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By L. A. Hill

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As early as 1915, Fisk could invoke data from physical examinations to show that Americans were not in good shape. 4% of insurance policyholders, he claimed, were normal. All the rest were imperfect and needed advice regarding their physical condition or living habits. He reported that about 93% had not been aware of their impairments and 66% had been referred to a physician for treatment. Results were similar for employees sent for examinations by banks and other businesses. 13 As time went on, the LEI generated data about clients that was unprecedented in scope.

Haven Emerson of the Columbia University School of Public Health replaced him and continued on the path set by his predecessors. Soon after taking office, he called on prominent cardiologists to advise the health department on how best to deal with heart disease. This led to the organization of the New York Committee for the Study and Prevention of Heart Disease, which later became the American Heart Association. 30 Preventing Death among Productive Men New York City was unique among American urban centers in taking such vigorous action against degenerative diseases so early in the twentieth century.

35 This preoccupation with the deaths of “productive” men between 40 and 65 28 Chronic Disease in the United States (usually expressed by men between 40 and 65) continued. 36 Such data was particularly disturbing as Americans by 1915 were contemplating the prospect of entering World War I. “How much longer may we hope successfully to meet the struggles of peace and war with the proportion of inactive, flabby-muscle, low-powered Americans constantly increasing? ”37 This situation was all the more dangerous because it was claimed that Europe had not experienced a corresponding increase in either the degenerative diseases or the general death rate in middle life.

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