The existence in Michigan of a Board of State Commissioners for the General Supervision of Charitable, Penal, Pauper, and Reformatory Institutions, and in Massachusetts of a board that covered public health, lunacy, and poor relief, was not unique. It testifies to the fact that the treatment of the poor, and treatment of the physically and mentally handicapped, the sick, and the delinquent, were frequently linked in nineteenth-century thought and practice. And since poverty did, indeed, often result from ill health or disability or was itself a cause of such conditions, and was in its turn not infrequently a spur to crime, this is not surprising. Again matters of public health – sanitation, water supply, medical practices – were to some extent connected with the problems of the poor. It is, therefore, convenient to treat these related topics in a single chapter, the more so since some of the records for their study are common ones.

It must be said, however, that often, except in the cases of public health and the relief of poverty, the scope for a purely local treatment will for some places be limited. Many of the institutions of welfare and correction were state establishments concentrated in state capitals, while much organized charity was exclusive to the larger cities where social problems were more threatening than in less populated places. Nevertheless the topics covered in this chapter embrace a wide spectrum of life and for many places there are likely to be some interesting matters for community historians to investigate.