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Second Look: Historic Images of the Seattle-King County Department of Public Health

A dual spirit of reform and generosity gave birth to the public health movement in Seattle and King County, as both recognized the fundamental importance of protecting the health and welfare of all their citizens. As City and County health functions developed, it became increasingly evident that each entity was directing the bulk of its own resources towards different aspects of public health: the City, on prevention, and the County, on treatment and curative medicine. From 1947-1951 the City and County eventually coordinated their resources and programs through a merger of the two departments.

The Seattle-King County Department of Public Health photograph collection at the King County Archives includes nearly two thousand prints and negatives that demonstrate a comprehensive range of Public Health Department activities encompassing the period from 1909 through 1970. The images selected for this exhibition represent but a sampling of these services.


As the population grew in Seattle, nearby springs and small companies could not provide the necessary water supply. In 1895, Seattle voters approved a $1,250,000 bond issue to buy a water source on the Cedar River and to construct a gravity-flow system to conduct water to the city. However, industry and human presence in the watershed area still posed threats to the purity of this water supply.

The Health Department collected samples from the river and its tributaries each week for bacteriological analysis as protecting the watershed against pollution was its responsibility until 1944. The Department also participated in efforts to keep public recreation areas sanitary. Various substances were used to treat beaches that had been polluted by sewage, including chloride of lime, liquid chlorine gas, and copper sulfate to keep down algae growth.


Following the 1908 observation of a federal inspector who claimed that he found Seattle’s dairies to be “among the worst I had ever seen,” the Department of Health embarked on a vigorous campaign for safe milk.

Milk inspectors were responsible for patrolling the farms and plants that made up the Seattle “milk-shed,” an area extending from Grays Harbor to the Canadian border. Samples were taken at several different stages of production for analysis in the Health Department’s laboratories.

Pike Place Market

The Pike Place Market was established by the City in 1907 as simple sidewalk stalls offering food products sold directly from the producers. The Sanitation Division of Seattle’s Health Department monitored the sanitary conditions at the Market and checked the quality of the vendor products, including fruits, vegetables, meat, fish, dairy, and baked goods. Market inspection was the responsibility of the Department until the creation of the Pike Place Market Preservation and Development Authority (PDA) in 1973.

Garbage Collection

After considerable public debate, the City of Seattle started collecting garbage in 1910. Private interests quickly clashed with the ideals of civic-minded health reformers as the City attempted to create a collection program that would be efficient, economic, and sanitary. In the summer of 1911, the City gave the collection of garbage to two contractors. More than a whiff of scandal had attached itself to the awarded contracts, and in February 1913 the Health Department seized control of the service. The Health Department revamped the old system by purchasing its own wagons and paying for the hire of each team of horses and collectors on a daily basis.

Garbage Disposal

Although early experiments in garbage disposal included incineration and the dumping of waste from barges into Puget Sound, the most popular method in Seattle during the first half of the twentieth century was an almost indiscriminate use of landfills. By 1914 the Health Department reported that it was operating eleven sanitary fills, including dumps at Interbay, Salmon Bay, and Union Bay.

It was common practice for the Health Department to circumvent the objections of those living near the dumpsites by promising that the fill, when completed, would become a park. Former landfill sites that were developed as recreational facilities include the Green Lake field house, the Washington Park play field and the Columbia City play field. In 1943 there were six landfills operating within city limits.

Special Events

Large-scale special events, such as world’s fairs and conventions, often can serve as a defining moment for a city. In terms of the development of Seattle’s self-image, the 1909 Alaska-Yukon-Pacific Exposition, the 1915 1st Annual Session of the Imperial Council of Nobles, the 1925 Knights Templar Conclave and the 1999 World Trade Organization Ministerial meeting rank as notable events of the 20th century. Photographs from the Seattle-King County Department of Public Health collection offer some unique insights into these gatherings.


Seattle’s Hooverville, named for the Depression era president, was established in 1931, primarily of unskilled laborers who had worked previously in a number of industries, including logging, fishing and construction. At its height, there were more than 200 makeshift houses located along Seattle’s waterfront on filled-in tide lands formerly occupied by the Skinner & Eddy shipbuilding corporation.

Hooverville was viewed as a hazard and a nuisance by city officials, and in 1932, the City burned several of the dwellings. Officials agreed to allow the residents to stay if certain regulations were met; however, the agreement was short-lived. In 1941, the City Council convened a shack abatement committee chaired by a Health Department representative, and an elimination program ensued. Authorities posted eviction notices, and destroyed the makeshift houses with fire and bulldozers.

Rodent and Insect Control

After bubonic plague claimed a Seattle life in 1907, bounties of five and later ten cents per rat were set for each rat trapped and returned to the Health Department. Special inspectors, regulations, and a laboratory were set up to curb the threat posed by infected rodents. By the 1950s rodent control focused on prevention and rat-proofing buildings.

In 1946 rodent and pest control operations were consolidated into one unit. The Health Department used a number of mosquito control substances throughout the years including oil, larvicides, and DDT. In 1964 the Department acquired a new mosquito-fogging machine and a new “orchard type” trailer-mounted sprayer. As part of the mosquito control program, the Department’s Education Division also conducted a public education campaign throughout May 1962.


In 1909, an organization called the Anti-Tuberculosis League of King County began its fight against the disease, employing nurses to survey the community. Horace Henry, president of the League, donated land and $25,000 towards a sanitorium. The County Commissioners allocated $4,000 towards building and equipment and Seattle issued a bond of $10,000. The Anti-Tuberculosis League turned the sanitorium complex over to the City, and the Firland Sanitorium opened in 1914.

By 1948, the Seattle Area Chest X-ray program was also created to fight tuberculosis. It was the first large city on the west coast to conduct the rapid tempo mass chest x-ray survey. By 1954 the Seattle-King County death rate from tuberculosis had decreased by 82% since the introduction of the program. 

Maternal and Child Health

Providing information to new mothers on childcare was an early concern of the Health Department, which started a Child Welfare Division in 1914. Early Department initiatives included the inspection of boarding homes, the establishment of a milk fund, and the creation of a “baby’s clinic.” By 1924 there were six clinics operating in Seattle.  Following the merger of the two Health Departments in 1947, services were greatly expanded throughout Seattle and King County.


From the onset of public health services in Seattle and King County, health officials, whether they were inspecting locales or delivering services, disseminated information to people and thus conducted outreach through newsletters, articles, annual reports, statistical reports, brochures, posters, displays, conferences and other materials and events for the public. In 1945, the Seattle Health Department hired its first full-time Health Educator, and by 1946, the King County Health Department established its Health Education Division.

School Visits

The earliest type of health visits to schools involved official inspections for communicable diseases. A formal program of health inspection and preventive care for schoolchildren began in 1907 by the Seattle Board of Health. After the unofficial amalgamation of the two health departments in 1947, school health services were extended to parochial and public schools in King County by the newly formed Seattle-King County Department of Public Health.

Additional Resources

Books and Articles

Dorpat, Paul and Genevieve McCoy. Building Washington: A History of Washington State Public Works. Seattle: Tartu Publications, 1998.

Lehman, Sanford P. The Road to Health: A Short History of the Seattle King County Health Department. Seattle: Seattle-King County Department of Public Health, 1954.

—— and Sylvia Bryson. “We combined our agencies ten years ago.” Nursing Outlook, April 1955, n.p.

Matthews, Mark A. Beginnings, Progress and Achievement in the Medical Work of King County, Washington. Seattle: Peters Pub. Co., n.d.

McDonald, Lucile. The Lake Washington Story. Seattle: Superior Pub. Co., 1979.

Public Health Then & Now: 1889 to 1989. Seattle: Seattle- King County Department of Public Health, 1989.

Rockefellar, Nancy. Public Health in Progressive Seattle. Masters thesis, University of Washington, 1986.

—— and James W. Haviland, M.D. Saddlebags to Scanners: The First 100 Years of Medicine in Washington State. Seattle: Washington State Medical Association Education & Research Foundation, 1989.

Roy, Donald Francis. Hooverville: A study of a community of homeless men in Seattle. Master’s thesis, University of Washington, 1935.

Seattle Department of Health and Sanitation. Annual report, 1901-1946.

Seattle Department of Health and Sanitation. Bulletin, 1908-1929.

Seattle Health Officer. Reports to the Seattle Health Department, 1883/84-1900.

Seattle-King County Department of Public Health. Annual report, 1948- .

Seattle-King County Department of Public Health. Seattle-King County Department of Public Health Outlook, May 1973.

Smith, Clarence, M.D. “The Medical Profession.” The History of King County. Vol. 1. Chicago: S. J. Clarke Publishing Co. 1929.

The Story of Firland. Seattle: Firland Sanitorium, 1935.

Archival Records

King County Department of Public Health records, held by King County Archives.

Seattle-King County Health Department records, held by Seattle Municipal Archives.

Online Resources

This exhibit is an online version of Second Looks: Selections from the Seattle-King County Department of Public Health collection at King County Archives for display at the Pacific Northwest Historians Guild Conference held on March 3, 2001. The exhibit also appeared in the King County Courthouse-Administration Building Tunnel from September 4-29, 2001. King County Archives staff updated this exhibit in 2023.