Risk assessment whether formal or informal, is inherent in many individual and collective human activities. Seeking to identify potential hazards and vulnerabilities that could cause our endeavors to fail, we gather data and analyze it by applying our experience, knowledge, and in many cases, statistical tools. We then use the results to make decisions about all sorts of things: for example, investing or loaning money, setting life insurance premiums, accepting or rejecting applications for certain jobs, or changing public health and welfare policies. Formal risk assessment tools and practices, including medical statistics, evolved rapidly between the 1860s and the mid-twentieth century; a variety of individuals and institutions used and also modified such tools for a range of different purposes.

Historical exploration of the records of collection and analysis of health data can reveal stories that go beyond the statistics. Who was collecting the data, and for what purpose? What kinds of data were collected: How was the data analyzed, and how were conclusions drawn? How does this process reflect the sociocultural or political context of the time? What kinds of data were not collected, and what biases might their absence indicate?

As part of its Profiles in Science project, the National Library of Medicine has made available online a digitized selection of historical materials from the Digital Collections of the National Library of Medicine, including the Louis I. Dublin Papers, to look at the evolution of health-related risk assessment since the 1860s, highlighting the range of individuals and institutions that collected and analyzed data, and the aims of such efforts. The concept of medical “risk factors” came into more common use in the 1960s, after the first reports from the Framingham Heart Study were published. The term referred to (and is currently understood as) various characteristics, conditions, or behaviors that can increase an individual’s chances of suffering injury, illness, or death. But the term itself dates back to the late 1800s; and the development of health-related risk assessment began in the early 1800s, carried out by social reformers, early public health advocates, military doctors, and life insurance companies.

This Profile is designed to introduce you to the development of health-related risk assessment beginning in the early 1800s through the 1950s, including the work of life insurance companies and public health agencies to collect and apply data to reduce risk. Narrative sections available from the navigation bar under “The Story” include a brief background on public health risk assessment, followed by sections detailing the development of this field of analysis.

Researchers can search the digitized items using the Search box or browse all Documents in the collection by selecting "Collection Items" from the navigation bar.