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The average American life span has increased dramatically. In 1900, life expectancy in the United States was 48.19 years. By 2020, it was 76.77. Initially, the increase was driven mainly by a reduction in infant mortality (PDF). Quality of life also improved for children, especially as protections we now take for granted were put in place, and cures or treatments for many diseases and conditions were discovered.

Many of the Americans who drove these transformative changes were women. These doctors, social workers, government officials, researchers, scientists, teachers and nurses encountered many barriers. We benefited greatly from their perseverance.

Three Women Who Helped Change the Trajectory of Life in America

I think it's time we recognized more of the remarkable American women who helped shape life as we know it today. In honor of Women's History Month, I would like to tell you about three women you may not have heard of who helped change the trajectory of life in America.

Before What to Expect When You're Expecting, There Was a Book of Medical Discourses

In 1864, Dr. Rebecca Lee Crumpler (1831–1895) became the first African American woman in the United States to graduate from medical school.

In addition to providing medical care to formerly enslaved Americans and others suffering from poverty after the Civil War, she wrote A Book of Medical Discourses. Dr. Crumpler's book has been described as "the forerunner to the famous What to Expect When You're Expecting." It may be the first medical text written by an African American author. Given that the United States did not abolish slavery until 1865 and that women did not obtain the right to vote in all states until 1920, Dr. Crumpler's achievements and contributions are even more inspiring and worthy of celebrating.

Born in Delaware, not far from Nemours Children's Hospital, Dr. Crumpler died at age 64 in Boston, Massachusetts. Her home is a stop on the Boston Women's Heritage Trail.

The First Woman to Head a Federal Agency in the United States

President Taft appointed Julia Lathrop (1858–1932) in 1910 to serve as the first chief of the Children's Bureau in the Department of Commerce and Labor. She was the first woman to head a federal agency in the United States. The department enforced new laws against child labor at a time when many young children were forced to forgo an education to work in factories and fields. Under Lathrop, the Children's Bureau advanced maternal health funding, researched child health and armed America's parents with up-to-date health information. In the 1940s, the Children's Bureau was folded into the Social Security Administration. Today, it is part of the Department of Health and Human Services.

The following remarks, which Lathrop delivered at the National Education Association convention more than 100 years ago, are relevant today:

"We cannot help the world toward democracy if we despise democracy at home; and it is despised when mother or child die needlessly. It is despised in the person of every child who is left to grow up ignorant, weak, unskilled, unhappy, no matter what his race or color."

Julia Lathrop was born in Rockford, Illinois, and died there at the age of 74. As historian Miriam Cohen explains, newspaper coverage of her death often quoted Lathrop's friend and fellow social reformer Jane Adams, who described Lathrop as "one of America's most useful women."

A Nobel Prize and Hope for Children with Leukemia

Gertrude B. Elion (1918–1999) revolutionized the development of pharmaceuticals. She won a Nobel Prize for her work in 1988.

At age 19, she graduated summa cum laude from Hunter College. Despite her high grades, Elion was initially rejected from graduate schools and research positions because of her gender. Fortunately for anyone who's benefitted from modern pharmaceuticals, Elion did not give up. Eventually, she was accepted into graduate school at New York University, which she attended while teaching high school.

When labs began hiring women out of necessity during the Second World War, Elion was hired by George Hitchings at Burroughs Welcome (now GlaxoSmithKline). With Hitchings and her own team, Elion developed a breakthrough drug for leukemia, the first antiviral drug, and a drug used in organ transplantation. Even during her retirement, she advised the team that developed AZT, the first drug approved to treat AIDs. In addition to her Nobel Prize, Elion was awarded 23 honorary degrees and granted 45 patents. Gertrude Elion passed away in 1999, the last year of a century during which she had a direct and lasting role in shaping the health of our nation and the world.

Inspiration for a Healthier 21st Century

Reading about women like Gertrude Elion reminds me that Nemours Children's Health owes its very existence to a determined, visionary woman who cared deeply about children. A school administrator before marrying Alfred I. duPont, Jessie Ball duPont was largely responsible for creating the vision through which his wishes were carried out after his death. As the founding chair of the Nemours Foundation, she oversaw the creation of the Alfred I. du Pont Institute (now Nemours Children's Hospital in Delaware). She stressed the importance of caring for the whole child and convened leaders from the public and private sectors to advance practices and policy. Her work lives on today as Nemours conducts cutting-edge research, provides free health information via KidsHealth.org, and advocates for government attention to child health at the highest levels of government.

I asked Dr. Kara Odom Walker, our Chief Population Health Officer and the former Secretary of the Delaware Department of Health and Services, for her thoughts on women's history month and this article. As a Delaware native passionate about chemistry, medicine and health equity, she said she feels connected to and inspired by women like Crumpler, Lathrop, Elion and duPont.

"Their visionary work in the 19th and 20th centuries is a model for the work we must do now to advance and improve life for all Americans in the 21st century — from advocating for a White House Office on Children and Youth to addressing the social determinants of health."

I couldn't agree more.

About Dr. Moss

R. Lawrence Moss, MD, FACS, FAAP is president and CEO of Nemours Children’s Health. Dr. Moss will write monthly in this space about how children’s hospitals can address the social determinants of health and create the healthiest generations of children.