January 2, 1900 The direction of the Chicago River is reversed so that it flows into the Chicago Sanitary and Ship Canal, thereby cleansing the city's Lake Michigan drinking water of waste and sewage.
1901 The American Medical Association (A.M.A.) reorganizes as the national organization of state and local associations. Membership increases from about 8,000 physicians in 1900 to 70,000 in 1910-about half the physicians in the country.
April 12, 1901 New York City's tenement house law dictates improved light and sanitary facilities for tenements.
September 24, 1901 The Flint Vehicle Factories Mutual Benefit Association is created, providing workers in the automobile industry with industrial, medical and accident insurance, issued by the workers' own mutual company. This association provides benefits to General Motors workers in Flint until 1928, when the company switched to group health insurance.
1904 The University of Chicago Hospital conducts the first organ transplant in the U.S.
1904 The National Tuberculosis Association (now the American Lung Association) is founded to encourage prevention and cure of tuberculosis.
1906 The American Association for Labor Legislation (AALL) is founded by university professors and social activists including Richard T. Ely and John R. Commons with the goal of convincing state legislators of the necessity of health insurance.
1906 The A.M.A. establishes its own chemical laboratory to test the safety and efficacy of drug products.
1906 Upton Sinclair publishes his novel The Jungle, a shocking exposé of unsanitary conditions in the American meatpacking industry that helps win support for federal oversight of food processing industries, resulting in the Meat Inspection Act of 1906.
June 30, 1906 The original Pure Food and Drug Act is passed by Congress and signed by President Roosevelt. It prohibits interstate commerce in misbranded and adulterated foods, drinks and drugs, and establishes the Bureau of Chemistry, now known as the Food and Drug Administration, which is given regulatory oversight of labels and packaging information for over-the-counter drugs but denied power to regulate claims appearing in print advertisements.
1907 Indiana becomes the first state to enact a sterilization law.
1908 The Mount Sinai Hospital, New York City, publishes the first mention of using a blood test for compatibility before human blood transfusion. It demonstrates that group O blood can be given to Group A and B patients, establishing the concept of universal donors.
1908 Milk pasteurization becomes mandatory for all milk sold in the city of Chicago.
1909 Sigmund Freud (1856-1939) of Vienna is invited to lecture at Clark University (MA). His new theories and treatment approaches will be adopted by prominent psychiatrists and psychoanalysis will become a leading therapy throughout the 20th century.
1910 Rush Medical College (Chicago) discovers sickle cell anemia.
1910 The Carnegie Foundation-financed Flexner Report is published, which advocates major reform of American medical schools.
1911 The giant mail order house Montgomery Ward & Co. provides disability income coverage for its employees, the first instance of group health insurance in the nation. The following year the company also insures the lives of its 2,912 employees through the Equitable Life Insurance Company.
1911 Wisconsin passes the nation's first workmen's compensation law compelling employers to compensate workers injured on the job.
March 25, 1911 The Triangle Shirtwaist Fire in New York kills more than 140 mostly young women and reveals unsafe conditions in the garment industry.
April 9, 1912 President Taft signs a law creating the Federal Children's Bureau, which investigates and reports on child welfare issues. Lillian Wald of the Henry Street Settlement House in New York and Florence Kelly of the National Consumers League are among those responsible for the idea of a federal agency to promote child welfare.
1913 The American Society for the Control of Cancer, later renamed the American Cancer Society, is founded. Its goal is to educate the public about cancer and help de-stigmatize the disease.
1913 The University of Michigan Medical Center pioneers the use of the electro-cardiograph (EKG) machine.
1913 The University of Kansas School of Medicine discovers that corn oil is good for cooking.
1915 The American Association of Labor Legislation (AALL) drafts a "standard bill" that stipulates a basic health insurance program from which states could vary according to their own interests. Although it is supported by the A.M.A., both the American Federation of Labor and the private insurance industry oppose it.
1915 The Association for the Prevention and Relief of Heart Disease, later renamed the American Heart Association, is founded.
1916 New York State introduces psychiatric classification into the penitentiary system.
1916 Ella P. Stewart becomes the first licensed African-American female pharmacist and one of the earliest practicing African-American pharmacists in the United States.
October 16, 1916 Margaret Sanger opens the first birth control clinic in Brooklyn, New York, and is jailed for violating the Comstock Act (an anti-obscenity law).
1918-1919 An influenza pandemic kills 15 million people worldwide, 600,000 of them in the United States, far more than the number of American soldiers killed in World War I.
1919 The Johns Hopkins School of Medicine discovers mercurochrome, a widely used antiseptic. Eighty years later, the U.S. F.D.A. removes mercurochrome from the "generally recognized as safe" classification due to fears of mercury poisoning.
1921 Heart disease becomes the leading cause of death in the United States, according to mortality data collected by the Census Bureau.
1921 At the age of 39, future President Franklin Delano Roosevelt contracts polio, which leaves him permanently paralyzed.
November 23, 1921 President Warren G. Harding signs the Sheppard-Towner Maternity and Infancy Protection Act, authorizing federal funding to provide maternal care and reduce infant mortality. Fiercely opposed by the A.M.A. and some members of Congress as too socialistic, the law is allowed to lapse in 1929.
1922 Canadian researchers Frederick Banting and Charles Best discover insulin, which helps the body manage the level of sugar in the bloodstream and control diabetes.
1923 Dr. George Papanicolaou first proposes the "Pap smear" to detect cervical cancer, although the test is not widely accepted until 1945.
June 1, 1923 The Tuskegee Veterans Bureau Hospital, No. 91, opens as the first federal civilian hospital for African-American veterans of World War I, although there are no black professional personnel.
1926 The Carnegie Foundation funds a report by Dr. William J. Gies of Columbia University that transforms American dental education into an oral specialty of medicine.
1927 Logan Clendening, a professor at the University of Kansas, School of Medicine, writes the most successful book on health for a lay audience, "The Human Body."
September 28, 1928 Alexander Fleming discovers penicillin, a mold byproduct, to cure bacterial infections.
1929-1930 Thirty states pass sterilization laws. In North Carolina, epilepsy, sickness and feeblemindedness are grounds for sterilization, but the Eugenics Board expands its authority to include promiscuity and homosexuality.
1929 Baylor Hospital in Dallas starts a prepaid program with a local teaching union to create what is thought to be the nation's first example of modern health insurance.
1930 The Ramsdell Act redesignates the Hygienic Laboratory (founded in 1887 at the Marine Hospital on Staten Island, N.Y.) as the National Institutes of Health.
1931 The Miles Laboratory in Elkhart, IN, introduces Alka-Seltzer, an analgesic tablet that fizzes when dropped into a glass of water. When Prohibition ends in 1933, Alka-Seltzer becomes popular as a cure for hangover.
1931 The Mount Sinai Hospital (NY) coins the term PMS, premenstrual syndrome.
1931 Dr. Michael Abraham Sadid forms the Farmers' Union Cooperative Health Association, generally considered to be the pioneering health maintenance organization.
1932 The U.S. Government's Report of the Committee on the Costs of Medical Care in the United States declares that even the wealthy lack essential care and calls for the use of health insurance to budget larger expenditures on health.
1932 The U.S. Public Health Service, working with the Tuskegee Institute, begins a study to record the natural history of syphilis in hopes of justifying treatment programs for African-Americans. The Tuskegee Study of Untreated Syphilis in the Negro Male is conducted without the patients' informed consent. Although penicillin becomes widely available for use against syphilis in 1947, patients never receive it. Originally projected to last six months, the experiments continue until 1972.
1933 Sodium pentathol is introduced as anesthesia for use during childbirth, replacing opiates and other sedatives that have a longer-lasting effect on mother and baby.
June 10, 1935 A New York doctor and Ohio surgeon start Alcoholics Anonymous in New York, founded on the self-help model of alcoholics telling one another their stories honestly.
August 14, 1935 Title VI of the Social Security Act is passed, authorizing the expenditure of up to $2 million on health grants to the states for "investigation of disease and problems of sanitation."
1936 Vassar College, then an all-female college in Poughkeepsie, NY, becomes the first college to establish a medical insurance group policy for its students, at $12 a year.
1937 Cook County Hospital in Chicago establishes the first blood bank.
August 1937 Congress establishes the National Cancer Institute.
September 1, 1937 The National Housing Act (Wagner-Steagall Act) inaugurates the federal housing program.
1938 Dr. Clarence Gamble, heir to the Proctor and Gamble fortune, works with Planned Parenthood founder Margaret Sanger on the "Negro Project," an effort that leads to North Carolina's providing the first government-sponsored birth control program in the nation.
1938 President Franklin Roosevelt establishes the National Institute for Infantile Paralysis. The March of Dimes campaign starts, and dimes are sent to the White House for the research and treatment of polio.
1938 DuPont introduces the first nylon toothbrushes.
1940 Howard Florey and Ernst Chain develop a method to produce a usable form of penicillin; a year later, the first clinical trials of the drug show it has a remarkable ability to cure life-threatening infections.
1940 Dr. Charles R. Drew receives his Doctor of Medical Science degree from Columbia University for his thesis, "Banked Blood: A Study in Blood Preservation."
June 23, 1940 Women graduate from Harvard Medical School for the first time.
November 13, 1940 The first permanent health museum in
1943 The Wagner-Murray-Dingell national health insurance bill is introduced in Congress. Based on a national payroll tax, it fails to win approval.
1944 Dr. Selman Waksman of Rutgers University (NJ) discovers streptomycin, a drug that can kill the bacteria causing tuberculosis.
1944 The New York Hospital/Cornell Medical Center establishes the first eye bank in the United States.
July 1, 1946 The Communicable Disease Center (now the Centers for Disease Control and Prevention) is founded in Atlanta, and focuses on fighting malaria, typhus and other communicable diseases.
July 3, 1946 Post-WW II realization of the increase in mental health needs in the population leads to passage of the Mental Health Act of 1946 that calls for the establishment of the National Institute of Mental Health.
August 13, 1946 Congress passes the Hill-Burton Act to finance a vast wave of hospital construction, principally in rural areas.
1947 Michigan becomes the first state in the nation to make mandatory the pasteurization of all milk sold in the state.
1947 The Mount Sinai Hospital Medical Center (N.Y.) performs the first kidney dialysis in the United States, using a Kolff artificial kidney.
1949 The United States Supreme Court upholds a National Labor Relations Board ruling that health benefits can be part of collective bargaining, thereby cementing labor's role in health care.
1950 American and British researchers publish papers presenting evidence that smoking causes lung cancer.
March 23, 1950 Congress passes the Oleomargarine Act, eliminating the 10-cents-a pound federal tax on colored margarine and requiring clear labeling to distinguish it from butter. Margarine then costs less than half the price of butter.
October 4, 1951 Henrietta Lacks dies at Johns Hopkins University in Baltimore from cancer of the cervix; her living cancerous cells removed from her body and preserved in a lab later launch a medical revolution.
October 26, 1951 The Durham-Humphrey Amendment defines the kinds of drugs that cannot be safely used without medical supervision and restricts their sale to prescription by a licensed practitioner.
1953 Surgeons perform the first successful open heart bypass surgery, using a heart-lung machine at Jefferson Medical College in Philadelphia.
March 26, 1953 Dr. Jonas Salk, City College of New York alumnus, successfully tests a polio vaccine on a small group of children. Following extensive testing, Salk announces the results on April 12, 1955, and the vaccine is licensed for use.
1955 Psychoactive drugs are introduced in the U.S. and their widespread use leads to increased discharges from mental hospitals. The next half-century sees a dramatic decline in hospital beds from 560,000 in 315 public mental hospitals to 53,000 beds in 230 hospitals.
1956 Drs. Muhler, Day and Nebergall at Indiana University demonstrate that stannous fluoride is the most effective compound in hardening tooth enamel and protecting it. The university licenses Proctor & Gamble, which introduces its Crest brand with fluoride.
1957 An extensive study commissioned by the American Cancer Society shows that heavy smoking significantly shortens life span.
1958-1960 The number of African-Americans sterilized under North Carolina's program exceeds the number of whites sterilized for the first time.
1959 The Barbie Doll is created, the first popular doll to be
May 9, 1960 The era of modern contraception begins when the birth control pill becomes gradually available.
1962 Thalidomide, a new pill to prevent "morning sickness," is found to have caused birth defects in thousands of babies born in Western Europe. The role of Dr. Frances Kelsey, F.D.A. medical officer, in keeping the drug off the U.S. market, arouses public support for stronger drug regulation.
1962 Consumer activist Rachel Carson publishes Silent Spring, documenting the dangers of pesticide use to humans and wildlife, and leading to the ban on DDT.
June 25, 1962 The U.S. Supreme Court, in Robinson v. California, rules that drug addiction is a disease rather than a crime.
October 10, 1962 The Kefauver-Harris Amendment on drug efficacy ensures greater drug safety. For the first time, drug manufacturers are required to prove to the F.D.A. the effectiveness of their products before marketing them.
January 11, 1964 Surgeon General Luther L. Terry M.D., issues a report declaring that smoking is a major health risk for cancer, cardiovascular disease and emphysema.
1965 Ralph Nader publishes Unsafe at Any Speed, charging that the American automobile industry is neglecting consumer safety issues.
July 27, 1965 The U.S. Congress passes the Cigarette Labeling and Advertising Act, requiring a label be placed on cigarette packages: "Warning: Cigarette Smoking May Be Hazardous to Your Health." This act is criticized for prohibiting the Federal Trade Commission and any state and local government from requiring any other label on cigarette packages and any warning in cigarette advertising until at least 1969.
July 31, 1965 The U.S. Congress passes legislation creating Medicare, medical care for the elderly and disabled, and Medicaid, care for the poor.
1967 Surgeon Rene Favaloro performs the first coronary bypass operation using a patient's vein, in Cleveland, Ohio.
1970 The F.D.A. requires the first patient package insert: oral contraceptives must contain information for the patient about specific risks and benefits.
1970 The first edition of Our Bodies, Ourselves is published by the Boston Women's Health Collective. It was written by women (not medically trained) to teach other women about their bodies and how to be discerning health care consumers.
1970 La Clinica de la Raza, a grassroots community health clinic, is founded in Oakland, CA; it will grow into a major provider of health services in the Bay Area.
February 27, 1970 In Upjohn v. Finch, a federal Court of Appeals upholds the F.D.A.'s right to ban ineffective drugs.
April 1, 1970 Congress passes the U.S. Public Health Cigarette Smoking Act, which bans cigarette advertising on television and radio from 1971 and requires stronger health warning on cigarettes.
April 22, 1970 Earth Day arrives as Americans express concern over environmental quality.
December 2, 1970 The Environmental Protection Agency is created by an executive order of President Nixon and establishes emission standards for specific chemicals.
December 4, 1970 Federal funding for family planning services for low-income women is established under the Family Planning Services and Population Research Act, which creates Title X of the Public Health Service Act.
1971 Latino students studying medicine meet in San Francisco and form the National Chicano Health Organization, which is designed to pressure health professional schools to increase recruitment of Latino students and promote community health care.
April 28, 1971 The Occupational and Safety Health Administration is established by the U.S. Department of Labor.
December 23, 1971 Congress passes the National Cancer Act, beginning the "War on Cancer." Federal funding grows from about $233 million annually to nearly $5 billion in 2008.
1972 Title IX revolutionizes athletics for women, prohibiting sex discrimination in all educational programs receiving federal funding.
October 1972 The Tuskegee Study of Untreated Syphilis in the Negro Male ends after a news report reveals that the subjects were never given the choice of quitting the study.
1973 The American Psychiatric Association declares that homosexuality is not a form of mental illness.
January 22, 1973 Roe v. Wade is decided by the U.S. Supreme Court. The court rules that laws prohibiting abortions violate a constitutional right to privacy. Texas attorney Sarah Weddington argues the case on behalf of "Jane Roe."
1975 Immigrant doctors trained in Latin America and working in California form the California Hispanic American Association to fight against being treated as second-class doctors. This group clashes with the more radical National Chicano Health Organization.
September 2, 1977 The U.S. Consumer Product Safety Commission announces a ban on lead paint on toys and furniture, nearly 60 years after studies show that lead is dangerous to children and decades of opposition from the lead industry.
August 2, 1978 The New York State Department of Health declares a state of emergency at Love Canal, Niagara Falls, NY, a residential neighborhood built atop a municipal and chemical waste dump site. More than 100 families are forced to move as their homes are demolished.
March 28, 1979 In the hours following the Three Mile Island nuclear emergency, the F.D.A. contracts with firms in Missouri, Michigan, and New Jersey to prepare and package enough doses of potassium iodide to protect those threatened with thyroid cancer if exposed to radiation. Nearly one quarter of a million bottles -enough for every household in the area - are delivered to Harrisburg, Pennsylvania, within 72 hours.
1980 The American Psychological Association adds Post Traumatic Stress Syndrome (PTSD) to its DSM-III (Diagnostic and Statistical Manual of Mental Disorders) classification system.
1981 Acquired Immune Deficiency Syndrome (AIDS) is reported to the Centers for Disease Control and Prevention as a new disease when symptoms are noted in many young men in Los Angeles and New York.
1982 The F.D.A. publishes its first "Red Book" (a successor to the 1949 "black book"), a guide to industry and the public concerning the procedures and methods for safety assessment of food and color additives.
1983 The Susan G. Komen Race for the Cure is established in Dallas, TX, to raise money for breast cancer research, education, screening and treatment programs.
1985 An AIDS test for blood is approved by the F.D.A. in its first major action to protect patients from infected donors.
1986 The Consolidated Omnibus Budget Reconciliation Act (COBRA) is signed into law, allowing many employees to continue their group health plan up to 18 months after losing their job.
1986 The Asian and Pacific Islander American Health Forum is organized to address health disparities in the Asian-American, Native Hawaiian and Pacific Islander communities.
December 29, 1987 The F.D.A. approves Prozac, which becomes the most prescribed antidepressant drug worldwide.