March of Dimes

Type: Not-For-Profit Foundation
Address: 1275 Mamaroneck Avenue, White Plains, New York 10605, U.S.A.
Telephone: (914) 428-7100
Fax: (914) 428-8203
Web: http://www.modimes.org
Employees: 225
Sales: $181.3 million (1998)
Incorporated: 1938
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.

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.

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.

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.

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 fundraising 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.

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.

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