Wealthy Americans can learn from the philanthropist who made milk safer

American public health policy was once grounded in a common-sense formula: Identify the pathogen, discover a science-based solution and tenaciously mobilize the public and policymakers behind it. Today, this foundation for public health protection is cracking. Health policy is now often being forged with an eye more to partisan political advantage than science, leaving us exposed to preventable crises. 

It was not always so. In America’s Progressive Era, from the 1890s to about 1920, medical scientists and social reformers repeatedly partnered with the government to bring science-based health solutions to the marketplace, clinic and home.

A dramatic example is the milk-pasteurization work that philanthropist Nathan Straus designed and funded. Joined by allies ranging from mothers’ groups to renowned medical researchers, Straus’s safe-milk campaigns eventually bore fruit, catalyzing municipal and state pasteurization mandates that protected the safety of one of nature’s most perfect foods: cow’s milk. 

In late 19th-century America, potential killers borne in raw cow’s milk, such as tuberculosis and cholera, had often threatened infants’ health. In New York City, such infectious diseases were contributing to an astonishing 25 percent mortality rate among infants under age one. Many solutions were proposed and tested. One turned out to be both definitive and economically scalable: milk pasteurization.

Enter Straus. He and his German-Jewish immigrant family had built their own international wholesaling firm and become the co-owners of Macy’s and Abraham & Straus, the largest department stores in Manhattan and Brooklyn. 

But for Straus, this was not enough. He had come to believe that millionaires like himself were commanded by God and by conscience to dedicate much of their wealth to preventing and relieving human suffering. And, as to disease in milk, there was also a more personal motive. Straus had himself lost his toddler daughter to milk later suspected to be infected. He was haunted by the thousands of families who suffered the same needless trauma.   

But, just what could an individual philanthropist do about this? By the early 1890s, Straus knew one possibility. A friend, the renowned pediatrician Dr. Abraham Jacobi, had for years been prescribing pasteurized, or heat-treated, milk for non-breast-fed babies with good results. Jacobi urged Straus to test this solution at scale in New York City and offered to coach him in how to pasteurize milk to destroy dangerous infection.

In 1893, Straus began putting Jacobi’s expertise and his own retailing experience and fortune to work. He established 17 pasteurized milk depots throughout Manhattan, together with the world’s largest milk-pasteurization plant. Staffed partly by nurses and a visiting pediatrician, the milk depots charged wholesale prices to families who could afford them and donated milk to the truly indigent.

Straus milk reached only about 2,500 families daily — admittedly only a small percentage of needy New Yorkers with babies and young children. But the program had a far-reaching impact in another way. By meticulously documenting dramatic reductions in infant sickness and death, Straus and his allies ultimately convinced New York City health officials to mandate the citywide milk pasteurization.

Over the next years, Straus was to bring his milk initiative to much of America, including six of the nation’s seven largest cities, which mandated city-wide milk pasteurization in 1914. Straus provided similar support to cities and towns across much of Europe, from the British Isles to the German-speaking lands. He sometimes faced fierce dairy industry opposition and had to navigate a mix of resistance and support from pediatricians and elected officials. In the end, he substantially prevailed, exerting unsurpassed influence in convincing the North Atlantic world of pasteurization’s life-saving power.   

Today, America’s federal government is softening or displacing evidence-based recommendations on vaccine use, declining to review or delaying major vaccine applications and scaling back or ending some investments in vaccine access, disease monitoring and the public preparedness for epidemics. The gap between our scientific capacities in public health and our political will to apply them is growing.

We can do much better. Generations ago, Straus and his allies showed that science-based advocacy backed by sustained grassroots pressure can hold policymakers accountable — and, in time, bring about sea changes in health policy. We can take heart — and resolution — from their example.

Andrew Fisher is the author of  “Nathan Straus: From Macy’s Magnate to International Humanitarian” (Rutgers University Press), which will be published on April 14.