must devote more attention to training men and women for country service. Those which train pastors, teachers and Y. M. C. Α. workers should establish courses of instruction, the content, spirit and emphasis of which will serve to specialize their students for constructive work in rural institutions. The nature of the rural community must be emphasized, its particular problems studied, and the agencies capable of supplementing and improving agricultural life receive much consideration. When training schools renounce the absurd notion that general training courses qualify equally well for rural and urban service, a great step in advance will have been taken. Educating individuals specifically for rural service has the double advantage of qualifying them to carry on constructive undertakings and of retaining them in that service because their qualifications tend to make them ineligible for urban positions.

Much is being accomplished by the county agent and the coöperative demonstrator which the agricultural colleges have educated for country service. The various states are, especially, placing many county agents in the field and they have proved themselves helpful in furthering not only production but community undertakings of different kinds. Many states have county and city high schools which are giving instruction in agriculture and farm subjects, and the occasional state agricultural high school is a still more intensified approach to the desired goal. Summer chautauquas with their lectures and instruction on farm life and with their visiting groups of farm boys and girls; farmers' institutes; farmers' clubs, and associations of farmers' clubs; and kindred organizations are helpfully contributing to the establishment of a constructive point of view concerning farm life and its problems.

However, the institution which is needed to reach the masses of country children and to do most to create an abiding interest in rural affairs is one which is located in the rural neighborhood, which touches and ministers to the lives of the residents daily, and which, filled with an agrarian content and spirit, exercises an abiding, moulding influence on the young in the direction of rural undertakings and improvement. The consolidated rural school, with communityized building and equipment, a corps of efficient teachers, a teacherage, experimental plot, graded and ruralized curriculum, and having high school facilities as an organic part of the socialized course of instruction, possesses the greatest power of appeal because it is articulated with actual farm life and because it is within reach of all. Such an institution should stimulate the talented class toward higher achievements, tending to command the permanent interest of some members of that class in farm life, and develop the abler members of the imitative group up to the level of their greatest efficiency. It doubtless also would accomplish for the less able individuals all that any training agency could hope to do for them.

HEALTH AS A MEANS TO HAPPINESS, EFFICIENCY AND SERVICE

BY LOUIS W. RAPEER, PH.D.,

Professor of Education, The Pennsylvania State College, State College, Pa.

Health is the first wealth and all other values rest on this. "How are you," expressed in one form or another, is one of the commonest greetings the world over. Instinctively all of us recognize that life itself is the ultimate value and that our first pursuit must be the increase of its vitality and the enrichment of its meaning. The nation or individual that loses this prime concern for health and normal physical development is doomed inevitably to a state of vital inefficiency, especially in a complex civilization where a highly artificial life conduces to vital impairment. Individual and national health and vigor are not merely natural concomitants of existence but are achievements to be attained by scientific study and strenuous endeavor. The ancient Greeks furnish the best example of a nation which added greatly to the abundance and meaning of life by continuous training in educational hygiene from infancy. The harsh demands of preparedness for possible or actual war have today led many nations to sudden consciousness of health values and of their widespread failure to achieve them.

INDIFFERENCE TO HEALTH PROGRAM

The common indifference to a thoroughgoing program of educational hygiene for children and adults on the part of those, who through fortunate heredity and environment have realized both health and position, is our principal obstacle to progress. Until these fortunate variations of a complex civilization are made to understand general health and development conditions and the means to their amelioration, the democratic socialization of health and "life more abundant" will be ideal dreams. Our leaders argue, "We are healthy. We hardly ever give thought to our health. It comes about naturally. We never have to take a drop of medicine. The way to be healthy is to forget it. All that we need to learn about it will be acquired incidentally." The answer is found in the undeniable health facts of our nation. Disraeli expressed the proper viewpoint in these words: "Public health is the foundation on which reposes the happiness of the people and the power of a country. The care of public health is the first duty of a statesman." And it may well be added as a corollary that to care for individual and family health is the first and most patriotic duty of a citizen.

In spite of marvellous scientific discoveries and achievements in the realm of health science in recent decades, we fail generally to realize how little health and normal physical development have been socialized and made a part of our common wealth. Measure by any reasonable standard of physical perfection and health at random thousand of the persons who pass on the street any day and what is the result? Learn how many, out of each thousand persons living in the community, remain at home, out of sight and unnoticed, ill and socially ineffective. Note how many of each thousand born reach maturity. Examine the children in the public schools and compute the facts. Study the efficiency of parents in the homes in bringing up healthy vigorous children so trained that they will naturally retain it throughout life. What is our actual health problem?

OUR HEALTH PROBLEM

The normal span of life from birth to death is about seventy years. Heredity is an important influence in determining the length of this span but environmental conditions may either play havoc with heredity or play directly into its hands. One fifth to one eighth of all the babies born in this country each year die before their first birthday. "Oh, these are the children of ignorant immigrant mothers in the slums of our great cities," the reader may exclaim; but the researches of health officers in New York City and Newark demonstrate that infant mortality is far greater in the homes of our native-born mothers. These astounding death losses occur all over the country and by effective efforts they may, as has been demonstrated, be reduced far below the general average of the country as a whole in even our most congested cities. What is possible in communities taken for demonstration is possible for whole states and the nation at large. One-fourth to one-sixth of all the children born each year in this country die before reaching the school age of six, and countless thousands who have survived enter our schools so weakened and maimed by disease and physical defects that they have little chance of profiting by even the most hygienic schooling or of living to the period of productive maturity. Each year approximately a hundred thousand school children, or children of elementary and high school age who should be in school, die in this country. Half of all who are born each year are in their graves before the age of thirty-an age when as we all realize most people are just ready to contribute something to the world. Where is our boasted civilization when we fail so miserably in conserving human life?

Extensive investigation indicates that at any one time three million persons-three out of every hundred of our population-are seriously ill, losing over a billion dollars a year to themselves and to society, not to mention the loss of greater values in the richness, vitality and meaning of life itself. While we have cut down infant mortality considerably in many places, our death rate remains almost stationary because of the great and recent increase of deaths due to degenerative diseases of the heart, kidneys and other organs. Extensive examinations of employes of big business firms by the Life Extension Institute, by Dr. Kristine Mann (department store women),1 and by others prove that nearly half of the workers of our indoor, city populations are low in vitality; suffer from physical defects, or harbor incipient or well-developed cases of disease. State insurance of workers against illness affords strong confirmatory data. Examinations for entrance into the army and navy add their evidence. The greatest problem faced by England in the war has been to obtain men who after a year's strenuous and scientific educational hygiene could be brought into passable physical condition for filling the trenches. Health is the first wealth; our present losses are over half preventable without great cost; we miserably fail in our first duty as individuals and as communities of citizens. These are grim, undeniable facts which we must resolutely face and vigorously attack with effective weapons.

SCHOOL HEALTH DATA

Medical supervision with its annual examination of millions of school children, from kindergarten to college, is today adding greatly to our knowledge of the extent to which we are providing for our 1 Journal of Public Health for May, 1916.