The Ripple Effect: Katherine Bain
A group of physicians sat around a table. In front of them were the medical records of two children. The policies of their hospital would likely kill one of the infants. Just entering the world in St. Louis, Missouri were two babies: one African-American, one white. They were born premature and without an incubator, their newborn lives were at risk. But there was only one incubator. As the group discussed the problem, one of the physicians offered the only reasonable solution. “Well, why not put them both in the same incubator?” he said. It was the great depression in Missouri. All over the country, people were suffering, even dying from hospital segregation policies. Although two long decades would pass before the hospital was formally integrated, the barrier was broken at St. Louis Children’s hospital that night. The babies, oblivious to their racial differences, lay side-by-side. Sitting at the table that day was a young pediatrician, Dr. Katherine Bain. The conversation was a turning point for her, one that would inspire her to research threats to children and racial disparity in health care. Over the next decades, her work would lead to new child safety standards, including child-resistant caps for medication. Today, her legacy lives on in improved technology to protect children from accidental poisoning.
Katherine Bain was accustomed to being the only girl in the room. She graduated medical school in 1925 from Washington University in St. Louis, the only girl in her class. She never felt that being a woman held her back. She refused to see being a girl as an obstacle. She started publishing her research in 1931. By 1940, she was experiencing a crisis. Her father died and the family was lost without him. Looking for guidance and meaning, she took a job at the Children’s Bureau, the first federal agency in the world to focus on the needs of children.
In 1954 Dr. Katherine Bain stunned the medical community with a single article, published in the Journal of Pediatrics. That article “Death due to accidental poisoning in young children” found that over 400 deaths due to accidental poisoning were occurring annually in the United States. This rate was four times higher than the UK. Notably, she found that the nonwhite death rate was three times higher than the white rate. The problem was mostly aspirin. In the 1940s, flavoring was added to aspirin to make it taste like candy. It was an easy way to induce sick children to take their medicine. The trouble was getting them to stop taking it. A quarter of all poisonings could be traced to aspirin. Bain’s paper made this problem clear, paving the way for the first child resistant caps emerging in the late 1950s to the poison prevention control act of 1970 to thousands of lives saved thanks to child safety caps today.
Still accidental poisonings in children persist. In 2011, a federal report found that more children under the age of six go to the emergency room from accidental poisoning than car accidents. Children from minority groups are disproportionately affected. African-American children die from accidental poisoning at a rate two and half times that of white children. Of all these poisonings, some 10,000 cases are due to liquid medications, which little ones can quickly gulp down. In fact, a 2013 study found that an open or improperly closed medication bottle can be downed by a toddler in under two minutes. This same study found that flow restrictors prevent this. This year flow restrictors are popping up all over drugstore shelves. Suprisingly, the FDA doesn’t mandate them yet. A ProPublica investigation reported that this regulation was “hindered by industry cost concerns and inaction by federal regulators.” Hopefully, this will change soon.
The lead author of the flow restrictor study is reminiscent of Katherine Bain. Maribeth Lovegrove is an epidemiologist at the Centers for Disease Control. Like Bain before her, she’s using her position in the government to improve the lives of children. She’s part of the PROTECT initiative, a collaborative group trying to protect children from our medicine cabinets. There’s a string of history tying these two women together. Born from a dark day in St. Louis in the 1920s, the research of one pioneering woman has branched out in a million directions, saving lives.