On the 100th anniversary of Lemuel Shattuck's 1850 Report of the Sanitary Commission of Massachusetts,1 Winslow praised the Report as “the most outstanding single ‘Book of Prophesy’ in the history of public health.”2 What was this report, and what made it so important?
Lemuel Shattuck was born in 1793 in Ashby, Massachusetts. His first career was as a teacher, and he moved westward with the wave of migration in 1817. Afflicted with poor health, he returned to the family home in Concord in 1822, where he became active in civic affairs. He had the strong conviction that collection of data could enhance the ability of government to respond to social ills. He wrote A History of Concord (which included statistical analyses based on church and municipal records), reorganized the local school system to provide a quantitative evaluation of student achievement, and founded the American Statistical Association. After moving to Boston in 1835, he opened a bookshop, was elected to the Massachusetts legislature, and campaigned for a census of Boston. The census was conducted in 1845 and was so successful that Shattuck was called to Washington, DC to help organize the 1850 US census. There he introduced procedures that revolutionized the national census.
Lemuel Shattuck's crowning achievement, however, was as Chair of a Commission authorized by the Massachusetts Legislature to conduct a “sanitary survey of the State” and make recommendations for the “promotion of public and personal health.” Shattuck planned, implemented, and wrote the Commission's Report. This Report was divided into 4 parts. The first 2 dealt with the history and status of the “sanitary movement,” locally and worldwide. The third provided the statistical evidence underpinning 50 recommendations for the organization and implementation of public health agencies, both at the state and local levels. These recommendations included infrastructure for collecting public health data.
The fourth part presented arguments supporting the recommendations, and included a model state public health law. The model law was enacted by the Massachusetts Legislature in 1866 and widely emulated by other States.
Most of the 50 recommendations of the Shattuck Report are now standard components of American public health practice. Shattuck was not just a “prophet” of American public health, but its most influential architect.
1. Winslow CEA. Lemuel Shattuck—still a prophet: the message of Lemuel Shattuck for 1948. Am J Pub Health
2. Shattuck L. Report of the Sanitary Commission of Massachusetts, 1850
. Cambridge: Harvard University Press; 1948 (Facsimile Reprint).