The Story of a Laboratory: Introduction

Public health is credited with adding 25 years to the human lifespan in the course of the twentieth century (CDC. MMWR 1999;48:241).  Public health systems are practices designed to prevent disease and promote a healthy life for all the members of a community.  They routinely depend upon laboratories to provide accurate data to allow decision-making and understanding problems.  Public health laboratories provide a large array of clinical and environmental testing that allows the diagnosis of disease and tracking of its progress through a population, monitoring the environment to detect threats to health from pollution or terrorism, and keeping track of chronic medical conditions to prevent them from becoming serious issues in the future.

A good example of this is the Town of Greenwich, Connecticut, whose Department of Health includes an active Laboratory Division. However, laboratories did not always offer services at their current level.  Public health laboratory practice in America has developed along with the field of public health in general.  The practice of public health changed during the course of the twentieth century.  This was due to scientific discoveries about disease control and the environment, as well as an understanding in society that disease control was appropriately a public, and not just an individual responsibility (Future of Public Health, 1988).  The services laboratories offered were modified to reflect this. As a result, laboratory practice at the end of the twentieth century was very different from that at the beginning (reflecting environmentalism, emerging diseases, or terrorism response, for example), and yet the earliest practices, such as water quality and vector control, remain an important part of laboratory practice today.  A lack of understanding of this historical development could lead to undervaluing the laboratory as a vital community resource, and overlooking its continuing potential to meet future unknown challenges.  As it approaches its hundredth anniversary, the Greenwich Department of Health Laboratory well illustrates the development of public health laboratory practice in America.  This is its story.