whenever a child scrapes his knee at recess or becomes ill and needs to go home early, the nurse is there. However, the school nurse and school medical inspections are, in America, largely a creation of the twentieth century. This photo, taken at the Alexander D. Bache School in 1912, is labeled “Medical Inspection Branch.” It dates from the late Progressive Era when the health and welfare of the poor was a matter of growing concern among social workers. For many reformers, efforts aimed toward adults failed to better the situations of poor people, and thus, they shifted their focus away from protecting the health of school children. Progressives believed that they could create a healthier society by maintaining young people’s constitutions and by teaching them proper hygiene.

Municipal officials assigned medical inspectors to schools across the country. In 1898, under the supervision of the city’s Board of Health, medical inspectors began working in Philadelphia schools. They identified and corrected various defects and contagious diseases occurring among the children. The inspectors also strove to maintain healthy conditions, thus protecting the children from illness and injury, and to maximize the efficiency of the schools. Later, the school nurse was introduced to carry out the recommendations of medical inspectors in caring for youths. In Philadelphia, after examinations by the medical inspector, children of disadvantaged families received access to free vaccinations, and other medical, dental, and vision care.


  • Cornell, Walter S. Health and Medical Inspection of School Children. Philadelphia: F.A. Davis Company, 1913. (Full text available online.)
  • Struthers, Lina Rogers. The School Nurse: A Survey of the Duties and Responsibilities of the Nurse in the Maintenance of Health and Physical Perfection and the Prevention of Disease among School Children. New York: G.P. Putnam’s Sons, 1917. (Full text available online.)