Public Health

3866

Public Health

conducts school surveys and furnishes bul-
letins and lectures on health teaching.

State department? of health, operating un-
der State-wide sanitary codes, work in fields
not specifically dealt with by the Federal
government. The principal agency in the
campaign for public health is the local health
department. Sanitary codes provide the local
commissioner of health with police powers.
State expenditures for health purposes vary
greatly between states, but in i<uo reached
about 10 cents per capita. Included in the
services of municipal health departments are:
health education, the taking of vital statistics,
prevention of communicable discuses, ma-
ternity and child hygiene, public health nurs-
ing, laboratory service, milk and food con-
trol, sanitary inspection, and industrial
hygiene.

The most important function of (he health
department is the education of the public in
the principles of healthful living and disease
prevention. The Model Vital Statistics Law,
or one which was similar, was in force in
1030 in all of the states, ft provided for a
central bureau of vital statistics in the State
health department and local registrars in
primary registration districts to register
births, marriages, and deaths. Only from such
statistics can the points of profitable attack
be discerned and the fruitfulness of various
preventive measures be estimated. See VITAL
STATISTICS.

The Bureau of Communicable Diseases in-
cludes the control of tuberculosis and vene-
real diseases, for which separates divisions are
provided, and the control of the acuttk com-
municable children's discuses and of diseases
of a communicable nature, In many diseases
the use of sera, for the cure of (host; affected,
or for the protection of those who have been
exposed, plays an important part in the prog-
ram of practical control. Diphtheria antitoxin
and toxin-antitoxin or toxoid, vaccines for
typhoid, paratyphoid and smallpox, antite-
tanic serum, antimcningococcus serum, and
the Schick test must be freely available to
physicians and for distribution by the divi-
sion of communicable diseases. Immunization
campaigns have been undertaken with
marked success to combat diphtheria in New
York State, New Jersey, and elsewhere.

Tuberculosis is of particular importance
because of its chronic character, because it
usually affects family groups, particularly in
young adult life, and because it is one of the
principal causes of death. Control depends
upon two distinct sorts of measures, those

designed to prevent the dissemination of the
infectious agent and those directed toward
the upbuilding of the vital resistance of ex-
posed individuals. Tuberculosis, if taken in
time, is curable. It is essential, therefore, to
conduct a far-reaching educational campaign
to familiarize the public with the early symp-
toms of the disease, and should provide dis-
pensaries where those who fear that they are
suffering from tuberculosis may go for diag-
nosis and medical advice. An intelligent at-
tempt to remove unsanitary living and work-
ing conditions is important in the anti-tu-
berculosis movement.

Another phase of public health work which
requires special machinery for its effective
development is the campaign against vene-
real disease, which is prevalent to an alarm-
ing degree in civilian life. The early detec-
tion of gonorrhoea and syphilis followed by
efficient treatment is vitally important to ef-
fect their cure and prevent their* further dis-
semination. All reported contacts should be
examined; adequate follow-up of ail cases is
necessary. Several States require the report-
ing by name, others require reporting by
number only. Public Health Laboratories oi
both State and local departments of health
should be prepared to make free diagnosis by
microscopic and cultural methods of diph-
theria, tuberculosis, typhoid, paratyphoid,
malaria, and other diseases, to conduct other
laboratory work in the detection of disease,
to examine water, milk, and other foods, tc
make urinanalyses for health clinics, to ex-
umine pathological specimens, and to keep in
stock antitoxins and vaccines,

The protection of the health of mothers
and young children is perhaps the most im-
portant of all possible lines of public health
endeavor. There should be prenatal clinics
where prospective mothers may receive di-
rections regarding the care of themselves and
their babies. Field nurses must be available
at time of delivery. Midwives must be li-
censed. An astonishing number of schoo?
children are found to suffer from defects oi
eyes, ears, teeth, or the upper respiratory
tract, und often the fitting of a child to
glasses, the securing of needed dental care>
or the removal of tonsils or adenoids effects
a complete revolution in general health, hap-
piness, and educational progress. In some
cities special school clinics furnish medical,
surgical, and dental care without charge.

The chief functions of a bureau of sanita-
tion concern problems of water supply, sew-
age disposal, sanitation of public buildings