Health bulletin

              HEALTH SCIENCES LIBRARY
OF THE
UNIVERSITY OF NORTH CAROLINA
This Book Must Not Be Taken
from the Division of Health
Affairs Buildings. pqur days
This JOURNAL may be kept outflHHHR
and is subject to a fine of FIVE CENTS a day
thereafter. It is DUE on the DAY indicated
below:
Vc ? ;^/
icia! Publication Of Th
Partnership for Health
ncpriy FO
S 4 'i=
MAR 9 1968
jF
rMTu -TrMR^. HBRAR'
Governor's
Conference
on
Heolfh
Stresses
Comprehensive
Planning
(See page 2 and following)
G^OVERNOR'S C0NreRE^
ON V\EWJH^
REMARKS BY GOVERNOR DAN MOORE
AT GOVERNOR'S CONFERENCE ON HEALTH
Thursday, January 25, 1968-11:00 A.M.
Memorial Auditorium — Raleigh, North Carolina
Thank you for coming today for this Conference on Health. I believe that
this meeting will be a landmark in North Carolina's continuing effort to protect
the health of its people and to provide adequately for the care and treatment of
its sick and infirm. The public and private health-oriented organizations represent-ed
at this Conference have cooperated through the years to provide for
improvements in health care programs for the people of this State.
In one sense, we have every reason to be thankful for the progress made in
recent years in protecting the health of the people. Considerable gains are
evident within our own lifetimes. Sanitation, once a major health concern, now
.5 taken almost for granted. Many of the serious communicable diseases have
oeen conquered. Medical treatment and hospital facilities have improved
considerably and are more readily available to the people. And, the expected
life span of man has increased by almost 20 years.
In another sense, however, it is most evident that we cannot become
implacent. Infant mortality rates in the United States are substantially higher
fhan in many other advanced countries, and the rates in this State are among the
highest in this country. Rejection of North Carolina military inductees for health
leasons occurs with greater frequency than in many other States. The costs of
medical care continue to climb adding increased hardship to many in need.
The purpose of this Conference is to focus attention on these and other
medical and health problems. I also want to report to you of our efforts to
promote, protect, and conserve the health of the citizens—an essential factor in
the total development of North Carolina. And, I want to ask for your support
and your help in a new effort to coordinate the utilization of health resource to
the end that every man, woman and child in this State has the finest in
health care.
THE HEALTH BULLETIN January, 1968
Of course, concern for the health of the people is nothing new for us.
North Carolina pioneered in the Better Health Movement during the 1 940's and
has never ceased its efforts to improve services. Under the leadership of the
State Board of Health, an excellent system of local public health services has
been developed.
During this biennium a total of $800,000 was made available in State aid to
local health departments. At the State level new programs are being implement-ed
which will insure quality care in the transportation of the sick and injured
and in genetic counseling. Existing programs for the control of salt marsh
mosquitoes, for the inspection of food and lodging establishments and for the
dental care program were strengthened.
The fine system of local hospitals is a credit to many people who worked
on the local. State and Federal levels under the coordination of the North
Carolina Medical Care Commission.
North Carolina now ranks 12th from the top among States in the number
of hospitals and 15th in the number of hospital beds. The State ranks 7th in
the nation in the number of hospital beds constructed and 3rd in the number
of Public Health Centers developed under the cooperative financing program.
North Carolina has at Chapel Hill the only State-supported medical center
in the South, with major professional schools for medicine, dentistry, nursing,
public health and pharmacy.
January, 1 968 THE HEALTH BULLETIN
A total of 271 students is preparing for health careers at Chapel Hill and
other nnedical centers under State scholarships for medical and paramedical
studies. Over 100 rural communities have benefited by the services of students
receiving these State scholarships.
Our system of mental health services, developed under the direction of
the State Board of Mental Health, is recognized as being one of the finest in the
country and is providing a pattern for other States.
Appropriations for mental health are at an all time high this biennium
with a total of $110 million going to provide care in the State mental hospitals
and community mental health programs. Cost accounting programs have been
implemented in the psychiatric hospitals and programs for alcoholism, mental
retardation, and for prisoners in the State corrections system have been supported
vigorously.
Even with the assistance of the Medicaid program, many States do not yet
provide the health services to welfare recipients as does the State Board
of Welfare.
During the past year payments to hospitals for the care of indigent patients
were increased and rate increases were made for domiciliary and nursing
home care for adult welfare recipients. The department is actively supporting
cooperative programs in family planning throughout the State. Overall at least
1,100 fewer persons are now on public assistance rolls today than there were
a year ago. The State is presently moving ahead with detailed advanced planning
for the provision of better medical services to this decreasing group through
the implementation of Title XIX of the Social Security Act.
The Vocational Rehabilitation Division of the Department of Public Instruction
is nationally recognized for its rehabilitation programs. And, we believe that
a comprehensive study presently under way will bring about further improve-ments
in vocational training for the handicapped. Environmental health continues
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 608 Cooper
^lemorial Health Building, 225 North ^Ic-
Dowell Street, Raleigh, N. C. Published
monthly. Second Class Postage paid at
Raleigh, N. C. Sent free upon request.
Editorial Board
Charles M. Cameron. Jr . M D . M P H.
Raleigh
John C. Lumsden. BC.H.E.
Jacob Koomen, Jr . M D.. M PH.
John Andrews. B,S.
Glenn a. Flinchum. B S.
H W. Stevens. M.D,. M.P.H.. Asheville
Guest Ed.—Edwin S. Preston, M.A.,LL.D.
Vol. 83 January, 1968 No. 1
Governor Moore & Mrs. Sue Jones of
Medical Care Commission.
THE HEALTH BULLETIN January, 1968
to receive special attention from the Department of Air and Water Resources,
the State Board of Health, the Department of Agriculture and other agencies.
The Medical Division of the Commission for the Blind has increased and
expanded its medical eye services, and last year 531 persons v/ere rehabilitated to
gainful employment by this agency. This represents an increase of 75 over the
previous year.
The biennial budget approved by the 1967 General Assembly provided
expenditures totaling over $124 million for health and hospitals. In addition,
sizeable State allocations for health-related programs were provided for welfare,
education, public safety, correction, and other special areas. Some of 45 State
agencies are involved. The total expenditure of State Government in the health
care field during the present biennium will be more than $150 million. This
represents a sizeable increase over similar expenditures for the last biennium,
and demonstrates the commitment of the State to providing for the health care
of its citizens.
These State programs and others which I have not mentioned complement
a network of health services provided by private organizations, voluntary
health agencies, and many, many dedicated individuals. Certainly, without this
total effort, the five million people of North Carolina would not have the health
and the medical well-being that they do today.
It is evident, however, that we in North Carolina have a great opportunity to
move forward rapidly in providing better health and medical services. Tremendous
advancements are being made. All may not be as dramatic as the recent heart
transplants, but all are important to better health and longer life. The people
of this State deserve the advantages that modern science and concern can provide.
And, while we cannot disregard the costs, we must not let them overshadow
our purpose.
These same factors, of course, are applicable to other State services. It was
this broad concern for greater coordination of State resources and better utilization
of Federal and State funds that led to my creating the State Planning Task
Force early in the Administration. It is significant that one of the first studies
undertaken by the Task Force dealt with State health services. This initial work
by the Task Force, in effect, gave North Carolina a head start in health planning
for the future.
We were ready to move ahead when Congress enacted legislation providing
for comprehensive health planning. Public Law 89-749. I designated the Director
of the Department of Administration as the State official to work in implementing
(Continued on page 10)
Advisory Council for Comprehensive Health Planning.
January, 1 968 THE HEALTH BULLETIN
Mrs. Annie B. Edwards, who retired January 1 of this year after 48 years of
service with the State Board of Health, during which she was secretary to four
State Health Directors. She is shown being presented a certificate of appreciation
by Dr. Jacob Koomen, State Health Director.
THE HEALTH BULLETIN January, 1968
Upon his retirement from service with the State Board of Health, Dr. J. W. R.
Norton received a Certificate of Appreciation from Dr. Jacob Koomen, State Health
Director. Dr. Norton served for 17V2 years as North Carolina's State Health
Director.
January, 1968 THE HEALTH BULLETIN
Retiring employees representing 409
years of service with the State Board of
Health were honored at year's end in a
special formal ceremony at Raleigh.
Dr. Jacob Koomen, the State Health
Director, expressed the appreciation of
the fellow workers in public health to
the sixteen persons who retired at the
end of December. They averaged a
quarter of a century in service to North
Carolina through public health. The
ceremonies were held in the John H.
Hamilton Auditorium of the Laboratory
Building of the State Board of Health.
Mrs. Annie B. Edwards, Local Health
Division, who entered on her duties in
1919, and has 48 years to her credit,
led the list in length of service. She
served as secretary for four State Health
Directors. Not far behind was Marcus C.
Allen, Laboratory Technician in the Ser-ology
Section, with 43 years to his cre-dit.
Charles M. White, Chief of the In-sect
and Rodent Control Section, Sani-tary
Engineering Division, had 34 years
of service.
Also retiring was Dr. J. W. R. Norton,
former State Health Director.
Other retirees with their length of
service and Department are: C. E.
Harrington, Laboratory Division, 32V2
years; William Murray Linker, Jr., Sani-tary
Engineering Division, 31 V2 years;
Oris Harris, Administrative Services Di-vision,
30 years; Miss Amy Fisher, Lo-cal
Health Division, 28 years; Edna R.
Jackson, Laboratory Division, 27 years;
Mrs. Wilma H. Harrell, Epidemiology Di-vision,
25 years; Mrs. Golda Walker,
Administrative Services, 23 years; Miss
Doris Tillery, Local Health Division, I8V2
years; Eugene E. King, Sanitary Engi-neering
Division, 15 years; R. F. Hill,
Sanitary Engineering Division ISVa
years; Miss Lena E. Simmons, Adminis-trative
Services, 10 years; Jesse W. Har-rell,
Sanitary Engineering Division, 8
years.
State Boarj
409i
From the left, seated — Mrs. Annie B. Ed
Golda Walker and Miss Amy Fisher. Stami
Eugene E. King; R. F. Hill; W. Murray I
8 THE HEALTH BULLETIN January, 1 968
ff Who Retired January First-
's Service Is Represented
Edna Jackson; Mrs. Wilma H. Harrell; Miss Lena Simmons; Miss Doris Tillery; Mrs.
cus S. Allen; Dr. J. W. R. Norton; C. E. Harrington; Oris Harris; Jesse W. Harrell;
nd Charles M. White.
January, 1968 THE HEALTH BULLETIN
(Continued from page 5)
this legislation. He, in turn, established an office of health planning which could
function in close liaison with the State Planning Task Force and other State
agencies. Dr. Charles Cameron of the School of Pubic Health at the University
of North Carolina at Chapel Hill was granted a leave of absence to become the
director of the Office of Comprehensive Health Planning.
To assist Dr. Cameron in the designing of a preliminary plan for planning, a
Technical Committee on State Health Planning and Health Services was established.
It consisted of the heads of the Department of Health, Mental Health, Welfare,
Public Instruction, and Personnel; the Medical Care Commission; the State
Planning Task Force; and the Division of Health Sciences of the University of
North Carolina. Their plan of study was submitted to the Public Health Service
in the fall and was approved October 31, 1967.
The Office of Comprehensive Health Planning has moved ahead in preparing
to initiate the program of study and planning. To advise and assist the Office
in its work, I am pleased today to announce the appointment of an Advisory
Council which, by law, includes a majority of consumers of health services as
well as representatives of the major health interests of the State. Members of
the Council are:
Clifton M. Craig, Commissioner, Department of Public Welfare, Raleigh
Grady Ranson Galloway, Executive Director, Commission for Blind, Cary
James A. Graham, Commissioner, Department of Agriculture, Raleigh
Dr. Eugene Alexander Hargrove, Commissioner, Department of Mental Health,
Raleigh.
William Freeman Henderson, Executive Secretary, Medical Care Commission,
Raleigh
Dr. Jacob Koomen, State Health Director, Board of Health, Raleigh
C. Arden Miller, Vice Chancellor, Health Sciences, University of North
Carolina at Chapel Hill
George Eugene Pickett, Director, Department of Water and Air Resources,
Raleigh
Dr. Henry Stuart Willis, North Carolina Sanatorium System, Chapel Hill
Dr. Andrew Arthur Best, Greenville
Herbert Clarence Bradshaw, Durham
Dr. Amos Summer Bumgardner, Charlotte
Senator Albert J. Ellis, Jacksonville
William Harry Entwistle, Jr., Hanes Corporation, Winston-Salem
James Clyde Gaither, Sr., Gaither's Restaurant, Inc., Brevard
Mrs. Foy T. Goodin, President, North Carolina Extension Homemakers Associa-tion,
Newton
Mrs. Geneva Bass Hamilton, Goldsboro
Thomas Royster Howerton, Wilson
Robert Earle Jones, Agricultural and Technical State University, Greensboro
State Representative Ernest Bryan Messer, Canton
Dr. John Duncan Robinson, Wallace
Wayland J. Sermons, Washington
Carl Wilson Anderson, School of Social Work, University of North Carolina
at Chapel Hill
10 THE HEALTH BULLETIN January, 1968
Dr. William George Aniyan, Duke University Medical Center, Durham
William Charles Barrett, The State Bank, Laurinburg
Reverend Cecil Bishop, Trinity AME Zion Church, Greensboro
Senator John R. Boger, Jr., Concord
Riley Wilson Clapp, Pleasant Garden
Thomas Hightower Collins, Chapel Hill
Thomas C. Day, Vice President, Citizens Bank and Trust Company, Hayesville
Reginald Morton Fountain, President, North Carolina Association of County
Commissioners, Tarboro
George Watts Hill, Durham
Dr. Frank W. Jones, Nev^^ton
Mrs. Mary Edith Rogers, Gaston County Health Department, Gastonia
Carlos Lowery Young, Shelby
State Representative Kenneth C. Royall, Jr., Durham
Alonzo Clay Edwards, Hookerton
Mrs. William Francis Wolcott, Asheville
Mrs. Joseph M. Hunt, Jr., Greensboro
Charles Curtis Johnson, Jr., R. J. Reynolds Tobacco Company, Winston-Salem
Mrs. Phebe Harlan Emmons, President, North Carolina Council of Women's
Organizations, Raleigh
James Gv^yn Gambill, West Jefferson
Rabbi Joseph Asher, Greensboro
Roger Hester Sloop, Warren's Drug Store, Rural Hall
Dr. John Gentry Martin, Boone
Charles Scott Venable, Jr., North Carolina Tuberculosis Association, Raleigh
John Alexander McMahon, President, North Carolina Blue Cross and Blue
Shield, Inc., Chapel Hill
I am pleased to appoint Mr. John A. McMahon as Chairman, and Mrs. Phebe
H. Emmons as Vice Chairman.
These members of this Advisory Council have assumed a most important
responsibility. Their duties include:
—Advising the Governor, the Department of Administration, and the Office
of Comprehensive Health Planning in the conduct of a comprehensive planning
program for health.
—Assisting the Office of Comprehensive Health Planning in the identification
of problems, needs and developments both within the State and elsewhere
which relate to our efforts to provide comprehensive health services to the
citizens of North Carolina.
—Recommending to the Governor, the General Assembly, the various boards
and commissions dealing wtih health-related programs and private and public
organizations, courses of action relating to the health needs and resources of
the State.
—Facililating communication and cooperation among agencies, organizations,
professions, and the public in the cause of better personal and environmental
health for North Carolinians.
The work of this Advisory Council will be instrumental in the development
of a State comprehensive health plan under the provisions of Public Law 89-749
—the Partnership for Health amendments to the Public Health Service Act. An
award of $67,000 has been made to finance the initial steps for this fiscal
January, 1968 THE HEALTH BULLETIN 11
year. The comprehensive study plan for health services in North Carolina is
designed to serve four maior purposes.
1. It will provide for a comprehensive and coordinated approach to health
planning with emphasis on the long-range investments which the State must make
in such areas as health manpower, health facilities, and in the financing of health
services. The study will help identify the underlaps and overlaps in the current
spectrum of health services available in North Carolina.
2. It will provide access to the health planning process for consumers as well
as a wide range of providers of health care.
3. It will provide for a new and more effective relationship among health
and health-related groups.
4. It will provide for a strengthening of State and local decision-making in
the health field through the comprehensive approach to health planning and
through greater flexibility provided under the grant programs.
In addition, this approach to comprehensive health planning will facilitate the
coordination of work by the various State agencies now active in the health
care field with each other and with the numerous agencies in the private sector.
And, it will also improve the communication between health planners and those
with responsibilities in other areas essential to the total development of our
abundant resources in North Carolina.
There is much to be considered by this Advisory Council. As I indicated earlier,
vast progress is evident in health and medicine. But, there is a definite need
for greater effort in many areas. There is often a gap between the potential for
modern health care and the practice. And, unfortunately, not all citizens have
the means or even the initiative to obtain good health care. Costs are increasing,
medical and health manpower is more difficult to find, and adequate medical
services are not readily available to all citizens. One of the early and high
priorties facing this Council is a definition and projection of health manpower
needs in order that the educational institutions in this State can make plans
to fulfill these needs
Study needs to be given the availability of health services in our less populat-ed
areas, particularly in the East and the West. Deficiencies must be identified
and recommendations made for their correction. The growing metropolitan
areas have special problems which must be given attention. The complexity
of agencies and services for health care often are confusing and difficult for
the would-be consumer to identify. Clarification and simplification are necessary.
Attention must be paid to the need for home health services, rehabilitation
facilities, nursing homes and other services for the aged and chronically ill. Special
services for school age children and emergency medical services for people
injured in accidents must be given consideration. Increasing costs will mean
increasing problems for the low wage earner and those on welfare. Ways must
be found to insure that all have access to adequate medical care.
There is an urgent need for a coordinated program of recruitment, develop-ment
and placement of health manpower. Attention must be given to the
distribution of available health manpower to areas of need with emphasis being
given to insure its full and proper utilization. The means must be found for
a greater exchange of views and greater understanding between the health
services consumer and the provider. Programs to minimize and eliminate
environmental health hazards must be stepped up.
12 THE HEALTH BULLETIN January, "l 968
This advisory Council must give careful attention in its planning to insure close
coordination and cooperation among all agencies and organizations involved in
health services. It is evident from the challenges confronting North Carolina in
this area that we cannot afford the luxury of unnecessary duplication. The num-erous
State agencies involved must join together with a new unity of purpose.
And, the State must work hand in hand with local and Federal governments,
private health-related organizations and individuals to get the necessary jobs
accomplished.
Ladies and gentlemen, today marks the beginning of a great new effort on
the part of North Carolinians to insure the finest in health and medical care for
all. It is a massive undertaking. Its size, however, is diminished by its importance.
The burden of responsibility for the preparation of this Comprehensive Health
Plan for the future is not limited to the Advisory Council named today. Nor
is it limited to the Office of Comprehensive Health Planning and the various
State agencies and departments which will contribute.
Success in the planning phase, as in implementation, depends upon the active
thought and participation of all concerned with the good health and well-being
of their fellowmen. Your assistance, your suggestions, your participation are
essential in the development of this Comprehensive Health Plan. We have an
opportunity in North Carolina today to move ahead in planning for the attainment
of the highest levels of health service for all citizens. With your help, we can
succeed in planning and in providing a total health program second to none.
Mrs. Kitty Ellington received the annual ,7>uch-coveted Outstanding Service Award
from Glenn Flinchum, president of the Public Hea.'.*.'" Academy.
January, 1968 THE HEALTH BULLETIN 13
Albert J. Klimas, who has been serv-ing
as Director of the Cabarrus County
Health Department since October. Klim-as
is 37, a native of West Virginia, who
completed his work for the M.S.P.H.
degree from the University of North
Carolina. He came to the North Caro-lina
position from Colorado where he
was Assistant Chief of the Chronic Dis-ease
Section of the State Department
of Public Health.
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
J. W. R. Norton, M.D., M.P.H. Director, Local Health Division
E. A. Pearson, Jr., D.D.S., M.P.H. Director, Dental Healt>i J}ivision
Lynn G. Maddry, Ph.D., M.S.P.H. Director^ Laboratory Division
Ben Eaton, Jr., A.B., LL.B. Director, J<i',y,inistrative Services Division
Theodore D. Scurletis, M.D. Director, Personal Health Division
14 THE HEALTH BULLETIN January, 1968
Stephanie Crane, Teenage Easter Seal Chairman
Brown-haired, green-eyed Stephanie
Crane, who was crowned Miss Teenage
America before a nationwide television
audience last November, has been nam-ed
National Teenage Chairman for the
1968 Easter Seal Campaign, Mar. 1 to
Apr. 14.
Stephanie, who turned 18 in Decem-ber,
is from High Ridge, Mo., a suburb
of St. Louis, and she is a senior with a
B-plus grade average at Cor Jesu Ac-ademy
in that city.
January, 1968 THE HEALTH BULLETIN 15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
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DIVISION OF HEALTH AFFAIRS
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CHAPEL HILL, N.C,
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DATES AND EVENTS
March 1-2 — Health Careers Congress,
Robert E. Lee Hotel, Winston-Salem
March 1-3 — American Association of
Pathologists & Bacteriologists, Chica-go
March 6-7 — NLN Regional Confer-ence,
Atlanta, Ga.
March 7 — 3rd Annual Wilson Memo-rial
Hospital Postgraduate Symposi-um,
"Heart Disease in the Child and
Adult," Wilson, N. C.
March 11-13 - National Health Coun-cil,
Los Angeles
March 11-13 — 14th Annua! Sectional
Meeting for Nurses and Doctors,
American College of Surgeons, Wil-liamsburg,
Va.
March 18-20 — American Academy of
Pediatrics, Atlanta, Ga.
March 21-22 — Annual Convention
North Carolina League for Nursing,
Blockade Runner, Wrightsville Beach,
N. C.
March 22-23 — Annual Convention Stu-dent
Nurse Association of N. C,
Blockade Runner, Wrightsville Beach,
N. C.
March 22-23 - 2nd National Congress
on the Socio-Economics of Health
Care, The Palmer House, Chicago, III.
March 25-28 — 6th Annual Meeting for
Registered Nurses, Sponsored by
Southeastern Surgical Congress, Sher-aton
Park Hotel, Washington, D. C.
April 3-5 — 4th Annual Migrant
Health Conference, Reidsville
April 4-6 — 3rd National Conference
on Health Education of the Public,
Pick Congress Hotel, Chicago, III.
April 19-20 — Population Association
of America, Boston, Mass.
April 19-20 — American College of
Surgeons, Blockade Runner, Wrights-ville
Beach
April 21-22 - Annual Meeting, N. C.
Conference for Social Service, Sir Wal-ter
Hotel, Raleigh
April 30-May 1 — Tuberculosis Associ-ation
Annual Meeting, Heart of Char-lotte
Motel, Charlotte, N. C.
16 THE HEALTH BULLETIN January, 1968
\/, ^ / ^fr
Jf^i^/
Lort and Lisa Yauch, 4-year-old identical twins, are 1968 National
Easter Seal Children. The daughters of Mr. and Mrs. Gail Yauch of
Detroit, the girls both are victims of cerebral palsy resulting in spastic
paraplegia. But, with the help of skilled physical and occupational thera-pists
at their Easter Seal treatment center, they are learning to over-come
their handicap and preparing themselves for the demands of life.
THE LONGEVITY OF DECEASED AMERICAN PRESIDENTS,
VICE PRESIDENTS, AND CANDIDATES FOR PRESIDENT
Presidents
Excluding Those
All Assassinated
Average Number of Years Lived 68.5 70.7
Pre-Civll War 74.2 *
Post-Civil War 63.4 66.6
Average Years Lived Above or Below
Expectation of Life at Inaugurationt. -3.6 -1.5
Pre-Civil War +1.3 *
Post-Civil War -7.9 -4.8
The
North
Carolina
Human
Bet-termenf
League:
An
Idea
Come
of Age
By Chester Davis
The North Carolina Human Better-ment
League, which celebrated its 20th
anniversary this past year, is less impor-tant
as an organization than as a sym-bol
of an idea that has come of age.
When the league was organized in
1947, birth control concerned a hand-ful
of zealous reformers like Margaret
Sanger and a very few, far-sighted men
who suspected that Thomas Robert
Malthus just might be right. Elsewhere
there was either powerful opposition—
that of the Catholic church, for ex-ample—
or a public distaste for open
discussion of such untidy matters as
contraceptives, sterilization and abor-tion.
Opposition Wavers
While the opposition continues, it
appears to be wavering. The tradition-al
Catholic position on birth control is
challenged now by growing and in-creasingly
articulate forces within the
church. And public distaste promises to
become a relic of our prim Puritan
past. The freedom with which we now
discuss the pill and related matters is a
measure of the change that has taken
place, it is change born of reality—the
reality of the population explosion
which is no longer a prospect but a
fact.
Demographers report that when men
and women first began experimenting
with the geometric progression of birth
it required half a million years or so—
until about 1650, they say-for world
population to reach the half billion
mark. Then, in 200 years, it doubled,
passing the billion mark by 1850.
It doubled again in the next 100
years. By 1966, world population was
put at 3.4 billion. The demographers
estimate that by 2000-34 years away-there
will be 6.8 billion people on
earth.
This has consequences which trans-late
into terms of numbers and quality.
February, 1968 THE HEALTH BULLETIN
The Least Able
The problem of quality results from
the fact that the least fit are doing most
of the breeding. In international terms,
it is the so-called developing nations of
Africa, Asia and Latin America which
have the highest birth rates. These, of
course, are the nations least able to
feed their populations, much less their
projected populations.
In terms of individuals, the quality
problem results from the fact the birth
rate is the highest—about two to one—
among those least qualified for parent-hood;
the mentally, physically, genetic-ally,
(and, for these reasons, the eco-nomically)
scrub stock. As William
Penn noted, we breed horses and dogs
with greater care than we breed human
beings. The long-range implications are
not pleasant.
The problem of sheer numbers—
a
problem now growing at the rate of 60
million a year—has even more immedi-ate
and distressing implications. It will
determine, for example:
—How much we will have to eat.
—The quality of our standard of
living.
—The degree and rapidity in which
we foul our environment with our own
wastes.
The economic cost we pay because of
our inability to check the run-away
birth rate has not been totaled. It
undoubtedly is staggering, because it
includes the cost of famine, air and
water pollution, and growing public
health and public welfare costs.
We have reached the crossroads Mal-thus
predicted for us. Either we check
the world's birth rate immediately and
substantially or it will be done for us
by what he described as the three ulti-mate
population controls: War (prob-ably
nuclear), famine and epidemic
disease.
In 1947, when the North Carolina
Rules and
Regulations
Governing
Ambulance
Service
Copies of Rules and Regulations gov-erning
Ambulance Service of the North
Carolina State Board of Health, adopted
October 12, 1967, are available on re-quest,
as a Supplement to the North
Carolina Health Bulletin from the Acci-dent
Prevention Section, Division of
Epidemiology, North Carolina State
Board of Health, Raleigh, North Caro-lina
27602.
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 608 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
Charles M Cameron. Jr., M.D., M.P.H.
Raleigh
John C. Lumsden, B.C.H.E.
Jacob Koomen, Jr., M.D., M.P.H.
John Andrews, B.S.
Glenn A. Flinchum, B.S.
H w. Stevens, M.D., M.P.H., Asheville
Guest Ed.-Edwin S. Preston, M.A.,LL.D.
Vol.83 February, 1968 No. 2
THE HEALTH BULLETIN February, 1968
Human Betterment League was organ-ized,
the focus was on the problem of
quality more than number. Dr. Clar-ence
J. Gamble of Milton, Mass., a
geneticist who built an international
reputation at both Harvard University
and at the University of Pennsylvania,
was particularly concerned with genetic
and economic folly in human breeding.
Draft Rejectees
In the period immediately after
World War 11, Gamble became in-trigued
by North Carolina's startling
rejection rate (14 per cent in 1942 and
48 per cent in 1944) of draftees for
reasons of mental illness or mental re-tardation.
At Gamble's instigation. Miss Else
Wulkop, a medical social worker, came
to the state to explore the facts behind
these statistics. With the assistance of
Dr. A. M. Jordan, an educational psy-chologist
at the University of North
Carolina, the intelligence level of the
school children of a rural county (Or-ange)
was tested.
The results of this test caught the
eye of James G. Hanes, then president
of the Hanes Hosiery Corp. Hanes
asked that a similar study be made of
the children of an urban county. This
was done in Forsyth County.
The results of the two studies—each
reflecting an alarming incidence of
mental problems, both illness and re-tardation—
was combined with addi-tional
data gathered by Miss Wulkop
and resulted in the formation of the
Human Betterment League in 1947.
it was the first of a number of such
leagues. Its essential purpose, then and
now, was to educate the people of the
state regarding the need for an effec-tive,
intelligent program of birth con-trol
and to instruct them regarding the
tools — and the use of the tools — of
birth conrtol.
Broadens Emphasis
Initially, the league emphasized the
quality by concentrating on programs
calculated to curb births, control the
least fit. More recently the league has
added its voice to those of similar or-ganizations
around the world to preach
the need to control human numbers
lest we breed ourselves out of standing
room.
During its formative years, the league
pushed for more effective use of the
state's Eugenics Law.
This law, adopted in 1933 and since
amended, creates a Eugenics Board
which consists of the secretary of the
State Board of Health, the commission-er
of public welfare, the attorney gen-eral,
the chief medical officer of the
State Hospital in Raleigh and one other
medical officer from a public mental
institution elsewhere in the state.
The board, operating on a limited
($25,000 for the 1964-66) budget meets
quarterly to pass on cases proposed for
selective sterilization by the directors
of the state's hospitals for the mentally
ill and retarded and from the superin-tendents
of the various county public
health departments.
The Eugenics Board can order steri-lization
in four types of cases:
—Where it is in the best interest
of the patient, mentally, physically or
morally.
—Where the operation is ruled to be
in the public interest.
—Where there is a request made by
the guardian of a mental patient.
—Where hereditary mental or phy-sical
ailments are likely to be trans-mitted
to the child.
Appeals from the board's orders to
the courts are possible, but they are
uncommon because the cases are care-fully
selected.
The operation is simple. For males
February, 1968 THE HEALTH BULLETIN
(the vasectomy), it consists of cutting
and tying off the tubes through which
sperm moves. For women (the salping-ectomy),
it consists of cutting and tying
the fallopian tubes through which the
egg moves.
In terms of sex, these operations
have only one effect; they forever pre-vent
conception. The sex function it-self
is not in any way impaired. In
fact, studies suggest that sexual grati-fication
more often than not is en-hanced
because of the removal of the
fear of pregnancy.
From 1934 until 1947, when the
league was formed, a total of only 1 ,-
827 sterilizations had been performed
under the state law: 1,214 patients
were feebleminded, 385 insane, and
228 suffered from epilepsy and other
heriditary afflictions.
In 1947 this state ranked 17 among
the 27 states having similar laws. Since
then, and largely because of the educa-tional
work done by the league. North
Carolina rather regularly has led other
states in protective sterilization.
Even so, the number of cases—an
average of something like 250 to 300
a year—processed under the state's
eugenics program is not large. It is
likely to increase somewhat in the im-mediate
future because the 1963 Gen-eral
Assembly amended the Eugenics
Law to remove the possibility of a
surgeon performing protective steriliza-tion
being held guilty of mayhem, an
ancient felony that has come down to
us out of English common law.
Moreover, the sterilizations perform-ed
under the Eugenics Law represent
less than 10 per cent of the total steril-izations
performed each year in this
state. A 1959 study of 83 hospitals in
North Carolina indicated that an aver-age
of 2,880 tubal litigations (protec-tive
sterilizations) were being perform-ed
each year. More than 90 per cent of
these were voluntary, and most of them
were done for the convenience of the
patient and because the patient was
unable to risk the burden and cost of
more children.
Results of Studies
Studies indicate that for every 100
feebleminded women (and 200 men)
who undergo this operation the birth of
90 retarded children is prevented each
year.
The social and economic consequen-ces
of this are apparent.
The program helps reduce the birth
rate among the least fit. And, accord-ing
to the record, the term "least fit"
has no racial connotation. Sterilizations
under the Eugenics Law rather closely
follow the white-Negro ratio of our
population.
The program also reduces welfare
and health costs. Equally important, it
protects unfit parents from the crush-ing
burdens of family, and at the same
time insures against the tragedy that
results when a child of normal intel-ligence
is born to retarded or insane
parents.
In recent years, as the league's in-terests
came to encompass the sheer
number of our birth rate as well as the
quality of the children being born, em-phasis
has been placed on local family
planning clinics.
North Carolina was the first state
to include birth control—counseling
about contraceptive devices— in its
public health program.
It was not, however, until the forma-tion
of a family planning clinic in
Mecklenburg County in 1960 that this
program really began to roll.
Large-Scale Control
The oral contraceptive—the pill-greatly
enhanced the prospects of large-scale
birth control programs. By 1962,
the Mecklenburg clinic had 99 women
(each with a history of one to 12 preg-nancies
and none able to support a
child) taking Enovid, an oral contracep-
THE HEALTH BULLETIN February, 1968
five which had proved highly success-ful
in mass experiments in Puerto Rico.
The cost was $2 a month for each pa-tient,
and the director of the clinic said
that in the first 13 months this pro-gram
saved Mecklenburg taxpayers
more than $20,000. Equally important,
it saved 99 women from burdens they
were incapable of bearing.
In June 1964, thanks to spade work
done by the league, by John McDowell,
director of Forsyth's public welfare pro-gram,
and Roger Sloop, a member of
the local board of healtn, a similar
clinic was established in Forsyth Coun-ty.
Administered by the Bowman Gray
School of Medicine and directed by Dr.
Henry C. O'Roark II, this clinic had
200 participants in its first four months.
That pace has accelerated.
Similar clinics, few of them as large
as those in Forsyth and Mecklenburg,
now exist in some 90 local health and
welfare departments in this state.
Attitudes Changes
This development reflects a funda-mental
change in public attitude in the
past two decades. This is not peculiar
to North Carolina. The same change is
occurring elsewhere. It is seen in many
ways. For example:
—Until recently two states—Mas-sachusetts
and Connecticut—had laws
which forbade anyone, including phy-sicians,
from giving out information
or devices related to birth control. The
Connecticut law was declared uncon-stitutional
by the U.S. Supreme Court
in 1965.
—At the state level, the trend is to-ward
removing blocks to effective birth
control programs. In 1967, for example,
the North Carolina General Assembly
greatly liberalized this state's abortion
law. There is accumulating evidence of
all sorts to indicate that we are evolving
a planned society. There are few areas
where this evidence is as clearly seen
as in birth control.
—In 1959, Dwight D. Eisenhower
said that birth control was not a mat-ter
that should interest the federal gov-ernment.
In 1963, in an article in the
Saturday Evening Post, Eisenhower
firmly, clearly changed his position.
—In fiscal 1966, the federal govern-ment
spent $4 million on birth control.
The amount was doubled in 1967. In
August of this year, the Department of
Health, Education and Welfare estab-lished
an office to administer birth con-trol
programs. In this same period,
birth control was given increasing at-tention
in anti-poverty programs.
More Interest
—Private foundations—the Ford
Foundation for one—are becoming in-creasingly
active in the family planning
field.
—Last year, the United Nations for
the first time took an unequivocal,
strong position endorsing an all-out,
international effort to control popula-tion.
This change results from two inter-acting
causes: The dire predictions of
Malthus have become realities; organ-izations
like the North Carolina Hu-man
Betterment League—and there
are now many of them here and abroad
—have opened the eyes of the world to
an alternative to the cruel and ultimate
population controls, war, famine and
plague. It is the alternative of con-trolling
our numbers and their quality
by the intelligent use of the birth con-trol
knowledge we possess.
Since 1948, the American Heart As-sociation
and its affiliates and subdi-visions,
such as the North Carolina Heart
Association, have chan^eled more than
$120 million into research. The Heart
Association is the largest source of non-governmental
research support in the
cardiovascular field.
February, 1968 THE HEALTH BULLETIN
Physician May
Treat Minor's
Venereal Disease
It has long been held in most states
that a physician who treats a minor
without parental consent—except in a
medical emergency—may be liable to
charges of assault and battery.
In North Carolina the attorney gen-eral
ruled some years ago that "the
situation when a person is infected with
a venereal disease is quite different
from that of other types of illness re-quiring
treatment so far as a minor is
concerned."
The law (Section 130-96) states:
"state and local health directors, or
authorized agents under their super-vision
within their respective jurisdic-tions,
are hereby empowered and di-rected,
when it is necessary to protect
the public health, to make examinations
of persons reasonably suspected of be-ing
infected with venereal disease, and
to detain such persons until the results
of such examinations are known, and
to isolate or quarantine persons with
a venereal disease when it is neces-sary
to protect the public health. Per-sons
infected with a venereal disease
shall report for treatment to a licensed
physician and continue treatment until
the disease is no longer communicable."
In the attorney general's opinion "no
parental consent is necessary for the
physician's protection in administering
treatment to a minor for a venereal
disease because the above-quoted sta-tute
furnishes the physician complete
protection."
Home Accidents Kill
Nearly 30,000 Americans were killed
and well over four million others in-jured
in home accidents in 1966. That's
why the National Society for Crippled
Children and Adults has launched an
all-out campaign to call attention to
home safety.
According to National Safety Council
estimates, more deaths—some 40 per-cent—
took place in bedrooms. But the
greatest number of disabling injuries
occurred in kitchens—well over a mil-lion
persons were hurt in kitchen ac-cidents
during the year.
Major home accident categories, as
detailed in the Easter Seal Home Safety
Checklist, and the numbers killed dur-ing
the year are as follows:
« FALLS: The greatest home danger is
from falling. An estimated 11,800
persons were killed during the year,
and many thousands more received
disabling injuries.
• FIRE: A total of 6,800 persons died
from fires, burns and related causes
including asphyxiation, falls and
falling objects related with home
fires.
• POISONING: A total of 2,800 per-sons
died from poisoning in the
home. Common causes were med-icines,
household poisons, carbon
monoxide.
• SUFFOCATION: Some 2,500 persons
died at home from choking on in-gested
objects, smothering and
strangulation.
• FIREARMS: Gun accidents killed
1,500 persons at home. Many took
place while cleaning or playing
with weapons.
OTHER: Miscellaneous accidents
claimed 4,100 lives in American
homes, including drownings, elec-trical
shocks and other accidents.
8 THE HEALTH BULLETIN February, 1968
Nat-ional Policy
For Elderly
Proposed
Establishment of national standards
and goals for meeting the problems of
older people in certain crucial areas
was called for today by Milton J. Shapp,
chairman of the public policy committee
of the National Council On the Aging.
In testimony before the Special Sen-ate
Committee on Aging Mr. Shapp
noted that many advances have been
made since the first national confer-ence
on aging, held in 1950. He sug-gested
that the "time has now come to
establish some national standards and
goals for the elderly in certain crucial
areas—to measure the need, to define
ways of meeting the need, to estimate
the cost, and to establish target dates."
Among the specific recommenda-tions
made by Mr. Shapp, a Pennsyl-vania
industrialist who was the 1966
Democratic candidate for governor of
his state, were:
• launching of a national study to
determine means by which federal
support could be given to localities
granting older people exemption
from real estate taxes
• another national conference on
aging, preferably by the end of
1969, to establish national goals, to
make recommendations for public
policy to realize these goals, and to
give direction to studies and smaller
meetings in advance of the confer-ence
• preparation by the special Senate
committee on aging of estimated
needs and costs involved in such
a national effort
• use of a consumer purchasing power
index in establishing a price tag on
the abolition of poverty.
Mr. Shapp noted that the social secur-ity
benefit increases proposed would
increase the minimum to $840 a year
for an individual and $1,260 a year for
a couple.
This would mean, he said, that the
average social security benefit would
still be slightly below the poverty
level.
In urging abandonment of the
"piecemeal" approach to problems of
older people in favor of a national
policy, Mr. Shapp said:
"These methods have brought results
in war efforts, in space exploration, in
public highway construction and—to
an extent— in public education.
"We can do no less with regard to
human goals for the older people of
the nation.
"The elimination of poverty in old
age," the NCOA spokesman said, "must
have first priority as a national goal.
It is now estimated that some five to
seven million people over 65 in this
country live in poverty. Forty percent
of the women living alone or with non-relatives
are poor. Non-white families
are almost three times as likely to be
poor as are the whte aged of the same
family status."
Mr. Shapp also emphasized the
housing needs of older people noting
that nearly three million older people
in 1960 were living in dilapidated, de-teriorating
housing, hazardous to health
and contributing to social breakdown.
Nearly four and a half million dwelling
units are needed to overcome the
acute shortage of appropriate housing
for the elderly.
February, 1968 THE HEALTH BULLETIN
Physical
Changes
May
Explain
Relapses
In
Drug Habit
The perplexing cycle of drug addic-tion,
treatment, and relapse may be
partially explained by physical changes
in the body which compel addicts to
resume their habit up to eight months
after withdrawal.
New findings reported at the Nation-al
Institute of Mental Health Addiction
Reserach Center in Lexington, Kentucky
show that morphine withdrawal causes
two distinct phases of physiological
changes in the body which may also
alter behavior.
The physical effects of withdrawal
were previously known to last only
three or four weeks, but a series of
studies in both rats and men indicates
that the "withdrawal syndrome" may
persist for up to 30 weeks.
These findings may partially explain
why 90 percent of the addicts who
relapse do so within six months after
treatment. Relapse of addicts is a seri-ous
problem since some studies show
that 80 to 90 percent of the treated
addicts eventually return to the habit.
The new findings show that patients
have lower than normal blood pressure,
slow pulse rate, and low body tempera-ture
after about nine weeks of absti-nence,
which is the opposite of early
effects of withdrawal. These symptoms,
as well as a marked decrease in the
respiratory center's sensitivity to car-bon
dioxide, last up to 30 weeks.
Immediate withdrawal of morphine
produces severe physical reactions,
although gradual reduction of the drug
and the use of medications can make
withdrawal easier for the patients. How-ever,
high blood pressure, rapid pulse
rate, and high body temperature usual-ly
persist for three or four weeks.
Another related finding is the discov-ery
of elevated levels of epinephrine
in the urine of test subjects several
months after withdrawal. Epinephrine
is produced by the adrenal gland and
may be liberated in excess quantities
during stress.
In addition, studies in rats indicate
that the withdrawn subjects have a
greater "appetite" for drugs than non-addicted
subjects for a long period
after withdrawal.
The investigators. Dr. W. R. Martin
and Dr. D. R. Jasinski, say that the find-ings
suggest that dependence on mor-phine
may cause changes in the central
nervous system that last for several
months and produce altered physiologi-cal
functions, an altered psyche, and
increased drug-seeking behavior.
Dr. Martin is the chief of the Addic-tion
Research Center and Dr. Jasinski is
chief of the opiate unit at the Center.
10 THE HEALTH BULLETIN February, 1968
or
"Run for your life—or jog—or walk-but
don't just sit there!"
One hears this advice increasingly
these days, and therefore the U.S.
|\m^ Public Health Service's National Center
for Chronic Disease Control is engaged
in examining what occurs if you follow
those simple suggestions.
rQi* In support of the hypothesis that
some form of habitual physical activity
helps reduce the chances of having a
heart attack, the National Center's Heart
^^f\mnm Disease Control Program is coordinat-ing
Center-sponsored physical exercise
research programs, including projects
at three State universities—Minnesota,
I l£^ Wisconsin, and Penn State.
At each of the universities exercise
programs consist of walking, jogging
or running, and calisthenics or modified
game activities. All activities are sup-ervised
by trained personnel. Participa-tion
is on the basis of 45 minutes each
day, three days a week. At Minnesota,
I
men were selected at random from two
JOQ of the local census tracts. At Wisconsin,
the group consists of middle-aged pro-fessors,
while at Penn State, participants
^^^^__ include a cross-section of male uni-versity
employees.
These projects were designed to an-
Q swer several questions:
D**r — What is the most effective way to
identify individuals in the community
who are at greater than average risk
I
of developing coronary heart disease?
tJUSi — What influences an individual's de-cision
whether or not to participate in
a physical activity program? And if he
decides to participate, what influences
^OH I ^'"^ ^° continue to participate on a reg-ular
basis over a long period of time?
— What problems are involved in or-ganizing
and administering group phy-sical
activity programs?
— What effects does participation in
physical activity programs have on a
person's health in terms of reducing his
February, 1968 THE HEALTH BULLETIN 11
Sit There
risk of developing a heart attack and
in changing his health attitudes and
health habits?
A long range goal of the overall re-search
effort is the eventual develop-ment
of coordinated physical activity
progranns in the nation's communities if
future research demonstrates that in-creased
physical activity reduces the
number and severity of heart attacks.
The projects, now entering their
second year of operation, are providing
university scientists and Heart Disease
Control Program specialists the oppor-tunity
to study the effects of various
types of physical activity upon selected
groups of individuals. Participating
at- the three universities are approxi-mately
450 men between the ages of
40 and 59. As a group, all of these
men were characterized by certain con-ditions
or living habits that increased
their chances of a heart attack. These
include:
— Overweight
— High blood pressure
— High cholesterol content in the
blood
— Cigarette smoking
— Lack of major habitual physical
activity
In the studies, participants are di-vided
about equally into two groups;
one that exercises and one that does
not. Periodically both groups are ex-amined
to determine what changes, if
any, have occurred in their health sta-tus
attitudes and habits.
Preliminary findings to date are en-couraging.
All three schools point to
improvements in the general health of
the exercise participants. At the Uni-versity
of Minnesota where the project
has been in operation the longest, there
has been among other things, consider-able
improvement in "heart rate re-sponse"—
the ability of the heart to
withstand increasing amounts of phy-sical
exertion at lower pulse rates. As
one participant put it—"we aren't huff-ing
and puffing as much as we used
to."
Perhaps the most significant finding
to date, however, is the conclusion that
individuals can be encouraged to ex-ercise
on a regular basis over a con-tinuing
period of time, provided:
— They are properly oriented to op-portunities
for exercise and the pos-sible
health benefits to be derived.
— The type of exercise to be per-formed
is determined, at least partial-ly,
by individual preferences.
Of major concern at this time is the
question of whether the present ex-ercise
programs are sufficient to reduce
the participants' risk of developing
heart disease. Project directors also
hope to find ways of motivating in-dividuals
to continue some appropriate
type of exercise after they leave or-ganized
programs.
Dr. Bruno Baike, director of the Uni-versity
of Wisconsin project, believes
the latter point may resolve itself, ex-plaining:
"Many participants already are or-ganizing
their own exercise groups
against the day when our project ends."
Dr. BaIke, along with project direc-tors
at the other two universities. Dr.
Henry L. Taylor, Minnesota, and Dr.
Elsworth Buskirk, Pennsylvania State
University, is convinced that data pro-vided
by the present series of projects
will become foundation blocks in the
long range efforts, not only to prevent
heart attacks, but also to help victims
of heart attacks to recover from them.
The doctor should be called immedi-ately
when a stroke occurs so that he '
can determine the proper individualized '
treatment for each patient, the North
Carolina Heart Association advises.
12 THE HEALTH BULLETIN February, 1968
EASTER SEAL HOME SAFETY CAMPAIGN
1 . He's fascinated by fire, a major
cause of home iniuries. The Easter
Seal Home Safety Checklist shows how
to make your home o safer place to live.
2. She's heading for a fall, the cause
of nearly 12,000 deaths last year and
a major contributor to the nearly Ao
million disabling injuries. Get a copy
of the Easter Seal Home Safety Checklist.
3. The medicine chest is a source of
danger for younger children. The Easter
Seal Home Safety Checklist will tell
you how to protect your children from
poisoning end other home threats.
THE NATIONAL SOCIETY FOR CRIPPLED CHILDREN AND ADULTS
2023 W. Ogden Avenue Chicago, I Mlnois 6061 2
February, 1968 THE HEALTH BULLETIN 13
Senator Belk
Receives
Award
The American Cancer Society has
awarded its 1967 Distinguished Serv-ice
Award to Charlotte businessman and
former Senator from Mecklenburg Coun-ty,
Irwin Belk. The award is the highest
honor in the Society.
Belk is the immediate past president
of the North Carolina Division, Ameri-can
Cancer Society, and has done volun-teer
work for the organization on both
the local and state levels. At present he
serves as Chairman of the Nominating
Committee as well as a member of the
Division Executive Committee. He also
serves as Chairman of the Committee
to Study the Utilization of Local Facil-ities
for the Improvement of Patient
Care for the Governor's Cancer Com-mission.
President of Belk Enterprises, Mr.
Belk is the ninth person to receive this
award. Other recipients are Dr. Ivan
Proctor, Raleigh; Judge John D. Larkins,
Jr., Trenton; Dr. H. Fleming Fuller, Kin-ston;
Dr. Donald B. Koonce, Wilming-ton;
Dr. H. Max Schiebel, Durham; Dr.
John R. Kernodle, Burlington; Dr. Paul
Kimmelsteil, Milwaukee, Wisconsin; and
Mr. John R. Jordan, Jr., Raleigh.
i\
In recent years, population studies
have developed a "coronary risk pro-file
" for high-risk America, the North
Carolina Heart Association reports.
With its assistance, physicians can readi-ly
identify "coronary-prone" individuals
years before open symptoms appear-and
can suggest changes in their way
of life or other measures to help ward
off the potential heart attack or stroke.
i
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. , ALP.H. Director, Epidemiology Division
J. W. R. Norton, M.D., M.P.H. Director, Local 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. 3., LL.B. . Director, Adtninistrative Services Division
Theodore D. Scurletis, M.D. 1. Director, Personal Health Division
14 THE HEALTH BULLETIN February, 1968
Heart Transplant-
Conference Held
The American Heart Association, in
order to provide reassurance to the
public and counteract any anxieties that
heart transplant surgery might be pre-mature,
called a conference early this
year in New York City to clarify its
position on the advisability of this ne\N
surgical technique.
The panel discussing the question of
heart transplants was composed of Dr.
Jesse E. Edwards, President of the
American Heart Association and Clini-cal
Professor of Pathology at the Uni-versity
of Minnesota School of Medi-cine.
Dr. Michael E. DeBakey, head of the
world's largest cardiovascular center at
Baylor University College of Medicine,
Houston, and renowned for his accom-plishments
in the development of
mechanical boosting pumps to help
faltering hearts; Dr. John P. Merrill,
Director of the Cardio-renal Section,
Peter Bent Brigham Hospital, Boston,
and leading authority on kidney trans-plantation;
Dr. John H. Gibson, Jr., one of the
developers of the heart-lung machine
which has made possible open-heart
surgery and, ultimately, heart trans-plants;
Dr. William L. Glenn, Professor
of Surgery at Yale University School of
Medicine, developer of surgical pro-cedures
to relieve congenital defects,
and a pioneer in pacemaker develop-ment;
Dr. Earl B. Mahoney, Chairman
of the American Heart Association's
Council on Cardiovascular Surgery and
a Professor in the Department of Sur-gery
at Strong Memorial Hospital,
Rochester, N. Y.; and Dr. Lewis E. Jan-uary,
Immediate Past President of Amer-ican
Heart Association, and Professor
of Medicine at the State University of
Iowa College of Medicine.
The 17th Southern Water Resources
and Pollution Control Conference will
be held April 16-18, 1968, at the Uni-versity
of North Carolina, Chapel Hill,
North Carolina. This annual Conference
is co-sponsored by the Department of
Environmental Sciences and Engineering
at the University of North Carolina, and
Departments of Civil Engineering at
North Carolina University and Duke
University. The 17th Conference will
feature presentations and discussions
on the technology of water resources
and water quality management with
particular reference to the southeastern
United States. A detailed program will
be available about January 1, 1968. For
additional information, please write to
Dr. Charles M. Weiss, Chairman Operat-ing
Committee, 17th SWRPC Confer-ence,
Department of Environmental
Sciences and Engineering, P. O. Box
630, Chapel Hill, North Carolina 27514.
Rachel D. Davis, M.D., prominent
Kinston physician and outstanding civic
and educational leader, was elected
President of the North Carolina Divi-sion,
American Cancer Society. She
succeeds Senator Irwin Belk of Char-lotte
in this post.
Deaths caused by high blood pres-sure
have dropped 52 per cent in the
past 20 years for Tarheel men between
the ages of 45 and 64. The North Car-olina
Heart Association says that ad-vances
in the treatment of high blood
pressure, made possible by Heart As-sociation-
supported scientific research,
is a major factor in this saving of lives.
February, 1968 THE HEALTH BULLETIN 15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
LIBRARIAN
DIVISION OF HEALTH AFFAIR:. LIEaA
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CHAPEL HILL, N.C.
If you do NOT wish to con-tinue
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please check here i i
and return this page to
the address above.
Printed by The Graphic Press, Inc., Raleigh, N. C
Dates & Events
April 21-22 — Annual Meeting, N. C.
Conference for Social Service, Sir Wal-ter
Hotel, Raleigh
April 30-May 1 — Tuberculosis Associ-ation
Annual Meeting, Heart of Char-lotte
Motel, Charlotte, N. C.
May 9-10 - Western Branch, N. C.
Public Health Association, High
Hannpton Inn, Cashiers, N. C.
May 13-17 — Biennnial Conven-tion:
Annerican Nurses' Association,
Dallas, Texas
May 15-17 — Meeting: 38th Annual
Statewide Industrial Safety Confer-ence,
Jack Tar Hotel, Durham
May 16 — N. C. Association of Indus-trial
Nurses, Durham
May 19-22 — Annual Meeting: Nation-al
Tuberculosis Association, Houston,
Texas
May 27-31 — Annual Meeting: South-ern
Branch, APHA, Roanoke, Va.
Migrant Projects
Fourteen migrant health projects, lo-cated
in four states, have recently been
av^arded Public Health Service grants
totalling $1,797,812, Surgeon General
William H. Stewart announced.
The grants, authorized by the Migrant
Health Act, will be used to improve
health services to migrant agricultural
workers and their families. Projects will
use these funds to provide family
health service clinics, medical and
dental care, nursing and sanitation serv-ices,
health education, and in-hospital
care.
Florida, a home-base area for many
migrants, received the largest number
of dollars, $908,588. Projects in Texas,
another home area, were awarded
$715,742. Colorado received $149,339;
Louisiana $24,143.
One hundred and fifteen projects in
36 states and Puerto Rico are now
receiving Public Health Service support.
Grants are made to State or local pub-lic
agencies and to non-profit private
organizations, which are required to
contribute part of the cost of the proj-ects.
16 THE HEALTH BULLETIN February, 1968
%^^3
-iira-u- rofinnnRY?
RECEIVED
JUN 15 1968
DIVISION OF
:alth affairs library
Of The Carolina State Board of Health
1968 Distinguished Service Award
Eugene Benson Crawford and Elisha Merriman Herndon, senior vice presidents of
North Carolina Blue Cross and Blue Shield, Inc., will receive the 1968 Distinguished
Service Award of the North Carolina Hospital Association.
Selection of Mr. Crawford and Mr. Herndon to receive the award, which is given
annually to an individual who has rendered outstanding service to the hospitals
of North Carolina, was made by the NCHA Trustees.
The two veteran Blue Cross leaders, who have given outstanding encouragement
to the concept of prepaid voluntary health care since the movement began in North
Carolina in 1933, will receive their awards jointly at the annual meeting of the
Hospital Association on June 25 at Wrightsville Beach.
Eugene Benson Crawford Elisha Merriman Herndon
ARTHUR C. STERN APPOINTED TO
UNIVERSITY OF NORTH CAROLINA
FACULTY
Arthur C. Stern, presently Assistant
Director of the National Center for
Air Pollution Control, Washington, D. C.
has accepted an appointment as Pro-fessor
in the Department of Environ-mental
Sciences and Engineering of the
University of North Carolina School of
Public Health. His appointment in the
Air and Industrial Hygiene program of
the Department v^as facilitated by the
Institute for Environmental Health Stu-dies
at the University.
For all of his professional life. Stern
has been in the air and industrial hy-giene
field. He was for thirteen years
Chief of the Engineering Unit of the
Division of Industrial Hygiene in New
York State and for seven years was
Chief of the Laboratories of Engineering
and Physical Sciences of the Division of
Air Pollution of the Public Health Serv-ice
at the Robert A. Taft Sanitary Eng-ineering
Center in Cincinnati. His edu-cational
background includes the AA.E.
degree in 1930 and the M.S. in 1933
from Stevens Institute of Technology.
Stern is listed in Who's Who in Amer-ica,
Who's Who in Engineering, and
American Men of Science. He is also
editor of the three-volume handbook
"Air Pollution," published in its second
edition this year.
Stern in his new faculty position will
provide a very close tie between the
University and the National Center for
Air Pollution Control which is in the
process of moving to the Research
Triangle of North Carolina only a few
miles from the University.
THE HEALTH BULLETIN March, 1968
Nationwide
Cervical
Screening
Program
Saves Lives
Nationwide cervical screening pro-ects,
supported by the Public Health
Service's National Center for Chronic
Disease Control, are responsible for
saving or prolonging the lives of thous-ands
of American women, according
to an analysis of Center reports cover-ing
a five year period starting in 1962.
Dr. William L. Roberson, Medical Of-ficer
responsible for review of the
screening proects, said that over one
million cytology examinations had been
made at various hospitals throughout
the country and that cervical cancer was
found in more than 6,500 women. More
than 4,000 cases of carcinoma in situ
were detected.
(Cancer is situ means that the malig-nancy
is at "stage zero," and that there
is no invasion of the normal adjacent
tissue. If treated immediately and
properly, such cancers are almost TOO
percent curable.)
There are 143 grant-supported pro-jects
in 35 States, the District of Colum-bia,
and Puerto Rico. Effort has been
concentrated on the low socioeconomic
groups because of their risk of cervical
cancer.
Dr. Roberson pointed out that the
Center's Cancer Control Program also
supports the American Academy of
General Practice in its "Office Detected
Cervical Cancer Program," now embrac-ing
more than 4,000 physicians in 36
States and the District of Columbia.
The Academy Program has been in
effect since 1965 and more than 546,-
000 women have been screened, about
one-third of them for the first time. A
total of 1,059 carcinomas have been
detected—865 in situ and 194 invasive,
according to latest available reports.
Cancer Detection in North Carolina
PERSONS EXAMINED IN CANCER DETECTION CENTERS
BY PLACE OF RESIOENCE: NORTH CAROLINA. 196?
(Total persons examined - 9.552)
CANCER DETECTION CENTERS
are located in
Asheboro
Ourha'n
El izabeth Ci ty
Greensboro
Loui sburg
Hew Bern
New I and
North Ui Ikesboro
Rdleigh
Rocky Hount
Rutherfordton
Siler City
Sylva
Ui Imington
Windsor
The Center Program staff assisted in
organizing the State academies for the
study. Dr. Roberson said. The project
calls for Pap examinations (a very
simple cancer test).
All patients with suspicious or posi-tive
results are followed up to insure
that they are disgnosed and treated if
cancer is present. Those treated for
cancer are scheduled for periodic checks
to make sure the therapy is adequate
and that there is no recurrence of
growth.
"The Academy Program establishes
the general practitioner's office as an
appropriate facility for carrying out
this cancer detection project," Dr. Rob-erson
said. "It alerts the private phy-sician
to the need for adequate exami-nation
and follow-up. It shows there is
an impressive number of undiagnosed
cases among the female population. Its
continuation and expansion will mean
much to the general good health of our
country," Dr. Roberson stated.
He added that the number of early
cases detected and cured was highly
significant and "supports our conten-tion
that cervical cancer can be con-trolled
if all women will have a pelvic
examination and Pap smear at least
once a year."
Dr. Roberson estimates that about 26
percent of the women over 20 years of
age in the United States were cytolog-ically
examined in 1966, up from 15
percent in 1963 and 10 percent in
1961. In comparison, Dr. Roberson
pointed to British Columbia, a province
of Canada, where the annual exami-nation
rate is about 65 percent.
All screening projects supported by
the NCCD subscribe to certain stand-ards
such as tissue diagnosis, definitive
treatment and adequate follow-up. In
other respects, the projects are con-trolled
and conducted by the institu-tions
receiving the grants.
Indian Plants Studied
in Cancer Drug Search
The Indian government's Central
Drug Research Institute at Lucknow has
renewed its agreement with the Na-tional
Cancer Institute, National Insti-tutes
of Health, to study native Indian
plants as a source of potential anti-cancer
drugs. A U. S. Public Health
Service contract, using blocked dollars
available under Public Law 480, is pro-viding
$136,000 (1,020,400 rupees)
to finance the next 3 years of investi-gation.
Under the program the Indian re-search
center, directed by Dr. M. L.
Dhar, collects indigenous plants and
from them prepares extracts for study
by the National Cancer Institute in
Bethesda, Maryland. Dr. Jonathan L.
Hartwell, project officer for NC! and
head of its Natural Products Section,
has the extracts tested for their ability
to inhibit animal cancers.
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 608 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
Charles M. Cameron, Jr., M D., M.P.H.
Raleigh
John C. Lumsden, B.C.H.E.
Jacob Koomen, Jr., M.D., M.P.H.
John Andrews, B.S.
Glenn A. Flinchum, B.S.
H. W. Stevens, M.D., M.P.H., Asheville
Guest Ed.—Edwin S. Preston, M.A.,LL.D.
Vol. 83 March, 1968 No. 3
THE HEALTH BULLETIN March, 1968
Improved Endoscopes
Aid in Early Cancer
Detection
A contract for the development of
five improved endoscopes for viewing
internal organs of the body to aid in
early detection of cancer has been an-nounced
by the Cancer Control Pro-gram
of the National Center for Chronic
Disease Control, Public Health Service.
Dr. William L. Ross, Chief of the
Cancer Control Program, said the con-tract
for development of the instru-ments
is budgeted at $149,222 and v^/ill
require approximately 18 months. The
contract was awarded to the I IT Re-search
Institute, an affiliate of the Il-linois
Institute of Technology in Chi-cago.
The instruments will be flexible
fiber optic probes for viewing the
throat, larynx, bronchial tubes, stomach
and a portion of the colon which will
enable doctors to view the interior of
the body without performing surgery.
Cancers in these 5 sites will cause al-most
100,000 deaths this year. The
endoscopes also will assist doctors in
diagnosing other diseases.
The contract calls for the develop-ment
of new synthetic fibers instead of
glass to transmit light around curves
in the body organs. The probes also
will have a mechanical system allowing
maneuverability and control by the ex-aminer.
Though glass fibers are flexi-ble,
they are not flexible enough to
prevent occasional breakage when
probes are flexed into sharp bends.
Poly-Optics Systems, Inc., Santa Ana,
California, will join IITRI in fiber de-velopment.
Lighting the body's dar1< interior for
examination will be achieved by send-ing
light through one or more fiber
optic bundles. Another optic bundle
will transmit a magnified image back
to the examiner through an eyepiece.
Several of the instruments will have a
channel for extracting biopsy speci-mens
and provision for washing the
lens without withdrawing the probe.
Optical scopes for endoscopic ex-amination
(examination of hollow or-gans
of the body) were first used over
75 years ago, but their usefulness has
been limited because of inflexibility,
large diameters, and optical shortcom-ings.
The new family of instruments
will permit viewing internal areas which
have been "blind" spots or entirely
inaccessible with former probes.
One glass-fiber endoscope for view-ing
the lower intestine, which was de-veloped
with CCP support, already has
undergone tests at the University of
Michigan Medical Center under the
direction of Dr. Bergein F. Overholt
(currently with New York Hospital,
Cornell Medical Center, N.Y., N.Y.).
Success achieved with the instrument,
called a fibersigmoidoscope, prompted
the proposed development of the
family of five probes.
Camera attachments for the instru-ments
will permit photographing
through them during examinations. The
probes will range in length from 15
cm. for the throat probe (laryngo-scope)
to 100 cm. for the stomach probe
(gastroscope). Diameters will range
from 6 mm. to 15 mm.
Medical consultants, in addition to
Dr. Overholt, who will work with IITRI
and the Cancer Control Program in
developing the endoscopes are Dr.
George M. Conner, Henry Ford Hos-pital,
Detroit; Dr. Daniel J. Fall, Uni-versity
of Michigan, Ann Arbor; Dr.
Jordon D. Mailer, Maimonides Hospital
of Brooklyn and State University of
New York College of Medicine; and Dr.
Marvin Pollard, University of Michigan.
March, 1968 THE HEALTH BULLETIN
The Problem of
Atherosclerosis
The problem of atherosclerosis is one
of the most crucial medical threats fac-ing
the civilized world today, states the
North Carolina Heart Association. Year
by year, the scourge of this disease be-comes
more evident and it knov\/s no
class, color, or race distinctions.
Exacavation in the Nile Valley has
indicated that even the Egyptian pha-roahs
of 2000 B.C. suffered from
atherosclerosis.
Just what is atherosclerosis? Athero-sclerosis,
practically speaking, is the
deposit of fat material, known as lipids,
along the walls of the arteries and,
more particularly, the vita! vessels of
the heart, brain, kidneys, and extremi-ties.
These lipids, usually composed of
cholesterol, slowly reduce the diameter
of the veins and arteries, making the
passage of blood more difficult. In
time, these cholesterol deposits may
become so great that a vessel or artery
is blocked entirely.
The effect of atherosclerosis has
often been likened to the problem en-countered
in old pipes in water sys-tems.
With passing years, corrosion and
clogging often render pipes in a water
system unuseable. When the arteries
are blocked, depriving any given por-tion
of the body of the blood and en-suing
oxygen it needs to maintain life,
death occurs in the portion so deprived.
Atherosclerosis is known to be the
chief cause of coronary artery disease
and of cerebral vascular accident
(stroke).
Western NCPHA Meets at High
Hampton Inn, Cashiers, N. C.
MAY 9 & 10, 1968
APPLY: RESERVATION MANAGER, HIGH HAMPTON INN, CASHIERS, N. C.
PACKAGE
RATES: 1. $12.18 (3 to a room)
2. 13.50 (2 to a room)
3. 15.75 (single room)
Package rates to include, lodging, buffet, banquet and dance, breakfast, and
luncheon, including tax and tips.
NON-PACKAGE For those not staying at the Inn.
RATES:
Banquet and dance $5.00
Luncheon 2.50
Breakfast 1.50
Registration begins Thursday, 2-7 P.M. and Friday 8-12 Noon.
Registration is $3.00. Wives and/or husbands of members and nonpublic health
guests register gratis.
THE HEALTH BULLETIN March, 1968
Older Americans Spend
Five Times the Medicine
Cost for the Young
Americans aged 65 years and older
spent about five times as much for
prescribed medicines in a one-year
period as did young people aged 15-24
years, according to Wilbur J. Cohen,
Acting Secretary of Health, Education,
and Welfare.
Mr. Cohen said persons 65 years and
older spent an annual average of
$41.40 compared to $8.10 by persons
aged 1 5-24 years.
He reported on a study which in-volved
a nationwide sampling of the
civilian, noninstitutional population by
household interviews. Approximately
42,000 households were visited, com-prising
about 134,000 persons.
"The largest part of the average of
$41.40 spent by persons 65 years and
older was $7.10 for treatment of high
blood pressure," Mr. Cohen said. The
next largest amount was $5.70 for
treatment of heart conditions.
Women 65 years and older annually
spent more on the average ($46.70)
than men ($34.70) for prescribed med-icines,
Mr. Cohen pointed out. Women
spent the largest part ($9.70) for treat-ment
of high blood pressure, followed
by $5.50 for treatment of heart con-ditions.
Men spent the most ($6.00) for
treatment of heart conditions and $3.90
for treatment of high blood pressure.
Prescribed medicines were defined
in the study as: (1) medicines obtained
by a physician's written prescription,
including refills; (2) medicines prepared
on the basis of a physician's telephone
order to a pharmacist; and (3) med-icines
given by a physician or his as-sistant
to a patient to take home.
The survey also obtained information
on costs and uses of nonprescribed
medicines—those obtained without pre-scriptions,
including pills, tonics, salves,
ointments, and first-aid supplies. For
nonprescribed medicines, Mr. Cohen
noted that persons 65 years and older
spent on the average the largest amount
($2.30 per person) for aspirin and its
compounds. The next largest amount
($1.70) was used for vitamins by this
age group.
Women 65 years and older on the
average spent the largest part ($2.60)
of their expense for nonprescribed med-icines
to buy aspirin and its compounds,
compared to $2 for men in the same
age group. Again, the second largest
amount was spent on vitamins— $1 .80
for men and $1.70 for women.
Automated Test for Heart
Disorders in Babies
Doctors may one day call upon the
computer to help detect heart disease
in newborn infants and other young
children.
An automated system for analyzing
the pediatric electrocardiogram (ECG)—
a test for heart disorders in babies and
children— is being developed by the
Public Health Service's National Center
for Chronic Disease Control, under the
direction of Dr. Lowell W. Perry.
"Each year an estimated 20,000
babies are born with congenital heart
disease in the United States," according
to Dr. Perry, chief of the Pediatric Sec-tion
of the Center's Heart Disease Con-trol
Program. "Deaths among these
babies most often occur during the
period shortly after birth, especially
during the first month of life. In ad-dition,
from one to two of every 1,000
school-aged children presently have
undetected heart disease."
March, 1968 THE HEALTH BULLETIN
Where the Eastern District NCPHA
Will Hold Its Annual Meeting
June 6-7 at Atlantic Beach
^htett^ir^s.
THE HEALTH BULLETIN March, 1968
EASTERN DISTRICT NORTH CAROLINA PUBLIC HEALTH ASSOCIATION
ANNUAL MEETING
John Yancey Motor Hotel, Atlantic Beach, North Carolina
June 5 and 7, 1968
Preliminary Program
THEME: Viewpoints of Comprehensive Public Health Planning in North Carolina
ThurscJay, June 6
Registration 1:00- 4:00 P.M.
First General Session 4:00- 5:00
Business Meeting
Hospitality and Fun Session 8:00-11:00 P.M.
Friday, June 7
Registration 8:30- 9:30 A.M.
Second General Session 9:30-12:00 Noon
Presiding I. S. Canady, President Elect
Comprehensive Health Planning in North Carolina
John Alexander McMahon, Chairman, Advisory Council on Comprehen-sive
Health Planning; President, North Carolina Blue Cross and Blue
Shield, Inc.
Ten Minute Break
Panel: Public Health From Three Angles
Moderator Dr. Jacob Koomen, State Health Director
Management of Public Health Personnel
E. Clark Edwards, Personnel Director, State Board of Health
Current Trends in Public Health Personnel Administration
Claude E. Caldwell, Director, State Personnel Department
Public Health Outlook as Viewed by County Commissioners
John T. Morrisey, Executive Secretary, North Carolina Association
of County Commissioners
Section Meetings 1:30- 3:30 P.M.
Third General Session 3:45
Reports and Announcement of New Officers
Fourth General Session 6:30- 7:30
Happy Hour
Buffet Banquet 7:30- 9:00
Adjournment 9:00
Dance ^ 9:00- 1:00 A.M.
March, 1968 THE HEALTH BULLETIN
That's What GRANDFATHERS Are Made Of
BY BERNICE JANE HERMAN
MY husband doesn't play the oboe, grow mushrooms in
the basement or crossbreed guppies. He has no col-lections
under glass, no enrichment hobbies. But he's not
unsettled by semiretirement nor troubled about identity. He
knows who he is and so do his grandchildren. He's a grand-father.
Right now the scoreboard reads eight, but this is an ex-panding
market and precise tabulation may not be accurate.
My husband doesn't fret. He's having a great time. "Who's
coming today?" he frequently asks.
"Tommy," I answer, or Ellen or Bill, Matthew or Janie,
Eric, John, Michael or any possible combination. Think of a
name and we probably have it. If not, we will.
"Fine," he says and cancels appointments, declaring he'll
stay home and help with the grandchildren.
This makes me purr as I sometimes feel engulfed when
grandchildren visit in platoons. I welcome any help Grandpa
can give.
What is the why of grandfathers? As babysitting fathers,
many of them were absolute duds. They may have been
good providers and tender husbands, but child care was
woman's work.
My husband, faithful to the mores of his times, didn't dare
to be a father. Only sissies pushed their own baby carriages.
A man might push a neighbor's baby carriage if the neigh-bor
was pretty, but an ail-American husband didn't take care
of his own children.
In those days husbands weren't conditioned by matricula-tion
in and graduation from an expectant-parent course.
They would have been frightfully discomfited bathing a
naked doll in a basin in front of a coeducational class. They
would have balked at homework that demanded studying a
diaper-changing manual or instructions on how to time the
labor pains.
Most of them were embarrassed by pregnancy. Not one
of them discussed it on the commuters' train. If they en-countered
it on the street they looked the other way. Father-hood
overwhelmed and frightened them. If they confided
their expectancy they avoided a declaration of truth and
whispered they were expecting a "surprise." Many of them
reacted with gross responsibility. They worked double time
and became overcautious, overinsured, overinvested and
overtired.
Reprinted by permission of Woman's Day Magazine. Copy-right
(C) 1966 by Fawcett Publications Inc.
10 THE HEALTH BULLETIN March, 1968
I
Happily, those fathers make splendid grandfathers. They
seem to know that what you do with children isn't as im-portant
as how you do it or what you say as important as
how you say it. So they enjoy. My husband takes grand-children
to the fire station. He spends more time there than
a stray cat. As a boy he liked to stand just inside the door
of the fire station, petting the Dalmatian with the red
eyes and feeling fascinated by the spic-and-span floor, the
highly polished brass and the smell of horses in their stalls.
Always he waited for the rare times when the fire alarm
rang and the firemen slid down the poles while the har-nesses,
suspended from above dropped down on the
horses.
Perhaps grandfathers have never stopped waiting for the
clang to sound. Perhaps they want to be with their grand-children
when the fire bell rings and the firemen slide into
their boots and ride away. Whatever the motivation, a
grandfather's pleasure is pure. Sometimes it brings him an
earned tribute.
Recently a firemaa asked one of our grandsons, "What
are you going to be when you grow up?"
This little boy looked up at the big fire engine, studied
the coiled hoses and patted the dark shiny boots.
"I'm going to be a grandfather," he said.
Grandfatthers are wonderful because they're natural. They
have no facades. And they're not concerned with setting a
good example. They are themselves.
Although they don't have to bandage bruised fingers or
dress and feed grandchildren, they know how to prevent
a crisis. When our grandchildren are tired my husband out-maneuvers
ennui. He takes out his lower plate. The chil-dren
are transported.
"Grandpa took out his teeth!" they report to everyone.
Sometimes grandfathers are what they are because grand-children
believe in them. Many years ago our oldest son
told some of his playmates, "My father used to be a foot-ball
player."
"Are you kidding?" they jeered. "That old man!"
Thirty-five years later the children we know best believe
that Grandpa used to be a football player. "That's how he
lost his teeth," one of these children explained to his
friends.
Grandfathers might never have had time to be fathers but
they take time to be grandfathers. They take grandchildren
to the zoo, the circus, the ball game, the barbershop and
the park. They read them stories and ride them piggyback.
They love their grandchildren on a straight person-to-person
basis without having to stumble over themselves.
That's why grandfathers are what they are.
March, 1968 THE HEALTH BULLETIN 11
John C. Lumsden Named
Occupational Health Chief
P^ John C. Lums-den
has been
named Chief of
the Occupational
Health Section,
Epidemiology Div-ision
of the North
%iM Carolina State
^.aF'W'Z ^'m ^°^^^ °^ Health,
Pfcy / aJ according to an-nouncement
by
Dr. Jacob Koomen, State Health Director.
Mr. Lumsden is known throughout
North Carolina as a qualified and high-ly
respected career public health work-er
who has devoted almost twenty
years' service as Industrial Hygiene
Engineer for the State Board of Health.
He is a graduate of North Carolina
State University and a member of a
number of professional organizations,
among which are the American Aca-demy
of Industrial Hygiene, the North
Carolina Board of Refrigeration Examin-ers,
the Governor's Council on Occupa-tional
Health, the American Industrial
Hygiene Association, and the North
Carolina Society of Engineers.
For a number of years, Mr. Lumsden
has served as Chief Industrial Hygiene
Engineer for the State Board of Health,
during which period the Occupational
Health Program has grown in scope
and complexity. On July 1, 1967 he
was appointed Acting Chief of the Oc-cupational
Health Section and has
served in this capacity until his recent
promotion to Section Chief.
Mr. Lumsden's long record of dedicat-ed,
efficient service and his outstanding
ability to work harmoniously and ef-fectively
with people at all levels com-mend
him to all who are interested in
public health and assures a continua-tion
of progressive growth for this im-portant
public health program.
Emphysema,
The Battle
to Breathe
What it means to have emphysema, a
progressive lung disease, is the sub-ject
of "Emphysema, the Battle to
Breathe," a new publication recently re-leased
by the National Center for
Chronic Disease Control, U.S. Public
Health Service.
"Emphysema, the Battle to Breathe,"
published by the Center's Chronic Res-piratory
Diseases Control Program, is a
reprint of an award-winning five-part
series written by Frank E. Carey, As-sociated
Press Science Writer and car-ried
by AP in September 1966. The
series generated strong public interest
in the fast-mounting and little under-stood
problems of chronic lung disease.
"Emphysema, the Battle to Breathe"
carries the reader into medical centers
for the care and rehabilitation of em-physema
patients and introduces actual
patients, describing the way of life dic-tated
by their breathing problems. The
booklet presents what can be done for
even those seriously crippled by the
disease, to restore them to more useful
and productive lives. Special attention is
given to steps which the patient can
be taught to clear his lung airways and
to retrain breathing muscles, programs
he can carry on in his own home. Mr.
Carey's series also highlights research
being conducted to uncover causes of
chronic lung disease.
Single copies of "Emphysema, the
Battle to Breathe," PHS Publication No.
1715, are available from the Public
Health Service, U.S. Department of
Health, Education, and Welfare, Wash-ington,
D. C. 20201.
12 THE HEALTH BULLETIN March, 1968
Increasing Family
Income Results
in More Visits
to Physician
The proportion of the female pop-ulation
with obstetric or gynecologic
visits to a doctor in a one-year period
increases sharply with increasing family
income. Where family incomes are be-low
$2,000, only 2.8 percent have
made such visits. At $2,000 to $3,999,
5.5 percent, and so on up to 12.5 per-cent
at family incomes of $10,000 and
above.
For visits to a pediatrician the story
is similar. At family incomes of under
$2,000, only 7.5 percent of the pop-ulation
under seventeen made such a
visit in a one-year period. At $10,000
and above the proportion was 53.0
percent.
The pattern of visits to a dentist is no
different. Where family income was
under $4,000, the num.ber of visits per
person per year was 0.8. Between $4,-
000 and $7,000, it was 1.4 percent and
so on up to 2.88 visits per person per
year at family incomes of ten thous-ands
dollars and over.
The relatively low figure of use by
low income families is not due to few-er
disease problems. The number of
chronic conditions and the annual ex-perience
of days per person of restrict-ed
activity, bed disability, and time lost
from work are marked greater for per-sons
with low family incomes. When
hospitalized the average length of stay
is longer among the lower income
groups.
Adapted From: The New England
Journal of Medicine.
Script for Radio Program
on Chronic Disease
This is Edwin S. Preston.
Our guest today is Dr. John Henry
of the Chronic Disease Section of
the State Board of Health.
1. Dr. Henry, what are the "chronic
diseases"?
Dr. Preston, these are illnesses which
cause disability over long periods
of time. They include diseases of
the heart, the lungs, the liver, and
the kidneys and such diseases as
cancer and diabetes.
2. Who is most likely to develop a
chronic illness?
Well, actually, persons of all ages
are susceptible to these illnesses,
although certain ones such as heart
disease and cancer are found more
often in people over the age of
forty.
3. Can any of these illnesses be pre-vented?
Yes, some of these can be complete-ly
prevented. Others can probably
be prevented if certain risks for the
diseases are recognized early and
preventive measure taken. However,
even in the ones which cannot be
prevented, such as diabetes, it is
very important to prevent complica-tions
and disability due to the ill-ness,
and these complications may
be prevented if the disease process
is diagnosed eariy in its course and
the individual is put under the care
of his physician.
4. Are methods available for detecting
risks and early signs of chronic ill-ness?
Yes, there are. First of all, individ-uals
should have regular medical
checkups by their physician, even
when they don't feel sick. The
physician's questions and physical
March, 1968 THE HEALTH BULLETIN 13
examination may reveal risks or
signs of illness. In addition, multiple
screening test programs or what we
call "multiphasic screening" may as-sist
the physician in his evaluation
of the patient who feels healthy.
5. Multiphasic screening is an interest-ing
term. What does it mean?
Well, multiphasic screening is the
performance of a broad group of
measurements and laboratory tests
on an individual. Abnormalities in
the results of these tests provide
general indicators to help physicians
track down risks of illness or un-known
illnesses.
6. What tests are included in a program
of multiphasic screening?
There are many possible tests for
screening programs, but some of the
basic ones include measurements of
height, weight, blood pressure, and
lung capacity, and examinations of
the blood chemistries, a chest x-ray,
a urine specimen, and a pap smear
in women. Electrocardiograms, eye-ball
pressure readings, and certain
other blood tests are desirable.
7. How does multiphasic screening help
the physicians and his patients?
Screening tests provide additional in-formation
to give helpful clues to
physicians in their regular care of
their patients. It may help to bring
patients to early treatment for cer-tain
illnesses. It should be emphasiz-ed
that screening does not substitute
for the physician's check-up, but
attempts to provide extra informa-tion
for such check-ups.
8. Is multiphasic screening being tried
in North Carolina?
Several pilot programs in multiphasic
screening are being conducted
throughout the state. These screen-ing
programs are being conducted
in local health departments or in a
local hospital. Different groups of
screening tests are being evaluated,
and as pilot projects, the programs
are being studied to determine how
much unknown disease is being
found. We believe many questions
will need to be answered by these
study programs, but we also think
multiphasic screening offers tremen-dous
opportunities in preventive
medicine in the future.
Our guest has been Dr. John Henry,
of the Chronic Disease Section of
the State Board of Health,
This is Edwin S. Preston.
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
14 THE HEALTH BULLETIN March, 1968
Margaret Dolan Appointed
Member of Health
Insurance Benefits
Advisory Council
Wilbur J. Cohen, Acting Secretary of
Health, Education, and Welfare, an-nounced
the appointment of Charles L.
Schultze, former Director of the Bureau
of the Budget, as the new Chairman of
the Health Insurance Benefits Advisory
Council. Mr. Schultze is now Professor
of Economics at the University of Mary-land
and Senior Fellow with the Brook-ings
institution. He succeeds Kermit
Gordon, whose term as Chairman re-cently
expired.
The appointment of 6 new members
was also announced, 3 to succeed mem-bers
whose terms have expired and 3
appointed in accordance with recent
legislation increasing the membership
of the Council from 1 6 to 19.
Mrs. Maragret B. Dolan, professor
and head of the Public Health Nursing,
School of Public Health at Chapel Hill,
is one of these new members.
The Council was appointed in No-vember
1965, to advise the Secretary
of Health, Education, and Welfare on
matters of policy in the newly enacted
Medicare program.
LSD Causes
Opposite Moods
LSD characteristically causes opposite
moods at the same time: one can feel
tense yet calm, or serious but silly with-in
the same few moments, scientists
at the National Institute of Mental
Health, U. S. Public Health Service,
have found.
Dr. Martin M. Katz, NIMH psycholo-gist
and senior investigator, described
major findings of the study. Scientists
selected 80 prison inmates of average
intelligence who knew little about LSD
as subjects in the project to pinpoint the
drug's psychological effects.
The prisoners were given either 50
micrograms of LSD, dextro-ampheta-mine,
or plain sugar pills. None knew
which of the three he was taking. The
subjects were then asked to answer a
carefully designed questionnaire on
their responses to the drug, and to
give their reactions to a series of pic-tures
of people. In addition, their voices
were recorded and analyzed for emo-tional
clues.
The results showed the LSD state
to be a unique and puzzling one. Its
primary characteristic consists of "very
strong but opposing emotions occurring
approximately at the same time" with-out
any particular reason or outside
stimulus. Dr. Katz noted. For example,
one subject said "I feel jittery and
nervous, but I also feel relaxed." An-other
reported "1 feel serious but some-how
everything seems funny and I feel
like laughing."
Other reactions included:
1) A feeling of one-'s emotions and
thoughts being out of control.
2) A feeling of detachment from the
real world.
3) A feeling of perceptual sharpness
at the same time the outer world
seems unreal.
4) A perception of others as friendly
but suspicious.
Dr. Katz found that subjects on the
amphetamine felt they had increased
control and improved motor reactions.
Those on sugar pills showed little
change from their normal moods. There
were three main types of LSD reactions:
One group felt moderately relaxed,
happy, and peaceful; another, tense and
jumpy; and the third, ambivalent, ex-periencing
opposite feelings at the same
time.
March, 1968 THE HEALTH BULLETIN 15
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Ino
1968
Printed by The Graphic Press, Inc., Raleigh, N. C
But nearly all subjects at some time
showed a confusing mixture of positive
and negative feelings. Dr. Katz said:
"They reported a number of feelings
to be occurring at approximately the
same time which would appear to the
rational observer as opposed and con-tradictory.
One of the most dominant
aspects of the experience, then, was the
contrariness and intensity of the basic
effects which take place in the early
stages of the LSD reaction."
Dr. Katz concluded that "this assem-blage
of competing emotions and per-ceptual
counterparts and the general
intensity of the reaction would appear
to create a very bizarre experience for
most individuals in our culture to un-dergo—
and one which may not be
easily assimilated or integrated into
their previous experience."
The attempt to find meaning in such
a paradoxical experience may help ex-plain
some of the philosophical con-cepts
reported by users on higher doses
of LSD, the investigators suggested.
The NIMH report, by Drs. Katz, Irene
E. Waskow, and James Olsson, appears
in the February 1968 issue of the Jour-nal
of Abnormal Psychology.
16 THE HEALTH BULLETIN
DATES AND EVENTS
April 28-May 2 — Southern Psychi-atric
Association, Southern Pines, N.
C.
April 29-AAay 24 — Rehabilitative Nurs-ing
Workshop, Charlotte Rehabilita-tion
Hospital, Charlotte, N. C.
April 30-May 1st — N. C. Tuberculosis
Association, Annual Meeting, Heart
of Charlotte Motel, Charlotte, N. C.
May 1-7 — Mental Health Week
May 9-1 C - Western Branch, N. C.
Public Health Association, High
Hampton Inn, Cashiers, N. C.
May 13-17 — Biennial Convention:
American Nurses' Association, Dallas,
Texas
May 15-17 — Meeting: 38th Annual
Statewide Industrial Safety Confer-ence,
Jack Tar Hotel, Durham
May 16 — N. C. Association of indus-trial
Nurses, Durham
May 19-22 — Annual Meeting: Nation-al
Tuberculosis Association, Houston,
Texas
May 27-31 — Annual Meeting: South-ern
Branch APHA, Roanoke, Va.
March, 1968
RECEIVED
JUN 5 196ti
DIVISION OF
HEALTH AFFAIRS LIBRARY
Wilbur J. Cohen
President Johnson's choice for a new secretary
of Health, Education and Welfare to replace
Dr. John Gardner, (see story on page 3.)
Physicians' Attitudes Toward Venereal
Disease Reporting
Is revealed in a recently conducted
survey by the National Opinion Re-search.
In sunnmary the survey indicat-ed
that "there are not two kinds of
physicians: those who faithfully report
each veneral disease case they treat and
those who consistently fail to report.
Though there are some physicians in
each of these categories, the majority
exercise their professional judgment in
each case and, on the basis of a mul-tiplicity
of factors, decide to report
some patients and not to report others."
To Determine The True Extent of
Venereal Disease
In this country, the American Social
Health Association will on July 1 mail
questionnaires to nearly 200,000 physi-cians
and 13,000 osteopaths in private
practice requesting them to report any
veneral disease cases treated within the
three-month period from April 1 to
June 30. A similar survey conducted
by ASHA six years ago revealed that
private physicians were reporting about
11% of the infectious venereal diseas-es
treated. The sponsoring organizations
for the VD Incidence Survey are the
American Medical Association, the Na-tional
Medical Association, and the
American Osteopathic Association, in
cooperation with the U. S. Public Health
Service. State and local medical societies
are urged to acquaint their membership
of the current survey.
Reported Cases of Gonorrhea
Continue to increase according to
figures recently released by the U. S.
Public Health Service. Gonorrhea in-creased
by 13.7 per cent the first quar-ter
of fiscal 1968 over the same period
the previous year. And fiscal 1967 saw
the second highest gonorrhea total in
history!
Southern Branch
APHA Meets
in Roanoke,
Virginia
"Elements of Total Family Health"
will be one of the major addresses of
the annual meeting of the American
Public Health Association's Southern
Branch May 28-31 in Roanoke, Virginia.
The speaker will be Dr. John J. Han-
Ion, President of the APHA. Dr. Han-
Ion is the health commissioner of De-troit.
His address will be delivered May
30, at the second general session of
the meeting. Sharing the platform will
be Dr. Paul D. Sanders of Richmond,
Virginia, editor of the Southern Plant-er,
who will discuss "Social and Eco-nomic
Impact of Family Health on the
Community."
At the first general session, on May
29, Dr. Carl S. Winters, lecture staff
consultant for General Motors Corpora-tion,
will deliver the keynote address,
based on the meeting theme of "Fami-ly
Health is Community Wealth."
Dr. Berwyn F. Mattison, APHA ex-ecutive
director, will tell the third gen-eral
session "What's New in APHA and
Affiliates."
The Southern Branch meeting is
expected to draw members from 16
Southern states and the District of Co-lumbia
to the Hotel Roanoke.
Sectional meetings will be held on
dental health, medical care, environ-mental
health, nutrition, health educa-tion,
public health nursing, personnel
administration, and records and statis-tics.
THE HEALTH BULLETIN April, 1968
Wilbur J. Cohen
Nominated as
New Secretary
for HEW
President Johnson's choice for a new
secretary of Health, Education and Wel-fare
to replace John Gardner has spent
a third of a century building impressive
credentials for the job.
Wilbur J. Cohen came to Washington
in 1934 as a research assistant to the
executive director of President Franklin
D. Roosevelt's Cabinet Committee on
Economic Security, which drafted the
original Social Security Act. And since
that time he has had a major hand in
nearly every piece of important social
and education legislation passed by
Congress.
Mr. Cohen, 55, is an energetic liberal
who has earned a reputation under
three HEW secretaries — Abraham A.
RibicofF, Anthony J. Celebrezze and
Mr. Gardner — as a master legislative
technician. He has been serving as act-ing
secretary since Mr. Gardner's resig-nation
took effect March 1.
Except for a stint as a public welfare
professor at the University of Michigan
from 1956 to 1961, Mr. Cohen has de-voted
his career to continuous govern-ment
service at HEW and its predeces-sor
agencies. In January 1961 he was
appointed by President John F. Ken-nedy
as HEW assistant secretary for
legislation. During his four-and-a-half
years in that post, some 65 legislative
proposals passed by Congress bore his
imprint.
He was appointed HEW undersecre-tary
by President Johnson on June 1,
1965, and served Mr. Gardner for two-and-
a-half years as coordinator of major
policy issues between the legislative
and executive branches. During that
time, he was a leading strategist in the
enactment of medicare legislation.
In many respects, Mr. Cohen has run
the massive HEW agency — which em-ploys
100,000 persons and has a bud-get
second only to that of the Penta-gon
— during the tenure of the last
three secretaries. As one observer put
it, "Wilbur Cohen knows everything a-bout
HEW." He is recognized as a skill-ed
administrator who, like former De-fense
Secretary Robert S. McNamara,
has so thorough a knowledge of his
subject that he can instantly produce
facts and figures about programs that
others run.
Mr. Cohen is also known as an offi-cial
who drives himself because his re-sponsibilities
matter personally to him.
In a magazine article last spring, Theo-dore
H. White listed Mr. Cohen, along
with John Gardner, McGeorge Bundy,
James Conant and others, as one of the
nation's, leading "action intellectuals."
"After all his years in the capital,"
Mr. White wrote, "Cohen has lost none
of his humanitarian glow — 'as though,'
an acquaintance once said, "he feels
every person in the country who is
home alone sick is his personal re-sponsibility.'
"
Though he has made his mark most
deeply in the fields of health and wel-fare,
Mr. Cohen's achievements in fed-eral
education legislation cannot be un-derrated.
He sees a great need for the
nation to extend federal education pro-grams
to help solve the poverty-welfare
cycle. "Education is a main part of the
welfare problem," he once told an in-terviewer.
"It is the central solution.
The vast majority of these people on
welfare have no education; they're
grade school and high school dropouts.
We've got to educate these people,
train them for jobs."
April, 1968 THE HEALTH BULLETIN
Natural Disaster
Hospitals
Being Located
Tornado and hurricane victims of the
future may not have to go to a hos-pital—
the hospital may go to them.
Boxed units of emergency medical
supplies and equipment are being posi-tioned
by the Public Health Service in
areas where natural disasters frequent-ly
occur. When a disaster strikes, the
unit can be loaded on a truck, rushed
to the scene, and used to aid the vic-tims.
The units are called Natural Dis-aster
Hospitals (NDH).
The first NDH has just been placed at
Enid, Oklahoma. "Enid's vulnerable lo-cation
in the tornado belt makes it a
prime site for an NDH," said Dr. Henry
C. Huntley, Director of the Division of
Health Mobilization which coordinates
the disaster services of the Public
Health Servcie.
In an agreement signed with DHM,
the Garfield County (Oklahoma) Civil
Defense Office has assumed responsi-bility
for the storage and transportation
of the unit.
Staffing of the unit will be handled
by the Garfield County Medical Associ-ation.
The NDH is one phase of the Public
Health Service's program to provide
emergency medical supplies, equipment,
and services quickly and efficiently in
times of disaster. Packaged Disaster
Hospitals (units of supplies and equip-ment
necessary to establish a 200-bed
hospital) and Hospital Reserve Disas-ter
Inventories (30-day backup inven-tories
of critical medical items for com-munity
hospitals) are phases already in
operation. The NDH serves a need dif-ferent
from the other programs in that
it is designed to operate as a short-term
medical facility for up to 24
hours.
In an emergency, the NDH can be
quickly set up as a complete 50-bed
unit. It can be used by a hospital to
expand its facilities or it can be set up
in a church, school or other available
building to serve the emergency needs
of approximately 300 casualties. The
unit is small—83 cases of supplies and
equipment; it is light-weight— 234 tons,-
it is mobile— it can be transported in
four station wagons or two pickup
trucks. Its ability to go to the injured
means that victims with slight injuries
can be treated on the scene and
released. Victims with grave injuries
can be given essential treatment before
being moved to permanent hospitals.
If necessary, the NDH can provide sur-gery
in the field.
The Public Health Service plans to
position 24 additional NDH's in high-risk
natural disaster areas this year.
The first group will be placed in the
middle west in anticipation of the
tornado season. The second group will
be placed in the hurricane-prone areas
of the coastal regions before fall.
THE HEALTH BULLETIN
First Published—April 1886
The official publication of the North Caro-lina
State Board of Health, 608 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Published
monthly. Second Class Postage paid at
Raleigh, X. C. Sent free upon request.
Editorial Board
Charles M, Cameron. Jr.. M D,, M.P.H.
Raleigh
John C Lumsden. B.C.H.E.
Jacob Koomen, Jr.. M.D., M.P.H.
John Andrews, B.S.
Glenn A. Flinchum. B S.
H W. STEVENS, M.D., M.P.H.. ASHEVILLE
Guest Ed.—Edwin S. Preston, M.A.,LL.D.
Vol. 83 April, 1968 No. 4
THE HEALTH BULLETIN April, 1968
Parents
of
Creaf-ive
Boys
Treat
Them
With
Respect
The parents of creative boys treat
them like responsible adults; they
regard their adolescent sons with
respect and let them make their own
decisions, according to the youngsters
themselves.
These facts were reported by scien-tists
of the National Institute of Mental
Health, U.S. Public Health Service.
Dr. Lois-ellin Datta and Morris Parloff,
Institute psychologists, asked 1,039
teen-age boys who had scored high in
the Westinghouse Science Talent Search
to describe how their parents had
treated them from childhood to the
present. The boys were divided into
two groups—the more and the less cre-ative—
according to how the judges had
rated the originality of their science
projects.
The two groups of boys appeared
to be similar in many ways. Slightly
more than half had fathers who were
employed in professional occupations,
they did not differ in scientific aptitude,
reported similar interest in becoming
scientists and had equally high scores
on the scholastic aptitude test.
However, the more creative students
were more likely to come from the
Northeastern States (44 versus 38 per-cent),
from metropolitan areas (51
versus 41 percent), and from Jewish
families (46 versus 38 percent).
In answer to NIMH questionnaires,
both the creative young scientists and
the controls said their parents were
moderately affectionate, non-rejecting,
and encouraged their intellectual inde-pendence.
But replies from the more creative
boys shows that they had been given
much more latitude and subjected to
considerably less discipline than the
less creative teen-agers. One boy said
"They allowed me as much responsibili-ty
as they felt I could handle ... I
felt I was trusted." Another said "Rules,
what rules? I was treated as a respon-sible
adult." A third remarked, "I was
simply allowed to make my own deci-sions."
In contrast, one of the less creative
boys complained that "My father has a
April, 1968 THE HEALTH BULLETIN
set of rules that makes the penal code
look like a picnic."
The study also showed that the more
creative students considered their moth-ers
as somewhat less rejecting and
authoritarian than the less creative boys
did.
However, relationships with fathers
appeared to be more important to early
scientific creativity in the boys than
that with the mothers.
One creative boy suggested that his
group may have represented fewer dis-ciplinary
problems than the average
teenager, making the parent's task an
easier one. He said "As ! never had any
desire to smoke, drink, stay out late,
ride in a fast car, or do any other unde-sirable
things, my mother never found
it necessary to condemn my avocations
and habits."
However, Dr. Datta emphasized that
the parents did not appear to practice
a disinterested hands-off policy. She
explained that the more creative boy
was "more likely to perceive both
parents as providing a 'no-rules' situa-tion
in which his integrity and respon-sibility
were assumed rather than one
in which expectations were enforced
by authoritarian control and punish-ment.
The results suggest that creative
behavior may be significantly related to
expectations communicated in ways
that the child sees as trust in his ability
to choose rationally, thus enhancing his
ability and desire to achieve by in-dependence."
Dr. Datta noted that 41 percent of
the more creative boys but only 26
percent of the less creative ones later
enrolled in six top colleges— M.I.T.,
Harvard, Princeton, Yale, Columbia Uni-versity,
and California Institute of Tech-nology.
The report by Drs. Datta and Par-loff
appears in the Proceedings of the
75th Annual Convention of the Amer-ican
Psychological Association.
Cities Chosen
for Narcotic
Addict Aftercare
Three cities have been selected as
the first sites of Federal aftercare con-tract
negotiating offices for narcotic ad-dicts.
The cities are Los Angeles, Chi-cago,
and New York.
These metropolitan area offices are
the first of a proposed national net-work
which will arrange for the treat-ment
of narcotic addicts discharged
from the inpatient units of the NIMH
Clinical Research Centers at Fort Worth,
Texas and Lexington, Kentucky.
NIMH officials said these cities were
selected because of their large addict
populations. Additional cities will soon
be added to complete the network.
The purpose of the program is to
reduce the high relapse rate of patients
who have been treated for narcotic drug
addiction.
Meeting Stresses
Better Health Care
for Migrants
Providing better health services to
migratory agricultural workers is the
concern of over 200 persons who at-tended
the Eastern States Migrant
Health Conference in Orlando, Florida.
Sponsored by the U.S. Public Health
Service, the meeting focused on the
problem of making health care avail-able
to the 80,000 migrants who har-vest
crops along the Eastern Seaboard.
Participants from eleven States in-cluded
representatives of national. State
and local governments, voluntary or-ganizations,
migrant health projects and
growers' associations.
THE HEALTH BULLETIN April, 1968
A "Cold
n
That Wosn't
A "Cold#/
And then there was the 39-year-old
waitress who complained for six months
about her "cold."
She had a low-grade fever almost
every day. She suffered from chills,
lack of sleep, and irritability. After
losing 20 pounds, she weighed 107
when admitted to a Philadelphia hos-pital.
Her trouble? Too much coffee-drink-ing.
She drank 15 to 18 cups a day, the
woman told her physician. Her cold
symptoms disappeared after five days
in a hospital, during which she was
limited to one cup of coffee a day.
A report on this case of caffeinism
appears in a recent (Dec. 18) Journal of
the American Medical Association. The
author is Hobart A. Reimann, M.D., of
Hahnemann Medical College and Hos-pital,
Philadelphia.
Several common household items can
cause illness if used excessively. Dr.
Reimann points out, and the illness can
be mistaken for other disease.
Coffee, tea, dentifrices, and even
peanuts contain chemicals called xan-thine
alkaloids and can induce illness
sometimes mistaken for other disease,
he said.
A cup of coffee contains about one-tenth
gram of caffeine. A single one-gram
dose of caffeine causes mental
confuision, shivering, tremor, vomit-ing,
and diarrhea. Ten grams of caf-feine
is said to be fatal.
The waitress's caffeine intake was
probably more than 1 V2 grams a day.
The intake was spread over several
hours, however—probably the reason
she was not more seriously ill.
The woman also smoked more than
a pack of cigarettes a day, and reg-ularly
took sleeping pills. The nicotine
and drugs also may have affected her
reactions to caffeine. Dr. Reimann said.
A main point of his report is that
great effort can be wasted on testing
for diseases which a patient does not
have, but whose symptoms are similar
to those caused by excessive use of
caffeine and other stimulants. In the
waitress's case. Dr. Reimann happened
to note that her fever rose after that
daily cup of hospital coffee, but de-clined
later. It was then that further
questioning disclosed how much coffee
she drank.
"The cause (of illness) is easily over-looked
unless a patient's habits are dis-covered,"
Dr. Reimann said. "Prompt
recognition (eliminates the need for)
much clinical effort, laboratory testing,
unnecessary therapy, and expense."
Reactions to caffeine are influenced
by a person's age, emotional or nervous
state, "or by the idiosyncrasies of peo-ple,"
Dr. Reimann said. Its effect is
widely variable, often opposite in dif-ferent
people or even in the same per-son
at different times.
"Caffeinism is said to be current
among intellectual workers, actresses,
vyaitresses, nocturnal employees, and
long-distance automobile drivers," Dr.
Reimann said. "Illness otherwise un-explained
may be caused by excessive
intake of the xanthine alkaloids (caf-feine),
including those in coffee, tea,
cocoa, and those in other popular
beverages."
"Removal of the cause is the cure,"
he said.
April, 1968 THE HEALTH BULLETIN
Franklin
Institute
Offers
Sculpture
Award
for
Best
Original
Achievement
in Control
Created by J. Daatselaar under a com-mission
from the Dollinger Corporation
of Rochester, New York, this sculptured
work signifies the newly established
Lewis L. Dollinger Pure Environment
Award. According to the artist, "The
burnished aluminum in its simplicity of
geometric shape symbolizes modern
day industrial technology. The ceramic
representation of the human embryo
within the industrial society suggests
purity and life support.
"The boldness of industrial strength,"
Mr. Daatselaar points out, "surrounds
and supports all of contemporary life.
Thus, the motion of the sculpture is
generated by this contrast of strength
with huddled dependence, giving way
to man's realization that his natural en-vironment
must be protected if his
future life is to be maintained."
The world's scientific, industrial and
academic communities will be scanned
for the "best-judged original contribu-tion,
available in print or otherwise,
reflecting significant achievement in
the recognition, detection and abate-ment
or control of environmental pol-lution."
The recipient of the sculpture
Award, who will also receive a cash
honorarium of $2,500, will be selected
by the Committee on Science and the
Arts of The Franklin Institute, Phila-delphia,
Pennsylvania, America's oldest
science institute.
of
Environmental
Pollution
See opposite page
THE HEALTH BULLETIN April, 1968
Lewis L. Dollinger Pure Environment Award 1968
Awarded by Franklin Institute
April, 1968 THE HEALTH BULLETIN
Whooping Cough
in Teenagers
and Adults is
Disabling Illness
Whooping Cough in teenagers and
adults is a disabling illness character-ized
by a severe persistent paroxysmal
cough occasionally culminating in vom-iting.
This often lasts for weeks or
months. The illness exists in mild forms
and is often simply called bronchitis.
A public health laboratory in Michi-gan
is carefully culturing and studying
persons with whooping cough. In 1967,
1,060 cases occurred in Michigan. A
study of persons exposed to whoop-ing
cough reveals that 21% of persons
who were vaccinated 0-3 years previ-ously
develop whooping cough. The
corresponding attack rate for persons
vaccinated 4-7 years previously is 47%,
for 8-11 years previously is 65%, and
for 12 or more years previously is
95%. Studies in Michigan reveal that
55% of positive pertussis cultures come
from the 10-19 year old age group.
Twenty percent come from persons 20
years old or older.
Analysis of the serotypes which have
been isolated suggests that infection
with organisms devoid of number 2
antigen are becoming more frequent.
It seems likely that the antigenic com-ponents
of the pertussis vaccine may
one day have to be altered.
Although pertussis is now a disease
of teenagers and adults (in immunized
communities), it is not clear whether
teenagers should receive another
"booster" vaccination. The neurologic
sequelae after vaccination, though rare,
may be more frequent in adults.
The North Carolina Supreme Court
According to a UPI report has de-clared
unconstitutional a Charlotte ordi-nance
designed to outlaw massages by
members of the opposite sex. The 1966
ordinance was passed at the request of
police who complained of "lewd mas-sages"
and prostitution in the city's
massage parlors. The ordinance exempt-ed
the YMCA, the YWCA and barber
and beauty shops. Supreme Court Jus-tice
Susie Sharp, writing for the majori-ty,
said the exemptions made the ordi-nance
discriminatory.
Motorcycle Riders
Beware
Motorcycle riders are sometimes
killed or injured because automobile
drivers or pedestrians refuse to share
the road with them.
The above statement can be found
in a new, revised edition of the pam-phlet,
"Motorcycles in the United
States." The pamphlet is published by
the injury Control Program of the Pub-lic
Health Service's National Center for
Urban and Industrial Health in Cincin-nati.
Other causes of motorcyclist injuries
and deaths, according to Dr. Richard E.
Mariand, Chief of the Center's Injury
Control Program, are: (1) many new
riders lack adequate training and ex-perience
in controlling their vehicles,
and (2) many riders have not been suf-ficiently
informed of the dangers of
riding motorcycles and are unprepared
to deal with hazardous situations.
The new pamphlet includes informa-tion
on motorcycle registrations, the
importance of wearing helmets and
other protective clothing, as well as
benefits of wearing reflective materials
for night visibility.
10 THE HEALTH BULLETIN April, 1968
An 1827 French
A Sfrange Alliance '"9 ^^^ third factor in LaPlace's law.
But the question was not answered
A Soap Bubble ^^ ^° whether this law of physics could
be put to practical use in terms of the
human heart. Dr. Hood and his associ-ates
have been investigating LaPlace's
p, . . 'aw of physics and its relationship to
rhySICIST heart patients. Evidence to date seems
to support the fact that LaPlace's law A Modern Computer does have clinical usefulness. The UNC
researchers have found that in response
to valve obstruction or leakage the left
What do a soap bubble, a French ventricular wall normally thickens "ap-physicist
who died in 1827, and a propriately" so that tension tending to
computer have to do with modern rupture the wall is minimized. If the
open-heart surgery? At the University wall does not thicken "appropriately,"
of North Carolina School of Medicine, it usually means the heart muscle is
William Hood, M.D., Charles Rackley, weak and the pumping ability of the
M.D., and Ellis Rolett, M.D., with the heart is impaired.
help of North Carolina Heart Associa- What does this mean to those indi-ton
Heart Fund dollars are putting these viduals who may need to undergo sur-three
seemingly unrelated pieces to- gery to replace a valve damaged
gether to add significantly to our through disease? If the heart muscle of
knowledge of how the heart works. such patients is weak, they may not
In the early 1800s, Pierre Simon de improve even though their valvular dif-
LaPlace formulated a law of physics ficulty is completely corrected. By eval-v/
hich can be used to calculate the sur- uating the appropriateness of the left
face tension of a soap bubble. Its prin- ventricular wall thickness, Dr. Hood
ciple guides engineers today in the ^""^ ^'^ associates hope to be able to
design of containers which hold com- P'edict which patients have good
pressed gas. The law of LaPlace relates enough pumping action to benefit from
the tension on the wall of a chamber surgery.
to the size and shape of the cavity, the """^s necessary calculations have been
pressure within the cavity, and the greatly facilitated by the use of com-
Ihickness of the wall. puter programs specially developed in
About five