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April 2012Vol. 13, No. 3CB and the Sheppard-Towner Act of 1921

The Sheppard-Towner Act of 1921 was the first major piece of Federal legislation focused on improving maternal and infant health. The law allocated nearly $1.2 million in Federal funds to States over 5 years for infant and maternal health care education. An article in Families in Society: The Journal of Contemporary Social Services describes the role that Children's Bureau research and advocacy played in the passage of the act.

Children's Bureau (CB) efforts not only paved the way for the groundbreaking legislation but also changed the face of social science research. CB's first Chief, Julia Lathrop, adopted a cohort approach to studying infant mortality to try to identify the causes of the high rate of infant mortality. Prior to the studies conducted by CB in the early 1900s, infant deaths had merely been counted. Factors contributing to the death, particularly factors that could prevent infant deaths, had not been evaluated. Moreover, Lathrop insisted the data be aggregated, evaluated, and disseminated to vulnerable populations.

By 1921, CB had published and disseminated 46 documents ranging from pamphlets on proper infant and child care to full field study reports and cross-national comparisons. This approach to research and subsequent findings led Jeanette Rankin, the first female Member of Congress, to introduce a bill to address infant mortality. It was later reintroduced by Senator Morris Sheppard of Texas and Congressman Horace Towner of Iowa, receiving the moniker Sheppard-Towner.

The act was the first of its kind, providing direct Federal funds to States and, in essence, extending the work of CB to the States. Lathrop repeatedly testified at congressional hearings that CB's research and dissemination efforts simply were not enough. Federal action was necessary to help States lower the nation's infant mortality rate.

The Sheppard-Towner Act passed the U.S. Senate on July 22, 1921, and passed the U.S. House of Representatives that November. President Harding signed the act into law on November 21, 1921, authorizing the flow of nearly $1.2 million through CB to States for 5 years, expiring on June 30, 1927. The act included provisions for:

  • Infant and maternal health care education
  • Visiting nurses
  • Child health centers
  • Child health conferences
  • Literature distribution

Following the implementation of the Sheppard-Towner Act:

  • The U.S. infant mortality rate fell from 76 per 1,000 live births in 1921 to 65 per 1,000 in 1927.
  • Nearly 145,000 health conferences provided health care to children and mothers.
  • Approximately 3,000 centers for prenatal care were established.
  • Nearly 20,000 infant and maternal care classes were conducted.

The article also explores the staunch opposition to the act, the failed attempts to extend the act for 2 years, and the act's implications on social work practice today.

"The Children's Bureau and Passage of the Sheppard-Towner Act of 1921: Early Social Work Macro Practice in Action," by Elizabeth Sammons Rodems, H. Luke Shaefer, and Marci Ybarra, is available on the Families in Society website: (212 KB)