Eleventh. The sanitary supervision of soldiers suffering from pulmonary tuberculosis, or those rejected from the army and naval forces.

Twelfth. The sanitary supervision of migratory laborers and of industrial

camps."

The proposal to create a reserve for duty in the Public Health Service in time of national emergency was presented in the form of a joint resolution which was to be introduced in Congress as soon as approved by the National Council for Defense.

REGISTRATION OF BIRTHS AND DEATHS.
Why Register Births?

That the birth, date of birth, parentage and other essential information for governmental and identification purposes may be made a matter of official record.

That the ages of school children may be definitely known, making the proper enforcement of school laws possible.

That the laws affecting child labor may be effective, and the children of the poor thereby protected.

That litigation in matters of inheritance and settlement of estates may be simplified by the definite knowledge of the ages of all persons concerned.

That the American-born children of foreign-born parents may have indisputable evidence of American birth which will protect them from enforced military service when visiting the mother country of the parents.

That blindness may be prevented by prompt medical attention to the infected eyes of the new born.

That infection and mortality among women may be prevented and that young babies may be saved by immediate attention by existing agencies for the relief of the poor.

Why Register Deaths?

That there may be available complete and accurate information as to deaths of all human beings, with dates of death and causes of death, to the end that preventable causes of death may be eliminated and human lives lengthened.

That the various public health agencies-national, state and municipal-may determine what part of our mortality is preventable and when and where preventable deaths occur.

That pestilential and epidemic diseases may be detected promptly. That we may apply our remarkable scientific knowledge of disease prevention at the time and in the place where such application is most needed.

That home-seekers and immigrants may be guided in the selection of safe and healthful homes by accurate information rather than by misstatement of interested persons.

That the settlement of estates and matters of inheritance, pensions, etc., may be definitely settled by official record of death instead of on the memory of interested witnesses.

Death registration without birth registration is like an accurate accounting of expenditures without consideration of income.--Bulletin Kansas State Board of Health.

"HELP MAKE OHIO A REGISTRATION STATE.'"

JOHN EMERSON MONGER, M. D.,

State Registrar, l'ital Statistics.

To the Health Officials and Local Registrars of Ohio:

Just as rapidly as possible we are making an effort to make the personal acquaintance of every health official in the state. So far, our experience in this line has been very pleasant, and I wish now to extend my thanks to those who have been so courteous to our inspecting force and to myself. I also want to assure you of our hearty and entire co-operation, for by this means I believe we can make our work mutually helpful.

The value of statistics to the sanitarian are incalculable, and it will be our effort to render the results of our work available for your use. This Bureau will have published monthly reports for each county. (and the 37 larger cities) in THE OHIO PUBLIC HEALTH JOURNAL, and also in the Journal of the Ohio State Medical Association.

Statistics are valuable in the exact ratio to the use made of them. Filed away in the archives of the State they do little, if any, good, but if put in the hands of the men who are administering the Health Laws we feel they will be of real value and help. Should you at any time wish data on your community, the mortality of a particular disease or group of diseases, the information will be promptly furnished upon request.

One of the interesting things in the work of this Bureau is the growing rivalry among cities and communities as to their death rates. in certain preventable diseases. "Well, we cleaned up on

last year. They were all puffed up on their rates for '15, but we surely "showed them up" in '16", was the expression of one of the ablest health men in the state when he came in recently and got the advance "dope" on his city. Some of them are as proud of their low rates as a star ball-player is of his batting average.

This rivalry is one of the finest things in Health Administration. The New York Bureau has as its slogan, "Public Health is Purchasable. Within Natural Limitations Any Community Can Determine Its Own Death Rate." There is a wonderful amount of truth in this slogan.

The tremendous strides made in one line of endeavor - tuberculosis is an example. Cleveland, Cincinnati and Columbus, in the period of 1906 to 1910, had a joint rate of 183.4 per one hundred thousand. In 1911 to 1915, 160.8, and in 1916, 154.5 per one hundred thousand. Typhoid, Diphtheria, and especially Diseases of Children "under two" show an even better gain.

Our registration of deaths is fairly well taken care of, our main difficulty being with delays where necessary and to send back for "Additional Information". In 1916 we were compelled to ask for "Additional Information" for 7 percent of the births, and II percent

of the deaths. This, in most cases, should have been taken care of by the local Registrar, thus saving a great deal of expense and delay. As an example: We were recently asked by the Federal Bureau to have the term "Broncho Pneumonia" more clearly defined. There are deaths from Broncho Pneumonia alone, but in the vast majority the Broncho Pneumonia is secondary to Measles, Scarlet Fever, or some other diseases. The high death rate ascribed to this disease directed the Department's atention to it, and we find that only a small percentage of these cases are true Broncho Pneumonia. The Local Registrars can save time by getting this information before sending in their certificates.

Important as death registration is, I believe birth registration to be more important. The United States Census Bureau requires that a minimum of 90 percent of all births be registered before a State is made a "Registration State," or, in other words, our data will not be accepted until we at least reach that standard. Dr. William H. Davis, Chief of the Federal Bureau, informs me that at some time in the near future he will conduct a test to find our exact rating. We are bending every energy toward making Ohio a "Registration State," and the amount of outside help we are getting is of very great value. The Press, Churches, Labor Organizations, and Federations. of Women's Clubs, are all helping, and with proper help from the Local Registrars' there is no reason why we should not succeed. It is a disgrace that the great State of Ohio which has been in the forefront in every great movement, is a laggard in this matter.

One reason for this is the idea that prevails among many physicians that the law under which we operate is not constitutional. The original law was passed in 1908 and put in operation in 1909. In January, 1912, a part of the law was declared unconstitutional. In 1913, this law was re-written to comply with suggestions made by the Supreme Court, and is now constitutional. At least no physician after careful investigation of its provisions, has seen fit to carry a case up. We are now preparing a great many prosecutions, but it is our desire not to prosecute, but to secure returns. Our Inspecting Force is now preparing athorough check, and we are acting on information secured. We only began prosecutions after ample warning. and while it has been the hardest duty of our work to swear out these warrants, yet it seems the only way to get some men to do their duty.

Birth registration is very important to the child, and it is true that the registration of a child's birth may save its life, health, liberty or property. Universal military service renders it absolutely necessary. Child Labor Laws, School Laws, Voting, Marriage, Practice of Professions, Graduation, Responsibility for Crimes By and Against the Individual, Federal and State Civil Service, Mothers' Pensions, Industrial Insurance, Life Insurance, Inheritance, Guardianship, Passports for Foreign Travel or Residence, are only a few of the examples of its need. In fact, there is no relationship from the cradle to the grave when inability to furnish a definite age and nativity may not seriously affect the individual. While in this great national crisis we are regretting that we did not establish a bureau years ago so that

we might know the exact ages of our military population, yet it points out to us its immense importance.

I believe that over 90 per cent, of the Registrars and Physicians are conscientious in their duties and that we are kept out of the "Registration Area" by the carelessness of a few. We are rapidly correcting the fault in the profession, and the support we are getting from influential individuals and organiations is encouraging, so that we feel confident of success. However, to achieve this success we must have the co-operation of the Local Registrars, and I wish to call your attention to the following section of the law:

"SECTION 203. A Local or Sub-Registrar who fails to efficiently discharge the duties of his office shall be forthwith removed from office by the Secretary of State, in addition to other penalties which may be imposed by law."

The Attorney General has held that when a Registrar is discharged from performing the duties of Registrar, he also loses the original position which automatically gave him his position as Registrar.

That there may be fair warning given to all, I will state that promptness and completeness of the returns of each Registrar are being checked up, and after fair and due warning has been given, we will refuse to receive and certify for belated returns, and ask the authorities to certify a new appointee.

This course is rendered absolutely necessary by the fact that the work of this Bureau and its success depends altogether on the work of the slowest Registrar in our force, because we cannot compile our data until all is in.

After June 1st we will mail to each mother a copy of the certificate of birth. This plan is now in use in New York, New Jersey, Virginia, Michigan and Wisconsin, and is giving excellent returns. Another valuable aid has been the publication of the lists of births and deaths. Every newspaper man is glad to get this news for it is real news and it will help you greatly in your work and amply repay you for your trouble.

In conclusion I wish to thank those Registrars who are earnestly working to make the work a success, and to assure you of our earnest co-operation. If you have suggestions for the improvement of the service, let us have them; but any way, lets make Ohio a "Registration State."

HEALTH LICENSE FOR FOOD WORKERS.

A regulation adopted by the Cincinnati board of health recently requires a health certificate and annual inspection of all persons engaged in handling, preparing or cooking foods and food products. Employers are required to demand health certificates before employing such workers.

LAWS PASSED BY 1917 LEGISLATURE PERTAINING TO PUBLIC HEALTH.*

(Senate Bill No. 101.)

AN ACT to create a state department of health, to transfer to such department the powers and duties now conferred and imposed upon the state board of health and granting such state department of health certain others powers, and to repeal sections 1232, 1233, 1234, 1235 and 1236 of the General Code.

Be it enacted by the General Assembly of the State of Ohio:

SECTION I. There is hereby created a state department of health, which shall exercise all the powers and perform all the duties now conferred and imposed by law upon the state board of health and all such powers, duties, procedure and penalties for violation of its sanitary regulations shall be construed to have been transferred. to the state department of health by this act. The state department of health shall exercise such further powers and perform such other duties as are herein conferred. The state department of health shall consist of a commissioner of health and a public health council.

SECTION 2. There shall be a commissioner of health, who shall be the administrative and executive head of the state department of health. The public health council, hereinafter provided for, shall, with the approval of the governor, appoint a commissioner of health, who shall be a physician, skilled in sanitary science, who shall serve for a term of five years and until his successor is appointed and qualified. The commissioner of health. shall perform all executive duties now required by law of the state board of health and the secretary of the state board of health, and such other duties as are incident to his position as chief executive officer. He shall administer the laws relating to health and sanitation and the regulations of the state department of health. He shall prepare sanitary regulations for consideration by the public health council and shall submit to said council recommendations for new legislation. During his term of office, the commissioner of health shall devote his entire time to the duties of his office. The salary of the commissioner of health shall be fixed by the public health council, subject to approval by the governor.

SECTION 3. There shall be a public health council, to consist of the commissioner of health, and four members, hereinafter called the appointive members, to be appointed by the governor. Of the appointive members, at least two shall be physicians who shall have had training or experience in sanitary science. Of the appointive members first appointed, one shall hold office until July 1st, 1918, one until July 1st, 1919, one until July 1st, 1920, and one until July 1st, 1921, and the term of office of members thereafter appointed. except to fill vacancies, shall be four years. Vacancies shall be filled by appointment by the governor for the unexpired term. The public

*Laws passed by the Eighty-second General Assembly of Ohio pertaining to Public Health will be published from time to time in THE OHIO PUBLIC JOURNAL. In this number is published the first.