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Many societal factors converged as founders organized the AAP :

January 8, 2020

Editor’s note:This is the first in a series highlighting the AAP’s 90th anniversary. Next month: the 1930s.

Societal forces helped pave the way for the Academy’s founding in 1930 and inspired a dedicated group of pediatricians.

There was momentum to address conditions in the country such as high infant and maternal mortality, rampant disease, child labor, poverty and malnutrition. The late 19th and early 20th centuries also were characterized by the great wave of immigration, women’s suffrage, migration to cities and poor housing conditions.

The science of public health was emerging, and experts started to take a greater interest in the effects on children.

“The founders at that time were actually thinking about what we now know as the social determinants of health,” said Lynn Olson, Ph.D., AAP vice president of Research. “These were the physicians in the 1930s. When you think about what was going on in the country … it’s not hard to see what was motivating the founders.”

The need was great to promote the highest pediatric standards.

“…it became obvious that our country needed national programs to improve child health and welfare,” AAP Past President James G. Hughes, M.D., FAAP, wrote in “American Academy of Pediatrics: The First 50 Years.”

Special calling

Child labor and other societal ills helped spur solutions to improve conditions for children in the Progressive Era, 1890s-1920s, part of broader reform efforts and motivation for the AAP founders.

While other pediatric groups existed, including the pediatric section of the American Medical Association (AMA), none seemed able to give pediatrics its due. The American Pediatric Society, for example, was geared toward scholarly endeavors. Despite their ties to the AMA, the pediatric leaders were not content to remain minor players.

Motivation to start a new society was even greater as a result of the first three White House conferences on children (in 1909, 1919 and 1930), where pediatricians played key roles. In 1909, President Theodore Roosevelt’s conference resulted in the formation of the Children’s Bureau in 1912. By the time President Herbert Hoover held the third conference, which was led by pediatricians, health care was a central focus. That meeting led to far-reaching, bold recommendations such as the Children’s Charter, which as far back as 1930 sought to put forth the rights of every child.

Guidance that emanated from the conferences hastened the need for a new group like the Academy.

AAP co-founder Clifford G. Grulee, M.D., FAAP, wrote: “…With the many recommendations which will come from that body (White House conference), there seemed to be no organization fitted to take up and carry on the work. In other words, the vast accumulation of material of great scientific and practical value would simply be wasted because of failure of any group to place it properly.”

Dr. Grulee, the AAP’s first secretary-treasurer and later executive secretary, went on to play a significant role in the AAP’s organization.

Another historical marker was the Sheppard-Towner Act of 1921, the first major federal legislation passed to provide grants to improve infant and maternal health. Many supported the legislation, but it was fought by groups such as the AMA. In 1922, pediatricians meeting in their section at an AMA meeting in St. Louis voted to support Sheppard-Towner, angering AMA leaders and precipitating a new rule that no section could vote independently on resolutions related to policies involving the AMA.

Sheppard-Towner opened the door to federal funding for home visits by nurses, child health conferences and distribution of literature on care of infants and mothers.

Founders’ advocacy

When the first national meeting of the new American Academy of Pediatrics took place June 12-13, 1931, in Atlantic City, N.J., there were 93 attendees and 304 members.

Other groups and organizations that promoted child health were the American Child Hygiene Association and American Child Health Association. Among their leaders were AAP founders Dr. Grulee; Isaac A. Abt, M.D., FAAP, the first AAP president; William P. Lucas, M.D., FAAP, a member of the first AAP executive committee; and Philip Van Ingen, M.D., FAAP, an AAP president.

Another pediatric leader active at that time was C. Anderson Aldrich, M.D., FAAP, a member of the first executive committee and one of the signatories with Drs. Abt, Lucas and Grulee on the AAP founding documents.

Some of the founders also had distinguished themselves in overseas service related to pediatrics. Dr. Lucas was chief of the children’s bureau at the American Red Cross (ARC). In 1916, he traveled with the American Commission for Relief in Belgium to survey child health and nutrition, and in 1918-’19, went to France in that role. Dr. Grulee headed the ARC children’s bureau in Lyon, France, and was in charge of a convalescent home-hospital for children.

These were the kind of people motivated to start the Academy.

On July 19, 1929, 35 pediatricians attending an AMA meeting met for dinner at the Portland, Ore., home of James Rosenfeld, M.D., a clinical professor of pediatrics at University of Oregon. They concluded that a new organization was needed and formed a subcommittee to address recruitment.

Dr. Abt recalled the meeting in his book Baby Doctor: “… For some time, I had felt that the children of the United States as a whole were not receiving care commensurate with the great development of pediatrics. Infant mortality still was too high, total facilities for treating children were inadequate, teaching was not everywhere of the best, (and) many children were failing to receive the benefits of preventive measures. …”

When looking back at the founders’ activities, it is clear that child advocacy was there from the beginning, experts say.

The mission is “what’s so core to the pediatricians … which has continued over 90 years,” said AAP CEO/Executive Vice President Mark Del Monte, J.D. “These are the things that knit us together.”

Archivist Allison Seagram, M.L.I.S., C.A., of the AAP Gartner Pediatric History Center,, contributed research. 


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