Iowa's Health Department—Changing With the Times

In the 1860s Iowa was a growing state. Its population was increasing. Transportation, especially railroads, covered the state. Many immigrants were coming to Iowa. They often arrived in Iowa on trains. As more people settled in Iowa outbreaks of contagious diseases followed that affected the entire state.

An 1867 law passed by the Iowa legislature made city, town and township boards of health responsible for health issues. As more people settled in Iowa, contagious diseases followed that affected the entire state. Local health boards were not able to handle the widespread health issues. More coordination was needed within the state. In 1880 the State Board of Health was created. The state’s role in watching out for public health has been ongoing and increasing ever since that time.

State Board of Health Is Created

A state senator and University of Iowa medical department professor, William S. Robertson, was responsible for the law that created the State Board of Health in 1880. Robertson became the board’s first president. Seven doctors, one engineer and the state attorney general made up the board. Robertson believed that the health law would give Iowans “purer water, better drainage, better ventilated homes, more healthy food and longer life.”

During its first five years the state board reported outbreaks of contagious diseases. It also tried to keep records of births and deaths. Every two years, reports were issued along with health bulletins. These provided ways for doctors to get information about important health issues such as:

  • How to disinfect a schoolhouse after diphtheria?
  • Where to locate a pest house to isolate smallpox patients?
  • How to choose the best kind of earth closets for use as indoor toilets?

Increasing Role in Public Health

The need to expand the state’s role in public health took place during the 1880s and 1890s. The board gained greater control to deal with quarantines, disinfection and other contagious disease problems. New members were added to the board including a veterinarian, bacteriologist and a chemist. Laws were passed that regulated pharmacy, dentistry and medical practice. Even though its responsibilities were increasing as the state’s population grew, the state board operated on the same amount of money the legislature had provided back in 1880—$5,000.

Around 1900 the State Board of Health began public campaigns to vaccinate the state’s population against smallpox, diphtheria and typhoid fever. About 300 places around the state distributed free diphtheria vaccine to the underprivileged. To others it was provided at a low cost. The board watched what cites and towns were doing as they developed new public water and sewage systems and plumbing codes. They took surveys of creeks, rivers and lakes to control pollution.

New Decades—New Challenges

World War I forced the nation and the State Board of Health to focus on venereal disease. At the end of the war the board won support for requiring that vital records be reported. The 1920s brought more health concerns in the state. The board made changes in hotel inspections. They also had to deal with many cases of a new infectious disease from cattle called "undulant fever" or "brucellosis". During this decade the Board of Health combined with other health agencies and boards to create one new agency called the Iowa Department of Health. In comparison to other states Iowa spent less on care of the sick and prevention of illness. Iowa spent only two cents per person compared to an average of nine cents in other states.

During the Great Depression public health agencies experienced major budget cuts from the state. But monies from the federal government helped support many programs. Social Security Act funds helped pay for an engineer for rural sanitation programs, a milk sanitarian, three graduate engineers, a vital records statistician, and more staff in various medical areas.

Water quality and waste disposal became health concerns in the 1930s and 1940s. The health department routinely inspected water. Controlling waste disposal was another responsibility of health departments. The Works Progress Administration (WPA) was involved in building nearly 1,000 sanitary facilities for homes and schools. Industrial hygiene focused on ventilation and air purity in factories. Good health was important for those who worked in weapons munitions plants during World War II. The department watched for job strain on workers’ eyes, ears, nerves and muscles.

Over a Century of Service

Each decade has provided new challenges and responsibilities for public health services. New diseases, pollution, polio, the fight for fluoridation and the push for public health nurses have been health issues over the past 50 years. For over 125 years the Iowa Department of Public Health has been watching out and taking care of the everyday health of Iowa’s citizens. Public health serves a variety of needs for everyone in the state.


  • Ginalie Swaim, "Salubrious or Unsanitary Iowa? The Struggle for the Public's Health," Iowa Heritage Illustrated 86, No. 2 (Summer 2005) 51-52.


Adapted from original article published in Iowa Heritage Illustrated