March of Dimes

1275 Mamaroneck Avenue
White Plains, New York 10605
U.S.A.
Telephone: (914) 428-7100
Fax: (914) 428-8203
Web site: http://www.modimes.org

Not-For-Profit Foundation
Incorporated: 1938
Employees: 225
Sales: $181.3 million (1998)
NAIC: 813212 Voluntary Health Organizations

The March of Dimes is one of the most successful and well-known nonprofit foundations in the United States. It was founded to fight polio, and after the disease was controlled by the invention of a vaccine, the March of Dimes turned its efforts to eradicating birth defects. The foundation funds research, giving grants to hundreds of scientists annually at a cost of more than $20 million. It organizes fundraising events to promote awareness and bring in cash for its programs, and it helps run community services and educational projects. The March of Dimes is responsible for backing major scientific breakthroughs in genetics and prenatal health. The organization has been highly effective in advocating for women’s and children’s health, for example working through its volunteers to pass legislation guaranteeing women a minimum hospital stay of 48 hours after giving birth to a baby. The March of Dimes also sponsors public awareness campaigns, such as its work in the late 1990s to encourage women of childbearing age to consume folic acid to help prevent birth defects. The roster of esteemed scientists the March of Dimes has supported through grants includes ten winners of the Nobel Prize. Among these laureates are some of the most famous names in medicine, including Linus Pauling, who discovered the relationship between molecular structure and human diseases, and James Watson, the discoverer of the structure of DNA. The March of Dimes is organized into more than 90 local chapters, overseen by a national office.

Polio Strikes in 1916

The March of Dimes began as an organization to combat a baffling and fearsome disease, polio. The sickness caused an inflammation of the spinal cord that could leave its victims unable to move arms, legs, or even lungs. Although isolated outbreaks had been noted since the middle of the 19th century, it was not until 1916 that it became serious enough even to be given a name. The first devastating outbreak of polio in the United States came in the summer of 1916. It began in New York City and spread to neighboring states, striking mainly children. The cause of the outbreak was completely unknown. It began with a few cases in June, and by August almost 9,000 people had come down with the ravaging illness. The epidemic spread, finally covering 26 states, causing 6,000 deaths out of a total of some 27,000 cases. It had lasted approximately six months. Because most of the victims were less than five years old, the disease was called infantile paralysis and given the scientific name poliomyelitis, which means inflammation of the anterior spinal cord.

Most of the victims of the outbreak survived, but many had withered limbs, for which there was no acceptable treatment or therapy. Few facilities existed for the care of such disabled people, and since the cause of the disease was unknown, families who had been visited by it were subject to prejudice that they had brought it on themselves through lack of hygiene. Many outbreaks of polio followed the 1916 epidemic, devastating communities. Though most of polio’s victims were young children, it also struck older people. In 1921 Franklin Delano Roosevelt, former Under-Secretary of the Navy, one-time Democratic vice-presidential candidate, and one of the leading lights of the Democratic party, became ill. On August 10 he went to bed fatigued. Two days later, his legs were paralyzed. He had polio, and he never walked unassisted again.

Roosevelt spent the next seven years trying to cure his paralysis. He was a wealthy and influential man, and he used his money on all the available treatments, from massage to stimulation with electrical currents. In 1924 he visited a spa in Georgia called Warm Springs to bathe in its naturally heated waters. Warm Springs was a resort for well-to-do Americans, but Roosevelt’s fame attracted other polio victims to the spa, and it soon transformed into a therapeutic center for people trying to recover from paralysis. The waters actually did nothing to cure the paralysis and muscle atrophy, but Roosevelt was able to exercise his other muscles in the warm pools so that he had the strength to support himself on crutches or on someone’s arm. He purchased Warm Springs in 1926, spending what was estimated as half his personal fortune to do so. Two years later he ran for governor of New York, and in 1932 he was elected to his first term as president.

When the nation’s most famous polio victim returned to public office, he left the running of Warm Springs to his law partner, Basil O’Connor. The spa was terribly expensive to keep up, and O’Connor helped Roosevelt transform it into a nonprofit foundation for polio victims. Its new name was the Georgia Warm Springs Foundation. O’Connor began raising money from wealthy patients and their families and used these funds to help other less well-off polio sufferers. Warm Springs was soon joined by a sister foundation, the National Foundation for Infantile Paralysis. After Roosevelt became president, O’Connor used his fame as the key to fundraising. Beginning in 1935, the National Foundation inaugurated a series of fundraising balls in the month of January, pegged to fall near Roosevelt’s birthday. In its first year, 6,000 balls were held across the country, and the Foundation raised close to $800,000. The money went both to patient care at Warm Springs and to funding research into the cause and prevention of poliomyelitis.

Roosevelt’s Foundation from the 1930s to the 1950s

By 1938, the January balls were in decline, bringing in less and less money each year, and a new kind of promotion was needed. That year the name March of Dimes was coined by the vaudeville entertainer Eddie Cantor, who was a leading fundraiser both for the Democratic party and for the National Foundation’s balls. The phrase was a play on the “March of Time,” a popular series of newsreels. The implication of Cantor’s phrase was that even a dime was of use in the fight against polio. Cantor and other entertainment world luminaries stumped for the March of Dimes campaign, urging people to send dimes to the White House. President Roosevelt established the March of Dimes foundation in January of 1938. This name was tagged onto the National Foundation’s, effectively revitalizing that organization. The March of Dimes immediately began issuing research grants, giving scholarships to doctors and nurses, and providing equipment for laboratories and hospitals. The nonprofit foundation was desperately needed, because there was little government funding for medical research, no public health insurance, and little private health insurance. The March of Dimes bought iron lungs, crutches, and laboratory equipment as well as trucks to transport it in, so all that was needed could be moved quickly to regions in the midst of an outbreak. National headquarters were in Basil O’Connor’s Wall Street law office, and local chapters sprang up across the country. Much fundraising was done by Hollywood stars and other popular idols. Mickey Rooney and Elvis Presley made March of Dimes fundraising appeals, as well as actresses Lucille Ball, Zsa Zsa Gabor, and Helen Hayes, among others. But the local chapters effectively raised money without star power. The March of Dimes called on ordinary people to contribute just a little money. One tactic was to go to movie theaters, stop the film in the middle, turn up the lights, and pass out a collection can. March of Dimes collection cans were placed on store counters, and people filled them with change. Children mailed in dimes on special cards.

Much of the credit for enlisting the middle class into the March of Dimes is attributed to Elaine Whitelaw. A wealthy New York society woman, Whitelaw made her career out of raising money. She first became a fundraiser during the Spanish Civil War, when she raised money for the Loyalists. During World War II, she worked with the National War Fund. In 1943 President Roosevelt appointed Whitelaw to head the national women’s committee of the March of Dimes. She moved in high society circles, dining with politicians, writers, and artists. Nevertheless, Whitelaw understood that polio was an issue that touched every ordinary woman with children. She orchestrated the campaigns that had such mass appeal, and she was key to the enormous success of the organization.

Whitelaw arrived at the March of Dimes during World War II, when many men were off in the armed forces. The organization began to concentrate even more on polio as a women’s issue, and more women fundraisers came into the foundation. One innovation was the poster child campaign, which began in 1946. The March of Dimes Poster Child was meant to look happy and attractive, though leg braces or some other symptom of disability was evident. These children were far from pathetic, and it was a vision of disability that had not been seen in the United States before. The image of the vibrant, though crippled, child projected hope for recovery and inspired people to give money to the foundation. Another campaign of the 1940s that was enacted all across the country was the porchlight campaign. Local chapters organized marches and told people in the community to turn their porchlights on if they wanted the marchers to stop by and collect.

Company Perspectives:

The mission of the March of Dimes is to improve the health of babies by preventing birth defects and infant mortality. The March of Dimes carries out this mission through programs of research, community services, education and advocacy.

The March of Dimes put its money into a variety of programs. The foundation set up more than a dozen respirator centers around the country, where doctors, physical therapists, and other health professionals worked with polio patients who had been confined to respirators. They aimed to get the patients back to breathing on their own. As this was not always possible, the March of Dimes also invested in new respirator technology so that some patients could be cared for at home. The foundation also funded rehabilitation centers, for long-term care of polio victims. In addition, the March of Dimes directly funded doctors and scientists working on curing polio. In 1949, the foundation chose Dr. Jonas Salk to lead its research efforts. By 1951, the March of Dimes had spent $1 million to support a number of scientists who finally identified all three types of polio virus. In 1953, Dr. Salk announced that a vaccine for polio was feasible, and the next year the March of Dimes organized and funded the first field trials of the vaccine. A total of 1,830,000 schoolchildren participated in the vaccine trial, and this was called the largest peacetime mobilization of volunteers in the nation’s history. The organization had put $9 million toward production of the vaccine, before it was proved safe and effective. If something had gone wrong, that money would have been gambled away. But in 1955, the Salk vaccine was declared effective. Mass inoculation began, and the fear of polio quickly died away.

Changing Gears After the Salk Vaccine: The Late 1950s Through the 1970s

The March of Dimes campaign to fight polio had been a remarkable victory. The organization had worked on all fronts, responding to the emergency of local outbreaks, funding and arranging long-term care for victims, mobilizing awareness, and paying for the research that led to the vaccine. After 1955, the impetus that had led people to give money to the foundation ebbed away, and the March of Dimes was in something of a quandary. It still had debts owing to its massive spending on the vaccine, but people were not willing to be stopped in the middle of a movie for a disease that could now be easily prevented. In 1958, the organization came up with a new mission. Its work on polio mostly behind it, the March of Dimes turned to another burning issue of infant health: birth defects. At the time, the term birth defects was not in use. Parents of a baby who was born with a debilitating condition were often not given any explanation for what affected their child. The numbers or percentages of babies born with these conditions were not known, and the diseases that affected children at birth were mostly mysteries. The March of Dimes put its volunteer and fund-raising organization to work in this new area. The foundation brought together scientists from diverse specialties to work together on birth defects, and as with polio, the March of Dimes had quick and concrete results. In 1961, research the March of Dimes had funded led to the development of the PKU test, which can identify and prevent some forms of mental retardation. In 1968, the organization funded the first successful bone marrow transplant used to correct a birth defect.

But birth defects had many causes, so this issue was not as focused as the fight against polio had been. Eventually, medical researchers identified approximately 3,000 distinct disorders causing birth defects. Some of these were genetic diseases, some were disorders caused by conditions in utero, and others were caused by problems with the birth itself, such as a child being born prematurely. The March of Dimes continued to use many of the techniques it had deployed during its polio campaign to raise funds to combat birth defects. The foundation used celebrities to lead fundraising and appealed to ordinary women with a variety of local events such as marches and store promotions. Elaine Whitelaw still led fundraising for the organization. She used her particular personal panache to launch glamorous events that raised hundreds of thousands of dollars for the charity. One exceedingly successful fundraiser was a fashion show, and another was the Gourmet Gala. The first Gourmet Gala was held in 1976. Hundreds of guests paid regal amounts to the March of Dimes to eat dinners prepared by celebrities and judged by cooking experts. With the money raised, the organization helped make possible many signal advances in the treatment of birth defects. Researchers it funded found in 1973 that alcohol consumption can affect fetal development. The organization also funded the first in utero treatment for a birth defect that year. The foundation had a far-reaching effect on hospital policy when it began working for the development of a regional system of neonatal intensive care units in the mid-1970s.

Broad Goals in the 1980s and 1990s

Education and outreach became a vital part of the March of Dimes agenda once it began work with birth defects, since some conditions turned out to be preventable. Researchers it funded had found that alcohol and drug use by the mother can influence fetal development, and other scientists had made many advances in treating birth defects before the babies were born. March of Dimes-funded doctors had perfected some in utero surgical techniques, and other researchers had discovered ways to diagnose certain birth defects prenatally. Good prenatal care was essential if doctors were to find preventable problems before birth. So in 1982 the foundation launched a public awareness campaign called “Babies & You,” which brought prenatal education into the workplace. This was followed by several other education campaigns in the 1990s. In 1994, the organization began a program to educate women of childbearing age on the value of taking folic acid supplements, since this can prevent some particular birth defects. That same year, the March of Dimes did something of a follow-up to Babies & You, aimed more succinctly at employers and their pocketbooks. The organization put out a book entitled Healthy Babies, Healthy Business, which detailed to employers the cost to them of poor birth outcomes among their employees’ children. It stressed the importance of prenatal care and gave tips to employers on how to make it easier for their workers to obtain the care they needed.

At the same time, March of Dimes funded research that led to impressive results. In 1985, research sponsored by the organization led to a new method to treat respiratory distress syndrome in infants. Four years later, a doctor funded by the foundation performed the first in utero surgery to repair a diaphragmatic hernia in an unborn child. In addition, scientists backed by the March of Dimes made a number of significant advances in the 1990s in identifying the genes responsible for particular syndromes.

Key Dates:

1938:

March of Dimes is founded by President Roosevelt.

1954:

March of Dimes mobilizes huge field trial for polio vaccine.

1955:

Jonas Salk’s polio vaccine is found safe and effective.

1958:

Organization changes focus to prevention of birth defects.

1976:

First Gourmet Gala fundraiser.

1982:

Babies & You campaign begins.

1998:

Birth Defects Prevention Act passes with March of Dimes support.

The March of Dimes was also influential in getting legislation passed in the 1990s that benefited mothers and children. In 1996, the organization’s volunteers were very visible in the fight to get the Mothers’ and Newborns’ Health Protection Act passed. This legislation guaranteed mothers a minimum hospital stay of 48 hours after delivery, ending the practice of some hospitals and insurers to send new mothers home as soon after the birth as possible. The next year, the organization was again influential in getting the State Children’s Health Insurance Program passed. This legislation ensured health insurance coverage for an estimated five million children. In 1998, March of Dimes volunteer workers helped bring about the Birth Defects Prevention Act, which established a national network for monitoring birth defects.

By 1998, the March of Dimes was composed of more than 90 local chapters, with approximately three million volunteers contributing to its work. Its revenue had grown to more than $181 million. A total of 75 percent of this went to its programs, with the remainder spent on fundraising costs, management, and general expenses. The March of Dimes set aside money that year for a six-year research program. It planned to invest more than $11 million over the six years in research into methods to deliver healthy genes to patients needing gene therapy. The organization planned to spend another $3.8 million over the same period on research into the causes of premature birth. The March of Dimes also launched a new, massive public health campaign beginning in 1998 and expected to last three years. This was a $10 million effort to get the word out about the benefits of folic acid. The foundation had been working on this since the mid-1990s, and the latest campaign was an intensification of that effort. The foundation also gave out $20.5 million in grants in 1998, awarded to 300 scientists. With a lot of vital work left to do, the March of Dimes seemed to be thriving as the century came to a close, expanding its revenue and attracting a growing number of volunteers.

Further Reading

Carey, Joseph, “New Insight into Genes: Now the Payoff,” U.S. News & World Report, August 6, 1984, p. 57.

Clune, Ray, “A Stroke of Generosity,” Daily News Record, October 12, 1995, p. 4.

“Coke Campaign Involves March of Dimes, Coleco,” Wall Street Journal, August 24, 1984, p. 14.

“March of Dimes Still Leading the Fight for Healthy Babies After 50 Years,” American Baby, May 1988, pp. 16–19.

Noble, Barbara Presley, “A Guide to Lower Health Care Costs,” New York Times, January 4, 1994, p. F25.

O’Neill, Molly, “Elaine Whitelaw, 77, March of Dimes Backer, Dies,” New York Times, December 17, 1992, p. B22.

——, “Learning To Turn Dimes into Millions,” New York Times, October 17, 1990, pp. C1, C7.

Seavey, Nina Gilden, Jane S. Smith, and Paul Wagner, A Paralyzing Fear: The Triumph Over Polio in America, New York: TV Books, 1998.

—A. Woodward

March of Dimes

Portrait of Donald Anderson

Poster

By: Anonymous

Date: January 8, 1946

Source: "Portrait of Donald Anderson." March of Dimes.

INTRODUCTION

The charitable medical organization now known as the March of Dimes was created by President Franklin Delano Roosevelt in 1937. It was originally called the National Foundation for Infantile Paralysis; its original mission was to generate funds for the treatment of polio. The nickname March of Dimes was the result of a play on words by a comedian named Eddie Cantor. He altered the name of a well known newsreel called The March of Time and called the fundraising campaign for which he was a celebrity spokesperson the March of Dimes, suggesting that every person in America send a dime to President Franklin Roosevelt at the White House, to pledge their support for the fight to conquer polio. This suggestion was so widely adopted that nearly two million dollars were raised by the charity within about a week, and nearly one sixth of that was sent directly to the president. The National Foundation for Infantile Paralysis adopted a multi-pronged approach to eradication of polio: it funded research on the types and etiology of the disease, on determination of the modes of transmission and incubation of the virus, on the viruses' epidemiology, and on its treatment. The foundation also trained and recruited health care professionals to respond to local outbreaks and epidemics, much like a contemporary emergency and disaster relief organization.

One of the unique aspects of the fundraising methodology for the National Foundation (referred to interchangeably as the National Foundation and the March of Dimes) was its humanity and directness: it targeted the average citizen, acknowledging that a contribution of even a dime would have a positive impact on the fight against polio. Rather than seeking corporate donors or soliciting the wealthy, the March of Dimes sought to empower the general population, carrying out their agenda on a grassroots level. Collection buckets were even passed through the audiences at movie theaters. This was also the first time that fundraising campaigns used celebrity spokespeople. By the early 1940s, the March of Dimes had begun using a poster campaign as a means of encouraging contributions; they used images of happy, healthy children who had genuinely benefited from the work of the charity. In 1954, the March of Dimes helped to spearhead the largest clinical trial ever conducted (at that time) in America. Jonas Salk (1914–1995), whose research had received funding from the National Foundation, had created a vaccine that was hoped to prevent polio, and it was widely field tested. In 1955, the National Foundation announced the successful result of the clinical trial, and the vaccine's ability to prevent polio. After this success, the National Foundation shifted focus, and began to study birth defects and premature births in the United States.

PRIMARY SOURCE

PORTRAIT OF DONALD ANDERSON

See primary source image.

SIGNIFICANCE

The March of Dimes "poster child" campaign successfully carried the organization's message until 1986, when children chosen to participate in promotions were re-designated March of Dimes National Ambassadors.

The March of Dimes has remained steadfast in its commitment to ensuring the health and well being of children, and of eliminating causes of death among the very young. At present, the focus of the March of Dimes is threefold: to prevent birth defects, to eliminate premature births, and to dramatically lower the rate of infant mortality. It seeks to accomplish its goals by funding and supporting research, by creating grass-roots educational campaigns, by conducting activities on the local level, and by engaging actively in advocacy at the state and federal levels. One of their large, ongoing programs regarding the elimination of birth defects concerns the use of folic acid as a means of preventing neural tube defects. The March of Dimes is engaged in an active educational campaign informing women of the need to take an appropriate dose of folic acid daily, beginning before pregnancy and continuing through early gestation. According to data published by the Centers for Disease Control and Prevention, nearly three quarters of all neural tube defects could be prevented by this one simple measure (taking a daily 400mcg dose of folic acid before conception and during the first trimester of pregnancy).

In addition to the prevention of neural tube defects, the March of Dimes is engaged in the process of determining the etiology (cause or origin) of birth defects caused by either genetics or the environment. Many birth defects are caused by exposure to environmental teratogens (substances or conditions capable of causing birth defects), such as tobacco or alcohol use, many types of prescription or over-the-counter medications, and some types of chemicals to which a person may become exposed. Birth defects can be manifested by any of several different means: the infant may have a physiological defect or abnormality, such as missing limbs or digits, cleft lip or soft palate malformation, neural tube defects, heart, circulatory, organ, or bodily system malformations; there may be an endocrine or metabolic abnormality, such as phenylketonuria (PKU); a developing embryo could be exposed to rubella (also called German measles), cytomegalovirus (also called CMV), HIV/AIDS, or any of several sexually transmitted diseases through its mother during the early stages of gestation.

As a result of ever-advancing technology, it is now possible to identify a significant number of birth defects during the early stages of gestation. In families where there is a risk of inherited disorder or in those in which there is an absence of family history (as in the case of a parent who was adopted and knows no history of biological origins), pre-pregnancy genetic counseling and screening may be recommended. For those who are already pregnant and present with risk factors such as potential heritability, lack of historical data, advanced maternal age, presence of a child in the family with an inherited disorder or other form of birth defect, people with teratogen exposure, women with a prior history of birth complications or miscarriages, or women who have an abnormal ultrasound or blood test associated with the pregnancy, further testing may be recommended in order to rule out birth defects.

The March of Dimes also advocates passage of the PREEMIE Act (S.707/H.R. 2861) before the U.S. Congress, that would authorize the National Institutes of Health and the Centers for Disease Control and Prevention to expand research into the causes of premature birth and develop strategies to prevent it, along with providing additional health services for those at risk for preterm birth.

FURTHER RESOURCES

Books

Black, Kathryn. In the Shadow of Polio: A Personal and Social History. Reading, MA: Addison-West, 1996.

Web sites

March of Dimes. "Study Finds Markers for Premature Birth Risk at the Molecular Level." 〈http://www.marchofdimes.com/aboutus/14458_14991.asp〉 (accessed January 18, 2006).

MayoClinic.com. "Prenatal Testing: What's Involved and Who Should Consider It?" 〈http://www.mayoclinic.com/health/prenatal-testing/PR00014〉 (accessed January 18, 2006).

OTIS: Organization of Teratology Information Specialists. "Fact Sheets." 〈http://otispregnancy.org/otis_fact_sheets.asp〉 (accessed January 18, 2006).

OTIS: Organization of Teratology Information Specialists. "Teratology, Information Specialists, and OTIS." 〈http://otispregnancy.org/otis_about_us.asp〉 (accessed January 18, 2006).

MARCH OF DIMES

MARCH OF DIMES. President Franklin D. Roosevelt established the March of Dimes in January 1938 to save America's youth from polio. The agency was officially known as the National Foundation for Infantile Paralysis. Roosevelt, a polio survivor, created the partnership between scientists and volunteers to conquer poliomyelitis.

Eddie Cantor, a comedian and entertainer, coined the phrase "March of Dimes." It reflected the first grass-roots fundraising campaign he started when he asked Americans to send dimes to the president.

The first president of the March of Dimes, Basil O'Connor, directed the foundation's early activities, including providing the first iron lung to assist polio victims in 1941. A year later Dr. Jonas Salk began leading research on the poliovirus. In 1953, Salk confirmed that a killed-virus vaccine for polio could stop the epidemic. In 1954, the foundation ran field trials of the Salk vaccine on 1,830,000 schoolchildren. The vaccine was declared safe the next year.

Virginia Apgar, an anesthesiologist and creator of the "Apgar Score" for newborns, was president of the foundation from 1959 to 1973. The foundation established the Salk Institute for Biological Studies in La Jolla, California in 1960. In 1962, the government licensed an oral polio vaccine developed by Dr. Albert Sabin with March of Dimes funding.

In 1958 the March of Dimes initiated its first efforts to save babies from birth defects. Subsequently, the foundation funded research on the in-utero treatment of birth defects, prenatal diagnosis of sickle cell anemia, spina bi-fida, and Marfan and Fragile X syndromes. In 1994 it began its successful folic acid campaign, which promoted the B vitamin to women of childbearing age for the prevention of birth defects of the brain and spinal cord called neural tube defects.

The March of Dimes has helped pass several national acts: the Mothers and Newborns' Health Protection Act (1996), the State Children's Health Insurance Program (S-CHIP) (1997), and the Birth Defects Prevention Act (1998). It also worked to enact the Children's Health Act of 2000. Nearly 3 million Americans volunteer with the March of Dimes.

BIBLIOGRAPHY

Gould, Tony. A Summer Plague: Polio and its Survivors. New Haven, Conn.: Yale University Press, 1995.

Sills, David L. The Volunteers, Means and Ends in a National Organization. Glencoe, Ill.: Free Press, 1957. Reprint, New York: Arno Press, 1980.

Smith, Jane S. Patenting the Sun: Polio and the Salk Vaccine. New York: William Morrow and Company, Inc., 1990.

RebeccaTolley-Stokes

See alsoMedical Research ; Poliomyelitis ; Volunteerism .