One Hundred Years of Health: Changing Expectations for Aging Well in 20th Century America

Cara Fallon is a Ph.D. candidate in Harvard University's Department of the History of Science. In 2014-2015, she was a Research Fellow of the Consortium. Here is a report on her project, “One Hundred Years of Health: Changing Expectations for Aging Well in 20th Century America.” The aim of my dissertation is to examine the ways aging challenged medical and social concepts of health in twentieth century America. While the effects of human longevity have long been debated, in the early twentieth century, aging and the potentially disabling effects of chronic disease became an increasingly acute concern in medical and public health circles. Emerging fields of geriatrics and gerontology sought to define the problems of aging while medical specialties such as cardiology, endocrinology, orthopedics and physical rehabilitation began to reorient their practices around chronic diseases. Medical specialists took on the problems of old age with new vigor, while growing concerns with physical deterioration influenced a range of fields from the consumer market to social welfare. My research at the Consortium has allowed me to examine the diverse perspectives of gerontologists, nurses, and life insurers and to reshape my project around particular issues of function, mobility, and gender in aging. Because of the diversity of perspectives involved in my project, I spent time gathering material from four different archives: the American Philosophical Society, the Hagley Museum and Library, the Barbara Bates Center for Nursing, and the College of Physicians of Philadelphia. At the American Philosophical Society, I explored the papers of Ernst P. Boas, a physician, national insurance advocate, and engaging writer on the issues of old age. Boas’s writings on arteriosclerosis and cholesterol, at the time considered part of the aging process, were particularly illuminating. I supplemented Boas’s medical perspective with a consideration of furniture for older people by anthropologist Ashley Montagu. This unique perspective allowed me to investigate the connections between aging and the material goods of everyday life. A research trip to the picturesque Hagley Museum and Library provided time to explore the extensive collection of Provident Mutual Life Insurance Company papers. I focused on the discussions of Old Age Security, risk of accidents to the elderly, and predictions of lifespan. While at Hagley, conversations with the archivists brought me to the work of Thomas Lamb and Marc Harrison on universal design, which I explored through the lens of aging. I completed this trip by examining trade catalogs of wheelchairs, canes, and crutches. Working with these archives also offered the opportunity to discover a particularly important case study for my research – falls in the elderly. While examining the papers at Hagley and the Barbara Bates Center for Nursing, I realized a critical issue in aging was the problem of falls in elderly patients. Falls were a persistent dilemma in medicine and public health, whether framed as home accidents or biochemical decline. At the College of Physicians of Philadelphia, I examined guides such as Home Accident Prevention: A Guide for Local Health Workers (Public Health Service, 1953), Is your home safe for you?, and the Home Nurse’s Handbook to Practical Nursing (1931), among others. I completed my research with the papers of gerontological nurses held by the Barbara Bates Center for the History of Nursing at the University of Pennsylvania. Often, what we know about the meanings of aging comes from medical writings, but the nurses offered insight into the daily realities of long lives, chronic disease, and gaps in medical care. Bringing this in dialogue with the medical writings from my earlier research allowed me to develop my chapter on falls as an important health problem of aging in the twentieth century. My research with the Consortium allowed me to ask new questions about the connections between social context and biomedical models of aging as well as the rising prominence of medical specialties that co-produced the problems of old age. It offered the time to explore a new aspect of my project and a vibrant intellectual community to further develop these ideas. The research I conducted through the fellowship provided critical support for my dissertation and allowed the flexibility and space to explore new and challenging aspects of my project. I am sincerely grateful for the support, insights, and camaraderie of the Consortium for the History of Science, Technology and Medicine, Babak Ashrafi, Phillip Honenberger, the archivists, librarians, and all of the dissertation research and writing fellows.