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vestigated the prevalence of scarlet fever in a southeastern Ohio village. Summarized, his report tells this story:

The village of 87 inhabitants has been incorporated for 50 years, but for several years last past no municipal officials have been elected and offices are vacant. With no one in charge of public affairs, public improvements have been neglected and sidewalks, drainage, buildings, etc., are in bad condition. Two creeks which flow through the village occasionally overflow and flood the streets. Sidewalks are buried in mud and bridges and board-walks have been destroyed. Children can not reach the school house in bad weather without wading through mud and

water.

All officers have resigned except the village clerk, who receives fees for acting as local registrar of vital statistics. Recently, however, the clerk has removed to another town five miles away. Such money as remains in the village treasury is insufficient to pay existing debts, and without proper officials it can not be appropriated for any other purpose. Lack of funds has kept the village without a health officer and efforts of the State Department of Health to persuade some resident to act as health officer without salary have been unsuccessful.

Scarlet fever has been prevalent since October in the village and surrounding area of the township. In the absence of a health officer, cases in the village have been left unquarantined and persons in the township have refused to observe quarantine while those in the village remained at large. The disease spread rapidly, more than 40 cases having occurred in less than three months.

Six families in the township outside the village had 27 cases in this period according to township officials. Only four of the six residences were quarantined. One of the township trustees (who constitute the township board of health) had four cases in his home, without quarantine or fumigation. A brother of another trustee had II cases in his residence, also without quarantine or fumigation. The township health officer who is also clerk of the township trustees, has been negligent in investigating reported cases, apparently feeling it is not his duty to do so without instructions from the trustees or a physician. He claims that his salary is inadequate and that he should receive extra compensation for making investigations and for fumigation.

In the village five families in less than three months had 16 cases. None was quarantined and many persons have been exposed. The Department investigator endeavored to enlist one of the men of the village to serve as health officer, but none was willing to do so without pay. It was intimated that quarantine regulations could not be enforced without the employment of guards and the making of arrests. Because of

the fact that no health officer could be installed, the cases of scarlet fever in the village remained unquarantined when the investigator left. Insuructions were given to the township health officer to enforce the law strictly outside the village.

Nearby towns are alarmed over the situation and one requested permission to quarantine against the village in question. Authority to do this was refused, but permission was given the health officer to deport from his town any persons known to have scarlet fever in the home or to have been exposed recently.

Child Hygiene Needed in Rural Districts

People are often inclined to think that it is only in the crowded cities that a great need for constructive work in child hygiene exists. Almost every study that is made, however, demonstrates that extremely bad conditions are very frequently to be found in rural sections and not in "backwoods" rural sections alone, but in the more prosperous, enlightened localities as well.

A recent example of such a situation is furnished in a report of the Federal Children's Bureau, the first of a series of reports on child hygiene work in rural sections. It tells of a study of a Kansas county where the level of prosperity is high, no home is more than twenty miles from a physician, telephones are numerous and roads are good.

Even under these favorable conditions, however, two-thirds of the mothers had no medical care before their children were born; more than one-third had no visit from the physician after the child was born; fourfifths of the women, farmers' wives, had to work for large farm crews until very near the time of confinement. Although the infant mortality rate was found to be fairly low in the county, it could be brought still lower by the provision of standard medical and nursing care, according to the plan proposed by the Children's Bureau.

"Hooverizing" the Public Health

America is engaged in raising huge war funds. She has financed two enormous Loberty Loans and a third is near at hand. She has provided liberally for the Red Cross and for war philanthropies of many kind, and is willingly awaiting further calls.

The people are denying themselves many former extravagances to further the work of making democracy supreme in the world. Conservation is the keynote of civilian life.

All this accentuates figures which are presented from time to time. to show the ways in which we waste our substance. Not the least

of these wasteful drains upon the national wealth is that of preventable diseases and postponable deaths.

Prof. Irving Fisher has estimated that the United States loses each year over a billion dollars on preventable or postponable deaths, another half-billion on doctors' fees, medicine and nursing for needless illness and still another half-billion on time and wages lost because of such illness.

In other words, development of public health work to the point where the ideal result of wiping out all preventable disease and deaths could be achieved, would in one year produce a saving that would pay off the first Liberty Loan.

In a practical way, every improvement in public health work which brings us nearer to this ideal, means the saving of a certain share of this $2,000,000,000.

War-time is, above all other times, the time when our efforts in preserving the health of the people should be pushed to the fullest extent. It is the patriotic duty of every government-local, state or nationalprovide every dollar possible for this cause.

As a Southern physician, Dr. Joseph C. Bloodgood, said in a recent address, "it would appear feasible to urge the different states to greatly increase all public health activities and appropriations and, if necessary, increase the personnel. If the public health officials in this country had sufficient men and means, the reduction in the number of communicable diseases in this country would be so great that a number of physicians in practice would be released for army work, because of reduction of sickness in the civil population."

Look at the Figures;

Then Go Ahead

Beginning this month, the Division of Communicable Diseases of the State Department will include in its monthly report,

as published in this magazine, tables giving a more complete statement than heretofore of the incidence of notifiable diseases in Ohio.

From the table giving statistics on all reportable diseases for the preceding month, with appropriate comparisons with previous years, any health officer can get valuable suggestions as to work which needs his attention.

From the city table, with its figures for ten leading preventable diseases, every city health officer can get further important data to guide his in his work. By looking at the statistics for his own city and comparing them with those for other cities and for the state at large, the health officer can see wherein his work in disease prevention has been weak and can take steps to strengthen it in future.

When it is remembered that these ten preventable diseases killed nearly 15,000 Ohioans in 1916, the importance of adequate efforts to conquer them will be recognized. Such efforts can be carried out with the greatest efficiency only when accurate information is at hand as to just what the situation is.

The 14,441 deaths which these preventable diseases caused in the state in 1916 were divided as follows: diphtheria 621, measles 781, meningitis (epidemic cerebro-spinal) 58, poliomyelitis (acute infectious) 124, pneumonia (acute lobar) 4,359, scarlet fever 210, smallpox 4. tuberculosis (all forms) 6,838, typhoid fever 772, whooping cough 674.

The reductions in these total which are easily possible depend largely upon the grasp which the local health authorities of the state have of the situation and upon the efforts which they exert to improve conditions.

Army Calls Another

Man from Department

Again the nation has called and again the JOURNAL records the departure of one of the members of the Department staff to

take service in the army of the United States.

E. I. Roberts, assistant engineer in the Division of Sanitary Engineering, has enlisted in the sanitary corps. He has been granted the customary leave of absence for the period of the war.

His co-workers, through these columns, congratulate him and bid him God-speed.

Next Month's Issue

of the OHIO PUBLIC HEALTH JOURNAL, due to appear shortly
before the opening of the "Children's Year," will be devoted
largely to matters of child hygiene.

Dr. FRANCES M. HOLLINGSHEAD, in charge of child
hygiene work of the State Department of Health and of
the Ohio Council of National Defense, will discuss the state-
wide activities of these two interrelated agencies.

Dr. R. A. BOLT, chief of Cleveland's bureau of child
hygiene, will have an article on "The Organization of a
Municipal Bureau of Child Hygiene."

Miss HELENA R. STEWART, director of nursing service
in the State Department of Health, will deal with the rela-
tions of the public health nurse to child hygiene activities.
Work being done by the several city bureaus of child hygiene
in the state will be outlined, and various other phases of
the subject will receive attention.

CHILDREN'S YEAR OPENS APRIL 6; OHIO'S
QUOTA OF LIVES TO BE SAVED IS 4,510.

Saving America's Babies

A War Measure for the United States - To Be Carried Out During Our Second Year of the Conflict. Ohio Ready to Do Her Share in Preserving From Unnecessary Death the Thousands of Children Needed to Build Up the Next Generation.

T

HE second year of the war for the United States, opening April 6, is to be devoted to saving the lives of babies, according to plans of the Federal Children's Bureau. A year's campaign to reduce the heavy infant mortality is planned, under the direction of the Children's Bureau and of the Women's Committee of the Council of National Defense. It will be carried into the states through the women's committees of the various state defense councils.

The co-operation of the Division of Child Hygiene of the Ohio State Department of Health in this program as broadly outlined is assured, as the Federal plan coincides in most respects with work already begun in Ohio. The Federal program will be knit up thoroughly with the state program in Ohio through the fact that Dr. Frances M. Hollingshead, director of the Division of Child Hygiene of the State Department of Health, is also chairman of child hygiene, health and recreation of the women's committee of the Council of National Defense, which is to act as the Federal agent in the state.

Half Baby Deaths Preventable

The first aim of the nation-wide campaign will be to obtain public protection for maternity and infancy. Public health authorities

agree that one-half the annual total of 300,000 deaths of children under five years old is preventable. They also consider that the larger proportion of the 15,000 mothers who died last year in bringing their children into the world died needlessly.

To save a certain definite proportion of these lives, with a definite quota, based on population, assigned to each state, is the underlying object of the "Children's Drive." It is believed that 100,000 deaths can be prevented this year, despite war's depletions in the ranks of physicians and nurses. Ohio's quota has been set at 4,510. which represents a reduction of about one-third in the state's baby deaths.

Methods Outlined

The methods to be followed will be those whose efficacy has been demonstrated in child welfare work in this and other countries. Briefly stated, these are as follows:

Registration of births, so that there may be an immediate record of every child born; nursin and medical care may be provided wherever family income does not permit its being obtained independently.

2. For every mother, prenatal care, necessary care of doctor and public nurse at confinement and after care.

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