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century later” (Wasik, 1993, p. 141). In Europe and the U.S., nurse home visitors
provided life-saving public health education to new mothers (Council on Community
Pediatrics, 2009), while across the United States, they cared for “ the urban poor,
especially. . . the new immigrants who flooded the country at the turn of the twentieth
century” (Wasik, 1993, p. 141). Throughout this time, there were also thousands of
volunteer home visitors, generally women who were organized by local charitable
societies and drawn from the ranks of the upper classes. Nurses and volunteers were
soon joined in these efforts by teachers and members of the new profession of social
work (Wasik, 1993).
Some of these newly established home visiting programs were grounded in a
philosophy that “environmental conditions significantly influenced personal problems
and illnesses” (Wasik, 1993, p. 141). Indeed, social work pioneer Jane Addams, and
many of her (paid and volunteer) colleagues in the Settlement House movement, did
home visits as one part of their outreach and social change work. Their visits allowed
them to have contact with those who could not come to the Settlement House; these
individuals and families were often experiencing significant difficulties. In this context,
home visits were used to educate people as to their options and rights, and to gather
information needed for individual and/or class advocacy (Meigs, 1970) – not to convince
individuals and families to change how they lived. Given the deplorable housing and
workplace conditions, extreme poverty, and lack of access to basic services that many in
the inner cities experienced during the late 1800’s and early 1900’s (Weiss, 1993), there
was no shortage of issues upon which to take action.
However, many other home visiting services of this time were modeled on the
belief that the poor created their own problems by being lazy, impulsive, and generally
of poor moral character (Carniol, 2005; Weiss, 1993). In a speech given in 1890,
emerging social work leader Mary Richmond stated, in reference to working with lowincome
families: “we have aimed to send to each family that needs an uplifting hand, a
patient, persevering, faithful friend, who, by the power of that strongest thing on earth,
personal influence [emphasis added], will gradually teach them habits of industry and
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