HEALTH OF CITY AND RURAL RESIDENTS Why those who live in country districts suffer a disadvantage BY DR. A. J. STILLSON Health Officer, Windsor, Broome county, N. Y. There has long been a controversy as to whether the residents of the city or rural districts are more healthy cr free from disease. The State Health News is publishing a series of articles on the subject. STATE SERVICE reprints here the views of Dr. A. J. Stillson, health officer, Windsor, N. Y. Dr. Stillson's statement is interesting alike to urban and rural communities.- EDITOR. A S a health officer in a rural community I read with some resentment the statement that the rural death rate exceeded that of the cities in this State. Then resentment gave place to a mental acknowledgment that the statement was true, because the source of the informa tion was of such a character that the claim was indisputable. Then the explanation came to me. Certainly those in the rural districts have not the opportunities for hospital care or quick laboratory facilities. In fact they have very few of the health advantages that the urban dweller possesses, except the presence of a physician and sometimes a trained nurse, and the physician is generally so far from some of his patients that his visits are often delayed, and more infrequent than is the case in the city. Incidentally, I want to say right at this point, that the general practitioner in the country is usually a selfreliant, energetic, over-worked, under-paid doctor, who is expected to be able to meet any emergency, and generally does that very thing. The rural sect ons are usually remote from dentists, and many peop ́e never form the habit of having the'r teeth cared for. To my mind this is one of the gravest faults of the ruralite. Following this line of thought there came into my mind medical school inspection and the rather startling conditions that I in com mon with every physician who examines rural school children have found. Diseased tonsils, adenoids, infected cervical g ands, etc., are discovered in a large number of cases. Back in the hills, where, if any place on earth there is plenty of good, fresh a'r, why should these conditions be so prevalent? In the dusty, smoky, and polluted atmosphere of the cities one would naturally expect a certain amount of such troubles, but in the country it s disconcerting to find so many physical defects in children. When the medical examination of rural school children is completed what happens? The parents, except in very few instances, forget that any defect has been reported, and the child goes on his way with his particular trouble untreated trouble untreated. In the country district schools, in spite of instruction given by teachers and information in text-books, neglected, decayed, and broken-down teeth are very commonly found. Our rural dis tricts have no dental clinics, and even the nearest dentist is hard to reach. Many rural residents with large families to feed and clothe are really financially unable to pay much for dental services and medical care Some provisions should be made for the adequate care of the teeth of those who cannot meet this expense without submitting them to the humiliation of appealing to the overseers of the poor. For the ruralite there is no hospital nearby with its free beds for indigent patients, no dental clinics, no public health nurse, except the county nurse, whose calls must be very far apart, while in the cities the poor are provided with all these necessities. DEN For those parents who will not insist upon the proper care of the teeth of their children, compulsory legislation is just as necessary for the physical future of the child as is the splendid compulsory school attendance law of this State for the child's education. The writer is not a be iever in the paternalist c form of government for this country of ours, but it does seem that the neglect of parents to see that the teeth of the chi dren have proper care should be overcome, if not by persuasion, then by mandate. Of course it is the p'ain duty of the health officer and the physician to be active in the pass ng of information to the parents, to the end that all defects that are correctable shall be promptly and carefully treated. In this connection we had a rather interesting plan which we tried out here. A well advertised mass meeting was held in this village, and all the people in the town and village and surrounding territory were invited. The local band was secured to furnish music, the moving picture manager obtained for us two films of an educationa nature, and the State department of health furnished a set of stereopticon slides on health propaganda. With these features for a drawing card the local physicians and a physician from a nearby town each presented a paper on an important health matter. The advertising, music, stereopticon slides, motion picture films, and the fact that the whole affair was unique, resulted in drawing a large and interested audience, which overcrowded the capacity of the town hall. We had a fine opportunity to get our ideas before the public, and I believe that our efforts were productive of good results. If those of us in the field devote more time and energy to health propaganda, and make a greater effort to take these matters up personally with parents, the future wil hold more promise for practical results. In common with other physicians who served as medical examiners on selective ser vice boards, I was astonished to see such an alarmingly large percentage of physical defects, mostly preventable, in the young men of draft age. At a time of life when these men should have been at the top of their vigor and physical capability they could not serve the country because of neglected teeth and various other disabilities, which were clearly the result of ignoring many of Nature's laws. The efforts of the State department of health in its publicity campaign is bearing fruit, however. fruit, however. People are taking more interest in public health matters in New York State. Health officers are more active and physicians are treating disease more and more on the basis of good general management, rational living and correct diet, and depending less on drugs. I am not a therapeutic nihilist, but we all know how many people have expected us to prescribe drugs for their ailments and then go calmly on their way, eating and drinking and doing whatever pleased them. Now they are realizing that they must first live as they should before Nature will assist them to overcome disease. And the returning soldier, robust, muscular and most decidedly fit from the vigorous training which our Uncle Sam gave him (simple diet, regular hours when in camp, systematic exercise, etc.), will shame the rest of us into taking better care of those who look to us, and incidentally, of taking better care of ourselves. TO PREVENT DISEASE Acting on the principle that a large percentage of the disease of the world is preventable, a nation-wide movement is about to be inaugurated in the United States for the promotion of public health. Information will be spread by lectures given by Red Cross nurses on Chautauqua circuits, which will be followed up in the smaller communities by nursing squads who will organize public health committees or render auxiliary aid if desired, where such committees have already been established. Every assistance will be given to communities in organizing and maintaining this service. GOVERNOR ON HIGHER PAY FOR TEACHERS Gives his reasons for approving the bil passed by the last legislature The N approving the bill passed by the last legislature to increase the salaries of school teachers in the State, Governor Alfred E. Smith filed a memorandum giving his reasons for the approval. governor's memorandum is as follows: "This bill amends the education law to provide increases in salaries of the teaching and supervising staff of the public schools throughout the State and increases the allotment of State funds to cities and rural school districts. Fifty-three thousand school teachers are affected by it. This measure establishes the principle of equal pay for women, corrects present discriminations and increases the inadequate salaries now paid to members of the teaching staff. It should result in It should result in filling the many vacancies in our schools, which were caused by higher compensation paid in other fields of employment. In my annual message to the legislature, I stated, The efficiency of the school cannot rise above the standard of qualifications set for the teaching service. To bring this about the teachers should be adequately paid and fairly pensioned. I strongly recommend that whatever curtailment may be necessary elsewhere, full and adequate provision be made for the education and training of our children.' "It has been certified to me by the State department of education that the training schools for teachers are not attended in a satisfactory manner due to the fact that the salaries paid to school teachers fail to attract women to that important service. This presents a serious situation and one that the State itself must deal with. It is a narrow minded statesman who thinks only of the day he lives in. If our common school system is to be maintained in the degree of efficiency that the greatness of the State suggests, we must build for the future. By this bill we are attracting to the school service the best talent the State can secure. "There has been much discussion in the public press as to the cost of this bill to the city of New York. It has been certified to me by State Commissioner of Education Finley that the cost will be as follows: "First year, 1920, $1,612,000. "There are two great functions the State performs for our people. performs for our people. One is the education of our children and the other is the preservation of health. General O'Ryan states that the intelligence of our soldiers contributed as much as any other one thing to the great successes our armies achieved in . the struggle for the freedom of civilization. “Our country has just been tested by the fires of war and our future safety rests upon the school system that will weave into the hearts and minds of generations to come the principles of American freedom and justice. The country or the State cannot be above. the efficiency of its people and no money spent for education or the preservation of health is ever wasted. "I have yet to meet the taxpayer who would admit that the education of our children should not be put above a mere matter of dollars and cents. The cost of this measure cannot be spoken of in the same terms as road improvements, canal construction and different other activities of the State for which many millions have been appropriated. The public schools must be adequately supported if they are to remain the bulwark of the nation and their success is dependent upon the number and ability of our teachers. "The president of the board of education of Great Britain in presenting the education bill during the war, said, 'That nation which after the war employs the best teachers with the highest pay will be the best governed and, therefore, the greatest nation.' Neglect the school houses and you provide a fertile field for the spread of the doctrines of the discon- WORK OF SPECIAL LEGISLATIVE SESSION Federal amendment for woman's suffrage ratified -Six bills passed to relieve the housing situation-State among first to ratify votes for women measure T HE extraordinary session of the legis- four hours. It passed the concurrent resolution ratifying the amendment to the federal constitution granting women the right to vote throughout the United States. It also passed six bills intended to relieve the housing situation in the State as follows: 1. Amending the tenement house law so as to permit the alterations of four-story and basement private houses to apartment houses, accommodating not more than four families. 2. Amending the banking law, so that savings banks on the woman's suffrage amendment was Senator Henry M. Sage of Albany who asked to be excused from voting. He declared that in his judgment the calling of an extra session for the ratification to the amendment was unnecessary. New York was thus placed among the early states to ratify the woman's suffrage amendment. It will require 36 or threequarters of the 48 states to make it a law. Woman suffragists throughout the United States are endeavoring to have 36 state may loan 60 per cent upon the value of land and buildings legislatures ratify the amendment in time in course of construction. 3. Providing that a landlord must give to a tenant, who has no written lease but is paying the agreed rent at least 20 days' notice of the termination of his tenancy. 4. Amending the municipal court act so as to authorize a municipal court justice to stay the issuance of a warrant of eviction in an apartment or tenement house not more than 20 days, provided the tenant shall deposit the amount of rent for such period in court or pay the same to the landlord. 5. Resolution asking congress to exempt four and a half per cent State land bank bonds from federal taxation. 6. Resolution urging congress to give early consideration to the several federal home loan bank bills now before congress. Another measure passed appropriated $6,683.10 to meet the expenses of mileage of members attending the session. The housing bills were passed without a dissenting vote in both houses. The only member who did not vote in the affirmative to permit the women throughout the country to participate in the national election of next year. Miss Mary Garret Hay, a prominent suffragist of this State, issued the following statement after the New York legislature had taken action: "New York has honored herself by honoring the women of the country. Through their unanimous action our legislators have shown true consideration for the womanhood of our land. New York women are filled with pride and gratitude. We are proud of the fact that the Empire State will go down in history as one of the first to champion the enfranchisement of all our women. We are grateful to the governor, who had the vision to see the significance of the Suffrage question and the courage to place his State to the forefront of the ratification fight. We are grateful to our representatives, who have shown themselves worthy of their positions and of their times, and who have proved themselves to be men who are just, progressive and generous. The housing bills passed at the special session of the legislature are expected to relieve in a measure the difficult situation in New York city. Nathan Hirsch, chairman of the mayor's committee on rent profiteering, in commenting on the bills said: "I am naturally much gratified at the action taken by the special session of the legislature in passing four bills and two resolutions which will materially aid the housing situation. "The Dodge law, which provides for the changing of four-story stone houses into apartments, is of the greatest importance. If builders take advantage of this bill it will mean that from 30,000 to 50,000 families can be cared for. "This act has been indorsed by the tenement house department. The only objection raised to the Dodge law was that of the Real Estate Board of New York and I declined to honor this objection by replying. 66 Four-story stone houses on the west side of New York can be bought for 50 cents on the dollar. This law will change that condition. Supposing a man owning a four-story house is getting $100 or $125 a month. If he changes it into a flat dwelling he will certainly get $75 a month for a good flat, and he will thus be almost tripling his money. If his house is worth $20,000 he can, so I am told, make it into a flat within a few weeks, conforming to the laws, for from $4,000 to $6,000. This will break the combination which has been gouging the New York dweller. "No less important is the law about savings banks lo ns. Formerly a savings bank could lend only 40 per cent on vacant property and 60 per cent on a finished building. The new law permits the banks to loan 60 per cent on buildings being constructed, which will help a great deal." COUNTY GAINS $1,000,000 What progressive methods can do for a single agricultural county in a few years is amazingly demonstrated by the experience of Pontotoc county, Miss. The agricultural revolution has all been accomplished in less than ten years, and has not cost a cent that was not returned many fold the same year it was expended. To be sure results were not big enough to be startling in the first few years, but since 1916 the county has added a million dollars to its cash reserves with prospects of doing better in the years to come. Pontotoc is a hilly county, mainly populated by small white farmers. The average farm is seventy-two acres, of which less than half was scheduled as improved land by the last census. In 1910, 44 per cent of the farmers operated their own farms, while 55 per cent were listed as tenants. A county agent of the department of agriculture has been in the county for some years, but the effect of his work is just being realized fully. Pontotoc used to be mainly a one-crop county, with cotton as the main crop. The boll weevil has never seriously injured its cotton industry, but the county, prior to 1916, never produced enough food for its own use. In 1915 the farmers made a good average crop. It is estimated that $150,000 worth of food and feed were brought from outside the county in that year. Until 1916 there had never been a carload of hogs, corn, molasses, sorghum seed, peanuts or popcorn shipped from the county; its main cash income came from cotton and some lumbering. From January 1, 1918, to February 15, 1919, the county agent assisted the farmers in producing and shipping from the county the following products other than cotton: 320 cars corn, valued at. $384,000 57,600 14,700 Did this have an effect upon the finances of the county? It did, in two ways: First, because the county produced more of its own food and feed, more of its cotton money came back to the county in cash rather than in necessities purchased with cotton money; second, the farmers got a good cash income from their other crops besides cotton, mainly because the county agent showed them how to ship farm products cooperatively in carload lots. On January 1, 1916, the total amount of deposits in the banks of the county was $519,592. The figures for 1918 are as follows: Amount on deposit in the five county banks Liberty bonds sold in the county during 1918 Total. $1,045,115 225,000 275,000 $1,545,115 This is an increase over January 1, 1916, of $995,522, mainly accounted for from the ready sale of food and feed crops, plus the saving of the cash money. A single crop is always a menace, but a well-balanced agriculture means prosperity, declared the specialists of the department of agriculture. New York Times. |