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Only one hundred years ago, in even the world’s wealthiest nations, children died in great numbers—of diarrhea, diphtheria, and measles, of scarlet fever and tuberculosis. Throughout history, culture has been shaped by these deaths; diaries and letters recorded them, and writers such as Louisa May Alcott, W. E. B. Du Bois, and Eugene O’Neill wrote about and mourned them. N Only one hundred years ago, in even the world’s wealthiest nations, children died in great numbers—of diarrhea, diphtheria, and measles, of scarlet fever and tuberculosis. Throughout history, culture has been shaped by these deaths; diaries and letters recorded them, and writers such as Louisa May Alcott, W. E. B. Du Bois, and Eugene O’Neill wrote about and mourned them. Not even the powerful and the wealthy could escape: of Abraham and Mary Lincoln’s four children, only one survived to adulthood, and the first billionaire in history, John D. Rockefeller, lost his beloved grandson to scarlet fever. For children of the poor, immigrants, enslaved people and their descendants, the chances of dying were far worse. The steady beating back of infant and child mortality is one of our greatest human achievements. Interweaving her own experiences as a medical student and doctor, Perri Klass pays tribute to groundbreaking women doctors like Rebecca Lee Crumpler, Mary Putnam Jacobi, and Josephine Baker, and to the nurses, public health advocates, and scientists who brought new approaches and scientific ideas about sanitation and vaccination to families. These scientists, healers, reformers, and parents rewrote the human experience so that—for the first time in human memory—early death is now the exception rather than the rule, bringing about a fundamental transformation in society, culture, and family life.


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Only one hundred years ago, in even the world’s wealthiest nations, children died in great numbers—of diarrhea, diphtheria, and measles, of scarlet fever and tuberculosis. Throughout history, culture has been shaped by these deaths; diaries and letters recorded them, and writers such as Louisa May Alcott, W. E. B. Du Bois, and Eugene O’Neill wrote about and mourned them. N Only one hundred years ago, in even the world’s wealthiest nations, children died in great numbers—of diarrhea, diphtheria, and measles, of scarlet fever and tuberculosis. Throughout history, culture has been shaped by these deaths; diaries and letters recorded them, and writers such as Louisa May Alcott, W. E. B. Du Bois, and Eugene O’Neill wrote about and mourned them. Not even the powerful and the wealthy could escape: of Abraham and Mary Lincoln’s four children, only one survived to adulthood, and the first billionaire in history, John D. Rockefeller, lost his beloved grandson to scarlet fever. For children of the poor, immigrants, enslaved people and their descendants, the chances of dying were far worse. The steady beating back of infant and child mortality is one of our greatest human achievements. Interweaving her own experiences as a medical student and doctor, Perri Klass pays tribute to groundbreaking women doctors like Rebecca Lee Crumpler, Mary Putnam Jacobi, and Josephine Baker, and to the nurses, public health advocates, and scientists who brought new approaches and scientific ideas about sanitation and vaccination to families. These scientists, healers, reformers, and parents rewrote the human experience so that—for the first time in human memory—early death is now the exception rather than the rule, bringing about a fundamental transformation in society, culture, and family life.

30 review for A Good Time to Be Born: How Science and Public Health Gave Children a Future

  1. 5 out of 5

    Andy

    Not my cup of tea. A good chunk of the book is a series of sad stories about dead children from history, literature and elsewhere. The author makes numerous interesting cultural observations about motherhood, but I was looking for more objective information about what led to the dramatic decline in childhood mortality. Instead, on that front, I felt the reader was often getting an unclear version of things. For example: -The title sets up a false dichotomy between "science and public health." Es Not my cup of tea. A good chunk of the book is a series of sad stories about dead children from history, literature and elsewhere. The author makes numerous interesting cultural observations about motherhood, but I was looking for more objective information about what led to the dramatic decline in childhood mortality. Instead, on that front, I felt the reader was often getting an unclear version of things. For example: -The title sets up a false dichotomy between "science and public health." Especially now in the midst of the COVID pandemic, do we want to be implying that public health is not science? -In the chapter on SIDS, we hear about Back to Sleep decreasing SIDS rates, but there's not a word about the preceding pandemic of SIDS that increased those rates in the first place. -There's a general impression given that infant mortality rates have decreased steadily over time, but that doesn't seem correct. As noted on page 73, infant mortality was increasing in New York City in the 19 Century. Did infant mortality peak with the industrial revolution? -There's a good section on the market milk problem, but other sanitary reforms with sewers, clean water supplies and such get short shrift (p. 60). Other books to consider:

  2. 4 out of 5

    Kathryn Bashaar

    This book is a survey of the medical breakthroughs of the past couple hundred years that have led to an astounding decline in infant and child mortality. The infant mortality rate in the U.S. in 2017 was 5.8 deaths for every 1000 births. As recently as 1915, the rate was 100 deaths for every 1000 births. Klass tells her story somewhat chronologically. In the 19th and early 20th century, medical science learned a lot about the contributions that contaminated waters and milk made to infant deaths. This book is a survey of the medical breakthroughs of the past couple hundred years that have led to an astounding decline in infant and child mortality. The infant mortality rate in the U.S. in 2017 was 5.8 deaths for every 1000 births. As recently as 1915, the rate was 100 deaths for every 1000 births. Klass tells her story somewhat chronologically. In the 19th and early 20th century, medical science learned a lot about the contributions that contaminated waters and milk made to infant deaths. Improved municipal water supplies and the practice of pasteurizing milk led to a big decline in infants deaths from diarrheic diseases in the late 19th and early 20th centuries. Over the course of the rest of the 20th century, diphtheria, strep infections, TB, and measles were conquered by vaccines and improved treatments. And premature babies who would have died as recently as the 1970s can now be saved. It is a great, heroic story, and Klass tells it in terms that a lay reader can understand. As a Boomer who grew up in the 1960s and raised my own children in the 1990s the book was a little time travel through my own life, too. I got measles, mumps and chicken pox as a child, but was vaccinated for smallpox and polio. My own children never even needed the smallpox vaccine, but were vaccinated for measles, mumps and polio. They were among the last cohort of children to get chicken pox, though. My only complaint about this book is that it started to get a little repetitive about 2/3 of the way through. Like my reviews? Check out my blog at http://www.kathrynbashaar.com/blog/ Author of The Saints Mistress https://camcatbooks.com/Books/T/The-S...

  3. 4 out of 5

    Steve

    Reading about the rampant infant mortality a hundred years ago was hard to take, but the book got happier as mortality decreased over the 20th century. A lot of things helped, and especially interesting to read about how the many vaccines were developed and put into use over the years.

  4. 5 out of 5

    Joseph

    I received a digital galley of "A Good Time to be Born," from Net Galley in exchange for a fair review. In general, this book gives an insightful overview of the medical advances over the past few centuries that have been critical in improving infant and child mortality. Klass does a nice job reviewing primary source material from public health workers, nurses, physicians and researchers that intelligently includes the contributions of African-Americans and women that have taken an event--childho I received a digital galley of "A Good Time to be Born," from Net Galley in exchange for a fair review. In general, this book gives an insightful overview of the medical advances over the past few centuries that have been critical in improving infant and child mortality. Klass does a nice job reviewing primary source material from public health workers, nurses, physicians and researchers that intelligently includes the contributions of African-Americans and women that have taken an event--childhood death--that used to be so common among both impoverished and wealthy families to where as now a childhood death is looked upon as unusual. When I first started reading the book, I became worried about the repetitiveness of how many similarities of the following statement occurred, "In previous centuries, no matter how rich and powerful parents were, no matter how many important doctors they could summon, they had a very limited ability to protect the children they loved," in the introduction and first chapter. The first chapter is essentially a review of how childhood death was portrayed in literature that emphasized the above quote. Portions of the first chapter could have been integrated into the other chapters to humanistically represent what cultural productions like plays, literature and movies portrayed about children's health. Fortunately, Klass eliminated my frustrations in the first sentence of Chapter 2 by starting it with the following sentence quoted from the anti-slavery newspaper ,The Liberator: "American mothers! Can you doubt that the slave feels as tenderly for her offspring as you do for yours?...Will you not raise your voices, and plead for her emancipation?" She then gives a forceful, inspiring narrative (including an 1860 document listing the prices of enslaved people), how African-American children suffered under the savagery of slavery and how African-American writers poignantly captured the grief of seeing their infants die, experiencing the same grief and loss as Caucasians and then continuing throughout the book highlights the important contributions that African-American pubic health workers, nurses and physicians contributed to improving childhood mortality. This is history that is inclusive and inspiring. The book goes on to highlight what you would expect a medically-focused history of childhood mortality to address--breastfeeding, infectious diseases, vaccine, the development of Neonatal Intensive Care Units, etc. All of which appear to be grounded by historical research and her clinical experience as a pediatrician when some of these developments occurred. She does a nice job explaining medically-related concepts in an easy to understand format but does not lose a more general reader who might be less interested in a scientific explanation of how these advances led to improved mortality. That said, a medical focus on improved mortality will necessarily not provide a comprehensive overview of the entire story of improved childhood mortality. Although Klass mentions other factors as early as the introduction-- poverty, education, environmental, personal behaviors--that contribute just as much, if not more, to improved mortality, these are not explained to any substantial degree, nor is HIV/AIDS in "A Good Time to be Born." Legislative and legal contributions, including regulatory improvements in environment, housing and labor, are also not given equal treatment compared to medical advances. This is not necessarily a fatal flaw, just that the book reflects the author's background in the medical sciences. Klass also mentions and laments how there is still a difference between African-American infant mortality versus Caucasian infant mortality. Even though rates have dropped precipitously compared to prior decades and centuries, we can't declare victory until this rate narrows and here is where a broader view of overall health rather than just medical care can help better inform these disparities of care and what needs to be done to advances these social determinants of health. Lastly, there is no discussion on how medical harm through the delivery of care sometimes contributes to less than optimal pediatric health outcomes. I don't want this review to focus on the potential omissions of Klass's book on why childhood mortality has improved over the past centuries, particularly because in her skillful telling she highlights the humanity in children and their families that you end up inspired by reading her narrative and want all of us to continue to ensure that all children grow up loved, cared for and supported by their parents and their communities. Although I didn't give this 5 stars, it still should be read for its literary and medical history merits.

  5. 4 out of 5

    Kathleen Gray

    I admit first that I have been a fan of Perri Klass for years because of her ability to bring difficult medical information into clear and humane focus. This latest volume, which is more medical history than anything else, is a fascinating look at infant mortality and, thankfully, how things have improved over the years. She delves into how race and class impact a child's prospects (or don't). childhood diseases, the value of vaccination, and other topics. Her writing is, as always, clear and di I admit first that I have been a fan of Perri Klass for years because of her ability to bring difficult medical information into clear and humane focus. This latest volume, which is more medical history than anything else, is a fascinating look at infant mortality and, thankfully, how things have improved over the years. She delves into how race and class impact a child's prospects (or don't). childhood diseases, the value of vaccination, and other topics. Her writing is, as always, clear and direct but with a tone that never hectors (even where it might be easy to do so). This has been deeply and carefully researched and her conclusions are supported by data which, rest assured, never overwhelms the narrative. She's encouraged by how things have changed and that comes through loud and clear. Thanks to Netgalley for the ARC. This is well worth a read.

  6. 5 out of 5

    victoria.p

    Fascinating, if a little heavy on Victorian child death anecdotes. I guess there were so many people who lost kids - and so many famous people - that there was a wealth to choose from.

  7. 4 out of 5

    Steve

    Science writing done right I loved everything about this book. Dr. Perri Klass’s excellent writing carried me along with her clever wording and some well placed humor. I couldn’t put the book down. Some parts of the book, where Klass discussed the bad old days, are absolutely heart-breaking but conversely, Klass explains how things have improved since then. The other aspect of the book I liked is that Klass puts herself into the story as we learn more about her and her journey. This book is an ex Science writing done right I loved everything about this book. Dr. Perri Klass’s excellent writing carried me along with her clever wording and some well placed humor. I couldn’t put the book down. Some parts of the book, where Klass discussed the bad old days, are absolutely heart-breaking but conversely, Klass explains how things have improved since then. The other aspect of the book I liked is that Klass puts herself into the story as we learn more about her and her journey. This book is an example of great science writing and is a must-read. Disclosure: I received a complimentary copy of this book via Netgalley for review purposes.

  8. 4 out of 5

    Krystelle Zuanic

    This book illuminates the way in which public healthcare has developed over the decades, and there's some fascinating insights into how the world has changed. Children were somewhat hit or miss, and nowadays the death of a child is a rare and incredibly painful thing for all society- whereas it used to be a matter of a lottery. All-in-all, an interesting insight into the world of public health, and how much things have changed for the better. This book illuminates the way in which public healthcare has developed over the decades, and there's some fascinating insights into how the world has changed. Children were somewhat hit or miss, and nowadays the death of a child is a rare and incredibly painful thing for all society- whereas it used to be a matter of a lottery. All-in-all, an interesting insight into the world of public health, and how much things have changed for the better.

  9. 5 out of 5

    José Antonio Lopez

    A well balanced, documented narrative of how humanity has achieved the lowest child mortality ever. As MD and prolific writer, Perri Klass supports her thesis with a wide and deep reference pool. One of the first lessons from A Good Time to be Born is that despite high child mortality in the past, families were not "used" and "toughen" with the death of children. Somehow the pain and impotence of the pervasive experience of loosing a child fueled the research for solutions at all levels. However A well balanced, documented narrative of how humanity has achieved the lowest child mortality ever. As MD and prolific writer, Perri Klass supports her thesis with a wide and deep reference pool. One of the first lessons from A Good Time to be Born is that despite high child mortality in the past, families were not "used" and "toughen" with the death of children. Somehow the pain and impotence of the pervasive experience of loosing a child fueled the research for solutions at all levels. However, it was until recently that humanity could provide enough pregnancy and child support to assure high rates of survival. From prenatal care to safety, a myriad of solutions had become common practice. Sometimes they needed government intervention, others it was community concern, or individual who having faced child mortality, envision a solution; but always it was a joint effort to save more children. Despite some well known names, history is incapable of recognize all the heroes that made progress possible. Klass work is a tribute to them, a tribute to their contribution. Among all the cases developed in A Good Time to be Born one seems specially interesting; vaccines. It is possible to draw parallels between the early vaccines, specially for measles that was considered a mild desease, with the current COVID-19 pandemic. Topics like the urgency to immunize as many people as possible, the dilemma of using government force to reach wide coverage, or dealing with anti-vax movement that back then had reasonable doubts, but after almost 100 yrs of experience with vaccines appeal to conspiracy theories. Let's celebrate life reading Perri Klass A Good Time to be Born. There is still work to be done, but working together humanity can achieve an even better time to be born.

  10. 5 out of 5

    Karenclifford61

    While the author provided background related to past childhood mortality issues, I felt this read more as a term paper (with footnoted sources) showing how progress in the 20th century has saved lives, and is probably a fine book to recommend to (insecure) first time parents. While I know childhood mortality has been greatly reduced through penicillin and knowledge/education/safer environments, I guess i was looking for more specific information on the actual suffering associated with loss. (Yes, While the author provided background related to past childhood mortality issues, I felt this read more as a term paper (with footnoted sources) showing how progress in the 20th century has saved lives, and is probably a fine book to recommend to (insecure) first time parents. While I know childhood mortality has been greatly reduced through penicillin and knowledge/education/safer environments, I guess i was looking for more specific information on the actual suffering associated with loss. (Yes, incredibly petty of me) The conclusion summarizes the author's ideas best by saying "...we are, no question the luckiest parents in history. However much we whine and cry about the hazards of parenting, none of us would trade any of our first world problems for a supposedly simplier world that doubled the chance of losing a child. A century ago, the chance was more than doubled and a century before that even greater...." She further goes on to say "...(today's) parents are haunted by the fear of making the wrong decision, forgetting a precaution, or exposing a child to the risks that continue to haunt parental nightmares." I suppose my insecurities toward parenting are more common than I thought. Still, this book just wasn't for me (a non-parent)

  11. 5 out of 5

    Roberta Wright

    An absolutely fascinating book fiction book about childhood health and diseases. The author is a pediatrician who had been working for decades, and tells us about her historical research and personal experience of what were once common childhood ailments, like measles, scarlet fever and diphtheria. It is amazing to think about how within living memory we have moved from virtually every parent having to live with the expected death of a child, to a world where childhood death is thankfully incred An absolutely fascinating book fiction book about childhood health and diseases. The author is a pediatrician who had been working for decades, and tells us about her historical research and personal experience of what were once common childhood ailments, like measles, scarlet fever and diphtheria. It is amazing to think about how within living memory we have moved from virtually every parent having to live with the expected death of a child, to a world where childhood death is thankfully incredibly rare. It really makes you realise how much we owe to sanitation, knowledge of germs and hygiene and vaccination to have changed our lives so fundamentally. The author did a great and very even handed job of explaining how vaccinations and the care of premature babies became contentious issues, and how both have changed family life. I read this book in one sitting, and although it might seem like a morbid subject, ultimately I felt uplifted by the massive progress we have made across the world in child life expectancy. A really great read.

  12. 4 out of 5

    Margaret

    Until this book I've only known the author, Perri Klass, as a writer in the realm of knitting (she's a prolific knitter and writes great knitting essays - yes, that's a thing). I knew she was also a doctor, and this book brings that home. It's a fascinating read about children's health and mortality, and how both have improved over the last 200 years due to advances in science and public health, including developments in understanding viruses and bacteriology, vaccines, improvements in milk and Until this book I've only known the author, Perri Klass, as a writer in the realm of knitting (she's a prolific knitter and writes great knitting essays - yes, that's a thing). I knew she was also a doctor, and this book brings that home. It's a fascinating read about children's health and mortality, and how both have improved over the last 200 years due to advances in science and public health, including developments in understanding viruses and bacteriology, vaccines, improvements in milk and water sources and sanitation, and also improvements in safety, such as seatbelts and sleep practices. Each chapter is a dip into various aspects of the foregoing, including details as to the vicious "old" diseases, such as diphtheria. Published in 2020, the Dr. Klass and the publisher were able to squeeze in some mentions of the Covid-19 pandemic, so this is pretty up to the minute.

  13. 4 out of 5

    Emily Waldron

    2.5 -3 stars. Interesting history with some specifically fascinating nuggets, but I found this book dry with waaaayy too many topics. Would be much more interesting if Klass focused on only one or two childhood diseases instead of so many. The book became repetitive, and I struggled to get through the last third of the book. I liked how Klass brought up references to childhood diseases thoughout literature (Little Women, Uncle Tom's Cabin ect) but again she went overboard and it become very repe 2.5 -3 stars. Interesting history with some specifically fascinating nuggets, but I found this book dry with waaaayy too many topics. Would be much more interesting if Klass focused on only one or two childhood diseases instead of so many. The book became repetitive, and I struggled to get through the last third of the book. I liked how Klass brought up references to childhood diseases thoughout literature (Little Women, Uncle Tom's Cabin ect) but again she went overboard and it become very repetitive with the slew of books and diseases she referenced.

  14. 5 out of 5

    Rick Elinson

    Perri Klass reviews in a fresh way all of the medical and social advances that have led to the huge decreases in infant and child mortality since 1850. She ranges over diphtheria, contaminated milk, TB, antibiotics, vaccines, scarlet fever, sulfa drugs, polio, measles, premature birth, breast feeding, SIDS, and many other things. Somehow she makes this enjoyable reading. Klass does this in part by relating the medical history to popular literature and culture and to her own experiences in traini Perri Klass reviews in a fresh way all of the medical and social advances that have led to the huge decreases in infant and child mortality since 1850. She ranges over diphtheria, contaminated milk, TB, antibiotics, vaccines, scarlet fever, sulfa drugs, polio, measles, premature birth, breast feeding, SIDS, and many other things. Somehow she makes this enjoyable reading. Klass does this in part by relating the medical history to popular literature and culture and to her own experiences in training to be a pediatrician. Quite a remarkable presentation.

  15. 5 out of 5

    Felicity

    I love Perri Klass--always so informative and practical and taking the side of the child. This is a fascinating history of children dying young throughout history. My own grandmother's tragic loss of two children now seems to fit into history instead of being a terrible stroke of bad luck. We are so lucky this pandemic has not affected children. In my own childhood, children were still dying of and being maimed by polio. Our children now are so lucky. We ought to take better care of them, all of I love Perri Klass--always so informative and practical and taking the side of the child. This is a fascinating history of children dying young throughout history. My own grandmother's tragic loss of two children now seems to fit into history instead of being a terrible stroke of bad luck. We are so lucky this pandemic has not affected children. In my own childhood, children were still dying of and being maimed by polio. Our children now are so lucky. We ought to take better care of them, all of them. We have the means.

  16. 4 out of 5

    Becky

    In A Good Time to Be Born, Perri Klass reminds us that the expectation that almost all our children will live to grow up and lead healthy lives is a gift. This book is a fascinating journey that takes us through the history of infant and childhood immortality giving insight to the heroic work that has nearly eliminated the devastation of childhood diseases to more recent advocacy efforts to lessen the unnecessary deaths from automobile accidents before car seats. It’s encouraging to see how far In A Good Time to Be Born, Perri Klass reminds us that the expectation that almost all our children will live to grow up and lead healthy lives is a gift. This book is a fascinating journey that takes us through the history of infant and childhood immortality giving insight to the heroic work that has nearly eliminated the devastation of childhood diseases to more recent advocacy efforts to lessen the unnecessary deaths from automobile accidents before car seats. It’s encouraging to see how far we’ve come and that we will overcome again.

  17. 5 out of 5

    Cass

    This is a moving and humbling book. Dr. Klass is very good at putting us into the world of the past, when children’s lives were immeasurably more fragile than today. The writing is friendly and accessible, just what we would hope for from a physician and parent. I wouldn’t have minded a little more statistical context, even as an annex, but that’s not really this author’s style. She also leaves aside the big question of what happens in a world with too many people, now that these children survi This is a moving and humbling book. Dr. Klass is very good at putting us into the world of the past, when children’s lives were immeasurably more fragile than today. The writing is friendly and accessible, just what we would hope for from a physician and parent. I wouldn’t have minded a little more statistical context, even as an annex, but that’s not really this author’s style. She also leaves aside the big question of what happens in a world with too many people, now that these children survive. That’s a tough one, and a totally different question, so it’s hard to fault her.

  18. 5 out of 5

    Jennifer Schultz

    Read if you: Want an eye-opening, heartbreaking, and inspiring look at how science and public health efforts have lowered the severity of formerly deadly childhood diseases, along with current social/health issues that affect children today. Racial/economic barriers and inequalities to health acess are discussed, which makes this wide-ranging. Librarians/booksellers: This is a fascinating medical history read, and quite timely as well. One of my favorite reads so far of 2020. Many thanks to W.W. Read if you: Want an eye-opening, heartbreaking, and inspiring look at how science and public health efforts have lowered the severity of formerly deadly childhood diseases, along with current social/health issues that affect children today. Racial/economic barriers and inequalities to health acess are discussed, which makes this wide-ranging. Librarians/booksellers: This is a fascinating medical history read, and quite timely as well. One of my favorite reads so far of 2020. Many thanks to W.W. Norton & Company and Edelweiss for a digital review copy in exchange for an honest review.

  19. 4 out of 5

    Daniel Farabaugh

    This is a timely homage to the good the public health initiatives have done over the last century to dramatically lessen child mortality. The author does a very good job of setting up the cultural changes as well as our expectations for children have changed. It was a bit unfocused at times but overall very good.

  20. 5 out of 5

    Sue Flaherty

    Thinking how dangerous a world we live in now? This book describes in sometimes rambling detail how dangerous the world was to infants and children in the past decades of time. Most families experienced the loss of a child, whether an infant or teenager. Indeed we are at a much better time in our world. Science will save us if we use it wisely.

  21. 5 out of 5

    Syabek

    Not for everyone. History of infectious diseases in children.

  22. 5 out of 5

    Gaby Lopez

    As a pediatrician, I found it to be a heavy reading, not because of the topics but because an endless list of examples in some sections. Covers good topics though.

  23. 4 out of 5

    K

    A pandemic is a good time to read a book such as this. Interesting to contemplate the arc of vaccine/antibiotic discoveries. Also to consider just how much we take for granted.

  24. 4 out of 5

    Amy

  25. 5 out of 5

    Anna Craig

  26. 5 out of 5

    Katie

  27. 5 out of 5

    Claire Turscak

  28. 5 out of 5

    Jacque

  29. 5 out of 5

    Megan

  30. 4 out of 5

    Breanna

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