The book Infant Mortality: Results of a Field Study in Johnstown, PA., Based on Births in One Calendar Year (1915), written by Emma Duke, detailed one of the first infant mortality field studies conducted by the US Children's Bureau. In the study, Duke and her colleagues collected information about over one thousand infants in the city of Johnstown, Pennsylvania. They used that information, along with interviews conducted with the families of the infants, to identify factors that affected infant mortality rates in the community. Duke and her team found strong correlations between elevated infant mortality rates and conditions experienced by Johnstown residents of lower socioeconomic status. The design and implementation of the study described in Infant Mortality: Johnstown, PA provided a model for future Children's Bureau research that resulted in seven additional infant mortality studies in other US cities. Infant Mortality: Results of a Field Study in Johnstown, PA., Based on Births in One Calendar Year quantitatively demonstrated the link between poverty and infant mortality.
Julia Clifford Lathrop was an activist and social reformer in the late nineteenth to early twentieth centuries and the first chief of the United States Children’s Bureau. In that capacity, she conducted demographic studies to identify links between socioeconomic factors and infant mortality rates. Lathrop mobilized the effort to increase birth registration and designed programs and publications to promote infant and maternal health throughout the US. Through her studies, she empirically linked poverty and lack of education with higher than normal risks of infant and maternal mortality, and her results supported legislation aimed at lowering infant and maternal mortality in the US.
In November 1921, US Congress passed the National Maternity and Infancy Protection Act, also called the Sheppard-Towner Act. The Act provided federal funds to states to establish programs to educate people about prenatal health and infant welfare. Advocates argued that it would curb the high infant mortality rate in the US. Many states accepted funding through the Sheppard-Towner Act, leading to the establishment of nearly 3,000 prenatal care clinics, 180,000 infant care seminars, over three million home visits by traveling nurses, and a national distribution of educational literature between 1921 and 1928. The Act provided funding for five years, but was repealed in 1929 after Congress did not renew it. Historians note that infant mortality did decrease during the years the Act was in effect. The Act also influenced provisions aimed at infant and maternity welfare in later legislation, such as the Social Security Act of 1935.