A comfortable start
Lillian D. Wald was born on March 10, 1867, in Cincinnati, Ohio, the third of four children of Max Wald, an optical goods dealer, and Minnie Schwarz Wald. Both sides of the family were German and Polish Jews, descended from merchants and rabbis, who had emigrated after the failed revolutions of 1848. In 1878 the family moved to Rochester, New York, which Wald always thought of as her home town.
Hers was a privileged and liberal household. She attended a private school for young ladies, received no formal Jewish education, and grew up in a cultured, comfortable world. At sixteen she applied to Vassar College and was turned away as too young.
Finding a vocation
In 1889 Wald met a young nurse and was inspired to train as one herself. She entered the nursing school of New York Hospital and graduated in 1891, then worked at the New York Juvenile Asylum, an orphanage with grim conditions. She went on to study at the Woman’s Medical College, intending to become a doctor.
In 1893, while still a medical student, she began teaching a class in home nursing for immigrant families on Manhattan’s Lower East Side. One day a child from the class led her to a tenement where the child’s mother lay ill in squalid conditions. Wald later called the experience her “baptism of fire” writing that she had seen “all the maladjustments of our social and economic relations epitomized in this brief journey.” She left medical school, and with a fellow nurse, Mary Brewster, moved into the neighbourhood, first to the College Settlement on Rivington Street and then to a tenement on Jefferson Street, so that they could care for the sick where they lived.
The house on Henry Street
Wald’s idea was simple and radical: that everyone, rich or poor, was entitled to good care, and that nurses should go to the patient’s home and treat the patient with respect, charging only what a family could afford, if anything. The banker and philanthropist Jacob Schiff quietly provided funds, and in 1895 Wald and her colleagues moved into 265 Henry Street, founding what was first called the Nurses’ Settlement and became the Henry Street Settlement.
The work grew rapidly. By 1906 Wald had twenty-seven nurses on staff, and by 1913 the staff numbered ninety-two. The settlement offered classes, clubs, playgrounds and, from 1915, the Neighborhood Playhouse, but its core remained home nursing. Its nursing service would eventually become the Visiting Nurse Service of New York. Wald described the work and the neighbourhood in two books, The House on Henry Street (1915) and Windows on Henry Street (1934).
Life at the settlement
Henry Street was meant to be a neighbour, not an institution. Wald believed that a family should not have to break up because one member was sent to hospital, and that good care at home could shorten hospital stays and cut costs. The nurses concentrated especially on the care of women and children, teaching hygiene and disease prevention as well as treating the sick, and the settlement’s clubs and classes made it a centre of neighbourhood life.
Wald was also a gifted fundraiser who cultivated personal friendships with her donors. Jacob Schiff’s early support was soon joined by that of non-Jewish philanthropists such as Elizabeth Milbank Anderson. In a 1901 lecture to the International Congress of Nurses in Buffalo, she described the settlement’s social life with characteristic humour: next to nursing typhoid fever, she said, its residents loved to give a ball.
Inventing public health nursing
Wald coined the term “public health nurse” for a nurse whose work was embedded in the life of a community and who addressed the social and economic causes of illness, not merely its symptoms. She argued that a nurse should understand the housing, schooling and social life of the neighbourhood she served. A nurse’s “organic relationship with the neighborhood” she believed, should be the starting point for a service that could reach everyone in a region, rich and poor alike.
In 1902 she persuaded New York City to try putting a nurse in its public schools. She lent one of her own nurses, Lina Rogers, who in her first month treated hundreds of pupils across four schools and made more than a hundred home visits. The results were so striking that the city quickly hired more nurses, creating the first municipal school nursing programme in the United States. Wald also persuaded the Metropolitan Life Insurance Company to offer nursing visits to its policyholders from 1909, a model other insurers followed; became the first president of the National Organization for Public Health Nursing; and helped establish nursing education at Columbia University. During the 1918 influenza pandemic she chaired the Nurses’ Emergency Council, which provided visiting nurses to sick families in their homes, and her leadership was critical in steering New York through the crisis. She even suggested a national health insurance plan.
Reformer for children and workers
Wald’s nursing work led her inexorably into politics. She was an early leader of the movement against child labour that became the National Child Labor Committee, which lobbied for federal child labour laws and in the 1920s proposed a constitutional amendment to ban child labour outright. In 1903 she suggested to the reformer Florence Kelley that the federal government, which already had a department to look after the nation’s farm crops, should have a bureau to look after its children. The two women carried the idea to President Theodore Roosevelt, and after years of lobbying and eleven failed bills, Congress created the U.S. Children’s Bureau in 1912, the first federal agency devoted to children’s welfare.
She organised New York campaigns for women’s suffrage and backed the social programmes of New York governor Al Smith, supporting his presidential campaign in 1928.
Peace and civil rights
Wald insisted that the classes at Henry Street be racially integrated. In 1909 she was among the founders of the National Association for the Advancement of Colored People, and the National Negro Conference from which it grew held a public meeting at the Henry Street Settlement.
When war broke out in Europe in 1914, she helped lead a women’s peace march in New York, and in 1915 she became president of the American Union Against Militarism. She remained involved with its offshoots, including the organisation that became the American Civil Liberties Union, and helped establish the Women’s International League for Peace and Freedom. Addressing the committee organising the women’s peace march in August 1914, she argued that women more than men could “strip war of its glamour” and see it as a demon of destruction.
Jewish roots and private life
Wald was not religiously observant, yet her life’s work was rooted in the Jewish immigrant world of the Lower East Side, where many of her first patients were poor Jewish newcomers from the Russian Empire. Her chief early backer, Jacob Schiff, was one of the most prominent Jewish philanthropists of the age, and quietly funded her care of the neighbourhood’s Jewish immigrants. In The House on Henry Street she argued against restricting immigration, writing that the newcomer brought new life to the nation. The settling of newcomers, she wrote, could best be achieved through contact with the immigrant “in which the dignity of the individual and of the family is recognized.”
She never married. Historians including Blanche Wiesen Cook have written about her close relationships with women at Henry Street, among them the lawyer Helen Arthur and the economist Mabel Hyde Kittredge, with whom she started a school lunch programme. Her biographer Clare Coss observed that she prized the personal independence that let her move quickly and act boldly.
Last years and legacy
In 1922 The New York Times named Wald one of the twelve greatest living American women, and she was later awarded the Lincoln Medallion as an “Outstanding Citizen of New York.” Ill health led her to withdraw from the active direction of Henry Street in the early 1930s. On her seventieth birthday in 1937, a radio tribute featured a letter from President Franklin Roosevelt praising her “unselfish labor to promote the happiness and well-being of others.” She died of a cerebral haemorrhage on September 1, 1940, aged seventy-three. A rabbi led her memorial service at the Neighborhood Playhouse, more than two thousand people gathered at Carnegie Hall for a tribute, and she was buried in Mount Hope Cemetery in Rochester.
Her fame reached popular culture during her lifetime. Helen Dore Boylston’s 1938 novel Sue Barton, Visiting Nurse has its young heroine meet Lillian Wald at Henry Street. In Manhattan, the Lillian Wald Houses on Avenue D, a public housing development, bear her name.
Wald was elected to the Hall of Fame for Great Americans in 1970 and the National Women’s Hall of Fame in 1993. Her ideas are now so familiar they seem obvious: that nurses belong in schools and communities as well as hospitals, that prevention matters as much as cure, and that health cannot be separated from housing, work and poverty. The Henry Street Settlement still serves New Yorkers, the visiting nurse service she started still makes home visits, and the model of community public health nursing she pioneered spread across the United States and far beyond.
Sources & further reading
Lillian Wald, Wikipedia · Wald, Lillian, Social Welfare History Project, VCU Libraries · Children’s Bureau, Part I, Social Welfare History Project · Lillian Wald, Wikiquote · Researched from the sources above and checked against them. Spotted an error? Tell us.
A life of tikkun olam. This is part of tikkun olam, the Jewish idea of repairing the world, and every one of us can add to it.