The March of Dimes.

 LETTERS  and the Institute for Social Research, University of Michi- gan, Ann Arbor. Requests for reprints should be sent to Nancy Krieger, PhD, Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115 (e-mail: nkrieger@hsph.harvard.edu). THE MARCH OF DIMES The August 2001 Images of Health article, “ ‘. . . So That Others May Walk’: The March of Dimes,” 1 is fascinating. The March of Dimes is an excellent example of institutional adaptation in the face of structural change. Vaccination greatly reduced the incidence of poliomyelitis in the 1950s and eventually led to the elimination, in 1991, of polio virus from the Americas. In response to this situa- tion, the anti-polio foundation had 3 options: to declare its mission fulfilled and close its doors, to focus on combating polio overseas, or to change its mission. The foundation chose the third path, and it is now officially the March of Dimes Birth Defects Foundation. The poster that is depicted appears to be more recent than the text’s topic of the found- ing of the March of Dimes in the 1930s. The nurse in the background has the words “polio vaccine volunteer” on her sleeve. Thus the “Help me, too” would seem to refer to those children who missed out on vaccination and contracted polio. The poster could be from an anti-complacency campaign conducted in the 1950s. After widespread vaccination was in- troduced in 1955, the public, and especially new parents, began to believe that the advent of vaccination meant that polio was van- quished. As the history of the March of Dimes attests, this period was the beginning of a major institutional adaptation. Andrew Noymer, MSc About the Author the August 2001 issue of the Journal. Noymer’s suggestion that the image dates from the mid-1950s seems highly plausible. The postcard in the National Library of Medi- cine collection is undated, but as the Poster Child campaign was introduced in 1946, the image must have been created after that date. It does seem likely that it was created in con- junction with the anti-complacency campaign. For a good sampling of the March of Dimes materials, interested readers can consult A Paralyzing Fear: The Triumph Over Polio in America, by Nina Gilden Seavey, Jane S. Smith, and Paul Wagner (New York, NY: TV Books; 1998), a companion volume to the film of the same title. Requests for reprints should be sent to Andrew Noymer, MSc, University of California at Berkeley, Department of Demography, 2232 Piedmont Ave, Berkeley, CA 94720 (e-mail: andrew@demog.berkeley.edu). Elizabeth Fee, PhD Theodore M. Brown, PhD Reference About the Authors 1. Helfand WH, Lazarus J, Theerman P. “. . . So That Others May Walk”: the March of Dimes. Am J Public Health. 2001;91:1190. The authors are Contributing Editors of the Journal. Eliz- abeth Fee is with the History of Medicine Division, Na- tional Library of Medicine, National Institutes of Health, Bethesda, Md. Theodore M. Brown is with the Depart- ments of History and of Community and Preventive Medi- cine, University of Rochester, Rochester, NY. Requests for reprints should be sent to Elizabeth Fee, PhD, National Library of Medicine, History of Medicine Division, 8600 Rockville Pike, Bethesda, MD 20894 (e-mail: elizabeth_fee@nlm.nih.gov). FEE AND BROWN RESPOND We were pleased to see the letter from Andrew Noymer about the Images of Health article in ERRATUM In a Letter to the Editor (Gori GB. Individualized or population risks: what is the argument? Am J Public Health. 2001;91:1919), I erro- neously quoted Colin B. Begg as stating, in his March 2001 article (Begg CB. The search for cancer risk factors: when can we stop looking? Am J Public Health. 2001;91:360–364), that “ ‘the primary purpose of epidemiology is to determine individual risks.’ ” In fact, this state- ment is not a direct quote. Begg states that “a primary purpose of epidemiologic research is to determine the extent to which this [unique individual] risk varies from person to person and the factors that explain this variation” (p 361). Gio B. Gori, The Health Policy Center, Bethesda, MD 20816. 158 | Letters American Journal of Public Health | February 2002, Vol 92, No. 2