March 10 celebrates the birth of an extraordinary woman: Lillian Wald. Wald was born into a middle-class New York family in 1867 and became a nurse at the age of 24. After taking medical courses, Wald’s journey to health care reformer began.
While working in Manhattan’s Lower East Side, Wald was confronted with poverty and a lack of care she hadn’t anticipated. Teaching home health care courses to New York’s immigrant poor of the late 19th Century wasn’t solving the problems Wald saw.
Thus, she created the Nurses’ Settlement, today called the Henry Street Settlement, in 1893. Today, the settlement serves one of the nation’s most ethnically diverse communities with a range of services. It and its founder also serve as models of public service and community care.
Wald’s Role
After leaving medical school to teach her home care classes, Wald began actively visiting her patients in their homes to provide care. She recruited a fellow nurse to join her in her visits, and then the seeds of Henry Street were sewn.
Wald and Mary Brewster, the second nurse, moved into rooms in the community in which they were practicing. This is when Wald coined a term that is still used today: public health nursing.
Community and public health nursing can be found in multiple iterations. As Wald’s terminology suggests, public health nurses rarely work in institutions like hospitals or clinics. If they are found in institutions, these are either non-profit or state-funded.
Following the example set by Wald and her fellows, community health care providers continue to provide care for underserved populations while reforming and innovating.
A Service Model
The settlement serves as a thorough model of community health care. Henry Street has four homeless shelters as well as an organically created retirement community. There are youth programs including college prep courses and GED classes and even a summer day camp.
For municipalities wishing to provide community health care, Henry Street’s holistic services are a great model to emulate. The settlement provides not only state-licensed primary care services through a family clinic, it also provides extensive mental health services to its community.
Because of the large population of Asian immigrants in the community, there are Asian Bi-Cultural Mental Health Services, staffed by health care providers who speak Mandarin, Cantonese, and Taiwanese. The settlement’s mental health services also provide satellite counseling at area schools.
One of the more progressive mental health programs at Henry Street is PROS, or Personalized Recovery Oriented Services. Modeled on theories like neurocounseling, which uses techniques like neurofeedback to re-train the brain and the body, PROS tackles severe cases of mental illness with holistic treatment. It includes treatment programs and workforce training to help integrate or reintegrate a patient into the community and the workforce.
The Visiting Nurse Service of New York, also founded by Wald, is another model of community health care for government entities looking to provide services to their constituents. During this year’s “Snowmageddon,” VNSNY care providers were on the ground in the harsh conditions, working with their everyday patients.
One VNSNY provider, a physical therapist, arrived for a regular appointment despite the lack of public transportation. Like the founder of his organization, he knew that providing routine access to care was essential to his patients.
The Past is the Future
Wald was a shining example of selfless service to the poor and disadvantaged. She was a health care innovator at the turn of the 19th Century. Now, health care innovation is an entire industry. Government entities create entire business functions around community health care because of the pioneering work of Lillian Wald. Celebrate her birthday by looking to the future of health care innovation.
