World War II Home Front History Presentations

posted on October 7, 2015

Two Kaiser Permanente Home Front history presentations


“More Than War Ships: Kaiser’s WWII Legacies in Healthcare, Childcare, Housing, and Environment”
Lincoln Cushing, Kaiser Permanente Archivist, with Dr. Jeffery Sanders, WSU
Thursday, October 15
, 7 pm – 9 pm
Part of current Oregon Historical Society exhibition (Portland, Oregon)
“World War II: A World at War, A State Transformed”
Free and open to the public

Child care center, Oregon shipyards, PA-912
Child Service Center, Kaiser Oregon shipyards

Kaiser Permanente historian Lincoln Cushing will present “Henry J. Kaiser’s World War II Home Front Legacy,” a slide show about the innovative support systems Kaiser built for wartime production workers, including child care centers, housing, transportation, and health care. Although Henry J. Kaiser earned the sobriquet “Patriot in Pinstripes” for his industrial contributions to the Allied military effort during World War II, it can be argued that his most enduring legacy was his comprehensive suite of Home Front social benefit programs. He will co-present with Dr. Jeffery Sanders, Washington State University.


“Emmy Lou Packard: Drawing New Conclusions in the Kaiser Shipyards”
Lincoln Cushing, Kaiser Permanente Archivist
Part of current exhibition at Rosie the Riveter National Park, Richmond, Calif., on display through 2015
Saturday, November 21, 11:00-12:00
Wednesday, December 9, 2:00-3:00 pm
Free and open to the public. Contact the park to reserve seats, space is limited.

For many, the shipyards was the first experience in working alongside people of different races; here, black-white cooperation is graphically reinforced by the positive and negative shadowing of the ship they have built together behind them. 2/22/1945
Emmy Lou Packard illustration, 2/22/1945

Two slideshow presentations which amplify the exhibition theme – the challenges of labor journalism during a time when the entire work force was changing. Packard’s illustrations in the weekly Kaiser Richmond shipyard newspaper Fore ‘n’ Aft were patriotic without resorting to racist jabs or stereotypes; she portrayed workers with dignity and character. She drew women’s experiences from a woman’s point of view – numerous vignettes show children (one of her regular subjects later in life), shopping, home life, and the challenges of survival and adjustment in a tempestuous time.

Exhibition review in Richmond Confidential.


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Order in the house! The Importance of Classification and Taxonomy

posted on October 1, 2015

Lincoln Cushing
Heritage writer

Article about helpful role of Physical Demands and Capacities Analysis, 1944-06-01; KPNW Discrete Collection, box 18

Article about valuable role of Physical Demands and Capacities Analysis, 6/1/1944

By now, everyone’s heard the jokes about the new International Classification of Diseases, the disease and health problem taxonomy standard managed by the World Health Organization. ICD is the latest in a series of efforts to classify diseases, starting in the 1850s. Originally called the International List of Causes of Death, the WHO assumed responsibility for the ICD when the organization was created in 1948. ICD version 10 (or ICD-10) is the newest code set. October 1 is the date on which ICD-10 compliance is required by the Centers for Medicare and Medicaid Services.

With 68,000 discrete diagnosis codes (as opposed to the previous 14,000), we are now able to define diagnoses at a very precise level of detail. Very, very, precise – such as “V97.33XD: Sucked into jet engine, subsequent encounter” orY92.146: Swimming-pool of prison as the place of occurrence of the external cause.” Yes, these are actual codes.

But, jokes aside, precise classification has its merits. It strengthens the storage and retrieval of diagnostic information for clinical, epidemiological and quality purposes. ICD descriptors also provide the basis for the compilation of national mortality and morbidity statistics. Kaiser Permanente has actively joined other health care providers in this massive project.

However, Kaiser health care practitioners during World War II were also trying to use precise descriptions to improve health, in a slightly different way.

Sample page from Physical Demands and Capacities Analysis, published by the Region XII War Manpower Commission, Bureau of Manpower Utilization, Division of Occupational Analysis and Manning Tables, San Francisco, CA, and the Permanente Foundation Hospitals; 1944-05

Sample page from Physical Demands and Capacities Analysis

In May, 1944, the 627-page dense tome Physical Demands and Capacities Analysis was published as a joint project of the Kaiser Foundation Hospitals and the Occupational Analysis and Manning Tables division of Region XII War Manpower Commission. The physician in charge of the study was Clifford Kuh, MD.

One of the primary goals of the Analysis was to make sure that individuals were assigned to jobs which they could perform without risk to their health. The study detailed 617 distinct job titles in the shipyards, from “Asbestos Worker, Cutter” to “Window Cleaner.” Although the Richmond shipyards did have the opportunity to use pre-placement physical examinations prior to hiring, the study provided the basis for accurate review of work-related health problems and suggestions for reassignment. During a short three-month survey period, only three workers had to leave their assigned job due to physical failure. During the four war years Kaiser’s yards employed almost 200,000 people.

An article in the Call Bulletin touted the survey, quoting William K. Hopkins, regional director of the United States War Manpower Commission:

“While the study has in mind the placement of all workers, the technique on which it is based will be invaluable in the post-war period – when tens of thousands of returning service men and women will have to be fitted into new jobs. I am particularly impressed with the study’s positive approach in emphasizing what a worker has the physical capacities to do, rather than the handicaps, often minor, which tend to prejudice his employment.”

Kaiser Permanente, building and using precise medical data for social benefit since 1944.


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Kaiser Permanente and NASA – Taking Telemedicine Out of this World

posted on September 23, 2015

Lincoln Cushing
Heritage writer


Space Technology Applied to Rural Papago Advanced Health Care logo

How do you handle medical testing and care in a remote location? A really, really remote location – such as outer space?

This was one of the challenges that the National Aeronautics and Space Administration faced in the early 1970s – and it got help from one of our founding physicians and Kaiser Permanente, through what was then the Kaiser Foundation International[i] program.

KFI to Help Develop NASA-Sponsored Health System”
Kaiser Permanente newsletter, August 9, 1972

Kaiser Foundation International became a major ($1.8 million) subcontractor to the Lockheed Missiles and Space Company to help design, develop and test a ground based remote health care delivery system.

The ground-based test unit will be installed at a sparsely populated site on earth to provide medical care to local residents. Trained physicians’ assistants will employ the unit to transmit medical information on residents of the area to physicians at an established facility many miles from the remote site. If the test program is successful, it may provide system technology to improve health care and medical services to remote areas on earth. Part of a four year NASA sponsored program, this concept, as applied to a remote area on earth, will be evaluated by NASA for possible use in advanced, long-duration, manned space missions.

Interior view of the mobile health unit with medical personnel, neonatal patient and mother, from "The STARPAHC collection: part of an archive of the history of telemedicine"

“Interior view of the mobile health unit with medical personnel, neonatal patient and mother” from Arizona Health Sciences Library

The back story is that in late 1970 Morris Collen, MD, attended a Northeast Electronics Research and Engineering Meeting in Boston that included a session on medical electronics. At that conference he served on a panel with Dr. Walton Jones, Director of Biotechnology and Human Research at NASA.

Kaiser Permanente’s Dr. Collen, in addition to being a brilliant physician in the Kaiser Richmond shipyards during World War II, was also an electrical engineer and considered one of the fathers of the field of medical informatics. He pioneered the use of the “multiphasic” examination, a battery of prescriptive medical tests for incoming health plan members, which later became the Automated Multiphasic Health Test.

By late 1971 J.P. Nash, the assistant general manager of Lockheed, told Dan Scannell, Kaiser Permanente’s director of public relations, some exciting news:

“Very shortly NASA is expected to solicit proposals for the design, development and testing of a Test Bed System for an Area Health Services Field Unit. This requirement has grown out of a NASA program for which [Lockheed] has been under contract for about four years called Integrated Medical and Behavior Laboratory Measurements System. IMBLMS is a four-phase program leading to the development and operation of a space flight biomedical laboratory, for research experiment in long-duration manned space flight in post-Apollo programs . . .”

IMBLMS project patch, circa 1973

Integrated Medical and Behavior Laboratory Measurements System project patch, circa 1973

On Jan. 4, 1972, Dr. Collen wrote to Sam L. Pool, MD, at the NASA Manned Spacecraft Center in Houston:

“Of special interest to us . . . would be the development of a completely automated self-administered multiphasic health testing laboratory in which a person in space could perform everything himself, utilizing automated equipment which enters the data into the computer which is programmed to provide advice and instructions. We believe that it is now technically feasible to develop such a prototype and with our experience we estimate such could be done within two to three years at a reasonable cost.”

The project, as noted in the 1972 news story, would use a “sparsely populated site on earth” to test equipment, systems, and personnel. That location would be the Papago Indian Reservation [now known as the Tohono O’odham Indian Nation] in southwest Arizona, with the catchy space-age title “Space Technology Applied to Rural Papago Advanced Health Care,” known as STARPAHC. Lockheed issued a summary report in June 1974 that explained the “Part 1 – Design and Definition” of the project:

STARPAHC will prototype a ground-based demonstration of IMBLMS space technology with two primary program objectives: (1) to obtain data for application to future spacecraft design and (2) to improve health care delivery through application of space technology. STARPAHC is designed to improve the capability for delivering health care to the Papago Indians located on the Papago Indian Reservation in southwest Arizona.

The STARPAHC operational concept was based on utilizing the professional staff of the Sells Hospital, where the Health Services Support Control Center will be located, to provide direction and consultation to paramedical and technical personnel stationed at the remote clinics, Local Health Services Center, and the Mobile Health Unit. The interchange of information between the HSSCC, LHSC, and MHU will be accomplished by voice, data, and video communication links. Computer-based data management techniques will implement record keeping, data retrieval, and data analysis.

“Patient viewing microscope” photograph from STARPAHC report.

“Patient viewing microscope,” STARPAHC report.

STARPAHC ended in 1977, and resulted in several advances in the nascent field of telemedicine. A 1979 article in Medical Care interviewed 47 individual care providers in the program, and concluded that the major problems were the unreliability of equipment and the time required for television consultations. The major benefit cited was improved access to health care for a population not previously receiving such care near their homes. Another positive outcome noted by non-physician providers was the linkage to physicians via television and voice communications from remote areas.

In 2001 the Arizona Health Sciences Library acquired important archival materials documenting the STARPAHC project and established the Arizona Archive of Telemedicine.

Telemedicine – terrestrial and beyond – has evolved considerably since the early 1970s. In 1980 Dr. Collen would serve as a member of the NASA Workshop on Space Shuttle Studies. And Kaiser Permanente is as deeply committed to exploring its applications now as it was when the field was brand new.


[i] In 1964 Kaiser Industries established the not-for-profit Kaiser Foundation International to administer foreign medical care programs. With Kaiser Permanente’s reputation on the rise, requests for consulting help started to come from places where Kaiser Industries didn’t already have a presence. Between 1964 and 1969, the international group was engaged for medical care projects in 15 African countries. When it closed down in 1975, KFI had been hired and paid for projects in 30 countries around the globe, including rural locations in California, Utah, and West Virginia. KFI was replaced by Kaiser Permanente International in 1996. Today KPI is a self-supporting subsidiary that offers educational programs about the Kaiser Permanente model and provides speakers at international conferences.


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Kaiser – Building Roads, and Bridges, with Cuba

posted on September 17, 2015

Lincoln Cushing
Heritage writer

File #CF-222 Cuba

Henry J. Kaiser (striped tie) with his partners and Cuban associates for the Cuban Central Highway project.

In addition to supporting the Affordable Care Act, one of President Barack Obama’s most notable achievements has been to begin normalizing diplomatic relations between the United States and Cuba. It’s been a rocky relationship ever since the Spanish American War of 1898, but the long arm of Kaiser history offers some positive examples.

In 1927 Henry J. Kaiser took on a $20-million contract to build 200 miles of roadways in Cuba. This was the beautiful and modern Carretera Central (Central Highway), running almost the entire length of the island.

It was a huge opportunity for Kaiser, and its success would help catapult him into the national area. He’d already worked on projects in Canada, and was eager for the challenges and rewards of the Cuban project,

Cuban Central Highway map, circa 1937

Cuban Central Highway map, circa 1937

Building the road

The total contract was for approximately 692 miles of highway, 481 of which was awarded to the Warren Brothers Company of Boston, Mass. (with whom Kaiser had partnered with in 1927 rebuilding Mississippi River levees), and 211 miles awarded to Compañia Cubana de Contratistas (Cuban Contractors Co.). The portion of the highway subcontracted to Kaiser Paving Company was about 200 miles.

The Warren Brothers/Kaiser Paving Company portion included the provinces of Pinar del Rio, Havana, Camagüey and Oriente, while the Compañia Cubana de Contratistas were to build the highway in Matanzas and Santa Clara provinces.

"Steamrollers,"  Kaiser Paving Company Cuban Central Highway construction, Camaguey, 1927; CF 431-646

“Steamrollers,” Kaiser Paving Company Cuban Central Highway construction, Camaguey, 1927

The pavement constructed under the Warren Brothers contract was 20 feet wide, with a 6-inch base covered by a 2-inch Warrenite surface. Warrenite was a dense and durable proprietary road surface material, composed of stone and bituminous cement.

The plans for the Central Highway, prepared by a firm of consulting engineers working in collaboration with the Cuban Department of Public Works and its chief engineer, called for the construction of a highway with a minimum gradient and restricted curvature. This necessitated the excavation of deep cuts through hilly sections and exceptionally heavy fills across valleys and depressions. In many sections the back fill material was of an unstable clay nature and it was necessary to put in a broken rock reinforcement between the native soil and the base of the pavement because the alternating wet and dry seasons created such a shrinkage that often broke the pavement.

One of the most unique features of the highway was the absence of railroad crossings, and the insertion of reinforced grade crossings for… bull carts. Roads used by carts laden with rural goodness were built along the main road, with granite blocks inserted at crossing points to protect the pavement.

File #CF-610 Cuban Highway Construction

Kaiser Paving Company, somewhere in Cuba, circa 1928.

The highway also required approximately 500 bridges. Some of the steel bridges along the highway were prefabricated in the United States under the supervision of the H.C. Nutting Co., of Cincinnati, Ohio.

The contract between the Warren Brothers Company and Kaiser Paving Company was dated February 19, 1927; Kaiser Paving started work on March 4, 1927. Although the contemplated completion date was July 31, 1931, in classic Kaiser fashion they finished a year ahead of schedule.

Kaiser put his most trusted men in charge of the operation. Alonzo B. Ordway was the general manager and Clay Bedford was the office engineer (later the general manager). Kaiser also hired George Havas, a Hungarian expatriate working as a banana plantation supervisor, as the office engineer. Havas was such an excellent part of the team that he was promoted to chief engineer, and went on to serve Kaiser Industries for many years.

The terms of the contract required that most of the labor be done by the Cuban workforce, with foreigners only staffing key positions. This proved to be a complicated blessing. Henry Kaiser was an early adopter of mechanization in the roadbuilding industry, but the conditions in Cuba thwarted his plans. It was soon found that in many cases using local hand labor and burros was a cheaper and faster method of construction than using the mechanical equipment imported for the purpose. The experience supported Kaiser’s trust in the human factor in production. He summarized the Cuba job this way:

""Ingersoll-Rand air compressor with 310 cubic foot capacity,"  Kaiser Paving Company Cuban Central Highway construction, Camaguey, 1927; CF 431-646

“”Ingersoll-Rand air compressor with 310 cubic foot capacity,” Kaiser Paving Company Cuban Central Highway construction, Camaguey, 1927

We learned you can’t get fine talent into your organization by simply offering high salaries. You and the men you work with have to build yourselves up to the capacity to tackle bigger and bigger jobs.

Kaiser Permanente and Cuba now

Henry J, Kaiser’s biggest legacy, the Kaiser Permanente Health Plan, has replaced road building with health care – and there’s a Cuba connection. Since 2012, a Kaiser Permanente Community Benefit grant has supported Oakland-based Medical Education Cooperation with Cuba in their MD Pipeline to Community Service program. The “pipeline” seeks to increase the number of diverse and socially committed physicians in underserved communities, and has provided support to more than 50 low-income, minority U.S. medical students trained at Cuba’s Latin American Medical School in the form of summer observerships and clinical placements. Sacramento student Sarah Hernandez commented on the experience:

There are a lot of things to learn, but it pushes me to work harder and find those niches where I can apply my excellent Cuban medical education with my U.S. clinical training…exposure to a U.S. clinical setting is essential to my training and possible residency placements.


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