Date of Award


Level of Access Assigned by Author

Open-Access Dissertation

Degree Name

Doctor of Philosophy (PhD)




Marli F. Weiner

Second Committee Member

Nathan Godfried

Third Committee Member

Richard Judd


Following new discoveries in bacteriology, public health developed slowly in rural Maine during the late nineteenth and early twentieth centuries, initially in response to communicable diseases and poor sanitation. The legislature created the Maine State Board of Health in 1885 and in 1887 required towns to appoint boards of health. Local responses to public health problems and disease control methods led to both cooperation and resistance. By the 1920s governmental and non-governmental health programs involved the participation of farmers, housewives, school children, women's club members, summer residents, business leaders and health professionals. Voluntary health organizations, such as the Maine Public Health Association, the American Red Cross, the Maine Federation of Women's Clubs, and the Maine Medical Association cooperated to develop Maine's public health services. When an increasing number of health policies and programs originated at state and federal levels (such as the Sheppard-Towner Act of 192 1 and the Social Security Act of 1935) or from the national offices of voluntary organizations (including the peacetime public health program of the American Red Cross initiated after World War I), tensions emerged at the local level. Politicians disliked federal interference in state affairs; the legislature initially rejected the federal Sheppard-Tower funds for maternal and infant hygiene because of states' rights concerns. Growing local support for public health nursing services changed Maine's attitudes about this federal funding by 1927. With increased federal funding in the 1940s public health nurses organized town health councils throughout the state, assisting the Bureau of Health to better meet local needs. The local dynamics of rural public health in Maine between 1885 and 1950 highlight changes in conflict and cooperation among those with similar goals. This study shows how health professionals and volunteers in communities across Maine improved public health among the state's residents. While working to meet local needs, these individuals managed not only to gain a measure of control, but to give life to the slogan adopted by the Maine Public Health Association, "All for HEALTH for All." Over time the balance of conflict and cooperation in rural public health shifted in favor of cooperation.