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Health history 

On the occasion of the 100th anniversary of the state Health Department comes Dr. Sam Taggart's book, "The Public's Health: A Narrative History of Health and Disease in Arkansas," published by the Arkansas Times. Taggart will sign books at 3 p.m. Jan. 25 at WordsWorth and from 5 p.m.-6:30 p.m. at Dizzy's.

The book brings to light not just the battle against disease in Arkansas, but battles between monied interests and the common good when it came to health, a parallel in part to today's situation.

In 1879, the Arkansas Medical Society tried to get the legislature to create a State Board of Health, but was unsuccessful. The governor, who declined to recognize an unofficial board created by the medical society, changed his mind after an outbreak of yellow fever in Memphis. Still, he made no dollars available. One of the reasons the legislature and the governor resisted the idea of a board of health was suspicion of "university-trained doctors," Taggart writes. It was not until 1881 that the legislature saw the wisdom of creating a state board to monitor disease, sanitary conditions and gather vital statistics.

There's nothing so persuasive as actual experience. Sen. Kie Oldham of Pulaski County, who was suffering from tuberculosis, was the father of the Arkansas Tuberculosis Sanatorium, which opened in Booneville in 1910 and operated for 62 years. In the first 40 years of operation, there was always a waiting list. Oldham died of TB in 1911. Arkansas's black population had no sanatorium until 1931; it was Dr. George Ish, the prominent Little Rock black physician, who "almost singlehandedly lobbied" to get the state to create the McRae TB Sanatorium in Alexander.

In the early years of the 20th century, one in five people in Arkansas suffered from hookworm, thanks to going barefoot and the lack of outhouses to contain waste. The John D. Rockefeller Foundation had money to give to eradicate hookworm, but didn't want to dole it out to a state board that was unfunded. Oddly, it was doctors who fought efforts to fund the state board because, as Taggart writes, "A common refrain on the part of the medical community was that the prevention of disease reduced the patient load of the physician."

The book details Arkansas's struggles with smallpox and diphtheria, citing the work of Ruby Odenbaugh Kinard, who traveled by buggy and horseback through Stone County to spread the word that folks should get immunized to smallpox and typhus. "She decided early on the only liquid she could drink in the homes was coffee because it was boiled and did not provide a typhoid risk." Dr. J.T. Herron, doing induction physicals in Helena at the beginning of World War II, discovered syphilis in 52 percent of the men who wanted to be soldiers. Herron went on to administer the federally-funded Emergency Maternal and Infant Care program in Little Rock. Again, there were Arkansas doctors more concerned with money than patients: Taggart writes, "The notes of the Board of Health meetings and the various reports of the more conservative members of the Arkansas Medical Society indicate that the doctors had concerns that this attempt to provide services for the poor [pregnant women] would broaden and interfere with their practice of medicine — taking away potentially paying patients. Infant mortality in Arkansas was high, especially among black babies — which was one reason the medical society ignored the problem, Taggart reports. In the late 1930s, state board pediatrician Dr. Francis Rothert named a black Tuskegee-trained nurse, Mamie Hale, to work with black midwives on sterile methods (Rothert said that one country doctor told her that he always washed his hands after delivery). Mortality was reduced, but by 1954, black mothers and children were still three times more likely than whites to have complications.

Taggart's 21st century reflections address the continuing struggles of the Arkansas Health Department to provide health care to rural areas. He believes the department will, with its upgraded trauma system, community health centers, telemedicine and the like, improve health in areas with scant access to medical care. "It is also highly probable," he writes, "before they have time to congratulate themselves another equally dreadful and dramatic problem will present itself."

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