Pulse
Minnesota’s Apostle of Public Health
Minnesota’s leadership in public health began with a physician, Dr. Charles N. Hewitt, from Red Wing, who was described by William W. Folwell, a historian and the first president of the University of Minnesota, as Minnesota’s “apostle of public health.”
A native of Vergennes, Vermont, Hewitt came to Minnesota in 1866 to practice medicine after serving in the U.S. Army during the Civil War. As an assistant surgeon, he had witnessed firsthand the consequences of poor sanitation and wanted to promote the new ideas about public health and hygiene that were just emerging.
After Massachusetts and California became the first two states to create their own boards of health in 1869 and 1871, Hewitt decided Minnesota also needed a state board of health and crafted legislation based on the Massachusetts law. With the support of the American Medical Association and the Minnesota State Medical Society, the bill was signed into law on March 4, 1872. Minnesota, which then had a population of approximately 450,000, became the third state in the nation to have a board of health.
Hewitt served as its first executive secretary. Under his guidance, town boards of health were established. In addition, he inaugurated a system of interstate notification and quarantine in 1879 that was implemented when people suspected to have infectious diseases crossed state lines. That was later expanded to an international system of notification and quarantine. Hewitt was appointed a nonresident professor of pubic health at the University of Minnesota in 1874—a position he held for 28 years. In 1889, he went to Europe to study bacteriology. There, he met Louis Pasteur and studied rabies in his laboratory. When he returned to Red Wing, Hewitt brought with him a Koch sterilizer and other equipment and set up the first bacteriologic laboratory concerned with the study of human infections west of the Allegheny Mountains.
In 1890, Hewitt established a vaccine station on a farm near his home. It supplied vaccine for the prevention of smallpox to health officials, local boards of health, and physicians in Minnesota.
Hewitt served as president of the American Public Health Association in 1888. He was elected to the Society of Health Officers in England and the Societe d’Hygiene of France. He held the office of executive secretary of the Minnesota state board of health until 1897. After that, Hewitt resumed private practice in Red Wing. He died on July 10, 1910, at age 74.—Kim Kiser
Sources: Keys T. The Medical Books of Dr. Charles N. Hewitt. Minnesota History Magazine.1940;21(4):357-71. Folwell WW. Biographic Memorial of Dr. Charles N. Hewitt. Minnesota Historical Society; St. Paul. 1915
Getting the Lead Out
Eliminating lead poisoning might be considered one of Minnesota’s recent public health success stories. In 2004, the Minnesota Department of Health set the goal of creating a lead-safe Minnesota where all children have blood lead levels below 10 μg/dL by the year 2010.
Since then, the number of children tested for lead in Minnesota has increased, with approximately 95,000 children tested in 2009 as compared with 72,000 in 2004, while the number of cases of elevated blood lead levels has decreased. In 2009, 779 Minnesota children had blood lead levels of 10 μg/dL or greater, and 147 had levels of 15 μg/dL or greater, as compared with 1,513 and 249, respectively, in 2004.
Health department officials say two populations remain at risk, however. Children receiving Medical Assistance and refugees are two to three times more likely than others to have elevated blood lead levels.
Source: Erik Zabel, Ph.D., M.P.H., Environmental Health, Minnesota Department of Health
Building a Research Base
Medicine has long tried to ensure that physicians base their practice decisions on evidence. More recently, public health has attempted to do the same. The field is amassing a body of research on the efficacy of public health programs, policies, and campaigns.
That research is being translated into guidelines that policymakers, funders, and organizations can use in their communities. One place to access the evidence is a CDC website known as The Community Guide (www.thecommunityguide). The site has reviews of more than 200 public health interventions. It also contains information about the cost and the potential return on investment of each. For reducing adolescent alcohol use, for example, the site gives better enforcement of laws that prohibit sales to minors a thumbs-up but says the evidence for school-based programs is still inconclusive. For obesity, it says there is not enough evidence to recommend provider interventions such as counseling patients about being active or eating less but that there is evidence to support community efforts such as workplace weight-control programs.
FDA Takes On NaCL
An Institute of Medicine report that salt consumption accounts for 100,000 premature deaths each year in the United States has prompted the Food and Drug Administration to recommend limiting it in packaged foods. Currently, food manufacturers are required to report the amount of salt on nutrition labels. The FDA wants to establish and phase in acceptable standards.