Health in Iowa

The term “health care” has meant many different things over the years. At one time in Iowa’s history “bleeding” was a common form of health care. Avoiding “night air” was considered a healthy practice. Some of the techniques used by health care providers may seem frightening. But 100 years from now isn’t it possible that some of the current health care practices may prove to be just as bizarre? Scientific advances have had an incredible effect on health care in Iowa. It’s safe to predict that these changes will continue.

One change that has occurred over the years is that the average life expectancy has increased. In 1900 a person could expect to live about 48 years. Compare this to a child born in 2002—that baby could expect to live about 78 years! In Iowa in 2003 one man lived 108 years and a woman lived 109 years! Let’s take a look at what has happened over the years to make a difference.

The Way It Was

In the 19th century people did not understand what caused disease nor how to treat it. Doctors did the best they could to help heal the sick. But in Iowa in 1850 there were far fewer doctors than there are today. There was only one physician for every 355 people in Iowa. So there were not enough doctors to provide care for all the people who needed it. The territory was so large that doctors had to travel great distances to reach their patients. 

Eventually, scientists discovered that germs caused infections. New medicines and techniques were created to treat illness. By the early 20th century, medicine was changing from the treatment of illness to the prevention of illness. Combined with new health care techniques, drugs and knowledge, preventive health care has contributed to longer life. In the 19th century, one-third of the children in the U.S. did not live to adulthood. In the 1980s, about 98 percent of children lived to adulthood.

Many Health Problems

Pioneers often relied on home remedies to cure disease before they contacted a physician. Fever and ague struck many homes. People could come down with chills and fever one afternoon and die the next day. The symptoms included chills, fever and lack of energy. Doctors were helpless to find a cure.

A less serious, but annoying ailment was called prairie itch. Often the home remedy was a lotion made "from the roots of the skunk-cabbage."

Malaria, cholera, typhoid and smallpox were serious health risks during the 1800s in Iowa. These diseases were often deadly. Scientists knew little about the causes and treatments for these diseases. In the mid-19th century it was believed that these diseases were caused by "bad air." It wasn't until the 1880s that scientists began to understand that germs caused certain diseases. 

In the late 19th and early 20th centuries tuberculosis was common in Iowa. Tuberculosis is a disease that attacks the lungs. In the past treatment for the disease included exposing victims to fresh air—in winter as well as summer. At the Oakdale Sanatorium, a treatment center for tuberculosis patients near Iowa City, patients slept on open-air porches even as snow drifted around their beds. 

In 1918 Iowa was affected by the flu epidemic that swept throughout the world. Officials in Iowa tried to stop the spread of the sometimes deadly disease by closing businesses, schools and churches, but before the worst of the epidemic had passed, about 8,000 Iowans were dead. 

Between the years 1940 and 1952 polio was another disease that caused fear among Iowans. The disease struck children mostly. There was no cure and no way to prevent polio at first. But by 1954 a vaccine was widely used to prevent the disease. 

Medical Training

Before the Civil War (1861-1865), some people practicing medicine were not graduates of medical schools. But many young people studying to be medical doctors read books, attended medical lectures, served as assistants to older physicians and observed operations. 

At the time, most medical students were trained in Europe or in the East. Many doctors came to Iowa with medical degrees from schools in Kentucky or Ohio.

Later more schools opened in the West. The State University of Iowa's medical department opened in its current home in Iowa City in 1870. The medical department existed before the opening of the hospital three years later. It first was called the College of Physicians and Surgeons of the Upper Mississippi in Keokuk in 1849-1850.

Iowa's first doctors were mostly males. A few women were gradually admitted into medical schools and became doctors in the latter part of the 19th century.

Bleeding

Physicians used simple drugs and instruments. In the medicine chests of most 19th century doctors were a stock of basic drugs: castor oil, bark, calomel, Dover's powder and quinine. They also carried unusual instruments. In case of fever, a patient was generally bled. Every physician carried lancets for this purpose. It was believed that bleeding would relieve the body of disease. 

Physicians often advertised their services in newspapers. One doctor's rates in Bloomington (now Muscatine) were:

First visit in town in the daytime  $1. 00
Every succeeding visit  $ .50
Visit in the night time  $1.50
Bleeding  $1.00
Tooth Extracting  $1.00
Attention on a patient all day or night by request $5.00

Not all physicians were strict about collecting their fees. Many doctors received food as payment instead of money.

Modern Health Care

As science and technology have evolved, the variety of health care professionals and services has expanded. Today the world of health care professionals includes, in addition to doctors, nurses, dieticians, dentists, pharmacists and others. Health care professionals must meet strict educational requirements. They study in medical school for years before they become licensed to practice medicine. Health care facilities included birthing centers, mental health centers, hospices, hospitals, nursing homes, residential care facilities and rural health clinics. 

Physicians diagnose illness by asking about a patient's medical history, performing physical examinations and ordering medical tests. Patients are now treated with drugs and surgery. Like mid-19th century doctors, today's doctors also give vaccinations and regular physicals and conduct scientific research.

Few, if any, Iowans die from diseases such as tuberculosis and smallpox today. And there have been no reports of prairie itch for quite some time. But Iowans are suffering from AIDS, E. Coli, hepatitis, mumps, salmonella and tuberculosis. In 2003 the leading causes of death in Iowa were: heart disease, cancer and stroke.

Still, Iowa has been ranked the 4th healthiest state in the United States. When people talk about health today they take these things into consideration: physical activity, obesity, tobacco use, substance abuse, mental health, environmental health and access to health care. 

Think about it! Health care in Iowa has evolved from lancets and the roots of the skunk-cabbage to robotic surgery and sophisticated pharmaceuticals. And think about this: when was the last time a dentist accepted food as payment for his or her services? A lot has changed over the past 150 years in Iowa’s health care. 

Sources

• Schwieder, D., Morain, T., Nielsen, L. Iowa: Past to Present. Ames: Iowa State University Press, 2002.
• Swaim, Ginalie. "Tuberculosis: The White Plague in Iowa." Iowa Heritage Illustrated 86, No. 2 (Summer 2005). Iowa City: State Historical Society.
• U.S. Department of Health and Human Services. Health, United States, 2004, http://www.cdc.gov/nchs/data/hus/hus04trend.pdf#027.