In 1909, MetLife Vice President Haley Fiske announced that "insurance, not merely as a business proposition, but as a social program," would be the future policy of the company. As a first step, Fiske hired the pioneering industrial social worker Lee Frankel to work at MetLife. Frankel envisioned insurance as a powerful means toward improving the lot of the underprivileged. To this end, he established MetLife's Welfare Division.
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Frankel's early work centered on the prevention of tuberculosis, the 'white plague' responsible for 20 percent of all death claims. Public education was the key. In 1909, 10,000 MetLife agents delivered Frankel's pamphlet 'A War Upon Consumption' to millions of urban poor, who were most at risk for tuberculosis. This document was the first of an ongoing series of MetLife health publications; by 1929, the company was distributing more than 50 million such brochures and pamphlets a year.
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The Welfare Division's most visible and memorable program was the Metropolitan Life Visiting Nurse Service. Lillian Wald, noted social reformer and director of the Henry Street Settlement on Manhattan's Lower East Side, had issued a challenge to Frankel to integrate MetLife's business objective - to insure America's workers - with a larger humanitarian perspective. He responded with a program that mobilized Henry Street nurses to visit acutely ill industrial policy holders. The service began in 1909 with a three month experiment on New York City's West Side that was later extended throughout the five boroughs. Insurance agents, who had day-to-day contact with the insured, urged policyholders to report illnesses at the earliest possible opportunity and left cards with information identifying the closest visiting nurse. The New York City program became a model for urban health reform, which MetLife then expanded to 13 other cities.
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The company's vigorous public health campaign, conducted through its agents, was the largest such endeavor launched by a public or private entity. For nearly a half century, approximately 20 million policyholders in more than 7,000 cities and towns in the U.S. and Canada received free nursing care. At its peak of service in 1935, 35 out of 1,000 policyholders were treated for illnesses such as diphtheria, influenza, smallpox, and tuberculosis.
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