Abstract Although philanthropist William Rathbone is generally recognized as the founder of district nursing (in Liverpool, England, in 1859), the Howard Association of New Orleans actually began to use a pattern of district nursing 26 years earlier as a response to yellow fever epidemics. Concepts brought forth by the association included dividing the city into districts; teaching preventive measures; using community members to locate those needing assistance; and caring for the sick in their homes, utilizing nurses when the need arose.