In the early 1900s, the Metropolitan Life Insurance Company began an unprecedented campaign to improve the health of its policyholders and poor families in general. As part of the campaign, the company’s agents distributed health information and for more than 40 years helped link the families with visiting nurses.
Insurance companies had traditionally sold insurance aimed at the middle class and well to do. The payments were substantial and the policy was seen as an investment and a way to protect a family from future poverty.
In 1879, Metropolitan Life, then a small
Most of these immigrants were from Central and Eastern Europe and south Italy. Most of them were very poor, had little education, and often spoke little or no English. Part of Metropolitan Life’s success lay in hiring agents from these communities.
Metropolitan Life agents visited policyholders’ homes each week, usually during the day, to collect premiums (3-10¢ per week—the equivalent of 70¢ to $2.35 today). The agent met the mother and younger children and therefore learned of illnesses in the family and saw the conditions of the home.
Metropolitan Life produced a series of pamphlets and booklets on cleanliness and health, written in the immigrants’ languages—German, Italian, French, Spanish, Polish, and Yiddish. The pamphlets taught basic health and hygiene to families who had no previous experience of living in cities and who did not know or did not accept newer scientific information about germs and disease agents. The company also put health and hygiene ads in immigrant newspapers.
Part of the goal—as with many other reforms of the period—was to help the immigrants assimilate to American culture and standards.
Doing Well by Doing Good: Effect of Metropolitan Life’s health programs
Metropolitan Life’s Welfare Program illustrates the alliance between private business and public health in the reform era of 1890–1920s. The company moved from being 18th among U.S. companies in 1879, when it began selling industrial insurance, to being the fourth-largest in 1900.
The company invested in the health campaigns because its leaders could see statistically that promoting better health lowered the mortality rates among its policyholders and therefore saved money for the company. Also, the image of Metropolitan Life as “Mother Met,” concerned about the health of the Met family, was a powerful advertising image.
The company’s health and welfare campaigns made it an industry leader, and today MetLife (as it is now known) is the largest life/health insurance company in the United States.
Metropolitan Life and the Visiting Nurses
In 1909, Metropolitan Life began to provide nursing services for its policyholders. The company entered an experiment with Lillian Wald, the well-known founder of the Henry Street Settlement House on
The company’s agents would notify the Visiting Nurse Association when a family needed help, and the company paid the nursing association 50¢ (in 1909) for each visit ($12 today).
The experiment was a resounding success for both Wald’s Visiting Nurse Association and the company, and Metropolitan Life quickly expanded the program to
Visiting Nurses were a major part of many public health campaigns of 1880s-1930s. They went into the home not only to care for the sick but also to teach modern hygiene to families. They emphasized cleanliness as essential to good health and taught families how to maintain clean water and food and to keep themselves and their children clean.
Nurses do this same kind of teaching today—they are now called community nurses—in communities around the world. The Public Health Department for the Charlottesville area, for example, has community nurses, as do departments throughout the country.