Prior to medical knowledge advancements, environmental sanitation focused on combating a broad spectrum of diseases rather than combating specific diseases. Water infrastructure improvements setup the fundamental framework that helped in the development of new public health.Through the ideological shifts public health continued to focus on ways to prevent and control disease outbreaks within a population. With the introduction of the germ theory came the need for modifications in the previous public health protocol in order to be more precise when combating disease. In light of the germ theory author Rosen argued, “[Americans] were more alert than their European confreres to its practical implications. Out of this awareness there developed a new public health institution.” [19] In doing so Americans were able to implement the germ theory into medical practices which ultimately led to changes in medical infrastructure. Bacteriology allowed for a more direct approach in diagnosis, treatment, and disease prevention and ultimately led to the modification of public health. In the article ‘Public Health and War’ historian Michael Sappol explains, “In the 19th century and first three decades of the 20th, the United States was a weak and fragmented nation-state, hobbled by divided sovereignty, laissez-faire ideology, and low tax revenues, unable to cope with the new conditions of industrial modernity and the rise of great cities” [20] Changes in political ideology and the need for epidemiological control allowed for the establishment of a state level public health system.

At the same time of the development of new public health, hand soaps started emerging on the consumer market during the late 19th century. Association between cleanliness and personal health allowed for the prevalence of hand hygiene practices to become a habit. Soaps became more accessible for the public regardless of what social class they belonged to. Public health encouraged working class individuals to partake in hygiene habits that once symbolized a superior wealthy class. Through soap advertisements the public slowly became aware that germs could be spread through contact with fomites and then transferred by hands. During this period advertisements typically included a doctor’s recommendation that stressed the importance of hygiene, which made the product more appealing for prospective consumers. Mothers were coined as ‘health doctors’ in Lifebuoy’s hand soap campaigns from the 1920s and onwards. Mass advertisement campaigns focused on educating the public to partake in the hygiene practice by promoting hopefulness of good health. Soap companies slowly pushed for the incorporation of contemporary hand washing habits by enforcing the idea of hand washing to prevent the disease transmission. The corporate push to implement hand hygiene was not necessarily for the common good, but rather for the hopes that the advertisements would lead to higher sales.

Despite the mass campaigns for hand washing practices promoted by soap companies, public health itself did not implement medical practitioners to partake in hand hygiene practices. The need for sanitary precautions occurred at an alarming rate with the onset of World War II. War revealed the possibility of widespread transmission between soldiers and the unhygienic battlefield environments. In response to unhygienic conditions, there were rapid scientific advancements to improve warfare. These advancements ultimately contributed to the development of a federal public health system. The Center for Disease Control and Prevention was founded in 1946, after World War II, and served as the United States’ federal public health official. However, hand washing was not implemented into public health until 1981. The first national guidelines for contemporary hand washing practice in a public health setting were outlined in Guidelines for hospital environmental control Section 1 Antiseptics, handwashing, and handwashing facilities. After this publication, handwashing became implemented and required for health professionals, which ultimately led to the reduction of disease transmission between medical staff and patients. Contemporary hand washing habits have become common practice through the enforcement of hand hygiene through advertisements and public health protocol.

References

[13] Virginia Tuberculosis Society. 1965. “Wash germs away,” Historical Collections & Services, Claude Moore Health Sciences Library, University of Virginia.

[14] Ad*Access On-Line Project – Ad #BH0960John W. Hartman Center for Sales, Advertising & Marketing HistoryDuke University David M. Rubenstein Rare Book & Manuscript Library. http://library.duke.edu/digitalcollections/adaccess_BH0960/

[15] Lever Brothers Company. 1934. Lifebuoy Wash-Up Chart Courtesy of Virginia. Coming Clean: Hand Washing and Public Health. Historical Collection at the Claude Moore Health Sciences Library. http://exhibits.hsl.virginia.edu/hands/wordtomother/

[16] Lever Brothers Company. 1934. Lifebuoy Wash-Up Chart Courtesy of Virginia. Coming Clean: Hand Washing and Public Health. Historical Collection at the Claude Moore Health Sciences Library. http://exhibits.hsl.virginia.edu/hands/wordtomother/

[17] Ad*Access On-Line Project – Ad #BH1181. John W. Hartman Center for Sales, Advertising & Marketing HistoryDuke University David M. Rubenstein Rare Book & Manuscript Library. http://library.duke.edu/digitalcollections/adaccess_BH1181/.

[18] Ad*Access On-Line Project – Ad #BH1173. John W. Hartman Center for Sales, Advertising & Marketing HistoryDuke University David M. Rubenstein Rare Book & Manuscript Library. http://library.duke.edu/digitalcollections/adaccess_BH1173/.

[19] George Rosen. 1993. A History of Public Health Expanded Edition. John Hopkins University Press. Baltimore, Maryland. 193.

[20] Sappol, Michael. 2011. Public Health and War. U.S. National Library of Medicine. https://www.nlm.nih.gov/hmd/digicolls/phfgtw/essay.html.