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History of the Johns Hopkins Medical Institutions in East Baltimore

1930's    |    1940's    |    1950's    |    1960's    |    1970's    |    Lessons Learned    |    References

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1930's

1932: The Baltimore City Health Department and the School of Hygiene and Public Health established the Eastern Health District, a one-square-mile model research and training area in the neighborhood surrounding the Hopkins medical campus. The EHD hosted clinics for mental hygiene, prenatal care, and screening for syphilis and tuberculosis, as well as research projects on infant nutrition, diphtheria prevalence, and other issues. These activities significantly involved medical school faculty and provided clinical training to both Hygiene students and Johns Hopkins Hospital residents and graduate nurses. By the mid-1950s, Hygiene faculty had published dozens of articles based on their research in the EHD.

1938: Baltimore City Health Commissioner Huntington Williams and SHPH faculty J. Earle Moore and Allen Freeman convinced the city government to allocate $125,000 for a syphilis control program in Baltimore, including a syphilis clinic in the Eastern Health District, which Parran hoped might become a model for other cities. According to the School of Hygiene VD control training program’s director, Thomas Turner, “the set-up to which we have access here will be one of the most favorable places in the world to study syphilis.”

1940's

Journalist and critic H.L. Mencken watched with horror as his native city of Baltimore was “inundated with several waves of low-grade immigrants, all American-born.” The Depression had brought “a rush of negro yokels from Virginia, the Carolinas and beyond,” soon joined by “anthropoid mountain whites from Appalachia” all of whom overtaxed the facilities of Johns Hopkins Hospital and dragged down the living standards of black Baltimorans who had resided in the city before the “influx of shiftless and unclean barbarians from the Southern swamps.” In his history of the Johns Hopkins medical institutions, Thomas Turner observed that “the Eastern Health District reflected the growing social instability of large urban centers, and the high hopes entertained that this district would become a teaching area for the School of Hygiene, somewhat analogous to The Johns Hopkins Hospital for the School of Medicine, foundered on the shifting sands of its mobile population." The wartime draft and defense industry jobs caused substantial outmigration from the district, which largely invalidated the School of Hygiene’s baseline population data that had been laboriously and expensively collected during the decade before the war.

In cooperation with Health Commissioner Huntington Williams and the Baltimore City Health Department, industrial hygiene expert Anna M. Baetjer evaluated the home environments of Baltimore children diagnosed with lead poisoning.

1944: The BCHD opens the Somerset Health Center at the corner of Orleans and Central avenues. It was an all-black health center that also served as a training site for black BCHD employees and white SHPH students.

After the war, Hygiene faculty played critical roles in establishing Maryland’s indigent medical care program. In conjunction with the state Committee on Medical Care, SHPH Dean Lowell Reed chaired the Committee to Study the Medical Care Needs in Baltimore, which recommended the adoption of a comprehensive plan for Baltimore City’s welfare recipients, including preventive, diagnostic, and therapeutic services as well as dentistry, nursing, and rehabilitation. The plan was based in part on the School of Hygiene’s intensive community-based studies of illness and medical care needs among families in the Eastern Health District. The City Health Department established a Medical Care Section in 1947. Reed’s committee also suggested that medical centers be organized in association with existing hospitals to provide home and ambulatory medical care through the integration of hospital outpatient departments and local physician services.

School of Hygiene leaders envisioned a united Johns Hopkins Medical Institutions that could foster expanded access to health services and also pioneer in creating innovative new educational programs. Reed’s committee expressed the hope that Baltimore’s medical centers would work with health department clinics to achieve “a most desirable coordination of medical resources” that “would have a distinct educational value and tend thus to raise the level of medical care for the whole community.” The Rockefeller Foundation likewise foresaw that the new medical care plan would “place Johns Hopkins in the lead of other medical environments in this country in the evolution of new service facilities for its community, especially as the School of Hygiene is more and more taking the leading role in the formulation of plans.”

By the late 1940s, the Johns Hopkins Hospital Outpatient Clinics received about 300,000 visits annually, or nearly 1,000 patients each working day, including 75 patients per day in the 24-hour emergency service. Twenty-five percent of JHH outpatients received free care, two-thirds were eligible for hospitalization at state expense, over 80 percent were city residents, and over 50 percent were African-American. The university and hospital leadership began lobbying the state and local governments to contribute to the rising cost of ambulatory care at Johns Hopkins, which served approximately half the city’s outpatients. In February 1948, the Johns Hopkins Hospital Medical Board approved the hospital’s participation in the Baltimore City Medical Care Program, provided that “it should be entered into as a desirable experiment designed to explore a method of giving comprehensive care to a segment of the population and also to determine accurately the cost of such a program.” The administrators of the Baltimore City Health Department and the Johns Hopkins Hospital and School of Medicine feared that the administrative and financial burdens of providing medical care on a mass basis would overwhelm their core missions.

After the war, federal policy underwrote the construction and mortgage insurance for millions of new homes, as well as for the highways, water and sewer systems, and other infrastructure that promoted suburbanization. Abel Wolman, chair of Sanitary Engineering, emerged during the 1940s as a compelling advocate for modern urban planning and environmental protection, particularly of water resources. His Ecology of Housing course at Hopkins dealt with the “health, social and economic implications” of housing and its relationships to public health and government programs in welfare, enforcement of housing codes, public housing, slum clearance and rehabilitation, and urban planning.

Wolman drew on his experience in managing the state’s conversion to wartime production and subsequent postwar planning to urge the university to broaden its vision of the Hopkins Medical Institutions to encompass the surrounding local neighborhood. With a prescient warning that “Deteriorating environment flanking the whole Center will become increasingly objectionable from the standpoint of student, staff and patient use,” Wolman proposed in 1947 that the university initiate comprehensive planning to rehabilitate the medical campus and its environs bounded by Fayette, Bond, Gay, and Chester streets. He hoped that Hopkins would lead in making East Baltimore a model for city planning in cooperation with the Health Department, the City Planning Commission, the Baltimore Housing Authority, the Redevelopment Commission, the Department of Public Works, and the Department of Public Welfare. The new federal public housing and hospital construction legislation would, Wolman predicted, result in the construction of facilities on “a scope perhaps far beyond our present planning."

1950's

Under Paul Lemkau in Mental Hygiene and Paul Harper in Maternal and Child Health, these divisions did a majority of their research and teaching in the EHD and conducted some of the earliest baseline studies that established the prevalence of mental disorders in a representative population as well as standard benchmarks for child development. Their divisions collaborated closely on studies of prematurity and its effects on growth and development as well as its role in mental and behavioral disorders, using data collected from the Eastern Health District and Johns Hopkins Hospital. This research depended heavily on the work of the EHD’s force of public health nurses, most of whom were assigned from the City Health Department.

Marcia Cooper in the Division of Mental Hygiene directed the Eastern Health District’s Mothers Advisory Service, which brought psychiatrists, public health nurses, and medical social workers together to offer practical childrearing advice and support mothers in improving relationships with their children. The service received referrals from local physicians and all the childcare agencies in Baltimore City as well as many across the state. By the late 1950s, the Mothers Advisory Service was one of the few remaining threads of the school’s relationship with the EHD, and Cooper moved into assisting clinics and social agencies in evaluating children with special needs in placement for foster care and adoption. Cooper’s multi-disciplinary team from the Division of Mental Hygiene, Baltimore City Schools, the School Health Division of the BCHD, and the Johns Hopkins Hospital departments of Child Psychiatry, Neurology, and Otology also helped coordinate the medical and educational needs of children with brain injury or communication handicaps, including screenings for participation in experimental classes.

SHPH faculty from the departments of Epidemiology, Biostatistics, Mental Hygiene, and Maternal and Child Health cooperated with the Eastern Health District, Baltimore Urban Renewal and Housing Agency, and Baltimore City Public Schools to conduct a two-year comparative study of children who live in slums versus those who live in new public housing, published by Daniel M. Wilner, Housing Environment and Family Life: A Longitudinal Study of the Effects of Housing on Morbidity and Mental Health (JHU Press, 1962).

After Harry Chant resigned as director of the EHD in 1948 to direct the Medical Care Clinic at Johns Hopkins Hospital, the position was vacant for years at a time. John Black Grant of the Rockefeller Foundation noted in 1958, “Apparently, the usefulness of the Eastern Health District [to the School of Hygiene] has markedly deteriorated, partly because of [strained] relations with Dr. Huntington Williams, and also because of the mediocre quality of the present director.”

Between 1950 and 1970, suburbanization depopulated the nation’s largest cities and eroded their tax bases, which was particularly pronounced in Baltimore. In 1956, Williams described the Baltimore City Health Department as “crumbling.” A PHS regional medical director identified the changing mission of local health departments “from their traditional role of providing direct services to a relatively small segment of the population to one of acting as a catalyst for all community services that have a health role: i.e., hospitals, physicians, voluntary health agencies,” yet this more expansive responsibility coincided with shrinking resources. The budget of the Eastern Health District was slashed from its 1951 peak of $132,165 (including $15,150 from the School of Hygiene), to $58,100 by 1961. The reduction was even more severe considering that the district had been progressively enlarged from its original square mile to include over 333,000 residents in a 24.2 square mile area by 1957.

1960's

1967: The university considered how best to address urban problems on an institution-wide basis, such an urban studies center to coordinate the current teaching and research on urban affairs in 16 departments across the university. JHU President Lincoln Gordon warned Hygiene faculty of the current critical situation in the neighborhood surrounding the East Baltimore campus, in which "Hopkins must assert greater leadership," and asked, "Is there more Hopkins could be doing in urban affairs through the School of Hygiene and Public Health?"

1968: After riots broke out in East Baltimore following Martin Luther King Jr.’s assassination in April, the Johns Hopkins Medical Institutions created the Health Care Programs Working Committee to evaluate whether it wanted to join the other urban hospitals across the country that were moving to the suburbs.
Robert M. Heyssel told the committee that "In many ways [JHH Ambulatory Care Clinics in East Baltimore were] a Social Action program more than a Medical Program. It is clear that what we do in East Baltimore should be related as far as is possible to what the people in East Baltimore would like to see us do, not what Hopkins believes is best. These statements are based on the experiences others are having in Chicago, New York, and elsewhere.” Heyssel recommended conversations with East Baltimore community leaders to determine community wishes and needs, as well as with local, state, and federal agencies to discuss financing and ensure compatibility with other non-medical approaches.

The Ford Foundation awarded a $500,000 grant to establish the Johns Hopkins Center for Urban Affairs to expand the university's course offerings on urban issues, conduct research, and evaluate existing city government programs and act as a consultant. President Gordon wanted the center to enable Johns Hopkins to "make significant contributions to the improvement of life in urban America." The center was on the East Baltimore campus and directed from 1968 to 1972 by Sol Levine, chair of the Hygiene Department of Behavioral Sciences, which had been established in 1965 to promote social and behavioral science research and training in public health.
During the riots, Gene Feinblatt, assistant to Mayor Thomas D’Alesandro, played a major role in minimizing violence and keeping the city calm. Feinblatt also drafted legislation that created the Baltimore City Urban Renewal and Housing Commission, which he later headed and led the redevelopment of the Inner Harbor and expansion of subsidized housing. Feinblatt joined the Hygiene faculty in Public Health Administration and the staff of the Center, where he and Levine met frequently with community residents and activists to hear their concerns and attempt to devise solutions. Community organizers began to conduct campaigns to raise East Baltimore residents’ awareness of their rights to care under Medicaid and other government programs.

After three years of studies and reports by faculty groups, the Board of Trustees of the University and Hospital approved plans to develop out-of-hospital health care programs and to reorganize the hospital out-patient department, with the goals of improving service to the community and providing educational and research opportunities for the Medical Institutions. The Medical Institutions created an Office of Health Care Programs, directed by Robert Heyssel with a black assistant director, to improve the delivery of medical care to East Baltimore residents. Its two main initiatives were the East Baltimore Medical Plan, a prepaid comprehensive health care program, and the East Baltimore Health Center.

At the same time, JHMI established another prepaid comprehensive health plan in the mostly white planned community of Columbia, Maryland. From the beginning, the Columbia plan represented competition for the East Baltimore programs, which were considered less suitable for teaching primary care to medical students and residents, and also represented a substantial financial drain during a time when the university’s budget was hard-hit by inflation and federal grants began to decline.

1969: On July 1, 1969, the Maryland state departments of health and mental hygiene were combined into a single cabinet-level agency. The state's often-criticized and financially troubled Medicaid program was transferred from the state Health Department to an office directly below the state Secretary of Health. Neil Solomon was named Secretary of Health, and Matthew Tayback was named Assistant Secretary in charge of planning and improving state indigent care programs and upgrading the quality of care in Medicaid and services for the mentally disabled. Tayback had chaired Mayor D'Alesandro's task force to alleviate hunger and malnutrition in inner city schools. Solomon and Tayback were both Hygiene faculty members.

The Commonwealth Fund, Carnegie Foundation, and Rockefeller Foundations provided $800,000 over three years to support the Office of Health Care Programs, "which will coordinate and lead an institution-wide commitment at Johns Hopkins to help improve the nation's systems and arrangements for providing medical services and care." The Office was touted as “a new chapter in the University's leadership in medical education” that would fulfill the medical school’s “promise that health care will emerge at Johns Hopkins as a field of study comparable in importance and quality to the School's distinguished work in the biomedical and clinical sciences.” The philanthropies expected their investment in the Office of Health Care Programs to “have a profound influence on the advancement of all of medical education, and on the improvement of the organization and delivery of health care in communities across the country."

JHU president Lincoln Gordon stated that the university’s leadership had viewed the Office of Health Care Programs “not merely as a new kind of service opportunity with considerable merit as such, but also and mainly as an innovative educational, research, and operational program with strong potential for application beyond Baltimore and Columbia. Dr. Heyssel has provided very effective leadership, and the cooperative spirit developed among the School of Medicine, the School of Hygiene and Public Health, and the Hospital has been exemplary."

The Eastside Development Corporation was formed in late 1969 to promote community development and economic investment, and proposed a new housing development surrounding the Hopkins community clinic.

The East Baltimore prepaid group practice program, directed by Torrey C. Brown, was financed through Medicare, Medicaid, and the State of Maryland. Ten different government agencies were involved, "all with different guidelines, administrative rules, etc.-a herculean task." The federal agencies were Medicare (Social Security Administration), Medicaid (with the state departments of health and welfare and Baltimore City Department of Welfare), Children's Bureau, Office of Economic Opportunity, PHS Bureau of Comprehensive Health Services, the National Center for Research and Development, HUD Model Cities, and the Baltimore City Health Department. A non-profit corporation, the East Baltimore Community Corporation, was developed by community representatives in order to provide guidance in designing and implementing the East Baltimore health plan.

Area physicians were "to the right of the AMA on the question of prepayment and group practice, and [they] have given us considerable difficulty and are continuing to do so." Treatment programs for drug abuse (with a staff of 25 headed by Leon Wurmser) and alcoholism (run by Torrey Brown and Anthony Redding) had also been started in East Baltimore. The alcoholism program had been more successful (measured by reduction of JHH and state hospital bed use) than the drug addiction program, which was inadequately funded by grants from NIMH, the Justice Department, and two state and two other federal grants. "Drug abuse really is the epidemic of the late 1960s and is something that we, as medical institutions, really should deal with and give priority to very much like those that we give to the control of heart disease or other illnesses."

To spearhead the research aspects of the community health programs, Malcolm Peterson began as director of the Health Services Research and Development Center on July 1, 1969. Kerr White, chair of the Hygiene Department of Medical Care and Hospitals, chaired the advisory board, with representatives from the medical institutions. The HSRDC was involved in developing the East Baltimore program and the record and information systems for the Columbia program. Clifton Gaus, a hospital administrator and SHPH doctoral candidate, was assistant to the director for program development.

1970's

Affirmative Action

1970: Baltimore City's population was 44 percent black. Blacks on the Johns Hopkins faculty represented only 0.2% of 527 in the medical school, 0.7% of 537 at Homewood, and 1.4% of 211 in the School of Hygiene. Black employees at the School of Hygiene included 12% of technicians, 18% of office/clerical staff, 19% of craftsmen, all 5 laborers, and 60 percent of 70 service workers. None of 14 managers were black. During early 1970, 45 percent of job applicants for positions in the schools of medicine and public health were minorities.

Civil rights legislation required all federal employers, including universities, to develop affirmative action plans that demonstrated nondiscrimination in hiring and to initiate training programs for employees to improve their job skills. Eligibility for federal grants and contracts depended on having an approved Affirmative Action plan. The U.S. Department of Health, Education and Welfare rejected the JHU Affirmative Action Program submitted in March 1970, resulting in a temporary withholding of federal funds from the university until a revised program was submitted in June.

JHU responded with a revised affirmative action plan, including a University Center for Urban Affairs to assist in solving the city's problems of poverty and racism and implementing its affirmative action program.

"The Johns Hopkins University has historically and uninterruptedly concerned itself with providing medical care for the indigent--which in the Baltimore environment has meant assistance to the black resident--and been involved in depth in the solution of the social and economic problems of the community. More recently it has made major efforts to understand and relieve the circumstances of disadvantaged youth."

The School of Hygiene established a committee on minority student recruitment.

1971: The School of Hygiene established a permanent affirmative action committee.

HEW disapproved Hopkins' plan twice before the third version was approved, which set specific goals for employment of women and minorities.
John Hume, dean of the School of Hygiene: "For many reasons, there is 'under representation' of women and minority groups on our faculty. It is vital to the university that [the School of Hygiene submits] an acceptable progress report [to HEW by June 12]. If the report is not accepted, it means that no Federal Grants and Contracts can be received by the University. Both the University of Michigan and Harvard University had their reports disapproved and for a period of approximately two months in each instance, did not receive any grants or contracts. Since our demonstrable progress has been minimal during the past year, we are eager to have as much evidence of interest and concern available for inclusion in the report as may be possible."

Substance abuse treatment programs

Baltimore City representatives called for the state health department to expand its heroin treatment efforts, and Tayback asked for an additional $3.3 million for its Drug Abuse Authority to support methadone maintenance and other treatment programs rather than education or counseling. About 1,000 of Baltimore's estimated 12,000 heroin addicts received treatment under Drug Abuse Authority programs, and the additional funding raised the figure to 3,000.

1972: Steven Muller, the new president of Johns Hopkins, also became president of Johns Hopkins Hospital after the former president retired. Muller acted to rename the Urban Health Center as the Center for Metropolitan Planning and Research and transfer it from the School of Hygiene to the Homewood campus. Its director, Sol Levine, left for Boston University and the center became focused on international urban planning issues, with most of its fellows coming from Western Europe.

1973: The School of Hygiene Advisory Board adopted a formal affirmative action policy.

1974: In January 1974, Barbara Starfield, chair of the SHPH Affirmative Action Committee, sent a letter to department chairs and chairs of active search committees requesting what specific actions their departments had taken to implement the school's affirmative action policy.

Roger M. Herriott, chair of Biochemistry, to John C. Hume Jan. 14, 1974
"I probably would take a conservative approach which is not to say--unsympathetic. From my knowledge and experience the School has shown the highest regard for women. Long before affirmative action we had female Professors and acting heads of departments. I believe we have not appointed one head of a department because we haven't seen one as good as the male candidates. We do not have to take a back seat on this issue yet I don't feel we should be belligerent about it."

Carl Taylor, chair of International Health to John Hume Feb. 1, 1974
"The policy adopted by the Board required little change in the recruitment methods of this department. Many years of performing research in the developing countries of Asia, Africa and Latin America, in close collaboration with the nationals of these countries, have long since made recruitment on 'affirmative action' basis a natural, fundamental part of all the department's activities. Thus, it is perhaps not surprising that the first black faculty member in the University to be elevated to the rank of professor was on the faculty of this department (Al Haynes), or that a substantial proportion of the department's employees have always been drawn from various minority groups. This approach will, of course, continue; we can offer the results of our many research projects as a demonstration of the positive benefits that can be obtained when individuals from diverse cultural and racial backgrounds work closely together toward common goals."

Most chairs’ responses emphasized progress toward hiring women but either admitted little success in hiring minorities despite sincere efforts or simply did not mention minorities. Taylor failed to mention sex as an affirmative action category. The Hopkins Population Center Survey Research Unit hired 29 part-time interviewers for a survey in East Baltimore, 59% of whom were black.

"The Johns Hopkins University Affirmative Action Program Fifth Annual Status Report" Affirmative Action included veterans, mentally and physically handicapped persons, racial minorities, women, and members of religious groups, and applied to students, faculty, and professional and support staff. "An increasing number of minority group individuals and women external to the University are invited to participate in University programs. The University seeks good community relations with all race/ethnic components of the Baltimore metropolitan communities. . . . At the Health Divisions, the 'Eastbo Fair' [begun in 1973] is also an important community relations program. The 'Eastbo' is a joint effort of East Baltimore merchants, community members, and the Office of Community Relations of the Health Divisions to present a variety of activities and entertainment for the Hopkins and East Baltimore community. . . . The 1974 'Eastbo' was dedicated to Billie Holliday," who grew up in East Baltimore.

1975: In the wake of Congressional hearings and public outcry following revelations that the U.S. Public Health Service had conducted a 40-year study of untreated syphilis in over 400 black men in Macon County, Alabama, stricter federal regulations concerning human subjects in research went into effect July 1, 1975. An SHPH committee reviewed all research proposals involving risk to human subjects to determine risks and benefits to the individuals and society; insure informed consent; and protect confidentiality of personal information.

Edgar E. Roulhac, an African American SHPH student and member of the Minority Recruitment Committee, led the student committee charged with surveying student attitudes toward "an organized learning experience designed to enhance and facilitate all health professionals' understanding of problems and issues unique to the delivery of health care to minorities and the disadvantaged." Among write-in responses were that the course should be developed in conjunction with a Division of Minority Affairs in Public Health, and should be "supplemented with field experience in agencies delivering care to minority populations." One respondent suggested that the topic should be "treated as any other important and significant area of public health without racial overtones." Other comments included the observation that disadvantaged groups were the primary recipients of medical care and public health services and therefore "the problems of administering health care to these groups should be seriously considered. It is about time that ivory tower medical care came down to the 'grass roots' problems faced by most of the world's population, be it India, Pakistan, or Appalacia [sic] USA." Another student disagreed, stating that "The problems of care delivery to minority groups should never be taught separately but only embraced within courses that consider the totality of care delivery to the public." One respondent charged that "There are definitely problems within the school (students, faculty, administration) in terms of knowledge of attitudes and behavior of minorities," and emphasized that "a course that is well-coordinated with outside speakers and interdepartmental input would be attractive to prospective students and enrolled students."

From 1978 to 1985, Roulhac was a School of Hygiene faculty member and dean of student affairs. He became JHU Vice Provost in 1985.

Lessons from the experience of JHMI in East Baltimore

  1. The most productive periods of research and teaching in community health were during the 1930s-early 1950s and the late 1960s-70s, when there was a favorable social and political context for reform and innovation along with relatively ample funding (from the Rockefeller Foundation and Social Security Act during the New Deal/World War II and from the Great Society during the 1960s-70s). Both these periods saw simultaneous increases in federal funding for both research and training programs, which fostered the integration of research and teaching objectives in community health.
  2. Committed leadership for extended time periods is essential for the success of university-community partnerships. The support of Health Commissioner Huntington Williams, U.S. Surgeon General Thomas Parran, the Rockefeller Foundation International Health Division, and SHPH deans Lowell Reed and Ernest Stebbins was essential to the success of the Eastern Health District. In the 1960s, JHU President Lincoln Gordon was committed to the success of the Urban Center in East Baltimore and was an ally of the School of Hygiene. The goal of improving the quality and availability of health services in East Baltimore was seriously undermined by the 1972 departure of Gordon and Urban Center director Sol Levine. President Steven Muller and the new center director, Jack Fisher, had different agendas that did not include East Baltimore.
  3. In the 1940s and again in the late 1960s, JHMI used its indigent care programs in East Baltimore to support successful appeals for large philanthropic and government grants. In each instance, the medical school, school of public health, and Johns Hopkins Hospital claimed to be innovators in the delivery and organization of health services and to be leading the way in state-of-the-art research and training programs, all of which were supposed to be developed as models to guide the rest of the country but achieved less than promised results.
  4. The most lasting changes brought about by JHMI’s relationship with East Baltimore have been a commitment to increasing race and gender diversity among students, faculty and staff; and successful research and treatment programs in health behavioral interventions such as those in substance abuse and sexually transmitted diseases (such as the ALIVE study of HIV-positive IV drug users). JHMI has been less successful in maintaining a commitment to providing affordable primary health care to the community or in integrating the goals of community outreach with its longstanding commitment to training elite medical and public health researchers. The need to find successful clinical and field training sites for students in its core medical and public health degree programs (the M.P.H. and M.D.) has required JHMI to look beyond East Baltimore to find sites with sufficient patient diversity in health conditions and socioeconomic status.

References

  1. Fee, Disease and Discovery, 179, 184-214; "Report on the Eastern Health District to the IHD,” 1941, 1942, 1943, 3a O. D. Corres., box 502037, “Rockefeller Foundation” folder, AMC.
  2. Thomas Parran to Wilbur A. Sawyer Jan. 22, 1938, John A. Ferrell to Thomas B. Turner Feb. 2, 1938, Turner to Ferrell Feb. 4, 1938, Parran to Ferrell Feb. 15, 1938, folder 319.
  3. qtd. in Keith Wailoo, How Cancer Crossed the Color Line, 42-43.
  4. Turner, Heritage of Excellence, 368.
  5. Fee, Disease and Discovery, 212; Committee on Medical Care, Maryland State Planning Commission, Administering Health Services in Maryland, 76-77; Grant Action Form, Mar. 22, 1948, "Johns Hopkins University-School of Hygiene and Public Health-Request to Foundation for Further Support," p. 14.
  6. MPDC Minutes, Mar. 9 and Apr. 7, 1948; "The Effect Upon the Teaching Program of the School of Medicine of a Reduction in the Patient Load of the Out-Patient Department of the Hospital”; MPDC, "A Report on the Johns Hopkins Medical Institutions," 22-25; Committee on Medical Care, Maryland State Planning Commission, Administering Health Services in Maryland, 66.
  7. Medical Planning and Development Committee, Reference Book No. 1, 1947-1952, Item No. 12, “Report of the Committee on the Indigent Medical Care Program, Johns Hopkins Hospital Medical Board,” Feb. 16, 1948; “1947-48 Report of the President,” JHU Circular 67 (1948), 103; MPDC Minutes, Feb. 27, 1948.
  8. Kenneth T. Jackson, Crabgrass Frontier: The Suburbanization of the United States (Oxford University Press, 1985), 232-33, 293; Martin V. Melosi, The Sanitary City: Urban Infrastructure in America from Colonial Times to the Present (Johns Hopkins University Press, 2000), 224-30, 293-94; 1944-45 SHPH Catalog, 39.
  9. Abel Wolman to Lowell J. Reed Mar. 17, 1947, MPDC Reference Book No. 1, box 507841.
  10. Elizabeth Fee, “Mental Hygiene and the Community,” unpublished MS, AMC; "Report on the Eastern Health District to the IHD 1943," 3a O. D. Corres., box 502037, “Rockefeller Foundation” folder, AMC; “1956-57 Report of the SHPH Director,” JHU Circular 76 (Nov. 1957), 143.
  11. Fee, Disease and Discovery, 201-04, 218; “1956-57 Report of the SHPH Director,” JHU Circular 76 (Nov. 1957), 143.
  12. 1953-54 Report of the Director of the SHPH, JHU Circular 73 (Nov. 1954), 93.
  13. 1947-48 Report of the Dean of the SHPH, JHU Circular LXII (Nov. 1948), 103; SHPH Advisory Board Minutes, June 8, 1951, p. 563; John Black Grant diary Mar. 29-Apr. 1, 1958, box 187, folder 2237 "200 L Johns Hopkins University-School of Hygiene and Public Health 1958-61,” RFA.
  14. Kenneth T. Jackson, Crabgrass Frontier: The Suburbanization of the United States (Oxford University Press, 1985), 283-85; “Dr. Williams Quizzed on Health Dept.” Baltimore Sun Dec. 6, 1956; SHPH 1951-52 Budget; Baltimore City Health Department, Guarding the Health of Baltimore (1961), 13; 1957-58 SHPH Catalog, 35.
  15. William Bevan to Lincoln Gordon Oct. 25, 1967, Records of the Office of the JHU President, series 9, box 33, "Hygiene-Faculty Coffee 1967" folder.
  16. Robert M. Heyssel to Health Care Programs Working Committee, Medical Planning and Development Committee, Chiefs of Clinical Service, May 22, 1968 memo re: Health Care Programs Working Committee, Records of the Office of the JHU President, series 9, box 30, "Health Care Programs 1968-69" folder; Science 160 (April 19, 1968), 290.
  17. Lincoln Gordon, David E. Rogers, Russell A. Nelson, and John C. Hume, Dec. 6, 1968 memo to Faculty of the School of Medicine and School of Hygiene and Public Health and Staff of Hospital, "Health Care Programs 1968-69" folder.
  18. "Tayback to Head Aid Programs On Health For Poor," Baltimore Sun June 26, 1969; Frederick P. McGehan, "Health Units Due Changes," Baltimore Sun June 30, 1969.
  19. David E. Rogers, "The Development of Community Based Health Care Programs by the Johns Hopkins Medical Institutions: A Proposal to the Commonwealth Fund, the Rockefeller Foundation, and the Carnegie Corporation of New York," July 2, 1969, Quigg Newton to Lincoln Gordon Nov. 14, 1969, Florence Anderson to Gordon Nov. 19, 1969, Gordon to Newton Dec. 8, 1969, J. Kellum Smith, Jr. to Gordon Dec. 10, 1969, "Health Care Programs 1969-71" folder.
  20. Robert M. Heyssel, "Office of Health Care Programs Progress Report January 1969-December 1969," Dec. 4, 1969, "Health Care Programs 1969-71" folder.
  21. "Additions to the Affirmative Action Program of the Johns Hopkins University" Mar. 23, 1970, RG2, Records of the Office of the JHU President, series 9 (presidency of Lincoln Gordon, 1967-1971), box 2, "Affirmative Action Program 1970" folder.
  22. Arnold R. Isaacs, "Health Unit Asks Extra $3 Million for Drug Budget," Baltimore Sun Feb. 17, 1971.
  23. "The Johns Hopkins University Affirmative Action Program Fifth Annual Status Report," Aug. 15, 1974, 3a D.O. Correspondence, box R111F4 (old box 3), "1975/76 University Affirmative Action Comm." folder
  24. Edgar E. Roulhac, "Report of Results: Student Opinions and Viewpoints" May 1975, 3a D.O. Correspondence, box R111F2 (old box 1b), "Report of Results--Minority Recruitment Committee" folder.
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