Shattuck's sanitary report for Massachusetts

The Massachusetts legislature passed its resolve in May 1849. It allowed the governor to appoint three commissioners to plan a sanitary survey of the state, with $50 for books and a ceiling of $500 on the whole cost. On 3 July Governor George N. Briggs named Lemuel Shattuck of Boston, Nathaniel P. Banks Jr. of Waltham and Jehiel Abbott of Westfield. Shattuck, a former teacher, bookseller and publisher, had come to statistics through genealogy. His efforts lay behind the state's registration of births, marriages and deaths, set up in 1842, and in 1845 he conducted a sanitary survey of Boston. As a legislator he had secured the 1849 resolve himself.

The report was presented on 25 April 1850. Its opening sections traced sanitary laws from Greece and Rome through France, Germany and Britain, then turned to Massachusetts, using the state's own registers. In the four years from 1845 to 1848, for example, the report counted 1,409 deaths from consumption among women aged 20 to 30 in the state and 708 among men of the same age.

The core of the report was 50 recommendations, numbered I to L. The first called for the state's health laws to be rewritten. Others asked for a general board of health of two physicians, a lawyer, a chemist, a civil engineer and two others; a local board in every city and town; a state census every ten years from 1855; complete registration of births, marriages and deaths with a uniform naming of causes of death; periodic vaccination in every town; study of consumption; house-to-house visits against epidemics; control of the smoke nuisance and of adulterated food; public baths and wash-houses; and schools to train women as nurses. The last few asked clergymen to preach on health once a year and families to keep records of their members' health. A draft Act for the Promotion of Public and Personal Health was appended.

The House of Representatives laid the report on the table and ordered 2,000 copies printed. No general board of health followed. Massachusetts created its State Board of Health in 1869, when the governor appointed Henry Ingersoll Bowditch and six others; Bowditch chaired it without pay until 1879. Harvard University Press reprinted the report in 1948, and in its foreword C.-E. A. Winslow called it perhaps the most significant single document in the history of public health.