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October 22, 1982

The Healthiest City: Milwaukee and the Politics of Health Reform

Author Affiliations

Illinois Institute of Technology Chicago


by Judith Walzer Leavitt, 294 pp, 29 illus, $22.50, Princeton, NJ, Princeton University Press, 1982.

JAMA. 1982;248(16):2054. doi:10.1001/jama.1982.03330160092038

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With the publication of Leavitt's book, there are now two major works concerned with the historical development of single municipal public health departments in the United States, the other being John Duffy's monumental two-volume record of the New York City experience. While the latter covers a much longer time span and is more comprehensive, Leavitt's opus does have certain advantages, particularly in regard to her major theme, understanding the process of health reform as it unfolded in the late 19th and early 20th centuries.

Instead of chronicling how Milwaukee faced all its major public health problems, Leavitt chooses to focus on three illustrative issues—smallpox, garbage, and milk—representing, respectively, the larger areas of infectious disease, sanitation, and food control. In each of these well-researched sections, she examines how serious conflicts over policy based on economic interests, political ideology, and culture were handled and ultimately resolved. Most interesting is her discussion of