| Third Report of the Committee on Municipal Health

 

— sea (October 91923) » > =

ent Practice of the american Public 8

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In view of the need for authentic information in re

 

and relative values of current developments in official health proced 0,

 

“~ Anerican Public Health Assogiation.in 1920 appointed a Committee on
that certain initial

 

: _ - | Municipal Hoalth Department Practice with the assurance
— — w
along this line yould be aided by the generous financial

 

 

studies to be made
. i assistance of the Metropolitan Life Insurance Company. ‘The Committee at the

2 , ve outset Limited its work to the 63 cities in the United States of approximately .
So 100,000 population or over in 1920. A survey of the administrative health 7
machinery of each of these sition was made sawing the year 1921 by member's of

(1)
representatives of the comi shee on the pasis of a detailed schedule inoluding

 

 

over 600 items. Some of the general results of ~ study were presented in.
S 2 os
ek preliminary form at the 1921 meeting in New Yorks The complete analysia of

 

the material and its preparation for publication proved a time-sonsuming :
| but a second report was re at the 1922 moeting in Cleveland and a mamber
_ te ee OO rH em oe oe me mee oe
(1) | Appreciative weucré should be made of the assistance quuerousiy
furnished by the United States Public Health Service and - the

“American Red Gross in the conduct of these arrays

 

(2) Aaerican Journal of Public Health, All, 7-15, 158-147, Januar
February, 1922. —

   

 

 

gard to the temlencies - -

 

 

  

 
 

 

 

 

 

of infividual ohapters of the “Gommittee's report, dealing with particular
phases of health department pashan have beon published aweing the past
eg: The caaplete report has now at last passed through the press
and has appeared during the past me a special bulletin of the
United States Public Health Services v
The objectives contemplated by the Committee on pnt ctyed’ Health

Department Practice seemed so important to the beaker American pabiie

 

Health Association that they wore given a 7 Wile of primary signi ficane 108
«AG
report of the Committee on Reorganization; adopted es a basis for the

 

in the 2

fundamental policies of the Association at the Cleveland meeting. thas in

the section of the Reorganization Soma anaes report dealing with Inter-

 
 

actives, reads as follows:

(3) Milk Inspedation, IleV.Hisoook, AvdePeHle, Zils 577-591, daly 1922.
Vital Statisties, LeleDublin, A.JePsHe, ALI, 750-757, September L922.
Water Supplies, AeWeFreeman, Aed aPeHe art, 759-763, September 1922+
Pablic Health Education, GeAmumdsen, A.d.PeH., AIL, 815-825, October 19226
Public Health Nursing, GewHeAeWinslow and M. Burkhardt, Pablic Health

Nurse, October 1922, pps514~-5206
An Ideal Health Department for a City of 100,000 Population, Ge-EeAsWinslow ~
and HI, Harris, AndaPolle All, 891-907» e -
fuberqulosia, Ce*E-A.Winslow and G+F.Baker, American Review of tubereulosis -
December 1923, pp»960~975. 2
_ Seen on of Health Departments, ‘AaWeProenan, AadeP ella g Bilt 65-161, oe
Sehool ‘Te Supervision, I.V-Hiscock and W.?.Fales, AvdaPells, Alii,
259-269, April 1923.
- Venereal Disease, Ml.A.Clark. Journal of Social Hygiene, IX, 27, 1923.
b

   

 

 

 

   

(5) American Journal of Public Health, XII, ps987, December 1922.

 

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"the objectives of the Association should be the preparation, study,

tdigation, and presentation of scientific public-health proceduresy

 

the best method by which such knowl edge

 

gan be given to the public, and the
expression to the public of professional opinion in regard te such procedurege" :

Later on under Section ¢, J

   

eGo the report recommends
"that there be maintained at the central office of the Association such
regords as are obtainable and gan be kept current with regard to the organ-

ization, e oxpenses, procedures and results of public#health practice in —

 

, meat th departments in countries represented in our membership."

Tn line with the policies thus foxmmlated, your Committee on ituniespal,
Hoal th Department Bractice first of all set ‘out to realize the ideas of a

ented Glearing house for current infomation in regard to health department

practice as suggested in the paragraph quoted above from the report of the

dommittee on Reorganization. Various possibilities suggested heneelvan.
along this Lines It is most desirable that the studies begun by the
Committee in the large Gities of the United States should be extended to the
large dities of Canada, Cuba and Mexico, to the smaller conmaunities,~ whose
need for standardization is perhaps even greater than in the case of the Large i
citles,~ and to the State and Provincial health departments. It soened to the
mommies, however, that the natural and logisal first Step was to provide
for the noeping up to date of the information already secured at Considerable
cost in regard to the large cities of the United States. ‘The United States 7
Public Health Service was, in our judgmont the logical body to eesied in this work «
in view of its general program and policies and in view of the surekes wank
it has rendered to so many individual communities in the ‘Line of gounsel

as to administrative health procedure, The matter was therefore presented
to Surgeon-General Cuming and it is a source of great gratification to be
able to report that General Cumming has agreed to establish within the

United States Public Health service an office of Administrative Health =»

   

 

 
 

   

vactice and has assigned to the direction of this work Surgeon Paul Preble, — |

 

‘whose experience in health survey work fits him in a unigue fashion for this. :
task. Dr. Preble will outline hia plans in the subsequent discussion and

it is only necessary for us to say further that the records now in the

 

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a possession of the Gomi ttee on Municipal Health Department Practice witt
Y d eo made aval able for the new office of the United States mee ae Health

  

   

members of the inectons Public Health Assogiation. Ome of our ideals, the

   
 
 

establishment of a _—. for eurrent informat ,On in} rege Le
departinent practice, te~ekwe substantially realized. 0 og OS eel os jet . mB
Ph in regard %

mt procedures Lt was felt that something more was necessarye As : A

 

‘mm addition to the Gollection and dissemination of informa

$0 ourre

 

we understand the nan of the members of this association they deal re a
clear picture of present couditions ehiefly in order that those conditions -
may be improved in the futures Public health practice is in a dynamic, not —
a static gonditions The object of the health official is to improve the
machinery now at his disposal go as to raise it to the highest point of
efficiency and to supplement that eure ad by obtaining new appropriations
sufficient make his organization $a, the requirements of the new publica
health, It ‘ins seemed to your committee that the most important service
which the American Public Health Association could possibly renter to
its members would be to establish a direct ¢ield service for the assistance

of the executive officers of health departubnts along the lines laid down

 

  
 
 
 
 

above. ‘The committee therefore sot out to obtain the funds necessary for

 

the establishaent of a service of this. sort and was once more fortunate in

ssouring the assistance of the lietropolitan Life Insur

 

AGG ) Company which 8
has evenniget the sum of $15,000 aoaaasary to carry on the work for ‘the year .
 

 

1925-244 It ig with the keenest satisfaction that we announce that

DreWeSe Rankin, State Health offtear of North Carolina, and, past Hrenkcant

of the American Public Health Association, has obtained leave of absence

from his state to undertake this work, which he has already attagked with

vision and enthfsiasm, and to which he will devote his full time after the

first of January. Wo more oonvinoing evidence could be found of the |

importance of this work and no better augury could be offered for its success

thon is found in the fact that Dr.Renkin has been willing to undertake it.
As Field Direator of the Committee on Municipal Health Department

 

Practice, DrsRankin, wrth—sseh-aortrt avy, will be at -
the service of the individual members of he American Public Health Association —

in aiding them through correspondence, personal visits, and spetial surveys,

: to build up the status of public health work in their individual commmitics,
| Your Gomnttee has felt that it would be of inestimable value to the health —

officer who is eriving to secure moral and financial Resting sor a constructive
public health program if there were available not only objective standards

by which the need for a rounded health program could be demonstrated

but also some definite machinery by which such standards acw.a be brought

to the attention of municipal officials and the general publicge We have —

felt it to be essential to the success of our objectives to create mach lnery

 

of this sorte As a first step it has seemed that a spirit of generous rivalry
between Gommunities could be promoted by offering a series of medals $i
recognition of attainment and advancement in community health services ‘the
first series of these medals (gold, silver, and bronze) we suggest may be |
awarded at the 1924 meeting of the American Public Health Association to the —

three cities of a. population of 100,000 and upward, which can show the most

nearly adequate coemennh te health service as of Jammry, 1924. Tho status aa

tne different sities ehould ¥ determined by personal surveys to be sonauated, ee

  

   

 

 
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the commmity health program (voluntary as well as official). It is the

hoped that scholarships or other methods of recognizing eminent personal :

Peason that we have taken no steps to earry out our plan im detail util : of

- . We have felt that any grading of health departments on al, 2, 3 basis

2 departments whose progress has been limiteds In Pogard to this matter,

 

he

. reprosentative agents of the Commi tte, rated on a scoring plan which will

 

be presented by Dr.Rankin during the present discussion for your consideration.
The scoring should take into agcount all health agencies forming a part of

 

purpose of the Committee that in awarding similar medals in succeeding
years the selection of the winners in the competition will be based not only

on actual attainment, but also on progress since Janay, 1924, and it is

accomplishment as well as commmnity achievement, may be introduced in the
titdang to develop & spirit of emulation in health services throughout the —
country. | |
Your Comaittee fully realizes the GL etioultios involved in such a program
and the importance of so carrying it out that the health officer who desires:
aid in the-stimmlation of local public opinion may regelve such aid without
the possibility of inviting eri ne of any ouier health department whieh
for. any reasen faile to measure up to the highest standards. It is for this

we had the opportunity at thie meeting for a full and frank Consultation
wit the health officers of the country's

 

or the etpression of their merits in terms of an arbitrary score card would a
be clearly out of the question. It is our hope that nitinately a APRA ORE i is

of departments into a small number of grades may pevhane be feasible; but for

 

the pResens we believe it would be bent to limit ourselves to the —

of notably distinctive serrlae without any attempt to evaluate the work of

 
 
 
  

however, we —_ to have the opinions of the z members of the Association expressed
in the course of the following discussions ] | oe
‘The basis on which health department practice shall be judged is a second
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health department practice mst be extended to the large

 

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point of perhaps even greater importance ant the nature of the recognition
to be granteds It is clear that the system of grading to be used must

be sufficiently elastic to take account of looal variations in the nature
of the health problems to be dealt with and of the part played in a given
cormuntity by voluntary agencies» ‘The Committee has given careful thought

to these wien during the past six months but has refrained fran adopting
any definite policy until your counsél could be obtained. Dr.Rankin will
present his ~eem@eteviews in regard to the matter in the subsequent :
discussion a we hope with your assistance that a sound basis for the work
oan be laide | :

In one respect, your Committee feels that its own personue]l needs to
~~ strengthened in order to deal wi th the problems involved in the proposed
program. Its membership at present includes but one mmicipal health officer
in agtive service and one other member who has served in the past as health
officer of a large city. We believe that several now meubers with direst

ee ftom
mandeipal ra
pie L

   

denies a nog should be — to our

, ne adi eet VE ees —— sm _— Pct Ca # ie

      

 

 

If the American Public Health Association is to fulfil its largest

| possibilities we are convinced that the work of standardiging and stimulating

 

Gities of Canada,
Cuba and Mexico, to small communities, to cowities and to state and provingial |

   

 

 
 

 

health departments. So soon as funds

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are available ines tasks too should —
be undertakene So far, however, as the problem primarily presented to the
eoopevation of the United States Public Health service and the Metropolitan

Committee is congerned we believe that the program worked ot through

 

Life Insurance Company Gonstitutes an encouraging report of progress. We

feel that the American Public Health Association, in initiating and supporting —

the activities of the past three years for the improvement of the character

i

of the service which its members render to their commu nities has shown a vision _ .

 

and a sense of public resp onsibility characteristic of the highest type of

professional spirits; and that the program if carried forward in the future
will Tesult in farereashing improvements of the public health service and
in @ substantial reduction in the burden of preventable disease and deaths