North Carolina Newspapers

    The news in this publi
cation is released for the
press on receipt.
Published Weekly by the
University of North Caro
lina for the University Ex
tension Division.
MAY 14,1924
VOL. X, NO. 2«
Editorial Boards B. C. Braaaoo, 3. H, Hobbs, Jr.. L. R, Wilson, B. W. Knigrht, D. D. Carroll, Ji B. Bullitt, H. W. Odum.
Entered as second-class raattor November 14.1914, at the Postofflce at Chapel Hill, N. C.. under the act of Auyost 24. 1911
Elsewhere in this issue will be found
a table which ranks the states accord
ing to the per inhabitant expenditures
for public health by each state
government daring the last fiscal
year. The accompanying column
shows the total expenditure by
each state government. The table does
not include appropriations for tubercu
losis sanatoria, nor expenditures for
the operation of county and city health
departments, except where the state
cooperates with such departments, as
in North Carolina where 28 cooperating
counties received $72,427 from the State
Board of Health in 1923. Nor does the
table include receipts from the Federal
Government and the International
Health Board which, for North Caro
lina, totaled about $63,000 last year.
Only three states rank ahead of North
Carolina in State Government expendi
tures for public health on a per inhab
itant basis. Our expenditure averaged
16.8 cents per inhabitant, while the av
erage for Delaware was 38 cents, Flo
rida 19.4 cents, and for Maryland 18.6
cents. The average for all the states
is around 8 cents per inhabitant per
year. The total state government ex
penditure on public health in North Ca
rolina at the present time, as defined
in the first paragraph is $460,000 annu
ally and the amount is larger in only
five states, all vastly richer and more
populous than North Carolina.
The average cost of 16.8 cents per in
habitant per year to operate the state
health work is less than the cost of a
moving picture ticket in most towns in
the state. It is less than the cost of a
gallon of gasoline. Yet North Carolina
ranks fourth from the top in per inhab
itant state expenditures on publichealth.
No state m the union has a better rec
ord of achievement in the field of pub
lic health work. Our State Board of
Health and our county health depart
ments, their activities and their ac
complishments are known not only
throughout the United States but in
many foreign lands. Many delegations
from other states and from foreign
countries have paid visits to North Ca
rolina to inspect our state health or
ganizations and to study its methods,
and to view the results. And in every
case they have gone away with a firm
conviction that looking after health
conditions is a proper function of
state government, and that no state is
doing better public health work than
North Carolina.
County Health WorK
On June 1,1911 the first county health
department to be provided in the Unit
ed States was established by Guilford
county. To North Carolina goes the
distinction of originating the county
health department idea, and from the
beginning North Carolina has main
tained undisputed leadership in the field
of county health work. According to
the Public Health Bulletin from which
most of the accompanying facts are
taken, there are today thirty-one county
health departments in as many coun
ties in the state, serving around half
of our entire population. The personnel
consists of 36 medical officers, 6 non
medical officers, 17 sanitary inspectors,
38 public health nurses, and 38 clerical
assistants. The budget of these 31
counties last year totaled $317,898.
North Carolina has more county health
departments than any other state, and
they are efficiently serving a greater
percent of the population than are sim
ilar departments in any other state.
Of these 31 counties, 28 cooperate
with the State Board of Health, and
receive state-aid, while 3 counties, Dur
ham, New Hanover, and Guilford, op
erate independently of the State Board.
In addition five cities maintain health
departments independentiyjof the coun
ties. These cities are Asheville, Char
lotte, Greensboro, Rocky Mount, and
Winston-Salem. Each of these cities
has an efficient personnel, and the an
nual budget totals around $140,000.
The counties which cooperate with
the State Board of Health are: Bertie,
Buncombe, Beaufort, Bladen, Cabar
rus, Columbus, Craven, Cumberland,
Davidson, Edgecombe, Forsyth, Gran
ville, Halifax, Henderson, Lenoir,
Mecklenburg, Northampton, Pamlico,
Pitt, Robeson, Rowan, Sampson, Surry,
Wake, Wayne, Wilkes, Wilson, and
Vance. State aid to these 28 counties
amounted last year to $172,427. The
State Board of Health is this year put
ting $2,600 into each of thirty counties.
Services Rendered
The county health departments serve
the people in a great variety of ways.
The officers are charged generally with
looking after hygienic conditions in the
respective counties. The main job of
county health department is to keep
the people well. If the first person
with a contagious disease can be isola
ted an epidemic may be averted, untold
s^affering prevented, and likely many
lives saved. The officers in the 28 coop
erating counties last year quarantined
a total of 37,166 persons with contag
ious diseases.
While it is of prime importance to
control contagious diseases, it is of far
greater importance to prevent their
occurrence, and this is the main job of
the county health officials, to keep the
county as free from sickness as is pos
sible. Three contagious diseases, typ-
hoiu fever, diphtheria, and smallpox,
can be prevented by vaccinations. The
officers of the 28 cooperating counties
last year vaccinated 61,609 persons a-
gainst typhoid, 45,251 against smallpox,
16,837 children were given immunizing
treatments of toxin-antitoxin to pre
vent diphtheria and 1,397 children were
vaccinated against whooping cough. A
total of more than 114 thousand people
were vaccinated or treated to prevent
the occurrence of diseases that are high
ly contagious once they develop.
Venereal diseases are far more prev
alent than is generally recognized, and
treating the 2,440 cases which were re
ported to these officers took a large
part of their time. Looking after the
tubercular is still one of the biggest
duties of the public health officers, and
although the death rate from tubercu
losis has been cut half in two in North
Carolina during the last 12 years, the
deaths from this disease are exceeded
only by deaths from heart disease and
Other activities of the county health
authorities are instructing expectant
mothers, instructing mothers about the
care of babies, giving courses to mid
wives, and in other ways caring for
the lives of mothers and infants. Igno
ranee is largely responsible for the
more than 10,000 children who last year
in this state were either born dead, or
died during the first year after birth
A well informed and well cared for
mother seldom loses her child. The
bulk of infant mortality occurs in the
homes of people who are ignorant and
whose children do not have proper med
ical attention.
Another great service is rendered
through the examination of thousands
of school children and the treatment
where found of defective tonsils, ade
noids, teeth, eyes, and other ills. The
health officers look after sanitary con
ditions in county homes, jails and con
vict camps. They give examinations
to prisoners in jail, physical examina
tion for certificate to obtain marriage
license, physical examinations to teach
ers, cooperate with the public welfare
officers, prosecuting the violators of
state and local health laws and in many
other ways they are constantly render
ing public service.
In the performance of their many
duties these 28 county health officers
and other members of their depart
ments last year traveled a total of
424,310 miles, or 17 times around the
A Million for Health
Public health work in North Carolina
has undergone remarkable expansion
during the last twelve years. In 1911
the total expenditure for health pur
poses by the state and local units with
health departments amounted to about
$65,000. Twelve years later the single
county health department had^grown to
31, the city departments to five, and
the total expenditure had increased to
more than a million dollars a year, more
than $600,000 of which comes from state
government appropriations, while a-
bout $386,000 is contributed by the 31
coun,ties and the five cities with health
North Carolina has the enviable rec
ord of having provided the first coun
ty health department in the United
States in the Guilford department,
established on June 1, 1911, Yakima
County, Washington, was the second,
that department being established
on July 1, 1911, following a most
severe epidemic of typhoid fever in
that county. The lead thus taken
has been continued, for today North
Carolina has more county health de
partments than any other State in
the Union, and is efficiently serving
a greater percentage of its popula
tion. Remarkable as ■ has been the
growth and development of the
State in agriculture and industry,
no less remarkable has been its
growth and development in the
safeguarding and promotion of its
public health. —Ronald B, Wilson,
in The Health Bulletin.
departments. An additional $65,000
comes from the Federal Government
and from the International Health
The progress, has been remarkable,
so remarkable that today North Caro
lina’s leadership in public health work
is recognized throughout the world.
The million dollars spent on promoting
public health in North Carolina returns
larger dividends than any million dol
lars the people of the state could pos
sibly spend in any other way. It is an
investment to prevent sickness, to check
disease, to promote intelligence, to pre
vent unnecessary deaths, to make North
Carolina the healthiest state in the
Union. Every county in North Caro
lina should have its dounty health de
partment. No state and no county can
afford not to protect the health and life
of its,]yeople.
Some Results
For many years North Carolina has
led the states of the union in birth
rates. However, until recently our
death rate, especially of infants and
children, was very high. Due largely
to the work of the State Board of
Health and the county health depart
ments the death rate is now below the
average for all the states. Most re
markable reductions have been made
in infant mortality. During the last 12
years the general death rate has been
reduced from 18.2 to 11.6 per 1,000 pop
ulation, while the reduction for all the
states has been only 2 per thousand of
population. Instead of about 49 thou
sand people dying in North Carolina in
1923, as would have been the case had
the death rate of 1911 prevailed, only
about 31 thousand people died.
The death rate from tuberculosis has
been reduced from 266.2 per hundred
thousand of population in 1911 to 97.6,
and our rate is now below the average
for the United States, even though
many stricken people from other states
seek renewed health in our mountains
and elsewhere in the state.
The death rate from typhoid fever
has dropped from 69.3 per hundred
thousand of population in 1911 to 11.2
in 1922.
These 'are merely a few of the results
that have been accomplished. Igno
rance is the one great cause of prevent
able sickness and death. The state and
local health departments have made
North Carolina a healthy state because
they have been educating the people a-
bout the causes of diseases and sick
ness, and how to prevent them. The
results accomplished in this state bear
witness to the value of public health
work. And the total cost of all public
health work, state, county, and city,
averaged only 39 cents per inhabitant
last year, while to operate the State
Board of Health, which has made North
Carolina famous around the world, we
spend annually just 16,8 cents per in
habitant per year.
North Carolina is naturally a healthy
state, one of the healthiest in the
union. When, through the efforts of
state, county and city health depart
ments, the intelligence of our people
comes to be on a par with our natural con
ditions North Carolina will be the health
iest state in the union.—Jr.
The University Extension Division
will conduct twelve extension classes
for practising physicians on the subject
of Pediatrics beginning the week of
June 9 and closing the last week in
August. It is believed that these
courses in children’s diseases will do
much toward improving the general
health and cutting down infant mor
tality throughout the state. When the
same course was given in 1916 one of
the doctors in High Point stated that
this one class was worth a million dol
lars in health to that community.
George B. Zehmer and Chester D.
Snell, directors of the University Ex
tension Division are now busy organiz
ing the classes which will be held in the
following cities: Western circuit—
Rutherfordton, Shelby, Gastonia, Char
lotte, Concord, and Lincolnton; Sand
Hill circuit—Durham, Sanford, Carth
age, Hamlet, Lumberton, and Fayette
The instructors for these two circuits
this year are from Dr. McKim Marri
ott’s Pediatrics clinic at Washington
University, St. Louis. Dr. Jean V.
Cooke, Associate Professor of Pedia
trics will be in charge of the Western
circuit and Dr. Phillip C. Jeans, Sen
ior Associate Professor of Pediatrics,
assisted by Dr. Alexis Hartmann, will
have charge of th^ Sand Hill circuit.
There will be one meeting each wedk
in the twelve towns mentioned above.
Each meeting will consist of an hour
lecture followed by an hour of clinical
Application blanks have been sent to
all the physicians on both of the cir
cuits and officials of the Extension Di
vision request that these applications
be filled out and mailed immediate
While only twelve cities are to have
classes this year, last year the Exten
sion Division gave postgraduate medi
cal courses in twenty-four cities and
nearly every doctor in the state had an
opportunity to attend. Over 380 phy
sicians took advantage of the three
courses in Internal Medicine and the
one course in Pathology.
North Carolina is one of the few
southerm states in which building and
loam associations have made gratifying
progress. This is the more remark
able im view of the fact that we have
mo large cities, and very few cities of
evem moderate size. According to
tables carried in the Manufacturer’s
Record North Carolina had 236 building
and loan associations in 1923 with a
total membership of 65,000 and assets
of $44,898,834. While the assets of alV
associations in the United States have
doubled since 1918, the assets of North
Carolina associations have nearly treb-
North Carolina has more building
and loan associations than any other
southern state, and only seven states
in the Union outrank us in the
number of associations. How
ever, due to the smallness of our towns ,
seventeen states rank ahead of us in
total membership and in total assets.
Yet considering the fact that only four
states have a larger rural population
ratio, and the additional fact that
our towns are small, our rank of eighth
in number of associations and seven
teenth in membership and assets speaks
well for the thrift of the small towns
and cities in this state.
As we have said before the building
and loan plan of saving for a home is an
American idea. It is a most excellent
and economical means of laying aside
for a home, and also it is an excellent
way to save money because the asso
ciations pay high dividends on install
ments in the form of accumulated in
terest and savings are tax exempt.
And as we have said before the same
plan which is now used so extensively
and successfully by city people can be
used by the farmers of North Carolina
as the laws of the state provide for
the organization and operation of rural
building and loan associations. Local
groups of farmers should look into the
possibilities of such associations for
the plan will work for them just as
well as it works for urban dwellers.
The farmers of Ohio have been operat
ing building and lojin associations for
several years.
Total and Per Inhabitant by States, 1923
The following table, based on Federal Public Health Reports and private
correspondence, shows the total and per inhabitant expenditures by states for
state public health work for the last fiscal year. The table includes only ex
penditures on the part of state governments, and does not include county and
city expenditures, appropriations for tuberculosis sanatoria or other institu
tions, except hygienic laboratories. Nor does it include receipts from the Fed
eral Government or other agencies.
Total state government expenditure for public health work in North Caro
lina in 1923 was $450,000 or a per inhabitant expenditure of 16.8 cents.
The state spent in addition $200,000 for the operation of its tuberculosis
sanatoria. The budget, exclusive of state-aid, of the twenty-eight counties
cooperating with the State Board of Health, and the three counties operating
independently totaled $246,271, while the budget of the five cities with separate
health departments totaled $140,000.
Net total expenditure in North Carolina in 1923 for public health work
$1,034,000, or 39 cents per inhabitant.
S. H. Hobbs, Jr.
Department of Rural Social Economics, University of North Carolina
Rank State Expend. State Total
Per Expendi-
Inhab. ture
1 Delaware 38.0 $ 87,600
2 Florida 19.4 203,000
3 Maryland 18.6 280,497
4 North Carolina .. 16.8 460,000
5 Maine 13.6 105,000
6 Connecticut 12.0 177,600
7 Massachusetts.... 11.7 471,860
8 Rhode Island 11.6 71,662
9 Nevada 11.4 8,800
9 Vermont 11.4 40,000
11 New Hampshire.. 11.0 62,250
11 Pennsylvania.... 11.0 1,000,000
13 New York 10.9 1,178,000
14 Michigan 9.6 377,800
14 Montana 9.5 67,916*
16 New Jersey 8.9 298,800
17 Kentucky 8.8 217,362
18 Ohio 8.6 631,471
19 Alabama 8.6 205,000
19 Oklahoma 8.6 183,070
21 Wisconsin 8.1 220,820
22 Colorado 8.0 79,640
23 Mississippi 7.8 140,000
23 South Dakota.... □ 7.8 60,800
* Plus unspecified fees
Rank State Expend. State Total
Per Expendi-
Inhab. ture
26 New Mexico 7.6 $ 28,500
26 California 7.3 277,318f
26 Illinois 7.3 497,366
28 South Carolina... 7.1 123,497
28 Virginia 7.1 169,174
30 Arizona 6.6 24,656
31 Idaho 6.4 30,010
32 Minnesota 6.3 167,600
33 Wyoming 6.8 1^,260
34 Indiana 5.6 170,000
36 West Virginia.... 5.6 85,800+
36 Utah 6.2 , 24,996
37 Nebraska 5.1 68,000
38 Kansas 4.9 88,200
39 Oregon 4.8 40,000
40 Louisiana 4.7 87,600
41 Arkansas 4.6 82,000
42 Missouri 4.2 146,900
43 Iowa 3.8 93,900+
44 Tennessee 3.6 85,106
46 Georgia... 3.6 91,481
46 Washington 3.2 46,416
47 Texas 3.1 164,217
48 North Carolina.... 2.4 16,274
+ Plus unspecified appropriaUon for
clerical help.

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