1999 - 1900United States of America
Robeson County, North Carolina established the first strictly rural county health department in the Uniteted States. 
The county health movement was a direct outgrowth of measures carried on from 1910 to 1915 against hookworm, typhoid fever, and other diseases. Guilford County in 1911 became the first county in the state to establish a health department. On February 12, 1912, the Robeson County commissioners hired Dr. B. W. Page, thus becoming the second county with a department. In his first year, Dr. Page inspected forty-five schools, checked 500 rural homes (quarantining 118), vaccinated 525 schoolchildren, and set up a lecture series.
North Carolina was at the forefront nationally in establishing county health departments. According to a national survey of such organizations, the first four were set up in Jefferson County, Kentucky (1908); Guilford County, North Carolina (1911); Yakima County, Washington (1911) and Robeson County, North Carolina (1912). The first three counties all had cities of over 2,500 in 1910, thus qualifying them as urban by 1910 Bureau of the Census standards. Robeson County, with Lumberton (1910 pop., 2,230) being its largest town, was defined as rural. The Robeson County Health Department was originally located in the basement of the courthouse and has since moved several times.
References:
  • John A. Ferrell and Pauline A. Mead, “History of County Health Organizations in the United States, 1908-1933,” Public Health Bulletin No. 222 (Government Printing Office, 1936)
  • Institute of Government, Health Law Bulletin No. 68 (July 1984)
  • Institute of Government, Public Health in North Carolina: A Guidebook for County Commissioners (1960)
  • North Carolina Board of Health, Bulletin, XXVI, no. 12 (March 1912)
  • Public Health in North Carolina: Historical Highlights, 1877-1977
  • Public Laws of North Carolina, 1874/75, 1876, 1879, 1895, 1911
  • Robeson County Board of Commissioners Minutes, 1910-1913