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Sunday, April 9, 2023

American Medical Association

FormationMay 7, 1847; 175 years ago
TypeProfessional association
36-0727175
Legal status501(c)(6)
Purpose"To Promote the art and science of medicine and the betterment of public health"
Headquarters330 North Wabash
Chicago, Illinois, U.S.
Region served
United States
Membership
271,660 as of 2022 
President
Jack Resneck Jr., MD 
Revenue (2018)
$332,293,652
Websitewww.ama-assn.org

The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was 271,660 in 2022.

The AMA's stated mission is "to promote the art and science of medicine and the betterment of public health." The Association also publishes the Journal of the American Medical Association (JAMA). The AMA also publishes a list of Physician Specialty Codes which are the standard method in the U.S. for identifying physician and practice specialties.

The American Medical Association is governed by a House of Delegates as well as a board of trustees in addition to executive management. The organization maintains the AMA Code of Medical Ethics, and the AMA Physician Masterfile containing data on United States Physicians. The Current Procedural Terminology coding system was first published in 1966 and is maintained by the Association. It has also published works such as the Guides to Evaluation of Permanent Impairment and established the American Medical Association Foundation and the American Medical Political Action Committee.

Susan R. Bailey, the third consecutive female president of the AMA and an allergist and immunologist from Fort Worth, Texas, was sworn in as president in June 2020. The current president is Jack Resneck Jr., a dermatologist from San Rafael, California.

History

1847–1900

In 1846, the organization created a committee dedicated to analyzing the methodology of vital records registration. It urged state governments to adopt measures to register births, marriages and deaths within their populations. In 1847, the American Medical Association was founded in Philadelphia by Nathan Smith Davis as a national professional medical organization. The AMA established the world's first national code for ethical medical practice, the AMA Code of Medical Ethics. The organization educated people about the dangers of patent medicines and called for legislation regulating their production and sale. One resulting legislation was the Drug Importation Act of 1848.

In 1848, the AMA began publishing Transactions of the American Medical Association, which included lists and reports of cases of physiological effects of ether and chloroform at the Massachusetts General Hospital in Boston, the New York Hospital and the clinics of the University of Pennsylvania and Jefferson Medical College.

At the organization's second meeting in 1849, Thomas Wood suggested a committee on medical science to establish a board to analyze quack remedies and nostrums to be published in order to inform the public about the dangers of such remedies. The AMA's attempts to expose quack remedies aided the passage of the first Pure Food and Drug Act in 1906.

The AMA Committee on Ethics advocated for recognition of qualified female physicians in 1869, and the AMA inducted its first female member, Sarah Hackett Stevenson, as an Illinois State Medical Society delegate in 1876.

In 1872, the AMA's book Nomenclature of Diseases was published.

The Journal of the American Medical Association was launched in 1883. The organization's founder, Nathan Smith Davis, served as the first editor of the publication.

In 1897, the AMA was incorporated in the state of Illinois.

AMA pushed for laws requiring compulsory smallpox vaccinations in 1899. In 1899, the AMA appointed a committee to report on tuberculosis, including on its communicability and prevention. The Committee on Tuberculosis presented its report in October 1900.

1901–1920

In 1901, the AMA was reorganized with its central authority shifted to a House of Delegates, a board of trustees, and executive offices. The House of Delegates was modeled after the United States House of Representatives and included representatives from medical organizations across the United States as a formal, reform-minded legislative body. The organization's new president appointed a Committee on Medical Education in order to evaluate medical education in the United States and make recommendations for its improvement.

The AMA's Committee on National Legislation established the Committee on Medical Legislation in 1901.

AMA created the Council on Pharmacy and Chemistry in 1905 to set standards for drug manufacturing and advertising. That same year, the AMA began a voluntary program of drug approval, which would remain in effect until 1955. Drug companies were required to show proof of the effectiveness of their drugs to advertise them in AMA's journal.

In 1906, the AMA established a Physician Masterfile designed to contain data on physicians in the United States as well as graduates of American medical schools and international graduates who are in the United States. Each file is established when an individual either enters medical schools or enters the United States.

The AMA established the Council for the Defense of Medical Research in 1908.

AMA's Council on Medical Education and Hospitals first published its annual list of hospitals approved for internships in 1914.

The AMA established a policy of opposition to compulsory health insurance by state or federal government in 1920.

1921–1960

In May 1922, the Woman's Auxiliary to the AMA was organized. The following year, the AMA established standards for medical specialty training residency programs. The AMA later published its first list of hospitals approved for residency training in 1927.

In 1927, Congress passed the Caustic Poison Act, lobbied for by the AMA, which required product labels to include warnings if they included lye or 10 other caustic chemicals.

In 1933, the AMA's general medical guide the Standard Classified Nomenclature of Disease, (referred to as the Standard), was released. Along with the New York Academy of Medicine, the APA provided the psychiatric nomenclature subsection. A number of revisions were produced, with the last in 1961.

The Normal Diet, a comprehensive listing of what Americans should be eating, was published by the AMA in 1938.

A formal partnership between the AMA and the Association of American Medical Colleges formed the Liaison Committee on Medical Education in 1942 in order to establish requirements for certification of medical schools. In 1951, the Joint Commission on Accreditation of Hospitals was created through merging the Hospital Standardization Program with quality standards from the American College of Physicians, the American Hospital Association, and the American Medical Association. The commission, established for evaluation and accreditation of healthcare organizations in the United States, governed by a board of commissioners including physicians, consumers and administrators.

The AMA publicly endorsed the principle of fluoridation of community water supplies in 1951.

The Physicians Advisory Committee on Television, Radio and Motion Pictures was established by the AMA in 1955 in order to maintain medical accuracy in media.

The AMA's Committee on Alcoholism issued a statement in 1956 calling alcoholism an illness and encouraging medical personnel and institutions to admit and treat alcoholic patients.

1961–1980

In 1961, the AMA opposed the King-Anderson bill proposing Medicare legislation and took out advertisements in newspapers, radio and television against government health insurance. The AMA established the American Medical Political Action Committee, which was separate from AMA though the Association nominated its board of directors. The AMA's efforts to defeat Medicare legislation was called Operation Coffee Cup and included secretive meetings in which the vinyl LP "Ronald Reagan Speaks Out Against Socialized Medicine" was played. The AMA created an "Eldercare" proposal rather than hospital insurance through Social Security.

The AMA first published the Current Procedural Terminology (CPT) coding system in 1966. The system was created for uniform reporting of outpatient physician services. The first manual was 163 pages and contained only four-digit codes with descriptions of each. A second edition of the book was published in 1970 with a fifth digit added.

In 1969, AMA proposed the Medicredit program. The program was created to be flexible so that all people had an option for health insurance.

The AMA published the first Guides to the Evaluation of Permanent Impairment in 1971. The guides were later republished in 1977 before the AMA Council on Scientific Affairs created 12 committees to review the guides before the second edition was published in 1984.

In the 1970s, the AMA spoke out against gender discrimination in medical institutions.

In 1972, the AMA launched a "war on smoking" and supported legislation that would prohibit tobacco sample disbursement.

The following year, in 1973, the AMA urged physicians to combat hypertension through a national program.

In 1975, the AMA adopted a policy stating that "discrimination based on sexual orientation is improper and unacceptable by any part of the federation of medicine." It adopted a resolution to repeal all state sodomy laws.

In 1976, the AMA began encouraging all public facilities to have handicap access.

1981–2000

The AMA released a survey in 1981 that found two short-term effects of dioxin on humans and recommended further studies. By 1983, the AMA accused the news media of conducting a "witch hunt" against the toxic chemical and launched a public information campaign to counter media hysteria.

In the early 1980s, the AMA advocated for raising the national legal drinking age to 21.

The Supreme Court of the United States upheld Federal Trade Commission order that allowed doctors and dentists to advertise without professional associations interfering in 1982. The order restrained the AMA from obstructing agreements between physicians and health maintenance organizations.

In May 1983, the Journal of the American Medical Association published a report that reviewed cases of childhood AIDS.

The AMA called for a ban on advertising and promotion of all tobacco products in any form of media. The AMA also proposed declaring snuff and chewing tobacco a health hazard, increasing the tax on cigarettes, prohibiting smoking on public transportation and urged medical facilities to ban smoking on their premises.

A Federal district judge ruled that the AMA had violated the Sherman Antitrust Act in 1987 by depriving chiropractors of access to the Association. The lawsuit, filed by four chiropractors, accused AMA of conspiring to prevent chiropractors from practicing in the United States.

In 1990, AMA published Health Access America, which proposed improved access to affordable health care for citizens without healthcare insurance.

The Journal of the American Medical Association first documented that Joe Camel cartoons reached more children than adults in December 1991. The Association called for the R. J. Reynolds Tobacco Company to stop using the Joe Camel character in its advertising because of its appeal to youth.

In 1995, Lonnie R. Bristow became the first African-American president of the American Medical Association. Before he became president, Bristow was the first African-American member of the board of trustees and first African-American chairman of the board.

In 1996, the AMA campaigned against health plan "gag clauses", which prohibited doctors from discussing with their patients treatments not covered by the plan, stating that the stipulations inhibit the communication of information and restrict the care doctors can give their patients. The clauses were removed from the contracts of five leading providers, and laws prohibiting such clauses were passed in 16 states.

In 1997, the AMA established the National Patient Safety Foundation as an independent, nonprofit research and education organization focused on patient safety.

In 1997, the AMA lobbied Congress to restrict the number of doctors that could be trained in the United States, claiming that, "The United States is on the verge of a serious oversupply of physicians."

Nancy W. Dickey was named president of the American Medical Association in June 1998. She was the first woman to head the organization and had been part of AMA's leadership since 1977.

2000–present

In 2002, the American Medical Association released a report that found a medical liability insurance crisis in at least a dozen states was forcing physicians to either close practices or limit services. The association called for Congress to take action and campaigned for national reform.

The American Medical Association launched the "Voice for the Uninsured" campaign in 2007 to promote coverage for uninsured citizens.

In 2007, AMA called for state and federal agencies to investigate potential conflicts of interest between the retail clinics and pharmacy chains.

The American Medical Association issued a formal apology for previous policies that excluded African-Americans from the organization and announced increased efforts to increase minority physician participation in the AMA in 2008.

In 2009, the American Medical Association released a public letter to the United States Congress and President Barack Obama endorsing his proposed overhaul to the public health care system, including universal health coverage. The following year, it offered "qualified support" for the Patient Protection and Affordable Care Act.

The AMA officially recognized obesity as a disease in 2013 in an attempt to change how the medical community approaches the issue. In 2014, the Association created the AMA Opioid Task Force to evaluate prescription opioid use and abuse. The American Medical Association supported the Medicare Access and CHIP Reauthorization Act of 2015, which introduced Medicare reforms and replaced the SGR formula with increased Medicare physician reimbursement.

In 2015, the AMA declared there is no medically valid reason to exclude transgender individuals from serving in the U.S. military. The Human Rights Campaign lauded the decision.

The Association announced its opposition to replacing the federal health care law in March 2017, claiming millions of Americans would lose health care coverage.

Patrice A. Harris, MD, MA, a psychiatrist from Atlanta, became the AMA's 174th president in June 2019, the organization's first African-American woman to hold this position.

Policy positions

The AMA has one of the largest political lobbying budgets of any organization in the United States. Its political positions throughout its history have often been controversial. In the 1930s, the AMA attempted to prohibit its members from working for the health maintenance organizations established during the Great Depression, which violated the Sherman Antitrust Act and resulted in a conviction ultimately affirmed by the US Supreme Court. In the 1940s, the AMA opposed President Truman's proposed healthcare reforms, which would have expanded healthcare facilities in low-income and rural communities, bolstered public health services, increased investments in medical research and education, and provided a national health insurance plan to help relieve the burden of excessive healthcare bills from sick persons. The AMA condemned Truman's plan as "socialized medicine."

The American Medical Association's vehement campaign against Medicare in the 1950s and 1960s included Operation Coffee Cup, supported by Ronald Reagan. Since the enactment of Medicare, the AMA reversed its position and now opposes any "cut to Medicare funding or shift [of] increased costs to beneficiaries at the expense of the quality or accessibility of care". However, the AMA remains opposed to any single-payer health care plan, such as the Medicare for All Act. In the 1990s, the organization was part of the coalition that defeated the health care reform advanced by Hillary and Bill Clinton.

The AMA has also supported changes in medical malpractice law to limit damage awards, which, it contends, makes it difficult for patients to find appropriate medical care. In many states, high risk specialists have moved to other states that have enacted reform. For example, in 2004, all neurosurgeons had relocated out of the entire southern half of Illinois. The main legislative emphasis in multiple states has been to effect caps on the amount that patients can receive for pain and suffering. These costs for pain and suffering are only those that exceed the actual costs of healthcare and lost income. At the same time however, states without caps also experienced similar results, suggesting that other market factors may have contributed to the decreases. Some economic studies have found that caps have historically had an uncertain effect on premium rates. A recent report by the AMA found that, in a 12-month period, five percent of physicians had claims filed against them.

The AMA sponsors the Specialty Society Relative Value Scale Update Committee, which is an influential group of 29 physicians, mostly specialists, who help determine the value of different physicians' labor in Medicare prices.

Lobbying

Between 1998 and 2020, the association has spent an average of $18 million annually on lobbying efforts. In the first quarter of 2021, they reported $6.36 million in lobbying expenses.

Position on racism

In 2021, the AMA published a plan to dismantle "structural racism" which would encourage "explicit conversations about power, racism, gender and class oppression, forms of discrimination and exclusion", based on critical race theory and the antiracism movement.

Political donations

The association has donated between $1.6 million and $3.4 million in election cycles between 1990 and 2020. Their distributions have varied from near parity for both Democrats and Republicans to heavily favoring Republican candidates at 75% in the 1996 and 2004 elections.

Contributions by party of recipient (1990 to 2020)
Cycle Total Democrats % to Dems Republicans % to Repubs
1990 $2,846,407 $1,398,543 49.13% $1,447,864 50.87%
1992 $3,451,005 $1,696,551 49.23% $1,749,454 50.77%
1994 $2,838,629 $1,206,192 42.57% $1,627,437 57.43%
1996 $2,869,846 $695,525 24.23% $2,174,571 75.77%
1998 $2,712,032 $804,018 29.84% $1,890,514 70.16%
2000 $2,290,025 $1,081,268 47.27% $1,206,007 52.73%
2002 $2,704,238 $1,074,695 39.74% $1,629,543 60.26%
2004 $2,353,510 $564,375 24.24% $1,763,950 75.76%
2006 $2,261,629 $743,554 33.05% $1,506,410 66.95%
2008 $1,875,337 $1,044,987 55.74% $829,700 44.26%
2010 $1,624,409 $867,750 53.46% $755,409 46.54%
2012 $2,117,640 $880,062 41.66% $1,232,578 58.34%
2014 $2,062,906 $793,776 38.51% $1,267,640 61.49%
2016 $1,994,697 $739,187 37.12% $1,252,093 62.88%
2018 $1,470,984 $715,539 49.13% $740,805 50.87%
2020 $1,573,836 $830,438 54.14% $703,513 45.86%

Between 1990 and 2020, the majority of contributions came from PAC money.

Contributions by source of funds (1990 to 2020)
Cycle Individuals PACs Soft (Individuals) Soft (Organization)
1990 $19,321 $2,827,086 N/A N/A
1992 $31,425 $3,371,794 $0 $47,786
1994 $26,341 $2,742,156 $0 $70,132
1996 $46,633 $2,617,176 $0 $206,037
1998 $21,666 $2,609,991 $0 $80,375
2000 $41,056 $2,216,104 $350 $32,515
2002 $33,657 $2,656,131 $700 $13,750
2004 $81,800 $2,257,425 $35 $14,250
2006 $61,080 $2,188,884 $665 $11,000
2008 $124,869 $1,749,818 $0 $650
2010 $64,550 $1,538,859 $1,000 $20,000
2012 $70,062 $2,047,578 $0 $0
2014 $66,700 $1,985,716 $490 $10,000
2016 $101,903 $1,880,594 $2,200 $10,000
2018 $62,734 $1,400,190 $2,560 $5,500
2020 $171,963 $1,362,650 $4,223 $35,000

Criticism

During the Civil Rights Movement, the American Medical Association's policy of allowing its constituent groups to be racially segregated in areas with widespread prejudice faced opposition from doctors as well as other healthcare professionals. Pressure from organizations such as the Medical Committee for Human Rights (MCHR) resulted in changed policies by the late 1960s.

Nobel Memorial Prize-winning economist Milton Friedman as well as his wife, Rose Friedman, have claimed that the organization acts as a guild and has attempted to increase physicians' wages and fees by influencing limitations on the supply of physicians and competition from non-physicians. In the book Free to Choose, the Friedmans stated that "the AMA has engaged in extensive litigation charging chiropractors and osteopathic physicians with the unlicensed practice of medicine, in an attempt to restrict them to as narrow an area as possible." The AMA was also criticized for holding up licensing of foreign-trained medical professionals after Adolf Hitler came to power, who were fleeing to the U.S. from Nazi-controlled Germany and adjacent nations. Profession and Monopoly also criticized the AMA for limiting the supply of physicians and inflating the cost of medical care in the U.S as well as its influence on hospital regulation. In a 1987 antitrust court case, a federal district judge called the AMA's behavior toward chiropractors "systematic, long-term wrongdoing". The AMA was accused of limiting the associations between physicians and chiropractors. In the 1960s and 1970s, the association's Committee on Quackery was said to have targeted the chiropractic profession, and for many years the AMA held that it was unethical for physicians to refer patients to chiropractors or to receive referrals from chiropractors.

In October 2020, the association used Twitter and Facebook to publicly oppose scope of practice creep, where non-physicians are permitted to provide healthcare services without physician oversight. The posts were removed the same day and the AMA commented that they were committed to "team-based healthcare guided by a physician" to "optimize patient outcomes." The American Academy of Physician Assistants published a letter expressing their frustration at the social media posts. Rebekah Bernard from the conservative advocacy group Physicians for Patient Protection publicly criticized the AMA for retracting their social media posts.

Structure

The AMA is composed of policy discussion groups that meet twice a year for an annual meeting and an Interim meeting. Within the AMA, there are sections that include Medical Students, Resident and Fellows, Academic physicians, Medical School Deans and Faculty, Physicians in group practice setting, Retired and Senior Physicians, International Medical graduates, Woman physicians, Physician Diversity and Minority health, GLBT, USAN, AMA board of Trustees, Foundation and Council. External organizations, called AMA member organizations, come to these meetings by sending representatives. Representatives come from a state, specialty or the federal services/government service medical societies.

Rosie the Riveter

From Wikipedia, the free encyclopedia
A "Rosie" putting rivets on an Vultee A-31 Vengeance in Nashville, Tennessee, in 1943

Rosie the Riveter is an allegorical cultural icon in the United States who represents the women who worked in factories and shipyards during World War II, many of whom produced munitions and war supplies. These women sometimes took entirely new jobs replacing the male workers who joined the military. Rosie the Riveter is used as a symbol of American feminism and women's economic advantage.

Similar images of women war workers appeared in other countries such as Britain and Australia. The idea of Rosie the Riveter originated in a song written in 1942 by Redd Evans and John Jacob Loeb. Images of women workers were widespread in the media in formats such as government posters, and commercial advertising was heavily used by the government to encourage women to volunteer for wartime service in factories. Rosie the Riveter became the subject and title of a Hollywood film in 1944.

History

Women in the wartime workforce

Women workers in the ordnance shops of Midvale Steel and Ordnance Company in Nicetown, Pennsylvania, during World War I (1918)

Because the world wars were total wars, which required governments to utilize their entire populations to defeat their enemies, millions of women were encouraged to work in the industry and take over jobs previously done by men. During World War I women across the United States were employed in jobs previously done by men. World War II was similar to World War I in that massive conscription of men led to a shortage of available workers and therefore a demand for labor which could be filled only by employing women.

Nearly 19 million women held jobs during World War II. Many of these women were already working in lower-paying jobs or were returning to the work-force after being laid off during the depression. Only three million new female workers entered the workforce during the time of the war.

Women responded to the call of need the country was displaying by stepping up to fill positions that were traditionally filled by men. They began to work heavy construction machinery, taking roles in lumber and steel mills as well as physical labor including unloading freight, building dirigibles (which are airships similar to air balloons), making munitions, and much more. Forty women were hired by Pan American Airways to replace men in the repair and maintenance department in the hangars at LaGuardia airfield for service, repair and overhaul on the fleet of aircraft including the Boeing 314 Flying Boat flying to and from Europe.

Many women discovered they enjoyed the autonomy these jobs provided them with. It expanded their own expectations for womanly duty and capabilities. Unfortunately, this was reckoned as unnatural and as men began to return home from the war, the government instituted another propaganda campaign urging women to "return to normalcy".

A 1943 Monsanto advertisement for refrigeration reveals ambivalence, emphasizing that after the war, women will return to their homes as "Rosie the Housewife."

Although most women took on male-dominated trades during World War II, they were expected to return to their everyday housework once men returned from the war. Government campaigns targeting women were addressed solely at housewives, likely because already-employed women would move to the higher-paid "essential" jobs on their own, or perhaps because it was assumed that most would be housewives. One government advertisement asked women: "Can you use an electric mixer? If so, you can learn to operate a drill." Propaganda was also directed at their husbands, many of whom were unwilling to support such jobs.

A woman operating a turret lathe (1942)

Many of the women who took jobs during World War II were mothers. Those women with children at home pooled together in their efforts to raise their families. They assembled into groups and shared such chores as cooking, cleaning and washing clothes. Many who did have young children shared apartments and houses so they could save time, money, utilities and food. If they both worked, they worked different shifts so they could take turns babysitting. Taking on a job during World War II made people unsure if they should urge the women to keep acting as full-time mothers, or support them getting jobs to support the country in this time of need.

Being able to support the soldiers by making all sorts of different products made the women feel very accomplished and proud of their work. Over six million women got war jobs; African American, Hispanic, White, and Asian women worked side by side. In the book A Mouthful of Rivets, Vi Kirstine Vrooman writes about the time when she decided to take action and become a riveter. She got a job building B-17s on an assembly line, and shares just how exciting it was, saying, "The biggest thrill—I can't tell you—was when the B-17s rolled off the assembly line. You can't believe the feeling we had. We did it!" Once women accepted the challenge of the workforce they continued to make strong advances towards equal rights.

In 1944, when victory seemed assured for the Allied Forces, government-sponsored propaganda changed by urging women back to working in the home. Later, many women returned to traditional work such as clerical or administration positions, despite their reluctance to re-enter the lower-paying fields. However, some of these women continued working in the factories. The overall percentage of women working fell from 36% to 28% in 1947.

The song

"Rosie the Riveter"
Rosie the Riveter cover.png
Cover of the published music to the 1942 song
Song by Kay Kyser
Published1942
Songwriter(s)Redd Evans, John Jacob Loeb

The term "Rosie the Riveter" was first used in 1942 in a song of the same name written by Redd Evans and John Jacob Loeb. The song was recorded by numerous artists, including the popular big band leader Kay Kyser, and it became a national hit. It was also recorded by the R&B group, The Four Vagabonds. The song portrays "Rosie" as a tireless assembly line worker, who earned a "Production E" doing her part to help the American war effort.

The identity of the "real" Rosie the riveter is debated. Candidates include:

  • Rosina "Rosie" Bonavita who worked for Convair in San Diego, California.
  • Rosalind P. Walter, who "came from old money and worked on the night shift building the F4U Corsair fighter." Later in life Walter was a philanthropist, a board member of the WNET public television station in New York and an early and long-time supporter of the Charlie Rose interview show.
  • Adeline Rose O'Malley, a riveter at Boeing's Wichita plant.
  • Rose Will Monroe, a riveter at the Willow Run Aircraft Factory in Ypsilanti, Michigan, building B-24 bombers for the U.S. Army Air Forces. Born in Pulaski County, Kentucky, in 1920, she moved to Michigan during World War II. The song "Rosie the Riveter" was already popular when Monroe was selected to portray her in a promotional film about the war effort at home. "Rosie" went on to become perhaps the most widely recognized icon of that era. The films and posters she appeared in were used to encourage women to go to work in support of the war effort. At the age of 50, Monroe realized her dream of flying when she obtained a pilot's license. In 1978, she crashed in her small propeller plane when the engine failed during takeoff. The accident resulted in the loss of one kidney and the sight in her left eye, and ended her flying career. She died from kidney failure on May 31, 1997, in Clarksville, Indiana, at the age of 77.

In Canada in 1941, Veronica Foster became "Ronnie, the Bren Gun Girl", Canada's poster girl representing women in the war effort.

A drama film, Rosie the Riveter, was released in 1944, borrowing from the Rosie theme.

Impact

During the Second World War

A man and woman riveting team working on the cockpit shell of a C-47 aircraft at the plant of North American Aviation (1942)

According to the Encyclopedia of American Economic History, "Rosie the Riveter" inspired a social movement that increased the number of working American women from 12 million to 20 million by 1944, a 57% increase from 1940. By 1944 1.7 million unmarried men between the ages of 20 and 34 worked in the defense industry, while 4.1 million unmarried women between those ages did so.

Although the image of "Rosie the Riveter" reflected the industrial work of welders and riveters during World War II, the majority of working women filled non-factory positions in every sector of the economy. What unified the experiences of these women was that they proved to themselves (and the country) that they could do a "man's job" and could do it well.

In 1942, just between the months of January and July, the estimates of the proportion of jobs that would be "acceptable" for women was raised by employers from 29 to 85%. African American women were some of those most affected by the need for women workers. It has been said that it was the process of whites working alongside blacks during the time that encouraged a breaking down of social barriers and a healthy recognition of diversity.

Postwar

Women at work on bomber, Douglas Aircraft Company, Long Beach, California (1942)

Women quickly responded to Rosie the Riveter, who convinced them that they had a patriotic duty to enter the workforce. Some claim that she forever opened the work force for women, but others dispute that point, noting that many women were discharged after the war and their jobs were given to returning servicemen. These critics claim that when peace returned, few women returned to their wartime positions and instead resumed domestic vocations or transferred into sex-typed occupations such as clerical and service work.

For some, World War II represented a major turning point for women as they eagerly supported the war effort, but other historians emphasize that the changes were temporary and that immediately after the war was over, women were expected to return to traditional roles of wives and mothers. A third group has emphasized how the long-range significance of the changes brought about by the war provided the foundation for the contemporary woman's movement. Leila J. Rupp, in her study of World War II, wrote "For the first time, the working woman dominated the public image. Women were riveting housewives in slacks, not mother, domestic beings, or civilizers."

After the war, as the nation shifted to a time of peace, women were quickly laid off from their factory jobs. The "Rosies" and the generations that followed them knew that working in the factories was in fact a possibility for women, even though they did not reenter the job market in such large proportions again until the 1970s. By that time factory employment was in decline all over the country.

Elinor Otto, known as "Last Rosie the Riveter", built airplanes for 50 years, retiring at age 95.

Homages

A "Wendy the Welder" at the Richmond Shipyards

According to Penny Colman's Rosie the Riveter, there was also, very briefly, a "Wendy the Welder" based on Janet Doyle, a worker at the Kaiser Richmond Liberty Shipyards in California.

In the 1960s, Hollywood actress Jane Withers gained fame as "Josephine the Plumber", a character in a long-running and popular series of television commercials for "Comet" cleansing powder that lasted into the 1970s. This character was based on the original "Rosie" character.

One of Carnival Cruise Line's ships, the Carnival Valor, has a restaurant located on the lido deck named Rosie's Restaurant. The restaurant is mostly a tribute to Rosie, but also contains artwork depicting other war-related manufacturing and labor.

In 2010, singer Pink paid tribute to Rosie by dressing as her for a portion of the music video for the song "Raise Your Glass".

The 2013 picture book Rosie Revere, Engineer by Andrea Beaty, features Rosie as "Great Great Aunt Rose" who "Worked building aeroplanes a long time ago". She inspires Rosie Revere, the young subject of the book, to continue striving to be a great engineer despite early failures. Rose is shown wielding a walking stick made from riveted aircraft aluminum.

Singer Beyoncé paid tribute to Rosie in July 2014, dressing as the icon and posing in front of a "We Can Do It!" sign often mistaken as part of the Rosie campaign. It garnered over 1.15 million likes, but sparked minor controversy when newspaper The Guardian criticized it.

Other recent cultural references include a "Big Daddy" enemy type called "Rosie" in the video game BioShock, armed with a rivet gun. There is a DC Comics character called Rosie the Riveter, who wields a rivet gun as a weapon (first appearing in Green Lantern vol. 2 No. 176, May 1984). In the video game Fallout 3 there are billboards featuring "Rosies" assembling atom bombs while drinking Nuka-Cola. Of the female hairstyles available for player characters in the sequel, one is titled "Wendy the Welder" as a pastiche.

Boeing Orbital Flight Test 2, an uncrewed test flight of the Boeing Starliner spacecraft to the International Space Station, carried an Anthropomorphic Test Device named "Rosie the Rocketeer." The device contained fifteen sensors to collect data on the effects of the flight on future passengers.

Recognition

Assembling a wing section, Fort Worth, Texas, October 1942

The Life and Times of Rosie the Riveter by Connie Field is a 65-minute documentary from 1980 that tells the story of women's entrance into "men's work" during WWII. Rosies of the North is a 1999 National Film Board of Canada documentary film about Canadian "Rosies," who built fighter and bomber aircraft at the Canadian Car and Foundry, where Elsie MacGill was also the Chief Aeronautical Engineer.

John Crowley's 2009 historical novel Four Freedoms covers the wartime industries, and studies the real working conditions of many female industrial workers. "Rosie the Riveter" is frequently referenced.

On October 14, 2000, the Rosie the Riveter/World War II Home Front National Historical Park was opened in Richmond, California, site of four Kaiser Shipyards, where thousands of "Rosies" from around the country worked (although ships at the Kaiser yards were not riveted, but rather welded). Over 200 former Rosies attended the ceremony.

In 2014, Phyllis Gould, one of the original Rosie the Riveters, visited President Barack Obama in support of a National Rosie the Riveter Day; the United States Senate approved the observance on March 21 in 2017. She also pushed for a Gold Medal for Rosies that will be given starting in 2022.

Also in 2014 a nationwide program, run by the organization Thanks! Plain and Simple, was founded to encourage cities to pick a project that "Rosies" can do with younger generations, in order to educate young people about women's roles in World War II, and to involve the "Rosies", many of whom have become isolated as they have gotten older, in community projects.

The name and logo of the Metropolitan Riveters, one of the founding members of the National Women's Hockey League, are inspired by the character of Rosie the Riveter.

The Rose City Riveters is the fan club for the Portland Thorns Football Club, a National Women's Soccer League team in Portland, Oregon, nicknamed the Rose City. They have taken their inspiration (and their name) from the 30,000 women who worked in the Portland shipyards in Portland during World War II.

Images

Westinghouse poster

"We Can Do It!", by J. Howard Miller, was made as an inspirational image to boost worker morale.

In 1942, Pittsburgh artist J. Howard Miller was hired by the Westinghouse Company's War Production Coordinating Committee to create a series of posters for the war effort. One of these posters became the famous "We Can Do It!" image, an image that in later years would also be called "Rosie the Riveter" although it had never been given that title during the war. Miller is thought to have based his "We Can Do It!" poster on a United Press International wire service photograph taken of a young female war worker, widely but erroneously reported as being a photo of Michigan war worker Geraldine Hoff (later Doyle).

More recent evidence indicates that the formerly misidentified photo is actually of war worker Naomi Parker (later Fraley) taken at Alameda Naval Air Station in California. The "We Can Do It!" poster was displayed only to Westinghouse employees in the Midwest during a two-week period in February 1943, then it disappeared for nearly four decades. During the war, the name "Rosie" was not associated with the image, and the purpose of the poster was not to recruit women workers but to be motivational propaganda aimed at workers of both sexes already employed at Westinghouse. It was only later, in the early 1980s, that the Miller poster was rediscovered and became famous, associated with feminism, and often mistakenly called "Rosie the Riveter".

Saturday Evening Post

Norman Rockwell's Saturday Evening Post 1943 cover featuring Rosie the Riveter

Norman Rockwell's image of "Rosie the Riveter" received mass distribution on the cover of The Saturday Evening Post on Memorial Day, May 29, 1943. Rockwell's illustration features a brawny woman taking her lunch break with a rivet gun on her lap and beneath her penny loafer a copy of Adolf Hitler's manifesto, Mein Kampf. Her lunch box reads "Rosie"; viewers quickly recognized that to be "Rosie the Riveter" from the familiar song.

Rockwell, America's best-known popular illustrator of the day, based the pose of his 'Rosie' on that of Michelangelo's 1509 painting Prophet Isaiah from the Sistine Chapel ceiling. Rosie is holding a ham sandwich in her left hand, and her blue overalls are adorned with badges and buttons: a Red Cross blood donor button, a white "V for Victory" button, a Blue Star Mothers pin, an Army-Navy E Service production award pin, two bronze civilian service awards, and her personal identity badge.

Rockwell's model was a Vermont resident, 19-year-old Mary Louise Doyle, who was a telephone operator near where Rockwell lived, not a riveter. Rockwell painted his "Rosie" as a larger woman than his model, and he later phoned to apologize. According to two of Doyle's obituaries, however, "twenty-four years after Doyle posed, Rockwell sent Doyle a letter calling her the most beautiful woman he'd ever seen and apologizing for the hefty body in the painting. 'I did have to make you into a sort of a giant,' he wrote."

In a post interview, Mary explained that she was actually holding a sandwich while posing for the poster and that the rivet-gun she was holding was fake, she never saw Hitler's copy of Mein Kampf, and she did have a white handkerchief in her pocket like the picture depicts. The Post's cover image proved hugely popular, and the magazine loaned it to the United States Department of the Treasury for the duration of the war, for use in war bond drives.

After the war, the Rockwell "Rosie" was seen less and less because of a general policy of vigorous copyright protection by the Rockwell estate. In 2002, the original painting sold at Sotheby's for nearly $5 million. In June 2009 the Crystal Bridges Museum of American Art in Bentonville, Arkansas, acquired Norman Rockwell's iconic Rosie the Riveter painting for its permanent collection from a private collector.

In late 1942, Doyle posed twice for Rockwell's photographer, Gene Pelham, as Rockwell preferred to work from still images rather than live models. The first photo was not suitable, because she wore a blouse rather than a blue work shirt. In total, she was paid $10 for her modeling work (equivalent to $157 in 2021). In 1949 she married Robert J. Keefe to become Mary Doyle Keefe. The Keefes were invited and present in 2002 when the Rockwell painting was sold at Sotheby's.

In an interview in 2014, Keefe said that she had no idea what impact the painting would have. "I didn't expect anything like this, but as the years went on, I realized that the painting was famous," she said. Keefe died on April 21, 2015, in Connecticut at the age of 92.

Total war

Ruins of Warsaw's Napoleon Square in the aftermath of World War II

Total war is a type of warfare that includes any and all civilian-associated resources and infrastructure as legitimate military targets, mobilizes all of the resources of society to fight the war, and gives priority to warfare over non-combatant needs.

The term has been defined as "A war that is unrestricted in terms of the weapons used, the territory or combatants involved, or the objectives pursued, especially one in which the laws of war are disregarded."

In the mid-19th century, scholars identified total war as a separate class of warfare. In a total war, the differentiation between combatants and non-combatants diminishes due to the capacity of opposing sides to consider nearly every human, including non-combatants, as resources that are used in the war effort.

Characteristics

According to an analysis by Tiziano Peccia of Stig Förster's works, total war is characterized on four dimensions:

  1. Total purposes (aim of continuous growth of the power of the parties involved and hegemonic visions);
  2. Total methods (similar and common methodologies among countries that intend to increase their spheres of influence);
  3. Total mobilization (inclusion in the conflict of parties not traditionally involved, such as women and children or individuals who are not part of the armed bodies);
  4. Total control (multisectoral centralization of the powers and orchestration of the activities of the countries in a small circle of dictators or oligarchs, with crossfunctional control over education and culture, media / propaganda, economic and political activities).

Tiziano Peccia adds a fifth dimension to Förster's: "total change". After a total war, the analysis shows that the political, cultural, economic and social assets persist beyond the end of the conflict ("total war is an earthquake that has the world as its epicenter").

Actions that may characterize the post-19th century concept of total war include:

Background

The phrase "total war" can be traced back to the 1935 publication of German general Erich Ludendorff's World War I memoir, Der totale Krieg ("The total war"). Some authors extend the concept back as far as classic work of Carl von Clausewitz, On War, as "absoluter Krieg" (absolute war), even-though he did not use the term; others interpret Clausewitz differently. Total war also describes the French "guerre à outrance" during the Franco-Prussian War.

In his December 24, 1864, letter to his chief of staff during the American Civil War, Union general William Tecumseh Sherman wrote the Union was "not only fighting hostile armies, but a hostile people, and must make old and young, rich and poor, feel the hard hand of war, as well as their organized armies," defending Sherman's March to the Sea, the operation that inflicted widespread destruction of infrastructure in Georgia.

United States Air Force General Curtis LeMay updated the concept for the nuclear age. In 1949, he first proposed that a total war in the nuclear age would consist of delivering the entire nuclear arsenal in a single overwhelming blow, going as far as "killing a nation".

History

Middle Ages

Written by academics at Eastern Michigan University, the Cengage Advantage Books: World History textbook claims that while total war "is traditionally associated with the two global wars of the twentieth century... it would seem that instances of total war predate the twentieth century." They write:

As an aggressor nation, the ancient Mongols, no less than the modern Nazis, practiced total war against an enemy by organizing all available resources, including military personnel, non-combatant workers, intelligence, transport, money, and provisions.

18th and 19th centuries

North America

The Sullivan Expedition of 1779 was an example of total warfare. As Native American and Loyalist forces massacred American farmers, killed livestock and burned buildings in remote frontier areas, General George Washington sent General John Sullivan with 4,000 troops to seek "the total destruction and devastation of their settlements" in upstate New York. There was only one small battle as the expedition devastated "14 towns and most flourishing crops of corn." The Native Americans escaped to Canada where the British fed them; they remained there after the war.

American Civil War

Sherman's March to the Sea in the American Civil War – from November 15, 1864, through December 21, 1864 – is sometimes considered to be an example of total war, for which Sherman used the term hard war. Some historians challenge this designation, as Sherman's campaign assaulted primarily military targets and Sherman ordered his men to spare civilian homes.

Europe

In his book, The First Total War: Napoleon's Europe and the Birth of Warfare as We Know it, David A Bell, a French History professor at Princeton University argues that the French Revolutionary Wars introduced to mainland Europe some of the first concepts of total war, such as mass conscription. He claims that the new republic found itself threatened by a powerful coalition of European nations and used the entire nation's resources in an unprecedented war effort that included levée en masse (mass conscription). By August 23, 1793, the French front line forces grew to some 800,000 with a total of 1.5 million in all services—the first time an army in excess of a million had been mobilized in Western history:

From this moment until such time as its enemies shall have been driven from the soil of the Republic all Frenchmen are in permanent requisition for the services of the armies. The young men shall fight; the married men shall forge arms and transport provisions; the women shall make tents and clothes and shall serve in the hospitals; the children shall turn old lint into linen; the old men shall betake themselves to the public squares in order to arouse the courage of the warriors and preach hatred of kings and the unity of the Republic.

The drownings at Savenay during the War in the Vendée, 1793
 
Napoleon's retreat from Russia in 1812. Napoleon's Grande Armée had lost about half a million men.

During the Russian campaign of 1812 the Russians retreated while destroying infrastructure and agriculture in order to effectively hamper the French and strip them of adequate supplies. In the campaign of 1813, Allied forces in the German theater alone amounted to nearly one million whilst two years later in the Hundred Days a French decree called for the total mobilization of some 2.5 million men (though at most a fifth of this was managed by the time of the French defeat at Waterloo). During the prolonged Peninsular War from 1808 to 1814 some 300,000 French troops were kept permanently occupied by, in addition to several hundred thousand Spanish, Portuguese and British regulars, an enormous and sustained guerrilla insurgency—ultimately French deaths would amount to 300,000 in the Peninsular War alone.

20th century

World War I

Damage and destruction of civilian buildings in Belgium, 1914
Propaganda

One of the features of total war in Britain was the use of government propaganda posters to divert all attention to the war on the home front. Posters were used to influence public opinion about what to eat and what occupations to take, and to change the attitude of support towards the war effort. Even the Music Hall was used as propaganda, with propaganda songs aimed at recruitment.

After the failure of the Battle of Neuve Chapelle, the large British offensive in March 1915, the British Commander-in-Chief Field Marshal John French blamed the lack of progress on insufficient and poor-quality artillery shells. This led to the Shell Crisis of 1915 which brought down both the Liberal government and Premiership of H. H. Asquith. He formed a new coalition government dominated by Liberals and appointed David Lloyd George as Minister of Munitions. It was a recognition that the whole economy would have to be geared for war if the Allies were to prevail on the Western Front.

Carl Schmitt, a supporter of Nazi Germany, wrote that total war meant "total politics"—authoritarian domestic policies that imposed direct control of the press and economy. In Schmitt's view the total state, which directs fully the mobilization of all social and economic resources to war, is antecedent to total war. Scholars consider that the seeds of this total state concept already existed in the German state of World War I, which exercised full control of the press and other aspects economic and social life as espoused in the statement of state ideology known as the "Ideas of 1914".

Rationing

As young men left the farms for the front, domestic food production in Britain and Germany fell. In Britain, the response was to import more food, which was done despite the German introduction of unrestricted submarine warfare, and to introduce rationing. The Royal Navy's blockade of German ports prevented Germany from importing food and hastened German capitulation by creating a food crisis in Germany.

Almost the whole of Europe and some of the European colonial empires mobilized soldiers. Rationing occurred on the home fronts. Bulgaria went so far as to mobilize a quarter of its population, or 800,000 people, a greater share of its population than any other country during the war.

World War II

The Second World War was the quintessential total war of modernity. The level of national mobilization of resources on all sides of the conflict, the battlespace being contested, the scale of the armies, navies, and air forces raised through conscription, the active targeting of non-combatants (and non-combatant property), the general disregard for collateral damage, and the unrestricted aims of the belligerents marked total war on an unprecedented and unsurpassed, multicontinental scale.

Shōwa Japan
Founding ceremony of the Hakkō ichiu Monument, promoting the unification of "the 8 corners of the world under one roof"

During the first part of the Shōwa era, the government of Imperial Japan launched a string of policies to promote a total war effort against China and occidental powers and increase industrial production. Among these were the National Spiritual Mobilization Movement and the Imperial Rule Assistance Association.

The State General Mobilization Law had fifty clauses, which provided for government controls over civilian organizations (including labor unions), nationalization of strategic industries, price controls and rationing, and nationalized the news media. The laws gave the government the authority to use unlimited budgets to subsidize war production and to compensate manufacturers for losses caused by war-time mobilization. Eighteen of the fifty articles outlined penalties for violators.

To improve its production, Shōwa Japan used millions of slave laborers and pressed more than 18 million people in East Asia into forced labor.

United Kingdom

Before the onset of the Second World War, Great Britain drew on its First World War experience to prepare legislation that would allow immediate mobilization of the economy for war, should future hostilities break out. Rationing of most goods and services was introduced, not only for consumers but also for manufacturers. This meant that factories manufacturing products that were irrelevant to the war effort had more appropriate tasks imposed. All artificial light was subject to legal blackouts.

..There is another more obvious difference from 1914. The whole of the warring nations are engaged, not only soldiers, but the entire population, men, women and children. The fronts are everywhere to be seen. The trenches are dug in the towns and streets. Every village is fortified. Every road is barred. The front line runs through the factories. The workmen are soldiers with different weapons but the same courage."

— Winston Churchill on the radio, June 18; and House of Commons 20 August 1940:

Not only were men conscripted into the armed forces from the beginning of the war (something which had not happened until the middle of World War I), but women were also conscripted as Land Girls to aid farmers and the Bevin Boys were conscripted to work down the coal mines.

Enormous casualties were expected in bombing raids, so children were evacuated from London and other cities en masse to the countryside for compulsory billeting in households. In the long term this was one of the most profound and longer-lasting social consequences of the whole war for Britain. This is because it mixed up children with adults of other classes. Not only did the middle and upper classes become familiar with the urban squalor suffered by working class children from the slums, but the children got a chance to see animals and the countryside, often for the first time, and experience rural life.

The use of statistical analysis, by a branch of science which has become known as Operational Research to influence military tactics, was a departure from anything previously attempted. It was a very powerful tool but it further dehumanised war particularly when it suggested strategies that were counter-intuitive. Examples, where statistical analysis directly influenced tactics include the work done by Patrick Blackett's team on the optimum size and speed of convoys and the introduction of bomber streams, by the Royal Air Force to counter the night fighter defences of the Kammhuber Line.

Germany

In 1935 General Ludendorff in the book Der Totale Krieg gave life to the term "Total War" in the German lexicon.

In contrast, Germany started the war under the concept of Blitzkrieg. Officially, it did not accept that it was in a total war until Joseph Goebbels' Sportpalast speech of 18 February 1943 – in which the crowd was told "Totaler Krieg – Kürzester Krieg" ("Total War – Shortest War”.)

Nazi rally on 18 February 1943 at the Berlin Sportpalast; the sign says "Totaler Krieg – Kürzester Krieg" ("Total War – Shortest War").

Goebbels and Hitler had spoken in March 1942 about Goebbels' idea to put the entire home front on a war footing. Hitler appeared to accept the concept, but took no action. Goebbels had the support of minister of armaments Albert Speer, economics minister Walther Funk and Robert Ley, head of the German Labour Front, and they pressed Hitler in October 1942 to take action, but Hitler, while outwardly agreeing, continued to dither. Finally, after the holidays in 1942, Hitler sent his powerful personal secretary, Martin Bormann, to discuss the question with Goebbels and Hans Lammers, the head of the Reich Chancellery. As a result, Bormann told Goebbels to go ahead and draw up a draft of the necessary decree, to be signed in January 1943. Hitler signed the decree on 13 January, almost a year after Goebbels first discussed the concept with him. The decree set up a steering committee consisting of Bormann, Lammers, and General Wilhelm Keitel to oversee the effort, with Goebbels and Speer as advisors; Goebbels had expected to be one of the triumvirate. Hitler remained aloof from the project, and it was Goebbels and Hermann Göring who gave the "total war" radio address from the Sportspalast the next month, on the 10th anniversary of the Nazi's "seizure of power".

I ask you: Do you want total war? If necessary, do you want a war more total and radical than anything that we can even imagine today?

— Nazi propaganda minister Joseph Goebbels, 18 February 1943, in his Sportpalast speech'

The commitment to the doctrine of the short war was a continuing handicap for the Germans; neither plans nor state of mind were adjusted to the idea of a long war until the failure of the Operation Barbarossa. A major strategic defeat in the Battle of Moscow forced Speer as armaments minister to nationalize German war production and eliminate the worst inefficiencies.

Under Speer's direction a threefold increase in armament production occurred and did not reach its peak until late 1944. To do this during the damage caused by the growing strategic Allied bomber offensive, is an indication of the degree of industrial under-mobilization in the earlier years. It was because the German economy through most of the war was substantially under-mobilized that it was resilient under air attack. Civilian consumption was high during the early years of the war and inventories both in industry and in consumers' possession were high. These helped cushion the economy from the effects of bombing.

Plant and machinery were plentiful and incompletely used, thus it was comparatively easy to substitute unused or partly used machinery for that which was destroyed. Foreign labour, both slave labour and labour from neighbouring countries who joined the Anti-Comintern Pact with Germany, was used to augment German industrial labour which was under pressure by conscription into the Wehrmacht (Armed Forces).

Canada

In Canada early use of the term concerned whether or not the country was committing enough to mobilizing its resources, rather than whether or not to target civilians of the enemy countries. During the early days of the Second World War, whether or not Canada was committed to a "total war effort" was point of partisan political debate between the governing Liberals and the opposition Conservatives. The Conservatives elected as their national leader Arthur Meighen, who had been the cabinet minister responsible for implementing conscription during the First World War, and advocated for conscription again. Prime Minister W.L. Mackenzie King argued that Canada could still be said to have a "total war effort" without conscription, and delivered nationally-broadcast speeches to this effect 1942. Meighen failed to win his seat in by-election in 1942, and the issue subsided for a short time. But eventually, national conscription was introduced in Canada in 1944, as well as dramatically increased taxation, another symbol of the "total war effort".

Soviet Union
Three men burying victims of Leningrad's siege, in which about 1 million civilians died

The Soviet Union (USSR) was a command economy which already had an economic and legal system allowing the economy and society to be redirected into fighting a total war. The transportation of factories and whole labour forces east of the Urals as the Germans advanced across the USSR in 1941 was an impressive feat of planning. Only those factories which were useful for war production were moved because of the total war commitment of the Soviet government.

The Eastern Front of the European Theatre of World War II encompassed the conflict in central and eastern Europe from June 22, 1941, to May 9, 1945. It was the largest theatre of war in history in terms of numbers of soldiers, equipment and casualties and was notorious for its unprecedented ferocity, destruction, and immense loss of life (see World War II casualties). The fighting involved millions of German, Hungarian, Romanian and Soviet troops along a broad front hundreds of kilometres long. It was by far the deadliest single theatre of World War II. Scholars now believe that at most 27 million Soviet citizens died during the war, including at least 8.7 million soldiers who fell in battle against Hitler's armies or died in POW camps. Millions of civilians died from starvation, exposure, atrocities, and massacres. The Axis lost over 5 million soldiers in the east as well as many thousands of civilians.

During the Battle of Stalingrad, newly built T-34 tanks were driven—unpainted because of a paint shortage—from the factory floor straight to the front. This came to symbolise the USSR's commitment to a policy of total war.

United States

The United States underwent an unprecedented mobilization of national resources for the Second World War; in a mere three years and eight months the previously isolationist country had fully embraced and was fueling a military-industrial complex that it still clings to to this day. Although the United States was not in danger of an existential attack, the national sense after Pearl Harbor was to use all the nation's resources to defeat Germany and Japan. Most non-essential activities were rationed, prohibited or restrained, and most of the fit unmarried young men were drafted. There was little urgency before 1940, when the collapse of France ended the Phoney War and revealed urgent needs. Nevertheless President Franklin Roosevelt moved to first solidify public opinion before acting. In 1940 the first peacetime draft was instituted, along with Lend-Lease programs to aid the British, and covert aid was passed to the Chinese as well. American public opinion was still opposed to involvement in the problems of Europe and Asia, however. In 1941, the Soviet Union became the latest nation to be invaded, and the U.S. gave its aid as well. American ships began defending aid convoys to the Allied nations against submarine attacks, and a total trade embargo against the Empire of Japan was instituted to deny its military the raw materials its factories and military forces required to continue its offensive actions in China.

In late 1941, Japan's Army-dominated government decided to seize by military force the strategic resources of South-East Asia and Indonesia since the Western powers would not give Japan these goods by trade. Planning for this action included surprise attacks on American and British forces in Hong Kong, the Philippines, Malaya, and the U.S. naval base and warships at Pearl Harbor. In response to these attacks, the U.K. and U.S. declared war the next day. Nazi Germany declared war on the U.S. a few days later, along with Fascist Italy; the U.S. found itself fully involved in a second world war.

As the United States began to gear up for a major war, information and propaganda efforts were set in motion. Civilians (including children) were encouraged to take part in fat, grease, and scrap metal collection drives. Many factories making non-essential goods retooled for war production. Levels of industrial productivity previously unheard of were attained during the war; multi-thousand-ton convoy ships were routinely built in a month and a half, and tanks poured out of the former automobile factories. Within a few years of the U.S. entry into the Second World War, nearly every man without children fit for service, between 18 and 30, was conscripted into the military "for the duration" of the conflict, and unprecedented numbers of women took up jobs previously held by them. Strict systems of rationing of consumer staples were introduced to redirect productive capacity to war needs.

Previously untouched sections of the nation mobilized for the war effort. Academics became technocrats; home-makers became bomb-makers (massive numbers of women worked in industry during the war); union leaders and businessmen became commanders in the massive armies of production. The great scientific communities of the United States were mobilized as never before, and mathematicians, doctors, engineers, and chemists turned their minds to the problems ahead of them.

By the war's end, a multitude of advances had been made in medicine, physics, engineering, and the other sciences. This included the efforts of the theoretical physicists working at the Los Alamos National Laboratory on the Manhattan Project, which led to the Trinity nuclear test and thus brought about the Atomic Age.

In the war, the United States lost 407,316 military personnel, but had managed to avoid the extensive level of damage to civilian and industrial infrastructure that other participants suffered. The U.S. emerged as one of the two superpowers after the war.

Unconditional surrender

Actually Dresden was a mass of munitions works, an intact government centre, and a key transportation point to the East. It is now none of these things.

— Air Chief Marshal Arthur Harris, in a memo to the Air Ministry on 29 March 1945

After the United States entered World War II, Franklin D. Roosevelt declared at Casablanca conference to the other Allies and the press that unconditional surrender was the objective of the war against the Axis Powers of Germany, Italy, and Japan. Prior to this declaration, the individual regimes of the Axis Powers could have negotiated an armistice similar to that at the end of World War I and then a conditional surrender when they perceived that the war was lost.

The unconditional surrender of the major Axis powers caused a legal problem at the post-war Nuremberg Trials, because the trials appeared to be in conflict with Articles 63 and 64 of the Geneva Convention of 1929. Usually if such trials are held, they would be held under the auspices of the defeated power's own legal system as happened with some of the minor Axis powers, for example in the post World War II Romanian People's Tribunals. To circumvent this, the Allies argued that the major war criminals were captured after the end of the war, so they were not prisoners of war and the Geneva Conventions did not cover them. Further, the collapse of the Axis regimes created a legal condition of total defeat (debellatio) so the provisions of the 1907 Hague Convention over military occupation were not applicable.

Post-World War II

Since the end of World War II, no industrial nation has fought such a large, decisive war. This is likely due to the availability of nuclear weapons, whose destructive power and quick deployment render a full mobilization of a country's resources such as in World War II logistically impractical and strategically irrelevant.

By the end of the 1950s, the ideological stand-off of the Cold War between the Western world and the Soviet Union had resulted in thousands of nuclear weapons being aimed by each side at the other. Strategically, the equal balance of destructive power possessed by each side manifests in the doctrine of mutually assured destruction (MAD), which determines that a nuclear attack by one superpower would result in a nuclear counter-strike by the other. This would result in hundreds of millions of deaths in a world where, in words widely attributed to Nikita Khrushchev, "The living will envy the dead".

During the Cold War, the two superpowers sought to avoid open conflict between their respective forces, as both sides recognized that such a clash could very easily escalate, and quickly involve nuclear weapons. Instead, the superpowers fought each other through their involvement in proxy wars, military buildups, and diplomatic standoffs.

In the case of proxy wars, each superpower supported its respective allies in conflicts with forces aligned with the other superpower, such as in the Vietnam War and the Soviet invasion of Afghanistan.

During the Yugoslav Wars, NATO conducted strikes against the electrical grid in enemy territory using graphite bombs. NATO claimed that the objective of their strikes was to disrupt military infrastructure and communications.

The Royal United Services Institute  has argued that the Russian Invasion of Ukraine can be seen as the first total war since the end of World War II.

Butane

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