FEBRUARY, 1945 (REPRINT) PROGRESS REPORT NO. RS-4 MEDICAL CARE SERVICES In NORTH CAROLINA A STATISTICAL AND GRAPHIC SUMMARY PREPARED FOR THE North Carolina Commission on Hospital and Medical Care BY THE Department of Rural Sociology NORTH CAROLINA AGRICULTURAL EXPERIMENT STATION L. D. BAYER, Director State College Station RALEIGH MEDICAL CARE SERVICES IN NORTH CAROLINA FACTUAL SUMMARY Shortage of Doctors North Carolina has normally 2,300 active doctors, but 1,300 additional doctors are needed to provide at least one doctor for each 1,000 people* All of the 1,300 additional doctors are needed in rural areas. Only 31 per cent of our doctors live in rural areas, but 73 per cent of our population is rural. Cities above 10,000 in population with only one-fifth of the state’s population have one-haIf of our doctors*.(See pages 8 and 38) There are only 144 Negro doctors in the state to serve a million Negro people* Assuming that Negro doctors should servo Negro people, we need about.850 addi- tional Negro doctors. (See pages 12 ..and 40) The number of rural doctors is declining* In 1914, there were 1,12.$ doctors living in rural areas of the state, but by '1940 wo had only 719 rural doctors. Tho number of rural people por physician went up from 1,678 in 1914 to 3,613 in 1940. (See page 76) The number of doctors above 55 years of age. in the state as a whole, has' gone up from 15*6 per cent in 1914 to 32.0 per cent in 1940. In rural -areas the per cent of doctors above 55 years of age went up from 14*6 in 1914 to 37*5 in 1940, (See page 74) In number of doctors per 100,000 population. North Carolina ranks, 45th in the nation* The three states having relatively fewer doctors are Alabama# South Carolina, and Mississippi. (See page 8) Inadequate Hospital Facilities The modern doctor requires hospital facilities and the young doctors are setting up practice in the larger centers where adequate hospital facilities are available* North Carolina has 128 general hospitals, containing 8,475 beds.1 In order to bring the state average up to 4 beds per 1,000 population, 6,000 additional hospital bods are needed* (See page 34) In 1940, North Carolina ranked 42nd among tho states in hospital bods por 1,000 population* (See page 4) Of the 8,475 general hospital beds, 41.7 per cent wore located in tho six largest urban counties of tho state. (See page 34) 34 counties have no hospital beds 31 counties have less than two beds per 1,000 population 'U. counties have from two to four beds per 1,000 population 4 counties have more than four beds per 1,000 population At least 20 of tho 54 counbie's without hospitals are large enough to require a 50 bed hospital and all of the others aro large enough for health clinics having from 10 to 25 beds. (See pages 34 and 62) Some hospital expansion is needed in at least 62 additional counties which already have some facilities# Thus, 82 counties need either hospital oynr.nsimi nr nnw hospital facilities? and 14 small counties need small health clinics« Riblie health centers are needed in many other counties. Negro hospital facilities are seriously inadequate. Wo have now 1,665 general hospital bods for Negroes and at least 2,450 mere are needed to supply the recommended minimum of 4 bods per 1,000, (See page 3?) Poor Health Conditions The result of inadequate facilities and personnel are poor medical care and poor health, as shown by the following facts: Only 38.1 per cent of our babies are doliverod in hospitals: 49,0 per cnct of tho white and only 13,6 por cent of the Negro, In this respect, the state ranks 40th, Only 17,1 por cent of all rural infants arc delivered in hospitals, (See pages 16,18,44) Six por cent of our -white babies and 34- per cent of our babies do not have a doctor attendant at birth. In this respect, the state ranks 40th. Twenty five per cent of our rural babies have no doctor attending at birth, (See pages 20,22,46) ivory 1,000 mothers die at- child birth and the state ranks 41st on The maternal mortality rate for rural mothers in 1940 was 4,9 and '•6 per 1,000 live births. Fortunately, we have a public health program which is helping to push this rate steadily downward, (see pages 24,56) Our infant mortality rate is also declining,but North Carolina still ranks 38th in this respect. The number of infant deaths plus stillbirths per 1,000 births is 89 per 1,000: 74 for the white and 120 for the Negro, 7,404 infant deaths and stillbirths occurred in North Carolina in 1940, Good medical care could have prevented a substantial percentage of* those. In some states and countries the infant mortality rate is less than half that of North Carolina, (See pages 26,52) North Carolina, in 1943, led the nation in percentage of registrants rejected for military service. The percentage of rejections, from February through August of 1943, was; 56.8 % of all registrants 49.2 % of white registrants 71.6 % of llcgro registrants These data arc not conclusive because if all registrants examined through March 31, 1944 are included the rejection rate for North Carolina is about 8 per cent lower. However, in spite of the tentative character of the data, the facts do reveal many serious physical deficioncos, many of which could have boon prevented if thorough physical examinations and needed corrections and treatments had been carried out at an early ago.* (See pages 12 A, 12 B, GO) Economic and Social Rioters North Carolina has inadequate medical services because it is a,poor and an agricultural state« Not income per capita in 1940 vms only $ 317 as com- pared vrith 573 for the nation as a --hole. In this respect. North Carolina ranks 44th(Seepage 82) The population side of the problem is correspondingly sorious* Our birth rato is high; being 90 por 1,000 women 15-44 years of ago as compared with 75*7 for the nation* We have moro people per occupied dwelling as well as more farm people per square mile of farm land than any other state in the nation. (See pages 81,82) The age distribution of our population is heavily weighted with children and old people* We have 585 children (under 15) and old persons (over 65) per 1,000 people 16-65 years of age* In’this respect, ytg rank 43rd in the nation; the national average being 486 per 1,000. (See Page 8l) In all indexes of level of living. North Carolina is also quite deficient * 42nd in value of dwellings, 38th in homes with electricity, 41st in homes with radios and running water, and 42nd in per cent of adults with less than a fifth grade education® (See page 82) In proportion to their ability to pay, and in proportion to the size of the medical care problem, the people of North Carolina working as individuals have gone about as far as they can go in helping themselves* Therefore, if the situation is to be improved to any great degree, reroup effort and public action on a state and national level will be necessary# The medical care problem of the state is not a simple one. There are many deficiencies, and many reasons why these deficiencies exist. It is to a largo degree a rural problem and a Negro problem. The medical care problem as a -whole has throe aspects, all of which result in poor medical care. These aspects are: (1) Lack of medical care facilities and personnel (2) Lack of appreciation for the need of good medical care (3) The inability of rural people to pay for modern medical care These are the three sides of the triangle: facilities, education, economics# No one phase of the problem can be considered without the other. The problem of rural medical care cannot be solved by only building hospitals, or by only educating the people to know the value of good facilities, or by only providing more convenient methods of payment. All three aspects of the problem must be worked on at once. More rural physicians must ho trained; more rural hospitals must bo built; more educational and preventive work must be carried on; and more convenient methods of raying for medical care must bo devised. The recommendations of the Governor’s Commission on Hospital and Medical Caro summarised below are designed to hole meet these reeds. SUMMARY OF REGGIO S.. DAT 10’TS OF THE COMMISSION Meeting on October 11, 1944, the Hospital and Medical Care Commission after giving careful consideration to the reports of the various subcommittees and to the facts summarized in this report, made a series of recommendations which may be summarized as follows : Medical School. That the two year medical school at the Uhiverstiy of North Carolina bo expanded into a four year school with a central hospital of 600 bods. 1/ The full report of the Commission Report, as well as other subcommittee reports, may bo obtained by writing Dr. Clarence Poo, Chairman, Raleigh, H.C. Loan Fund for Medical Students. That a loan fund be established by the state legislature, particularly for promising youth who wish to become physicians in North Carolina, with, extra inducements for those ivho will agree to practice medicine at least four years in rural areas. Medical Training foy Negro Youth. That North Carolina consider the advisability of establishing, in cooperation with neighboring states, a regional medical school for Negroes. New Hospitals and Health Centers. That the state legislature set up a $ 5,000,000 fund to aid communities and counties to build new hospitals and health centers and to expand present facilities where needed. It is estimated that $ 10,000,000 additional funds would be provided by other sources* Rural hospitals and health centers are emphasized. Health Insurance and Prepayment Plans. That the state encourage in every practical way"the development' of group medic a1 care plansj and that the Blue Cross plan be expanded to include the services of general practicioners and drugs. Hospital Aid for Low Income Croups. That the state appropriate | 1 per day to help pay the hospital expenses of each indigent person treated, the remainder of the hospital cost to be paid by philanthropic agencies, such as the Duke Endowment, and by the counties and municipalities wherein the patients reside. It is estimated that this will cost the state about $ 500,000 each year. Public Health Program. Endorsed the proposal for a general examination of school children to discover remediable physical defects, such defects to be remedied at public expense in cases where parents are not financially able to pay for such treatment. Appropriations for public health work should be increased until the state has entirely adequate program for the prevention of disease, thus reducing needed hospital and medical care to the lowest practicable minimum. State Hospital and Medical Care Council. That a State Hospital and Medical Care Council composed of qualified persons be set up to administer the proposed program, so that high standards of service, efficiency, economy, and professional excellence might be maintained. Administrative control of hospitals aided would, however, remain in the hands of properly constituted local boards or governmental units. In concluding its report, the Commission took pains to point out that no claim was made that the proposed program was complete or perfect. Much remains to be done, but a substantial beginning has been made toward the ultimate goal set forth by Governor Broughton, " that no person in North Carolina shall lack adequate hospital care or medical treatment by reason of poverty or low income•" MEDICAL CARE SERVICES IH NORTH CAROLINA Contents factual Summary . • • • i Summary of Recommendations of the Governor’s Commission . • iii Foreword . . 2 United States Data Hospital facilities and Utilization . ...... 4 Doctors, Dentists, and Nurses ...... ... 8 Selective Service Rejections ......... • 12 A Births and Conditions of Birth •••• 14 Maternal Mortality 24 Infant Mortality and Stillbirths ...... 26 Adjusted Death Rate .......... 28 Average Value of Dwellings 30 State Government Expenditures 32 North Carolina Data Hospital Facilities 34 Doctors - Total and Negro 38 Births and Conditions of Birth 42 Death Rate by Causes U*S. and N.G. 50 Infant Death Rates; U.S. and IT. C . • • 52 Maternal Death Rates: U.S* and N.G. •••••• 56 Death Rates by Counties .... ....... 58 Selective Service Rejections ..... 60 Population by Color and Residence ............. 62 Full-time Public Health Expenditures ...... 64 Medical Care and Hospitalization Expenditures • 68 Source of Hospital Income and Extent of Free Hospital Care 70 Rural-farm Level of Living Index 72 Trend in Distribution of Doctors . 74 Ago of Physicians and Specialization 76 Net Cash Income per Farm Worker • * 78 Summary Table on How North Carolina Ranks •».•••••• 80 Additional copies of this report may be obtained from Dr. C. Horace Hamilton, Chairman Department of Rural Sociology North Carolina State College Raleigh, North Carolina MEDICAL CARE SERVICES IN NORTH CAROLINA Foreword In February 1944, Governor J. Melville Broughton appointed a State Hospital and Medical Care Commission to survey the hospital and medical care needs of our state and to recommend a program to the people and to the legislature of North Carolina, Dr. Clarence Poo v;as appointed Chairman of the Commission and Dr. Carl V. Reynolds, Secretary. Several sub-committees were appointed. The sub-committee on Statistical Data and Publications, which was responsible for preparing this report, was composed of the following persons; C. Horace Hamilton, Head, Department of Rural Sociology, North Carolina State College, Chairman; S. H* Hobbs, Professor, Rural Social Economics, University of North Carolina; R. T. Stimson, M. D., Director, Division of Vital Statistics, North Carolina State Board of Health* Dr. W. S, Rankin of the Duke Endowment could not servo as a member of the committee, but rendered great service in making available the Duke Hospital statistics. Arrangement of Data Those data are arranged first, to show how North Carolina stands in the nation; and second, how the counties stand in the state with regard to hospital and medical care services, health conditions, and social and economic factors affecting health and medical care. Practically every table is illustrated with a chart: the table being on the left side facing the chart. This arrangement facilitates study of both the charts and the statistical data. Vihorovor available, the data show white and nonv.rhito, rural and urban comparisons. Most of the data apply to 1940 except whore otherwise stated. Acknov/lo dgomont s The committee acknowledges with much appreciation the assistance of the following members of the North Carolina Department of Rural Sociology, who worked faith- fully and carefully in assembling 'the data and in making the maps and charts; Dr, Selz C. Mayo, Miss Margaret Cole, Mrs, Rosemary Vaughan, and Martin R. Chambers. COORDINATED HOSPITAL SERVICE PLAN Based on data from the U.S.Committee on Education and Labor OBSTETRICS EMERGENCY MEDICAL AND SURGERY LABORATORY X-RAY BACTERIOLOGY DENTISTRY PRIVATE OFFICE OR OFFICES FOR PRIVATE PHYSICIANS ADMINISTRATIVE PUBLIC HEALTH OFFICES HEALTH OFFICER SANITARIAN PUBLIC HEALTH NURSES PUBLIC HEALTH CLINICS MATERNAL AND CHILD HEALTH TUBERCULOSIS VENEREAL DISEASE PUBLIC HEALTH EDUCATION INTERNAL MEDICINE OBSTETRICS EYE, EAR, NOSE, THROAT DENTISTRY MINOR SURGERY LABORATORY X-RAY BACTERIOLOGY Esaas ■IOSPITAL CENTER NSTITUTION (CHRONIC DISEASE) IURSING HOME (CHRONIC DISEASE) 5 7? | MAJOR SURGERY OBSTETRICS INTERNAL MEDICINE COMMUNICABLE DISEASES TUBERCULOSIS VENEREAL DISEASE OTHER PEDIATRICS EYE. EAR, NOSE, THROAT DENTISTRY PHYSIOTHERAPY LABORATORY X-RAY PATHOLOGY BACTERIOLOGY CHEMICAL TEACHING NURSES INTERNS DIETETICS HOSPITAL SERVICE AREA FVe PLAN PROVIDES FOR CONSTANT EXCHANGE BETWEEN HOSPITALS OF INFORMATION, TRAINING, AND CON- SULTATION SERVICE, AND PERSONNEL, AND FOR REFERRAL OF PATIENTS WHEN INDICATED Teaching Research Consultation CANCER CLINIC PSYCHIATRIC SERVICE HEART CLINIC MAJOR SURGERY INTERNAL MEDICINE OBSTETRICS PEDIATRICS ORTHOPEDIC SURGERY COMMUNICABLE DISEASES TUBERCULOSIS VENEREAL DISEASE OTHER TEACHING NURSES INTERNS RESIDENTS POST GRADUATES LABORATORY X-RAY PATHOLOGY BACTERIOLOGY CHEMICAL PHYSIOTHERAPY DENTISTRY EYE, EAR. NOSE, THROAT DIETETICS Pag© 4 GENERAL HOSPITAL FACILITIES AND ADMISSIONS, 1940 Beds per 10,000 population Admissions per 1 ,000 population Rank and State Ratio Number Rank and State Ratio Number •# 26 UNITED STATES - 35 462,360 24 UNITED STATES 70 9,210,496 1 Nevada 62 680 1 Montana 105 58,803 2 Montana 56 3,108 2 Nevada 98 10,797 3 California 53 36,851 3 Arizona 93 46,297 4 Massachusetts 52 22,466 4 Washington 90 155,962 4 Wyoming 52 1,297 5 LOUISIANA 89 210,672 S Colorado 51 5,691 5 Minnesota 89 249,669 7 Arizona 49 2,441 7 California 88 605,429 8 New Hampshire 46 2,235 8 Mas s ac hus etts 87 373,896 9 New York 45 60,314 8 New York 87 1,169,580 10 Hew Mexico 44 2,551 8 Oregon 87 95,157 11 Washington 43 7,488 11 North Dakota 86 54,969 12 De1aware 42 1,119 11 Vermont 86 30,993 12 Maryland 42 7,690 13 Connecticut 85 145,955 12 Michigan 42 22,089 13 New Hampshire 85 41,883 12 Rhode Island 42 2,986 15 Wyoming 84 21,171 12 Vermont 42 1,513 15 Colorado 84 93,521 17 Minnesota 40 11,103 17 Illinois 82 648,914 17 North Dakota 40 2,546 18 Wisconsin 81 254,243 19 South Dakota 39 2,515 19 Utah 79 43,323 20 Oregon 38 4,091 20 Delaware 78 20,634 20 Wisconsin 38 12,000 21 South Dakota 76 49,081 22 Connecticut 37 6,362 22 Michigan 73 584,949 22 LOUISIANA 37 8,658 23 Maryl and 71 128,928 24 Illinois 36 28,469 24 New Jersey 70 289,620 24 Kansas 36 6,501 25 Idaho 69 36,2 83 26 Maine 35 2,951 26 Maine 68 57,743 26 Nebraska 35 4, 602 26 Pennsylvania 68 669,051 26 Pennsylvania 35 35,086 20 West Virginia 67 126,552 26 Utah 35 1,913 29 FLORIDA 65 123,297 30 New Jersey 34 14,150 29 Iowa 65 164,521 31 FLORIDA 33 6,277 31 Kansas 64 116,078 32 Missouri 32 11,967 31 Ohio 64 442,868 33 VIRGINIA 31 0,263 33 Nebraska 63 82,728 34 Idaho 30 1,550 34 New Mexico 62 32,751 35 Iowa 28 7,126 35 VIRGINIA 61 164,480 35 Ohio 28 19,635 36 Missouri 60 228,056 35 West Virginia 28 5,292 37 Indiana 58 198,036 38 Indiana 25 8,501 37 Texas 58 371,610 38 Oklahoma 25 5,882 39 NORTH CAROLINA * * 56 119,250 40 ALABAMA 24 6,884 40 GEORGIA 52 163,348 40 Texas 24 15,445 40 Rhode Island 52 36,760 42 NORTH CAROLINA ' * * 23 8,372 42 SOUTH CAROLINA 61 97,615 42 SOUTH CAROLINA 23 4,365 45 Oklahoma 50 116,218 44 TENNESSEE 22 6,278 44 TENNESSEE 47 136,826 45 GEORGIA 21 6,437 45 ALABAMA 42 117,816 46 KENTUCKY 19 5,361 46 KENTUCKY 40 114,984 47 ARKANSAS 13 3,451 47 MISSISSIPPI 37 81,136 48 MISSISSIPPI 15 3,363 48 ARKANSAS 31 59,461 Source: American Medical Association Based on data from the American Medical Association HOSPITAL BEDS PER 10,000 POPULATION, 19H0 Un i ted States RATIO 45 and up 40-44 35-39 25-34 Under 25 Scale of Miles N.C.Agricultura1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY UTILIZATION OF GENERAL HOSPITAL FACILITIES. 1940 Percent beds occupied * Days hospitalization per 100 population Rank and State . Percent Beds occupied , per day Rank and State Ratio Number days 17 ix. states 70.3 325,160 20 UNITED STATES 90 118,683,400 1 New York 78.3 47,219 1 Nevada 152 167,900 2 LOUISIANA 76.1 6,592 2 California 139 9,577,600 3 Rhode Island 75.3 2,243 3 Massachusetts 136 5,864,090 4 Connecticut 74.9 4,768 4 Montana 131 733,285 5 Illinois 74.3 21,148 5 Now York 128 17,234,935 6 Maryland 73.9 5,685 6 Colorado 119 1,339,185 7 Maine 73.4 2,167 7 Arizona 115 573,415 8 Ohio 73.2 14,372 7 Rhode Island 115 820,520 9 Missouri 72.2 8,646 9 Maryland 114 2,075,025 10 Oregon 71.9 2,941 10 Michigan 110 5,771,015 11 Michigan 71.6 15,811 11 Vermont 105 376,315 12 Massachusetts 71.5 16,066 12 Minnesota 104 2,891,165 13 Pennsylvania 71.4 25,054 12 New Hamnshire 104 512,095 14 Minnesota 71.3 7,921 12 Washington 104 1,804,560 15 California 71.2 26,240 15 LOUISIANA 102 2,406,080 16 New Jersey 70.7 10,007 16 Connecticut 100 1,707,470 17 SOUTH CAROLINA 70.0 3,056 16 Illinois 100 7,719,020 18 TENNESSEE 69,1 4,336 16 Oregon 100 1,073,465 19 VIRGINIA 68.7 5,674 19 Wisconsin 94 2,951,390 20 Indiana 68.4 5,818 20 Maine 93 790,955 21 Vermont 68.1 1,031 20 Wyoming 93 232,870 22 ALABAMA 67.8 4,668 22 Pe xm s y 1 vani a 92 9,144,710 23 Nevada 67.6 460 23 Delaware 90 240,535 24 Wisconsin 67.4 8,086 23 New Mexico 90 480,340 25 Utah 67.3 1,288 25 North Dakota 89 572,685 26 GEORGIA 67.1 4,302 26 New Jersey 88 3,652,565 27 Idaho 66.0 1,023 27 Utah 85 470,120 27 Vifashington 66.0 4,944 28 Kansas 84 1,507,450 29 MISSISSIPPI 65.5 2,202 29 Missouri 83 3,155,790 30 Iowa 65.0 4,632 29 South Dakota 83 533,995 31 Montana 64.8 2,009 31 Nebraska 77 1,012,510 32 Colorado 64.5 3,669 31 VIRGINIA 77 2,071,010 33 Arizona 64.4 1,571 33 Ohio 76 5,245,780 34 Wost Virginia 63.6 3,364 34 FLORIDA 75 1,427,515 35 Kansas 63.5 4,150 35 Idaho 71 373,395 36 New Hampshire 62.8 1,403 36 Iowa 67 1,690,680 37 ARKANSAS 62.6 2,161 37 West Virginia 65 1,227,860 38 FLORIDA 62.3 3,911 38 Indiana 62 2,123,570 39 North Dakota 61.6 1,563 39 ALABAMA 60 1,703,820 40 NORTH CAROLINA * * 60.8 5,093 40 SOUTH CAROLINA 59 1,115,440 41 Nebraska 60.3 2,774 41 Oklahoma 54 1,258,520 42 KENTUCKY 60.2 3,229 41 TENNESSEE 54 1,582,640 43 Texas 59.4 9,179 43 NORTH CAROLINA * * 52 1,858,945 44 Delaware 58.9 659 43 Texas 52 3,350,335 45 Oklahoma 58.6 3,448 45 GEORGIA 50 1,576,800 46 South Dakota 58.2 1,463 46 KENTUCKY 41 1,178,585 47 New Mexico 56.0 1,316 47 ARKANSAS 40 788,765 48 Wyoming 49.2 638 48 MISSISSIPPI 37 803,730 Based on data from the U.S.Bureau of the Census DAYS HOSPITALIZATION PER IOO POPULATIONf 1940 United States PERCENT Ove r 110 100-109 85- 99 65- 84 Under 65 N.C.Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY TOTAL DENTISTS, PHYSICIANS AND SURGEONS, AND NURSES PER 100,000 TOTAL POPULATION, 1940. Dentists Physicians and Surgeons Trained Nurses and Student Nurses Rank and Stats Ratio Rank and State Ratio Rank and State Ratio 16 UNITED STATES 58 16 UNITED STATES 125 20 UNITED STATES 270 1 California 78 1 New York 193 1 Massachusetts 488 2 New York 76 2 Massachusetts 164 2 Connecticut 443 2 Oregon 76 3 Maryland 161 3 New Hampshire 403 4 Illinois 75 4 California 158 4 New York 598' 5 Minnesota 74 . 5 Colorado 146 5 California 3S5 6 • Washington 72 5 Illinois 146 6 Maryland 350 7 Nebraska 70 7 Connecticut 145 6 Vermont 350 8 Wisconsin 67 8 New Jersey 141 8 Minne sota 341 9 Massachusetts 65 9 Missouri 132 9 Delaware 339 10 Iowa 64 10 Nevada 130 9 New Jersey 339 10 New Jersey 64 10 Ohio 130 11 Colorado 333 12 Connecticut 63 10 Pennsylvania 150 12 Washington 329 13 Missouri 60 10 Rhode Island 130 13 Oregon 327 13 Pennsylvania 60 14 ' Oregon 128 14 Rhode Island 313 15 Colorado 59 14 Vermont 128 15 Maine 302 16 Ivans as 56 16 Delaware 125 16 Arizona 298 16 Utah 56 17 Minnesota 122 17 Montana 296 18 Ohio 54 18 Nebraska 120 18 111inoi s 289 19 Indiana 53 18 Washington 120 IS Pennsylvania 284 19 Rhode Island 53 20 Michigan 117 20 Ohio 267 21 Michigan 50 21 Iowa 115 21 Michigan 263 21 Montana 50 21 Kansas 115 22 Wisconsin 256 23 Nevada 49 23 New Hampshire 114 23 Nevada 251 23 Wyoming 49 24 Indiana 113 24 FLORIDA 250 25 Maryland 48 25 Arizona 112 25 Utah 242 26 South Dakota 47 26 FLORIDA 103 26 North Da koto. 236 27 New Hampshire 46 26 Wisconsin 108 | 27 Kansas 219 28 Maine 44 28 Maine 105 28 Iowa 216 29 Vo rmont 42 29 Utah 100 28 Missouri 216 30 Idaho 41 30 LOUISIANA 99 28 Nebraska 216 30 North Dakota 41 31 VIRGINIA 98 31 South Dakota 213 32 Do laware 39 32 Texas 97 32 VIRGINIA 210 33 FLORIDA 38 33 Oklahoma 96 33 Indiana 209 34 LOUISIANA 33 34 Montana 94 34 Idaho 203 35 Oklahoma 32 34 TENNESSEE 94 35 Wyoming 202 35 VIRGIN LI 32 3 6 West Virginia 91 36 LOUIS LINA 181 37 Arizona 31 37 Wyoming 90 37 Texas 176 37 Texas 31 38 KENTUCKY 89 38 NORTH CAROLINA * 175 37 West Virginia 31 39 ARKANSAS 86 39 West Virginia 161 40 .TENNESSEE 29 40 GEORGIA 82 40 SOUTH CAROLINA 160 41 KENTUCKY 28 41 New Mexico SO 41 TENNESSEE 159 42 GEORGIA. 26 41 North Dakota 80 42 Now Mexico 152 43 NORTH CAROLINA * 22 43 Idaho 78 45 GEORGIA 145 44 ALABAMA 21 43 South Dakota 78 44 Oklahoma 154 44 Nov; Mexico 21 45 NORTH CAROLINA * 72 45 KENTUCKY 131 46 ARKANSAS 20 46 ALABAMA 66 46 ALi-BALiA 118 47 MISSISSIPPI 19 46 SOUTH CAROLINA 66 47 ARKANSAS 96 47 SOUTH CAROLINA 19 48 MISSISSIPPI 61 48 MISSISSIPPI 92 Sources United States Census, 1940. Eased on data from the U.S.Bureau of the Census RATE 7 0 and up 60-69 SO-59 40-49 30-39 Under 30 DENTISTS PER 100,000 POPULATION,1940 UnI ted States N.C.Agricu11ura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY WHITE DENTISTS, PHYSICIANS AND SURGEONS, AND NURSES PER 100,000 WHITE POPULATION, 1940 Dentists Physicians and Surgeons Trained Nurses and Student Nurses Rank and State Rate Rank and State Rate Rank and State Rate 16 UNITED STATES 58 13 UNITED STATES 136 21 UNITED STATES 295 1 California 80 1 New York 200 1 Massachusetts 494 2 New York 78 2 Maryland 186 2 Connecticut 452 3 Illinois 77 3 Massachusetts 165 3 Maryland 412 3 Oregon 77 4 California 162 4 California 410 5 Minnesota 75 5 Illinois 160 5 New York 404 6 Washington 73 6 LOUIS IANA 149 6 New Hampshire 403 7 Nebraska 70 7 Colorado 147 7 Delaware 388 8 New Jersey 67 7 Connecticut 147 8 New Jersey 356 8 Wisconsin 67 9 New Jersey 146 9 Vermont 350 10 Massachusetts 65 10 FLORIDA 142 10 Minnesota 343 11 Connecticut 64 11 MISSISSIPPI . 141 11 Colorado 337 11 Iowa 64 12 Delaware 140 12 Washington 335 13 Missouri 63 13 Nevada 133 13 Arizona 333 14 Pennsylvania 61 14 Missouri 135 14 Oregon 330 15 Colorado 59 15 Ohio 134 15 FLORIDA 324 16 Kansas 58 15 Pennsylvania 134 16 Rhode Island 318 17 Ohio 56 17 Rhode Island 131 17 Montana 306 17 Utah 56 18 Arizona 129 18 Maine 303 19 Maryland 55 18 Oregon 129 19 Illinois 301 20 Indiana 54 20 Vermont 128 20 Pennsylvania 296 21 Rhode Island 53 21 Minnesota 123 21 Ohio 279 22 Michigan 52 22 VIRGINIA 122 22 LOUIS TANA 275 22 Nevada 52 22 Washington 122 23 Michigan 272 24 Montana 51 24 Nebraska 120 24 Nevada 263 25 LOUISIANA 50 25 Michigan 119 25 VIRGINIA 259 25 Wyoming 50 26 GEORGIA 118 26 Wisconsin 258 27 FLORIDA 49 27 Kansas 117 27 SOUTH CAROLINA 256 27 South Dakota 49 28 Iowa 116 28 Utah 244 29 New Hampshire 46 29 Indiana 115 29 North Dakota 239 30 Maine 45 30 New Hampshire 114 30 Kansas 226 31 Delaware 43 31 Texas 111 30 NORTH CAROLINA * 226 31 MISSISSIPPI 45 32 SOUTH CAROLINA 110 32 Missouri 219 33 Vermont 42 33 -Jhuu.S^S 109 32 Nebraska 219 34 Idaho 41 33 Wisconsin 109 32 South Dakota 219 34 North Dakota 41 35 Maine 105 35 Iowa 217 36 VIRG IN IA 39 36 TENNESSEE 104 36 Indiana 216 37 GEORGIA 38 37 Oklahoma 102 37 MISSISSIPPI 209 38 Arizona 35 38 Utah 101 38 Wyoming 206 38 Texas 35 39 Montana 98 39 Idaho 205 40 Oklahoma 34 40 ALABAMA 95 40 Texas 201 41 TENNESSEE 32 41 NORTH CAROLINA * 94 41 GEORGIA 195 41 ?fest Virginia 32 41 West Virginia 94 42 TENNESSEE 182 43 ALABAMA 30 43 KENTUCKY 93 43 West Virginia 169 43 SOUTH CAROLINA 30 44 Wyoming 92 44 ALABAMA 159 45 KENTUCKY 29 45 New Mexico 86 44 New Mexico 159 46 NORTH CAROLINA * 28 46 North Dakota 81 46 Oklahoma 144 47 ARKANSAS 24 46 South Dakota 81 47 KENTUCKY 138 48 New Mexico 23 i 48 Idaho 79 48 ARKANSAS 124 Source: United States Census, 1940. Based on data from the U.S.Bureau of the Census RATE 140 and up 120-139 100-119 80- 99 Under 80 PHYSICIANS PER 100,000 POPULATION, 1940 United States N.C.Agricultura1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY NONWHITE DENTISTS, PHYSICIANS, AND NURSES PER 100,000 NONWHITE POPULATION, 1940. Dentists Physicians and Surgeons Trained nurses and Student nurses Rank and State Rate Rank and State Rate Rank and State Rate 27 UNITED STATES 12 26 UNITED STATES 28 19 UNITED STATES 54 1 Wyoming 241 1 Missouri 82 1 Montana 316 2 Idaho 179 2 Massachusetts 76 2 New York 278 3 . Massachusetts 56 3 Illinois 72 3 Vermont 235 4 Montana 53 4 Oregon 71 4 Idaho 179 5 Connecticut 50 4 Colorado 71 5 Missouri 172 6 Colorado 47 6 California 61 6 Oregon 122 7 Oregon 43 7 Michigan 60 7 Utah 108 7 Rhode Island 43 8 New Jersey 59 8 Ma s s ac hu s o11 s 96 9 California 42 8 Kansas 59 9 Arizona 92 9 Washington 42 10 I owa 58 10 California 88 11 Illinois 30 11 Nebraska 55 11 North Dakota 76 12 Pennsylvania 28 12 New York 54 12 Colorado 65 13 Indiana 27 13 Indiana 51 13 Illinois 63 13 Nebraska 27 14 Connecticut 50 13 New Mexico 63 15 New Jersey 25 15 Pennsylvania 48 15 VIRGINIA 60 1G New York 24 16 Ohio 47 15 South Dakota 59 16 Ohio 24 17 TENNESSEE 44 17 Washington 58 16 Wisconsin 24 18 KENTUCKY 43 18 Kansas 56 19 Iowa 23 19 West Virginia 40 19 FLORIDA 52 20 ’.Tost Virginia 22 20 Minnesota 39 19 TENNESSEE 52 21 Minnesota 21 21 Maine 37 21 GEORGIA 51 22 Kansas 20 22 Maryland 36 21 Michigan 51 22 Missouri 20 22 Oklahoma 36 23 Nevada 48 24 Michigan 18 24 Washington 34 23 Wisconsin 48 25 TENNESSEE 15 25 Wisconsin 32 25 NORTH CAROLINA * 46 26 Delaware 14 26 Utah 27 26 Oklahoma 44 26 KENTUCKY 14 27 Delaware 25 27 Nov/ Jersey 43 26 Utah 14 27 VIRGINIA 25 28 KENTUCKY 42 29 Maryland 10 29 Texas 18 28 Maryland 42 29 VIRGINIA 10 ,30 FLORIDA 17 30 ALABAMA 41 31 Texas 9 30 NORTH CAROLINA * 17 31 Pennsylvania 40 32 FLORIDA • 8 30 Rhode Island 17 32 Maine 37 32 Oklahoma 8 33 Nevada 16 32 West Virginia 37 34 ARKANSAS 6 34 ARKANSAS 15 34 Ohio 32 34 NORTH CAROLINA * 6 34 GEORGIA 15 35 SOUTH CAROLINA 51 36 GEORGIA 5 36 Arizona 12 36 Connecticut 30 36 SOUTH CAROLINA 5 37 LOUISIANA 11 36 Indiana 30 38 ALABAMA 4 38 ALABAMA 10 38 Minn©sota 26 38 LOUISIANA 4 39 SOUTH CAROLINA 9 38 Rhodo Island 26 40 Arizona 3 40 MISSISSIPPI 5 S3 Texas 26 40 MISSISSIPPI 3 41 South Dakota 4 41 Delaware 25 40 New Mexico 3 42 Now Mexico 3 42 LOUIS XANA 14 43 Maine 0 43 I daho 0 43 ARKANSAS 15 43 Nevada 0 43 Montana 0 44 Iowa 12 43 Now Hampshire 0 43 New Hampshire 0 44 MISSISSIPPI 12 43 North Dakota 0 43 North Dakota 0 46 Nebraska 11 43 South Dakota 0 43 Vermont 0 47 New Hampshire 0 43 Vermont 0 43 Wyoming 0 47 Wyoming 0 Source: United States Census, 1940 Based on data from the U.S.Bureau of £he Census RATE 350 and up 300-350 250-299 200-249 150-199 Under ISO NURSES PER 100,000 POPULATI ON, <1940 United States N.C.Agricultura1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY Scale of Miles PERCENTAGE OF REGISTRANTS REJECTED FOR MILITARY SERVICE ( At local boards and induction stations) February 1943 through August 1943) Preliminary All Registrants White Registrants Negro Registrants Rank State 'Percent Rank ' State jP ercent Rank 1 State i 'Percent 32 UNITED STATES 39.2 23 UNITED STATES 36.0 38 UNITED STATES 56.9 1 Oregon 24.4 1 Oregon 24.4 * Arizona 2 Kansas 25.4 2 Kansas 24.8 * Colorado 3 Utah 26.1 3 Utah 26.0 :V Idaho 4 Washington 28.2 4 Washington 28.0 * I owa 5 Wyoming 29.1 5 Delaware 28,2 * Maine 6 I daho 29,3 6 Idaho 29.0 *' Minnesota 7 Connecticut 31.0 7 New Jersey 29,1 * Montana 8 South Dakota 31.1 8 Wyoming 29.2 * Nebraska 9 Nebraska 31.6 9 Connecticut 30.4 * Nevada 10 Pennsylvania 31.8 10 Pennsylvania 30.9 * New Hampshire 11 Delaware 31.9 11 South Dakota 31.1 * New Mexico 12 Illinois 32.9 12 Nebraska 31.3 * North Dakota 12 Nevada 32.9 13 Illinois 31.6 * Oregon 14 New Jersey 33.0 14 Maryland 32.4 * Rhode Island 15 Iowa 33.1 15 Nevada 32.6 * South Dakota 16 North Dakota 33.8 16 MISSISSIPPI 32.9 * Utah 17 California 35.6 17 I owa 33.0 * V ermont 18 Minnesota 35.7 18 North Dakota 33.7 * 'Washington 19 Ohio 35.8 19 Ohio 34.8 * Wisconsin 20 Indiana 36.2 20 California 35.2 ♦ Wyoming 21 Montana 36.5 20 Indiana 35.2 21 Kansas 33.4 22 Missouri 37.2 22 Missouri 35.4 22 West Virginia 41,0 23 Rhode Island 37.3 23 Minnesota 35,6 23 Illinois 41.8 24 Michigan 37.4 24 Michigan 36.3 24 Pennsylvania 43.1 24 Maryland 37.4 25 Montana 36.5 25 North Dakota 44.5 26 Maine 37.5 26 New York 36.8 26 Delaware 44.7 27 Massachusetts 37.7 27 Rhode Island 37.2 27 Connecticut 45.1 27 New York 37.7 28 Maine 37.4 28 California 46.4 27 West Virginia 37,7 28 Me issachusetts 37.4 29 Ohio 46.9 30 New Hampshire 38.9 28 West Virginia 37.4 30 New York 48.0 30 Wisconsin 38.9 31 Oklahoma 38.2 31 Indiana 48.3 32 Arizona 39.0 32 Arizona 38.4 32 KENTUCKY 49.7 33 New Mexico 40.1 33 Wisconsin 38.7 33 Missouri 50.4 34 Oklahoma 40.6 34 New Hampshire 38.9 34 Michigan 51.2 35 Texas 42,9 35 Texas 39.4 35 Ma s s achu s e11 s 52.4 36 Colorado 43.1 36 ALABAMA 39,5 36 Maryland 53.1 37 TENNESSEE 44.7 37 New Mexico 39.9 37 MISSISSIPPI 54.2 38 MISSISSIPPI 45.0 38 TENNESSEE 40.1 38 Oklahoma 56,9 39 KENTUCKY 45.4 39 FLORIDA 41.4 39 TENNESSEE 57.4 40 Vermont 45.7 40 LOUISIANA 42,5 40 GEORGIA 57.8 41 ALABAMA 49.0 41 SOUTH CARO LIMA 42.9 40 Texas 57,8 42 GEORGIA 51.5 42 Colorado 43.0 42 ALABAMA 61.0 A rZ S.KJ VIRGINIA 52.2 43 KENTUCKY 45.1 45 VIRGINIA 63.9 44 LOUISIANA 52.6 44 VIRGINIA 45.5 44 LOUISIANA 64.0 45 FLORIDA 53.2 45 Vermont 45.7 45 FLORIDA 65.8 46 ART AITS AS 55.9 46 ARKANSAS 46.9 46 SOUTH CAROLINA 69.4 46 SOUTH CAROLINA 55.9 46 GEORGIA 46.9 47 ARKANSAS 70.9 48 NORTH CAROLINA 56.8 48 NORTH CAROLINA 49.2 48 NORTH CAROLINA 71.5 * States having less than 0.3 per cent of total Negro registrants are omitted. Source; U.S, Senate Hearings Subcommittee on Wartime Health and Education. PERCENTAGE OF REGISTRANTS REJECTED FOR MILITARY SERVICE Per cent Rejected Under 30.0 30.0- 35.0- 40.0- 45.0- 50.0- Baaed on data from U.S. Senate Hearings Subcommittee on Wartime Health, and Education N.C. Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY Limitations of Selective Service Data The data on Selective Service rejections are not only of a preliminary character but are subject to other limitations* Col, Leonard G. Rowntree, Chief of the Medical Division, National Headquarters, Selective Service System, has the following to say about rejection rates; "It is important to remember that, so far, the discussion has dwelt only on primary defects, i*e«, the principal cause of rejection* Rejection rates based upon the nember of registrants rejected for military service per 1,000 men examined have limitation in their use as criteria of good civilian health. Rejection rates are dependent upon too many factors, as for instance (l) changes in standards for induction,(2) changing defer- ment policies, (3) varying numbers of registrants by age, race, urban-rural areas all of which introduce variables correctable only through the ealeu* lation of specific rejection’rates, (4) whether a registrant is coming up for the first, second, third, or fourth examination and (5) how far military standards exceed those required of normal civilian living* Selective Service therefore regards the rejection rate per 1,000 examined as useful in measuring the Nation*s health only in terms of the limitations placed upon such rates• • •. • • " i/ These data published herewith are preliminary and are of limited scientific value because they apply to a very short period of time - February through August 1943, The table on page 60 of this publication which shows the North Carolina rejection rate to bo only 48,1 per cent, was based on a sample of all data available from the beginning of this war through March 1943. Obviously, the rejection rate must have risen considerably after March* Perhaps there were many 4-F’s coming up for the second and third examinations. Until more complete data become available, wo can not bo sure as to the signif- icance and importance of Selective Service rejection rates* 1/ U. S. Senate Subcommittee on Wartime Health and Education Hearings, Part V, Washington, D. C«, July 10, 11, and 12, 1944j Page 1626* PERCENTAGE OF NEGRO REGISTRANTS REJECTED FOR MILITARY SERVICE Percentage Rejected UNITED STATES NORTH CAROLINA ARKANSAS SOUTH CAROLINA FLORIDA LOUISIANA VIRGINIA ALABAMA TEXAS GEORGIA TENNESSEE OKLAHOMA MISSISSIPPI MARYLAND MASSACHUSETTS MICHIGAN MISSOURI KENTUCKY INDIANA NEW YORK OHIO CALIFORNIA CONNECTICUT DELAWARE NEW JERSEY PENNSYLVANIA ILLINOIS WEST VIRGINIA KANSAS N #C• Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY Based on data from U.S.Senate Hearings Subcommittee on Wartime Health and Education LIVE BIRTHS PER 1,000 FEMALES 15-44 YEARS OF AGE, 1940. Total White Nonwhite Rank and State Rate Rank and State Rate Rank and State Rate 17 UNITED STATES 73.7 17 UNITED STATES 72.5 26 UNITED STATES 83.3 1 New Jersey 56,4 1 New Jersey 55.4 1 New Mexico 53.1 2 New York 56.7 2 New York 56.9 1 New York 53.1 3 Connecticut 60.0 3 Connecticut 59.7 3 Ve rmont 56.8 4 Rhode Island 61.1 4 Rhode Island 60.6 4 KENTUCKY 60.3 5 Massachusetts 62.5 5 Massachusetts 62.3 5 Iowa 60.9 6 Illinois 63.5 6 Illinois 63 • 6 6 Illinois 61.4 7 California 68,0 7 California 67,8 7 TENNESSEE 61.8 8 Missouri 68,2 8 Pennsylvania 68.0 8 Missouri 63.0 9 Pennsylvania 68.3 9 Delaware 68.2 9 Texas 63.5 10 Ohio 69,0 10 Missouri 68,6 10 Kansas 66.4 11 Kansas 69.8 11 Maryland 68.8 11 Ohio 67.1 12 FLORIDA 70,1 12 Ohio 69.1 12 Indiana 67.3 12 Oregon 70.1 13 Oregon 69.7 13 FLORIDA 67.6 14 Delaware 70.3 14 Kansas 69,9 14 Michigan 67.8 15 Washington 70,7 15 Washington 70.2 15 New Hampshire 68.0 16 Maryland 72.4 16 FLORIDA 71.2 16 Connecticut 71.3 17 Nebraska 72.7 17 Nebraska 72.7 17 California 71.4 18 New Hampshire 75.0 18 New Hampshire 75.0 18 West Virginia 71.S 19 Wisconsin 76.1 19 Wisconsin 75.8 19 Massachusetts 72.0 20 TENNESSEE 76.5 20 GEORGIA 77.4 20 Pennsylvania 72.4 21 Indiana 77.2 21 Indiana 77.7 21 New Jersey 72.9 22 Iowa 78,1 22 Iowa 78.2 22 Colorado 73.1 23 Michigan 78.8 23 LOUIS IANA 78.7 23 Nebraska 74.5 23 Texas 78.8 24 Michigan 79.4 24 ARKANSAS 75.6 25 Oklahoma 80.3 26 TENNESSEE 80.0 25 Oklahoma 79.6 26 Colorado 80.7 26 Oklahoma 80.4 26 Delaware 83.2 27 Minnesota 81.0 27 Minnesota 80.5 27 Maine 88.5 28 Maine 81.8 28 Colorado 80.8 28 Idaho 89.3 29 GEORG LA. 82.0 29 South Dakota 81.4 29 Maryland 89.6 30 ARKANSAS 82.9 30 Texas 81.6 i 30 GEORGIA 89.9 31 South Dakota 83.7 31 Maine 81.8 31 Rhode Island 93,6 32 LOUISIANA 85.0 32 Nevada 81.9 32 ALaBAMn 95,9 33 Nevada 85.2 33 SOUTH CAROLINA 83.3 32 LOUISIANA 95.9 34 VIRG HI IA 88.1 34 VIRG INIA 84.6 34 Washington 96.0 35 ALABAMA 90.0 35 ARKANSAS 85.4 j 35 Utah 96.5 35 NORTH CAROLINA * 90.0 35 NORTH CAROLINA * 85.4 36 VIRGINIA 98.6 37 Ve raont 90,1 37 ALABAMA 86.7 37 Oregon 98,7 38 Wyoming 90.3 38 MISSISSIPPI 87.6 38 NORTH CAROLINA *101.6 39 North Dakota 91.8 39 Wyoming 89.4 39 Arizona 103.0 40 Montana 93,4 40 Vermont 90.1 40 SOUTH CAROLINA 109.3 41 West Virginia 93.8 1 41 North Dakota 90.3 } 41 MISSISSIPPI 110.2 42 SOUTH CAROLINA 94,3 42 Montana 90.7 42 Wiscons in 117.0 43 KENTUCKY 97.6 43 West Virginia 95.4 ! 43 Minnesota 142.9 44 Arizona 98.5 44 Arizona 97.8 ; 44 South Dakota 151.0 45 MISSISSIPPI 99.0 45 Idaho 100,5 | 45 Nevada 151.2 46 I daho 100.4 46 KENTUCKY 100.9 1 46 Wyoming 161.1 47 Utah 104.3 47 Utah 104.4 ! 47 Montana 180.0 48 New Mexico 119.8 48 New Mexico 124.8 48 North Dakota 188.1 Source: United States Vital Statistics, 1940, Based on data from the I?. S. Bureau of the Census LIVE BIRTHS PER 1.000 FEMALES 15-44 YEARS OF AGE.1940 United States RATE Unde r 6 5.0 65.0- 75.0- 9 85.0- 95.0 and over N.C.Agricu11ura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY PERCENTAGE OF LIVE BIRTHS OCCURRING IN HOSPITALS, 1942. Total White Negro Rank State Percent Rank State Percent Rank State Percent 31 UNITED STATES 67.9 25 UNITED STATES 72.7 36 UNITED STATES 28.S 1 Connecticut 95.9 1 Connecticut 96.1 1 Idaho 100.0 2 Washington 94.5 2 Washington 94.7 1 Oregon 100.0 3 Oregon 93.4 3 Oregon 93.5 3 Nevada 93.3 4 New York 92.2 4 California 92.5 4 Washington 91.4 5 California 92.1 5 New York 92,3 5 Utah 90.9 6 Massachusetts 91.7 6 Nevada 92.0 6 Neiv York 89.8 7 N evada 91.2 7 Massachusetts 91.8 7 Connecticut 88.5 8 Hew Jersey 90.2 8 New Jersey 91.1 8 Minnesota 86.7 9 m o at ana 89.2 9 Montana 90.0 9 Rhode Island 83.6 10 Lode Island 87.3 10 Rhode Island 87.4 10 New Hampshire 83.3 1 - t. X if ew Hampshire 86.4 11 New Hampshire 86.4 11 California 81.1 9 .i. 1 linois 84.9 12 Illinois 85.6 12 Yvyoming 80.0 13 pt ah 82.5 15 De1 aware 84.0 13 Massachusetts 79.2 1 A Wyoming 81.3 14 Utah 82.5 14 Maine 78.6 .10 daho 81.0 15 Wyoming 81.6 15 New Jersey 77,7 J. O Michigan 79.2 16 Idaho 81.1 16 Iowa 76.5 ]. 7 M innesota 79.1 17 Michigan 79.6 16 Wisconsin 76.5 .18 Delaware 78.0 18 Minnesota 79.2 18 Montana 75.0 11 Wisconsin 77.7 19 Wisconsin 77.8 18 North Dakota 75.0 20 Ohio 75.4 20 Ohio 75.9 20 Nebraska 73.3 21 North Dakota 74.6 21 Arizona 75.0 21 Illinois 73,2 22 Penns yIvani a 73.9 22 North Dakota 74.5 22 Pennsylvania 72.1 23 Arizona 73.2 23 Pennsylvania 74.1 23 Michigan 69.2 24 Colorado 72.7 24 I1 la ry land 73.1 24 Arizona 66.5 26 I daho 72.0 25 Colorado 72.8 25 Ohio 63,8 26 7© mont 70.5 26 Iowa 72.0 26 I lissouri 60.6 27 Nebraska 70.4 27 Kansas 71.1 27 Colorado 60.5 28 K ansas 70.1 28 Vermont 70.5 28 South Dakota 60,0 29 South Dakota 69,3 29 Nebraska 70.4 29 Do laware 46.2 30 Indiana 69.1 30 FLORIDA 70.3 30 Maryland 43«9 31 Maryland 67.7 31 Indiana 70.1 31 New Mexico 42.3 32 Maine 67.6 32 South Dakota 69.8 32 I Cans as 42.0 33 H f issouri 59.6 33 Maine 67.6 33 Indiana 41.5 34 FLORIDA 55.6 34 LOUIS IAEA 63.9 34 LOUISIANA 34.8 34 Texas 55.6 35 Texas 59.8 35 TENNESSEE 29.9 36 Oklahoma 55.2 36 Missouri 59.5 36 Texas 26.8 37 LOUISIANA 52.4 37 Oklahoma 57.4 37 KENTUCKY 25.2 38 VIRG INI A 44.8 38 GEORGIA 55,2 38 FLORIDA 17.5 39 GEORGIA 40.5 39 VIRGINIA 54.5 39 VIRGINIA 16.3 40 New Mexico 40.2 40 SOUTH CAROLINA 50.0 40 Oklahoma 15.9 41 NORTH CAROLINA * 38.1 1 41 NORTH CAROLINA * 49,0 41 GEORGIA 15.5 42 TENNESSEE 38.0 42 MISSISSIPPI 42.6 42 West Virginia 13.8 43 West Virginia 32.2 43 ALaiBAMA 40.3 43 NORTH CAROLINA * 13.6 44 SOUTH CAROLINA 29.9 44 New Mexico 40.2 44 i xLABAMA 11.5 45 ALABAMA 29.8 45 TENNESSEE 39,4 45 SOUTH CAROLINA 7.2 46 ARKANSAS 27.7 46 j xR KANSAS . 34.7 46 xRKANSAS 4.9 47 KENTUCKY 27.3 47 West Virginia 33.3 47 I IISSISSIPPI 3.9 48 MISSISSIPPI 21,5 48 KENTUCKY 27,4 ** Vermont - - Source; United States Vital Statistics, 1942. * * No Negro births. PERCENTAGE OF LIVE BIRTHS OCCURRING IN HOSP1TALS,I9U2 Un i ted States TOTAL N.C.Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY * No Negro bi rths BASED ON DATA FROM THE U.S.BUREAU OF THE CENSUS PERCENTAGE OF BIRTHS OCCURRING IN HOSPITALS, BY RESIDENCE, 1940. Urban Places with 10,000 population and over Rural Places with less than 10,000 population Rank and State Percent Rank and State Percent 21 UNITED STATES 80.5 33 UNITED STATES 36.5 1 Nevada 96.9 1 Connecticut 88.9 2 Oregon 96.7 2 California 80.7 3 Montana 95.9 3 Washington 80.1 4 Washington 95.1 4 Massachusetts 79.5 5 New York 92.0 5 Oregon 79.0 6 Connecticut 91.9 6 New Jersey 77,6 7 Minnesota 91.6 7 Nevada 77.2 3 California 90.0 8 Montana 76.0 9 Delaware 88.5 9 Rhode Island 70.5 10 North Dakota 87.9 10 New York 70.4 11 New Jersey 37.5 11 New Hampshire 68.4 12 Utah 37.4 12 Wyoming 63.8 13 Illinois 87.1 13 Arizona 56.4 14 Wyoming 87.0 13 Idaho 56.4 15 Idaho 86.2 16 North Dakota 55.9 16 Massachusetts 86.0 16 Utah 55.8 17 South Dakota 83.0 17 Minnesota 55.2 13 Missouri 82.3 18 Delaware 55.0 19 Wisconsin 81.4 19 Vermont 52.9 20 Iowa 81.2 20 South Dakota 51.6 21 Nebraska 80.4- 21 Illinois 51.2 21 New Hampshire 80.4 22 Wisconsin 51.1 23 Ohio 79.0 23 Colorado 49.0 24 Rhode Island 78.2 24 Maryland 48.7 25 Colorado 77.9 25 Iowa 43.6 26 LOUISIANA 77.3 26 Michigan 47.4 27 Pennsylvania 77.0 27 Pennsylvania 45.4 28 Vermont 76.4 28 Kansas 44,3 29 Michigan 75.6 29 Maine 43,4 50 Arizona 75.6 30 Nebraska 41.3 31 Maryland 73.2 31 Ohio 40.3- 32 Maine 72.4 52 Indiana 37.6 33 FLORIDA 70.6 33 LOUISIANA 29.9 34 Kansas 70.5 34 Texas 28.9 35 Oklahoma 69,3 35 FLORIDA 28.5 56 GEORGIA 63.6 36 New Mexico 24.3 37 Indiana 67,9 37 Missouri 22.9 38 VIRGINIA 67.0 38 VIRGINIA 19.3 39 TENNESSEE 66.8 39 NORTH CAROLINA * * 17.1 40 Texas 66. 6 40 GEORGIA 13.8 41 KENTUCKY 64.3 41 TENNESSEE 15.7 42 ARKANSAS 61.6 42 SOUTH CAROLINA 13.2 43 West Virginia 61,2 4o ALABAMA 12.4 44 NORTH CAROLINA * * 55.9 44 West Virginia 11.5 45 ALABAMA 54 • 6 45 ARKANSAS 11.4 46 New Mexico 52.8 46 MISSISSIPPI 10.1 47 MISSISSIPPI 52.3 47 Oklahoma 9.3 48 COUTH CAROLINA 51.3 48 KENTUCKY 0*0 Source; United States Vital Statistics, 1940. PERCENTAGE OF BIRTHS OCCURRING IN HOSPITALS,BY RESIDENCE,I QUO United States URBAN PERCENTAGE Below 20 21-39 M-50 60-79 80-99 N.C.Agricu11ura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY BASED ON DATA FROM THE U.S.BUREAU OF THE CENSUS Page 20 PERCENTAGE OF LIVE BIRTHS NOT ATTENDED BY A PHYSICIAN, 1942 Total White Negro Rank and State Percent Rank and State Percent Rank and State Percent 36 UNITED STATES 7.4 33 UNITED STATES 2.5 40 UNITED STATES 46.8 1 New Hampshire 0.0 1 Massachusetts 0.0 1 Idaho 0.0 1 Ohio 0.0 1 New Hampshire 0.0 1 Maine 0.0 1 Vermont 0.0 1 Ohio 0.0 1 Nebraska 0.0 4 Iowa 0.1 1 Vermont 0.0 1 Nevada 0.0 4 Kansas 0.1 5 Connecticut 0.1 1 New Hampshire 0.0 4 Massachusetts 0.1 5 Indiana 0.1 1 North Dakota 0.0 4 Nebraska 0.1 5 Iowa 0.1 1 Oregon 0.0 4 Pennsylvania 0.1 5 Kansas 0.1 1 South Dakota 0.0 9 Connecticut 0.2 5 Nebraska- 0.1 1 Utah 0.0 9 Illinois 0.2 5 Oregon 0.1 1 Vermont 0.0 9 Indiana 0.2 5 Pennsylvania 0.1 1 Washington 0.0 9 Washington 0.2 5 Washington 0.1 1 Wisconsi n 0.0 9 Wisconsin 0.2 5 Wisconsin 0.1 1 Wyoming 0.0 14 Idaho 0.3 14 Illinois 0.2 14 Ohio 0.1 14 Michigan 0.3 14 Michigan 0.2 15 Kansas 0.2 14 Oregon 0.3 14 Nevada 0.2 15 Massachusetts 0.2 17 Rhode Island 0.4 14 Wyoming 0.2 17 Pennsylvania 0.3 17 Wyoming 0.4 18 Idaho 0.3 18 Illinois 0.4 19 California 0.6 18 South Dakota 0.3 18 Iowa 0.4 19 Minnesota 0.6 20 Rhode Island 0.4 20 California 0.5 19 New York 0.6 21 California 0.5 21 Michigan 0.7 19 Utah 0.6 21 Minnesota 0.5 22 Colorado 0.8 23 Maine 0.7 21 Montana 0.5 23 Connecticut 1.0 24 Montana 1.2 21 Now York 0.5 24 New Jersey 1.1 24 Nevada 1.2 26 Utah 0.6 25 Indiana 1.2 26 New Jersey 1.4 26 Maine 0.7 26 Rhode Island 1.5 27 South Dakota 1.6 27 New Jersey 1.4 27 Minnesota 1.7 28 Colorado 1.7 28 Do lawo.ro 1.5 28 Now York 2.1 29 North Dakota 2.1 28 Oklahoma 1.5 28 West Virginia 2.1 30 Missouri 3.4 30 Colorado 1.7 30 KENTUCKY 7.5 31 Oklahoma 3.9 31 North Dakota 1.9 31 Arizona 8.5 32 West Virginia 4.6 32 Maryland 2.2 32 Missouri lo • c 33 Maryland 5.7 33 Missouri 2.7 53 Montana 16.7 34 Delaware 6.6 34 West Virginia 4.6 34 Now Mexico 19.2 35 TENNESSEE 7.2 35 TENNESSEE 4.7 35 TENNESSEE 20.7 36 Arizona 8.5 36 FLORIDA 5.1 36 Maryland 20.8 37 Texas 14.3 36 MISSISSIPPI 5.1 37 Oklahoma 33.2 38 KENTUCKY 14.4 38 SOUTH CAROLINA 5.4 38 Delaware 33.7 39 VIRGINIA 18.8 39 ARKANSAS 6.0 39 Texas 43.6 40 NORTH CAROLINA * 20.7 40 NORTH CAROLINA * 6.1 40 NORTH CAROLINA 54.0 41 ARKANSAS 22.0 41 Arizona 6.2 41 VIRGINIA 54.5 42 FLORIDA 22.2 42 GEORGIA 6.8 42 LOUISIANA 54.9 43 LOUISIANA 26.4 42 VIRGINIA 6.8 43 ALABAMA 64.4 44 New Mexico 27.3 44 ALABAMA 7.0 44 FLORIDA 66.7 45 ALABAMA 27.9 45 LOUISIANA 7.7 45 GEORGIA 69.6 46 GEORGIA 30.2 46 Texas 10,2 46 ARKANSAS 74.2 47 SOUTH CAROLINA 39.2 47 KENTUCKY 14.8 47 SOUTH CAROLINA 77.3 48 MISSISSIPPI 46.2 48 New Mexico 26.5 48 MISSISSIPPI 80.2 Source; United States Vital Statistics. PERCENTAGE OF NEGRO LIVE BIRTHS WITH NO MEDICAL ATTENDANT UNITED STATES AND EACH OF THE 29 STATES WITH 500 OR MORE NEGRO LIVE BIRTHS, 1940 United States Mississippi South Carolina Arkansas Georgia Florida Alabama North Carolina Virginia Louisiana Texas Delaware Oklahoma Tennessee Maryland M issouri Kentucky M assachusetts West Virginia New York M ichigan New Jersey California 111inois Connecticut Pen nsylvania Kansas Indiana Ohio District of Columbia U.S. Department of Labor CHILDREN’S BUREAU C horf No. B 40-9 Based on data from U.'S. Bureau of the Census PERCENTAGE OP LITE BIRTHS NOT ATTENDED BY PHYSICIANS, 1942 Total Urban Rural Rank and State Percent Rank and State Peroent Rank and State Percent 36 UNITED STATES 7.4 35 UNITED STATES 2.6 37 UNITED STATES 14.2 1 Now Hampshire 0.0 1 Iowa 0.0 1 Connecticut 0.0 1 Ohio 0.0 1 Maine 0.0 2 Iowa 0.1 1 Vermont 0.0 1 Nebraska 0.0 2 Massachusetts 0.1 4 Iowa 0.1 1 New Hampshire 0.0 2 Nebraska 0.1 4 Kansas 0.1 1 Ohio 0,0 2 Now Hampshire 0,1 4 Massachusetts 0.1 1 Vermont 0.0 2 Ohio 0.1 4 Nebraska 0.1 1 Washington 0.0 2 Vermont 0.1 4 Pennsylvania 0.1 1 Wisconsin 0.0 8 Illinois 0.2 9 Connecticut 0.2 9 Idaho 0.1 8 Indiana 0.2 9 Illinois 0.2 9 Kansas 0.1 8 Kansas 0.2 9 Indiana 0.2 9 Massachusetts 0.1 8 Pennsylvania 0.2 S Washington 0.2 9 Michigan 0.1 8 Wisconsin 0.2 9 Wisconsin 0.2 9 North Dakota 0.1 13 Idaho 0.3 14 Idaho 0,3 9 South Dakota 0.1 13 New York 0.3 14 Michigan 0.3 15 Connecticut 0.2 15 Rhode Island 0,4 11 Oregon 0.3 15 Illinois 0.2 15 Washington 0.4 17 Rhode Island 0.4 15 Indiana 0.2 15 Wyoming 0.4 17 Wyoming 0.4 15 Minnesota 0,2 18 Oregon 0,5 19 California 0.6 15 Montana 0.2 19 California 0.6 19 Minnesota 0.6 15 Nevada 0.2 19 Michigan 0.6 19 New York 0.6 15 Oregon 0.2 21 New Jersey 0.7 19 Utah 0.6 15 Pennsylvania 0.2 22 Minnesota 1.0 23 Maine 0.7 15 Utah 0.2 23 Maine 1.1 24 Montana 1.2 15 Wyoming 0.2 24 Utah 1,2 24 Nevada 1,2 25 Rhode Island 0.4 25 Nevada 2.0 26 New Jersey 1.4 25 West Virginia 0.4 26 Montana 2.2 27 South Dakota 1.6 27 California 0.5 27 South Dakota 2.3 28 Colorado 1.7 28 Now York 0,7 28 North Dakota 2.8 29 North Dakota 2.1 29 Colorado 0.8 29 Colorado 3.1 30 Missouri 3.4 30 KENTUCKY 1.0 30 Oklahoma 5,4 31 Oklahoma 3.9 31 Missouri 1,2 31 Missouri 6.1 32 West Virginia 4.5 32 New Jersey 1.6 31 West Virginia 6.1 33 Maryland 5.7 33 TENNESSEE 1.9 33 Maryland 9.3 34 Do1aware 6.6 34 Oklahoma 2.1 34 Delaware 10.3 35 TENNESSEE 7.2 35 Maryland 3.0 35 TENNESSEE 10.4 36 Arizona 8.5 36 Delaware 3.5 36 Arizona 11.1 37 Texas 14.3 37 Arizona 6.2 37 Texas 19.7 38 KENTUCKY 14.4 38 VIRGINIA 8.6 3 8 KENTUCKY 20.9 39 VIRGINIA 18.8 39 ARKANSAS 9.5 39 NORTH CAROLINA * 24.7 40 NORTH CAROLINA * 20.7 40 NORTH CAROLINA * 10,0 40 VIRGINIA 24.8 41 ARKANSAS 22.0 41 Texas 10.3 ' 41 ARKANSAS 26.9 42 FLORIDA 22.2 42 LOUISIANA 11.3 42 FLORIDA 28.9 43 LOUISIANA 26.4 43 GEORGIA 14.3 43 ALABAMA 35.0 44 New Mexico 27.3 44 ALABAMA 14.6 44 New Mexico 35.5 45 ALABAMA 27.9 45 New Mexico 14.7 45 LOUISIANA 38.5 46 GEORGIA 30.2 46 SOUTH CAROLINA 16.8 46 GEORGIA 40.9 47 SOUTH CAROLINA 39.2 47 FLORIDA 17.0 47 SOUTH CAROLINA 48.9 48 MISSISSIPPI 46.2 48 MISSISSIPPI 25.3 48 MISSISSIPPI 51.2 Source: United States Vital Statistics, PERCENTAGE OF RURAL LIVE BIRTHS NOT ATTENDED BY PHYSICIANS, 1942 Percentage of live births UNITED STATES MISSISSIPPI SOUTH CAROLINA GEORGIA LOUISIANA NEW MEXICO ALABAMA FLORIDA ARKANSAS VIRGINIA NORTH CAROLINA KENTUCKY TEXAS ARIZONA TENNESSEE DELAWARE MARYLAND WEST VIRGINIA MISSOURI OKLAHOMA NORTH DAKOTA SOUTH DAKOTA MONTANA NEVADA UTAH MAINE MINNESOTA ALL OTHERS Based on data from the U. S, Bureau of the Census North Carolina Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY Page 24 MATERNAL DEATHS PER 1,000 LIVE BIRTHS, 1940 Total , Rural Nonwhite Rank and State Rate Rank and State Rate Rank and State Rate 29 UNITED STATES CO • to 29 UNITED STATES 4.0 33 UNITED STATES 7.7 1 North Dakota 1.8 1 North Dakota 1.5 1 Idaho 0 2 Minnesota 2.2 2 Oregon 1.6 1 Maine 0 3 Rhode Island 2.5 5 New Hampshire 2.1 1 New Hampshire 0 4 Oregon 2.6 4 Washington 2.2 1 Rhode Island 0 5 California 2.8 5 Connecticut 2.3 1 Vermont 0 5 Connecticut 2.8 5 Iowa 2.3 1 Wyoming 0 5 Maryland 2.8 5 Michigan 2.3 7 Wisconsin 1.5 5 Massachusetts 2.8 8 Massachusetts 2.4 8 Minnesota 2.9 5 Utah 2.8 8 Nebraska 2.4 9 Connecticut 3.1 10 Indiana 2.9 10 Indiana 2.5 10 Oregon 3.4 10 Michigan 2.9 10 Montana 2.6 11 Idaho 4.2 10 New York 2.9 12 Minnesota 2.6 12 Ohio 4.4 10 Washington 2.9 13 California 2.7 13 Maryland 4.6 10 VTi scons in 2.9 14 New York 2.9 13 Michigan 4.6 15 Illinois 3.0 14 Utah 2.9 15 Kansas 4.7 15 New Jersey 3.0 16 Illinois 3.0 16 Massachusetts 4.9 17 New Hampshire 3.1 16 Ohio 3.0 17 California 5.0 17 Ohio 3.1 16 Pennsylvania 3.0 17 West Virginia 5.0 19 Nebraska 3.2 16 South Dakota 3.0 19 North Dakota 5.1 19 Pennsylvania 3.2 20 Maryland 3.1 20 Nevada 5.6 21 Montana 3.3 20 New Jersey 3.1 21 Missouri 5.8 21 South Dakota 3.3 20 Wisconsin 3.1 22 New Jersey 5.9 23 Iowa 3.4 23 Wyoming 3.2 23 Pennsylvania 6.0 24 Idaho 3.5 24 Kansas 3.3 24 Illinois 6.4 24 West Virginia 3.5 25 Idaho 3.4 24 Indiana 6.4 26 Kansas 3.7 26 KENTUCKY 3.6 26 Washington 6.7 26 KENTUCKY 3.7 27 West Virginia 3.8 27 Washington 6.9 26 Vermont 3.7 28 Vermont 3.9 28 KENTUCKY 7.2 29 Missouri 3.8 29 Missouri 4.0 29 New York 7.5 30 Wyoming 4.0 29 Oklahoma 4.0 29 VIRGINIA 7.5 31 Colorado 4.1 31 Maine 4.1 31 MISSISSIPPI 7.6 31 Maine 4.1 31 Rhode Island 4.1 31 NORTH CARO UNA * 7.6 31 Oklahoma 4.1 33 Colorado 4.4 33 Oklahoma 7.7 34 VIRGINIA 4.5 33 New Mexico 4.4 34 LOUISIANA 7.8 35 TENNESSEE 4.6 33 VIRGINIA 4.4 34 TENNESSEE 7*8 35 Texas 4.6 36 TENNESSEE 4.5 36 GEORGIA 8.1 37 Nevada 4.7 36 Texas 4.5 37 South Dakota 8.2 38 New Mexico 4.9 38 ARKANSAS 4.9 38 ARKANSAS 8.6 39 Arizona 5.0 38 NORTH CARO UNA * 4.9 39 Montana 8.9 39 ARKANSAS 5.0 40 Arizona 5.2 40 SOUTH CAROLINA 9.2 41 NORTH CAROLINA * 5.1 41 LOUISIANA 5.4 41 ALABAMA 9.6 42 LOUISIANA 5.3 42 Delaware 5.8 42 FLORIDA 10.2 43 Delaware 5.5 42 GEORGIA 5.8 43 Texas 10.3 44 GEORGIA 5.7 44 ALABAMA 6.0 44 New Mexico 10.9 45 ALABAMA. • 6.1 44 MISSISSIPPI 6.0 45 Arizona 11.3 46 MISSISSIPPI 6.2 46 FLORIDA 6.2 46 Delaware 12.0 47 FLORIDA 6.5 47 SOUTH CAROLINA 6.6 47 Colorado 13.7 48 SOUTH CAROLINA 6.9 48 Nevada 7.2 48 Nebraska 15.2 Source: United States Vital Statistics. Based on data from U. S. Bureau of the Census MATERNAL MORTALITY RATE IN EACH STATE UNITED STATES. 1940 Maternal deaths per 10,000 live births U. S, Deportment of Labor CHILDREN’S BUREAU Chart No. MM40-I Less than 30 30 - 39 40 - 49 50 or more INFANT DEATHS PLUS STILLBIRTHS PER 1,000 LIVE BIRTHS PLUS STILLBIRTHS, 1940* Rank and State Ratio No. infant deaths and stillbirths Total White Nonwhite 30 UNITED STATES 76 69 123 184,786 1 Washington 51 49 116 1,462 2 Connecticut 53 52 82 1,376 2 Oregon 53 52 120 9 62 4 Minnesota 54 53 90 2,897 5 South Dakota 56 52 120 684 6 California 58 57 77 6,600 6 Iowa 58 57 163 2,658 6 Nebraska 58 57 142 1,304 6 Utah 58 58 102 792 6 Wisconsin 58 57 114 3,253 11 Illinois 59 58 81 7,550 12 Newr Jersey 60 56 98 3,651 13 Kansas 61 60 105 1,816 14 Idaho 63 61 263 758 14 Massachusetts 63 62 97 4,231 14 Wyoming 63 59 205** 333 17 Indiana 64 62 102 4,018 17 Montana 64 59 141 753 17 Rhode Island 64 63 118 716 20 Michigan 65 64 92 6,607 20 New Hampshire 65 65 143 552 22 North Dakota 66 56 98 3,651 22 Ohio 66 64 93 7,720 24 Vermont 68 68 ** 482 25 Nevada 69 66 98 148 26 Delaware 70 61 137 327 27 Pennsylvania 71 69 104 12,142 28 ARKANSAS 72 64 97 2,844 29 Oklahoma 73 69 112 3,3 62 30 Missouri 77 73 137 4,901 31 Maine 80 80 22** 1,254 32 TENNESSEE 81 74 117 4,580 33 Colorado 82 82 102 1,777 33 KENTUCKY 82 80 132 5,423 35 New York 85 82 135 17,525 36 Maryland 86 72 136 2,910 36 West Virginia 86 84 128 3,760 38 NORTH CAROLINA * * * 89 74 120 7,404 39 VIRGINIA 91 76 129 5,368 40 FLORIDA 92 71 141 3,246 41 ALABAMA 97 79 127 6,381 41 Texas 97 90 139 12,661 43 MISSISSIPPI 98 71 118 5,403 44 LOUISIANA 99 72 135 5,205 45 GEORGIA 101 77 133 6,840 46 Arizona 108 98 173 1,275 47 SOUTH CAROLINA 110 78 142 5,133 48 New Mexico 125 122 220 1,905 * Births and deaths by place of residence. ** Less than 1,000 women 15-44 yrs. old. Source: United States Vital Statistics. Based on data from the U-S.Bureau of the Census INFANT DEATHS AND STILLBIRTHS PER 1,000 BIRTHS,1940 Un i ted States RATIO 90 and up 80-89 70-79 60-69 50-59 N.C.Agricu11ura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY ADJUSTED MORTALITY RATES, PER 1,000 POPULATION, 1940 * Excluding age groups under one and 75-up. Rank and State Rato Total White Nonwhite Rural White 29 UNITED STATES 7.56 7.02 13.14 6.18 1 Nebraska 5*65 5.57 10.86 4.92 2 I owa 5*68 5.65 11.12 4.61 3 North Dakota 5,72 5.62 12.18 5.15 4 South Dakota 5.75 5.49 12.28 4.93 5 Minnesota 5.78 5.74 11.52 5.21 6 Kansas 5.85 5.69 10.72 4.82 7 Wisconsin 6.22 6.14 13.08 5.76 8 Oregon' 6.59 6.54 12.63 4,89 9 Oklahoma 6.60 6.10 11.10 4*95 10 Idaho 6.68 6.66 11.74 5.38 11 Maine 6.78 6*77 5.66 6*3 6 12 Utah 6.83 6.78 10.00 6.43 13 Wyoming 6.84 6.70 15.21 5.74 14 New Hampshire 6.85 6.82 17.57 6,55 15 Colorado 6.94 6.88 11.93 5.93 16 Vermont 6.96 6.98 1.59 6*51 17 Washington 7.01 6.88 13.45 5.80 18 Connecticut 7.02 6,92 11.41 5.80 19 Missouri 7.04 6.56 14.06 5.54 20 Indiana 7.07 6.85 13.31 6.14 2q Michigan 7.07 6.85 12.69 6.53 22 Montana' 7.16 6.97 12,19 6.11 23 Massachusetts 7.19 7.13 11.18 7.00 24 ARKANSAS 7.20 6.21 10.26 5.30 25 Ohio 7.26 6.94 13.82 6.53 26 California 7.34 7.21 10,52 7.24 27 West Virginia 7.40 6.95 14.03 6.28 28 Rhode Island 7.45 7.35 14.40 6.80 29 KENTUCKY 7.55 6.95 14.10 6.13 30 Texas 7.59 6,91 12.00 5.61 31 New Mexico 7.64 7.65 6.83 6.07 32 Illinois 7.75 7.40 14.79 6,56 33 New York 7.79 7.57 12.94 7,42 34 New Jersey 7.88 7.58 13.95 7*94 35 Pennsylvania 7.98 7.67 14.48 7.35 36 Delaware 8.03 7.01 15.35 6.18 37 TENNESSEE 8.04 6.79 13.93 6,21 3 8 NORTH CAROLINA * * 8.12 6.72 12,25 6.40 39 FLORIDA 8.65 6.64 15,00 5*73 40 Maryland 8.72 7*56 15*31 6.89 41 VIRGINIA 8.83 7.00 14.91 6.56 42 Arizona 8.84 8.48 10.89 4.62 43 MISSISSIPPI 9.05 6.61 11.92 6.11 44 ALABAMA 9.08 6.98 13.37 6.40 45 GEORGIA 9.16 6.88 14,06 5.91 46 Nevada 9.27 8.87 16*95 7.88 47 LOUISIANA 9.34 7.64 12.63 6.07 48 SOUTH CAROLINA 10.28 7.49 14*89 6.53 * Adjusted to the age distribution of the total United States population « Adjusted to the age distribution of the total U*S » population, 1940 Baaed on data from the U. S. Census. Death Rate , _ fT 1 RURAL WHITE MORTALITY RATE » Excluding age groups under one and 75-up under 5*50 5.50- 6.00- 6.50- 7.00- N*C. Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY AVERAGE VALUE OF OCCUPIED DWELLING UNITS, UNITED STATES, 1940 Total dwellings Farm dwellings Rank and State Value Rank and State Value id- unit: d states $ 2,503 29 UNTIED STATES | 1,070 1 New York 4,028 1 Connecticut 3,831 2 Now Jersey 3,546 2 New Jersey 3,173 o Connecticut 3,481 3 Rhode Island 3,056 4 Delaware 3,367 4 Massachusetts 3,010 5 Massachusetts 3,329 5 New York 2,351 6 California 3,143 6 New Hampshire 2,131 7 Illinois 3,085 7 Pennsylvania 2,100 8 Rhode Island 3,007 8 Delaware 1,974 9 Pennsylvania 2,906 S Maryland 1,958 10 Ohio 2,902 10 Ohio 1,732 11 Michigan 2,792 11 California 1,646 12 Wisconsin 2,658 12 Vermont 1,592 13 Maryland 2,597 13 Maine 1,559 14 Minnesota 2,411 14 Michigan 1,545 15 New Hampshire 2,338 15 Iowa 1,508 16 Nevada 2,329 16 Wisconsin 1,496 17 Vermont 2,248 17 Nevada 1,450 18 Utah 2,221 18 Washington 1,433 19 Washington 2,197 19 Illinois 1,385 20 Indiana 2,176 20 Utah 1,379 21 FLORIDA 2,104 21 Minnesota 1,374 22 Oregon 2,071 22 Indiana 1,360 23 Maine 2,051 23 Oregon 1,268 24 Colorado 2,047 24 Idaho 1,138 25 VIRGINIA 2,046 25 VIRGINIA 1,124 26 Missouri 2,024 26 Nebraska 1,113 27 Iowa 2,015 27 Colorado 1,087 28 Nebraska 1,804 28 Kansas 1,083 29 West Virginia 1,806 29 North Dakota 1,056 30 Montana 1,741 SO Wyoming 1,016 31 Wyoming 1,734 31 West Virginia 975 32 Arizona 1,682 32 Montana 974 33 Kansas 1,642 33 South Dakota 969 34 Idaho 1,630 34 Missouri ' 887 35 North Dakota 1,-571 35 Arizona 869 36 Texas 1,539 36 FLORIDA 852 37 KENTUCKY 1,460 37 Texas 712 38 South Dakota 1,451 38 NORTH CAROLINA * * 700 39 LOUISIANA 1,373 39 KENTUCKY 691 40 Oklahoma 1,358 40 Oklahoma 644 41 TENNESSEE 1,353 41 TENNESSEE 629 42 FORTH CAROLINA * * 1,346 42 Now Mexico 582 43 New Mexico 1,296 43 GEORGIA 555 44 GEORGIA 1,237 44 SOUTH CAROLINA 540 45 SOUTH CAROLINA 1,132 45 LOUISIANA 517 46 ALABAMA 1,039 46 ARKANSAS 474 47 ARKANSAS 684 i 47 ALABAMA 471 48 MISSISSIPPI 843 48 MISSISSIPPI # 459 Source: United States Census of Housing, 1940. AVERAGE VALUE OF OCCUPIED DWELLING UNITS Un i ted States.1940 TOTAL VALUE $3,000 and over 2.500- 2.000-2,499 1.500- Under 1,500 FARM VALUE $2,UOO and over 1.600-2,399 1,200-1.599 800-1,199 Linder 800 N.C.Agricu11ura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY based on data from u.s.bureau of the census PER CAPITA STATE GOVERNMENT EXPENDITURES, 1940 Total Expenditures Health Expenditures Rank and State Por capita Amount in 1,000 1 s Rank and State Per capita Amount in 1,000fs 25 UNITED STATES 36.80 | 4,844,861 33 UNITED STATES .37 $ 48,987 1 Nevada 71.96 * 7,933 1 Nevada 1.07 118 2 California 56.99 393,681 2 New Mexico .79 419 3 Washington 56.71 98,456 3 Vermont .72 257 4 Wyoming 56.69 14,214 4 LOUISIANA .70 1,655 5 Delaware 53.71 14,315 5 Delaware .69 185 6 Arizona 50.50 25,212 6 Arizona .65 323 7 New Mexico 50.18 26,686 7 Utah .59 324 8 Utah 49.78 27,393 8 New Hampshire .58 286 9 Colorado 49.32 55,400 8 North Dakota .58 375 10 Montana 45.85 25,649 10 FLORIDA .56 1,060 11 New York 44.67 602,115 10 Montana .56 316 12 Pennsylvania 44.24 437,964 12 Maryland .54 988 13 LOUISIANA 43 • 3 o 102,423 13 Idaho .53 276 14 Connecticut 42.70 72,979 13 Wyoming .53 133 15 Michigan 42.51 223,463 15 ALABAMA .52 1,480 16 New Hampshire 41.83 20,560 16 Michigan .49 2,562 17 Ohio 41.46 286,359 17 Rhode Island .47 .335 18 Massachusetts 40.96 176,832 17 VIRGINIA .47 1,248 19 Vermont 40.65 14,603 19 Kansas • 46 837 20 Minnesota 40.54 113,206 19 TENNESSEE .46 1,349 21 Oregon 40,46 44,084 21 Maine .45 378 22 Maine 40.08 33,955 21 Oregon .45 492 23 Idaho 38.94 20,437 23 Colorado .44 498 24 Wisconsin 37.07 116,318 23 SOUTH CAROLINA .44 842 25 Rhode Island 36.50 26,040 23 South Dakota .44 236 26 Indiana 35.62 122,098 26 KENTUCKY .43 1,221 27 FLORIDA 35.22 66,830 26 Massachusetts .43 1,856 28 Oklahoma 35.04 81,877 28 Connecticut .41 708 29 Maryland 34.76 63,305 29 GEORGIA .40 1,254 30 Illinois 34.47 272,194 29 NORTH CAROLIN * .40 1,424 31 Iowa 34.10 86,562 31 ARKANSAS .39 751 32 New Jersey 34.02 141,549 31 California .39 2, 669 33 North Dakota 32.48 20,853 31 MISSISSIPPI .39 861 34 South Dakota 31.71 20,388 31 New York .39 5,304 35 West Virginia 30.99 58,940 55 Minnesota .35 983 36 VIRGINIA 28.23 75,583 36 Oklahoma • 32 751 37 Kansas 27.34 49,235 36 Wisconsin .32 1,019 38 NORTH CAROLINA ♦ 26.96 96,275 38 Illinois . oO 2,336 39 Texas 26.95 172,894 38 Iowa .30 754 40 MISSISSIPPI 26.80 58,534 40 New Jersey .29 1,198 41 Nebraska 26.61 35,010 40 West Virginia .29 551 42 Missouri 25.86 97,856 42 Washington .28 482 43 SOimi CAROLINA 24.92 47,343 43 Pennsylvania .27 2,646 44 GEORGIA 23.15 72,326 44 Indiana • 2 6 904 45 ALABAMA 22.86 64,749 45 Ohio .24 1,644 46 TENNESSEE 21.31 62,136 46 Missouri .25 853 47 KENTUCKY 20,70 58,902' 46 Nebraska .25 309 48 ARKANSAS 20,08 39,145 46 Texas .23 1,487 Sources United States Census: Financial Statistics, 1940, PER CAPITA STATE GOVERNMENT EXPEND ITURES, i940 Health Expenditures £1, Per Cap i ta fa 60 and up 50-59 UO-49 30-39 Under 30 CENTS Total Exnenditunes ySS’ \Jer Capi ta a; DOLLARS Over 50 M2.5-50.0 35.0- 27.5-34.9 20.0- N.C.Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY BASEE ON DATA FROM THE U.S.BUREAU OF THE CENSUS HOSPITAL BEDS PER 1,000 POPULATION, NORTH CAROLINA, 1944 * County Rank Ratio No. beds County Hank Ratio No. beds NORTH CAROLINA 27 2.4 8,475 Alamance 64 .7 42 Johnston 65 .5 35 Alexander No hospital beds Jones No hospital beds Alleghany No hospital beds Lee 22 2,7 50 Anson 50 1.4 40 Lenoir 22 2.7 113 Ashe 59 1.1 26 Lincoln 11 3,8 93 Avery 2 6.4 87 McDowell 39 1,8 42 Beaufort 30 2.3 83 Macon 5 5.4 86 Bertie No hospital beds Madison No hospital beds Bladen No hospital beds Martin 52 1.3 35 Brunswick 17 2.9 50 Mecklenburg 7 4.5 679 Buncombe 10 4,0 436 Mitchell No hospital beds Burke 13 3.5 134 Montgomery No hospital beds Cabarrus 33 2.2 130 Moore 26 2.6 80 Caldwell 42 1.7 60 Nash 8 4.2 235 Camden No hospital beds New Hanover 3 6.3 303 Carteret 22 2.7 49 Northampton No hospital beds Caswell No hospital beds Onslow 22 2.7 48 Catawba 27 2.4 12 6 Orange No hospital beds Chatham 62 .9 22 Pamlico No hospital beds Che ro kee 59 1.1 21 Pasquotank 30 2.3 48 Chowan No hospital beds Pender No hospital beds Clay No hospital beds Perquimans No hospital beds Cleveland 47 1.6 93 Person 61 1.0 25 Columbus 47 1.6 72 Pitt 62 .9 57 Craven 27 2.4 75 Polk 27 2*4 28 Cumberland 14 3,3 195 Randolph 42 1.7 74 Currituck No hospital beds Ric imond 50 1.4 50 Dare No hospital beds Robeson 30 2.3 180 Davidson 52 1.3 72 Roc kingham 36 1.9 112 Davie No hospital beds Rowan 42 1.7 117 Duplin No hospital bods Rutherford 52 1.3 58 Durham 1 10,3 82 5 Sampson 66 .2 9 Edgecombe 52 1.3 62 Scotland 42 1.7 39 Forsyth 3 6.3 798 Stanly 16 3.2 105 Fran Min No hospital beds Stokes No hospital beds Gaston . 47 1.6 140 Surry 17 2.9 122 Gates No hospital beds Swain No hospital beds Graham No hospital beds Transylvania 35 2.0 25 Granville 42 1.7 49 Tyrrell 11 3.8 21 Greene No hospital beds Union 52 1.3 50 Guilford 17 2.9 439 Vance 21 2.8 83 Halifax 39 1.8 100 17a ke 14 3.3 358 Harnett 36 1.9 85 Warren No hospital beds Haywood 33 2,2 75 Washington No hospital bods Henderson 9 4.1 108 Watauga 33 1.9 35 Hortford No hospital beds Wayne 39 1,8 106 Hoke No hospital beds Wilkes 57 1.2 52 Hyde No hospital beds Wilson 17 2.9 148 Irodell 6 5.1 256 Yadkin No hospital beds Jackson 57 1.2 24 Yancey No hospital beds * Based on 1940 population. Source; United States Census and data supplied by the Duke Endovnnont. Based on data from U.S.Bureau of the Census and data supplied by the Duke Endowment. HOSPITAL BEDS PER 1,000 POPULATION North CaroIina,1944 N.C.Agricu11ura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY RATIO Ove r 3.0 2. 1-3.0 1. 1-2.0 0.1- 1.0 No beds HOSPITAL BEDS FOR WHITE PERSONS PER 1,000 WHITE POPULATION, NORTH CAROLINA,1943 * County Rank Ratio Number beds County Rank Ratio Number beds NORTH CAROLINA 29 2.6 6,810 Alamance 64 .8 37 Johnston 65 .6 30 Alexander No hospital bods Jones No hospital bods Alleghany No hospital beds Lee 21 3.1 41 Anson 47 1.7 24 Lenoir 14 3.9 91 Ashe • 61 1.1 25 Lincoln 12 4.0 84 Avery 3 6.4 85 McDowell 47 1.7 37 Beaufort 26 2.8 65 Macon 7 5.4 84 Bertie No hospital bods Madison No hospital bods Bladen No hospital bods Martin 29 2.6 35 Brunswick 20 3.2 36 Mecklenburg 5 5.5 594 Buncombe 10 4.2 386 Mitchell No hospital bods Burke 16 3.4 122 Montgomery No hospital bods Cabarrus 38 2.1 106 Moore 25 2.9 62 Caldwell 49 1.6 53 Nash 7 5.4 175 Camden No hospital bods Now Hanover 2 6.7 208 Carteret 26 2.8 43 Northampton No hospital beds Caswell No hospital bo dc Onslow 23 3.0 39 Catawba 29 2.6 119 Orange No hospital bods Chatham 62 1.0 17 Pamlico No hospital beds Cherokee 62 1.0 18 Pasquotank 32 2.5 30 Chowan No hospital beds Ponder No hospital bods Clay No hospital bods Perquimans No hospital bods Cleveland 49 1.6 71 Person 49 1.6 25 Columbus 44 1.9 59 Pitt 55 1.3 42 C raven 38 2.1 36 Polk 33 2.3 24 Cumberland 12 4.0 156 Randolph 49 1.6 66 Currituck No hospital bods Richmond 49 1.6 40 Dare No hospital beds Robeson 29 2.6 131 Davidson 55 1.3 64 Rockingham 33 2.1 96 Davie No hospital beds Rowan 45 1.8 99 Duplin No hospital bods Rutherford 58 1.2 47 Durham 1 13.0 674 Sampson 66 • 3 9 Edgecombe 42 2.0 46 Scotland 35 2.2 26 Fc rsyth 4 6.2 526 Stanly 18 3.3 96 Franklin No hospital bods Stokes No hospital bods Gaston 49 1.6 118 Surry 26 2.3 110 Gates No hospital beds Swa in No hospital bods Graham No hospital beds T ransylvania 45 1.8 21 Granville 33 2.3 33 Tyrrell 9 4.8 17 Greene No hospital beds Union 55 1,3 40 Guilford 23 3.0 363 Vance 18 3.3 53 Halifax 21 3.1 77 Wake 16 3.4 248 Harnett 35 2.2 70 Warren No hospital bods Haywood 38 2.1 70 Washington No hospital beds Henderson 10 4.2 100 Watauga 42 2.0 35 Hertford No hospital beds Wayno 35 2.2 73 Hoke No hospital beds Wilkes 58 1.2 47 Hyde No hospital bods Wilson 15 3.7 107 Iredell 5 5.5 226 Yadkin No hospital bods Jackson 58 1.2 23 Yancey No hespit xl bods Source: Duke Endowment Hospital Statistics. * Based on 1940 population. Based on data from Duke Endowment Hospital Statistics HOSPITAL BEDS FOR WHITE PERSONS PER 1,000 WHITE POPULATION North Carol Ina, 1943 N.C.Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY RATIO Over 3.0 2.1-3.0 1. 1-2.0 0.1-1.0 No beds HOSPITAL BEDS FOR NEGROES PER 1,000 NEGRO POPULATION, NORTH CAROLINA, 1943 * County j Rank Ratio lKumber j bods County [ Rank (Ratio Number ' bods NORTH CAROLINA Alamance 40 60 1*7 • 5 1,665 5 Johnston 62 .4 5 Alexander No hospital bods Jones No hospital bods Alleghany No hospital beds Loo 40 1.7 9 Anson 51 1.1 16 Lenoir 50 1.2 22 Ashe 27 2.1 1 Lincoln 16 2.7 9 Avery 2 7.7 2 McDowell 16 2.7 5 Beaufort 46 1.3 18 Macon 9 4.3 2 Bertie No hospital beds Madison No hospital beds Bladen No hospital beds Martin No hospital beds Brunswick 21 2.4 14 Mecklenburg 29 2.0 85 Buncombe 12 3.1 50 Mitchell No hospital beds Burke 10 3.8 12 Montgomery No hospital beds Cabarrus 19 2,5 24 Moore 31 1.9 18 Caldwell 19 2.5 7 Nash 13 2.6 60 Camden No hospital beds New Hanover 4 5.6 95 Carteret 25 2.2 6 Northampton No hospital beds Caswell No hospital beds Onslow 51 1.9 Q w Catawba 43 1.4 7 Orange No hospital beds Chatham 58 .6 5 Pamlico No hospital beds Cherokee 1 16.5 3 Pasquotank 27 2.1 18 Chowan No hospital beds Pender No hospital beds Clay No hospital beds Perquimans No hospital beds Cleveland 40 1.7 22 Person No hospital beds Columbus .55 .9 13 Pitt 60 .5 15 Graven 15 2.8 39 Folk 21 2.4 4 Cumberland 31 1.9 39 Randolph 36 1.8 8 Currituck No hospital beds Richmond 56 .8 10 Dare No hospital beds Robeson 31 1.9 49 Davidson 43 1.4 8 Rockingham 46 1.3 16 Davie No hospital beds Rowan 43 1.4 18 Duplin No hospital beds Rutherford 36 1.8 11 Durham •6 5.3 151 Sampson No hospital beds Edgecombe 58 .6 16 Scotland 51 1.1 13 Forsyth 3 6.6 272 Stanly 24 2.3 9 Franklin No hospital beds Stokes No hospital beds Gaston 40 1.7 22 Surry 8 4.7 12 Gatos No hospital beds Swain No hospital beds G raham No hospital beds T ransylvania 7 4.8 4 Granville 51 1.1 16 Tyrrell 29 2,0 4 Greene No hospital bods Union 51 1.1 10 Guilford 21 2.4 76 Vance 25 2.2 30 Halifax 57 .7 23 Wake 14 3,0 110 Harnett 46 1.3 15 Warren No hospital beds Haywood 4 5.6 5 Washington No hospital beds Henderson 10 3.8 8 Watauga No hospital beds Hertford No hospital beds Wayne 46 1.3 33 Ho ke No hospital bods Wilkes 36 1.8 5 Hyde No hospital beds Wilson 31 1.9 41 Iredell 12 3.1 30 Yadkin No hospital beds Jackson 36 1.8 1 Yancey No hospital beds Source: Duke Endowment Hospital Statistics. * Based on 1940 population. Based on data from Duke Endowment Hospital Statistics HOSPITAL BEDS FOR NEGROES PER 1,000 NEGRO POPULATION North Carolina, 1943 N.C.Agricu1tura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY RATIO Over 3.0 2. 1-3.0 1. 1 - 2.0 0. 1- 1.0 No beds AREAS more than 15 MILES FROM ANY HOSPITAL WITH 40 BEDS OR OVER 4-0-69 BEDS 70-99 BEDS 100-199 BEDS 200 -OVER NORTH CAROLINA HOSPITAL AREAS PHYSICIANS PER 100,000 POPULATION, NORTH CAROLINA, 1940 County 1940 Number County 1940 Number Rank Ratio 1940 1944 Rank Ratio 1940 1944 NORTH CAROLINA 28 64 2 ,298 1,688 Alamance 25 66 38 30 Johnston 68 46 29 19 Alexander 63 37 5 4 Jones 83 37 4 3 Alleghany 17 72 6 4 Lee 28 64 12 10 Anson 80 39 11 11 Lenoir 10 78 32 20 Ashe 77 40 9 5 Lincoln 56 50 12 13 Avery 71 44 6 6 MeDowell 31 61 14 11 Beaufort 30 63 23 13 Macon 71 44 7 5 Bertie 74 42 11 8 Madison 96 27 6 6 Bladen 97 26 7 6 Martin 74 42 11 5 Brunswick 94 29 5 2 Mecklenburg 4 102 155 120 Buncombe 1 128 139 80 Mitchell 56 50 8 4 Burke 34 60 23 16 Montgomery 83 37 6 5 Cabarrus 19 69 41 33 Moore 13 74 23 22 Caldwell 62 48 17 12 Nash 31 61 34 26 Camden 45 55 n O 3 New Hanover 7 94 45 40 Carteret 11 77 14 9 Northampton 74 42 12 11 Caswell 99 20 4 3 Onslow 69 45 8 6 Catawba 38 58 30 17 Orange 31 61 14 11 Chatham 86 36 9 7 Pamlico 50 52 5 2 Cherokee 19 69 13 6 Pasquotank 16 73 15 15 Chowan 50 52 6 5 Pender 95 28 5 5 Clay 91 31 2 2 Perquimans 55 51 5 3 Cleveland 41 57 33 17 Person 86 36 9 10 Columbus 56 50 23 18 Pitt 28 64 39 21 Craven 18 70 22 19 Polk 26 67 8 '4 Cumberland 60 49 29 17 Randolph 50 52 23 13 Currituck 92 30 2 3 Richmond 49 54 20 18 Dare 9 83 5 1 Robeson 37 59 45 31 Davidson 38 58 31 21 Rockingham 45 55 32 21 Davie 77 40 6 4 Rowan 38 58 40 31 Duplin 69 45 18 10 Rutherford 62 48 22 15 Durham 2 115 92 73 Sampson 82 38 18 15 Edgecombe 19 69 34 24 Scotland 66 47 11 8 Forsyth 8 85 107 90 Stanly 26 67 22 13 Franklin 44 56 17 10 Stokes 71 44 10 4 Gaston 45 55 48 47 Surry 19 69 29 23 Gates 92 30 3 3 Swain 13 74 9 3 G raham 66 47 3 1 Transylvani. 41 57 7 4 Granville 50 52 15 8 Tyrrell 100 18 1 1 Greene 82 38 7 6 Union 60 49 19 14 Guilford 6 96 148 109 Vance 56 50 15 8 Halifax 62 48 27 25 Make 5 97 106 83 Harnett 50 52 23 15 Warren 80 39 9 7 Haywood 19 69 24 15 Washington 41 57 7 5 Henderson 3 104 27 17 'Watauga 45 55 10 4 Hertford 80 36 7 7 Wayne 19 69 40 37 Hoke 13 74 11 11 Wilkes 90 33 14 10 Hyde 12 76 6 4 Wilson 54 60 30 28 Iredell 34 60 50 22 Yadkin 62 48 10 5 Jackson 86 36 7 7 Yancey 98 23 4 4 Source; American Medical Association Directory and Dr. Hubert Haywood, Raleigh, N* C Based on data from the American Medical Association Directory PHYSICIANS PER 100,000 POPULATION North Caroli na,I 940 N.C.Agricu11ura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY RATIO 7 5 and ovei 65-74 5 5-64 45-54 Under 45 TOTAL NEGRO PHYSICIANS PER 100,000 NEGRO POPULATION, NORTH CAROLINA, 1944* County Rank Ratio dumber' Phys ic ians County Rank Ratio Number Phys io ians NORTH CAROLINA 28 Alamanco 19 14.7 18.9 144 2 Johnston 41 7.4 1 Alexander - - - - Jones - - - - Alleghany - - - - Lee - - - - Anson 42 7.2 1 Lenoir 23 16.8 3 Ashe - - . - Lincoln - - - - Avery - - - - McDowell - - - - Beaufort 28 14.5 2 Macon - - - - Bertie 44 6.7 1 Madison - - - - Bladen - - - - Mart in - - - - Brunswick - - - - Mecklenburg 14 23.1 10 Buncombe 3 37.2 6 Mitchell - - - - Burke - - - - Montgomery - - - - Cabarrus 9 30,7 3 Moore 34 10.7 1 Caldwell 2 37.3 1 Nash 22 17.1 4 Camden - - - - Now Hanover 6 35.2 6 Carteret - - - - Northampton 48 5.7 1 Caswell - - - - Onslow - - - - Catawba - - - ~ 0 rang o - - - ~ Chatham - - - - Pamlico - - - - Cherokee - - - - Pasquotank 7 34.2 3 Chowan 20 18,4 1 Pender — - - - Clay - - - - Perquimans 18 21.2 1 Cleveland - - - - Person 33 11,0 1 Columbus 30 14.0 2 Pitt 43 6.9 2 Craven 10 28.5 4 Polk - - - - Cumbe rland 11 24.7 5 Randolph - - - - Currituck - - - - Richmond 25 16.4 2 Dare - - - - Robeson 38 7.8 2 Davidson 8 33,9 2 Rockingham 24 16.6 2 Davie - - - - Rowan 27 15.4 2 Duplin - - _ - Rutherford - - - Durham 12 24.5 7 Sampson 47 6,1 1 Edgecombe 40 7.5 2 Scotland 36 8.6 1 Forsyth 4 36.5 15 Stanly - - - - Franklin 39 7.7 1 Stokes - - _ - Gaston 13 23.8 3 Surry - - - * Gates - - - - Swain • - - « G rah am - . - - - Transylvania - - - - Granville 31 13.4 2 Tyrrell - - - - Greene - - - - Union 15 21.8 2 Guilford 1 40,4 13 Vance 17 21.5 3 Halifax 46 6,2 2 Wake 16 21.7 8 Harnett 37 8.4 1 Warren 45 6.6 1 Haywood •r - - - Washington 21 18.3 1 Henderson - - - - Watauga - - - - Hertford - - - - Wayne 26 15.8 4 Hoke 32 11,6 1 Wilkes 5 35.4 1 Hyde - - - - Wilson 29 14.2 3 Iredell 35 10.4 1 Yadkin - ~ - - Jackson - - - - Yancey - - - - Source; Clyde Donnell, M. D., Secretary-Treasurer, Old North State Medical, Dental and Pharmaceutical Society, Inc. , Durham, North Carolina, Includes 15 physicians not in active practice. PYHSICIANS PER 100,000 POPULATION North Carolina, 1940 WHITE NEGRO • COUNTIES HAVING LESS THAN 1,000 NEGRO POPULATION N.C.Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY BASED ON DATA FROM THE AMERICAN MEDICAL ASSOCIATION DIRECTORY LIVE BIRTHS PER 1,000 FEMALES 15-44 TEARS OP AGE BY RESIDENCE, NORTH CAROLINA, 1940♦ (Exclusive of stillbirths) County Rank "1 Totalj (White I Non- white County f Rank Totalj Whitei Non- white NORTH CAROLINA 54 90.0 85,4 101,6 Alamance 17 81.6 76.7 104.5 Johnston 53 101.5 100.2 106.3 Alexander 79 111.1 106.0 174.1 Jones 63 103.7 100.3 108.1 Alleghany 30 88.2 91.0 15.2 Lee 58 102.7 100.0 109.2 Anson 76 110,7 100.6 121.0 Lenoir 26 86.1 76.2 99.1 Ashe 56 102.3 102.0 120.5 Lincoln 28 87.3 85.5 98.6 A ve ry 100 138.2 138.2 133.3 McDowell 50 99.3 100.2 88.5 Beaufort 45 95.0 86.2 109.3 Macon 77 111.0 113.6 28.8 Bertie 98 129.2 90.3 161.8 Madison 61 103,2 102.7 145.3 la den 96 126.1 115.4 141.2 Martin 72 108,8 90.4 129.0 Brunswick 88 117.3 10X.4 146.7 Mecklenburg 7 68.9 69.1 68.6 Buncombe 9 71.4 76,6 46.4 Mitchell 90 118.6 118.4 150.0 Burke 20 84.3 85.4 71.4 Montgomery 26 86.4 79.2 110.3 Cabarrus 11 74.3 75.2 70.2 Moore 19 83.6 81.8 87.8 Caldwell 89 118.2 121.2 32,3 Nash 69 107,4 90.4 131.6 Camden 18 82.8 64,5 111.3 New Hanover 13 76.9 73.1 83.4 Carteret 34 90.5 90.6 89.8 Northampton 71 108.6 64.2 138.0 Caswell 81 113.2 90,6 140.5 Onslow 92 121.0 106.6 162.3 Catawba 38 91,6 92,4 84.9 Orange 24 85,6 70,6 118.7 Chatham 26 86.4 69.7 123.0 Pamlico 84 115.2 98.9 147.7 Cherokee 87 116.6 114.6 280.0 Pasquotank 5 66.7 54.1 84.6 Chowan 54 102,1 90.1 116.7 Pender 85 116,0 93,6 135.6 Clay 64 104.4 105,5 41.7 Perquimans 31 88.5 72.6 106.8 Cleveland 33 89.0 65.2 102.7 Person 61 103.2 92.2 123.1 Columbus 94 123.2 116.0 137.6 Pitt 47 95.6 83,5 108.6 Craven 29 87.4 81.1 95,3 Polk 44 94.5 90,8 117.3 Cumberland 32 88.6 91.2 84.1 Ran do Iph 23 85.3 8o . 3 104.4 Currituck 1 58.7 58.0 60.1 Richmond 43 94.3 95.4 32.2 Dare 8 70.7 72,0 56,9 Robeson 93 122.0 100.4 139.8 Davidson 22 84.7 84.9 85,7 Rockingham 12 75. S 75.3 76.4 Davie 45 95.0 86.8 148 • 3 Rowan 6 68,3 67.7 70.7 Duplin 66 105.7 102,6 111.3 Rut he rf o rd 40 92.5 90.2 106.3 Du rliam 2 65.2 61.0 72.2 Sampson 74 109.4 105.7 116.0 Edgecombe 47 95.6 77.0 111.8 Scotland 37 91.4 86.4 95.8 For syth 4 66.9 69.4 62.4 Stanly 14 77.5 80.6 56.9 Franklin 35 91.3 70.8 120.8 Stokes 68 106.2 105,1 117.2 Gaston 15 78.6 81.4 62,8 Surry 52 101.4 102,0 91.4 Gatos • 77 111,0 72.1 156,8 Swa in 99 130.4 114.4 237,4 G- rah am 91 118.8 119.8 88.9 Transylvania 67 106d 111.2 37.0 Granville 51 99.4 80.9 118,4 Tyrrell 55 102.2 84.5 134.4 Greene 85 116.0 104.6 131.0 Union 73 106.9 101.3 133,1 Guilford 5 67.1 69.4 59.0 Vance 41 93.3 76.4 113.5 Halifax 79 111.1 76.7 141.6 Wake 10 73.6 66,1 90.6 Harnett 65 104.6 99,2 118.5 Warren 94 123.2 78.4 149.3 Ha y wo o d 49 99.0 100,0 66.7 Washington 75 110.4 84.8 145.9 Henderson 42 93,5 94.7 81.1 Watauga 60 103.0 103.9 50.0 Hertford 56 102,3 71.8 125,1 Wayne 21 84.6 83.0 86.5 Ho ke 59 102.8 75.3 120,8 W i 1 ke s 83 115,0 115.4 110.1 Hyde 70 107.8 84.5 145.7 Wilson 39 92.4 80.2 109.2 I re a 11 16 78.3 75.9 38.4 Yadkin 35 91,3 92.4 70.2 Jackson 82 113.9 119.2 47,9 Yancey 97 128.6 129.5 58.8 Source: United States Vital Statistics, 1940. LIVE BIRTHS PER 1.000 FEMALES 15-44 YEARS OF AGE BY RESIDENCE North Carolina, 1940 total WHITE birth rate 120.0 and up HO.0-119.9 ‘ 100.0- 90.0- 99.9 80.0- 89.9 Under 80.0 N.C.Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY BASED ON DATA FROM U.S.BUREAU OF THE CENSUS NUMBER AMD PERCENT OF LIVE BIRTHS OCCURRING IN HOSPITALS, NORTH CAROLINA, 1940. County Rank Percent Number County Rank Percent Number NORTH CAROLINA 25 24.2 15,434 Alamance 10 36.7 461 Jo 1ms ton 68 7.9 123 Alexander 77 5.9 20 Jones 58 11.1 29 Alleghany 93 3.2 5 Lee 34 20.8 97 Anson 62 10.1 75 Leno ir 24 26.0 249 Ashe 85 4.5 23 Lincoln 18 29.1 144 Avery 17 30.4 123 McDowell 13 33.9 184 Beaufort 28 23.2 196 Macon 68 7.9 30 Bertie 48 14.6 113 Madison 85 4.5 23 Bladen 79 5.1 39 Martin 75 6.3 41 Brunswick 41 18.0 81 Mecklenburg 3 62.0 1,887 Buncombe 8 40.4 837 Mitchell 89 4.2 18 Burke 5 47.6 398 Montgomery 75 6.3 20 Columbus 6 44.3 527 Moore 27 24.0 149 Caldwell 25 24.3 242 Nash 31 21.7 318 Camden 67 8.1 8 New Hanover 1 89.5 904 Carteret 12 35.3 138 Northampton 70 7.2 50 Caswell 71 6.7 34 Onslow 83 4.6 22 Catawba 11 35.9 437 Orange 21 27.7 132 Chatham 61 10.4 50 Pamlico 97 2.5 6 Cherokee 49 14.4 71 Pasquotank 47 14.9 51 Chowan 99 2.2 6 Pender 60 10.6 47 Clay 96 2.8 4 Perquimans 90 4.1 8 Cleveland 20 28.4 3 64 Person 50 14.3 88 Columbus 33 20.9 269 Pitt 64 9.6 141 Craven 51 14.1 94 Polk 30 22.1 58 Cumbe rland 29 23.1 289 Randolph 25 24.3 230 Currituck 56 11.5 10 Richmond 59 10.9 95 Dare 52 13.0 13 Robeson 46 16.1 358 Davidson 42 17.6 201 Rockingham 35 19.7 221 Davie 42 17.6 56 Rowan 19 28.4 346 Duplin .. 73 6.5 64 Rutherford 38 4.4 45 Durham 2 65.4 1,020 Sampson 80 5.0 60 Edgecombe 44 17.1 203 Scotland 65 8.7 45 Forsyth 4 60.0 1,470 Stanly 16 32.6 213 Franklin 78 5.3 35 Stokes 82 4.9 27 Gaston 37 19.3 349 Surry 53 12.6 129 Gates 85 4.5 11 Swain 39 19.0 68 Graham 100 1.2 2 Transylvania 38 19.2 56 Granville 71 6.7 46 Tyrrell 63 9.9 13 Greene 80 5.0 25 Union 66 8.5 84 Guilford 7 43.0 1,253 Vance 40 18.6 130 Halifax 36 19.5 291 Wake 9 38.0 838 Harnet b 54 12.4 137 Warren 93 3.2 20 Haywood 15 33.0 270 Washington 91 3.6 11 Henderson 23 26.1 152 Watauga 22 26.9 110 He rtford 95 3.0 14 Wayne 56 11.5 144 Hoke 97 2.5 9 Wilkes 55 12.3 137 Hyde 73 6.5 12 Wilson 32 21.2 252 I redell 14 3o. o 325 Yadkin 45 16.8 72 Jackson 92 3.5 17 Yancey 83 4.6 22 Source: United States Vital Statistics, 1940. Based on data from U.S.Bureau of the Census" PERCENTAGE OF LIVE BIRTHS OCCURRING IN HOSPITALS .NORTH CAROLINA, 1940 N.C.Agricu11ura I Experiment Station DEPARTMENT OF RURAL SOCIOLOGY PERCENTAGE fT-T-V't 30 and up 20-29 10-19 5- 9 0- 4 PERCENTAGE OF LIVE BIRTHS NOT ATTENDED BY PHYSICIANS, NORTH CAROLINA, 1940. County Rank Percent Number County Rank Percent Number NORTH CAROLINA 43 24,9 20,063 Alamanco 5 3*3 42 Johnston 42 22,9 355 Alexander 23 11,3 38 Jones 70 40,6 106 Alleghany 10 4,5 7 Lee 40 22,5 105 Anson 89 55.5 414 Lenoir 74 42,1 403 Ashe 75 42.5 215 Lincoln 23 11.3 56 Avery 69 40,5 164 McDowell 9 4.4 24 Beaufo rt 67 39.9 337 Macon 52 29,6 112 Bertie 98 64.6 501 Madison 83 45.2 232 Bladen 87 49,9 385 Martin 84 47.5 311 Brunswick 96 61.2 276 Mecklenburg 3 2,6 78 Buncombe 20 10,5 218 Mitchell 64 36,9 157 Burke 28 13,4 112 Montgonery 50 28.8 92 Cabarrus 27 12,1 144 Moore 52 29.6 184 Caldwell 13 7,1 71 Nash 58 32.8 480 Camden 92 57,6 57 New Hanover 4 3.1 31 Carteret 33 17,4 68 Northampton 99 68.8 476 Caswell 61 36,0 182 0nslow 48 28,3 136 Catawba 26 12,0 146 Orange 32 16,6 79 Chatham 44 25,7 125 Pamlico 76 42,6 103 Cherokee 71 40,7 200 Pasquotank 81 44.2 151 Chowan 80 43.2 120 s Pender 91 56,9 252 Clay 44 25,7 37 Perquimans 85 47,9 93 Cleveland 41 22,8 292 Person 29 13.5 83 Columbus 88 52,5 676 Pitt 73 40,9 601 C raven rjrj 42,8 286 Polk 49 28,5 75 Cumberland 51 29,0 363 RandoIph 17 9.3 88 Currituck 60 35.6 31 Richmond 57 31,1 271 Dare 38 21.0 21 Robeson 68 40.2 893 Davidson 1 1,8 21 Roc kingham 15 8.6 96 Davie 18 10,1 32 Rowan 19 10.3 125 Duplin 56 30.8 303 Rutherford 29 13,5 138 Durham 16 8,9 139 Sampson 77 42,8 517 Edgecombe 82 44,6 520 Scotland 93 58,9 504 Forsyth 2 2,3 57 Stanly 11 4,6 30 Franklin 62 36,5 240 Stokes 14 7.2 40 Gaston 12 6.0 108 Surry 25 11.9 122 Gatos 95 60,4 148 Swain 43 25,4 91 Graham 66 39,4 65 Transylvania 21 11,0 32 Granville 34 17,8 123 Tyrrell 65 38,2 50 Greene 54 29,9 150 Union 35 19.9 197 Guilford 8 4,3 124 Vance 79 43.1 301 Halifax 90 55,8 332 Wako 37 20,8 459 . Harnett 46 27,4 302 Warren 100 74,2 460 Haywood 6 3.4 23 Washington 94 59,0 181 Hondorson 22 11,1 65 Watauga 36 20,3 83 Hertford 72 40,8 189 Wayne 39 22,2 278 Hoke 97 63,4 227 Wilkes 54 29,9 333 Hyde 86 48,6 90 Wilson 59 35,0 416 Iredell 31 16,1 157 Yadkin 7 4.0 17 Jackson 47 28,1 135 Yancey 63 36,7 177 Source; United States Vital Statistics, 1940. Based on data from U.S.Bureau of the Census PERCENTAGE OF LIVE BIRTHS NOT ATTENDED BY PHYSICIANS NORTH CAROLINA,1940 N.C.Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY PERCENTAGE 50 and up 40-49.9 30t 39.9 20-29.9 10-19.9 Under 10 PERCENTAGE OF ILLEGITIMATE LIVE BIRTHS, NORTH CAROLINA, 1940 County Total White Ilonwhite County 1 Total White Nonwhite Rank % of /° * jRank ! % % % NORTH CAROLINA 57 8*1 2.6 19.6 Alamance 32 5.2 1.7 17.0 Johnston 40 6,0 2.1 19.2 Alexander 66 9.0 4.7 41.0 Jones 70 9.9 4.2 16,7 Alleghany 11 3.0 3.0 - - Lee 62 8.8 2.5 22.4 Anson $4 13.2 2.6 22.2 Lenoir 93 13.1 3.1 23.5 Ashe 19 5.9 3.7 - 14.3 Lincoln 38 5.7 2.8 22.1 Avery 27 4.8 4.8 - - - McDowell 35 o • 4 3.8 25,0 Beaufort 85 11.7 2.1 23.9 Macon 8 2.8 2.8 - - Bertie 68 9.7 2,4 13,1 Madison 20 4,0 4.0 _ . Bladen 62 8.8 3.5 15,1 Martin 80 11.5 2.1 18.8 B runswiok 91 12,6 3.9 25.3 Mecklenburg 67 9.3 1.8 26.5 Buncombe 27 4.8 2.7 20.9 Mitchell 4 2,4 2.4 - - Burke 19 3.9 3.1 „ 13.8 Montgomery 74 10.4 3.1 28.0 Cabarrus 41 6.1 3,3 20.5 Moore 62 8.8 1,6 23.4 Caldwell 11 3.0 2.7 8,6 Nash 90 12.4 3,9 20.9 Camden 75 11.0 3,8 17,9 New Hanover 84 11.8 1,9 25,8 Carteret 36 5.6 2.5' “■ 21.9 Northampton 38 12,3 1.8 15.7 Caswell 68 9,7 1.7 16.1 Onslow 87 12.1 1.9 31.4 Catawba 25 4.7 3.7 14.3 Orange 42 6.4 1,5 12.7 Chatham 78 11.3 5,6 18.5 Pamlico 59 8.4 3.0 15.4 Cherokee 16 3,5 3.4 6.7 Pasquotank 48 7.0 1,8 11.5 Chowan 99 16.0 2.2 28.6 Pender 76 11.1 1.4 19.3 Clay 6 2,0 2.6 - - Perquimans 81 11.6 2.3 18.8 Cleveland 42 6,4 2.1 19,0 Person 34- 5.3 2.5 8.9 Columbus 49 7.1 2,0 16.0 Pitt 88 12,3 2.2 20.7 Craven 97 14.5 4.0 25.9 Polk 71 10,0 6,8 25,0 Cumberland 55 7,6 1,9 18,1 Randolph 23 4,6 3.1 15.9 Currituck 22 4.2 - - 11.4 Richmond 73 10,1 1,9 26.2 Dare 2 2.1 1.1 16.7 Robeson 76 11.1 5,6 15.6 Davidson 30 4.9 2,6 23.1 Rockingham 31 5.1 1.9 17.1 Davie 14 3,4 1.9 9.2 Rowan 46 6,5 2.5 22.9 Duplin f 42 6,4 1.1 15.6 Rutherford 47 6,7 3.4 2d:. 2 Durham 94 13,2 2.8 27,3 Sampson 53 7.5 1.8 17,4 Edgecombe 100 18.8 2.7 28.6 Scotland 85 11.9 2.6 19,1 Po rsyth 86 12.0 2.3 30.8 Stanly 16 3,5 1,8 19,0 Franklin 42 6.4 1.7 10.8 Stokos 1 1.8 1,2 6.9 Gaston 32 5,2 3.0 21,6 Surry 4 2,4 1,3 11.9 Gates 51 7,3 - - 11.3 Swain 25 4.7 4,5 5.9 Graham 3 2.3 2.4 - - Transylvania. 14 3,4 3,1 14.3 Granville 57 8.1 1.8 12,4 Tyrrell 36 5,6 - - 11.8 Greene 60 8.6 1.8 16,3 Union 57 8.1 2.8 20.2 Guilford 50 7,2 3.2 22.8 Vance 52 7,4 2.2 11.4 Halifax 78 11.3 2,8 15.4 Wake 61 8.7 1.7 18.7 Harnett 27 4.8 2.0 12,0 Warren 53 7.5 2.6 9,1 Haywood 25 4.6 4.4 18,8 Wash ington 96 13.8 2.2 22.9 Henderson 39 5.8 3,9 28,9 Watauga 10 2.9 2.7 25.0 Hertford 62 8.8 0.7 12,3 Wayne 81 11.6 2.8 21.7 Hoke 98 15.5 1,9 20.9 Wilkes 6 2,6 1.7 14.7 Hyde 71 10.0 4.4 15,2 Wilson 92 12.9 1.6 24.3 Irodell 56 8,0 2.8 26,0 Yadkin 8 2,8 2,3 15.0 Jackson 18 3*6 3,1 17.6 Yancey 13 3,2 3,0 33.3 Sources United States Vital Statistics. PERCENTAGE OF ILLEGITIMATE LIVE BIRTHS north Carolina,iquo TOTAL WHITE NONWHITE p 24 and uc 20-23.9 16-19.9 12-15.9 8-11.9 4- 7.9 2- 3.9 Under 2 PERCENTAGE * INFORMATION NOT AVAILABLE N.C.Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY BASED ON DATA FROM THE U.S.BUREAU OF THE CENSUS DEATHS PER 100,000 POPULATION BY PRINCIPAL CAUSE, UNITED STATES, 1940 Principal cause of death Rate Ratio of Nonwhite to White Rate Rate Ratio of Rural to Urban Rate , Total , Nonwhite Rural TOTAL DEATHS 1,076.39 1,382.79 133 982.54 86 Typhoid,paratyphoid fever 1.10 3.20 372 1.53 201 Cerebrospinal meningitis .55 .62 119 .57 116 Scarlet fever .51 .26 48 .60 140 Whoopinh cough 2,22 5.91 328 3.16 211 Diphtheria 1.11 1.78 173 1.56 205 Tuberculosis,pulmonary 42.21 116,60 346 38.17 84 Tuberculosis,other forms 3.68 11.36 404 3.10 75 Malaria 1.10 5,57 944 1.94 431 Syphilis 14.43 54.29 548 13.32 87 Po1iomye1it i s,po1io enc e phalit is .78 .54 67 .92 137 Cancer & other malignant tumors 120.25 78.43 63 92.35 65 Acute rhuematic fever 1.31 2.57 220 1.27 95 Diabetes mellitus 26.59 17.90 65 19.31 60 Exophthalic goiter 2.78 1.90 66 2.27 72 Pellagra (except alcoholic) 1.61 6.34 593 2.43 246 Intercranial lesions of vasculai 90.95 111.71 126 89.17 97 Diseases of ear,nose,throat 5.32 7.52 148 5.33 100 Chronic rhuematic heart diseases 20,83 24.43 120 18.87 84 Disease of coronary arteries,angina 77.06 34.31 42 57.40 62 Diseases of heart,other forms 194.65 189.71 97 160.42 73 Influenza,pneumonia-all forms 70.27 125.39 193 75.85 115 Ulcer of stomach,duodenum 6.80 6.41 94 5.10 63 Diarrhea,enteritis 7.63 16.14 242 9.76 163 Appendicifcis 9,87 10.39 106 8.40 76 Hernia, intestinal obstruction 9.02 10.95 124 7.71 77 Corrhosis of the liver 8.57 5.77 65 5.28 48 Diseases of the gall bladder 5,99 2.52 40 4.57 65 Nephritis 81,53 124.72 163 78.37 93 Puerperal septicemia 2.75 6.28 2 67 2.79 102 Other puerperal causes 3.99 10.53 325 4.78 141 Congenital malformation 9,98 6.15 59 9.66 94 Premature birth 24,57 37.51 163 24.25 98 Suicide 14.36 4.63 30 12.03 75 Homicide 6.23 33.33 1,058 5.70 86 Motor vehicle accidents 26.20 23.76 90 25.73 97 Other accidents 47.38 53.43 114 46.66 97 Deaths from all other causes 132.22 229.92 190 142.22 114 Source: United States Vital Statistics, 1940, DEATHS PER 100,000 POPULATION BY PRINCIPAL CAUSE, NORTH CAROLINA, 1940. Principal cause of death Rate Ratio of Nonwhite Rate Ratio of Rural to Total | Nonwhite to "'Hite Rato ,, Rural Urban Rat e TOTAL DEATHS 893.26 1,160.07 147 844.06 82 Typhoid,paratyphoid fever 1,06 1.49 166 .89 58 Cerebrospinal meningitis * 62 1.00 213 • 69 168 Scarlet fever .28 ,30 111 .19 37 Whooping cough 2.52 5.08 334 2.75 140 Diphtheria 3.00 2.89 95 3,27 145 Tuberculosis,pulmonary 41.77 93.83 43 8 35.80 62 Tuberculosis,other forms 3.25 S. 17 619 2.69 57 Malaria , 1.68 2.69 209 2.00 244 Syphilis 12.38 32.67 736 10.09 55 Po1iomyo1 itis,po1ioencephalit1s ,45 ,60 154 .42 82 Cancer & other malignant tumors 58.57 52.49 86 51.74 67 Acute rheumatic fever 1,88 3.09 221 2.08 156 Diabetes mellitus 14.08 12.75 87 12.09 62 Exo pht ha1ic go it e r 1.18 1.20 105 1.00 61 Pe1lagra(except alcoholic) 4.68 4.18 86 5.24 165 Interoranial lesions of vascular 88.59 111.36 140 83.50 82 Diseases of ear, nose, throat 6.83 8.37 134 6.93 105 Chronic rheumatic heart diseases 14.70 18.33 138 15.09 111 Disease of Coronary arteri®s,angina 37,66 20.32 46 29.95 51 Diseases of heart,other forms 113.90 126.30 116 107.07 81 Influenza,pneumonia-all forms 75; 15 108.67 175 74.88 99 Ulcer of stomach or duodonum 3.56 3.39 94 3.04 62 Diarrhea,enterit is 13.72' 23.31 234 15.09 150 Appendic it is 6,27 6, IS 98 5.43 64 Hernia, intestinal obstruction 5.77 7.97 152 5.20, 71 Cerrhosis of the liver 4«o 1 5.49 75 3,20 44 Diseases of the gall bladder 2.69 1.00 30 2.04 46 Nephritis 96,12 127.79 153 91.13 83 Puerperal'- septic:omia 3.70 6,57 256 3,73 104 Other puerperal causes 7.84 12.95 222 7,82 99 Congenital malformation 9.58 7.77 76 9.82 110 Premature birth 37.21 48.11 146 36.38 92 Suicide 8.15 2.59 25 6.93 61 Homicide 10.86 28.39 708 7.82 41 Motc*r vehicle accidents 28.3 6 27.09 94 26,03 75 Other accidents 36,93 43.83 128 oo.l 5 93 Deaths from all other causes 134.00 193,93 175 135.90 105 Source; United States Vital Statistics, 1940. INFANT .DEATHS PER 1,000 LIVE BIRTHS BY COLOR, UN ITED STATES AND NORTH CAROLINA*, 1915-1942. Year Total White Nonwhite U. S. N. C. U. S, j N. C, U. S, j N. C. 1942 40.4 48.3 37.3 41.4 64.6 63.7 1941 45.3 59.7 41.2 49,9 74.8 80.5 1940 47.0 57.6 43,2 49.8 73.8 75.8 1939 48.0 59.1 44.3 51.2 74,2 75.5 1938 51.0 68.6 47,1 59.9 79.1 87.4 1937 54,4 65.5 50.3 56.5 83.2 84.6 1936 57.1 68,9 52.9 59.9 87.6 88.6 1935 55,7 68.8 51,9 59.6 83.2 88.5 1934 60.1 77.9 54.5 67.2 94.4 101.1 1933 58.1 66.0 52.8 55.0 91.3 89,8 1932 57.6 66.5 63,3 57.2 86.2 87.2 1931 61.6 72.9 57.4 60.0 93.1 102.2 1930 64.6 78.6 60.1 67.1 99.9 105.1 1929 67.G 79.1 63.2 66.6 102.2 106.9 1928 68.7 85,7 64.0 75,3 106.2 108.8 1927 64.6 79.1 60.6 65.8 100.1 108.9 192 6 73.3 82.3 70.0 71,1 111.8 107,2 1925 71,7 78.8 68.3 67.0 110.8 104.9 1924 70.8 82.3 66.8 69.9 112.9 109.9 1923 77.1 81.0 73.5 69.8 117.4 105.7 1922 76.2 79,5 73,2 69.6 110.0 101.5 1921 75.6 75.0 72.5 66,2 108,5 94.8 1920 85.8 84.9 82.1 73.1 131.7 112.6 1919 86.6 84.3 85.0 75.9 130.5 108.8 1918 100.9 101.8 97.4 84,8 161.2 139.5 1917 93.8 99,6 90,5 84.8 150.7 133.1 1916 101.0 - - 99.0 - - 184.9 - - 1915 99,9 — — 98.6 - - 181.2 — “ INFANT DEATHS PER 1,000 LIVE BIRTHS BY RESIDENGE**AND COLOR, UNITED STATES AND NORTH CAROLINA, 1940, Residence Total White Nonwhite U. S. N. 0. U. S. IT. C. U. S. K. C. TOTAL 47*0 57.6 43.2 49.8 73.8 73.8 RURAL 50*1 57.7 45.9 51.6 73.4 70.1 URBAN 44.4 57.2 41,1 44.4 74.4 86.2 2,500 - 9,999 53.4 54.5 50.2 46.2 90.0 SI.4 10,000 - 24,999 48.4 63.3 - - 54.6 - - 83.8 25,000 - 99,999 45,1 58.1 - - 41.0 - ~ 88.5 100,000 and over 39.3 45.7 36.1 26,1 o4.0 91.2 * Place of occurance,1915-38; place of residence,1939-42. ** Place of residence. Source: United State-s Vital Statistics, * INFANT MORTALITY RATES 3-vear moving average North CaroI ina, 1918-1943 Deaths per 1,000 live births MATERNAL MORTALITY RATES 3-Vear moving average North CaroI ina, I 9 I 8-I 943 Deaths per IO.OOC live births N.C.Agricu11ura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY Based on data from the U.S.Bureau of the Census • Preliminary INFANT DEATHS PER 1,000 LIVE BIRTHS, NORTH CAROLINA, 1940 County Total White Nonwhite County Total White Nonwhite Rank Rate Rate Rate Rank .Rate ( Rate Rate NORTH CAROLINA 63 57.6 49.8 73.8 Alamamce 3 29,5 27.9 3 4 « 8 Johnston 19 45.2 38.2 69.4 Alexander 2 26.7 30.2 - - Jones 74 69.0 69.0 69.0 Alleghany 93 82.8 76.9 1,000.0 Lee 29 49.3 31.4 87.2 Anson 39 52.3 40,9 61.9 Lenoir 67 64.7 60.5 68.9 Asho 89 79.1 78.6 100.0 Lincoln 60 60.6 62.1 52.6 Avery 71 66.7 67.3 - - McDowell 32 49.8 47.4 83.3 Beaufort 94 82.9 67.5 102.7 Macon 53 58.0 58.5 - - Bertie 84 73.5 3 6.4 90.7 Madison 36 50.7 51.4 - - Bladen 76 70.0 79.7 58.5 Mart in 56 59.5 59,6 59,5 Brunswick 73 68,7 54.1 88.5 Mecklenburg 28 49.0 31,5 89.6 Buncombe 25 47.7 46.1 60,3 Mitchell 13 42. o 42,6 - - Burke 4 31.1 30.7 36,3 Montgomery 1 21.0 17.6 32.3 Cabarrus 69 65,6 56.4 112.2 Moore 21 46,6 28.4 85,0 Caldwell 22 47.3 47.9 37.0 Nash 55 58,7 47.0 70.2 Camden 99 101.0 85.1 115.4 New Hanover 45 54.5 43.4 70.6 Carteret 75 69,1 66.7 82.0 Northampton 5 '7 A 7 UT • 1 12.3 41.6 Caswell 23 47.4 40.7 52,6 Onslow 97 95.8 86.3 113,8 Catawba 40 52.5 51.7 60,3 0 range 35 50,4 59.3 38.8 Chatham 11 41.8 41.4 42.3 Pamlico 64 62.0 79.7 38,5 Cherokee 17 44.7 46.0 - - Pasquotank 81 73.1 61.3 83.8 Chowan 78 71.9 67.2 76.4 Fender 50 56.4 30.0 73.2 Clay 95 83.3 83.9 - - Perquimans 63 61.9 35.3 82,6 Cleveland 43 53.1 58.5 37.3 Person 8 37.3 25.4 53.6 Columbus 79 72.3 70.5 75.3 Pitt ' 85 74.1 52.5 92.2 C raven 47 55.3 43.7 67.5 Polk 30 49 • 4 41.5 87.0 Cumberland 31 49.5 50.6 47.5 Randolph 6 35.9 33.5 54.1 Currituck 91 80.5 89.3 64.5 Richmond 65 63.1 67.0 55.2 Dare 10 40.0 32.3 142,9 Robeson 72 67.9 66.5 68.7 Davidson 54 58.6 57.1 70.9 Rockingham 57 59.7 54,7 77.9 Davie 51 56.5 43,7 106.1 Rowan 37 51.8 38.9 104.2 Duplin 46 54.8 60.8 45.2 Rutherford 26 47.9 46.5 55.2 Durham 42 52.6 37.8 72,8 Sampson 49 56.3 51.0 64.8 Edgecombe 80 72.6 67.4 75.8 Scotland 96 89.1 105.3 76.4 Forsythe 86 76,8 52.0 126.7 Stanly 38 52.1 54.2 31.7 Franklin 81 73.1 66.7 78.4 Stokes 92 81,4 84.5 53.6 Gaston 20 45.4 40,9 78.0 Surry 52 56.8 55.8 72,7 Gates 98 98.0 69.8 113.2 Siva in 17 44.7 47.6 35.3 Graham 7 36.4 31.1 250.0 Transylvania 68 65.1 66.7 - - Granville 16 43.5 42.1 44,4 Tyrrell 9 38.2 42.9 32.8 Greene 11 41.8 38.5 45.5 Union 40 52.5 47.1 65.7 Guilford 27 48,1 45.0 60.3 Vance 33 50.1 32.3 64.3 Halifax 57 59,7 26.9 75,5 Wake 48 55.8 43.9 72.8 Harnett 62 61.6 50,2 86,5 Warren 100 111.3 82.8 120.0 Haywood 33 50.1 48.6 125.0 Washington 88 78.2 73.0 82.4 Henderson 14 42.9 39.0 88.9 Watauga 83 73.3 73.9 - - Hertford 87 77.8 50.4 89.5 Wayne 89 79.1 72,3 87.3 Hoke 24 47.5 38.5 51,2 : Wilkes 15 43.1 39.3 98.6 Hyde 44 54.1 22.7 82.5 , Wilson 70 66,4 50.3 82.5 Iredell 77 71.8 59.1 116,8 I Yadkin 61 60.7 60.8 58.8 Jackson 66 64.6 53.8 400,0 i Yancey 59 60.2 60.4 - - Source: United States Vital Statistics. 1940. INFANT DEATHS PER 1.000 LIVE BIRTHS North Carolina, 1940 TOTAL WHITE NONWHITE RATIO 75 and up 65-74.9 55-64.9 45-54.9 Under 45 Information not available N.C.Agricultura1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY BASED ON DATA FROM U.S.BUREAU OF THE CENSUS Page 56 MATERNAL DEATHS PER 1,000 LIVE BIRTHS BY COLOR, WIPED STATES,MD NORTH CAROLINA,* 1922-1942. Year Total White Nonwhite U. S. N. C. U. S. N. C. U. S. N. C. 1942 2.6 3.4 2.2 m 5.4 1941 3.2 4,0 2.7 - - 6.8 - - 1940 3.8 5.1 3.2 4.0 7.7 7.6 1939 4.0 4.7 3.5 3.7 7,6 6.8 1938 4.4 5.3 3.8 4.0 8,5 8.0 1937 4.9 5.4 4.4 4.2 8,6 7.9 1936 5.7 6.6 5.1 5,6 9.7 8.8 1935 5.8 6.5 5.3 5.3 9.6 3.9 1934 6.9 7.1 6.4 6,2 9,0 9.1 1933 6.2 6.8 5.6 5.8 9,7 9.0 1932 6.3 6.8 5.8 5.4 9.8 9.8 1931 6. 6 8.0 6.0 6.4 11.1 11.6 1930 6..7 8.3 6.1 6.7 11.7 12.1 1929 7.0 8.4 6.5 7.2 12,0 11.2 1928 6.9 7,8 6.3 6.7 12.1 10,5 1927 6.5 6.6 5.9 5.1 11.3 9.9 1926 6.6 8.8 6.2 7,1 10.7 12.6 1925 6,5 8.7 6.0 6.8 11.6 12.8 1924 6.6 7.7 6.1 6.6 11,8 10,4 1923 6.7 8.0 6.3 6.7 10,9 10.7 1922 6.6 8.0 6.3 7.0 10.7 9.9 HATEHiTAL MORTALITY RATES**BY COLOR AND POPIJLAT ION-SIZE GROUPS*** UNITED STATES .AND NORTH CAROLINA, 1940. Population-size group Total White Nonv/hite U. S. N. C. U. S. N% C. U. S. | N. C. TOTAL C*J • OD 0.1 j - S' n-u,- „r, W/%1 -Pr, i.ased on data from the North Carolina Board of Charities PER CAPITA EXPENDITURES FOR MEDICAL CARE AND HOSPITALIZATION OF THE INDIGENT,FISCAL YEAR 1943-44.NORTH CAROLINA N.C.Agricu1tura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY CENTS 20.0,and up 15,Or 19.9 10.Or 14.9 5.Or 9.9 Under 5 None SOURCE OF GENERAL HOSPITAL INCOME AND EXTENT OP FREE HOSPITAL CARE NORTE CAROLINA, 1934-1942. Source of income Year 1934 1936 1938 1940 1942 Number of hospitals 75 81 85 Income in $ 1,000 90 *s 89 Total income ff 3,661- | 4,761 | 6,729 * 7,039 | 9,292 Patients 2,441 3,359 4,215 5,242 7,787 Federal government - - 2 17 28 State government — 12 52 49 52 County governments 195 245 324 564 333 City governments 100 139 147 127 144 Religious organizations 51 61 65 76 89 Duke Endowment Other organizations and 627 566 529 571 420 individuals 269 274 314 477 307 Inve ctmonts 52 73 81 95 94 Nonhospital 26 32 - - 21 38 Percentage of free days of hospital care Total 53*2 46,2 38*5 35.1 22.5 ■White 46*6 40*0 31*6 27*7 15*8 Negro 77*4 70*8 66*2 66*0 53.5 Source* Duke Endowment Hospital Statistics* Those data relate only to those hospitals that were assisted by tho Duke Endowment* SOURCE OF GENERAL HOSPITAL INCOME NORTH CAROLINA, 1942 Based on data from Duke Endowment Statistics DEPARTMENT OF KURIL SOCIOLOGY N.C.Agricultural Experiment Station RURAL-FARM LEVEL OP LIVING INDEX, NORTH CAROLINA, 1940 County Rank Index County Rank Index NORTH CAROLINA 39 84 Alamance 7 98 Johnston 53 80 Alexander 39 84 Jones 69 75 Alleghaney 8 95 Lee 26 87 Anson 96 64 Lenoir 43 83 Ashe 47 82 Lincoln 14 91 Avery 51 80 McDowell 26 87 Beaufort 79 73 Macon 53 80 Bortio 95 65 Madison 53 80 Bladen 86 70 Martin 69 75 Brunswick 91 68 Mecklenburg 14 91 Buncombe 8 95 Mitchell 32 86 Burke 26 87 Montgomery 86 70 Cabarrus 16 90 Moore 64 78 Caldwell 32 86 Nash 68 77 Camden 53 80 Now Hanover 4 101 Carteret 47 82 Northampton 98 • 62 Caswell 61 79 Onslow 95 65 Catawba 11 94 Orange 8 95 Chatham 61 79 Pamlico 39 84 Cherokee 86 70 Pasquotank 39 84 Chowan 53 80 Pender 79 73 Clay 49 81 Perquimans 82 72 Cleveland 22 88 Person 64 78 Columbus 73 74 Pitt 73 74 Craven 49 81 Polk 36 85 Cumberland 91 68 Randolph 32 86 Currituck 39 84 Richmond 90 69 Dare 1 108 Robeson 82 72 Davidson 5 99 Rockingham 22 88 Davie 32 86 Rowan 5 99 Duplin 84 71 Rutherford 20 89 Durham 16 90 Sampson 73 74 Edgecombe 86 70 Scotland 100 58 Forsyth 2 102 Stanly 26 87 Franklin 73 74 Stokes 26 87 Gaston 13 92 Surry 26 87 Gatos 53 80 Swain 49 81 G raham 61 79 Transylvania 16 90 Granville 64 78 Tyrrell 69 75 Greene 43 83 Union 36 85 Guilford 2 102 Vance 69 75 Halifax 91 68 Wake 22 88 • Harnott 43 83 Warren 94 67 Haywood 16 90 Washington 79 73 Henderson 11 94 Watauga 36 85 Hertford 84 71 Wayne 49 81 Hoke 99 61 Wilkes 64 78 Hyde 73 74 Wilson 53 80 Iredell 22 88 Yadkin 20 89 Jackson 73 74 Yancey 43 83 Source: Calculations based on 15 U.3.Census items related to both cash and noncash aspects of family living* Based on data from 15 U.S.Census items related to both cash and noncash aspects of family living RURAL FARM LEVEL OF LIVING INDEX NORTH CAROLINA,1940 N.C.Agricu11ura 1 Experiment Station DEPARTMENT OF RURAL SOCIOLOGY INDEX 95 and up 84-94. 9 79-83.9 73-78.9 Under 73 TREND IN THE NUMBER AMD DISTRIBUTION OP ACTIVE PHYSICIANS IN NORTH CAROLINA, 1914 TO 1940 Year —m— active phy- sicians In urban areas In rural areas Total urban | 2,500- | 10,000 10,000-: 25,000 [ Over 25,000 Total rural Under 1,000 1,000- 2,500 Number of physicians 1944 1,688 1,186 324 260 584 502 276 226 1940 2,298 1,579 451 381 747 719 407 312 1954 2,164 1,403 445 290 668 761 455 306 1925 2,110 1,176 453 385 338 934 635 299 1914 1,936 811 420 261 130 1,125 836 289 Percentage distribution 1944 100.0 70.3 20.3 15.4 34,6 29,7 16.3 15.4 1940 100.0 68.7 19.6 16.6 32.5 31.3 17.7 13.6 1954 100.0 64.9 20.6 13.4 30.9 35.1 21.0 14.1 1925 100.0 65.7 21.4 18.3 16,0 44.5 30.1 14.2 1914 100.0 41.9 21*7 13#5 6,7 58.1 43,2 X4#9 NUMBER OF PEOPLE PER ACTIVE PHYSICIAN IN URBAN AND RURAL AREAS OF NORTH CAROLINA, 1914 TO 1944 Year Population People per physician Population Census A.M.A. Directory State [ Urban i , Rural ,. State Urban Rural 1940 1944 5,571,623 974,175 2,597,448 2,116 821 5,174 1940 1940 3,571,623 974,175 2,597,448 1,554 617 3,613 1930 1954 3,170,276 809,847 2,360,429 1,465 577 3,102 1920 1925 2,559,123 490,370 2,068,753 1,213 417 2,215 1910 1914 2,206,287 318,474 1,387,813 1,140 392 1,678 Source: American Medical Directory and North Carolina Agricultural Experiment Station. . , ACTIVE PHYSICIANS IN URBAN AND RURAL AREAS, NORTH CAROLINA Based on data from the American Medical DEPARTHEITT OP RURAL SOCIOLOGY N.C.Agricultural Experiment Station Directory and H.C. Agricultural Experiment Station. PERCENTAGE OF ACTIVE PHYSICIANS OVER 55 YEARS OF AGE BY YEARS IN URBAN AND RURAL AREAS,NORTH CAROLINA, 1914-44, Year Number of physicians Percentage over 55 State Urban Rural State Urban , Rural 1944 1,688 1,186 502 42*5 40.1 48,2 1940 2,298 1,579 719 32*0 29.4 37,5 1934 2,164 1,403 761 28.6 24*5 36,8 1925 2,110 1,176 934 22.9 20,4 26,2 1914 1,936 811 1,125 15.6 16,4 14,6 DISTRIBUTION OF ACTIVE PHYSICIANS BY AGE AND RESIDENCE SHOWING DEGREE OF SPECIALIZATION,NORTH CAROLINA,1914-1944 Year State Urban places Rural areas Total t 1 Under i. 45 45 and t ovor Total Under 45 . 45 and i over r_... ..... Total Under i 45 45 and over ■ Number of physicians 1944 1,686 510 1,176 1,184 373 811 502 137 365 1940 2,266 1,008 1,258 1,569 741 828 697 267 430 1934 2,095 889 1,206 1,374 630 744 721 259 462 1925 1,912 984 928 1,094 587 507 818 397 421 1914 1,456 754 702 624 319 305 832 435 397 - Percentage of physicians classed as full-time specialists 1944 23.3 23.9 23,0 32.4 28.7 31,8 5.4 10.9 3,3 1940 22.7 23.9 21,7 31.0 31,0 31.0 3,9 4.1 3.7 1934 18.7 21,9 16.3 26,9 29,2 24.9 3.1 4.2 2,3 1925 12.7 14.3 10,9 20,3 22.0 18.3 2.4 3.0 1.9 1914 4.0 5,8 2,0 8.8 13.5 3,9 .4 • 2 .5 Sources American Medical Directory and North Carolina Agricultural Experiment Station, PERCENTAGE OF ACTIVE PHYSIC LINS OVER 55 YEARS OF AGE BY YEARS IN URBAN AND RURAL AREAS,NORTH CAROLINA, 1914-44. Based on data from the American Medical Directory and the N,C.Agricultural Experiment Station DEPARTMENT OP RURAL SOCIOLOGY N.C.Agricultural Experiment Station NET INCOME PER FARM 'YORKER, NORTH CAROLINA, 1939. County Rank (cash income) Income County Rank (cash income] Income Total Cash ' Total Cash NORTH CAROLINA 43 513 357 Alamanoe 66 488 236 Johnston 6 666 541 Alexander 68 410 226 Jones 15 620 486 Alleghany 78 432 184 Lee 37 549 378 Anson 75 304 186 Lenoir 9 629 528 Ashe 61 468 2 69 Lincoln 64 454 243 Avery 88 410 105 McDowell 87 437 125 Beaufort 6 632 ■541 Macon 92 438 80 Bertie 22 54* 452 Madison 80 394 179 Bladen 41 495 363 Martin 3 760 627 Brunswick 63 401 244 Mecklenburg 67 383 229 Buncombe 84 510 166 Mitchell 95 453 66 Burke 94 343 69 Montgomery 74 372 188 Cabarrus 68 416 226 Moore 53 489 292 Caldwell 91 416 89 Nash 23 565 447 Camden 30 502 403 New Hanover 47 3 36 330 Carteret 20 580 457 Northampton 45 433 341 Caswell 28 555 412 Onslow 45 441 341 Catawba 75 418 186 Orange 50 605 327 Chatham 72 392 213- Pamlico 18 573 472 Cherokee 100 325 , 13. Pasquotank 10 626 526 Chowan 15 586 486 Pender " 73 ' * ‘S3& 193 Clay 98 343 33 Perquimans 38 493 376 Cleveland 51 481 314 Person 24 586 434 Columbus 31 527 402 Pitt 4 643 566 Craven 11 610 513 Polk 86 410 129 Cumberland 47 442 330 Randolph 82 381 176 Currituck 43 441 358 Richmond 60 398 275 Dare 54 778 286 Robeson 25 521 432 Davidson 62 514 264 Rockingham 34 557 395 Davie 70 595 221 Rowan 54 511 286 Duplin 27 537 420 Rutherford 75 404 186 Durham 51 505 314 Sampson 26 533 428 Edgecombe 19 542 467 Scotland 56 343 284 Forsyth 1 962 738 Stanly 83 398 167 Franklin 31 534 402 Stokes 39 576 372 Gaston 58 491 278 Surry 40 572 366 Gates 47 455 330 Swain 93 736 77 Graham 99 459 29 Transylvania 85 456 137 Granville 42 510 362 Tyrrell 13 684 505 Greene 2 770 653 Union 65 368 240 Guilford 35 631 388 Vance 28 589 412 Halifax 44 460 353 Wake 21 609 453 Harnett 5 691 547 'Warren 71 349 218 Haywood 78 500 184 Washington 17 637 479 Henderson 88 532 105 Watauga 80 373 179 Hertford 14 614 503 Wayne 12 612 511 Hoke 33 461 400 Wilkes 96 258 51 Hyde 57 386 2 80 Wilson 8 643 539 Iredell 59 436 277 Yadkin 36 530 382 Jackson 97 360 40 Yancey 88 405 105 Source: U* S. Bureau of the Census» 194Q« Based on data from the U.S.Bureau of the Census NET CASH INCOME PER FARM WORKER NORTH CAROLINA,1939 N.C.Agricultural Experiment Station DEPARTMENT OF RURAL SOCIOLOGY NET INCOME Under $100 100-199 200-299 300-399 400-499 500 and up HOW NORTH CAROLINA RANKS IN HEALTH AND MEDICAL CARE AND IN SOCIAL AND ECONOMIC CONDITIONS AFFECTING HEALTH Explanatory Note On the following three pages there is a summary table showing how North Carolina ranks in the nation with regard to many subjects covered in this report. In most cases the rani: order is obvious but in other cases this is not so. This explanation will, it is hoped, clear up any co?ifusion which may have arisen. In general, the most disadvantaged ste.te is given a rank of "48" and the least disadvantaged state a rani: of "l”. Some items, however, may be considered as disadvantaging in one respect and just the opposite in another respect. In such cases, the rank order used may be determined by comparing the average for North Carolina with that for the United States. Fbr instance, the birth rate of North Carolina is higher than the average for the nation and North Carolina ranks 14th, moaning that there are 13 states with higher birth rates. Some people may feel that a high birth rate is a "bad" or "disadvantaging" condition, as indeed it may be if one is thinking of infant mortality or possibly the size of our child health problem. However, there are many reasons for holding that a high birth rate is a "good" thing, partic** ulariy because a decreasing birth rate is now considered as a threat to national survival. 3e that as it may, tho ordor of ranking is more or loss obvious. In the case of "farm people per square mile" the rank order could just as well have been reversed, because the more densely settled an area, is, the more economically can medical car© services bo provided. Yet the fact that "over- population" may indicate conditions leading to poor health justifies tho rank ordor ’which no have used. It may be said in conclusion that any rank order system must bo used with caution. All states might bo vory similar, say within two or throe per cent of each other, and yot tho range of ranks would still bo from "1" to "48". Also, a state might improve itself a great deal in some respect and yot keep tho same rank ordor because some or all of the other states may also be improving them- selves. Therefore, it is suggested that the reader, in addition to observing North Carolina’s rank, note also the averages or percentages for both North Carolina and tho United States. HOW NORTH CAROLINA RANKS IN HEALTH AND MEDICAL CARE AND IN SOCIAL AND ECONOMIC CONDITIONS AFFECTING HEALTH.* Subjects Average or Percentago North Carolina United States .North Carolina rank HEALTH AND MEDICAL CARE Hospital beds per 10, 000 population 35 23 42 Days hospitalization per 100 population 90 52 43 Doctors per 100,000 population 125 72 45 White doctors per 100,000 white population 136 94 41 oiT/.hito doctors per 100,000 Nonwhito population 28 17 30 Dentists per 100,000 population 58 22 43 White dentists per 100,000 population 58 28 46 Nonwhite dentists per 100,000 nonwhito population 12 6 34 Nurses (including students) per 100,000 population 270. 175 38 White nurses per 100,000 white population 295 226 30 Nonwhite nurses per 100,000 nonwhite population 54 46 25 Percentage livo births in hospitals (1942) 67,9 38.1 41 Percentage white births in hospitals (1942) 72.7 49.0 41 Percentage Negro births in hospitals (1942) 28.9 13.6 43 Percentage urban (over 10,000) births in hospitals 80.5 55.9 44 Percentage rural (under 10,000) births in hospitals 36.5 17.1 39 Percentage of livo births with no modical attendant (1942) 7.4 20,7 40 Percentage of white births with no medical attendant (1942) 2*5 6.1 40 Percentage of Negro births with no medical attendant (1942) 46*8 54.0 40 Percentage of urban births with no modical attendant (1942) 2,6 10.0 40 Percentage of rural births with no medical attendant (1942) 14*2 24.7 39 Maternal .deaths per 1,000 livo births 3.8 5.1 41 Rural maternal deaths per 1,000 live births 4.0 4.9 38 Nonwhito maternal deaths per 1,000 livo births 7.7 7,6 31 * These data are for the year 1940 unless otherwise stated. HOW NORTH CAROLINA RANKS Continued Average or Percentage North Carolina Subjects United States , North . Carolina Rank Infant deaths plus still births per 1,000 births 76 09 38 White infant deaths plus stillbirths per 1,000 births 69 74 35 Nonwhite infant deaths plus stillbirths per 1,000 births 123 120 26 Mortality rate (per 1,000 population) * 7.56 3.12 38 White mortality rate (per 1,000 population) * 7.02 6.72 15 Nonwhite mortality rate (per 1,000 Population) * 13.14 12.25 21 Rural white mortality rate (per 1,000 population) * 6,19 6.40 32 Live births per 1,000 females 15-44 years of age 73.7 90,0 14 White births per 1,000 females 15-44 years of age 72.5 85.4 14 Nonwhite births per 1,000 females 15-44 years of age 83.3 101,6 11 POPULATION Population per square mile 44.2 72,7 35 Rural population per square mile 19,2 52.9 39 Farm people per square mile farm land 18.4 56,4 48 Percentage of population living on farms 22.9 46,4 43 Percentage of population living in rural areas 43.4 72,7 43 Percentage of population which is Negro 9,8 27,5 43 Percentage of employed males over 14 years of ago engaged in agriculture 23.2 41,4 t 37 People under 15 and over 65 per 1,000 people between 15 and 65 468 585 43 Total number of people in 1,000’s 131,669 3,572 11 Percentage of population increase 1930 to 1940 7,0 12,7 9 * Excluding ago groups under one and 75-up. Adjusted to the ago distribution of the total United States population. HOW NORTH CAROLINA RANKS... Continued Subjects Average or Percentage North Carolina United States North Carolina rank INCOME AND LEVEL OP LIVING Net income per capita | 573 | 317 44 Average value of dwellings 1 2,503 $ 1,346 42 Average value of farm homes 1 1,070 =69= -0 o o 38 Percentage of home ownership 43.6 42.4 36 Average number (median) of people per home 3.3 4.0 48 Percentage of homes with more than one person per room 20.3 35.3 38 Percentage of homes with electricity 78.7 54.4 38 Percentage of homes with radios 82.8 61.8 41 Percentage of homes with running water 69.9 39.1 41 Percentage of homes with mechanical refrigeration 44.1 28.2 38 Percentage of adults with less than 5th grade education 13.5 26.2 42 Rural-farm Level of Living Index 100 84 40 STATE AND COUNTY FINANCE Per capita State Government expenditures 3 36.80 | 26.96 38 Per capita State Government expenditures for public health | .37 | .40 29 Per capita County Government expenditures 1942 $ 12.09 $ 11,53 28 Percentage State and local.tax collections are of total Income payments 11.2 11.3 24 Percentage taxable income over | 5,000 is of total income payments 1938 9,9 6.2 30 Per Capita federal aid to states $ 28.82 1 20.78 43 Ratio (per $100) federal aid to state and local tax collections 44.7 57.8 26 Source: Based largely on U. S, Census, reports of State Departments, American Medical Association Directory, and reports of special agencies concerned. SELECTED REFERENCES ON MEDICAL CARE PROBLEMS A.M.A. MEDICAL SERVICE PLANS. Chicago: American Medical Association, Bureau of Medical Economics# 1943. P. 72. The American Medical Association expresses opposition to the inclusion of compulsory sickness insurance under the Social Security Bill# Statement of ten principles for guidance in setting up any medical care plan# Description of plans now in existence and a discussion on the Association’s experience with prepayikent plans# A.M.A. GROUP MEDICAL PRACTICE# Chicago: American Medical Association, Bureau of Medical Economics# 1940# P# 70# Booklet attempts to define group medical practice. Gives historical development in the United States# Quotes from comments received from groups themselves as to advantages and disadvantages of such a set-up. No conclusion made for or against group practice as opposed to individual practice# Amidon, Beulah. WHO CAN AFFORD HEALTH? New York: Public Affairs Committee, Inc., 1944. P. 31. Prepared on the basis of the National Health Survey made in 1935- 36 by the United States Public Health Service and other government research projects# Stresses the relationship between income and amount of medical care needod and obtainable# Brief discussion of plans for mooting the problem. Anderson, Elin L. "ADEQUATE MEDICAL CARE FOR RURAL BUffUSS." Journal of Memo Economics, Vol.36, No.7, pp.397-400. September, 1944. Discussion of the need for medical care; summary of several plans now operated successfully; and con- clusion as to what the next step must be. Anderson, Elin L. et al. MEDICAL CARE AND HEALTH SERVICES FOR RURAL PEOPLE. Chicago: Ibrm Foundation. 1944. P 226. Report of the Farm Foundation Conference held at Chicago April 11-13, 1944. Summarizes discussion and presents detailed account of proceedings. Atkinson, Miles. BEHIND THE MASK OF MEDICINE. New York: Charles Scribner’s Sons. 1941. Pp. xiv t 548. A popular presentation of the history of medicine empha- sizing the ethical and social problems involved. Has chapter on "Socialized Medicine." Outlines a general state plan and discusses difficulties and problems involved. Bradbury, Samuel. THE COST OF ADEQUATE MEDICAL CARE. Chicago: The University of Chicago Press. 1937. Pp.ix + 86. Data collected by Lee and Jones used in the study of tho cost of medical care today. Appendix contains statistical tables showing services required for various disease categories, disease expectancy by age groups, fee schedules, and more detailed information regarding costs of illness. Bureau of Cooperative Medicine. NEW PLANS OF MEDICAL SERVICE. Now York: 1940. P. 72. Givos thirty selected examples of organized local plans for providing or paying for medical services in tho United States. Canadian Federation of Agriculture. HEALTH ON THE MARCH. Toronto: January, 1943. P. 31. Part 1 containos principles for a plan of national health insurance which wero presented to tho Dominion Government by tho Canadian Federation of Agriculture. Each principle followed by explanatory statements. Part II describes systems in other countries, some plans already in effect in Canada, and a brief picture of what the fururo should hold for Canadian citizens. CominittGG on the Costs of I Iodic al Caro, HEDICAL CARE POP THE AHERI CAN PEOPLE* Chicago: The University of Chicago Press* 1932* Pp, xvi ♦ 213* This report outlines the present situation, states the problem, presents the essentials of a satisfactory medical program, and shows how the latter can bo put into practice* It describes plans already in use, discussing their advantages and disadvantages* Five broad recommendations arc made followed by specific plans for their develop- ment, and the final chapter expresses the need for present action o.nd gives practical stops to be taBnn at once* Committee of Physicians for the Improvement of Medical Care, Inc. A SUMMARY AND CRITICAL ANALYSIS OF THE MEDICAL FEATURES OP THE WAGNSR-MURRAY-DINGELL BILL. Ndfv Havenj Connecticut# December, 1943. This committee favors a National Health Insurance Program but is dissatisfied with some features of the Wagner-Murray- Dingoll Bill. Suggestions arc made for its improvement. Committee on Research in Medical Economics, PRINCIPLES OP A NATION-WIDE HEALTH PROGRAM. New York: November,1944. P. 34. "The health program presented here arises from the belief that there is now need for public action to make adequate medical care more widely accessible to the American people and to improve the quality, organization and economy of medical service." CIO, Department of Education and Research. FOR THE NATION'S SECURITY. Washing- ton; D.C., 1943. P* 32* Discussion of the things needed for security in the United States and the way in which the Wagner-Murray-Dingell Bill meets those needs. A report most favorable to all provisions of the Bill. Davis, Michael M., Editor. "MEDICAL CARE FOR A HUNDRED MILLION PEOPLE." Medical Care, Vol.3, No.3. pp. 239-256. August, 1943. Summary of the Wagnor-IJurray- Dingell Bill followed by comments by Wagner, organized medicine, progressive physicians, and two dentists. Davis, Michael M. and Mrs. Rose Ehrlich. "FOUR NAT 10IIIL HEALTH BILLS COMPARED.” Medical Caro, Vol.3, No.4. pp. 331-339. November, 1943. Factual comparison of Magner-Murray-Dingell Bill of 1943, TTagnor Bill of 1939, Health Insurance Bill of 1935, and Canadian Health Act of 1943. No evaluation made. do Kauif, Paul. KAISER WAKES THE DOCTORS* How York; Korcourt, Brace, and Co. 1945. P. 158. Describes and discusses very favorably in a popular style the group health care plans and ideas of Henry Kaiser. Erikson, Carl A* "THE SMALL HOSPITAL”. Hospitals, February, 1940* Discussion of housing and caro of sick, centralization of the nodical personnel, and the principles of construction. Plans for a number of hospitals aro given and con- structive criticism is made concerning then. Faxon, N,W, "THE PUCE OF COMPULSION IN PREPAID HEALTH CARE”. Hospitals, August, 1944# Fhvors the use of compulsory medical care plans to supplement voluntary insurance* Would accept the Wagncr-Barray*-Dingo 11 Bill with reservations* Hamilton, C. Horace. CONCLUSIONS AND PRINCIPLES OP THE FARI.I INUNDATION CON- FERENCS ON I.EDICAL CARE AND HEALTH SERVICE IN RURAL AREAS * Raleigh, N.C» North Carolina State College of Agriculture and Engineering. 1944. P.5. Mimeographed# Unofficial summary of conference hold in Chicago April 11-13, 1944* Outlines present conditions in rural areas, the basic principles and objectives to bo ob- served in drawing up medical care plans. Cites several practical plans and programs# Hamilton, C. Horace. MEDICAL CARE HEEDS AND PUNS POP RURAL PEOPLE IN NORTH CAROLINA. Raleigh,N*C* North Carolina State College of Agriculture and Engineer- ing* July, 1944. P.10* Mimeographed* Series of four newspaper articles dis- cussing the need for group health care in rural areas, commercial and cooperative medical care plans, the Blue Cross plan, and federal public health insurance* Hamilton, C. Horace. ELEMENTS OP A STATE MEDICAL CARE PUN. Raleigh, N. C: North Carolina State College of Agriculture and Engineering, 1944* P.7. Mimeo* graphed. Outlines a state plan for public health insurance, showing need for federal aid. Halbert, Blanche. HOSPITALS FOR RURAL COMMUNITIES* U.S.D.A. Farmers Bulletin No, 1792, P,41. Washington, D.C. November, 1937. This bulletin "gives information on hospital needs, size, cost, financing, and plans, based on th,e experiences of many localities." Heilman,'Richard. "THE FARMERS TRY GROUP MEDICINE" Harpers Magazine, Pp.1-8. December, 1940. Experience of the Farm Security Administration in providing for the health of rural people. Hollingsworth, Helen and Margaret C. Klem. MEDICAL CARE AND COSTS IN RELATION TO FAMILY INCOME. Washington, D. C» Bureau of Research and Statistics. March, 1943. P. 219. Statistical source book including data on medical care expenditures and prevalence, incidence, severity, duration, and frequency of illness. Johnson, Victor, John Peters, and Louis Wirth. "SHOULD WE ADOPT GOVERNMENT HEALTH INSURANCE?" The University of Chicago Round Table, No. 354. Pp.1-25. December 31, 1944. Radio discussion broadcast' from 'the "University of Chicago. Supplemented by several notes and charts. Julius Rosenwald Rmd. HOSPITAL FACILITIES IN RURAL AREAS. Chicago. 1935. P.2S. Reprints of articles from Bulletin of the American Medical Association, The Commonwealth Rind, and The Modern Hospital. Concerned with need for hospitals in rural areas, principles to be considered in meeting needs, and plans for building small rural hospitals. Kleinschmidt, L.S. "HOW CAN BETTER RURAL HEALTH BE DEVELOPED?" Rural Sociology, Vol.9, No.l. Pp. 21-27, March, 1944. Discusses present health conditions in rural areas and the need for improvements. Lists questions to be answered in studies of the problem. Klem, Margaret C. PREPAYMENT MEDICAL CARE ORGANIZATIONS. Washington, D.C; Bureau of Research and Statistics. June, 1944. Pp. x -f 130. Digest of prepay- ment plans now in use in the United States and Canada, Statistical summary showing number of persons eligible for care under existing plans and personnel associated with these organizations. Also more detailed information showing specific services received. Data given by census region, state, and type of organization. Liebeler, Virginia M. "HOW THE BLUE CROSS CAME TO RURAL AMERICA." The Modern Hospital, February, 1944. Story of the enrollment in the Blue Cross plan of rural people in Minnesota, Difficulties involved in enlisting farmers in the plan and how they are being overcome. N. C. Commission on Hospitals and Medical Care. MEDICAL CARE AND HOSPITAL FACILITIES FOR RURAL PEOPLE IN NORTH CAROLINA. Raleigh, N. C; October, 1944. P. 10. Mimeographed. Report of tho Committee on Hospitals and Medical Caro for Rural People. Summarizes needs of rural people in North Carolina and makes recommendations as to how those needs can be mot. Other reports of the Commission arc also available. Physicians Forum, H0W*S YOUR HEALTH? Now York; 1944. P. 8. A popular leaflet showing arguments for and giving enthusiastic endorsement to the plan for national prepaid health insurance, as is proposed in the Wagner-Murray-Dingell Bill. The Physicians Fbrum is an organized group of liberal doctors, headed by Ernst P. Boas, M.D. of Columbia University. Porter, Amy. "DO WE WANT NATIONAL HEALTH INSURANCE?" Collier’s, pp,20-21| 65-66. January 27, 1945. Arguments for and against the Wagner-Murray-Dingell Bill. Article recognizes need of some form of health insurance and is favorable toward compulsory national health legislation. Rankin, W.S. et al. THE SMALL GENERAL HOSPITAL. The Duke Endowment Bulletin No. 3, P. 125. Charlotte, North Carolina. January, 1932. General principles of hospital planning. Also contains"more detailed information and designs adopted to the special interest and needs of building committees and technical groups, physicians, hospital consultants, and architects, who are more directly concerned with the planning, designing, and building of hospitals.” Includes designs for three ideal small type hospitals as well as descriptions, photographs, and designs of ten hospitals recently built in North and South Carolina with the help of The Duke Endowment. Ratcliff, J.D. "CO-OP HOSPITAL". Collier’s. Pp. 24-26. July 31, 1943. Story of a successful cooperative community hospital in Elk City, Oklahoma, Sarvis, Lewis J. and Graham L. Davis. "SOUTH HAVEN HOSPITAL: IT IS EFFICIENT AND EZPANDABLE." Hospitals. September, 1943. Comprehensive description of the South Haven hospital, including the architect’s plans and a detailed statement of the cost of building and equipment* Southmayd, Henry J. and Goddes Smith. SMALL COMMUNITY HOSPITALS• Now Yorks The Commonwealth Rmd. 1944, Pp x + 182, Includes discussions as to which comma**' nitios should have hospitals, the area a hospital should serve, the administration and organization, distribution of the costs, and ways in which the hospital can aid the community getting bettor medical care. United Electrical, Radio and Machine Workers of America— CIO. UE GUIDE TO GROUP INSURANCE. New York; 1944. P. 127. Booklet "designed to help organizers and locals in negotiating group insurance," Discussion of the need for group insur- ance, concrete plans to be put into use, and some of the things every group insurance should include. Warbasse, James Peter. COOPERATIVE MEDICINE. New York: The Cooperative League of the U.S.A. 1942. P. 42, Suggestions for setting up a cooperative health association in a community. Illustrations of such associations already in ex- istence. Discussion of cooperative medicine as opposed to state medicine, stress- ing the advantages of the cooperative system. Sample set of by-laws, rules, and agreement with doctors.