PUBLIC HEALTH ADVISORY CONCERNING FENTANYL AND FENTANYL-LACED SUBSTANCES

Health Department History 1926 - 1960

1926: Rutherford County becomes the first county in the state to have a Blue Ribbon program to “for the use of parents, teachers and health workers as a means of arousing in children a normal understanding and interest in their health.”  Children were eligible to receive a Blue Ribbon award for making satisfactory in studies; being amenable to the ordinary requirements of school discipline; being reasonably cooperative in the practice of health habits; and being free of remediable physical defects and meeting certain immunity standards.  Also in 1926:

  • The central state laboratory in Nashville began the manufacture of sliver nitrate ampules for distribution to physicians and midwives of the state, to be used in the prevention of opthalmia neonatorum.
  • The Tennessee Public Health Association has its beginning as a Conference of Public Health Workers.  (It was officially chartered Oct. 14, 1939.)

1927: A milk sanitarian was added to the staff of the Tennessee Department of Health.  At the time, 48.3 percent of milk was pasteurized (it rose to 74.6 percent in 1937).

1927:  Between 1927 and 1937, a total of 65,895 approved privies were constructed, many by Works Progress Administration (WPA) workers.

1927: There were 83 nurses employed by local health departments.   By 1952, the number would rise to 231.  Also in 1927: The divisions of the State Department of Public Health included the following:  Administration, Vital Statistics, Epidemiology, Tuberculosis Control, Child Hygiene and Public Health Nursing, Sanitary Engineering, Health Education, Laboratories and Local Organization.  

1928:  Tennessee has 23 full time county health departments.

1929: Crippled Children’s Services organized under the State Department of Institutions, until being placed under the supervision of the Department of Health by the Reorganization Act of 1937. 

1930: A portable x-ray machine was purchased (in April) and an x-ray technician employed by the department to assist with the identification of tuberculosis . 

1933: The first death in Tennessee from Rocky Mountain spotted fever occurs.  November 23, the State Superintendent of Education instructed every county superintendent of education to develop a county wide sanitary privy construction program at schools, “these privies to be approved by the State Department of Public Health.” 

1934:  Between 1934 and 1935, Department of Health state laboratories examined 2,506 animal heads for rabies.  In 1934 there were 38 full-time county health departments in Tennessee.  Also that year, federal Civil Works Administration employees were charged with projects to assist with the eradication of malaria-carrying mosquitos. By the end of the year, there was a reduction in the number of cases of malaria compared with the previous year – 4,382 cases vs. 3,431 cases.

1935: Tennessee State Health Department moves all central staff into newly remodeled building at 420 6th Avenue North in Nashville – the first real home for the department. 

That same year, the Department of Health was again reorganized by act of the State Legislature, creating a State Board of Health composed of six physicians, a dentist, druggist and a representative of the Tennessee Federation of Women’s Clubs. The board was charged with powers and duties formerly vested in the Commissioner of Health.  The Commissioner, appointed by the Governor, acted as Secretary to the Board of Health and its Executive Official. The members of the Board included:

Dr. John M. Lee, President, Nashville
Dr. Oren A. Oliver, Vice-President, Nashville
Dr. L.F. Mitchell, Nashville
Dr. E.M. Fuqua, Pulaski
Dr. W.K. Vance, Jr., Bristol
Dr. C.P. Fox, Sr., Greeneville
Dr. J.R. Thompson, Jackson
Mrs. Ferdinand Powell, Johnson City
Dr. J.C. Ayres, Memphis

Also in 1935, Dr. Bishop resigns as Commissioner to become medical director for the Tennessee Valley Authority; he is replaced by Dr. W.C. Williams, who previously served as director of county health work in Williamson County. 

1935: July 1, 1935, through January, 1936, money comes from the Rockefeller Foundation.

1936: Between July 11 and December 26, a total of 370 cases of poliomyelitis reported in west Tennessee.

1936: Between July 11 and December 26, a total of 370 cases of poliomyelitis reported in west Tennessee.

1936: Dental hygiene unit organized in late 1936 to create a general awareness for preventive and corrective dental care in younger age groups and to provide emergency and important dental services to school and preschool children who are unable to pay for these services.

1936: Diphtheria notification slips send out for the first time, featuring greeting cards stating the importance of diphtheria immunizations.

1937: Disastrous floods in late January causes suspension of all routine activities in the central office and in counties adjacent to the Mississippi River, with all efforts direct toward meeting emergency needs.

Midwives, who attend approximately 13 percent of all live births in Tennessee, are brought under the jurisdiction of local health departments.  They are taught to: “take sanitary precautions, to use silver nitrate in the eyes of newborn, to report births, to refrain from making physical examinations and to procure medical aid in any abnormal case.

A program for postgraduate medical instruction in obstetrics was begun in Tennessee Jan. 1, 1937, sponsored and financed by the Tennessee Department of Health, the Tennessee Medical Association, the University of Tennessee Medical School, Vanderbilt University Medical School and the Commonwealth Fund.

Tennessee and North Carolina become first states to have birth control clinics associated with health and welfare services.  Tennessee’s first was in Nashville. 

1938: The first Photostat machine was installed in the Division of Vital Statistics, for the purpose of making certified copies. 

1939: The Tennessee Public Health Association was chartered Oct. 14, 1939, tracing its roots to the Conference of Public Health Workers in 1926.

1939: Tennessee has 56 full time county health departments.

1940: A survey of health departments in 1940 found that 23 were located in courthouses, 26 in rented buildings, six in public buildings and six in their own buildings.  All health departments in Tennessee at the time had at least ten services to render to the community:

  1. Acute communicable disease control
  2. Tuberculosis prevention and control
  3. .Venereal disease control
  4. Maternal hygiene
  5. Infant and preschool health
  6. School hygiene
  7. Sanitation – milk, food, water, etc.
  8. Vital Statistics
  9. Crippled Children’s Services (Crippled was the term used at the time)
  10. Health Education

The first nutritionist was employed by the Tennessee Department of Public Health September, 1940. 

1941: Effective July 1, 1941, a new law went effect requiring brides and grooms to have a pre-marital examination, including blood test for syphilis (the law had been passed in 1939). Many couples skirted the law by going to another state to be married.

That same year, Governor Prentice Cooper signs legislation that creates the first State Tuberculosis Hospital. 

1941: There are 67 full-time county health departments in Tennessee. Largest outbreak of acute poliomyelitis ever in Tennessee: 522 cases in the summer and fall.  That same year, the U.S. Army begins series of maneuvers involving 850,000 soldiers in middle Tennessee. 

1942: Lanham Act makes federal funds available “for quarantine of promiscuous women infected with V.D.”  The first facility was the Knoxville Isolation Hospital in the county workhouse.

That same year, Tennessee was the scene of the first operation of the federal May Act (which approved by President Roosevelt the previous year).  It covered 27 counties and was designed to protect military forces participating in the Second Army maneuvers, along with citizens of the area, from venereal disease.  It provided for fines and/or imprisonment for those engaging in or abetting prostitution.

1943:  101 people died from Whooping cough (compared with 34 in 1942 and 24 in 1944).

1945: Stream Pollution Control Board established by the Tennessee General Assembly to “protect all waters of the state for all reasonable and necessary uses.”

1947:  The 75th General Assembly of Tennessee passed House Bill 234 (Feb. 6, 1947), which provided for a “State Licensing Board for the Health Arts.”  It was signed into law the next day by Governor Jim Nance McCord.  The Board members included the Secretary of State, the State Treasurer and the Commissioner of Public Health (to serve as Executive Officer of the Board).

That same year, the State Board of Education approved rules and regulations (April 18) pertaining to health education services.  It set out: “’Health Education Services’ shall compromise all those procedures designed to determine the health status of the pupil, to enlist his cooperation in health protection and maintenance, to inform parents of the defects that may be present, to correct remediable defects, and to afford the leadership and training of those who carry on these activities.”

1948: U.S. Congress appropriates money for fluoride programs; 23 counties in Tennessee have demonstration projects.

1949: Tennessee General Assembly appropriates funds for a cancer control program, aimed at early detection instead of palliative or terminal care.

1949: First soil studies done to pinpoint source of histoplasmosis in Tennessee.

1950: A total of 7.5 percent of all lives births in Tennessee were premature.

1950: The population of Tennessee reached 3,291,718.

1950: Average monthly salary of nurses in Tennessee is $222.

1950: There were 1,874 cases of Whooping Cough in Tennessee.   

1951:  Tennessee Tuberculosis Hospital in Chattanooga accepts its first patients October 22, 1951. Other TB hospitals built in Tennessee include West  Tennessee Tuberculosis in Memphis (October, 1948), East Tennessee Tuberculosis Hospital and Field Service in Knoxville (January 15, 1951), Middle Tennessee Tuberculosis Hospital in Nashville (1953).   In 1951, the average daily census of all state tuberculosis hospitals was 630. The Learline Reave Sanatorium was the first state-owned tuberculosis hospital in Tennessee. The 32-bed facility in Greeneville closed April 30, 1951; it had been operated by the state since April 1, 1942.

1951: The Tennessee Department of Health creates an Office of Public Health Education; its director was interviewed on WSM TV, believed to be the first television interview involving a TDH employee.

1951:  Tennessee Department of Health authorities are notified a railroad shipment of hides infected with anthrax was coming to west Tennessee. The authorities work with the tannery to oversee processing (soaking in a solution containing sodium bifluoride).

1952: Veterans of overseas combat are believed to be a prime factor for the state’s number of malaria cases: 168.

1953: Anti-rabies law passed.  That same year the State Legislature authorized service titled “Hospital Service for the Indigent.”  It was designed to pay for the cost of hospitalization for those residents of the state who were ill or injured, who could be helped markedly by treatment in a hospital and who were clearly unable to pay.

1953: Tennessee General Assembly creates a hospital service for the indigent program, administered by the Department of Health. 

1955:  There were 6,293 cases of measles in Tennessee.  The Tennessee Department of Public Health moves it central offices from 420 Sixth Avenue North to the new Cordell Hull Building in May. Also in 1955, 643 midwives delivered babies in Tennessee.

1957:  An influenza outbreak occurs in the fall and winter, with 180,164 cases reported and a death rate of 8.7 per 1,000 population.  It is the largest outbreak in Tennessee since 1918.

1958: The Tennessee Department of Health initiates an Accident Prevention Service to gather information on “existing hazards and unsafe practices.”  That year  119 polio cases were reported in the state; of these, 76 were paralytic.

1959: Tennessee becomes the second state in the nation to appropriate state funds for heart disease control.

1960: Tennessee experiences the highest incidence of infectious hepatitis in its history: 2,100 cases.

1960:  A total of 357 residents die from tuberculosis in Tennessee.