Public Health in America

Course Description

This course traces the history of public health in the United States, beginning with the Indigenous world that preceded the country’s founding and ending with the country’s twenty-first century readiness for epidemic disease. Students will read and discuss both historical documents and modern scholarship, using them to contemplate the causes and consequences of major shifts in medical knowledge and public health policy in United States history. Yet “Public Health in America” does not only consider public health history as a development of medical knowledge in institutions. Instead, we will study the changing meaning of “public health” as a concept over time and across diverse communities. For centuries, American politicians, Indigenous peoples, enslaved and free African-Americans, Progressive sanitarians, and radical activists have continually reimagined community care and redefined the government’s role in protecting it. Students will facilitate these discussions, work which will culminate in a final collaborative project that uses the history of public health to reconsider the causes and effects of major modern problems in public health.

Learning Objectives

  • demonstrate knowledge of significant events and chronologies in the history of public health. This knowledge will serve as the base on which students will evaluate the meanings ascribed to historical events and processes both in historical sources and modern historical scholarship.
  • interpret historical sources (what historians call “primary sources”). These sources are always subjective, incomplete, and can be contradictory. You will gain experience in reading these sources critically and consider how the complexity of primary sources shapes the narratives we construct about the past.
  • evaluate the arguments of modern historians and incorporate them into your own engagement with the past. Critical engagement with primary sources leads to the next step in historical inquiry, in which these sources are brought together as evidence for an argument. With every piece of modern scholarship (secondary source) we read, we will ask a series of questions: what is the historian’s argument? What sources did they use to construct it? What are the merits and limits of the argument? Discussions like these will help to illustrate how the research process progresses and will aid you as you make your own historical arguments.
  • evaluate the impacts of historical events and processes on the lives of living people. Historical knowledge helps us to understand the world we live in today. In learning the historian’s toolkit of content knowledge, interpretation, and argumentation, you will also become more literate in modern politics, geography, and socioeconomic inequity.
  • understand and evaluate the historical and social construction of health, medicine, and disease. The sweeping nature of this course will demonstrate that concepts of “health” “disease” and “medicine” are not objective, but rather are embedded in time and place. We will continually ask how the social construction of health and medicine informs our reading of primary and secondary sources, and our understanding of global health as a developing paradigm.

Assignments, Feedback, and Assessment

Group discussion leadership and participation in class discussion are graded for completion; in other words, you will receive a 100% for full participation. Primary source analysis papers and the final project will be graded according to attached rubrics.

Attendance and Participation. Excepting two free absences after our first meeting, students will receive credit for attending course meetings and for participating during them through discussion and collaboration when relevant. 20% of final grade.

Group Discussion Leadership. For most classes, I will collaborate with a work-team of two students, and together, we will post a short comment on the readings, along with a set of discussion questions to lead and guide the class in its discussion. This means that the work-teams must do the reading for their assigned week in advance and collaborate on the comment and the discussion questions. A good discussion question is one that asks a student to make an interpretation about history based on the facts and evidence from the assigned readings. I will cover the first week’s discussion questions alone as an example for the teams. Responsibility for each class’s readings will rotate among the teams. I will help the teams as they talk among themselves about posing good interpretative questions. 10% of final grade.

Reading Responses. Each student is required to participate in class discussion of readings online by posting a response to the discussion questions before the class period when readings will be discussed once per week (either Tuesday or Thursday, minus the week your team is leading
discussion). Your response should show that you have read and analyzed the assigned readings and should address at least one of the specific questions given. A missed week cannot be made up with double responses the next week unless given prior approval based on absence due to family or medical need. 20% of final grade.

Primary source analysis paper. This 1200-word assignment will analyze a primary source reading, in other words, an historical document. The primary source analysis should analyze the source’s origins: its author, audience, purpose, form, etc. and should discuss what it teaches about the historical context from which it arose. 15% of final grade.

Annotated Bibliography. A list of ten secondary sources you could use to support claims in an historical research paper. For each source, you should write a paragraph (200-400 words) describing the source’s key question, argument, scholarly intervention, and how you would use it. 15% of final grade.

Final Research Proposal. Seven pages proposing an historical research project on a topic in public health history. The proposal should make an original historical argument based on research in primary sources and should clarify the project’s key question(s) and scholarly intervention. It will also summarize the primary and secondary sources used to support its argument. I highly encourage drawing from prior assignments (the primary source analysis paper and annotated bibliography) to
complete this paper. 20% of final grade.

Letter grades map approximately onto the following scale, which I will use in calculating your final grade for the course (grades in between these ranges will be rounded down or up to the nearest number):

A+ (97–100)                A (93–96)                     A- (90–92)

B+ (87–89)                  B (83–86)                     B- (80–82)

C+ (77–79)                  C (73–76)                     C- (70–72)

D+ (67–69)                  D (63–66)                    D- (60–62)

F (0-59)

Course Policies

From January 6 to January 18, you will access our class meeting via the Zoom links provided on the course Sakai. I have set all meetings to begin ten minutes prior to class and participants can join before the host. If you are having trouble accessing the meeting, email me immediately – in the
first few minutes of class, I will send you an individual link.

Diversity and Inclusion: This course takes place on land which has long served as a site of meeting and exchange amongst Indigenous peoples, including the Catawba, Shakori, and Tuscarora Nations. Want to help with decolonizing this land? Decolonizing means returning the land to Indigenous groups. If you have the means, you can help decolonizing efforts by donating to legal efforts to return land back to Indigenous groups and/or protecting Indigenous lands.

This class is an inclusive learning environment, and I am committed to ensuring that all students are respected and valued. Student diversity in identity and background is a crucial source of strength. I expect that for all class activities and discussions, we will contribute together to the enrichment of our collective learning environment by respecting the diversity of thoughts, perspectives, and experiences present amongst ourselves by listening to one another’s views. This means that personal attacks or insults will not be tolerated. Additionally, please advise me as to your correct name and pronouns at the start of the semester.

Accommodations: You have an inalienable right to whatever services you need for academic success. If you have any specific personal or academic accessibility requirements (due to learning disability, physical disability, language comprehension, chronic illness, or mental illness), I welcome you to speak with me or email me to let me know how to best accommodate your needs. You are not obligated to disclose any of these needs with me, but I encourage you to let me know at least whether there are any accommodations required. I am happy to adapt course materials to your needs. You are also encouraged to register with Duke’s Student Disability Access Office, but again this is not a requirement.

Laptops and tablets are allowed in class but should be used for class related purposes such as taking notes or looking up material relevant to the lecture. Visitation to other, non-relevant sites is inappropriate. It distracts those seated behind you and lowers your attention to lecture.

Attendance and Participation: This course is structured around collaborative engagement with primary and secondary readings that should be read before the class period for which they are listed. Therefore, your participation is crucial to both you and your classmates. If you miss multiple classes in a row, I will email to check in and assess your need for further support.

If you are sick, injured, or have an emergency (death or serious illness in the family, automobile accidents/breakdowns), please inform me as soon as possible by sending me a short, explanatory e-mail and by filling out a STINF form. If you or a family member contracts COVID-19 or another serious illness, I am committed to ensuring it does not negatively impact your grade. This requires open communication between us: please email me as soon as possible if something like this happens.

Importantly, federal and state law requires me to protect your health privacy in all email communications. I encourage you to protect your own privacy online. Therefore, when emailing me about health-related matters, please include “Personal and Confidential” in the email subject line.

Formatting and Document Design: It is your responsibility as a scholar to present your work in a clear, transparent, and careful manner. I will ask you to resubmit any piece of writing that seems hurried or carelessly prepared and it will thereafter be subject to late penalties. Aspects of professional-quality academic documents include:

12 pt. Times New Roman font (or equivalent)   


Double line spacing

One-inch margins all around                               



In accordance with Chicago/Turabian citation style formatting guidelines

Submission of Assignments: Written assignments, discussion questions, and the final project will be submitted electronically by email. Please refer to the assignment prompts for detailed instructions. Regular reading responses will be uploaded to that week’s Sakai forum.

Late Work: I will accept late submissions for the primary source analysis
paper and annotated bibliography for up to three days after the original due date. For each day after the original due date that the assignment is not submitted, five points will be deducted from the total earned. I will not accept late reading responses or a late final research proposal. Note: these policies are for unexcused late submissions. If you miss class and submit a STINF or otherwise talk with me about an absence or other problem that has arisen, we can negotiate a sensible way to allow you to complete work without it seriously compromising your grade.

Integrity: Academic writing is seldom self-contained with respect to its ideas and proof. Quoting and citing sources strengthens your writing by explicitly situating your argument within an ongoing conversation and body of evidence. There are several systems for documenting sources. In this course, we will learn and employ Chicago Style citation. We will discuss quotation, paraphrase, and citation in pre-writing workshops.

On occasion, a student may attempt to disguise sources, sometimes due to being unprepared to complete an assignment, or because of time constraints. Copying without attribution from the work of a classmate, from a printed text, or an electronic text weakens your integrity as a student and writer and prevents you from engaging properly with other scholars through writing. Getting caught carries very serious consequences. If I suspect anyone of plagiarism, I am obligated to report it to the Duke University Office of Student Conduct. Plagiarism on any aspect of our course work will result in failure of the course.

Recall the Duke Community Standard: 1. I will not lie, cheat, or steal in my academic endeavors, nor will I accept the actions of those who do; 2. I will conduct myself responsibly and honorably in all my activities as a Duke student. Please ask me if you have any questions about what constitutes plagiarism. You may also consult:

Required Texts

Charles Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago: The University of Chicago Press, 1962).

All other readings are available online through Duke Libraries or will be posted under “Resources” on Sakai. I recommend for a cheap version of The Cholera Years or for other course readings if you prefer print copies.

Course Schedule and Readings

DateTopicReadings and Deadlines
Thursday, 6 JanuaryIntroductions  

Essential Question: what does it mean to practice public health?
Read syllabus before course meeting  
Tuesday, 11 JanuaryThe Medical Kaleidoscope of Early America: Part I

Question: how did Indigenous people
respond to familiar and foreign public health crises
before and during the colonial period?
Paul Kelton, Cherokee Medicine, Colonial Germs: An Indigenous Nation’s Fight Against Smallpox, 1518-1824 (Norman: University of Oklahoma Press, 2015), pp. 59-101.  

Total pages: 42
Thursday, 13 JanuaryNo class
Tuesday, 18 JanuaryThe Medical Kaleidoscope of Early America, Part II

Essential Question: How did encounters between African, European, and Indigenous medical knowledge contribute to the production of American materia medica?
Harold J. Cook and Timothy D. Walker, “Circulation of Medicine in the Early Modern Atlantic World,” Social History of Medicine 26, no. 3 (2013), pp. 337-351.

Total Pages: 14
Thursday, 20 JanuaryThe Making of American Medicine, Part I: Smallpox

Essential Question: how did political ideology affect public health responses to infectious disease in the early American republic?
Rebecca Fields Green, “‘Simple, Easy, and Intelligible’: Republican Political Ideology and the Implementation of Vaccination in the Early Republic,” Early American Studies 12, no. 2 (2014): 301-337.

Total Pages: 36
Tuesday, 25 JanuaryThe Making of American Medicine, Part II: Yellow Fever

Essential Question: how did political ideology affect public health responses to infectious disease in the early American republic?
Jim Green, “Pandemic Reading: Yellow Fever in Philadelphia,” The Library Company of Philadelphia, April 27, 2020,

Martin S. Pernick, “Politics, Parties, and Pestilence: Epidemic Yellow Fever in Philadelphia and the Rise of the First Party System,” The William and Mary Quarterly 29, no. 4 (1972), pp. 559-586.

Total Pages: 31
Thursday, 27 JanuaryPlantation Public Health

Essential Question: how did enslaved people navigate antebellum medical systems?
Sharla Fett, Working Cures: Healing, Health, and Power on Southern Slave Plantations (Chapel Hill: UNC Press, 2002), pp. 15-59.

Total Pages: 44
Tuesday, 1 FebruaryBones in the Basement

Essential Question: what roles did enslaved people have in the accumulation of antebellum medical knowledge?
Deirdre Cooper Owens, Medical Bondage: Race, Gender, and the Origins of American Gynecology (Athens: University of Georgia Press, 2017), pp. 15-41.

Total Pages: 26
Thursday, 3 FebruaryCholera Years, Part I

Essential Question: how did 19th century cholera epidemics change the role of municipal governments in American life?
Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849 and 1866 (Chicago: University of Chicago Press, 1962), pp. 13-39, 65-81.

Total Pages: 45
Tuesday, 8 FebruaryCholera Years, Part II

Essential Question: how did 19th century cholera epidemics change the role of municipal governments in American life?
Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849 and 1866 (Chicago: University of Chicago Press, 1962), pp. 192-225.

Total Pages: 33
Thursday, 10 FebruaryDisease and Public Health in the Civil War and Reconstruction

Essential Question: how did wartime crisis alter public health policy in the United States?
Jim Downs, “Emancipation, sickness, and death in the American Civil War,” The Lancet 380, no. 9854 (2012): 1640-1641.

Margaret Humphreys, Marrow of Tragedy: The Health Crisis of the American Civil War (Baltimore: Johns Hopkins University Press, 2013), pp. 76-102.

Total Pages: 27
Tuesday, 15 FebruaryYellow Fever and the Nationalization of Public Health

Essential Question: how did 19th century yellow fever epidemics change the role of the federal government in American life?
Margaret Humphreys, Yellow Fever and the South (Baltimore: Johns Hopkins University Press, 1999), pp. 1-17; 149-179.

Total Pages: 47
Thursday, 17 FebruaryImmigration, Plague, and Chinese Exclusion

Essential Question: how did public health and disease influence the early development of America’s immigration law?
Howard Markel and Alexandra Minna Stern, “The Foreignness of Germs: The Persistent Association of Immigrants and Disease in American Society,” The Milbank Quarterly 80, no. 4 (2002): 757-767.

Guenter Risse, ‘A Long Pull, a Strong Pull, and All Together: San Francisco and Bubonic Plague, 1907-1908,” Bulletin of the History of Medicine 66 (1992), pp. 260-286.

Total Pages: 36
Tuesday, 22 FebruaryPublic Health in the Imperial Laboratory

Essential Question: How did the expansion of the United States empire affect developing public health policy and medical knowledge?
Michelle Therese Moran, Colonizing Leprosy: Imperialism and the Politics of Public Health in the United States (Chapel Hill: UNC Press, 2007), pp. 1-16.

Warwick Anderson, “Racial Hybridity, Physical Anthropology, and Human Biology in the Colonial Laboratories of the United States,” Current Anthropology 53, no. S5 (2012), pp. S95-S107.

Total Pages: 28
Thursday, 24 FebruaryVariola minor and the Vaccine Mandate

Essential Question: How did vaccination become a matter of federal oversight in the United States?
Primary Source Analysis due February 24th at midnight

James Colgrove, “Manifold Restraints: Liberty, Public Health, and the Legacy of Jacobson v. Massachusetts,” American Journal of Public Health 95, no. 4 (2005): 571-576.

Scott Bomboy, “Current constitutional issues related to vaccine mandates,” Constitution Daily, August 6, 2021.

Total Pages: 5
Tuesday, 1 MarchFrom Raw Milk to Radioactivity: Industrial Health Reform

Essential Question: how did Progressive ideology and popular organizing make food and occupational safety matters of public health?
James Harvey Young, “The Pig That Fell Into the Privy: Upton Sinclair’s The Jungle and the Meat Inspection Amendments of 1906,” Bulletin of the History of Medicine 59, no. 4 (1985), pp. 467-480.

Claudia Clark, Radium Girls: Women and Industrial Health Reform, 1910-1935 (Chapel Hill: University of North Carolina Press, 1997), pp. 1-11.

Total Pages: 24
Thursday, 3 March1918 Influenza

Essential Question: how did 1918’s massive epidemic influence the development of America’s public health infrastructure?     
Nancy Tomes, “‘Destroyer and Teacher’: Managing the Masses During the 1918-1919 Influenza Pandemic,” Public Health Reports 125, supplement 3 (2010), pp. 49-62.

Howard Markel et al., “Nonpharmaceutical Interventions Implemented by US Cities During the 1918-1919 Influenza Pandemic,” Journal of the American Medical Association 298, no. 6 (2007): 644-654.

Total Pages: 23
Tuesday, 8 MarchSpring Break
No class
Thursday, 10 MarchSpring Break
No class
Tuesday, 15 March
Negative Eugenics at the Borders and in the Heartland

Essential Question: how did eugenicists evaluate health and fitness? Did this alter the landscape of public health in the United States?
Wendy Kline, “Immigration, Medical Regulation, and Eugenics,” The Oxford Handbook of American Immigration and Ethnicity (New York: Oxford University Press, 2016).

Alexandra Minna Stern, “Eugenics, sterilization, and historical memory in the United States,” História, Ciěncias, Saúde – Manguinhos 23, supplement (2016), pp. 195-212.

Total Pages: 31
Thursday, 17 MarchEugenics and Pronatalism

Essential Question: how did eugenics-imbued public health policy contribute to American national identity?
Amanda Rubenstein, “Pumpkins, Pigs, and People,” Nursing History Review 17 (2009), pp. 179-184.

Laura L. Lovett, Conceiving the Future: Pronatalism, Reproduction, and the Family in the United States, 1890-1938 (Chapel Hill: UNC Press, 2007), pp. 78-108.

Total Pages: 35
Tuesday, 22 MarchMalaria in the Exceptional South

Essential Question: how did wartime crisis alter public health policy in the United States?
Margaret Humphreys, “Kicking a Dying Dog: DDT and the Demise of Malaria in the American South,” Isis 87, no. 1 (1996): 1-17.

Total Pages: 17
Thursday, 24 MarchPublic Health and Mutual Aid in Post-War America

Essential Question: how did the Civil Rights Movement change the process of public health policy development?
Annotated Bibliography due March 24th at midnight

Alondra Nelson, Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination (Minneapolis: University of Minnesota Press, 2011), pp. 75-114.

Total Pages: 39
Tuesday, 29 MarchThe Reproductive Justice Movement

Essential Question: how did reproductive justice advocates understand the concept of reproductive rights? Does this differ from the framework of reproductive rights you are familiar with today?
Brianna Theobald, Reproduction on the Reservation: Pregnancy, Childbirth, and Colonialism in the Long Twentieth Century (Chapel Hill: UNC Press, 2019), pp. 147-172.

“Reproductive Rights and Reproductive Justice,” from OSU’s History Talk, June 23, 2016, Podcast. (31:55)

Total Pages: 25
Thursday, 31 MarchThe Disability Rights Movement

Essential Question: how did the demands of disability rights activists challenge extant paradigms of public health?
Nicole Newnham and James Lebrecht, Crip Camp: A Disability Revolution (2020), Film. (1:48:00)

Kim E. Nielsen, A Disability History of the United States (Beacon Press, 2012), pp. 157-183.

Total Pages: 26
Tuesday, 5 AprilThe Environmental Justice Movement

Essential Question: how did environmental justice activists keep and change the public health paradigm developed by earlier civil rights activists?
“Environmental Justice: Opposing a Toxic Waste Landfill,” from PBS Learning Media, Video clip. (4:33)

Vann R. Newkirk, “Fighting Environmental Racism in North Carolina,” The New Yorker, January 16, 2016,

Kate Brown, Plutopia: Nuclear Families, Atomic Cities, and the Great Soviet and American Plutonium Disasters (New York: Oxford University Press, 2013), pp. 19-37.

Total Pages: ~23
Thursday, 7 AprilThe HIV/AIDS Crisis: Part I

Essential Question: how did HIV/AIDS alter immigration and criminal justice policy in the United States?
 Jennifer Brier, “‘Save Our Kids, Keep AIDS Out’: Anti-AIDS Activism and the Legacy of Community Control in Queens, New York,” Journal of Social History 39, no. 4 (2006): 965-987.

Naomi Paik, “The ‘Visible Scapegoats’ of U.S. Imperialism: HIV Positive Haitian Refugees and Carceral Quarantine at Guantanamo Bay,” Paper for the Tepoztlán Institute on the Transnational History of the Americas, 2006,

Total Pages: 44
Tuesday, 12 AprilThe HIV/AIDS Crisis: Part II

Essential Question: how did HIV/AIDS activists change the public’s role in crafting government health policy?
 David France, How to Survive a Plague (2018), Film. (1:49:00)
Thursday, 14 AprilU. S. Preparedness since 1990

Essential Question: how have public health workers evaluated national preparedness for epidemic disease since 1990?
Umesh D. Parashar and Larry J. Anderson, “SARS Preparedness and Response Planning,” Emerging Infectious Diseases 10, no. 2 (2004), pp. 384-385.

“Top Actions the United States Should Take to Prepare for MERS-CoV and Other Emerging Infections,” Trust for America’s Health Issue Brief, June 2015,–advocacy/current_topics_and_issues/emerging_infections_and_biothreats/statements/060115-tfah-2015-mers-brief-final.pdf

Lena H. Sun, “None of these 195 countries – the U.S. included – is fully prepared for a pandemic, report says,” The Washington Post, October 24, 2019,

Total Pages: ~9
Tuesday, 19 AprilContemporary Issues in Public Health TBD