itself successful and four similar centers were o-
pened the following year.
In 1917, District Health Officers were ap-
pointed on a full-time basis and, in 1918, three
more health districts were planned for Brook-
lyn (3). However, growing opposition from the
New York Academy of Medicine and other medi-
cal societies halted further progress and by 1918
the newly-created District Health Administration
within the Department had already vanished.
The health center movement was catching on
nationally, however. C.E.A. Winslow noted in
1919 that "the most striking and typical de-
velopment of the public health movement of the
present day is the health center." A 1919 Red
Cross survey revealed 72 health centers in 49
American communities, with 33 more planned,
most under public control. By 1930, a White
House conference had obtained data from 1,511
major and minor health centers in the United
States (4).
In 1929, a plan for the consolidation of district
administration was developed under Health Com-
missioner Shirley W. Wynne. The plan proposed
30 districts throughout the City, each with a
health center serving as headquarters for both
the field activities of the Department and private
health and welfare agencies. Impressed, Mayor
James J. Walker appropriated money the fol-
lowing year for the implementation of this plan.
Although this funding was later withdrawn be-
cause of the Depression, a persistent Commissioner
Wynne managed to procure funds to establish sev-
en centers in the City's worst "sore spots." In
1934, Mayor Fiorello LaGuardia endorsed the
district health program, declaring, "We are going
to have other health centers all over the city be-
cause the people have a right to be healthy."
In spite of such support, the seven function-
ing districts found themselves continuously em-
broiled in conflict. Within the Department con-
flict existed between the Department's special-
ized services, centrally-based in Bureaus, and the
more general, community-based District services.
External attacks were also frequent as the District
services seemed to represent the most clearcut
challenge to those in private medical practice.
Thus, while the district health system continued
to grow, its progress was constantly stymied by
these built-in conflicts.
Following a 1947 blizzard, in which the dis-
trict health officers were impaired in their ability
to respond to the emergency due to internal con-
flicts over lines of authority, Commissioner
New York City
Department o! Health Firsts
• School nursing service with routine exami-
nation of children (1902-1905).
• Employment of public health nurses by
the Health Department (1902).
• Well baby clinic, associated with the dis-
pensing of free milk (1908).
• Laboratory for making serologic tests for
syphilis and fixation tests for gonorrhea
(1912).
• Venereal disease clinics (1913).
• Bureau of Health Education (1914).
• Dental clinics in public schools but under
control of Health Department (1921).
• Nutrition education service (1932).
• Cardiac consultation clinics (1948).
Mustard made them "responsible for all local-
ized activities of DOH in their districts. . . .which
heretofore were directed by the respective bureaus
in central office, and [gave them the] authority
to make any necessary decisions and allocations
of personnel." This gave the district health of-
ficers the strongest authority that they ever had,
and went a long way toward allowing them to
gain control over activites within the districts
during the following decade (3).
The early 1960s witnessed a shift toward a
new standard of comprehensive care, and the
Department, with the help of federal funding,
set up new programs for geriatrics, pediatrics and
generalized medical care in the districts. Prenatal
and tuberculosis clinics were expanded and were
affiliated with hospitals. Twenty Child Health
Stations, which functioned as satellites of the Dis-
trict Centers, were converted and upgraded to
Pediatric Treatment Centers (providing both sick-
and well-child services). Nationally, the War on
Poverty witnessed legislation creating OEO Neigh-
borhood Health Centers (NHCs), and seven such
NHCs were soon created in New York City.
The Model Cities and Comprehensive Health
Planning programs also facilitated community 9