New York City and the Chronic Disease Movement in Interwar America

Common, costly, and preventable: these traits unite the seemingly disparate diseases cancer, diabetes, obesity, heart disease and stroke—also known as chronic diseases, which now affect one in four adults in the United States. After World War I, the U.S. became the first nation to transform chronic diseases into a major political issue, seeing all communicable diseases as a single problem that required a coordinated social response. The heart of this movement was New York City and particularly its medical community centered in The New York Academy of Medicine led by Ernst Boas. Figures in the public health, social welfare, insurance and hospital administration domain also contributed to New York City’s uniquely activist chronic disease programs, which culminated in the creation in 1941 of the Goldwater Chronic Disease Hospital on Welfare (now Roosevelt) Island and in Montefiore Hospital’s pioneering home-care program. With the election of Franklin Roosevelt as President of the country in 1932, several major New York figures went to Washington and brought the chronic disease problem onto the national stage. This issue served initially as a major justification for the reform of healthcare financing. Although the political campaign for healthcare reform failed, the model of an activist chronic disease strategy spread widely by the 1950s, leading to the Commission for Chronic Disease (1949-1957) which enduringly influenced American healthcare policy during the following decades.