Health bulletin

              UNC-CH HEALTH SCIENCES LIBRARY
H00338139R
j
HEALTH SCIENCES LIBRARY
OF THE
UNIVERSITY OF NORTH CAROLINA
AT CHAPEL HILL
Inside
FDA Issues Warning About
Artificial Sweeteners . .
How It Was in the
Old North State
North Carolina Gets
Chief Medical Examiner
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 106 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Published
monthly. Second Class Postage paid at
Raleigh, N. C. Sent free upon request.
Editorial Board
John Andrews, B.S., Raleigh
Glenn A Flinchum. B.S.. Raleigh
Jacob Koomen. Jr., M.D , M.P.H., Raleigh
John C Lumsden, B C HE., Raleigh
H W Stevens. M.D., M.P.H., Asheville
Editor: H. B. Rogers
Vol. 84 January 1969 No. 1
Physical Therapy Assistant:
A New Health Career . .
Cover: Dr. R. Page Hudson Jr. takes
the oath of office as North Caro-lina's
first chief medical examiner.
He will direct the first statewide
system for post-mortem medicolegal
examinations.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
James S. Raper, M.D., President Asheville
Lenox D. Baker, M.D., Vice President Durham
Ben W. Dawsey, D.V.M. Gastonia
Ernest A. Randleman, Jr., B.S.Ph. Mount Airy
Paul F. Maness, M.D. Burlington
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pines
J. M. Lackey Rt. 2, Hiddenite
Howard Paul Steiger, M.D. Charlotte
EXECUTIVE STAFF
Jacob Koomen, M.D., M.P.H. State Health Director
W. Burns Jones, M.D., M.P.H. Assistant State Health Director
J. M. Jarrett, B.S. Director, Sanitary Engineering Division
Martin P. Hines, D.V.M., M.P.H. Director, Epidemiology Division
Ronald H. Levine, M.D., M.P.H. Director, Community Health Division
E. A. Pearson, Jr., D.D.S., M.P.H. Director, Dental Health Division.
Lynn G. Maddry, Ph.D., M.S.P.H. Director, Laboratory Division
Ben Eaton, Jr., A.B., LL.B. Director, Administrative Services Division
Theodore D. Scurletis, M.D. Director, Personal Health Division
THE HEALTH BULLETIN January 1969
FDA Issues Warning About
Artificial Sweeteners
The U. S. Food and Drug Administration has warned against
the unrestricted use of cyclamates, the most commonly used
artificial sweeteners.
FDA has issued a statement reflecting interim findings of the
National Academy of Sciences, ivhich conducted a review of the
safety of artificial sweeteners.
An FDA spokesman said, "Our one concern is that children
and adults not only drink artificially siceetened carbonated soft
drinks hut also consume many other products containing artificial
sweeteners such as gum, candy, puddings, cookies, etc."
The text of the official FDA statement:
Many kinds of foods and
drinks sweetened with su-gar
substitutes are now
available in the stores. Be-cause
of this widespread
and growing use, FDA
sometime ago asked the
National Academy of
Sciences to review the
safety of these artificial
sweeteners.
An Academy Committee
has now submitted an in-terim
report advising that
cyclamate sweeteners
should not be used in total-ly
unrestricted amounts.
Cyclamates are the most
commonly used artificial
sweeteners.
The Committee's rec-ommendation
was made
because of questions scien-tists
still have about the
effects of the cyclamates.
However, the Committee
did say this: An adult can
consume up to five grams
of cyclamate a day without
any probable hazard. Chil-
January 1969 THE HEALTH BULLETIN
dren should use propor-tionately
less. The smaller
they are, the less they
should use. The World
Health Organization has
recommended a daily limit
based on weight. Its for-mula
works out to a limit
of about one and one-third
grams of cyclamate a day
for a 60-pound child.
Here's one way to trans-late
that into practical
terms: Artificially sweet-ened
carbonated soft drinks
—which account for most
of the cyclamate consump-tion
by the average con-sumer—
contain from one-quarter
to a little more
than one gram of cyclamate
in each 12-ounce bottle.
How It Was In The
Old North State
HOW TO SLEEP
Here are a few common sense directions guaranteed to be bene-ficial
in ninety-five out of every one hundred cases of insomnia.
Get enough phvsical exercise during the day to tire you.
Go to bed at the first urgent invitation of Morpheus.
Be sure the bed is comfortable and the room is quiet.
Think pleasant thoughts.
Don't have the head of the bed lower than the foot.
Be sure there is no other livestock in the bed with you; if there
are, change boarding- houses.
If you haven't bathed latelv, try a good application of soap and
warm water just before retiring. This is said to work wonders in
more directions than one.
If vour neighbors' cats also have insomnia, throw them a few
Jackson crackers. If this fails, a shotgun is known to be a sure
remedy.
Eat supper at least two hours before retiring. Eat a light supper
and take nothing indigestible.
Don't worry and don't take dope.
If vou don't get to sleep right awav and if vou don't sleep quite
as much as vou think vou should, remember that even lying awake
in bed is very restful. — The Health' Bulletin, Vol. XXX, No. 3,
June 1915
THE HEALTH BULLETIN January 1969
Dr. Hudson (right) checks
a point with Associate Jus-tice
Susie Sharp of the
State Supreme Court fol-lowing
sicearing -in cere-mony.
Justice Sharp admin-istered
the oath of office
to the new chief medical
examiner.
North Carolina Gets
Chief Medical Examiner
"I shall not be sparing of my-self
or others in an effort to
seek the truth and contribute to
justice."
With these words, Dr. R.
Page Hudson Jr. took office as
North Carolina's first chief med-ical
examiner.
Associate Justice Susie Sharp
of the North Carolina State Su-preme
Court administered the
oath of office at ceremonies
December 6, 1968 in Raleigh.
On the platform with Dr.
Hudson and Justice Sharp were
Dr. Jacob Koomen, State health
director, and State Senator
John J. Burney of Wilmington,
author of the bill passed by the
1967 North Carolina General
(Continued on page 8)
State Senator John J. Bur-ney
of Wilmington wrote
the legislation enacted by
the 1967 General Assembly
creating North Carolina's
first statewide medical ex-aminer
system.
January 1969 THE HEALTH BULLETIN
Physical Therapy Assistant:
A New Health Career in North Carolina
BY NANCY L. DUCKETT
Public Information Officer
Department of Communty Colleges
An educational program to
train people to become physical
therapy assistants is now avail-able
for the first time in North
Carolina. The pilot program is
being offered by Central Pied-mont
Community College in
Charlotte.
According to Robert L. Gos-sett,
director of the Central
Piedmont physical therapy as-sistant
program, there are 11
students already enrolled in the
six-quarter course, which began
at the community college early
in October.
Even though all of the stu-dents
presently enrolled are
women, Mr. Gossett points out
that the program is most desira-ble
for men, too.
To be admitted into the pro-gram,
a student must be a
high school graduate or he must
have earned a high school
equivalency certificate.
Mr. Gossett explained that
the physical therapy assistant
curriculum is made up of gen-eral
college courses and techni-cal
offerings. So that the stu-dents
are able to practice what
they are taught at the com-munity
college, they spend time
away from the school in clinical
areas. "This will begin mid-way
through the second quarter,"
said Mr. Gossett.
In no way should the physi-cal
therapy program, which
leads to an associate in applied
science degree, be confused
THE HEALTH BULLETIN January 1969
with those programs designed
to prepare a person to become
a physical therapist. A physical
therapist must have, at the
minimum, a baccalaureate de-gree.
In addition, to meet the
standards for qualification of
the American Physical Therapy
Association (APTA), a person
must be licensed or registered
by the state when licensure
laws are applicable.
The American Physical Ther-apy
Association recently adopt-ed
a policy statement support-ing
the training and utilization
of the physical therapy assist-ant.
This resulted from the
current inability of established
programs for the education of
physical therapists to produce
numbers of professionals to
meet the growing health needs,
coupled with the realization
that many patient care needs
can be met by a type of worker
who has formal training at the
technical level.
The 1967 policy statement de-fines
the physical therapy as-sistant
as "a skilled technical
health worker who has com-pleted
an educational program
approved by the association."
The statement continues to
explain that "such an individu-al
functions to assist the quali-fied
physical therapist in pa-tient
related activities. The
degree of assistance depends, in
part, upon the type of physical
therapy service in which the
assistant is employed and upon
the health needs of the patient."
Also, "He [the physical thera-py
assistant] is capable of per-forming
routine treatment pro-cedures
in accordance with
planned programs and of assist-ing
the qualified physical thera-pist
in carrying out complex
procedures and programs. The
physical therapy assistant
works within a physical thera-py
service administered by a
qualified physical therapist
who meets the standards of
APTA. The assistant performs
his duties with direction and
supervision of the physical
therapist to whom he is direct-ly
responsible."
Programs for the education
of the physical therapy assist-ant
are being established in
many areas c ' *he nation. In
North Carolina, the State Ad-visory
Committee for the edu-cation
of the physical therapy
assistant was formed in 1967
by the Department of Commu-nity
Colleges at the request of
the State Physical Therapy As-sociation.
This committee is
made up of physical therapists
and others interested in provid-ing
better and more complete
health care.
In 1967 the laboratory division of the North Carolina State Board of
Health was requested to distribute 84,690 doses of typhoid vaccine. The
year before that, 82,220 doses were distributed.
There were five new cases of typhoid in North Carolina in 1967.
Typhoid immunization is indicated only if there is household contact
with a known typhoid carrier, or if there is a common-source outbreak
in a community, or if a person is traveling to a foreign country.
January 1969 THE HEALTH BULLETIN
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
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N.C. DENTAL SOC.
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RALEIGH, N.C.
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Chief Medical Examiner (Continued from page 5)
Assembly creating the state-wide
medical examiner system.
Among the 100 persons look-ing
on were members of Dr.
Hudson's family, colleagues
from the campus of the Univer-sity
of North Carolina at Chapel
Hill, and associates from the
State Board of Health adminis-trative
staff.
The office of chief medical
examiner, a function of the
State Board of Health, is housed
on the university campus. It
will operate in close collabora-tion
with the UNC School of
Medicine.
Dr. Hudson recognized the
oath-taking ceremony as a trib-ute
to the extended concern for
people by state and local gov-ernments
in North Carolina, to
determined cooperation of the
legal and medical professions,
and to enlightened public opin-ion.
The medical examiner sys-tem,
he said, will bring medical
science and other sciences to
the investigation of sudden, un-expected
or unnatural deaths in
North Carolina. There are some
9,000 such cases in the State
each year.
He declared four objectives
for the medical examiner pro-gram
:
• protection of the innocent
• recognition of homicide
and suicide
• unbiased medical evidence
for criminal and civil
courts
• identification of public
health and industrial haz-ards.
8 THE HEALTH BULLETIN January 1969
[HUOTH
icial Publication Of The North Carolina State Board of Health
Inside
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 106 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Published
monthly. Second Class Postage paid at
Raleigh, N. C. Sent free upon request.
Editorial Board
John Andrews, B.S., Raleigh
Glenn A. Flinchum. B.S., Raleigh
Jacob Koomen, Jr., M.D., M.P.H., Raleigh
John c Lumsden, B C.H.E., Raleigh
Rubella Vaccine Being
Tested 2
The 1969 Official Easter
Seal Child 5
Revised Communicable
Disease Regulations 7
Easter Seal Programs 12
Medicare Premium
Stays Same 15
Research Triangle Facility
Elevated 16
Editor: H. B. Rogers
Vol. 84 February 1969 No. 2
Cover: Three years ago, when she
was four, Donna Kay Howell was
crippled by a rare childhood stroke
which left the right side of her
body completely paralyzed. She
couldn't stand or walk, and she
had a problem with her speech.
Now, Donna Kay is seven. She
is making a remarkable recovery,
thanks to the skill of doctors and
the physical, occupational and
speech therapists at the Easter
Seal Rehabilitation Center in Tal-lahassee,
Florida.
Donna Kay Howell is the 1969
official Easter Seal child. Her story
is on page 5.
THE HEALTH BULLETIN February 1969
German Measles Vaccine
Being Tested
One Test in North Carolina
By DR. JOHN D. HAMILTON
An effective vaccine for ru-bella—
German measles—is now
a very real possibility for the
near future. And an experiment
underway in North Carolina's
Wake County is playing a ma-jor
role in the developments.
With few other vaccines has
the potential for prevention of
serious consequences been so
great as with the rubella vac-cine
now being tested.
Although a relatively incon-sequential
disease in itself, ru-bella
may have devastating con-sequences
for a pregnant wom-an—
and for the child she is
carrying.
For many years the causes of
cataracts, deafness, congenital
heart disease and mental re-tardation
were not known. But
in 1941 a doctor reported for
the first time that cataracts in
a newborn infant can follow
Dr. Hamilton is Epidemiology In-telligence
Service Officer for the
North Carolina State Board of
Health.
when the mother had German
measles during pregnancy. In
the years since that original re-port,
the association of maternal
rubella to the other conditions
in newborn infants has been
well documented.
In 1964-65 the United States
was hit by an epidemic of ru-bella.
Experts say some 10,000-
20,000 infants may have been
born with congenital malforma-tions
as a direct result of mater-nal
infection.
The rubella virus was suc-cessfully
cultivated in tissue
culture in 1962. This opened the
door to serologic studies — the
groundwork in developing any
vaccine. Soon afterwards, stu-dies
began on a vaccine pre-pared
by two physicians at the
National Institutes of Health.
Today, after several years of
testing for both favorable and
adverse effects, clinical trials of
the Meyer - Parkman HPV-77
duck embryo vaccine are being
conducted. One of the most ex-
February 1969 THE HEALTH BULLETIN
tensive trials has been under-taken
in Wake County with the
support of the Merck Institute
for Therapeutic Research.
The North Carolina rubella
trial started last September. Dr.
Joseph Pagano of the Depart-ment
of Medicine at the Uni-versity
of North Carolina at
Chapel Hill and Dr. Richard
Lipman of the Department of
Pediatrics there directed and
coordinated the project.
Cooperating and collaborating
with these investigators were
Dr. Millard Bethel and Dr. Jane
Wooten of the Wake County
Health Department and their
entire staff. Full cooperation
also came from superintendents,
principals and teachers in the
Raleigh city and Wake County
schools. In addition there were
volunteers from the North Caro-lina
State Board of Health in
Raleigh and North Carolina
Memorial Hospital at Chapel
Hill.
The trial has involved 63
schools in Wake County. Ap-proximately
5,200 first and sec-ond
graders received a dose of
the live rubella vaccine. Their
reactions were documented by
daily fever records taken in the
schools. Home records were
kept by the parents.
Eight schools were involved
in vaccine-serolosy studies. At
these schools 671 families, in-cluding
this same number of
mothers and 1,077 of their chil-dren
between the ages of 4-9,
received the vaccine or placebo
(artificial harmless fluid), ac-cording
to a pre-arranged sche-dule.
Acute serum blood sample
was taken and careful records
kept on the patients. In Novem-ber
a follow-up blood sample
was taken. Serologic evaluation
of these patients will allow the
investigators to determine and
document the effectiveness of
the vaccine in immunizing the
children, and, at the same time,
to measure the effectiveness of
the vaccine in controlling the
transmission of the disease from
children to mothers. Any ad-verse
reactions will be docu-mented
by home and school
records.
The results of the Wake
County trial will soon be avail-able.
Previous studies suggest
that the immunologic response
will be excellent, and transmis-sibility
and adverse reactions
absent. In addition, the trial has
allowed the effective immuniza-tion
of a large segment of Wake
County's primary school popu-lation.
If all goes well, the results of
the Wake County study and
others underway in other places
will lead to licensing of the ru-bella
vaccine within a year
—
hoDPfully before the next lar?e
rubella enidemic, which is pre-dicted
in 1970.
THE HEALTH BULLETIN February 1969
The 1969 Official Easter Seal Child
Donna Kay Howell
Donna Kay Howell, seven-years-
old, of Tallahassee, Flori-da,
has been named 1969 Na-tional
Easter Seal Child. The
campaign this year opens March
1 and continues to April 6.
The pretty little brunette,
victim of a rare childhood
stroke, will help launch the
Easter Seal appeal and take a
nationwide trip.
Hit by the stroke when she
was four, Donna Kay suffered
complete paralysis of the right
side of her body. She was un-
1
able to stand or walk, and she
had a problem with her speech.
After a three-week period of
hospitalization, Donna Kay was
referred to the Easter Seal Re-habilitation
Center in Tallahas-see.
There, physical, occupa-tional
and speech therapists be-gan
working to help her over-come
the crippling effects of the
stroke.
Donna Kay made a full recov-ery
from her speech defect after
a month of treatment. She still
receives physical and occupa-tional
therapy at the center
once a week to correct a slight
limp and restore full use of her
right hand. Treatment includes
muscle re-education, gait train-ing
and electrical stimulation
to the wrist.
Donna Kay's father, Jack, is
a draftsman and her mother,
Opal, is a beautician. The cou-ple
has one other daughter,
Janice Lynn, three-years-old.
February 1969 THE HEALTH BULLETIN
Despite her handicap, Donna
Kay is active, sometimes a tom-boy,
sometimes a demure young
lady. She runs and plays with
neighborhood children and
when it comes to climbing trees,
one of her favorite activities,
she can out-shinny almost every
boy in the neighborhood.
Donna Kay, a second grader
in public school, is bright, alert
and attentive in class.
Easter Seal affiliates in every
state, Puerto Rico and Washing-ton,
D. C, provided direct treat-ment
and other services to more
than 253,000 crippled children
and adults last year. Contribu-tions
made during the annual
appeal are the major source of
financing for 2,844 Easter Seal
facilities and programs.
Short Course For Nurses
A two-week short course for pro-fessional
nurses who supervise per-sonnel
in cardiac units will be given
three times in the coming year at
the University of North Carolina at
Chapel Hill.
The course, entitled Scientific
Approach to Supervision of Cardiac
Units—Personnel, Patients and Prac-tices,
will be offered through the
Continuing Education Program of
the UNC School of Nursing.
Federal traineeships are available.
Starting dates for the course this
_
vear are April 21 and November 3.
A course will start February 2, 1970.
Further information is available
from
:
Susanna L. Chase, Director
Continuing Education in Nursing
The University of North Carolina
at Chapel Hill
Chapel Hill, N. C. 27514
Public Health Workers to Meet
The 1969 meeting of the Southern Branch of the American
Public Health Association will be held May 21-23 in Oklahoma
City, Oklahoma.
The 37th annual meeting of the organization is expected to
attract public health workers from 16 states and the District of
Columbia.
The theme of the meeting will be "The Seventies—Decade for
Decision."
Keynote speaker will be Dr. Myron E. Wegman, dean of the
School of Public Health at the University of Michigan. He will
speak on "The Health Consumer—Needs and Wants."
World Health Day ivill be observed April 7, 1969. The day will mark the
anniversary of the coming into force of the World Health Organization
(WHO). The theme of World Health Day this year is "Health, Labor
and Productivity."
THE HEALTH BULLETIN February 1969
Reportable Diseases
Communicable Disease Regulations
Revised By State Board of Health
On the following four pages is a newly published summary of
revised communicable disease regulations approved by the North
Carolina State Board of Health last fall.
The new regulations mark the first general revision since 1944.
The main changes, according to Dr. J. N. MacCormack, con-sultant
to the Communicable Disease Control Section of the State
Board of Health, are in the isolation and quarantine regulations
for individuals.
Copies of the summary are available upon request from the
Communicable Disease Control Section, North Carolina State
Board of Health, Post Office Box 2091, Raleigh, N. C. 27602.
February 1969 THE HEALTH BULLETIN
CO s c
10 THE HEALTH BULLETIN February 1969
Adults and
Children Are
Beneficiaries of
Easter Seal
Programs
'•
An elderly stroke patient gets help
along the road to recovery by a phy-sical
therapist at an Easter Seal
Center.
It has been half a century
since the National Easter Seal
Society, a voluntary organiza-tion
that now serves almost a
quarter of a million crippled
children and adults annually,
first extended its services to one
crippled child in a hospital in
Ohio.
The plight of the child, a boy
who needed expensive surgery
and therapy if he was to be able
to stand and walk, came to the
attention of Edgar F. Allen, an
Elyria businessman whose own
son had been injured in a street-car
collision and died for lack of
emergency medical facilities.
Allen gave up his prosperous
business, set about raising the
necessary funds, and, in 1921,
opened a hospital for crippled
children.
The hospital was not an im-mediate
success. Parents of
crippled children were slow to
risk public exposure in order to
bring their children to the new
hospital for treatment.
It took the patience and per-sistence
of volunteers and pub-lic
health nurses to seek out the
children and persuade their par-ents
to abandon their feelings
of guilt and shame to get help
for their offspring.
12 THE HEALTH BULLETIN February 1969
As parental resistence was
broken, the hospital's staff found
itself deluged with requests for
treatment.
Rotarians provided major
support for the society's pro-grams
of medical and referral
care for crippled children in the
early days. They also did much
to bring about legislation estab-lishing
state services for handi-capped
children.
But progress was slow. In
1924, three years after Allen
founded the hospital, there
were only 9,000 beds available
in hospitals and other institu-tions
to treat 289,000 children
known to be suffering from con-genital
defects, cerebral palsy
and crippling caused by tuber-culosis
and other conditions.
Five years later — in 1929 —
there were 23 state crippled
children's societies, operating
largely through making direct
payments for the care, treat-ment
and education of crippled
children and seeking legislation
for them.
Easter Seal rehabilitee
ion centers offer voca-tional
training that can
open the door to new
life for accident victims
by teaching them new
trades.
The National Society adopted
Easter Seals as a fund raising
device in 1934. That year, the
Easter Seal appeal raised $47,-
052. In 1967, its income was
more than $27 million.
An era of expansion began
with the National Society's
move to Chicago in 1944. With
Easter Seal societies in various
stages of development in 40
states, the national organization
soon included state and local
affiliates in the 50 states, the
District of Columbia and Puerto
Rico.
A national staff of profes-sional
consultants in care and
treatment organization, public
education and fund raising was
developed to serve these affil-iates
and to formulate new na-tional
projects and programs.
The society's treatment pro-grams
were extended and their
emphasis changed to meet new
health needs. Programs which
formerly were centered around
hospitals and convalescent care
were redirected to rehabilita-
February 1969 THE HEALTH BULLETIN 13
tion services at the community
level.
Having established care and
treatment and education pro-grams
in fulfillment of its ob-jectives,
the Society, in 1953,
established the Easter Seal Re-search
Foundation, realizing a
third major objective.
Today, the Easter Seal So-ciety,
with its hundreds of state
and local affiliates, operating
more than 2,000 facilities and
programs, is the largest of its
kind in the nation. Its affiliates
offer help to handicapped chil-dren
and adults through re-habilitation
and treatment cen-ters;
clinics; camps; sheltered
workshops; home employment;
physical; occupatio nal and
speech therapy programs; and
other related services.
Physical therapy is an
important first step to-ward
rehabilitation for
youngsters at Easter
Seal centers.
Heart Acts as Thermostat
for the Body
Your heart and blood play an important part in "thermal
regulation," which helps keep you warm in cold weather and
cool in hot weather, says the North Carolina Heart Association.
Because the body's built-in thermostatic machinery takes time
to adjust to weather extremes, you should be careful about jump-ing
from one extreme to the other. Make the change gradually,
if possible. Or, if you find yourself caught in a sudden change,
try to rest before becoming active. This will give your body time
to adjust to the different weather environment.
14 THE HEALTH BULLETIN February 1969
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
James S. Raper, M.D., President Asheville
Lenox D. Baker, M.D., Vice President Durham
Ben W. Dawsey, D.V.M. Gastonia
Ernest A. Randleman, Jr., B.S.Ph. Mount Airy
Paul F. Maness, M.D. Burlington
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pines
J. M. Lackey Rt. 2 , Hiddenite
Howard Paul Steiger, M.D. Charlotte
EXECUTIVE STAFF
Jacob Koomen, M.D., M.P.H. state Health Director
W. Burns Jones, M.D., M.P.H. Assistant State Health Director
J. M. Jarrett, B.S. Director, Sanitary Engineering Division
Martin P. Hines, D.V.M. , M.P.H. Director, Epidemiology Division
Ronald H. Levine, M.D., M.P.H. Director, Community Health Division
E. A. Pearson, Jr., D.D.S., M.P.H. Director, Dental Health Division
Lynn G. Maddry, Ph.D., M.S.P.H. Director, Laboratory Division
Ben Eaton, Jr., A.B., LL.B. Director, Administrative Services Division
Theodore D. Scurletis, M.D. Director, Personal Health Division
Medicare Premium Stays Same
The monthly premium older
people pay for the voluntary
medical insurance part of Medi-care
will remain at the present
$4 for the period July 1969
through June 1970.
The premium covers half the
cost of protection that helps pay
doctors' and surgeons' bills and
a variety of other health care
expenses. The other half is paid
out of federal general revenues.
Robert A. Flynn, social secur-ity
district administrator in Ra-leigh,
said that 95 per cent of
the population aged 65 and over
are now enrolled in the supple-mentary
medical insurance pro-gram.
Participation is up from
the 91 per cent enrolled when
Medicare began July 1, 1966.
Flynn said a new enrollment
period opened January 1, 1967
to provide another chance for
people who missed out earlier to
sign up for the medical insur-ance
protection. For persons
born on or before October 1,
1901, and for those who have
been enrolled but dropped out
before January 1, 1967, the new
period will be the last chance
to enroll.
Older people who delay in en-rolling
pay a premium that is
10 per cent higher for each full
year they could have had the
medical insurance protection
but were not enrolled. And
those who wait three years past
their first chance to sign up can-not
get the coverage at all.
February 1969 THE HEALTH BULLETIN 15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
EXEC
If you do NOT wish to con-tinue
receiving The Health Bul-letin,
please check here l l
and return this page to
the address above. Printed by The Graphic Press, Inc., Raleigh, N. C
Research Triangle Park Facility
Is Elevated
The National Institute of
Environmental Health Sciences
(NIEHS) in North Carolina's
Research Triangle Park has
been established as one of the
National Institutes of Health.
The headquarters and re-search
center of NIEHS operate
under a budget of $17.8 million
for the current fiscal year. The
facility, directed by Dr. Paul
Kotin, is the only major com-ponent
of NIH located away
from the parent organization's
campus at Bethesda, Md.
Scientists at the research cen-ter
are working to identify
harmful environmental agents,
to determine the mechanisms
by which those agents affect an
individual's health, and to de-velop
data on the effects of long-term,
low-level exposures.
NIEHS is also the hub for
nationwide federal support of
basic research and research
training in the environmental
health sciences.
Former HEW Secretary Wil-bur
J. Cohen said knowledge
developed at the Research Tri-angle
facility will provide a
scientific base upon which meas-ures
can be developed to help
control or prevent environmen-tal
health problems. He called
this "a major priority for
HEW."
16 THE HEALTH BULLETIN February 1969
can/a™ bqdqjui™
The Official Publication Of The North Carolina State Board of Health
bu ,|o«d ^°n t°
3ie 's „„_„
March, 1969
Inside
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 106 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Published
monthly. Second Class Postage paid at
Raleigh, N. C. Sent free upon request.
Editorial Board
John Andrews, B.S., Raleigh
Glenn a. Flinchum, B.S., Raleigh
Jacob Koomen, Jr., M.D.. M.P.H., Raleigh
John c. Lumsden, B.C.H.E., Raleigh
Editor: H. B. Rogers
Social Security's Disability
Program
By Robert A. Flynn 3
Vol. 84 March 1969 No. 3
Man Can Function in Deep
Water for Extended Period of
Time 7
Cover: Certificate of live birth,
Persons Examined in Cancer
_. . „ . „ t, license and certificate of marriage,
Detection Centers in North °
Carolina (Map) 10 certificate of fetal death, certified
record of divorce decree granted,
Vital Statistics in North certificate of death: the documents
Carolina
By Glenn Flinchum 11
that record the Vltal events of 0Ur
lives. These are the makings of the
Also Public Health Statistics Section of
A reminder about heart the North Carolina State Board of
disease 6 Health. Keeping tabs on the docu-ments
for millions of North Caro-
Tips for Parents of Young ... . ~. ~. ri .
_
H s
linians keeps Director Glenn Flm-
Campers 9
chum and his staff busy. Mr.
How it Was in the Old Flinchum tells the story, starting
North State 13 on page 11.
2 THE HEALTH BULLETIN March 1969
So-tied SeccciCtcft
Disabled workers and their dependents can get
financial help at the time they probably need it
most. But they must know about the benefits
and apply for them.
By ROBERT A. FLYNN
Disability, whether caused by
injury or illness, can mean
serious financial problems for
any family. If your income stop-ped
because of disability, would
your family need help to meet
the necessities of life?
Social security disability in-surance
benefits help replace
lost income by paying monthly
cash benefits when serious dis-ability
strikes.
Mr. Flynn is Raleigh district man-ager,
Social Security Administrar
tion.
Each year about 300,000 dis-abled
workers and their families
begin receiving social security
disability benefits. In recent
months about two of every
three disabled workers who ap-ply
for benefits have been found
eligible. Unfortunately, many
disabled workers who could re-ceive
benefits do not apply for
them, often because they do not
know these benefits are avail-able.
Four of every five men and
women age 25-64 can count on
receiving benefits in the event
March 1969 THE HEALTH BULLETIN
the breadwinner suffers a
severe and prolonged disability.
This protection means that
you can look to social security
for financial help if you become
severely disabled and cannot
work. At a time when you
would probably need help the
most, social security disability
benefits would be available to
help you through the financial
crisis.
What Is 'Disabled?
Just what does "disabled"
mean? Well, you're disabled if
you have a physical or mental
impairment which prevents you
from doing substantial work
and which has lasted (or is ex-pected
to last) twelve months or
more. The payments can begin
with the seventh month of dis-ability.
Monthly benefits con-tinue
as long as your disability
prevents you from working.
Payments for a disabled
worker now range from $55 to
$204 a month, depending on his
average earnings under social
security. And if you start re-ceiving
benefits, your wife and
children also may receive bene-fits
as your dependents. Total
family benefits can amount to
as much as $415.20 a month at
this time.
A person who is over 31 when
he becomes disabled can receive
benefits if he has social security
credit for five years of work in
the ten years before he became
disabled.
Before 1968 the five-years-of-work
rule applied to everyone.
A change in the law early in
1968, however, reduced the
amount of work credit needed
by a worker disabled before 31.
Now a worker who becomes dis-abled
between 24 and 31 needs
social security credit for only
half the time between 21 and
the beginning of his disability.
Workers disabled before 24 need
one and one-half years' credit
in the three-year period before
the disability begins.
Dependent's Benefits
There are two other impor-tant
types of social security dis-ability
payments; both go to de-pendents
of workers after the
worker has started receiving re-tirement
or disability benefits
or has died. These are benefits
for adults disabled before 18
who continue to be disabled
after 18, and benefits at 50 or
later for disabled widows. Dis-abled
widowers who were de-pendent
on their wives for sup-port
can also get benefits under
this part of the law, as can some
former wives who had been
divorced but who were still re-ceiving
support from their
former husbands.
Disabled widows 50-60 can
get benefits based on their
spouse's social security record
only if they become disabled be-fore
the worker's death or with-
THE HEALTH BULLETIN March 1969
in seven years after his death.
However, if a widow received
social security benefits as a
mother with children, she can
get disabled widow's payments
if she becomes disabled before
those payments end or within
seven years after they end.
The seven-year period is in-tended
to give her an opportun-ity
to work long enough under
social security to receive social
security disability benefits on
her own earnings.
Childhood Disability Benefits
A person who was disabled
before 18 and has not married
can get benefits based on the
earnings of either of his parents.
The payments begin at the time
the parent covered under social
security retires, becomes dis-abled,
or dies.
Each year about 25,000 peo-ple
begin to receive these "child-hood
disability" benefits. Some
of them are in their fifties and
sixties at the time benefits be-gin.
A disabled widow, widower,
or divorced wife may be consid-ered
disabled only if she or he
has an impairment so severe
that it would ordinarily pre-vent
a person from working.
Other factors such as age, ed-ucation,
and work experience
may be considered in determin-ing
whether a worker is dis-abled
but are not considered for
these survivors.
At 62 a widow receives 82.5
per cent of her deceased hus-band's
retirement benefit. If she
starts receiving widow's dis-ability
benefits at an earlier
age, she gets a permanently re-duced
amount.
The amount depends on what
the husband's retirement bene-fits
would have been had he
been 65 at the time of his death
and how old the widow is at the
time benefits begin. For ex-ample,
if a widow starts to get
benefits at 50, she receives 50
per cent of her husband's bene-fit
(figured as though he was
65 at death). At 55 she receives
about 60.75 per cent of the hus-band's
amount. At 58, it is about
67 per cent.
Objective Is Self-Support
A major objective of the so-cial
security disability program
is to encourage disabled persons
to undertake rehabilitation pro-grams
and to become self-sup-porting.
All disability applicants are
considered for vocational re-habilitation
services whether or
not their claims are approved.
The services are provided by
State vocational rehabilitation
agencies—usually at no cost to
the disabled person. The agen-cies
provide vocational counsel-ing
training and help in finding
a job, and medical services and
supplies.
State vocational rehabilita-
March 1969 THE HEALTH BULLETIN
tion agencies have so far report-ed
about 100,000 disability
claimants successfully rehabil-itated.
Since the program began,
more than 185,000 disabled
beneficiaries have been taken
off the disability benefit rolls
because of recovery or return
to work.
Rehabilitation services are
generally financed jointly by
the State and the federal gov-ernment,
with funds from gen-eral
revenues. In some cases,
however, social security pays
the cost of rehabilitating peo-ple
receiving disability benefits.
These cases should save social
security funds in the long run
because the cost of rehabilitat-ing
beneficiaries is less than the
cost of paying them benefits.
The social security disability
program has helped millions of
disabled workers in times of
financial stress by providing a
regular monthly income when
the breadwinner could not
work. Thousands of workers
have been returned to produc-tive
work through the joint ef-forts
of the Social Security Ad-ministration
and State vocation-al
rehabilitation agencies.
Your social security office
will answer any questions you
may have about social security's
disability program. Call, write,
or visit the office. The people
there will be glad to help you.
HEART DISEASE STILL EPIDEMIC
The North Carolina State Board of Health, in its recently released
report of vital statistics for the year 1968, indicated that there were
23,617 deaths attributable to cardiovascular-renal diseases.
Overall deaths reported in the Tar Heel State for 1968 were 44,396.
This points up that out of all deaths in North Carolina for the year 1968,
53.2 per cent were the direct result of cardiovascular-renal diseases.
According to the State Board of Health report, of the 23,617 deaths
attributed to heart and kidney diseases, heart disease was responsible
for 15,768, stroke accounted for 5,747, atherosclerosis 639, nephritis
257, and other cardiovascular-renal diseases 1,206.
The North Carolina Heart Association notes that while the total
number of deaths from heart disease is still holding at about the same
percentage of total deaths as in the past five years, the figure of 53.2
per cent is still indicative of the epidemic proportions of heart disease
in our State.
THE HEALTH BULLETIN March 1969
NEW EQUIPMENT TESTED—Chief Mur-ray
Cato, one of the five divers who par-ticipated
in Duke University's simulated
dive to 1,000 feet beneath the surface of the
sea, tests new underwater equipment in the
hyperbaric chamber's "wet pot." At left is
Chief Sam Smelko, also of the U.S. Navy.
Frank Falejczyk of Scott Aviation Corp is
on the right.
Duke University Experiment
MAN CAN FUNCTION IN DEEP WATER
FOR EXTENDED PERIOD OF TIME
The world that exists one
thousand feet beneath the sur-face
of the sea has been opened
to human exploration by scien-tists
and technicians on the
landlocked campus of Duke Uni-versity
at Durham, N. C.
In an experiment lasting six-teen
days last December, five
divers entered the hyperbaric
March 1969 THE HEALTH BULLETIN
«
MONITORING THE DIVE—Duke University Medical Center personnel
listen to reports from five divers who spent 16 days in an experimental
simulated dive at the Duke hyperbaric chamber. From left are Dr. Herbert
Saltzman, director of the hyperbaric unit; Mrs. Laura Sheppard, chief
medical technologist; Dr. John V. Salzano, associate professor of phy-siology-
pharmacology; and Dr. Wirt W. Smith, assistant director of the
hyperbaric unit.
chamber at the Duke Medical
Center and demonstrated that
man can function effectively at
one thousand-foot depths for
extended periods.
The divers, two from the uni-versity
and three from the U.S.
Navy, spent IIV2 hours at a
simulated pressure of one thou-sand
feet. The rest of the time
was spent compressing down to
the bottom depth and then re-turning
to normal pressure.
In the experiment the men
breathed a mixture of gases
containing 96 per cent helium,
3 per cent nitrogen, and 1 per
cent oxygen. The normal con-centrations
of nitrogen and oxy-gen
in surface air are poisonous
or narcotic at the depths to
which the men descended.
During their three days at
the bottom, the divers under-went
a battery of physical and
psychological testing. The re-sults,
while not yet conclusive,
indicate that man can function
at such depths with little or no
impairment or discomfort.
8 THE HEALTH BULLETIN March 1969
The exercise tests, which
used a calibrated cycle and in
which blood gases, expired gas-es
and atmosopheric gases were
measured, indicated normal
function. The psychological
tests showed some anxiety on
the part of the men, but only
what was described as normal
under the circumstances.
Some of the divers experi-enced
slight pain in their joints
where the joints were fully ex-tended
during exercises, but
monitors considered this nei-ther
significant nor unexpected.
One of the divers experienced
a slight case of the bends—
a
decompression sickness which
occurs when divers ascend too
rapidly. But the problem was
quickly remedied.
The divers were, from Duke:
Delmar L. Shelton, hyperbaric
chamber operator and techni-cian,
and Frank J. Falejczyk of
Scott Aviation Corp., working
with the university; from the
U.S. Navy Experimental Diving
Unit: Lt. Cmdr. James Kelly,
M.D., Chief Francis J. Smelko,
and Chief Murray Cato.
Dr. Herbert A. Saltzman is
director of the hyperbaric unit.
Lt. Cmdr. James Summitt is
senior medical officer of the
Navy's Experimental Diving
Unit.
TIP FOR PARENTS OF YOUNG CAMPERS
Sending a child to camp this summer?
It's always a good idea to check out the camp thoroughly, in advance.
Take a close look at the camp site and physical plant, to be sure. But
also evaluate carefully the food and water supply and the medical care
and staff supervision.
A good camp director will be eager to have you visit, to talk to staff
members and campers, and to ask questions.
March 1969 THE HEALTH BULLETIN
ct oo
UJ U3
10 THE HEALTH BULLETIN March 1969
VITAL STATISTICS IN NORTH CAROLINA
BY GLENN FLINCHTJM
In the minds of many people,
the word statistics connotes an
array of dull, dry figures which
are of little interest to anyone
but a statistician.
If preceded by the word "vi-tal,"
however, we get a new
meaning which becomes quite
personal when we consider that
all of us at one time or another
counted in the statistics of life
and death.
The term "vital statistics" as
used here applies to records of
birth, death, marriage and di-vorce,
as well as information
derived from these records.
North Carolina began record-ing
births and deaths on a state-wide
basis on October 1, 1913.
The motivating force behind the
action was the pressing need
for birth and death information
upon which to base public
health programs.
Dr. W. S. Rankin, State
health officer at the time, gave
this need number one priority
in his legislative program. He
stated his case as follows:
". . . We have reached the
stage in public health work in
this state from which we can
make practically no advance
until a vital statistics law is
passed."
He further stated that trying
to administer public health
without vital statistics was like
fighting an unknown enemy in
ambush: You fire a few shots
here and there, never knowing
if you're shooting at the right
places.
Following the enactment of
the law by the General Assem-bly,
the Bureau of Vital Statis-tics
was established and work
was begun on the appointment
of over 1,400 local registrars in
each town and township
throughout the State. These
registrars collected the certifi-cates
for all births and deaths
occurring in their districts,
made copies for local use, and
forwarded the originals to the
State Board of Health each
month for permanent filing.
They also issued permits for
burial and transportation of
dead bodies. They received a fee
for their services of 50^ per
certificate, paid by the county.
Helpful Information
Within a short time, the vital
statistics began to produce some
basic information which was of
tremendous help to the physi-cians
and public health workers
who were trying to make the
(continued on page 12)
March 1969 THE HEALTH BULLETIN 11
best possible use of their mea-ger
resources. Though far from
being precise measurements,
the available statistics made it
possible to get some answers to
such questions as: What sec-tions
of the state have the high-est
death rates? What diseases
are the greatest contributors to
the death rate? What segments
of the population are hardest
hit by certain diseases? Within
a few years it was also possible
to determine the effectiveness
of some of the public health
measures that were put into
effect.
Today, the vital statistics reg-istration
procedures are essen-tially
the same as in 1913, ex-cept
that in most counties the
local health departments have
taken over the responsibilities
of local registrars. This change
had several advantages. It was
more economical and efficient
to use the existing facilities of
the local health departments as
the central location for regis-tering
births and deaths. Also,
the local health director could
consult with the physicians,
midwives, and funeral directors
in his county concerning any
medical problems arising in the
registration procedure. Anoth-er
important advantage was
the immediate availability to
the health director of informa-tion
concerning deaths from
contagious diseases or any other
causes which would require
his immediate attention.
Individuals Are Responsible
In every county certain indi-viduals
are charged with the
responsibility for actually pre-paring
and filing vital records.
The attending physician or mid-wife
is responsible for complet-ing
the certificate of birth or
fetal death (stillbirth). If no
physician or midwife is in at-tendance,
it is the duty of the
father, mother, or owner of the
premises to report the birth.
Death certificates are pre-pared
by the funeral director,
or the person who takes charge
of the body after death. The fu-neral
director must also obtain
from the attending physician
his opinion as to the cause of
death. If there was no physician
in attendance, then the medical
examiner or coroner must certi-fy
to the cause of death.
(continued on page 13)
Springtime is check-up time for your car. How about you? You can
trade in your old car, but your heart has to last you a lifetime. Help
make it a long one, says the North Carolina Heart Association, by seeing
your doctor regularly.
12 THE HEALTH BULLETIN March 1969
The central registration of fore 1958 if the county where
divorces became effective on the divorce was granted was
January 1, 1958. The clerks of unknown, it was necessary to
court in each county report to inquire of all 100 counties in
the State Board of Health each order to locate the record. In
month all divorces granted in addition to their value to the
their court during the preceding individuals, these records pro-month.
Records are prepared vide valuable information con-in
Raleigh and indexed by the cerning the extent of the di-names
of both plaintiff and de- vorce problem in our State,
fendant for easy reference. Be- (continued on page 14)
HOW IT WAS IN THE
OLD NORTH STATE
RECREATION NECESSARY FOR HEALTH
The Creator of the universe in His all-wise wisdom implanted in the
minds of children the longing for play. Health and growth depend upon the
exercise of muscles. The instinct for play, therefore, plays a large part in
the development of each individual.
After childhood has passed there is a tendency on the part of most of us
to suppress, or forget, this instinct for play. We get so busy striving for
wealth or fame, or just trying to make a living, that we are apt to think
of play as something unobtainable, something that we have not the time for.
Therein we make a great mistake ....
Nearly all the degenerative diseases result from a lack of play. Mentally
and physically we need recreation that really recreates, that relaxes tired
muscles, that gives wearied nerves a chance to retain exhausted vitality.
Exercise in the gymnasium is fine, but frequently it is too methodical, or
else we overstrain. The more simple games, and particularly those that can be
played out of doors, do the most good. In those we get the ideal combination
of exercise of muscles, fresh air and sunshine, the combination which, taken
regularly, means prolonged life and better life.
Health is a state of physical and mental and moral equilibrium, a normal
functioning of the body, mind and soul. It is the state when work is a
pleasure, when the world looks good and beautiful and the battle of life seems
worthwhile-. Health is the antithesis of disease, degeneration and crime. To
maintain it we must obey the laws of nature which demand that there shall
be a proper mixture of work and play, of rest and sleep. And of these we
need to place particular stress on play.—R.B.W.
—The Health Bulletin, Vol. XXXVI, No. 6, June, 1921.
March 1969 THE HEALTH BULLETIN 13
some characteristics of the
persons involved, and the num-ber
of minor children.
Marriages were added to the
vital statistics family in Janu-ary
1962. The register of deeds
in each county is the local offi-cial
responsible for the initial
preparation and issuance of the
marriage license. After the mar-riage
takes place, the minister
or other officiant certifies to the
date and place of the event,
obtains the signatures of two
witnesses, and files the com-pleted
certificate in duplicate
with the register of deeds. Each
month the register of deeds for-wards
one copy of each com-pleted
certificate to the State
Board of Health. Here again,
much valuable data is obtained
for use in public health, social
and welfare programs. These
statistics, when combined with
other information, make it pos-sible
to estimate or project fig-ures
on migration, birth rates,
housing needs, and changes in
marriage trends.
The tremendous value of
these vital records to the indi-vidual
citizen has become quite
apparent in recent years. When
World War II began, many peo-ple
left their homes to work in
defense plants or other war-re-lated
industries. For security
purposes they found it neces-sary
to prove certain facts about
themselves. The birth certifi-cate
became the primary docu-ment
used for proving age,
place of birth, and citizenship.
Today it is required for many
purposes: entering school, ob-taining
driver's license, employ-ment,
and passport. The death
certificate is an equally impor-tant
document for settling es-tates,
insurance claims, court
cases, and social security bene-fits.
Millions of Records
The processing, storage,
maintenance, and indexing of
all vital records accumulated in
the past 55 years (approximate-ly
7,000,000) adds up to a fairly
complex job. When the State
Board of Health was reorgan-ized
in 1950, the former Bureau
of Vital Statistics was incorpo-rated
into what is now called
the Public Health Statistics
Section. Each month the section
receives and processes records
on approximately 8,000 births,
3,500 deaths, 4,000 marriages,
and 1,000 divorces. In addition,
more than 4,500 certified copies
are issued monthly. A person
born in this State may obtain a
copy of his birth record by writ-ing
to the State Board of Health
and furnishing his name, date
of birth, county of birth, and
parents' names. The fee for this
service is $1.00 per certificate.
Certified copies may also be ob-tained
from the register of
(continued on page 15)
14 THE HEALTH BULLETIN March 1969
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
James S. Raper, M.D., President Asheville
Lenox D. Baker, M.D., Vice President Durham
Ben W. Dawsey, D.V.M. Gastonia
Ernest A. Randleman, Jr., B.S.Ph. Mount Airy
Paul F. Maness, M.D. Burlington
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pines
J. M. Lackey Rt. 2, Hiddenite
Howard Paul Steiger, M.D. Charlotte
EXECUTIVE STAFF
Jacob Koomen, M.D., M.P.H. State Health Director
W. Burns Jones, M.D., M.P.H. Assistant State Health Director
J. M. Jarrett, B.S. Director, Sanitary Engineering Division
Martin P. Hines, D.V.M. , M.P.H. Director, Epidemiology Division
Ronald H. Levine, M.D., M.P.H. Director, Community Health Division
E. A. Pearson, Jr., D.D.S. , M.P.H. Director, Dental Health Division
Lynn G. Maddry, Ph.D., M.S.P.H. Director, Laboratory Division
Ben Eaton, Jr., A.B., LL.B. Director, Administrative Services Division
Theodore D. Scurletis, M.D. Director, Personal Health Division
deeds in the county of birth.
Those persons who were born
prior to the enactment of the
vital statistics law, or who for
any reason did not have a cer-tificate
filed at the time of their
birth, may file a delayed certifi-cate
of birth with the register of
deeds in the county in which
they were born. It is necessary,
however, to furnish at least
three written documents which
will prove the facts concerning
the birth. These documents may
be school records, family bible
records, insurance policies, and
census records.
Another important part of
vital statistics work involves
the correction and amendment
of records. In the early years of
vital statistics registration,
many names were misspelled
and sometimes important infor-mation
was omitted. In order to
make any changes on the origi-nal
certificate, it is necessary
for the registrant or parent to
furnish proof as to the correct-ness
of the requested change. In
some instances, such as a
change of father's name, a court
order is required before a
change can be made.
When a child is adopted, or
when an illegitimate child is
legitimated by subsequent mar-riage
of the parents, a complete-ly
new birth certificate is pre-pared
and no access to the old
certificate is permitted except
by order of a court.
(continued on page 16)
March 1969 THE HEALTH BULLETIN 15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
If you do NOT wish to con-tinue
receiving The Health Bul-letin,
please check here l
|
and return this page to
the address above.
KR„ A. v. CUNNINGHAM, EXEC. !
N.C. DENTAL SOC.
BX. 11065 KORDECAI
RALEIGri, N.C.
Printed by The Graphic Press, Inc., Raleigh, N. C
Vital Statistics in North Carolina (continued from page 15)
In addition to the processing
and handling of vital records,
the Public Health Statistics Sec-tion
prepares and publishes re-ports
containing a variety of
statistical data which is used
not only by public health work-ers,
but also by research work-ers,
county and city planners,
school officials, students, and
many others. The section also
collaborates with other agen-cies,
such as the University of
North Carolina, the State Medi-cal
Society, and the U. S. Public
Health Service in carrying out
special studies and research
projects. The large volume of
records involved requires the
use of electronic data process-ing
equipment to produce the
many detailed tabulations need-ed
monthly, quarterly, and an-nually.
As the population of North
Carolina continues to increase,
and as new public health pro-grams
are developed, the Public
Health Statistics Section staff
will be facing new challenges
and new opportunities of serv-ice.
Such activities as compre-hensive
health planning and
regional medical programs gen-erate
new demands for statis-tical
data which must be met.
The primary objective of the
section, however, will continue
to be to serve the citizens of
North Carolina efficiently and
well and to preserve for pos-terity
the records of life's most
intimate events.
ran/a™ mum
The Official Publication Of The North Carolina State Board of Health
»
APRIL 1969
MEDICAL LAB
ASSISTANT
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 106 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Mailing ad-dress:
Post Office Box 2091, Raleigh, N. C.
27602. Published monthly. Second Class
Postage paid at Raleigh, N. C. Sent free
upon request.
Inside Editorial Board
John Andrews, B.S., Raleigh
Glenn A Flinchum. B.S., Raleigh
Jacob Koomen. Jr , M.D., M.P.H., Raleigh
Camp Easter-in-the-Pines 3 john c lumsden. b.c.h.e.. Raleigh
The Need for Family Planning Editor: H. B. Rogers
in North Carolina ^mbm^^™^^^—^^»»-
By C. Horace Hamilton 6
Medical Lab Assistants Vo l 84 April 1969 No. 4
By Margaret Darst Smith 13
ALSO Cover: Patricia Haire, a graduate
of the medical laboratory assist-
Food Can Be Dangerous ants pr0gram at Holding Technical
. . . Sometimes 5
Institute, Raleigh, is a staff assist-ant
today. Mrs. Haire received her
Regional Rural Health
Conference 5 diploma in August 1967.
Margaret Darst Smith, director of
Struvite and Canned Seafood 9 Public relations for Holding Tech,
supplied the photograph of Mrs.
How It Was in the Old North Haire, as well as the photographs
State 14 that illustrate her story.
THE HEALTH BULLETIN April 1969
CAMP EASTER-IN-THE-PINES
North Carolina's Easter Seal Camp
A boy bound to a wheelchair
competes with other disabled
children in a unique game of
baseball in which the rules of
the game are scaled down to fit
the handicaps of the team mem-bers.
Unusual?
Not at Camp Easter-in-the-
Pines, North Carolina's Easter
Seal camp.
Baseball, dock fishing, swim-ming,
archery, a trip through
the woods to discover wild flow-ers:
rare treats, all, for the
handicapped person — but all
possible at Camp Easter-in-the-
Pines.
North Carolina's Easter Seal
camp, located at Southern
Pines, is open to all physically
handicapped persons from 7 to
50 years of age who would
benefit from a camping expe-rience.
The handicaps repre-sented
at the camp include
those that have resulted from
cerebral palsy, polio, visual and
hearing defects, muscular dys-trophy,
spina bifida, accidents,
burns, amputations, rheumatic
heart, and congenital defects.
Young disabled campers get expert supervision from well-trained
staff at Camp Easter-in-the-Pines.
At Camp Easter-in-the-Pines
everyone is on equal footing
with everyone else, for all cam-pers
are physically disabled.
Every cabin has ramps ap-proaching
it. Every building
has wide doors. Wheelchair
paths wind throughout the
camp, from the arts and crafts
building to the huge main lodge.
The main emphasis at Camp
Easter-in-the-Pines is recrea-tion,
and a well-trained staff of
instructors provides responsible
leadership. In addition, a phys-ical
therapist works with chil-dren
in the lake every day.
Camp Easter-in-the-Pines will
offer four sessions in the sum-mer
of 1969 to children and
teenagers and adults. All phys-ically
handicapped persons may
be considered for admission.
The cost of a two-week camp
session is $90. Local Easter Seal
societies, individual donors and
civic groups have helped pro-vide
"camperships" for children
and adults.
For application forms write:
Camp Easter-in-the-Pines
Drawer 1099
Southern Pines, N. C. 28387
Camp Easter-in-the-Pines is a
facility of the Easter Seal So-ciety
for Crippled Children and
Adults of North Carolina, Inc.
THE HEALTH BULLETIN April 1969
Food Can Be Dangerous
. . . Sometimes
Of the 100 outbreaks of hu-man
salmonella infections at-tributable
to specific sources in-vestigated
by the National Com-municable
Disease Center dur-ing
the three-year period 1963-
1965, 61 were traced to foods,
21 to human carriers, and 18 to
animal contacts.
There were 51 other out-breaks
which were investigated
but which could not be traced
to specific sources.
Foodborne salmonellosis can
most frequently be traced to
eggs or egg products, poultry,
or beef and pork products. A
host of other foodstuffs have
also been incriminated, how-ever,
including such items as
soya milk, dried yeast, coconut,
cotton seed protein, cereal pow-der,
and even a food coloring
substance (carmine dye).
Animal feeds have been wide-ly
incriminated as potential
sources of infection for domes-tic
animals.
Regional Rural Health Conference
Child health and home health care are topics for the 1969 Regional
Rural Health Conference sponsored by the Medical Society of the State
of North Carolina.
The conference will be held Thursday, June 12 at Lambuth Inn at
Lake Junaluska, starting at 10:30 a.m. It will be open to medical peo-ple,
laymen and interested citizens who wish to attend.
Dr. Hugh A. Matthews, director of health affairs at Western Carolina
University, will preside. Several speakers will participate.
A special feature will be recognition of the 1968 4-H health king
and queen and their families.
April 1969 THE HEALTH BULLETIN
The Need For Family Planning
In North Carolina
By C. HORACE HAMILTON
Associate Director
Carolina Population Center
and
Visiting Professor of Sociology and Biostatlstics
The University of North Carolina at Chapel Hill
Many counties, cities, and
communities have some more or
less systematically organized
family planning programs.
Moreover, the current down-ward
trend in the birth rate is
evidence that family planning
is practiced by a large percent-age
of North Carolina families.
The practice of birth control
has no doubt been facilitated by
the development of the "pill"
and other contraceptive meth-ods.
Because of these trends and
facts, many people are under
the impression that we need no
longer be seriously concerned
about the problem of overpopu-
Reprinted from the University of
North Catolina News Letter, Vol.
LIII, No. 3, September 1968.
lation or of the need for invest-ing
public funds in family plan-ning
programs.
If there is any complacency
over the need for family plan-ning,
a look at the latest avail-able
facts about births in North
Carolina should dispel any idea
that we can now relax and for-get
about the problem. During
the calendar year 1966, accord-ing
to the Statistics Section of
the State Board of Health, there
were 92,727 births and 42,218
deaths. The difference between
births and deaths, i.e., natural
increase, was 50,509. Thus, from
one point of view, in 1966, the
state had 50,509 more births
than were needed to maintain
the population at a stable level.
THE HEALTH BULLETIN April 1969
A similar excess of births
over deaths has existed through-out
our state's history. As a re-sult
of the relatively high rate
of natural increase, North Caro-lina
has experienced a heavy
out-migration and, at the same
time, has increased in popula-tion.
Most people, intuitively,
think that population growth is
a good thing, but that heavy
out-migration is a bad thing.
Just how bad and how good
these trends are is a matter of
opinion, but it is not the pur-pose
of this paper to discuss
population policy. It suffices to
point out that rapid population
growth, not only in other coun-tries
but also in our own state
and nation, is creating serious
social and economic problems.
There are many ways to mea-sure
the need for family plan-ning,
although there may be
some disagreement as to how
many children a family should
have. In a free and democratic
society the decision on family
size is considered to be the pre-rogative
of individual families.
Yet many surveys show that
most married couples do not
want more than two to four
children. (In order to maintain
a stable population, only about
230 children per hundred mar-ried
couples are needed to main-tain
the population.)
In spite of the fact that most
women in this country no lon-ger
want the very large fam-ilies
which were common in the
rural areas of our nation for
many generations, the current
birth statistics show that a sub-stantial
percentage of North
Carolina families are still giving
birth to more children than they
can provide for even at a mod-est
standard of living. In 1966,
the vital statistics show that
more than a fourth of the babies
were born to North Carolina
mothers who already had three
children. However, a more re-fined
and accurate estimate of
the number of "excess" births
may be arrived at by taking into
consideration the age of the
mother.
On the basis of known rela-tionships
between maternal and
child health and the timing and
number of births, we shall de-fine
as "excess" births all those
born to mothers either under 15
years or over forty years of age.
For all other age groups, we
shall define as excessive all
births occurring during 1966 to
mothers in the following age
and birth order groups:
Age of
Mother
Although these assumptions are
made partly for the purpose of
establishing some sort of rea-sonable
and convenient statis-tical
criterion, it can also be
argued that such limits are in
the interest of both the individ-ual
family and of society which
must pay part of the cost of ex-cessively
large families among
the low income groups.
Actually our definition of ex-cess
births is more on the lib-eral
than the conservative side.
tive number of women with
zero, one or only two children
should increase, there would
need to be some increase in the
number of mothers with three
or more children.
On the basis of the above as-sumption,
it is found that 33,-
033, or 35.6 percent of the 1966
births were excessive, and most
of them were probably unwant-ed
by the parents. This number
of excessive births may be
broken down by age of mother
TABLE 1
Number and Percentage of Excess Birlhs By Color and Age of Mother,
North Carolina, 1966
Age of Mother
attainment, and occupational
level, irrespective of race.
The county differences (see
Table 2) in the number and per-centage
of excess births, indica-tive
of the need for family plan-ning,
also reflect differences in
the social, economic, and educa-tional
characteristics of the
population. Counties with high
percentages of farm people have
high percentages of excess
births; and the large metropoli-tan
and urban counties have re-latively
low percentages of ex-cess
births.
Greene County, an eastern
North Carolina agricultural
county, has the highest percent-age
of excess births. Practically
all of the other counties ranking
high in excess births are also
found in eastern North Caro-lina.
Among white mothers the
highest percentages of excess
births are found in the rural
mountain counties, such as
Madison, Clay, Alleghany, Gra-ham,
and Ashe.
Among nonwhite mothers,
the highest percentage of ex-cess
births are found in such
predominantly a g r i c u 1 1 ural
counties as Greene, Halifax,
Edgecombe, Jones, and Nor-
Struvite Crystals and Canned Seafood
Glass in your canned shrimp? Probably not.
From time to time people in the canned seafood industry and at the
Food and Drug Administration get complaints from consumers who
believe they've found glass in their canned seafood—especially shrimp.
Examination, however, usually reveals it isn't glass at all, but
"struvite" — crystalline magnesium ammonium phosphate to the
chemist — which occasionally forms in canned seafood from normally
present constituents.
While struvite isn't actually desirable, it doesn't affect the safety
of the food at all, according to FDA. Seafood canners have devoted
considerable attention to the problem of struvite formation, but they
still haven't been able to prevent it.
If you do happen to find a hard, clear crystalline bit of material in
canned seafood, here's a simple test to distinguish between struvite
and glass. Simply place the material in warm vinegar for a while. The
struvite crystals will dissolve; glass of course, will not.
April 1969 THE HEALTH BULLETIN V
TABLE 2
Estimates of the Number and Percentage of Excess Births
In North Carolina Counties, 1966
State and
48.
thampton.
Urban metropolitan counties,
such as Wake and Mecklenburg,
in general have low percentages
of excess births, but even in
these counties the percentage of
excess nonwhite births is
greater than the white. In Wake
County only 18.8 percent of the
white births are classed as ex-cess.
+her counties having a
low percentage of excess white
births are Orange, Tyrrell, Le-noir,
Durham, Mecklenburg,
Hertford, Chowan, Gates, and
Pasquotank. Among nonwhite
mothers having lower than av-erage
percent excess births are
those of Durham, Chatham, Lee,
Guilford, Pamlico, Orange, Ran-dolph,
Stanly, Onslow, and Cho-wan
counties.
The data presented in this
issue of the News Letter are of
great significance from the point
of view of developing an effec-tive
family planning program.
Since nearly all babies are now
delivered by physicians in hos-pitals,
the counseling of mothers
needing family planning and
clinical services can most effec-tively
be carried out by physi-cians
and other professional
health personnel at the time a
mother is having either an un-wanted
or a higher order birth.
Unfortunately, very few hos-pitals
and physicians (except at
the three medical schools in
North Carolina) have developed
effective programs for guiding
mothers in modern family plan-ning
practices.
Since these data apply only to
women at child birth, we must
not overlook the fact that many
women who do not give birth
to a child during any particular
year may also be in need of
family planning. However, by
combining data on births by age
of mother and birth order for
several years, a more complete
picture of the overall need for
family planning in a county can
be derived.
A complete program of family
planning in any county involves
also a consideration of the so-cial,
educational and economic
status of the county's popula-tion.
Many counties now have
local family planning commit-tees;
and they work closely with
the health and welfare depart-ments.
However, a survey of
family planning programs in the
counties shows that health and
welfare departments simply do
not have an adequate supply of
health personnel to do the kind
of job required.
More effective family plan-ning,
in both public and private
programs, will help to: ( 1 ) raise
the level of living; (2) improve
the health of both mothers and
children; and (3) improve the
overall quality of life—the hu-man
dividend — for all North
Carolinians.
12 THE HEALTH BULLETIN April 1969
MEDICAL LAB ASSISTANTS
Classroom Study
Clinical Training
Peggy Fish (left) of Raleigh and Marie Straley
of Mt. Pleasant, Michigan, peer into the dual
teaching microscope at Holding Tech. Miss Stra-ley's
father, a medical technician, sent his daugh-ter
to Holding Tech for the medical laboratory
assistants course because he knows of the out-standing
reputation the school enjoys.
By MARGARET DARST SMITH
The second largest medical
laboratory assistants program
in the United States is offered
in North Carolina by Holding
Technical Institute at Raleigh.
The author is director of public re-lations
for Holding Tech.
Holding Tech, a local and
state tax-supported member of
the North Carolina Community
College System, began its med-ical
laboratory assistant pro-gram
in 1964 with a total of 19
students.
Last fall the enrollment
April 1969 THE HEALTH BULLETIN 13
Etheleen Hartsfield of Bunn, N.
C. uses the spectrophotometer
to measure homoglobin.
HOW IT WAS IN
THE OLD NORTH STATE
GARDEN PRODUCES
THREE CROPS
"Plant a Garden" has become a
new health slogan. A garden has
so many health possibilities that
no home should be without one.
Among the health products of a
garden may be mentioned sun-shine,
fresh air, and exercise as
the first crop. The second crop is
the supply of those early vege-tables
that are so essential to
health, in spring and summer
—
spinach, mustard, lettuce, toma-toes,
radishes, peas, beans, squash,
onions, etc. The third is a reduced
market bill which leaves a neat
little sum on which to take a two
weeks' vacation in summer.
The Health Bulletin,
June, 1915, Vol. XXX, No. 3.
totalled 50 men and women.
These 50 started the one-year
diploma program in September.
Another group began in March
of 1969.
This is the only diploma or
degree course offered by Hold-ing
Tech in which there are two
new classes starting each year.
It is made possible by the fact
that students spend six months
of the course in the classrooms
at Wake Memorial Hospital and
the final six months of the
course in clinical training at
various hospitals throughout
eastern North Carolina. During
the final six month period, stu-dents
are rotated through the
different departments of the
hospital in order to develop
skills in all laboratory func-tions.
As currently enrolled stu-dents
leave the classroom, an-other
group may begin the
classroom phase of the training.
The curriculum for the med-ical
laboratory assistants course
was designed jointly by medical
technologists, pathologists, and
educators for the purpose of giv-ing
the students the necessary
knowledge and laboratory prac-tice
during the first six months
of instruction to enable them to
move into a hospital laboratory
with a minimum of orientation.
Each of the laboratory courses
provides experiences similar to
those the student can expect to
(continued on page 16)
14 THE HEALTH BULLETIN April 1969
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
James S. Raper, M.D., President Ashevllle
Lenox D. Baker, M.D., Vice President Durham
Ben W. Dawsey, D.V.M. Gastonia
Ernest A. Randleman, Jr., B.S.Ph. Mount Airy
Paul F. Maness, RI.D. Burlington
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., RI.D. Southern Pines
J. RI. Lackey Rt. 2, Hlddenlte
Howard Paul Steiger, RI.D. Charlotte
EXECUTIVE STAFF
Jacob Koomen, RI.D., RI.P.H. State Health Director
W. Burns Jones, RI.D., RI.P.H. Assistant State Health Director
J. RI. Jarrett, B.S. Director, Sanitary Engineering Division
Rlartin P. Hines, D.V.M., RI.P.H. Director, Epidemiology Division
Ronald H. Levine, RI.D., RI.P.H. Director, Community Health Division
E. A. Pearson, Jr., D.D.S., RI.P.H. Director, Dental Health Division
Lynn G. RIaddry, Ph.D., Rl.S.P.H. Director, Laboratory Division
Ben Eaton, Jr., A.B., LL.B. Director, Administrative Services Division
Theodore D. Scurletis, RI.D. Director, Personal Health Division
Two teenagers and a housewife study together
in the medical laboratory assistants course at
Holding Tech. They are (left to right) Pat John-son
of Raleigh, Anna Whitener of Raleigh (for-merly
of Haverton, Pa.) and John Davison of
Garner, N. C.
April 1969 THE HEALTH BULLETIN 15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
«R A. «. CUNNINGHAM. E>
R.C. ^NTAL SOC. ^
BX. U0fa5
RAUEIGHt N.C.
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Printed by The Graphic Press, Inc., Raleigh, N. C
Medical Lab Assistants Program (Continued from page 14)
meet when they move into their
clinical training.
The medical laboratory assist-ant
works under the direct su-pervision
of a medical technol-ogist
or a medical doctor. The
assistant is taught to collect
specimens, prepare slides, and
perform routine laboratory
tests. Although most of the
graduates will be employed in a
hospital, many will be hired by
doctors to work in their offices,
or by agencies conducting med-ical
or industrial research.
Only persons with a high
sense of responsibility and the
ability to do careful, scientific
work should consider entering
the field. Graduates of the cur-riculum
are eligible to take the
national examination of the
Board of Certified Laboratory
Assistants. Upon successfully
completing this examination
they are awarded the title of
Certified Laboratory Assistant.
Holding Tech's students in
the medical laboratory assistant
program are assigned during
the six month clinical phase of
the course to leading hospitals
and to the Duke University
chemistry department labora-tory,
county health depart-ments,
the State Laboratory of
Hygiene, and doctors' offices
and clinics.
16 THE HEALTH BULLETIN April 1969
con/rai ®mmi
The Official Publication Of The North Carolina State Board of Health
Helicopter Moves Burn Victim
A burn victim is gently placed in the Chicago Fire Department's Bell 47J
helicopter for transfer to a special burn center for treatment. Depart-ment
Pilot Robert Hack has participated in a number of rescues involv-ing
the agency's three helicopters. The ships are used to assist victims
of traffic accidents, fly aerial patrol on Lake Michigan, serve as a com-mand
post for large fires and work as an emergency supply/medical
vehicle. (See article on page 7)
MAY 1969
Inside
Freedom from Want
—
Food as a Health Need
Helicopter Ambulance
Service—To The Rescue
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 106 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Mailing ad-dress:
Post Office Box 2091, Raleigh, N. C.
27602. Published monthly. Second Class
Postage paid at Raleigh, N. C. Sent free
upon request.
Editorial Board
John Andrews, B.S., Raleigh
Glenn A. Flinchum, B.S., Raleigh
Jacob Koomen, Jr., M.D., M.P.H., Raleigh
John c. Lumsden, B.C. HE., Raleigh
Guest Editor: Edwin S. Preston,
M.A., LL.D.
The Home Swimming Pool
—
Happy Hours or Tragic Ones n
Vol. 84 May, 1969 No. 5
Cover: Helicopters are becoming a
ALSO necessary means of transportation
for the sick, the accident victims
Treat Electricity as a Friend 12 and the | ife.saving needs of the
_ . . „, .,, „ „ . military in Vietnam and elsewhere.
Driving Skills of Senior
Motorists 14 Photos and story courtesy Bell
Helicopter, Fort Worth, Texas, one
How It Was in the Old North , A1 .. ..
of the largest suppliers of hehcop-
State 15
ters for the United States in Viet-
Safeguards for Children 16 nam. (Article on page 7)
2 THE HEALTH BULLETIN May 1969
Freedom
From
Want
Food as a Health Need
By Elizabeth W. Jukes
Chief, Nutrition Section
N. C. State Board of Health
Are you old enough to re-member
World War II and the
Four Freedoms? It was said
that there were four freedoms
worth fighting for: Freedom of
Speech and Religion; Freedom
from Want and Fear. Most of
us would agree that these free-doms
are still worth working
for. Now we call it Freedom
from Want, Freedom from
Hunger, and, perhaps, over
simplify the situation.
But our understanding of the
importance of food to health
has grown and deepened con-siderably
in the twenty-five
years since those four freedoms
were pronounced. We are learn-ing
about relationships between
growth patterns of children and
the protein in the food they eat;
about the importance of ade-quate
food to the maximal men-tal
development of very young
children; about the importance
of having combinations of food
values in the intestinal tract at
the same time in order that the
body can use its food supply ef-ficiently;
about the importance
of a regular food supply to the
child's development of trust in
other people. Trust is, after all,
one basis on which every so-ciety
depends.
As important as food is, food
alone cannot bring freedom
from want. In this day, when so
many have so much, it is hard
for us to believe that families
living in the same county do not
have what we consider the es-sentials
of life: a secure house,
sufficient clothing for decency
and protection, an adequate
food supply, clean water, elec-tricity,
a cook stove. Somehow
we do accept the idea that some
people do not have any toilet
facility, as necessary as this is
to health.
In our country, where food
supplies are still more than ade-quate
to feed all of our popula-tion,
there are some programs
that intend to provide the food
May 1969 THE HEALTH BULLETIN
needed. These include the dis-tribution
of commodity foods
(sometimes called surplus
foods), the food stamp program,
emergency food and medical
program, emergency food order,
and supplementary food pro-gram.
Counties have an option of
choosing to administer either
the commodity food program or
the food stamp program. The
commodity foods are available
to people certified by the county
Department of Welfare to be
eligible at a warehouse, usually
at the county seat. The food
stamp program is a plan for in-creasing
the food buying power
of eligible families. Again, the
county Department of Welfare
certifies families on the basis of
income and size of family. A
family may pay $24.00 and re-ceive
$36.00 worth of stamps.
These may be spent for foods in
grocery stores that agree to ac-cept
the stamps instead of cash.
The Emergency Food and
Medical Program is available in
certain counties as part of their
Office of Economic Opportunity
Program. The Emergency Food
Order is part of the budget of
county welfare departments. It
provides immediate availablity
of food for people with immedi-ate
needs.
The Supplementary Food
Program is a new idea. From
time to time, public health
workers have expressed con-cern
that although drugs and
services are available for low
income patients, food was not
available to all patients who
had need for it. As a means of
meeting this need, arrange-ments
have been made jointly
by the U. S. Department of"
Agriculture, the Children's
Bureau of the Department of
Health, Education, and Wel-fare,
and the Office of Economic
Opportunity for foods to be
made available to certain high
risk groups in our population.
For the first time, it is the
responsibility of health depart-ments
and physicians providing
free or reduced cost services to
patients to prescribe foods. The
physician or the professional
worker who acts for the phy-sician
certifies that the patient
would benefit from the foods
prescribed. Provided that the
patient is already receiving
medical services free or at re-duced
cost, there is no other
limitation on who can receive
the food.
High risk is a term used to
designate people who are in
greater than average risk of ac-cident,
disease, or death. For
the purposes of this program,
these people are children from
the time of birth to school age
and women who are pregnant
or who have had an infant with-in
a year. Any of these people
who are receiving below cost
medical care may have foods
prescribed for them.
Since good food is necessary
for everyone, especially the
people in this vulnerable or
THE HEALTH BULLETIN May 1969
high risk group, who should re-ceive
this additional food? Let
us take just one example. An-emia
is so common among in-fants
that iron is added to some
commercial formulas and cere-als
intended for infants, and
some physicians routinely pre-scribe
iron for infants. Much of
this need for iron could be pre-vented
if the mothers' diets had
been adequate before they be-came
pregnant, or remained
adequate during their pregnan-cies.
In that case, the baby
would have stored enough iron
in his body to protect him until
he was old enough to eat foods
like cereal, bread, meat, eggs,
and green leafy vegetables.
These foods would provide his
iron needs as they do yours and
mine.
Therefore, in prescribing the
foods, workers should consider
not only the patients' current
food intake, but their long-term
food habits. Our bodies are
strong or weak because of food
habits of our entire life span,
not because of the current diet
with which we are living temp-orarily.
In other words, every
portion of our lives depends
upon the condition of all the
former portions. Or, to put it
another way, the children of
mothers who were sick or poor-ly
fed during pregnancy could
benefit from supplementary
food. This does not necessarily
mean a diagnosis of malnutri-tion,
but rather the recognition
that the patient would benefit
from additional foods.
Foods may be ordered by
kind and amount, according to
five age groupings. Infants
from birth through the third
month may be given evaporated
milk, corn syrup, fruit juice,
and fortified farina. Infants
from four months through one
year are given the same foods,
plus scrambled egg mix.
Children 13 months, through
two years, are given evaporated
milk, fortified farina, fruit
DISTRIBUTION GUIDE FOR SUPPLEMENTAL FOODS-(HEALTH)
juice, scrambled egg mix, can-ned
meat, canned vegetable or
fruit, instant potatoes, dried
milk. Children three years
through five years are given all
these foods, plus peanut butter.
Pregnant women, nursing
and post-partum mothers are
given all the foods given to
three to five year age group,
plus chocolate milk beverage
mix.
Since these foods are ordered
as a prescription, certain foods
can be reduced or deleted from
the order. Maximum amounts
which can be prescribed for
each age group are set by the
U. S. Department of Agricul-ture.
Standards for eligibility
are relatively simple and do not
exclude individuals receiving
other forms of financial or food
assistance. This program is not
intended to provide the only
nourishment for "starving fami-lies,"
but is intended to pro-vide
supplemental nourishment
for those living under physio-logic
stress, or, in other words,
the stress of rapid growth.
This is the first time food is
available as a treatment for a
health need. People need to be
encouraged to accept and eat
the food prescribed not as a
charity, but as a remedy. When
money is available to the fami-lies,
they should be encouraged
to buy and use the same kinds
of foods.
Pood does make a difference.
It can contribute to Freedom
from Want.
Gaston County Hospital
Budget Approved
Gastonia—A proposed capital
outlay of $544,235 and an op-erating
budget of $58,359 for
the first year 1969-70 have been
approved by the Gaston County
Hospital board of trustees. The
board has also approved archi-tectural
drawings for the new
hospital.
Dr. McPheeters, Former
Wayne County Director, Dies
GOLDSBORO — Dr. Samuel
Brown McPheeters, 88, former
director of the Wayne County
Health Department, died in
May.
Suriviving: his wife, Mrs.
Virginia Gibbes McPheeters,
and a sister, Mrs. F. W. Jar-nagin
of Nashville, Tenn.
Dr. McPheeters came to
Wayne County from Charlotte
in 1937 as director of the health
department, which he headed
for nearly 20 years. Under his
direction the department was
expanded from four to 26 em-ployes.
In the 1940s he was re-sponsible
for the erection of the
present county health depart-ment
building.
Following his retirement he
was instrumental in the organi-zation
of the Wayne County
Mental Health Association. He
was a graduate of Washington
and Lee University.
THE HEALTH BULLETIN May 1969
Helicopter
Ambulance
Service -
To the Rescue
A 41-year-old man falls asleep
while smoking in bed, touching
off a fire resulting in 70 per
cent burns over his body.
Two teenagers are critically
injured in a freeway traffic mis-hap.
Snow in record proportions
blankets a city, halting all sur-face
traffic. A young man, walk-ing
through a park, falls on ice,
paralyzing his legs.
Each of the cases is critical in
nature and demands rapid em-ergency
response. Fortunately,
in Chicago where they occurred,
fast medical evacuation to a
hospital was available. In each
instance a Chicago Fire Depart-ment
Bell helicopter responded
to the emergency call.
Public officials around the
country are becoming increas-ingly
aware of the advantages
available through use of heli-copters
in medical evacuation
work. In addition to Chicago
there are air ambulance pro-grams
underway in such states
as Pennsylvania, North Caro-lina,
California, Michigan and
Montana.
One boost for such efforts
comes from the medical com-munity
which has seen the heli-copter
used effectively as an
ambulance in Vietnam.
Crew of Superior Ambulance
Company carries "patient" from
its Bell 47J helicopter after land-ing
at University of Michigan
Hospital, Ann Arbor during dem-onstration
of the first private
helicopter ambulance service in
U.S.
May 1969 THE HEALTH BULLETIN
The U.S. Army's 92nd Air
Medical Service in Vietnam op-erates
more than 100 Bell UH-
1D "Hueys". To date these air-craft
have evacuated over 182,-
000 patients from remote battle
sites to field hospitals. Of this
total, only two per cent reach-ing
the hospital have died. In
World War II the mortality rate
was 4.5 per cent; in Korea
where helicopters were first
used this dropped to 2.5 per
cent. The even lower rate of
Vietnam is a record in military
history.
Military officials in Vietnam
now boast that no man, any-where
in the country, is more
than 30 minutes from medical
aid.
American civic and medical
officials are questioning why
this cannot be the case at home
today. It is unfortunately true
that auto accident victims daily
succumb on crowded freeways
or remote highways while sur-face
ambulances struggle to
reach the scene and return to a
hospital.
Over a 20-month period in
1966-67 an average 137 U.S.
servicemen died weekly in Viet-nam
combat. During that same
period 1,020 Americans died
weekly on the nation's high-ways.
This does not represent
the burn victims, drownings
and other emergency situations
that call for fast response.
The first helicopter medical
"rescue" mission was recorded
on Jan. 3, 1944 when an ex-plosion
rocked a Navy destroy-er
loading ammunition at Sandy
Hook, N. J. Cmdr. Frank A.
Erickson delivered plasma to
the accident site and was credit-ed
with saving many lives.
Since then the heliborne med-ical
mission has become a
routine, if not sufficiently wide-spread,
practice. For example:
—This year the first private
helicopter ambulance service in
the United States was founded.
Superior Ambulance Service of
Wyandotte, Mich., a Detroit
suburb, now operates a Bell 47J
in addition to its large fleet of
surface ambulances. One of the
firm's first airborne missions
was the transfer of a brain
tumor patient from Dayton,
Ohio to Ann Arbor, Mich., a
200-mile trip.
—During the 1968 Indian-apolis
500-mile Memorial Day
Classic and earlier preliminary
trials seven persons were air
evacuated by Bell's litter-equip-ped
JetRanger from the track
to a nearby hospital. —Nineteen crew members of
an off-shore oil rig 25 miles out
in the Gulf of Mexico were pick-ed
up by helicopters after a
spectacular explosion and flown
to a New Orleans hospital.
Within minutes all were given
emergency treatment. No lives
were lost.
One roadblock to greater
usage of the helicopter in this
role has been the lack of heli-ports
across the nation.
The 1967 edition of the Ver-
THE HEALTH BULLETIN May 1969
tical Lift Aircraft Council's Di-rectory
of Heliports/Helistops
states there are 1,225 approved
landing sites in the United
States, Canada and Puerto Rico
with another 93 proposed.
Hospital heliports have mul-tiplied
from only 34 in mid-
1965 to 70 today with another
10 planned. However, leading
government and medical au-thorities
warn that the number
of hospital heliports around the
country is inadequate to proper-ly
serve the American public.
By 1972, the Department of
Transportation's National Safe-ty
Bureau estimates, highway
accidents will result in 75,000
The U.S. Army's 92nd Air Medical
Service in Vietnam operates more
than 100 Bell UHID "Hueys". To
date these aircraft have evacuated
over 182,000 patients from re-mote
battle sites to field hos-pitals.
deaths annually. In fact, more
traffic accident victims occupy
hospital beds than do cancer
and heart ailments combined.
Compared to the life-saving
rates achieved in Vietnam, it is
apparent the American public
must begin to place the same
emphasis on saving lives and
limbs during peace-time as it
does on the battlefield.
In some areas action is under-way.
The Montana Aeronautics
Commission last year inaugur-ated
a program where it offer-ed
to construct hospital heli-ports
anywhere in the state if
hospital administrators would
May 1969 THE HEALTH BULLETIN
provide usable ground or roof-top
space. Once the area is al-located
the commission designs,
develops, constructs and marks
the new heliport. In the first
five months the program was
initiated the commission re-ceived
14 hospital responses.
The U.S. military's helicop-ters
also are being utilized in a
limited manner. Hospital de-tachments
at Fort Rucker, Ala.
and Fort Sam Houston, Texas
evacuated more than 70 high-way
accident victims last year.
A Department of Transporta-tion
official recently said there
is a strong likelihood the mil-itary
may make some 200 of its
helicopters based around the
nation available to the public as
rescue vehicles.
And the Trinity Hospital of
Minot, N. D., has purchased a
Bell helicopter to be piloted by
a local flying service for hand-ling
emergencies within a
radius of up to 100 miles of the
hospital. The aircraft is the first
hospital-owned helicopter am-bulance
in the nation.
While this is progress there
is much work still to be done.
Medical spokesmen point out
that the general public is, in al-most
all instances, unprepared
for the emergency situation.
There is a need to have more
persons trained in first aid. One
partial solution recommended
has been to place former mil-itary
corpsmen in helicopters to
serve as a medical aide when
the aircraft goes on an emer-gency
call.
There is a need for faster
communications, particularly in
remote sections. The Bell Tele-phone
system has taken one
step to correct this with the
recent announcement it will
have a central nationwide em-ergency
number, 911.
And, as previously mention-ed,
there is a need for a new
awareness by local government
officials, city planners and hos-pital
administrators to provide
adequate emergency facilities
and procedures, one of which is
heliports.
Scientists Win Awards
Dr. Solomon C. Goldberg, As-sistant
Chief of the Psychophar-macology
Research Branch of
the National Institute of Mental
Health, Chevy Chase, Md., shar-ed
with two former NIMH
scientists the Lester N. Hof-heimer
Prize for Research con-ferred
at the recent 125th an-niversary
meeting of the Amer-ican
Psychiatric Association at
Bal Harbour, Florida.
Other recipients of the award
were Dr. Jonathan O. Cole, now
Superintendent of Boston State
Hospital and Professor of Psy-chiatry
at Tufts University,
Boston, and Dr. Gerald Kler-man,
now Director of the Con-necticut
Mental Health Center
and Associate Professor of Psy-chiatry
at Yale University, New
Haven.
10 THE HEALTH BULLETIN May 1969
The
Home
Swimming
Pool
Happy Hours
or
Tragic Ones
The ever-increasing number
of automobiles on our highways
is one of the factors responsible
for the growth of the home
swimming pool industry. Today
there are more than one-half
million such home pools not
counting the surface plastic and
wading pools. Because of the
desire to avoid traffic and
crowded highways, there more
than likely will be a continued
upward trend in this industry.
The home swimming pool can
be the source of healthful and
happy recreation but it can also
result in tragedy. A 1965 study
has indicated that there were
almost 500 pool deaths in the
United States and that most
pool deaths occurred in resi-dential
pools, such as pools in
private homes, apartments or
motels. Over half of the victims
were youngsters of age four and
under. Most of the tragedies re-sulted
from the lack of super-vision,
inadequate physical pro-tection,
the inability to swim
and a disregard for safety prac-tices.
A youngster should never be
left unattended in or near a
swimming pool. The mother,
father or an adult should al-ways
be present. Children
should never be entrusted to
other children. In fact, even
adults should not swim or work
in a pool unless someone else is
present. Slips, falls and physical
attacks can be fatal.
Every home swimming pool
should be adequately fenced
with the entire pool area visible
from the home. Fencing should
be of sufficient height to pre-vent
entry by youngsters and
make it difficult for older people
to climb over the fencing and
become atrespasser. There
should be depth markings on
the pool deck and sides and
protective float lines to warn of
changing depths from shallow
to deep water.
Items such as plastic boats,
balls and floating toys can be
fun for the youngsters but must
be used with precaution. Swim-mers
should never be allowed to
rely on these objects as support
May 1969 THE HEALTH BULLETIN 11
for deep-water areas. Pushing,
shoving, ducking or running on
pool decks should be strictly
prohibited. Such practices can
lead to disabling injuries and
even death. Adults as well as
youngsters should adhere to
these safety measures. Further,
adults should never attempt to
swim after drinking alcoholic
beverages, eating or taking
drugs or medication.
Cleanliness is very important
to health and safety. Pool decks
should be periodically scrubbed
to prevent them from becoming
slippery. Papers and other re-fuse
which may lead to slips
and falls should be placed in
trash containers. Glass bottles
should never be taken to the
pool area.
To prepare for possible em-ergencies,
it is prudent to have
a signal or some warning device
in the immediate vicinity of the
pool to summon help and a ring
buoy to toss to a swimmer in
trouble. A telephone should be
readily accessible and all pool
owners and users should be
taught the technique of mouth-to-
mouth resuscitation. Wheth-er
or not a pool is used for
night-time swimming, there
should be an immediate source
of emergency illumination.
A handy wallet card prepared
in cooperation with the Amer-ican
National Red Cross and the
U. S. Department of Health,
Education and Welfare, con-taining
safety tips, is enclosed
for your usage.
Treat Electricity
as a Friend
In this modern world of to-day
we have a most valuable
servant, steady, dependable and
most powerful. As a friend it
works through lights, applian-ces
and modern kitchens. It
lightens daily chores, brings
you comfort and convenience
and allows you leisure time to
relax and enjoy your favorite
radio or television programs.
This friend and servant is elec-tricity
but it has its rules which
must be adhered to. It can be
an obedient servant. Ignore its
rule and it can become violent
and a deadly killer.
Severe or even fatal injuries
result when electric energy
flows through the body. The ex-tent
of injury depends on the
path and the amount of current
flow. The flow can be fatal if
its course is through a vital or-gan.
When the flow of electric
current does not pass through
vital body organs, injuries are
likely to be less severe. How-ever,
the muscular reaction to
a small shock can startle a per-son
to the extent that he may
lose his balance and fall. This
involuntary motion may cause
serious injury.
While deaths due to misuse
of electricial current are few in
comparison to other causes, an
undetermined number of deaths
and burn injuries result from
12 THE HEALTH BULLETIN May 1969
nearly 140,000 fires throughout
the nation caused by faulty
electrical appliances, wiring
and other electricial equipment.
Statistics indicate that we
now have available to us over
150 types of electricial applian-ces
and with technological ad-vancements,
many more are an-ticipated.
Consequently, it may
be well to mention something
about the proper installation
and maintenance of electrical
equipment and appliances from
a safety point of view.
1. Before plugging an appliance
into an outlet, check the
capacity of your home wir-ing
circuit. Never connect
more than 1600 watts on a
general-purpose circuit un-less
you know that the cap-acity
of your home circuit
can carry more than this cap-acity.
2. Cords with worn or crack-ed
insulation should be re-placed.
Never run cords over
hot pipes, radiators or other
hot objects. Use convenient
wall outlets rather than ex-tension
cords or light sockets
for connecting appliances.
3. Never run a cord under a
rug or door or hang the cord
over a nail or sharp object.
4. Connect electrical appliances
by putting cord or probe-type
temperature controls in-to
the appliance before plug-ging
into the electrical out-let
and always turn off the
appliance whenever plugging
in or disconnecting from the
electrical outlet. Major ap-pliances
should always be
grounded.
5. Electrical equipment should
not be handled with wet
hands or when standing on a
wet or damp surface. Avoid
touching an appliance and a
grounding source such as a
pipe, radiator, faucet or sink
at the same time. Common
house current can be lethal.
6. Always disconnect applian-ces
before oiling or cleaning.
Clean and oil the appliances
periodically if recommended
by the manufacturer as car-bon
particles and dirt can
set up current paths to ex-terior
paths.
7. Do not overload your cir-cuits.
A normal household
circuit will carry 15 amperes
of electricity. If a 15 ampere
fuse blows out continuously,
you should add another cir-cuit
to your home rather
than replacing it with a high-er
ampere fuse.
8. Wall outlets attract small
children and they are temp-ted
to insert hair pins or
small objects into the outlet.
When not in use, the wall
outlet should be covered with
a plastic cap or a piece of
furniture should be placed
in front of the outlet to keep
it out of sight.
Robert F. McDonald, Chief
Injury Control Program
Providence, Rhode Island
May 1969 THE HEALTH BULLETIN 13
Driving Skills of Senior
Motorists
The results of a nationwide
study into the driving records
of senior motorists may well
catapult the over-65 driver to
a respected place on the high-way
and make his current
reputation as a "hazard" a myth
of the past.
A report on the accident in-volvement
of the senior driver,
released by the University of
Denver College of Law, is so
favorable to the senior motorist
that Judge Sherman G. Fine-silver,
head of the study team,
believes it "will be pivotal in
refuting current popular think-ing
about older drivers." In the
31 jurisdictions for which data
were available, senior drivers
(persons age 65 and over) aver-aged
37 percent fewer accidents
than would exist if their pro-portion
of accidents were in di-rect
ratio to their proportion of
the driving population.
Although senior drivers rep-resented
7.4 percent of all driv-ers
in the states surveyed, they
were involved in only 4.8 per-cent
of all accidents in these
states. They averaged lowest of
all age groups in frequency of
injury-producing accidents and
40 percent below their propor-tionate
share of the driving pop-ulation.
Judge Finesilver expressed
the opinion that "the senior
driver has been made a scape-goat,
the senior driver is
not only a good risk, but often
may be among the safest motor-ists
on the highway."
. . . from More Life For Your
Years, 5/69
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
James S. Raper. M.D., President Asheville
Lenox D. Baker, M.D., Vice President Durham
Ben W. Dawsey, D.V.M. Gastonla
Ernest A. Randleman, Jr., B.S.Ph. Mount Airy
Paul F. Maness, M.D. Burlington
A. P. Cllne, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pines
J. M. Lackey Rt. 2, Hlddenite
Howard Paul Steiger, M.D. Charlotte
EXECUTIVE STAFF
Jacob Koomen, M.D., M.P.H. State Health Director
W. Burns Jones, M.D., M.P.H. Assistant State Health Director
J. M. Jarrett, B.S. Director, Sanitary Engineering Division
Martin P. Hines, D.V.M., M.P.H. Director, Epidemiology Division
Ronald H. Levine, M.D., M.P.H. Director, Community Health Division
E. A. Pearson, Jr., D.D.S. , M.P.H. Director, Dental Health Division
Lynn G. Maddry, Ph.D., M.S.P.H. Director, Laboratory Division
Ben Eaton, Jr., A.B., LL.B. Director, Administrative Services Division
Theodore D. Scurletis, M.D. Director, Personal Health Division
14 THE HEALTH BULLETIN May 1969
How It Was
In the Old North State
AN INDECENCY
However chivalrous the purpose of the North Carolina Senate in its passage
of an amendment to the marriage laws repealing the requirement of an affidavit
of physical soundness on the part of the masculine member of the matrimonial
partnership before the contract may be entered into, those voting for it have
lent themselves to a mighty sorry business.
A few years since this State had a marriage law that, while not perfect, was
a testimonial to the intelligent respect which the more thoughtful of our men
and women feel for their kind. Publication of the banns, health certificates for
both bride and groom, protected them and the race. Of course a few nice
youngsters in a hurry eloped to other states, as did some who could not have
been certificated at home. Marrying magistrates of Virginia, South Carolina,
and perhaps an occasional Tennessee or Georgia squire, picked up a few dollars
which border counties would have liked to retain within their bounds; but what
of it?
We were making an honest effort to give to marriage that self-respect to
which it as an institution is entitled. We were attempting to avert some of the
tragedies resulting from the propagation of the species by its sorriest specimens.
But the past two-three Legislatures have jested or worse at the ideals embodied
in the best-contrived marriage law of this section of the United States. It
was thought indelicate to require a mother of men to be examined by her
family physician as to her fitness for motherhood. It was deemed perversive of
public interest to require a notice to the public from those who desired to
enter into the contract which most concerns the public.
And now it would seem all bridegrooms of whatever age or physical condi-tion,
must be considered Bayards, sans pen, sans re-proche, and fit for mating
at the drop of a hat.
—
Greensboro News.
The Health Bulletin,
June 1935, Vol. 50, No. 6
May 1969 THE HEALTH BULLETIN 15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
U0b5
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Safeguards for Children
Patricia R. Hitt, Assistant
Secretary for Community Field
Services, Department of Health,
Education and Welfare has
urged enactment of legislation
to protect children against elec-trical,
mechanical, and thermal
hazards of toys and other items
intended for use by children. A
bill now pending in Congress,
which has been endorsed by the
Food and Drug Administration
would provide this protection.
Action is sought on the basis of
findings disclosed by the Na-tional
Commission on Product
Safety, appointed to make rec-ommendations
to the President
and Congress on ways to reduce
the hazards of household pro-ducts.
Under the existing Hazardous
Substances Act, the law does
not protect children against
hazards such as sharp or pro-truding
edges, fragmentation,
explosion, strangulation, suffo-cation,
asphyxiation, electric
shock, electrocution, heated sur-faces,
or unextinguishable
flames.
The urgent necessity for im-mediate
action, the Assistant
Secretary said, is clearly il-lustrated
by the casualty fig-ures
gathered by the Commis-sion.
More than 15,000 children
die each year from accidents.
This figure is higher than child-hood
deaths from cancer, com-municable
diseases, heart dis-eases,
and gastroenteritis com-bined.
More than half of the
children who died as a result of
accidents in 1966 were pre-school
children.
. . . from HEW Field Letter
16 THE HEALTH BULLETIN May 1969
mmmmfi
Official Publication Of The North Carolina State Board of Health
DR. E. R. HARDIN
Who retired July 1, 1969, after 50 years of continuous service
as Health Director of Robeson County Health Department.
(Story on page 3.)
June 1969
Inside
Dr. E. R. Hardin
Retires after 50 years 3
Hodges Heads New
State Health Move 7
Environmental
Health Protection 9
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 106 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Mailing ad-dress:
Post Office Box 2091, Raleigh, N. C.
27602. Published monthly. Second Class
Postage paid at Raleigh, N. C. Sent free
upon request.
Editorial Board
John Andrews, B.S., Raleigh
Jacob Koomen, Jr., M.D., M.P.H., Raleigh
John c. Lumsden, B.C.H.E., Raleigh
Guest Editor: Edwin S. Preston,
M.A., LL.D.
Vol. 84 June, 1969 No. 6
ALSO
Cover: Madge Pittman of the Robe-
Malpractice Insurance
Firm Advises Physicians son County Health Department
on Birth Control Pill _ 8 sta ff sent us this photograph of
retiring Health Director, Dr. E. R.
Dental Irrigating
Device Approved _ __11 Hardin, with this note: "This is
our favorite photo of Dr. Hardin
—
Preventive for hope you like it too." We do! His
Chicken Pox Reported 14 . . „ „„„,> o ; c <*
story, beginning on page 3, is a
profile of North Carolina's health
Live German Measles
Vaccine Licensed 16 progress in this past half-century.
2 THE HEALTH BULLETIN June 1969
Dr.
Eugene
Ramsey
Hardin
Retires After Fifty Years
As Health Director Of
Robeson County
Here is the story of those years as
told in Dr. Hardin's Nomination for
The Rankin Award of the N. C.
Public Health Association.
Dr. Eugene Ramsey Hardin
graduated from the University
of Georgia Medical College in
1911. His grades secured for
him an internship in Lamar
General Hospital. At the end of
this service he was appointed
intern in Nursery and Child's
Hospital, New York City, a
pediatric and obstetric service.
From there he interned in Wil-lard
Parker Hospital, the larg-est
contagious disease hospital
in New York City. While there,
he had the privilege of observ-ing
Dr. Bela Schick, who was
doing his experimental work in
diphtheria.
In 1915 he accepted the posi-tion
of Health Officer of Samp-son
County, N. C. After one and
a half years, he resigned this
position to begin private prac-tice
there. This was interrupt-ed
by the war, and in August of
1917, he entered training for the
Army Medical Corps and was
assigned to duty as a First
Lieutenant at Camp Lee, Va.
In October, 1918, he was sent
overseas and landed in France,
November 10, 1918, just in time
to help the French celebrate the
Armistice. After the Armistice,
it was Army policy not to re-lease
medical officers for sever-al
months. It was July, 1919,
therefore, before he returned to
the United States and to North
Carolina. He was discharged
from the Army August 31, 1919.
Dr. Hardin began work as
Health Officer for Robeson
County September 1, 1919.
At that time, much pioneer
work had been done by Doctors
B. W. Page and W. A. Mc-
Phaul, the first health officers,
but there was still a vast num-ber
of public health problems
to be solved. The county, one of
the largest in the state, had a
population of more than fifty
thousand people divided among
three races, no paved roads, one
hundred and fifty schools, one
small hospital, no dairies, and a
very low per capita milk con-sumption.
There were 190 midwives
practicing. The maternal and
infant mortality was very high,
as were deaths from infectious
and contagious diseases. The
water supply of most people in
small towns and rural sections
June 1969 THE HEALTH BULLETIN
was obtained from open wells
and shallow driven wells.
Screens were practically un-known
in the rural sections,
and sanitary sewage disposal
was extremely poor. Many
schools did not have sanitary
privies and obtained their water
from one pitcher pump. Typ-hoid
fever, infectious diarrheas,
diphtheria, tuberculosis, mal-aria,
pellagra, and hookworm
disease were very prevalent,
and thousands of people fell vic-tims
to these diseases every
year. Venereal disease was very
prevalent. Smallpox was com-mon.
In the beginning, the
main attack of the health de-partment
was directed against
the major public health prob-lems
of that time: Typhoid
fever, diphtheria, tuberculosis,
infantile diarrhea, hookworm
disease, and the high maternal
and infant death rate.
Better sanitation, water sup-plies,
and sewage disposal facil-ities
were urged.
The health department staff
at this time consisted of the
health officer and a secretary.
TYPHOID FEVER has
shown a steady decline since
1920. From 1920 through 1943
the health department Vacci-nated
66,030 against typhoid.
Clinics were held in stores,
private homes, country church-es,
voting booths, tobacco barns,
or anywhere people could as-semble.
Now, typhoid fever has
become a rare disease in Robe-son
County.
DIPHTHERIA: The health
department began an intensive
immunization campaign against
diphtheria in 1925, shortly after
the advent of the long-time
diphtheria preventive toxin-anti-
toxin. There has been no
letup in the fight since that
time. In the four year period
1920 through 1923, five hund-red
and sixty-two cases of
diphtheria with nineteen deaths
were reported to the health de-partment.
In the four-year peri-od
beginning 1925 through 1943
the health department vaccinat-ed
27,505 babies and older chil-dren
against diphtheria. During
this time, more than ten thou-sand
were given the Schick
test to determine diphtheria
susceptibility. The last case of
diphtheria was reported in 1959.
SMALLPOX: In the early
years smallpox cropped up fre-quently,
occasionally reaching
the epidemic stage. Vaccina-tions
over the years have con-trolled
the disease. No smallpox
has been reported since 1931.
TUBERCULOSIS clinics
were begun in 1920. Clinics
were held by a doctor from the
State Sanatorium. These clin-ics
were continued every few
years until about 1940, when
the state mobile X-ray units
were secured for several years.
Realizing the need, Dr. Hardin
was successful in organzing the
Robeson County Tuberculosis
Association in 1940. A few years
ago, Dr. Hardin persuaded the
county commissioners and the
THE HEALTH BULLETIN June 1969
T. B. Association to purchase an
X-ray machine that makes
small and large films. This
machine has provided Robeson
County with complete coverage
at all times. The Robeson Coun-ty
T. B. Association also pays a
part-time X-ray technician for
the health department.
The course of tuberculosis in
Robeson County gives an ex-ample
of the problems, the
work, and the results of public
health in the county. Dr. Hard-in
had not only the problem of
the rampant disease itself, but
he had also to deal with the
ignorance, superstitions, and
fears that had been present for
generations. Realizing that the
only way to change people was
through endless education, he
wrote hundreds of newspaper
articles, spoke at every possible
P.T.A., church, or civic gather-ing,
and visited endlessly with
the greats, near-greats, and the
nobodys-at-all throughout the
county.
That this work was not in
vain is evidenced by the de-crease
of deaths and cases. Ex-amination
of contacts has been
virtually one hundred per cent
for years. Thousands of county
residents come voluntarily to
the health department each
year to receive free chest X-rays.
MATERNAL AND INFANT
CARE: Robeson County has one
of the outstanding pre-natal
clinics in North Carolina. Until
recent years, prenatal clinics
were held once each month in
each town in the county. Sever-al
years ago all of these clinics
were consolidated into one clin-ic
held weekly at the health de-partment.
Here the patients re-ceive
excellent medical care,
nursing supervision during the
pre-natal and post-natal period,
nutrition consultation, and
necessary drugs. This has pro-duced
healthier mothers and
babies, as shown by the lower
maternal and infant deaths,
rates, and lower premature rate.
When Dr. Hardin came to
Robeson County, there were al-most
two hundred midwives.
An article on the history of the
health department in the March
7, 1962, issue of the Robesonian
described the work done by
these midwives. "Midwives
came under careful scrutiny.
They were investigated and
carefully screened. A course for
them given in the early 1920's
was attended by 130; 100 com-pleted
the course. Each was aid-ed
in assembling materials to
be carried in a little bag. Each
was trained in sterilization of
materials, the use of antiseptics,
the use of drops to be placed in
babies' eyes. In those early
years, three midwives were
taken to court for failing to put
drops in the eyes of newborn."
The last of these midwives re-tired
in 1962.
The effectiveness of this pro-gram
was recognized when it
played a part in bringing the
Merit Award of the N. C. Public
June 1969 THE HEALTH BULLETIN
Health Association to Robeson
in 1958.
VENEREAL DISEASE has
always been a problem in Robe-son
County. As early as 1920,
the fight began and still con-tinues.
In 1920 a venereal dis-ease
campaign was organized
with moving pictures, and a
lecturer from the U. S. Public
Health Service, here for a five-week
tour. The truck moved
into all parts of the county,
reaching all segments of the
population.
The modern developments in
the treatment of V.D. have, of
course, been of help in the con-trol
of this problem. In 1951
there was a county-wide blood
testing program, in which clubs,
and churches did their part in
getting out everyone possible to
be tested for possible infection.
This blood-testing program was
repeated in 1958. Treatments
were arranged for those need-ing
them. Through constant
checks of persons involved in
foodhandling and other related
occupations, a check is kept on
V.D. and possible contacts are
found and treated.
THE CRIPPLED CHIL-DREN'S
CLINIC, which is held
the first Friday of each month
as regularly as clockwork, be-gan
in the 1930's. In this work,
Mrs. A. F. McLeod, head of the
welfare department, was a
strong partner for Dr. Hardin.
The 30's were a period of de-pression
and health needs of
every type, including those in-volving
handicaps of children,
were great. The best doctors in
their fields come each month
to these clinics to examine new
cases and to check on former
cases. With the aid of the wel-fare
department and other sour-ces,
children who need medical
care, surgery or the like are
aided. Many a child in Robeson
today is a better person phy-sically
and emothionally be-cause
physical handicaps have
been alleviated by the Crippled
Children's Clinic.
PELLAGRA today is almost
an unknown disease, but when
Dr. Hardin came to Robeson it
was one of the big problems.
Great as it had been, it became
even more of a menace in the de-pression
years of the 30's. The
county commissioners included
enough money in the budget to
purchase mineral yeast, a very
effective agent to fight pellagra,
but a most unpleasant sub-stance
to take. Despite the un-pleasant
taste, when people
learned that yeast overcame
pellagra, they came in droves
for it. It is estimated that in the
course of several years, several
carloads were distributed, at
the request of the people need-ing
it.
HOOKWORM is another
poverty disease, but has far
more overtones in the health
picture since it can be trans-mitted
to others. In the early
years the fight began and still
continues. There were checks,
(Continued on page 12)
THE HEALTH BULLETIN June 1969
Hodges Heads
New State
Health Move
Needs In Medical Education
To Be Evaluated
By BEBE MOORE
Staff Writer
Former Gov. Luther H. Hod-ges
is chairman of a new com-mittee
which will promote
health planning in North Caro-lina.
The North Carolina Commit-tee
for Better Health was form-ed
in May, by some 30 persons
who gathered at the Statler Hil-ton
Inn here at Hodges's invita-tion
to discuss health needs and
the status and coordination of
health planning.
The committee's purpose,
Hodges said, is "to come up
with some ideas as to what we
can do to achieve . . . the best
health program that North
Carolina can afford."
He said such a program in-cludes
training of medical per-sonnel,
providing adequate fa-cilities,
and making available
"the best medical care possible
at the most reasonable cost to
the individual and the state.'
"
May Serve As Nucleus
The committee may serve as
the nucleus of a grassroots
movement similar to the "good
health movement" of the late
forties, Hodges said.
This movement was the fore-runner
of the present active N.
C. Health Council.
The earlier movement has
been described as the first great
statewide thrust for health. It
resulted in passage by unani-mous
vote in the 1949 General
Assembly of a package of 12
items that included creation of
the four-year medical school at
the University of North Caro-lina
and appropriation of state
funds to match federal (Hill-
Burton) funds for construction
of medical facilities.
Several participants in the
meeting Tuesday stressed the
importance of public involve-ment
in efforts to meet the
state's health needs. Dr. Jacob
Koomen, state health director
and acting director of the Office
of Comprehensive Health Plan-ning,
said that citizens now
"scream to the state legislature
(to meet health needs), rather
than to the federal govern-ment,"
as they did in the period
of the forties.
The committee will seek the
best method of developing a
comprehensive statewide health
plan.
Such a plan was recommend-ed
in a statement from Watts
Hill Jr., chairman of the State
Board of Higher Education.
June 1969 THE HEALTH BULLETIN
The statement, read by high-er
education board director Dr.
Cameron West in Hill's absence,
said that it is "difficult if not
impossible" for the board to
plan and promote ways of meet-ing
health needs without a com-prehensive
statewide plan.
Hill also pointed out that a
plan could assign to agencies
and institutions involved in
health care "responsibility for
subsections within its area of
special competence." and make
it possible to weigh the needs
in specific areas "against total
needs and priorities."
Ed Rankin, vice president
and secretary of the North Caro-lina
Citizens Association, was
appointed chairman of a steer-ing
committee to set directions
for the larger committee.
Others on the steering com-mittee
are William Snyder, edi-tor
of The Greensboro Daily
News; Dr. Koomen; state Rep.
Hugh Johnson, D-Duplin, who
headed a Legislative Research
Commission study of the state's
doctor shortage; state Sen.
Lindsay Warren Jr., D-Wayne;
Dr. West of the board of higher
education; Dr. James Musser,
director of the North Carolina
Regional Medical Program; Dr.
Amos Johnson of Garland,
former president of the Amer-ican
Academy of General Prac-tice;
and Asheville attorney
Lamar Gudger.
Raleigh News and Observer
May 14, 1969.
Malpractice
Insurance Firm
Advises Physicians
On Birth Control
Pill
A Los Angeles firm dealing
in malpractice insurance has ad-vised
its 18,000 physician-clients
to get patients request-ing
birth control pills to sign
statements acknowledging
"awareness of the serious risks
involved."
The firm, the Nettleship Co.,
administers professional liabil-ity
programs for 12,000 doctors
in Southern California and for
6000 osteopathic physicians na-tionwide.
It is the second larg-est
company of its kind.
In a "claims prevention let-ter"
dated May 14, Nettleship's
president John C. Allen told
doctors of "the increasing
awareness of potential compli-cations
from contraceptive
pills" and disclosed that his
firm is "already handling law-suits
dealing with some of these
complications."
The Government-approved
instructions for prescribing the
Pill say that it increases from
seven to 10 times the risk of
serious and fatal blood clotting
compared with the rate in non-users.
3 THE HEALTH BULLETIN June 1969
Environmental
Health
Protection
Charles C. Johnson, Jr.
Administrator
Consumer Protection and
Environmental Health Service
Public Health Service
Excerpts from an address prepared
for delivery at the Spring meeting
of the Southern Regional Legisla-tive
Seminar on Current Public
Health Problems, sponsored by the
Southern Conference of the Council
of State Governments.
We shape our environment,
and then our environment
shapes us. We have only to look
around us to see that we are
well on the way—particularly
in our urban areas—to creating
a world which can have the
most serious adverse effects on
human health.
We are "engaged in a race be-tween
catastrophe and the in-telligent
use of technology, and
it's not at all clear we are going
to