by Dr. Gerhard Falk
D. Wald (1867 - 1940)
Lillian D. Wald was the originator of public-health
nursing and the founder of the Visiting Nurse Service in New York City. She also
initiated the first public-school nursing program in the United States and
founded the Henry Street Settlement in New York City.
Wald was born on March 10, 1867, in Cincinnati, Ohio, the third of four children
in the second daughter of Max D. and Minnie Schwartz Wald. Wald's father moved
his family from Cincinnati to Rochester, New York, when Wald was still a young
child, hence, she viewed Rochester as her home town. A dealer in optical goods,
Max Wald descended from a long line of German-Jewish scholars, rabbis, and
merchants. Jewish as well, her mother's ancestors were Polish and German. Wald's
grandfather, Gutman Schwartz, lived with the family for several years and had a
great deal of influence on her.
Because her father's income was good, Wald was educated in an expensive private
school. She learned to speak both French and German. She applied to Vassar
College in 1883 but was turned down because she was too young. Instead she
traveled for six years and briefly worked as a newspaper correspondent.
In 1889 Wald met a nurse who had been trained at Bellevue Hospital in New York
City. This nurse influenced her to enter the nursing profession and she enrolled
in the two-year nursing program at New York Hospital in August 1889 at the age
of 22. She graduated in March 1891, having had the benefit of guidance by the
program's director of nursing, Irene H. Sutliffe.
After graduation from nursing school, Wald entered the Women's Medical College
to study for an M.D. degree. She also volunteered her services as a home nurse
among the immigrants moving into the lower east side of New York City. Having
been trained in a “hands-on” setting it New York Hospital, Wald felt neither
degraded nor diminished by her work among the poor.
Wald determined that the poor on the lower east side needed immediate help. She
left medical school in 1893 and moved into a house on Jefferson Street in order
to help the poor within her own community. She began her work with the aid of
her friend Mary Brewster, whom she had known at the New York Hospital. Two years
later in 1895, Wald in Brewster moved into a nearby house on Henry Street and
from there organized services and programs that became the model for similar
settlements in the United States, Canada, and Europe.
At the turn of the century and for some time thereafter, over 90% of the sick
stayed home. Poor people had no money to pay physicians, and hospitals were
reserved for extreme cases and generally did little good. Therefore, the Henry
Street Settlement was useful not only in that it served Wald and Brewster in
bringing nursing services to the poor, but it also served as a means of
promoting education, recreation, housing, and relief for the unemployed in the
neighborhood. In short, it grew into a multiple-service agency.
Although a few denominational groups had made similar efforts, their work was
directed only at members of the denomination offering the service and depended
on the occasional efforts of part-time volunteers. Wald and her associates were
able to conduct their visiting-nurse activities on a full-time basis because
they lived in the neighborhood where the services were needed and because they
offered these services without respect to religion or race.
Their efforts attracted others to their cause. Betty Loeb, the wife of one of
New York City's financiers, became interested in the activities of Wald and
introduced her son-in-law, Jacob Schiff, to buy the house on Henry Street for
Wald and her visiting nurses.
In 1893 when Wald moved to Henry Street, she had 10 associates, nine of whom
were trained nurses. In 1900 there were 15 nurses, and by 1906 there were 27.
During those years, New York City received an average of 20,000 immigrants per
The nurses from the settlement received $60 per month, money contributed by the
Loeb in Schiff families. Wald was known as a successful fundraiser, and her
enterprise continued to grow. By 1913 the Henry Street Settlement had seven
houses in two uptown branches. Three years later in 1916, 250 visiting nurses
were seeing 1300 patients per day, and the membership of the visiting nurse
service had grown to nearly 4000. Wald administered a budget of $600,000 per
year, all from private contributors. Wald was able to raise large sums in part
because she was able to appeal to potential contributors by dealing with
individual cases and was able to convey to others a willingness to serve.
The projects and ideas developed by Wald over the years were varied and
original. In 1902 she succeeded in persuading the New York City Board of
Education to hire school nurses for the first time. Directly thereafter, she
persuaded President Theodore Roosevelt to support the establishment of the
Federal Children's Bureau in an effort to protect children from the practices of
child labor, which she attacked vigorously in an article in the American Journal
of Nursing in 1906. The Federal Children's Bureau finally came into existence in
1912 during the administration of William Howard Taft. That same year, Wald
founded the Town and Country Nursing Service of the American Red Cross.
Only two years earlier in 1910, Wald had persuaded Columbia University to
appoint her friend Mary A. Nutting as the first professor of nursing, thus
establishing the first nursing department in any American institution of higher
education. She also succeeded in convincing the Metropolitan Life Insurance
Company to institute a nursing service for its industrial policyholders. In 1909
she organized the first conference on the prevention of infant mortality at New
Although Wald considered all of her activities as nursing services and although
she objected to being viewed as a social worker, she was nevertheless
responsible for several programs beyond the usual scope of nursing. As early as
1900, she educated for better laws to assure alimony payments for abandoned
women. In August 1914 she organized a march against World War I, an event that
led the Daughters of the American Revolution to list are as dangerous. She also
helped found the Women's Trade Union League in 1903 to protect women from the
horrors of the sweatshops of that era.
Wald used to Henry Street Settlement in several different ways. It served as a
recreation center for neighborhood families, with swings and other equipment for
the use of children. She organized upgraded reading classes for children who
needed help, joined Elizabeth Farrell in introducing special school classes for
“backward” children, and opened study rooms, where she helped children with
homework after school. In 1906 she found that the Vocational Guidance Committee
at the Henry Street Settlement.
Wald opened a convalescent home in South Nyack, New York, in 1899, and
campaigned in speeches and in writing against the practice of boarding out
babies, a practice to which the poor often resorted to alleviate their financial
needs. Wald promoted the use of foster homes as a solution. She taught
immigrants to save money and supported the cause of organized labor by demanding
medical inspection of industry in order to ensure adequate ventilation and other
health needs of workers and to prevent the use of child labor. She visited
industrial executives and argued for the advantages of ventilation and medical
services in factories on the grounds that changes in these areas would save them
Wald served on many committees. As early as 19, she served on the so-called
Pushcart Commission in New York City, whose purpose it was to rid the poor
neighborhoods of the pushcarts that were not allowed in wealthier areas. She
chaired the nurses' emergency council of the Atlantic division of the Red Cross
during the influenza epidemic of 1918 and the Red Cross committee on home
nursing during World War I. In 1919 she represented the United States at the
Committee of Red Cross Societies in Cannes, France. Together with Florence
Kelley, she founded the National Labor Committee in 1924.
The influence of Wald was worldwide. In 1924 she visited England, Germany,
Italy, and the Soviet Union. Later, she visited Mexico. Wherever she went, she
carried the message of public-health nursing. Having refused marriage, Wald had
devoted herself entirely to the needs of others. She inspired others to work
with her and succeeded in many of her causes because people wanted to do things
for her, even if they were not completely convinced of the cause itself. During
her lifetime she received the Gold Medal of the National Institute of Social
Sciences (1912), the Rotary Club Medal, and the Better Times Medal.
In 1925 Wald began to suffer from heart trouble and anemia. Nevertheless, she
continued her rigorous schedule until 1932, when she was forced to reduce her
workload because of an operation from which she never fully recovered. In 1933
she gave up her position as head worker at the Henry Street Settlement and moved
to Westport, Connecticut. There she wrote her second book, Windows on Henry
Street, in which she described her career since the publication of The House on
Henry Street in 1915. In 1937 she gave up her position of president of the board
of the Henry Street Settlement.
Walt died at her Connecticut home on September 1, 1940. Her ashes were buried in
the family plot in Rochester, New York.
In September 1971 a bronze bust of Wald was placed into the Hall of Fame for
Great Americans at New York University.
Dr. Gerhard Falk is the author of
numerous publications, including Football
& American Identity (2005) & Youth
Culture and the Generation Gap (2005) with Dr. Ursula A. Falk.