In Exhibiting Health: Public Health Displays in the Progressive Era, Dr. Jennifer Lisa Koslow introduces readers to a short-lived but vibrant aspect of progressive reform: the public health exhibit. Health reformers across the country produced visual displays for public consumption on a wide variety of public health concerns. And while large-scale sanitation projects proliferated during the late nineteenth century, by the early twentieth century, reformers’ focus had turned to the individual. As Koslow notes, individual responsibility became “the cornerstone of modern disease prevention” (5). Armed with creative and visually engaging exhibits, public health leaders optimistically believed they could enact widespread change by educating individual Americans.

The first chapter of Exhibiting Health lays the foundation for Koslow’s study of public health promotion. With early tuberculosis displays as a model, health exhibits gained popularity across the country in the early twentieth century. Koslow argues that these exhibits lay at the intersection of two important Progressive Era goals: “Americanizing” recent immigrants by altering their individual hygienic and home practices and engendering support for governmental regulatory controls in areas such as industrial safety and child welfare. As Koslow notes, reformers hoped to push public opinion toward protective legislation, but the persuasive personal hygiene messaging could also serve as a “potential failsafe” if the legislative route failed (11). Assuming that many of their viewers would not be intelligent or literate enough to absorb the exhibit message, public health displays often relied on emotion or shock value to draw attention. One particularly gruesome electrified exhibit, for example, “lowered a scythe every twenty seconds on the head of a baby to represent infant mortality rates” (64).

Koslow devotes close attention to the complicated processes involved in creating medical models for public health displays. Exhibit planners, confronted with a lack of experienced model makers, regularly sought out “scientific artisans” (32). Yet these craftspeople, though artistically talented, were not necessarily medically inclined. In 1914, for instance, the International Health Commission (IHC) retained German model craftsman Philipp Rauer to produce lifelike wax figures depicting hookworm infection. Rauer created impressively realistic specimens, much to the IHC’s delight. But in the process of casting his figures using a human subject, Selma Ellis, Rauer caused a large ulcer on Ellis’s leg to break open. Unable to work, Ellis sued. The resulting financial liability soured the IHC on Rauer.

Progressive reformers often sought to define and standardize disciplines, and exhibit-making was no exception. The reason so many public health exhibits looked alike, Koslow shows, was due to the efforts of one man: Evart G. Routzahn. He served the Russell Sage Foundation for over twenty years, becoming the “dominant voice in the etiquette of popular public health education” (46). Evart and Mary Routzahn essentially standardized the industry with their 234-page book on the subject, The ABCs of Exhibit Planning. The sheer size and scope of the Routzahns’ work support Koslow’s conclusion that creating effective public health exhibits was “a conundrum” even for experienced reformers (51).

One particularly interesting aspect of Exhibiting Health is Koslow’s investigation of mobile exhibits in repurposed train cars. Reformers employed these “health trains” to bring the gospel of health into the farthest reaches of the country and teach rural Americans about sanitation, hygiene, and childcare. The trains functioned as a combination of propaganda, business advertisement, spectacle, and public health exhibit. Louisiana health train exhibitors, for instance, recorded efforts directed specifically at African Americans. Health officials coordinated segregated visits to the trains and offered lectures “on the subject of sanitation by a trained negro physician who is specially fitted for this work” (64). Organizers’ racial biases appeared most obviously in these outreach projects. Koslow demonstrates that Louisiana health officials offered special viewings and lectures because they believed that “this race of people is both potentially and actually more capable of disseminating disease among the white people than are the white people among themselves” (65).

Indeed, public health exhibits did not always operate without controversy. In her last chapter, Koslow introduces two exhibitions that sparked heated debate between organizers, audiences, and other stakeholders. In 1914, a Morristown, New Jersey, display about housing conditions among immigrant populations drew the ire of the town’s sizable Italian population. The display, sponsored by the local Presbyterian congregation, apparently used photographs of local Italian families to illustrate “tenement conditions” (85). A group of Italian men tore down the entire display, sparking a statewide controversy. As the Presbyterians found out, failing to consider the implications of their display—and failing to include the Italian community in the design process—doomed it to failure. Similarly, the 1928 Parents’ Exposition in New York City illustrated the risks inherent in offending stakeholders, coming under fire almost immediately from those who objected to the inclusion of the American Birth Control League (ABCL) as an exhibitor. Despite viewing birth control as a positive aspect of family health, exposition organizers severed their ties to the ABCL to maintain a cordial relationship with city leaders (98).

Koslow reveals that reformers truly believed in the power of the public health exhibit: the passion with which they constructed exhibitions, the personal and philanthropic investments they made, and their ongoing “faith in the value of the visual” all bear witness to their general conviction that such displays improved American lives (100). Whether or not they succeeded, however, remained unclear. Though audiences certainly turned out in large numbers to view public health exhibits, it is uncertain whether attendees profited from the experience. Did rural Californians build modern, “good” dairy barns after viewing a health train exhibit on farm sanitation (56)? Did Rauer’s lifelike depictions of hookworm spur change in individual hygienic practices? Koslow demonstrates that, in the absence of reliable statistical data, these questions, unfortunately, remain unanswered.