Yellow Fever and Institutional Development: The Rise and Fall of the National Board of Health

We examine the rise and fall of the National Board of Health (NBH), which was a federal institution created in response to the yellow fever epidemic of 1878 to direct national disease policy. Historical accounts suggest a number of reasons why the NBH was not reauthorized in 1883, four years after it was created and granted significant quarantine authority. We examine these arguments through an analysis of roll-call voting in Congress. We find that the creation and empowerment of the NBH in 1879 is best seen as an emergency action. Republican members of Congress — and conservative members outside the South, more generally — were willing to put the country's interests ahead of their own for a time. But as relatively epidemic-free years followed, Republicans and more conservative members of Congress — conditional on the recency of their state being affected by yellow fever — were largely unwilling to maintain a federal entity with power to significantly affect commercial activity.