Thirdly, the public health problems in American cities were becoming simply too horrible and obvious to ignore. The 1848 Irish potato famine and the 1849 political revolutions throughout Europe sent uncounted thousands streaming to the United States for sanctuary. What they found were rapidly expanding cities willing to exploit their muscles but unable or unwilling to provide adequate housing, sewage removal, and clean water. Thousands lived in dark, dank basements with little or no ventilation and were forced to rig boards attached to the ceilings when their cellars flooded from heavy rains and inadequate or non-existent city drainage to keep from drowning.
The final factor for renewed interest in organized public health was the emergence of an organized American medical profession. Although Edward Jarvis' 1845 view of the typical American physician was correct. The AMA, one year after its founding in 1847, created a Committee on Hygiene in 1848 to study and report on the status of America’s public health.