Balancing the past and the present: Healthcare and humidity

Fall is here, sort of, and the dogs are settling into the change in routine and the change in weather.  This is a time of transition for us as the college help goes back to school and we scramble around the schedule to accommodate their classes and internships.  Who knew the hottest days of the summer would be in September?  We added extreme heat and humidity (comparatively) to a largely understaffed week at work and the start of school for the teenage son (and his first out of town varsity football game).  With the usual combination of awesome husband, after work cocktails and dumb luck, I managed to survive it all, plus a gardening injury that sent me to Urgent Care for some super glue and a tetanus shot!

So here we are a week away from the abstract deadline for our national meeting (The American Association of Physical Anthropology) and the plan is to spend the day looking at the physician reports from the Erie County Poorhouse.  They are contained within the Proceedings of the Erie County Board of Supervisors from 1880-1910 (Available at the Buffalo and Erie County Public Library).  The working hypothesis is that the Erie County Hospital (part of the Erie County Poorhouse complex) provided adequate care for the city’s poor.  Quantitatively, we have the Hospital Department Report (sometimes called the Physician’s Report).  These reports documented the number of people treated, what they were treated for, if they were cured and if they died (among other variables, such as nativity, or country of origin).  We will use these data to calculate crude death rates and disease specific death rates for the Erie County Hospital to compare with the census data for the general population. (Below: Proceedings of the Erie County Board of Supervisors, 1895, from the Buffalo and Erie County Public Library)

There are also qualitative data such as resolutions or written reports from the Medical Superintendent that documented changes in procedure, such as the report below.  This report documented the hospital’s move to the former lunatic asylum (now Hayes Hall on the University at Buffalo’s Main Street Campus) by Dr. Francis Metcalf in 1894.  This report discussed the reclassification of many cases from chronic to treatable, as well as improvements/changes to the facility and the staff.  These types of reports are critical to understanding what else was going on in terms of policy and procedural changes that might have impacted the quality of care available at the hospital. (Below: Proceedings of the Erie County Board of Supervisors, 1894, from the Buffalo and Erie County Public Library)

Why are we interested in the quality of care at the Erie County Hospital, you ask?  Well, we have determined that most of the individuals excavated from the Erie County Poorhouse Cemetery were likely not inmates of the poorhouse, but rather residents from the city of Buffalo who couldn't afford alternative health care.  We have been able to compare the diseases, injuries, and other conditions identified in the skeletons with those recorded in the hospital’s mortality index.  However, these data only allow some understanding of the people who died.  The Physician Reports also document those individuals who were treated and survived their ailments, therefore providing us with a more complete picture of the health issues experienced by the city’s poor and the health care available to them.

Having only been through 20 of the 30 reports, I had better stop blogging and finish collecting data! (Go Bills!)