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As New York City has grown and changed, so has the Visiting Nurse Service of New York.
In 1893, the Lower East Side was the most densely populated area in the world, with more than 1,000 people per acre, most living in squalid tenements. The majority of the residents were impoverished immigrants who had come to America with little more than their dreams. Disease was rampant, and the connection between health and hygiene was still not fully understood.
Lillian Wald and her colleagues sought to strengthen this connection among their neighbors and patients. They also recognized that illness had a social and economic impact on families. In addition to caring for the sick, the Henry Street Settlement provided financial assistance and incentives such as scholarships to the community, and established social programs.
By 1903, the Settlement had opened branches throughout Manhattan and the Bronx, some designed to serve specific immigrant populations and ethnic groups. Nurses began caring for the black community in 1906, and by 1925 fifteen percent of patients were black.
In the years following World War II, advances in medical science and the migration of families with young children to the suburbs had a marked effect on patient demographics. In the 1920s, half of VNSNY patients were under age 5. By 1950, nearly 20 percent of home care patients were elderly people with chronic illnesses, and by the end of the decade this number had increased to 50 percent.
Changing demographics led to other initiatives as well. Naturally Occurring Retirement Communities (NORCs) were identified. Single-room occupancy hotel projects gave care to large groups of needy, often elderly, people. Within a few years, VNSNY provided services in several such facilities, and soon expanded its Housing-Based Care program to other residential settings.
When the AIDS crisis hit New York, VNSNY was there. As early as 1981, VNSNY was working with New York City officials to address the needs of patients, and within 10 years, VNSNY nurses cared for almost 1,200 AIDS patients daily. VNSNY Home Care established a variety of clinical, psychiatric, and personal services and programs to assist AIDS and HIV-positive individuals.