In the early years of the twentieth century, African-Americans were leaving rural, agricultural settings to become urban dwellers. As industry and business increased in cities, so did minority populations. Their American Dream had begun – this new environment seemed to hold unlimited possibilities. At the same time, the relationship between health and social conditions became increasingly apparent to scientists and social reformers. Public health practitioners undertook a variety of activities to decrease preventable death and disease. As state boards of health and volunteer agencies increased both financially and in professional stature, they worked to make citizens aware of how social and living conditions affected health. Programs to establish sanitary water and sewage disposal, hookworm eradication campaigns, and programs to screen and treat a variety of illnesses exemplify some of the work accomplished by these agencies. While these activities benefited hundreds of individuals in many communities, they were disproportionately led by and directed towards white people.