The history of public health in Chicago is characterized by multiple interacting political, economic, social and medical trends of the last two centuries.Jennifer Koslow, "Public Health" Encyclopedia of Chicago (2004) onlineThomas Neville Bonner, Medicine in Chicago, 1850–1950: A Chapter in the Social and Scientific Development of a City (1957) pp. 175-198.
Bad sanitation for polluted water caused much of the disease and death in the 19th century. Many Chicagoans distrusted hospitals and relied on folk remedies. Finally large-scale projects cleaned up the streets and neighborhoods, and health providers realized they needed to keep washing their hands. A strong network of hospitals emerged with broad support. As late as 1900, the leading causes of death were tuberculosis, pneumonia, chronic diarrhea of infancy, and gastroenteritis—largely the afflictions of infants, children, and in the case of tuberculosis, young adults. The population had grown largely by the immigration of young people from Europe, which continued until 1914, when the world war ended civilian travel. After 1914, the population largely stabilized and grew older. Medical cures and vaccines were increasingly found for children to cure or prevent contagious diseases, but it was much more difficult to deal with the heart conditions and cancer that killed older Chicagoans.Bonner, Medicine in Chicago, pp.143–145.
Epidemics
An outbreak of cholera in 1849 killed 678 persons, 2.9 percent of the city's population, and an 1854 outbreak killed 1,424 people. Another cholera epidemic hit the city in 1866 and 1867.Chicago Public Library (Web Archive) In the late 19th century, typhoid fever mortality rate in Chicago averaged 65 per 100,000 people a year. The worst year was 1891, when a long outbreak of typhoid killed around 2,000 and threatened the 1893 Columbian Exposition; the typhoid death rate was 174 per 100,000 persons.
Chicago faced various epidemics beyond waterborne diseases. Smallpox, diphtheria, and whooping cough were significant threats in the 1830s to 1890s.William K. Beatty, “When Cholera Scourged Chicago.” Chicago History 11 (Spring 1982). The city was hard hit by the worldwide 1918 Spanish flu pandemic, with about 20,000 deaths.Walter Nugent, "Epidemics" Encyclopedia of Chicago (2004) online
COVID-19 closed down schools and offices and most gathering places in 2020–2021. About 7,400 Chicagoans died, especially victims over age 80 .Bea Malsky, "COVID-19 Deaths in Chicago’s Neighborhoods: A Live Tracker" South Side Weekly February 2, 2023, online
The Chicago 1885 cholera epidemic myth is a persistent urban legend, stating that 90,000 people in Chicago died of typhoid fever and cholera in 1885. Although the story was widely rumored, there was no such event and these deaths did not occur.
Summer heat waves
The arrival of air conditioning after 1960 made intense hot summers tolerable in middle-class neighborhoods, but poor districts still suffered from the intense heat and high humidity.. An extreme case was the 1995 Chicago heat wave when the temperature reached 106 °F (41 °C) at Midway Airport, with a heat index of 119 °F (48.3 °C), an all-time peak. Over 700 people died, especially, the elderly. Researchers discovered: "a higher risk of deaths among people who lived alone, on the top floor of a building, in apartment houses, in single room occupancy dwellings, in homes with a small number of rooms, who had less access to public transportation, and who were socially isolated."Eric Klinenberg, "Denaturalizing disaster A social autopsy of the 1995 Chicago heat wave," Theory and Society (1999) 28: 239–295, online, quoting page 286.Eric Klinenberg, Heat Wave A Social Autopsy of Disaster in Chicago (2015) online .
Waterborne disease control Chicago's early public health efforts focused on combating the greatest threats to public health: waterborne diseases, particularly cholera and typhoid.Louis P. Cain, Sanitation in Chicago: A Strategy for a Lakefront Metropolis," in Encyclopedia of Chicago (2004) online Starting with a cholera outbreak in 1832, for the rest of the century, Chicago struggled with repeated waves of bacterial diseases.B. C. Miller, "Cholera as it prevailed in Chicago, in 1873." Public health papers and reports (1873): 261+ online. Medical experts in Britain had demonstrated that bad sanitation in overcrowded neighborhoods without adequate sewers caused disease. In 1834, the city dug its first drainage ditch down State Street. The sewers emptied into the Chicago River, which in turn emptied into Lake Michigan. Streets and buildings were raised 8–10 feet above ground level to improve drainage.Arlan Juhl, P.E., "History of Flood Control & Drainage in Northeastern Illinois" (Illinois Department of Natural Resources, 2025) online Chicago's drinking water came from the Lake—the sewers could not empty there. The solution was to reverse the Chicago River's flow in 1900 through the construction of the Sanitary and Ship Canal. The dirty water now went south and (hopefully) would be clean by the time it reached the state line. It was a landmark achievement, diverting wastewater away from Lake Michigan. The city also built an extensive sewage treatment system so that what was dumped into the river was not so bad. Major treatment works were constructed in the 1920s and 1930s. The Tunnel and Reservoir Plan (TARP) currently underway, was adopted in 1972 to manage combined sewer overflows and reduce flooding.Louis Cain, "Sanitary Strategy for a Lakefront Metropolis, The Case of Chicago" (Northern Illinois University Press, 1978) online.Kenneth R. Olson, and Lois Wright Morton,. "Chicago's 132-year effort to provide safe drinking water." Journal of Soil and Water Conservation 72.2 (2017): 19A–25A. online
Establishment of health departments
Chicago's health governance evolved over time.Bonner, pp.175–198. The city's 1837 charter included a Board of Health and a health officer. In 1867, health functions were established under an actual department of health. The Department of Health was reorganized in 1876, creating the position of Commissioner of Health. Milk inspection began in 1892. Water sterilization was implemented in 1912, dramatically reducing typhoid rates. The Chicago Municipal Tuberculosis Sanitarium opened in 1915.Koslow, "Public Health". Public health officials tried repeatedly to clean up the unsanitary slaughterhouses, but business resisted until the federal government finally imposed Pure food laws in 1906.Bonner, pp.184–188.
The most prominent leader of public health was Dr. Herman Bundesen the city's health commissioner from 1922 to 1928 and 1931 to 1960. He proved an able, if eccentric, administrator. He was eager for publicity and claimed credit for the city's reduction of infant mortality, improvement of milk sanitation, and the curtailment of diphtheria and smallpox. He tried to reduce venereal disease and promoted birth control. He identified and eradicated an outbreak of amoebiasis during the 1933 Chicago World's Fair. Polio eradication was a high priority, and he made Chicago one of the earliest U.S. cities to introduce the Salk vaccine in 1955. He was the unsuccessful Democratic candidate for governor in 1936, making public health a major campaign issue.see "Dr. Bundesen Dead at 78" Chicago Tribune August 25, 1960.onlineRon Grossman. "The Chicago public health czar who craved celebrity" Chicago Tribune. (May 31, 2019)
Hospitals
The history of hospitals in Chicago is rich with innovation, diversity, and rapid growth, reflecting the city's development as a major medical center.See " History of Chicago hospitals before 1930" in "North Chicago Hospital Building 2551 N. Clark St. Preliminary Landmark recommendation approved by the Commission on Chicago Landmarks, January 8, 2009" onlinePaul A. Buelow, "Hospitals" in Encyclopedia of Chicago online Before the emergence of modern hospitals, Chicago relied on a neighborhood based dispensary system to provide medical help for poor people without charge.Paul A. Buelow, "The dispensary comes to Chicago: Health care and the poor before 1920" (PhD dissertation, University of Illinois at Chicago; ProQuest Dissertations & Theses, 1997. 9728507).
Rapid Expansion and Specialization Before the 1870s, hospitals had a bad reputation. Poor people went there to die, even those who were not fatally ill when they arrived. Bad sanitation on the part of doctors spread disease inside the hospital. Finally.the discovery of the germ theory of disease produced an immediate transition to concerns with sanitation. and cleanliness.Bonner, Medicine in Chicago, pp.147–174. After the Great Fire of 1871, Chicago's hospital system grew rapidly in response to the city's burgeoning population. The city's first hospital was built in 1843 in response to epidemic fears. Vaccination programs for the poor began in 1848. Specialized facilities were created for specific health crises, such as smallpox and cholera. The expansion was characterized by steady increases of bed capacity to meet growing demand; specialization to serve specific communities and medical needs; and the development of new facilities and technologies.
In 1927 and 1928—years of peak prosperity—numerous hospitals expanded or were newly built, including Mercy Hospital (now part of Insight Hospital and Medical Center), Passavant Memorial Hospital (now part of Northwestern Memorial Hospital), and Edgewater Hospital. In 1916 the University of Chicago obtained funding for. an independent academic medical school effort with a teaching hospital. The facility opened in 1927 and is now the Pritzker School of Medicine.Walter L. Palmer, "Franklin Chambers McLean and the Founding of the University of Chicago School of Medicine." Perspectives in biology and medicine 22.2 (1979): S2-S32.
Community-focused Care Many hospitals in Chicago were established to serve specific ethnic, religious, or cultural communities:
Over twenty Catholic hospitals were built, including Mercy Hospital, St. Elizabeth's Hospital, and St. Anne's Hospital. The main Jewish hospitals were Michael Reese Hospital and Mount Sinai Medical Center.Alan M. Kraut, "No Matter How Poor and Small the Building’: Health Care Institutions and the Jewish Immigrant Community." in Religion and Immigration: Christian, Jewish, and Muslim Experiences in the United States (2004): 129–158. German Hospital (renamed Grant Hospital in World War I) was built by the German Protestant population.See " The Grant Hospital of Chicago, 1883–1950" online Provident Hospital (Chicago) was founded in 1891 to train Black nurses, who were not welcome in other hospitals but were needed by the rapidly growing African-American community.Bonner, Medicine in Chicago, pp.154–156.Vanessa Northington Gamble, "The Provident hospital project: a experiment in race relations and medical education," Bulletin of the History of Medicine 65#4 1991, pp. 457–75. online
This approach ensured that diverse populations could receive care in environments that respected their cultural and linguistic needs. One major result was that the specific communities patronized "their" hospitals and generated political support.Timothy Walch, "Catholic Social Institutions and Urban Development: The View from Nineteenth-Century Chicago and Milwaukee." in Institutional Life (Routledge, 2014) pp.242–259.
Medical Innovation and professional education Chicago became a hub for medical advancement and education: The world's first successful open-heart surgery was performed at Provident Hospital in 1893. Cook County Hospital became a major training center, with one in four American physicians receiving training there at one point. The University of Chicago established a medical campus in Hyde Park, expanding clinical departments and building specialized hospitals
Transition to Modern Healthcare