.|  Baltimore Ecosystem Study
Demographic and Socioeconomic Research Projects
History of Public Health for the City of Baltimore: 1880-1920
  • Christopher Boone, School of Human Evolution & Social Change/School of Sustainability, Arizona State University
  • Sarah Hinman, Leiden University, The Netherlands
The study investigated the state of public health in Baltimore during a period of rapid expansion in the city's history. Similar to other industrializing cities, Baltimore suffered through growing pains as management plans (relying mainly on private provision of services) that worked for early 19th century cities, but no longer sufficed for metropolitan areas at the end of the century. One of the consequences of inadequate infrastructure was worsening public health. Many of the changes we associate with the modern city - comprehensive water and sewerage, water and wastewater treatment, building codes, zoning, city planning, public transportation - are related to a large degree to the need for improved public health. Responses to worsening public health, a factor of environmental and social variables, act as a 'feedback loop,' often resulting in environmental modifications (draining swamps, removing cesspools, regulating densities). Baltimore's changing ecology in the late nineteenth and early twentieth century affected public health, and methods for improving public health affected the city's ecology.
The focus of the study is on patterns of infant mortality. Using death records, the study identifies all deaths that occurred under the age of one and records data included on the death certificates -- name of the deceased, color, sex, age, married or single, occupation, birthplace, date of death, cause of death, when a minor, the name of the father and mother, ward, street and number of house, date of burial. Data from the death records were cross-referenced to the manuscript census data for a more complete picture of household conditions. Infant mortality patterns were mapped to search for spatial correlations with other variables such as soil type, elevation, slope, drainage, proximity to sewerage and clean water. Public responses to infant death patterns were examined, including decisions that affected the ecology of the city. Impacts of a comprehensive sewer construction project beginning in 1906 received particular attention.

Boone, Christopher G. "Obstacles to Infrastructure Provision: The Struggle to Build Comprehensive Sewer Works in Baltimore." Historical Geography (2003) 31: 151-168.
Hinman, Sarah E. “Urbanization and Public Health: A Study of the Spatial Distribution of Infant Mortality in Baltimore, Maryland, 1880.” M.A. Thesis, Department of Geography, Ohio University (May 2002).
Boone, Christopher G. "Public Health and Environmental Conditions in Turn-of-the-Century Baltimore." Paper presentation at the American Society of Environmental History, Durham, NC (March 2001).
"Long Overdue: Explaining Delays in Building Baltimore's Sewers, 1850-1905." Paper presentation at the 5th Annual Meeting of the Baltimore Ecosystem Study, Baltimore, Maryland (October 2002).
"Oysters and Limburger Cheese: The Struggle to Build Sewers in Baltimore." Paper Presentation at Association of American Geographers 99th Annual Meeting, New Orleans, Louisiana (March 2003).
"Politics of Infrastructure Provision in the Most Northerly Southern City: Sewers for Baltimore, 1850-1905." Paper Presentation at the Eastern Historical Geographers Association Annual Meeting, St. Augustine, Florida (February 2003).
"Urban Ecology and Public Health." Invited Colloquium, School of Environment and Natural Resources, University of Vermont (April 2004).
Data and Data Collection
Microfilm copies of death records for Baltimore City (1880, 1890, 1900, 1910, 1920) were obtained from the Maryland State Archives.
“Explaining Health Disparities: Infectious Disease Mortality in Baltimore.” (Mooney p.i; Boone and others co-p.i.). National Institutes of Health. $2,046,463 (2006-2011). (not funded)