64TH CONGRESS, HOUSE OF REPRESENTATIVES. 1st Session. DIVISIONS OF MENTAL HYGIENE AND RURAL APRIL 1, 1916.-Committed to the Committee of the Whole House on the state of the Union and ordered to be printed. Mr. COADY, from the Committee on Interstate and Foreign Commerce, submitted the following REPORT. [To accompany H. R. 721.] The Committee on Interstate and Foreign Commerce, to whom was referred the bill (H. R. 721) to provide divisions of mental hygiene and rural sanitation in the United States Public Health Service, having considered the same, report thereon with amendment and as so amended recommend that it pass. The bill as amended has the approval of the Treasury Department, as will appear by the letter attached and which is made a part of this report. Amend the bill as follows: Page 2, line 3, strike out the word "duty" and insert in lieu thereof the word "duties." PURPOSE OF THE BILL. The purpose of the bill is to provide two additional administrative divisions in the Bureau of the Public Health Service to meet the increasing work of the service for the general purposes specified. The performance of these duties by the service was authorized in the act of August 14, 1912. NEED FOR ADDITIONAL DIVISIONS. The importance of mental hygiene as a national problem is evidenced by the definite record of over 187,000 mental defectives domiciled in institutions in the United States Studies of the causes and methods for the prevention of mental disorders and the best methods for their care are obviously a function which can be performed more advantageously by the central public health authorities than by those of the separate States. Important phases of the insanity problem with which the Public Health Service is already dealing are those which pertain to the mental condition of immigrants and the occurrence of insanity among pellagrins, and this service now has a number of men trained especially for duty in the field of mental hygiene. Over 50 per cent of the population of the United States is rural. The advancement of sanitation in rural districts in recent years has by no means kept pace with the progress in urban communities. Notwithstanding the many natural advantages of country life, from a health standpoint, certain diseases dependent upon insanitary conditions have a higher rate of prevalence in our country districts than in our cities. Between the rural and urban communities there is a free interchange of infections. Thus rural sanitation affects the general welfare of the whole population. The securing of adequate local health organizations for the rural districts comes more slowly and is relatively more costly than is the case for the cities. The advancement of rural sanitation now depends largely, and probably for some time will depend largely, upon the conception of the importance of and the installation of sanitary improvements by the individual citizen. Such progress depends upon public health education. The Public Health Service has a force of men trained for and engaged in field and laboratory studies of rural sanitation. With the forces of the Public Health Service engaged in collecting data on both mental hygiene and rural sanitation, the creation of additional divisions in the central bureau to direct the work, compile, correlate, and publish the data, and so serve as clearing houses for these vitally important lines of study, appears at this time to be strongly indicated. COST OF PROPOSED MEASURE. The enactment of the bill will entail an increase in expenditures of about $7,400 per annum, as is shown by the following statement: 2 assistant surgeons general, at $900 when promoted from grade of surgeon. 2 clerks, at $1,600... 2 clerks, at $1,200... Total...... $1,800 3, 200 2,400 7,400 TREASURY DEPARTMENT, The CHAIRMAN COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE, United States House of Representatives. SIR: I have the honor to acknowledge the receipt of your communication of the 21st ultimo inclosing copy of bill (H. R. 721) to provide divisions of mental hygiene and rural sanitation in the United States Public Health Service, and requesting the views of the department concerning this measure. This bill is identical with bill H. R. 16637, which was introduced at the last session of the preceding Congress and acted upon favorably by the House of Representatives. Its essential object is to provide improved administrative facilities for carrying on systematic studies in mental hygiene and rural sanitation for which authority already has been given in law. It is conservatively estimated that there are now in the United States 250,000 insane persons and 300,000 mental defectives. The influence of these abnormal states on the production of pauperism and criminality and on race development require systematic investigation to determine their causes and methods of prevention. The social, economic, and public-health problems involved affect not only each State, but the Nation as a whole. Some studies are now being made, but they should be extended, and there is need of correlating all existing data in order that they may be made available to protect the mental health of the public at large and to ameliorate conditions among those already suffering from mental disorders. This work can well be done through a division such as is contemplated. Enlarged facilities are also needed in the central bureau of the Public Health Service with which to advance rural sanitation. Studies of this subject, with special reference to typhoid fever, malaria and other diseases, are now under way, and the work is of such volume as to require an additional division for its proper conduct. Over 50 per cent of the total population of the United States is rural. Urban centers are far ahead of rural communities in measures for the protection of the public health. These latter should, therefore, be the particular object of attention of the Federal and State Governments from a public-health stand point. The creation of the two divisions contemplated will in reality provide for rearrangement of present work and the assignment of one additional medical officer for each division to carry on the work, which officers are already in the employ of the Government. With the exception of the employment of additional necessary clerks, for which there is already authority in law, there would be little additional expense, and the enactment of the bill into law would be a further step in improving publichealth organization. I am heartily in favor of the measure, therefore, and strongly urge that bill H. R. 721 be enacted into law. Respectfully, O W. G. MCADOO, Secretary. |