This photograph album presents detailed visual documentation of the Commonwealth Fund Child Health Demonstration’s (CHD) study of children from Rutherford County, Tennessee, between 1924 and 1928. The CHD’s philanthropic venture was to promote the welfare of humanity by providing publicly funded child health education and care, building hospitals, and promoting the idea of county appointed health officers. Dr. Harry Stoll Mustard (1889-1966), a physician educated at the College of South Carolina and the College of Charleston, was the on-site director based in Murfreesboro, Rutherford County’s seat of government. At the time of his appointment to Murfreesboro he was serving as a county health officer in West Virginia, where he successfully developed a rural health program.
The Commonwealth Health Fund, established in 1918, was the brainchild of Anna Harkness, widow of one of the early investors in Standard Oil. Her goal was to “do something for the welfare of mankind,” and the CDH always operated with the welfare of at-risk populations in mind. In the Progressive spirit of the day, the Harkness family humanitarian investment led to the construction of hospitals and rallied communities to become more involved in public health care.
The Commonwealth Fund was among the first philanthropic foundations to be started by a woman. According to its current mission statement, the Fund aims to promote a high standard health care system for society’s most vulnerable: the poor, the uninsured, minorities, young children, and elderly adults. The Fund still supports research on health care delivery and awards grants to improve its quality.
The Dr. Harry S. Mustard Photograph Album documents the Commonwealth Fund Child Health Demonstration (CHD) study of Rutherford County, Tennessee, children between 1924 and 1928. The CHD promoted the welfare of humanity by encouraging publicly funded child health education and care, building hospitals, and promoting the idea of county appointed health officers. Dr. Mustard was the onsite director based in Murfreesboro, the seat of government in Rutherford County.
Rural health experiments, a legacy of the Progressive Movement and its social reform-minded adherents, focused on safe, compassionate, and efficiently delivered care. Because of the movement’s vast industrial reform, many associate Progressivism with urban environments. The Mustard Album reveals that a good portion of the reform efforts encompassed agrarian interests, traditionally the backbone of the American economy. Impoverished Tennessee, with its racial and geographical diversity, was the ideal place to test the progressive theories of the child health demonstration.
The album that he compiled chronicles his study of child welfare and public health issues. The photographs depict dilapidated schools and homes, poorly dressed and diseased students, inoculated children, hygiene and nutrition classes, and sanitation advances. The CDH’s biggest challenges in this grassroots effort were convincing rural parents to overcome their mistrust of the outside world and that changing their lifestyles (e.g., nutrition) would improve their children’s health. According to historian Mary S. Hoffschwelle, an expert on the Rutherford County project, the mission of improving child health hid a more ambitious goal: convincing rural counties to financially support and staff their own public health facilities. Twenty-seven communities in Rutherford County, including such places as Christiana, Smyrna, Walter Hill, Eagleville, and Lascassas, participated in the child health demonstration.
Health problems were common among the rural poor and included such diseases and conditions as diphtheria, intestinal parasites, typhoid, tuberculosis, rickets, scarlet fever, and poor dental care and diet. Such conditions can be partially explained because 31 percent of the population was illiterate, leaving rural people medically uneducated. The program was successful in combating illiteracy in great part because of the close organization between parents and teachers. The album shows the progression toward improved public health care among both white and African-American families. Public health care and knowledge of self-care were almost non-existent before the Fund began its study. As soon as families made the recommended applications, the health landscape began to improve. Schools competed with each other for awards recognizing their progress. By the time the study ended in 1928, the county had built the Rutherford Hospital and inspired the Division of Public Health to operate field units in other counties. Dr. Mustard became the county’s first public health officer.
Progressivism’s political and ideological surge influenced Dr. Mustard’s work in public health service. The CHD’s Rutherford County experiment and others like it prompted a national trend in supporting patient-centered care in rural communities and construction of rural hospitals. Inoculations became more common, infant mortality declined, and parent-teacher organizational skills were developed. Progressivism’s influence on political thinking and ideology were keystones of the early twentieth century. The field of child development transformed into a science, as did the professional social worker. It came to be a well-established Progressive era doctrine that welfare and social work should be undertaken by those who were appropriately trained for it Child labor laws were established, standards of living were raised, and labor was organized. These efforts continued during the twentieth century; the Hill-Burton Act, using public monies to fund hospital construction, was passed in 1947. Since 1995, the Commonwealth Fund has focused its resources on improving health care coverage and access. Dr. Mustard went on to hold positions at The Johns Hopkins University Medical School, New York University College of Medicine and the Columbia University School of Public Health. The album leaves an invaluable record of rural Progressivism in Tennessee.
It was donated to the Tennessee Historical Society (whose collections are maintained at TSLA) by Mary B. Mustard Duval in 1984.
Hoffschwelle, Mary S. Rebuilding the Rural Southern Community: Reformers, Schools, and Homes in Tennessee, 1900-1930. Knoxville: University of Tennessee Press, 1998.
Mustard, Harry S. M.D. Cross-Sections of Rural Health Progress. New York: Commonwealth Fund Division of Publications, 1930.
People of the Cumberland. A film by Robert Stebbins and Eugene Hill. 21 min., Highlander Folk School, 1939. Videocassette.
Tennessee Encyclopedia of History and Culture, “Commonwealth Health Fund” by Mary S. Hoffschwelle. Nashville: Tennessee Historical Society and Rutledge Hill Press, 1998.
Tennessee Encyclopedia of History and Culture, “Harry Stoll Mustard” by Mary S. Hoffschwelle. Nashville: Tennessee Historical Society and Rutledge Hill Press, 1998.
www.cmwf.org Commonwealth Fund website (2007).
Note: TSLA does allow for the printing of low resolution, watermarked copies of the images found in TeVA for educational purposes only. Click here for more information.