DEATHS OF CHILDREN UNDER FIVE YEARS. OF AGE IN OHIO, BY COUNTIES, IN FIRST SIX MONTHS OF 1918, WITH 1916 TOTALS Total six months. months if 26 Mercer 18 30 30 22 75 22 19 123 230 66 41 13 14 9 16 29 22 12 30 9 50 61 98 10 457124 16 22 16 19 52 39 18 52 13 14 37 10 1 DEATHS FROM ALL CAUSES FOR ALL AGES AND UNDER 5 YEARS OF AGE, WITH RATES FOR ALL AGES PER 1,000 POPULATION 65 170 42 163 148 59 413 42 258 28 52 177 66 38 Adams 252 54 12.2 11.3 21.5 155 12.3 14.6 19.7 28 14.6 12.6 11.9 143 14.3 14.4 17.6 50 12.5 10.1 15.1 14.2 33.3 13.6 13.6 180 15.1 15.8 16.4 41 16.2 12.9 13.8 41 13.7 12.3 11.7 255 13.7 14.3 22.5 40 11.6 10.5 19.7 19.4 16.9 9.2 15.2 19.3 15.9 29.7 11.3 23.8 10.6 12.5 15.9 10.8 14.0 21.6 12.4 18.0 27.1 15.3 14.8 10.5 434 11,233 493 329 390 683 420 267 3,942 298 428 195 465 485 7,654 492 475 206 238 398 284 199 457 330 1,053 391 335 523 494 503 294 284 493 420 422 365 357 631 57 2,972 87 42 58 53 68 48 609 47 57 23 68 123 1,218 78 90 30 34 53 67 35 56 87 371 59 58 157 89 12,7 14.5 13.1 77 11.4 11.6 17.6 7.8 66 15.6 14.8 14.6 115 10.1 10.1 25.3 1,096 15.5 15.5 15.9 59 13.0 11.1 15.9 62 15.6 13.2 18.9 29 10.8 13.4 14.6 38 9.5 9.9 14.3 52 13.9 13.6 13.3 56 12.0 11.9 23.6 44 11.1 12.3 17.6 62 12.9 13.5 12.3 115 | 10.7 13.7 26.4 305 13.4 13.2 ! 35.2 38 12.3 11.4 15.1 47 14.1 15.0 17.3 173 13.2 | 15.0 30.0 9.5 16.3 23.1 15.2 16.2 9.7 11.4 15.0 23.3 14.2 14.0 15.5 11.3 15.3 13.3 19.9 19.9 12.9 27.3 28.7 10.4 13.2 27.4 DEATHS FROM ALL CAUSES FOR ALL AGES AND UNDER 5 YEARS OF AGE, WITH RATES FOR ALL AGES PER 1,000 POPULATION 807 759 368 1,021 3,879 214 2,731 551 328 381 307 679 231 3,227 258 195 876 240 288 183 367 359 196 473 277 303 671 598 399 883 633 121 48 305 895 52 867 101 50 46 56 76 37 486 20 29 137 72 47 42 85 72 43 76 27 60 103 105 111 13.2 12.3 15.0 43 13.1 12.2 12.2 250 12.9 11.2 26.5 789 17.7 17.5 23.3 40 13.3 10.8 19.6 945 17.2 18.2 | 34.7 100 13.2 14.6) 20.4 34 13.9 13.2 14.5 54 12.9 14.9 13.9 66 11.4 11.2 17.9 105 13.2 14.6 12.5 43 8.8 9.5 17.4 484 16.3 17.1 16.1 24 13.6 16.0 9.1 20 13.7 11.6 12.6 118 13.8 14.4 16.5 50 11.9 12.9 ! 32.4 49 11.0 12.8 19.2 30 8.5 8.1 21.7 91 9.2 9.7 | 24.6 63 11.6 13.7 23.8 41 12.0 12.5 22.9 67 15.1 15.2 16.3 45 13.8 11.6 8.2 64 11.2 10.1 17.9 103 12.6 13.4 16.5 102 13.5 14.9 19.4 50 13.0 11.1 15.9 285 15.2 16.4 31.1 96 14.1 14.6 12.1 51 12.8 12.0 21.0 451 14.4 15.9 20.7 335 962 Licking 395 265 2,499 494 344 330 313 609 213 3,018 219 230 829 222 246 194 345 303 188 468 330 296 2,277 3,070 969 676 286 264 171 352 538 518 299 567 2401 74 251 74 66 422 787 226 141 43 45 31 53 98 72 40 104 29 19.4 22.8 31.0 217 15.7 16.9 25.4 130 ! 12.2 11.4 19.5 33 12.4 13.1 15.8 36 8.7 9.1 17.8 38 | 12.6 13.1 18.8 49 16.5 14.4 13.2 76 12.0 11.8 18.0 78 13.6 13.6 13.8 32 12.5 | 11.8 | 12.6 125 11.7 | 12.2 19.1 29 11.3 11.6 11.8 14.6 11.7 24.5 20.3 18.7 34.6 18.1 10.4 14.2 21.5 15.5 18.6 15.0 9.3 10.3 13.5 20.8 17.0 16.4 24.8 17.5 20.9 14.2 16.2 21.1 15.4 17.1 12.5 32.3 15.2 17.2 19.8 31.3 22.4 19.2 11.5 13.6 22.2 13.9 14.1 15.1 10.7 22.0 12.1 626 540 464 807 610 315 2,034 2,541 891 724 272 253 165 403 544 520 317 544 245 Municipal Public Health Organization* By Allen F. Gillihan, M. D., State District Health Officer, Santa Rosa, Calif. a / In order to understand the health and sanitary problems of a city of 35,000, it is first desirable to outline the process of an ideal health department, thus forming a basis with which to evaluate the actual work done in the average city of this size and on which to build an efficient department. These may be briefly registered as follows: Health Department Functions a. Reporting c. Laboratory diagnoses. 5. Morbidity statistics. 1. Supervision of child's early life. a. Prenatal supervision Guidance of prospective mothers. Supervision of maternity homes. Postnatal care. Control of ophthalmia. Supervision of baby and child farms. Little mothers' clubs. physical development. 3. Supervision of child labor. III - FOOD SUPERVISION. 1. Milk Registration of producers and dealers, supervision of 2. Foodstuffs? plants and products by field inspectors and labora3. Meats. tory examinations. IV - SANITARY SUPERVISION. supplies ? Elimination of insects and animals transmitting disease. Birth registration. Burial registration, Reprinted from the California State Board of Health Monthly Bulletin, XIV, 1 (July, 1918). } We find in the average city that Birth registration is not actively we have a part-time health officer enforced, so no determination can who is usually engaged in active be made of infant mortality rates. practice. He can not enforce health Nothing is done about child labor. measures without creating antago- Under food supervision we very nism amongst his professional frequently find more activity brethren, and amongst his own pa- shown than in any other departtients to the detriment of his prac- ment. A milk inspector, and fretice; therefore we find him doing quently a food inspector, will be as little as possible. found, and occasionally stock is inIn the control of communicable spected at the time of killing. diseases we find lax reporting, and Sanitary supervision is usually more lax supervision. The quaran- reduced to the abatement of nuitinable diseases are placarded, but sances, and is a very secondary the complaints of the public are part of the work of the plumbing depended upon to secure observ- inspector. ance of the quarantine regulations. A laboratory is usually mainNo epidemiological investigation is tained for the examination of undertaken, and the unnecessary swabs for diphtheria and sputum expense of fumigation is indulged for tuberculosis for diagnoses. in. The quarantining and fumigat- Bacterial and chemical examination ing are very frequently done by of milk is also done, but we find the plumbing inspector, or sanitary as little as possible is done where inspector, as a side issue to his the pay is part time and there is regular duties. no incentive to increase the amount The health officer usually makes of work. no examination for release from quarantine or isolation. He in Public Health Bookkeeping variably neglects the minor dis Under office detail we usually eases, makes no tabulations other find a clerk whose duties are about than those required by the state equally divided between receiving board, and is unable to work out a reports of cases of communicable morbidity rate; in fact, I doubt if diseases from physicians, ordering he knows what such a thing is. quarantines and fumigations, re In the conservation of child life, ceiving and registering birth cerwith possibly the exception of tificates, death certificates, issuing medical inspection in schools, prac- burial permits, answering 'phone tically nothing is being done in the kicks, issuing permits for milk, average city. We frequently find meat, and other vendors, and makbaby week campaigns have been ing reports to the State Board. held; these are usually fostered by No bookkeeping of public health is mothers' clubs of the city, but this done, therefore no information is very good work is not followed available which would show the up by the health department. No health situation of the city. An supervision of midwives, maternity annual report is usually not prehomes, or homes for children is pared. "Bookkeeping of Public undertaken, except possibly the Health” is a very good term borregistration of midwives. (Under rowed from Irving Fisher. A city the present laws of California any- which does not do such bookkeepbody can be a midwife.) ing is on a par with the business |
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