Health bulletin

              HEALTH SCIENCES LIBRARY
OF THE
UNIVERSITY OF NORTH CAROLINA
This Book Must Not Be Taken
from the Division of Health
Affairs Buildings. four days
This JOURNAL may be kept ou t
and is subject to a fine of FIVE CENTS a day
thereafter. It ia DUE on the DAY Indicated
below:
he Phy
and the Child"
Laboratory
Testing
Well
Baby
Clinics
Water
Fluoridation
^^-r U'-(-
Governor Dan K.
Moore and
a Local Health
Director
The State Legislative Building
Where Public Health Laws
Are Enacted and Administered
The State Capitol
Don't You
Envy
This
Public
Health
Nurse?
The Health Bulletin
First Published—^April 1886
The official publication of the North Carolina State
Board of Health, 608 Cooper Memorial Health Build-ing,
225 North McEtowell Street, Raleigh, N. C. Pub-lished
monthly. Second Class Postage paid at Raleigh,
N. C. Sent free upon request.
EDITORIAL BOARD
Charles M. Cameron. Jr.. M.D.. M.P.H.
Chapel Hill
John C. Lumsden, B.C. HE.
Jacob Koomen, Jr., M.D.. M.P.H.
Bryan Reep, M.S.
John Andrews, B.S.
Glenn A. Flinchum, B.S.
H. W. Stevens. M.D.. M.P.H.. Ashevlle
Editor—Edwin S. Preston, M.A., LL.D.
Vol. 82 January, 1967 No. 1
THE HEALTH BULLETIN
The
Public Health
Policy Makers
The North Carolina State Board of Health
with Governor Dan K. Moore
Mrs. Dan K. Moore
Has An Interest
in Public Health
Dr. Jacob Koomen, the State Health Director, conducted North Carolina's
First Lady on a tour of many activities in the Health Buildings
National Leaders
of the
Council on the
Aging
Older People Have Many Opportunities for Service
THE HEALTH BULLETIN
'The Patient's
Heart Has
Stopped -
But He Is
Still Alive"
Prize Picture
Photo Courtesy
of the
B. F. Goodrich Company
THE HEALTH BULLETIN
THE HEALTH BULLETIN
Inf-ensive Care
and
Correctional Treatment
V?«(J(S-Immunization
Prevention
Is the
Best
Health
Investment
Dental Health
This
Young Man
Has a
Weight
Problem
The
Public Health
Nurse
Goes Where
the People Are
^
>~
V
The "Little Jack
Puppet Show"
Teaches Good
Dental Health
National
and State
Public Health
Leaders Confer
The
Lost Colony
at Manteo
Invites to
Constructive
Recreation
Visit
Our
Beautiful
Legislative
Building
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
Lenox D. Baker, M.D., President __^ Durham
James S. Raper, M.D., Vice-President Asheville
Ben W. Dawsev, D.V.M. Gastonia
Samuel G. Koonce, Ph.G. Chadbourn
Oscar S. Goodwin, M.D. Apex
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, Sar^itary 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 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. Acting Director, Personal Health Division
14 THE HEALTH BULLETIN
The
Handicapped
Can Be
Helped
Starting
Over
with
Help
and
Encouragement
THE HEALTH BULLETIN 15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602 LIBRARIAN
DIVISION OF HEALTH AFFAIRS LIBRARY
N.C. UE^f.. HOSP. U. N. C.
CHAPEL MILL, N.C.
If you do NOT wish to con-tinue
receiving The Health Bul-letin,
please check here i—
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and return this page to '—
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the address above.
Printed by The Graphic Press, Inc., Raleigh, N. C.
Public
Health
Gets
Under
Your Skin
Find YOUR
Piece of Service
16 THE HEALTH BULLETIN
^*> F^g n^^y
UB8l«t
Sanitarians Needed
Excellent growth opportunities for
ambitious professional sanitarians.
The Engineering—Sanitation Section
of A. P. H. A. has about 1,500 mem-bers
and Fellows. Too few of these are
sanitarians. Too few of the members
are Fellows (either engineers or sani-tarians).
Tomorrow's leadership wil come from
those young men willing to give a small
amount of time and money to advance
the profession in which they practice
public health.
Maintain your interest and loyalty to
your particular professional associa-tion.
Sanitarians associations both local
and national need and deserve your
full support.
You can help to further those in-terests
through membership and active
participation in the increasing en-vironmental
health functions of the
Engineering-Sanitation Section of the
A. P. H. A. (William V. Hickey is
chairman). For a membership applica-tion
write to:
Department M
American Public Health Association
1740 Broadway
New York, New York 10017
The two recent cases of typhoid
fever reported from Burke County dem-onstrate
the present epidemiology of
typhoid. The patient, age 15, has lived
all her life in the home of her aunt
who had typhoid years ago. Positive
stool cultures obtained from both the
aunt and the patient were identified
by serologic typing as Salmonella ty-phosa
at the State Board of Health.
Vaccination was recommended only
for immediate household contacts.
The society which scorns excellence
in plumbing because plumbing is a
humble activity and tolerates shoddiness
in philosophy because it is an exalted
activity, will have neither good plumb-ing
nor good philosophy. Neither its
pipes nor its theories will hold water.
—John Gardner.
Don't- Neglect Sore Throat
Sore throat is nature's warning sys-tem
that something in your body is
out of order.
Often a sore throat accompanies a
common cold and the soreness passes
in a few days with no further effect.
But a sore throat also can be the symp-tom
of a wide range of diseases, from
diphtheria to leukemia, that require
your doctor's skill, not your guessing,
to diagnose.
Allergies can cause sore throats.
Cold, dry winter air can trigger it. So
can extreme thirst, excessive smoking
or mouth breathing—anything that dries
out the throat and cuts off secretions
that normally wash dust away.
Virus infections of many types also
are a cause of sore throat, and every-one
who has had "flu" knows that this
particular virus disease often causes the
throat to hurt.
"Strep throat" is a serious infection
that occasionally leads to rheumatic
fever and possible heart damage. Early
treatment with penicillin or other anti-biotics
offers an excellent chance of
eliminating the potential threat of rheu-matic
fever.
There is little or nothing you can do
to cure a sore throat at home. There
are medications which bring temporary
easing of the discomfort but the cure
must be prescribed by your physician.
American Medical Association
THE HEALTH BULLETIN February, 1967
Glue Sniffing . .
The Quest for Ecstasy
A Georgia View
(N. C. Senate Bill 135, introduced
by Ellis and others, concerns this
problem.)
Glue-sniffing among teenagers, a
relatively new means of enjoying quick
thrills and adventure in unreality, seems
to be gaining followers. Police authori-ties,
a juvenile court judge, doctors and
other health authorities were interview-ed
to determine the extent of this prob-im
in Georgia and its immediate and
long-range effects on the glue-sniffer.
Since the problem is a recent one, much
about it is unknown. The following ac-count
presents the problem and its
dangers as seen by the authorities in-terviewed.
With only a brown paper bag and a
]0i tube of glue a teenager is quick-ly
caught-up in a fantastic world of
vivid dreams and hallucinations. Enter-ing
this world, like entering Dante's
immortal hell, can be a step "into the
eternal darkness, into fire and ice." It
is a world from which some never com-pletely
return.
When the teenager first inhales glue
fumes, he is exhilarated, "dizzy,"
' "drunk," free from reality. Then he
begins to act drunk; his speech is slur-red.
He becomes depressed, mentally
I confused. He may display bizarre be-havior.
He may black out.
Feelings of reckless abandon often
lead to dangerous impulsive acts. One
boy in his early teens is reported to
have assumed a fighting stance before
an oncoming train and narrowly es-caped
death. Another young glue-snif-fer,
convinced he could fly, leapt to his
death from the top of a building. Teen-agers
under the influence have joined
in wild automobile rides in the night.
What happens to the chronic glue-sniffer?
Long range effects are not
easy to assess, and doctors themselves
do not always agree. The concentra-tion
of the solvent in the glue, fre-quencey
of glue-sniffing, the lapse
between times of intoxication, and dif-ferences
in the physiological makeup
of individuals all contribute to determ-ining
the chronic results to any indi-vidual.
Extensive damage to the kid-neys
seems to be the major effect, ac-cording
to Dr. H. K. Sessions, Occupa-tional
Health Service, Georgia Health
Department. "Exposure over long pe-riods
of time could also cause brain
damage and blood dyscrasias with
bleeding in the lungs," Dr. Sessions
continued. Graver consequences—even
death—result from glue-sniffing while
drinking beer.
Is glue-sniffing a serious problem in
Georgia? It is, according to Atlanta
Police Superintendent Clinton Chafin.
Superintendent Chafin reports that dur-ing
the 13-month period from January
1, 1966, to January 31, 1967, 176
teenagers were arrested who had been
sniffing glue. The majority of the teen-agers
arrested (43) were 15-year-old
boys. An astonishing 39 were 12 years
of age or under. Most of the arrests
were made in lower income areas.
Superintendent Chafin feels that the
problem is increasing in the Atlanta
area and that corrective measures must
be taken.
Fulton County Juvenile Court Judge
Elmo Holt—who comes in daily contact
with many varieties of juvenile offend-ers—
substantiates the reports of a grow-ing
problem with glue-sniffers. "We
had never heard of glue-sniffers here
until about three years ago," Judge
Holt said. The problem first appeared
February, 1967 THE HEALTH BULLETIN
in the North and West, according to
Judge Holt, and spread to this part of
the country. Judge Holt also believes
that the problem is primarily a low-in-come
area problem. A survey was con-ducted
in the Juvenile Detention Center
in March, 1966. Of the 96 boys present
at that time, 36 admitted having snif-fed
glue. Some 30 were habitual glue-sniffers.
Juvenile authorities suspect
that an additional 10 boys had sniffed
glue but would not admit it. These
figures show that almost one-half of
the boys in the Center at that time
were glue-sniffers!
What kind of trouble do these young
people become involved in? "Every
kind of trouble— burglary — robbery-shoplifting,"
Judge Holt says. Superin-tendent
Chafin also reports teenagers
arrested for burglary in connection with
glue-sniffing.
What causes a teenager to sniff glue?
Dr. Charles K. Bush, a psychiatrist and
director of the Hospital Services Branch
of the State Health Department's Di-vision
of Mental Health, has several
theories about glue-sniffers. Dr. Bush
would classify them with those who
begin taking dope or smoking mari-juana.
"It's done for kicks. It is pos-sible
that they begin because it's the
smart thing to do. A status symbol. The
first thing they know, they are 'hook-ed.'
"Teenagers who practice glue-sniffing
are insecure with their peer group or
family," Dr. Bush continued. "They
lack security. A youth who feels good
about his relationship with his family
and his peers doesn't do this sort of
thing."
What can be done about this appar-ently
growing problem? Several cities
and states have passed ordinances re-stricting
the sale of glue or making
glue-sniffing illegal. Atlanta this month
passed an ordinance forbidding the sale
of glue to minors under eighteen years
of age and restricting the retail sale
of "model glue" to one medium sized
container in a 24-hour period. The or-dinance
further stated that "it shall be
unlawful for any person to intentional-ly
smell or inhale the fumes of any
type of 'model glue,' or to induce any
other person to do so, for the purpose
of causing a condition of, or inducing
symptoms of intoxication, elation, eup-horia.
. . ."
Is this the answer? Can legislation
prevent teenagers from trying this
tempting bout with danger? Will edu-cating
teenagers to the permanent dam-ages
of glue-sniffing discourage them
from trying a fad? The answers are
unknown. Much about the problem it-self
is unknown. The need for research
is evident. Only then may a light be
cast on the problem.—From "Georgia's
Health"
The Health Bulletin
First Published—April 1886
The official publication of the North Carolina State
Board of Health, 608 Cooper Memorial Health Build-ing,
225 North McDowell Street, Raleigh, N. C. Pub-lished
monthly. Second Class Postage paid at Ralefgh,
N. C. Sent free upon request.
EDITORIAL BOARD
Charles M. Cameron, Jr.. M.D.. M.P.H.
Chapel Hill
John C. Lumsden. B.C. HE.
Jacob Koomen, Jr., M.D.. M.P.H.
Bryan Reep, M.S.
John Andrews, B.S.
Glenn A. Flinchum. B.S.
H. W. Stevens. M.D., M.P.H.. Ashevlue
Editor—Edwin S. Preston, M.A., LL.D.
Vol. 82 February, 1967 No. 2
THE HEALTH BULLETIN February, 1967
The Problem of Hernia
Hernia, while not an important cause
of death, is a common impairment and
a leading cause of hospitalization. Thus
it is a significant factor in considering
problems of hospital use and health
care.
Based on National Health Survey
findings, it is estimated that approxi-mately
2,900,000 people in the United
States—about 15 per 1,000—have a
hernia.* The condition occurs most often
at the extremes of life, in infancy for
congenital reason and in old age as
a result of weakened body tissues. It
is reported three times more frequently
among males than females, reflecting
the generally more strenuous activities
of men as well as their great vulner-ability
to hernias affecting the groin.
As the accompanying table shows, 23.2
per 1,000 males report a hernia com-pared
with 7.1 for females. A distinct
disparity by sex exists in every age
group but is especially marked at ages
75 and older, where the prevalence of
123 per 1,000 among males is more
than 6 times that for females. Hernia
occurs least often in the teens and
early twenties, its prevalence rising
steadily thereafter.
As a cause of hospitalization among
males, hernia is exceeded only by resp-iratory
conditions, injuries, and dis-eases
of the heart. t The average length
of hospital stay for men undergoing a
hernia repair or correction is about a
week. Women, who account for only
a fifth of the hospitalized cases, stay
on the average almost three days
longer. Both frequency and duration of
*Hernias Reported in Interviews, United
States, July 1957-June 1959; National Cen-ter
for Health Statistics, Series B.—No.
25, Washington, D. C, December 1960.
fHospital Discharges and Length of Stay:
'^hort-Stay Hospitals, United States, July
i963-June 1964; National Center for Health
Statistics, Series 10—No. 30, Washington,
D. C, June 1966.
V
\
-7-
HERNIA PREVALENCE AND MORTALITY IN THE UNITED STATES
Age Perio
(Yeorsl
All Ages
Under 1
1-14
15-24
25-34
35-44 .
45-54
55-64
65-74
75 and over
ge Frevdience Rates peFj^^BI^^Mrge Death Rates per 100,000
5 July T 957-Jwne 1959 "WSj^^^f^: T962-64
T«fat Persons Males Femafef*^ 'total Persons Moles FerrtdJe's
14.9
5.6
4.1
9.4
12.1
19.0
32.2
49.5
64.6
23.2
8.2
6.4
12,4
17.7
28.1
51.8
86.5
122.9
7.1
3.0
2.1
6.7
6.9
10.2
14.1
17.0
19.9
1.8 1.9 1.7
15.7
hospitalization increase with age; al-most
half the discharged patients are
45 and older, with the length of stay
rising from 3.3 days at ages under 15
to 9.7 at ages 45 and older.
Almost all of these hospitalizations
are for surgery; indeed, hernia repairs
are second only to tonsillectomies in
the frequency of operations performed
on males in short-stay hospitals in the
United States. Surgery is the treatment
of choice for most simple hernias un-less
contraindicated by a patient's poor
general health or advanced age. The
surgical risk is extremely low; a study
of 1,162 hernia patients operated upon
during 1950-59 reported an operative
mortality of only 0.3 percent. t After
survery, recurrences are generally ex-perienced
only by older people or
those with weakened tissues.
The accompanying table shows the
death rates attributed to hernia during
1962-64, by age and sex. This infor-mation
was made available by the
National Center for Health Statistics
•and is not "given in published mortality
reports. On the average, there were
3,451 deaths from hernia annually dur-ing
this period. This figure excludes
deaths from intestinal obstruction with-out
mention of hernia (I.S.C. 570).
The hernia death rate, at all ages
combined, is 1.8 per 100,000 popu-lation.
Mortality is highest among in-fants
and the elderly, and negligible at
the school and early adult ages. Death
rates are slightly higher for males than
for females.
It is noteworthy that about 60 per-cent
of the hernia deaths reported dur-ing
this period were due to conditions
specified as gangrenous, incarcerated,
irreducible, strangulated or causing ob-struction,
indicating that hernia be-comes
dangerous only when treatment
is unduly postponed or when other
factors increase the risk of surgery.—
Statistical Bulletin, Metrolopitan Life In*
surance Company.
First Rabies Case in 2 Years
The first case of dog rabies in more
than two years was confirmed in the
State Board of Health Laboratory in
February. The dog appeared on a farm
about four miles west of AAt. Airy and
as the farmer was attempting, to run
the dog away, the dog ran into a near-by
farm and attacked a calf. The dog
severely bit the calf on the legs and
head. Shortly after attacking the calf,
the dog died. After it was determined
that the dog was rabid, the calf was
sacrificed and buried.
No human exposure occurred dur-ing
this incident. However, this case
of rabies served well as a fair warning
and the activities of the rabies control
program have been increased in Surry
County. An additional dog warden has
been employed by the county and em-phasis
is being placed on the vaccina-tion
of dogs and the elimination of
strays.
JRydell, W. B. Jr., Inqidnal and Fe-moral
Hernias, Archives of Surgery, Vol.
87, pp. 493-499, September 1963.
Birth Rate Down: The U.S. birth rate
during 1966 reached the lowest level
since 1936, and the total number of
births was the lowest since 1950, re-ported
the U.S. Public Health Service.
The 1966 birth rate was 18.5 per 1.000
population, and births totaled 3,629,-
000. It was the ninth consecutive yearly
decline in the birth rate.
Measles: Secretary of Health, Edu-cation
and Welfare John Gardner said
a federally supported vaccination drive
may eliminate rubeola from the United
States this year. The program is under-written
by $7 million in federal grants.
THE HEALTH BULLETIN February, 1967
Decade of
Progress
In
Public Healfh
1957-1966
Halifax County
North Carolina
By Robert F. Young, M.D.
Halifax County Health Director
During the decade 1957-1966 more
progress was made in public health
and more new programs were initiated
than during the 37 previous years of
the Halifax County Health Department's
existence. At least ten major programs
have been developed, while the staff,
including the regular employees and
those on special cooperative projects,
has more than doubled from 19 to 41.
Pediatric clinics were developed in
1957 in cooperation with the Halifax
County Medical Society and with the
Department of Pediatrics at Duke Medi-cal
Center. These clinics which now
number four each month provide serv-ices
to medically indigent children from
birth to ten years of age, but are de-signed
primarily for infants and pre-school
children.
The next big development came in
1959 when the Mental Health Program
was initiated with a position for a
clinical psychologist. Dr. Carl Eisdorfer
from the Department of Psychiatry at
Duke was the first mental health spe-cialist
to fill this position and has
continued with the program through
the years making an outstanding con-tribution.
In the meantime, two addi-tional
clinical psychologists and a psy-chiatrist
from Duke have joined Dr.
Eisdorfer. In addition to these men,
there are four psychology interns and
three graduate students in clinical psy-chology
from Duke who visit in this
county under the supervision of Dr.
Eisdorfer and the other psychologists.
A comprehensive Human Relations Cen-ter
(mental health) is being planned at
the present time. Another very signifi-cant
development in mental health has
been the proposed Suicide Prevention
Program which will begin operation in
the near future.
Hard on the heels of this Mental
Health Program came the Special Tu-berculosis
Control Project which has
been conducted in cooperation with
the United States Public Health Serv-ice,
State Health Department, the local
medical profession and the State Sana-torium
System. The Tuberculosis Asso-ciation
also has aided in this program.
It has been financed to the extent of
approximately $85,000 by the Public
Health Service since its inception. In
Continued to Page 14
February, 1967 THE HEALTH BULLETIN
An Inyifrat-ion
The Western North Carolina Public
Health Association especially invites you
to their next annual meeting to be held
in the Grove Park Inn, Asheville, North
Carolina. PLEASE MARK THIS DATE ON
YOUR CALENDAR. THE DATE IS MAY
18, AND 19, 1967.
We expect to have an excellent sci-entific
session and social events which
you will thoroughly enjoy. At a later
date, you will receive further announce-ments
about this meeting, giving you a
preview of the program and other
events.
We particularly wish to invite com-mittees,
executive committees, boards
of directors, and examining boards to
hold their spring meeting with us.
This would combine an interesting pub-lic
health meeting with business mat-ters
concerning related public health
fields. If you happen to be a member
of such a committee that can be in-vited
to hold one of their regular
spring sessions during or with the
Western North Carolina Public Health
Association, please advise me immed-iately.
I will certainly contact the chair-man
or president of such a committee
or board and especially invite him to
hold a session of his group with the
WNCPHA Meeting.
Remember-PUT THIS DATE ON
YOUR CALENDAR. The air-conditioned
city in the Land of the Sky is very
beautiful during the month of May.
For your reservations (get them in
early) write to Reservation Manager,
Grove Park Inn, Asheville, North Caro-lina,
28801.
H. W. STEVENS, M. D., CHAIRMAN
LOCAL ARRANGEMENTS
P. O. BOX 7607
ASHEVILLE, NORTH CAROLINA
28807
i
|9S
THE HEALTH BULLETIN February, 1967
Grove Park Inn Welcomes You
Any Time of Year
February, 1967 THE HEALTH BULLETIN
SOUTHERN BRANCH
AMERICAN PUBLIC HEALTH ASSOCIATION
35th Annual Meeting - 1967
Sheraton-Jefferson Hotel
May 10, n, 12 - St. Louis, Missouri
PROGRAM
THEME: REGIONALIZATION FOR PERSONAL HEALTH SERVICES
Wednesday, May 10, 1967
FIRST GENERAL SESSION
9:30 A.M.
Presiding H. P. Hopkins, Ph.D., President
Invocation The Very Reverend William H. Mead
Dean, Christ Church Cathedral, St. Louis
Announcements and Early Business J. Earl Smith, M.D., Commissioner of
Health, St. Louis Division of Health, and Chairman,
Local Arrangements Committee
Greeting C. Howe Eller, M.D., Dr. P. H., Commissioner of Health,
St. Louis County Health Department, and President,
Missouri Public Health Association
Welcome Address L. M. Gamer, M.D., M.P.H., Acting Director,
The Division of Health of Missouri
Greetings from A.P.H.A.
Milton Terris, M.D., President
American Public Health Association
Dr. Terris
10 THE HEALTH BULLETIN February, 1967
Introduction Robert F. Lewis, Ph.D., 1st Vice President
President's Address H. P. Hopkins, Ph.D., President
Introduction _ Albert V. Hardy, M.D., Director, Southern Branch,
APHA, Continuing Education Project
Keynote Address:
"Planning: The Key to Regionalization'
William L. Kissick, M.D.
Director, Office of Program Planning
and Evaluation
Public Health Service
Washington, D. C.
Dr. Kissick
Governing Council Luncheon—Baroque Room 12:15 p.m.
SECTION MEETINGS 2:00-4:30 p.m.
President's Reception—Boulevard Room 6:30-7:30 p.m.
Thursday, May 11, 1967
SECOND GENERAL SESSION
9:30 A.M.
Presiding Charles G. Jordan, B.S.C.E., Secretary-Treasurer
Introduction '. _ John S. Neill, M.D., Chairman, Program Committee
"Regionalization of Environmental Health
Services"
Franklin D. Yoder, M.D., Director of Public
Health, Illinois Dept. of Public Health
Springfield, Illinois
Dr. Yoder
February, 1967 THE HEALTH BULLETIN n
Introduction. Edward M. Campbell, D.D.S.
Co-ChairmaTi, Program Committee
"Regionalizing Clinical Services for Personal Health"
Robert Q. Marston, M.D.
Associate Director, NIH, and Director, Div. of
Regional Medical Programs
National Institutes of Health
Bethesda, Maryland
Dr. Marston
SECTION MEETINGS 2:00-4:30 p.m.
Governing Council Meeting—Baroque Room 5:00 p.m.
Banquet and Dance—Gold Room 7:30 p.m.
Friday, May 12, 1967
THIRD GENERAL SESSION
9:30 A.M.
Presiding H. P. Hopkins, Ph.D., President
APHA Correlative Business Berwyn F. Mattison, M.D.
Frederick W. Hering, M.S.P.H.
i
Business Session:
Committee Reports
Section Reports
Introduction of New Officers
Dr. Mattison
Closing remarks and adjournment H. P. Hopkins, Ph.D.
Executive Committee Meeting Immediately following - Arch Room
12 THE HEALTH BULLETIN February, 1967
"Black Market Medicine"
On May 15, Prentice-Hall will pub-lish
"Black Market Medicine," by Mar-garet
Kreig. It is the chilling and shock-ing
story of hoodlum infiltration into
the drug industry that may be one of
the most widely discussed books of
1967.
"Black Market Medicine" reveals the
heretofore unpublicized multi-million
dollar counterfeit drug racket that
threatens the health of nearly every
person in the United States.
Science reporter Margaret Kreig lit-erally
took her life in her hands to
ride with U. S. Food and Drug Admin-istration
inspectors on the trail of the
vicious gangsters who are polluting the
health stream of America at its very
source.
Mrs. Kreig's first book "Green Medi-cine"
gained national attention as a
best-seller here and abroad. The au-thor
has contributed to This Week,
Reader's Digest, Good Housekeeping,
Mademoiselle and other major national
magazines. She is a member of the
National Association of Science Writers,
and the International Narcotics Enforce-ment
Officers Association.
Aging Population: By 1980, there
will be 24.5 million people in the
United States over the age of 65, the
National Council on the Aging said. In
1966, acording to the Council, the U.
S. had 18.5 million people over age
65.
A Public Health Service official to-day
cautioned people who wear paper
clothing that they risk burning them-selves
if they wear it near an open
flame after it has been laundered, dry
cleaned or worn in a soaking rain.
Dr. Richard E. Marland, Chief of the
Public Health Service's Injury Control
Program within the National Center for
Urban and Industrial Health, said any-one
wearing this new type of garment
should discard it once it becomes soil-ed.
"The manufacturers themselves ac-knowledge
that many of these paper
dresses and other garments lose what-ever
flame retardant finish they have
after washing," Dr. Marland said. "In
fact, we are asking the Bureau of Stand-ards
to test samples of paper clothing
to determine just how resistant these
garments are to fire when they are
new."
Donald B. Perry (left) the Supply and
Service Officer of the State Board of
Health, was presented the Most Out-standing
Service Award for 1966 by
Bryan R. Reep, president of the Pub-lic
Health Academy.
February, 1967 THE HEALTH BULLETIN 13
Continued from Page 7
1965, a report was made on this pro-gram
at the International Union Against
Tuberculosis meeting in Munich, Ger-many.
During this time the number of
cases of tuberculosis had been cut in
half in Halifax County.
Then, in 1960 a new program was
developed in the field of chronic dis-eases
which provides services particu-larly
to stroke patients. This program
was developed in cooperation with the
State Health Department, with a new
position for a public health nurse be-ing
added to the budget of the health
department. Also, a physical therapist
was provided by the State Health De-partment
on a part-time basis to work
with the local personnel. At the pres-ent
time, a program has been develop-ed
with the Department of Physical
Therapy at Duke whereby a physical
therapist visits this county once a
week from that medical center.
Two big research projects were con-ducted
by the health department in
cooperation- with the National Insti-tutes
of Health, investigating an un-usual
eye disease and cleft palate.
Funds were provided for the salary
and travel of a public health nurse
during a two year period.
One of the most important and ex-citing
programs of the decade was be-gun
in January, 1964, when Halifax
County was selected as one of 21 com-munities
throughout the Nation to par-ticipate
in the Community Action-Stu-dies
Project. This project was of three
major programs of the National Com-mission
on Community Health Services.
Dr. Ralph Kilby, who was assigned to
this department by the Army to serve
a year's Residency in Public Health,
served as co-ordinator for this impor-tant
project. Later, when Dr. Kilby's
residency was completed, Mrs. Lois
Batton, one of the public health nurs-es,
continued as the co-ordinator.
Twenty-one leading citizens in the
county served as members of the Hali-fax
County Health Commission, the
local official agency for this study, with
Mr. Paul Johnston of Littleton serving
as chairman. The results of this pro-gram
were reported to the Nation at
the National Health Forum in New
York City in May, 1966. Several ma-jor
community health projects were
recommended for Halifax County by
the locra! commission including, first,
an increase in physicians and other
medical personnel; second, the Human
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
Lenox D. Baker, M.D., President Durham
James S. Raper, M.D., Vice-President Asheville
Ben W. Dawsey, D.V.M. Gastonia
Samuel G. Koonce, Ph.G. Chadbourn
Oscar S. Goodwin, M.D. Apex
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 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, Presonal Health Division
14 THE HEALTH BULLETIN February, 1967
Relations Center; and, third, a Rural
Renewal Project.
Partially, as a result of the detailed
study of the county made during the
Community Action-Studies Project, an
intensive Maternity and Infancy Care
Program was approved for this county
by the Children's Bureau in cooperation
with the State Health Department. The
main objective of this program is to
improve the way of life of the patients
who are eligible for this service and to
produce a more adequate product of
life. Eleven new positions have been
provided the Halifax County Health De-partment
for carrying out this program,
while additional personnel have been
added on the state level including Dr.
John King, pediatrician and project di-rector.
Furthermore, there are 18 consultants
in the various state agencies and at
the Duke Medical Center who assist
with the planning and operation of the
program. The clinics for this program
are staffed by Dr. L. C. McCampbell,
obstetrician, and by Dr. Miles Gregory,
pediatrician, of Roanoke Rapids, and by
residents in obstetrics from the Duke
Medical Center. This service includes in-tensive
prenatal care for medically in-digent
women and a specialized serv-ice
in planned parenthood. Patients with
complications are provided hospitaliza-tion
at either Roanoke Rapids Hos-pital
or the Duke Medical Center.
During 1966, a cooperative program
was developed with the Halifax Coun-ty
School System with funds provided
by the Elementary and Secondary Edu-cation
Act which added four nurses.
Later in the year four additional nurs-es
were added by the cooperative pro-gram
with the Multi-Service Center es-tablished
by the Choanoke Area De-velopment
Association. These eight
nujses are under the direct supervis-ion
of Mrs. Davis Clark, nursing direc-tor
of this department. An additional
servcie added by this Multi-Service Cen-ter
is a bus which provides transpor-tation
for patients attending the vari-ous
clinics operated by the health de-partment.
During 1966, the Halifax County
Health Department was officially ap-proved
as a Home Health Service Ag-ency
to participate in Medicare.
The highlight of the decade came
when the Halifax County Health De-partment
was given the Group Merit
Award by the North Carolina Public
Health Association in 1966. This award
is given to the health department that
is judged by the North Carolina Pub-lic
Health Association as rendering the
most outstanding service in North Ca-rolina
for a given year. The health de-partment
was given the Reynold's
Award in 1951 for outstanding per-formance
and particularly for develop-ing
a new case finding procedure in
tuberculosis control.
In summary, then, the past decade
has been a very rich and rewarding
period for new public health programs
in Halifax County. It is hoped fervent-ly
that these services will not only
add "years to the life", but more hope-fully,
"life to the years" of the citi-zens
in Halifax County,
STATE HEART CONVENTION AT
DURHAM TO FEATURE TOP HEART
SPECIALISTS
Nationally-known authorities on car-diovascular
disease will participate in
the North Carolina Heart Association's
18th Annual Meeting and Scientific
Sessions to be held at the Jack Tar
Hotel in Durham on May 17 and 18.
The Scientific Sessions are designed
to keep North Carolina physicians up
to date on the latest clinical and lab-oratory
findings in the cardiovascular
field.
February, 1967 THE HEALTH BULLETIN 15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
LIBRARIAN
DIVISION OF FIEALTH AFFAIRS
N.C. MEM. HOSP. u. N. C.
CHAPEL liILL, N,C.
If you do NOT wish to con-tinue
receiving The Health Bul-letin,
please check here i—
i
and return this page to '—
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the address above.
Printed by The Graphic Press, Inc., Raleigh, N. C.
Money Making
Ideas at Home
Perhaps you can turn a hobby into
a money making idea, using your own
home as your workshop. Here are some
ideas:
If you have a phone and nice voice
Assurance service—small fee to call
stay-ins daily.
Phone solicitation— notify local
businesses that you will be glad
to do this. Solicit customers for
diaper service, magazine sub-scriptions,
baby sitting, etc.
If you are handy
Fix-it shop— repair household ap-pliances,
watches, clocks, auto-mobiles;
refinish furniture;
wood working; metal working.
If you have business skills
Typewriting and mimeographing
—advertise; contact churches,
clubs, small firms for overload.
Addressing envelopes by hand
and by machine.
Part-time accounting for small
firms.
Employment agency (from home)
Be income tax expert—contact in-individuals
or accounting firms.
If you sew
Dressmaking
Make handmade items in quantity,
such as aprons, potholders,
patchwork quilts, monograms,
hand-loomed mat sets, braided
rugs, hand-knitted baby
clothes, doll clothes, or rag
dolls. Promote your products
through friends, articles in local
paper; exhibit work at fairs,
bazaars, hobby and craft shows.
Contact local stores.
Do Some Checking First
Consult your local library for infor-mation.
Size up your neighborhood
needs. Write for Government Bulletins.
Check any sales products with Better
Business Bureau. Ask Chamber of Com-merce
about license and other proce-dures.
"Your Home Can Be Your Workshop"
DYNAMIC MATURITY
16 THE HEALTH BULLETIN February, 1967
'>Aa>.«^^ l*^^*^
^^'"^
Juanit'o M. Kreps, Ph.D.
of Durham
who presided at the Oilie A. Randall
Award Dinner during the 16th Annual
Meeting of the National Council on the
Aging held in New York this sprirtg. Dr.
Kreps is in the Department of Economics
of Duke University, (see pages 2,8-13)
Jusfice for All Men - Even the Aged
AImighty God, Father of all creation, you constantl^^
confront us — whether in belief or disbelief — and make
us uncomfortable.
You battle and elude the grasp of our finite minds, yet
you never move outside a concern and love for your
creation.
Help us to be concerned.
Give us concern for those who are grown old. Not because
they are old but because they are people — too often
hurt �� whose gifts and strengths are frustrated, by other
people, by frailty of body, by loneness, by poverty, by the
unfulfilled promises of their youth, by uncertainty as to
who they are or — why.
Teach us compassion — wise, persistent compassion.
Give us a passion Lord for justice, for all men — even
the aged.
Make us instruments of justice that in this great land
they may enjoy thy bounty and the labors of their hands,
to live secure, to have opportunity by right to live with
dignity and to die with dignity, to be persons of worth, not
cowering as un-persons without hope.
Give us a passion Lord for justice.
Dedicate us Lord: in the pattern of those who have given
so much and done so much to bring some shining rays of
hope to those grown old — They are leaders, persons of
sensitive, generous, soaring spirit, unflagging zeal for ser-vice,
often indignant, outraged at injustice, enriching us
all with a deeper sense of compassion and justice.
In honoring them tonight, let their achievements be our
continuing inspiration.
Dedicate us Lord — grant us grace to press for those
things that are riaht and just in service to you who art
eternal — Lord of Lords.
Invocation delivered at the 1967 OIlie Randall Award Dinner in
New York, Sixteenth Annual Meeting of National Council on the
Aging, by Harold W. Reisch, Secretary for Special Ministries of
the Board of Social Ministry, Lutheran Church in America.
2 THE HEALTH BULLETIN March, 1967
GOVERNOR MOORE PROCLAIMS SENIOR CITIZENS MONTH
North Carolina's Governor presents to former Senator Roy Rowe a proclamation
designating MAY as Senior Citizens Month. Rowe, second from left, is Chairman
of the Governor's Coordinating Council on Aging. Many activities are being carried
on in May honoring the older citizens of the State. Also in the picture are Dr. John
S. Rhodes, Chairman of Senior Citizens Month for the Council, at left; and J. Eddie
Brown, Executive Director of the Council, at right. Dr. Rhodes, the Chairman for
Senior Citizens Month, is a former member of the State Board of Health and a past
President of the Medical Society of the State of North Carolina.
March, 1967 THE HEALTH BULLETIN
Rheumatic Fever
Accounts for Much
Heart Disease in Children
Rheumatic fever is said to account
for much of the heart disease found in
children and young adults.
Rheumatic fever usually occurs be-tween
the ages of 5 and 15, although
adults can have it. It may affect any
part of the body temporarily, but
damage to the heart, which can be
long lasting, is the greatest danger.
Rheumatic heart disease results from
the scarring of the heart muscle and
valves by rheumatic fever. This may in-terfere
with the vital work of the heart.
Many patients recover without perma-nent
injury to the heart valves, but the
disease has a way of repeaing itself
and each attack renews the chances of
heart damage.
Rheumatic fever Is preceded by a
streptococcal infection such as strep
sore throat, scarlet fever or a strep ear
infection. It can be prevented by treat-ing
the strep infection promptly and
thoroughly with antibiotics. Because
persons who have had rheumatic fever
are susceptible rather than immune
to repeat attacks, long-term preventive
treatment is often prescribed for them.
Regular doses of penicillin, under the
direction of a physician, can prevent
further strep infections and thus ward
off subsequent attacks of rheumatic
fever.
You can protect your child against
rheumatic fever by consulting your doc-tor
if the child develops a sudden, se-vere
sore throat, or if he has been
exposed to someone with scarlet fever
or another strep infection.
A computer system that picks up in-audible
speech changes in persons with
early neurological disease and gives an
immediate warning of their condition
is now under development by the Pub-lic
Health Service's National Center for
Chronic Disease Control.
The system is scheduled to be ready
for use in multi-phasic disease-detection
programs in three years. It will spot
neurological disorders before other
symptoms are evident.
The first case of poliomyelitis to oc-cur
in New York City since 1964 has
been reported.
The case is that of a 31 year old
man who had a Salk vaccine series of
injections ending five years ago. His
wife and infant have been, or are in
the process of, being immunized.
The Health Bulletin
First Published—April 1886
The official publication of the North Carolina State
Board of Health, 608 Cooper Memorial Health Build-ing,
225 North McDowell Street, Raleigh. N. C. Pub-lished
monthly. Second Class Postage paid at Raleigh,
N. C. Sent free upon request.
EDITORIAL BOARD
Charles M. Cameron. Jr.. M.D.. M.P.H.
Chapel Hill
John C. Lumsden, B.C. HE.
Jacob Koomen, Jr., M.D.. M.P.H.
Bryan Reep. M.S.
John Andrews, B.S.
Glenn A, Flinchum, B.S.
H. W. Stevens. M.D.. M.P.H., Ashevlle
Editcr-Edwin S, Preston, M.A., Ll.D.
Vol. 82 March, 1967 No. 3
THE HEALTH BULLETIN March, 1967
A Message By Acting Secretary
Of Commerce Alexander B. Trowbridge
Humanpower is a most precious resource. The waste of the tal-ents
of 19 million Americans aged 65 and over is indefensible at a
time when talent is in premium demand, when only one in five sen-ior
citizens has a job, when five million elderly live below the pov-erty
level, and when our senior population is growing at a rate of
almost 4000 a day.
Many people think of us as a Nation of youth. It is true our youth
population is growing. But our over-65 population is also growing —and, thanks to the increase in human knowledge, living longer.
In the last half century our older population has more than dou-bled.
By 1985 we likely will have 25 million Americans 65 and over,
and by the year 2000, more than 28 million. A busy, productive Na-tion
—"a Nation on the move" as President Johnson has called it —cannot afford to waste this important reservoir of talent. It must
not cast by the wayside any segment of our population because of
the stigma of "overage."
Ability has no age. We must not deny opportunity to those who wish
to fill a productive role in our society. This may even include having
jobs created for them, and providing facilities, where needed, for their
retraining to meet work requirements of the technological age.
The theme of Senior Citizens Month 1967 is "Meeting the Challenge
of the Later Years". The talents, skills, and experience of our senior
citizens have helped shape our country, make our economy strong, and
give us the highest standard of living in the world. We need now and
will need in years to come the example of their patience, stability,
loyalty, and wisdom.
This is the challenge "of the later years" that faces not only the
older American but the Nation as a whole.
March, 1967 THE HEALTH BULLETIN 5
MAY IS BEING OBSERVED
AS SENIOR CITIZENS MONTH
Theme: "Meeting The Challenge of the Later Years"
Dr. John S. Rhodes, Vice Chairman, N. C. Governor's Coordinating
Council on Aging and Chairman of N. C. Senior Citizens
Month in North Carolina.
Activities:
The North Carolina Senior Citizens Convention in Greensboro
—
May 5th and 6th—Sponsored by N. C. Recreation Society.
Visitation Days to Shut-ins—Hospitals
Nursing Homes
Private Homes
Open Houses—Welfare Departments
V. A. Hospitals
Nursing Homes
Senior Citizens Centers
Housing for the Elderly
Trips— Bus Trips
Train Trips
Religious— Sermons at Churches
Social Activities—
Craft Fairs
Hobby Fairs
Fashion Shows
Dinners
Luncheons
Theater Parties
Baseball Games
Picnics, etc.
6 THE HEALTH BULLETIN March, 1967
Dr. Scurletis
Appoinf-ed
Director of
Personal Health
Division
Dr. Jacob Koomen, State Health Di-rector,
announced the appointment on
March 21st of Theodore S. D. Scurletis,
M.D., as the new director of the Per-sonal
Health Division of the State Board
of Health. Dr. Scurletis had been serv-ing
as Acting Director of this Division
since the death of Dr. James F. Donnel-ly
last summer.
The Personal Health Division, one of
the seven divisions in the administra-tive
structure of the Board, includes
responsibility for Medicare, Maternal
and Child Health, Chronic Disease, Crip-pled
Children, the Medical Referral pro-gram
for rejected draftees. Nutrition,
and Nursing Home Licensing.
Dr. Scurletis v/as born in Pittsburgh,
Pa., and received his B. S. and M.D.
degrees from the University of Pitts-burgh.
After receiving his medical de-gree
from the School of Medicine, Dr.
Scurletis served his internship at Pitts-burgh
Hospital. The University con-tinued
him as instructor while for six
years he was in private practice in
pediatrics in Pittsburgh^
In 1961 Dr. Scurletis came to the
State Board of Health as Pediatric
Consultant in the Personal Health Di-vision
and in 1963 was named Chief of
the Maternal and Child Health Section.
Upon the death of Dr. James F. Don-nelly
last June, he was appointed as
Acting Director of the Personal Health
Division.
Active in the Cerebral Palsy Associ-ation,
the Association for Retarded
Children and various medical organiza-tions.
Dr. Scurletis makes a civic con-tribution
beyond his professional duties.
He married Christine Harrison in 1963
and they have two children, a boy
and a girl.
Dr. Theodore D. Scurletis (center) was
appointed in March as Director of the
Personal Health Division by Dr. Jacob
Koomen (right) State Health Director.
Dr. John T. King (left) was named chief
of the Maternal and Child Health Sec-tion.
March, 1967 THE HEALTH BULLETIN
One of the concurrent- sessions during the T6th An-nual
Meeting of the Notional Council on the Aging
meeting in New York this Spring.
TH€ HEALTH BULLETIN March, 1967
Secretary of Labor, W. Willard Wirtz (leff) accept-ing
on behalf of President Johnson the OIlie A. Randall
Award of the National Council on the Aging for Dis-tinguished
Service to Older People.
March, 1967 THE HEALTH BULLETIN
North Carolina's Senior Citizens
NORTH CAROLINA
DEMOGRAPHY
Over 65
In 1950 226,it25 persons 65 and older
S-i>% of population
In 1966 S'tg.OSS persons 65 and older
7.2^ of popul at ion
In 1980 502,413 persons 65 and older
In 2000 655,7'tl persons 65 and older
Over 75
In 1950 65,000 persons 75 and over
In i960 97,215 persons 75 and over
15,14't over 85
In 1980 180,977 persons 75 and over
Men to Women (age 65 & over)
1955 122 women to 100 men
i960 126 women to 100 men
1966 131 women to 100 men
2000 1^3 women to 100 men
Longev i ty
In 1949"1951 Life expectancy at 65 v/hite males 13-1 years
Life expectancy at 65 white females 15-'* years
Life expectancy at 65 nonwhite males 13-'* years
Life expectancy at 65 nonwhite females 15-'* years
In 1959-1961 Life expectancy at 65 white males 13-1 years
Life expectancy at 65 white females 16. 1 years
Life expectancy at 65 nonwhite males 12.5 years
Life expectancy at 65 nonwhite females I'*. 7 years
10 THE HEALTH BULLETIN March, 1967
Senior Citizens in the United States
(next three pages)
FACT SHEET
SUMMARY FROM 15 YEAR APPRAISAL
DEMOGRAPHY
OVER 65
In 1950 12,269,637 persons 65 and older
In U.S. 8.1/^ of population
In 1966 18,500,000 persons 65 and older
9'^i> of population
In 1980 2l+, 500,000 persons 65 and over
In 2000 26,000,000 persons 65 and over
OVER 75
In 1950 3,85^,000 persons 75 and over
In i960 5,562,500 persons 75 and over
nearly 1 Million over 85
In 1980 9,382,000 over 75
t4EN TO V/0I4EM
1955 115 women to 100 men
i960 121 women to 100 men
1966 129 women to 100 men
2000 II+8 women to 100 men
STATE DISTRIBUTION
1950 Only New York had more than 1 million
i960 New York, Pennsylvania, California had more than 1 million
1965 New Yorl:, Pennsylvania, California and Illinois had more
than 1 million
1965 One-third of all over 65 lived in 1 of U states; New York,
California, Pennsylvania or Illinois
1985 New York and California over 2 million
Florida, Illinois, Ohio, Pennsylvania and Texas; over 1
million.
1950 New Hampshire 10. 8^0 over 65 (highest
)
1965 Iowa 12.5fo over 65 (highest)
LONGEVITY
In 1950 Life expectancy at 65 men 12.8 years
Life expectancy at 65 women 15 years
In i960 Life expectancy at 65 men 12.9 years
Life expectancy at 65 women 16 years
(Note: 1 entire year for women)
March, 1967 THE HEALTH BULLETIN 11
Older vorl'.or defined as over k')
196'+ 5*5 million over h^ in population
29 million in work force
1980 66 million in population
3^+ million in work force
(Mostly in U5-6U age group. Over 65 only about ^00,000 of increase
of 5 million between 1964 and I980.
)
SOCIAL SECURITY
1950 2,600,000 over 65 receiving benefits
1966 15,328,000 over 65 i-eceiving benefits
2,000,000 between 62 and 65 receiving benefits
1950 average monthlybenef it for workers h'i,86
average monthlybenef it for v/idows 36.5^
1965 average monthlybenef it for workers 83.92
average monthlybenef it for v/idows 73.75
Between 195*+ and I965 wages increased by ^9.3^/0 - cost of living
2l,9fo - Social Security benefits llj-.l^c.
OLD AGE ASSISTANCE
1950 About 25^ (3 million) receiving OAA averaging $^+3 per month
(from $18 per month in Mississippi to $70 in Connecticut)
1967 About 11^4 (2 million) receiving OAA averaging $39.20 per month
in Mississippi to $102 in California.
MINORITY GROUPS
NEGROES
Life expectancy at birth 7-8 years less than whites.
INDIANS
Avei-age age at death ^3.
HOUSING
1950 Q.k'fo of all over 65 lived in dilapidated housing.
i960 19^ of all units occupied by elderly dilapidated.
i960 Cornell University estimate ky/, living in unsuitable housing -
h^ million units needed to overcome shortage and provide ap-propriate
housing.
1950-1965 310,000 units of special housing for aged built.
Nearly 66'^ of those over 65 ovm Lheir own homes, about 1+0'^ over
50 years old, 80^ over 30 yeai's old.
12 THE HEALTH BULLETIN March, 1967
racoME
1950
1965
1965
77^j over 65 had incomes less than $1000. per year.
Median income for unrelated individuals $6U6. per year.
Median income for familieG i/ith head over 65 $1903. per year.
One-thix'd unrelated individual's Incomes less than $1000. per year
Tliree-fifths unrelated individuals less than $1500 per year.
One-fourth of families vith head over 65 less than $2000. per year.
T^/o-fifths of families uith head over 65 less than $3000. per year.
(Note: Poverty definitions $1500 for individuals.
$1850 for couple.
)
31/f of all aged living in poverty by government definition.
Half of aged widov;s and non-married women less than $1000.
3^3 had incomes of over $10,000.
As aggregate persons over 65 represent a i+0 billion dollar consumer
market.
RETIREI.ffiNT INCOME
If Bureau of Labor ."Statistics "modest but adequate" budget ($l800
for individual and $2500 for retired couple) is accepted as
standard, 2 million retired couples and 6 million unattached re-tired
persons do not have adequate standard of living.
SOURCES OF INCOME
1950 i960
Emplojinent
Social Insurance (mostly OASI)
Old Age Assistance
Private Pensions
3lf^
Are You
Immunized
Against
'Xockjaw'?
With the advent of the spring sea-son
of 1967 most of us are beginning
to get out of doors again. There are
gardens and lawns that need work and
outdoor chores of all sorts that have
accumulated during the winter.
With the return of outdoor activities
comes once again the hazard of minor
accidents, cuts and scratches. Most often
these aren't serious and will heal quick-ly
if properly cleaned and protected.
But sometimes these little scratches
can be more serious. Sometimes they
are the channel through which you
could get tetanus (lockjaw).
Tetanus-producing spores lie dor-mant
in the soil of your garden, the
dirt of your garage, and the dust in-side
your house. These spores can in-fect
you through the tiniest wound—
a
pin scratch, a bee sting or a small cut,
says a pamphlet of the American Medi-cal
Association.
Tetanus spores may remain in your
body for long periods without produc-ing
the disease. Or, they may produce
poison effects in five to fourteen days,
even though the wound has healed.
First signs of tetanus are irritability
and restlessness. Muscles rapidly be-come
rigid, eventually causing a
clenched-jaw leer that gives tetanus its
nickname—lockjaw.
When symptoms appear, the outlook
is grim, even with the best treatment.
To avoid the deadly consequences, be
sure you are immunized with tetanus
toxoid. When you are immunized, your
body manufactures antibodies that will
fight tetanus toxin. A booster is need-ed
every ten years and whenever you
are injured.
If you aren't protected, in an emerg-ency
there is no time for immuniza-tion.
If you have no built-in immunity,
your physician may inject tetanus anti-toxin.
An emergency shot, however, is
not always effective.
Your only long-range guarantee
against tetanus is immunization with
tetanus toxoid. Only one of every four
Americans has this protection. Have
you? — American Medical Association.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
Lenox D. Baker, M.D., President Durham
James S. Raper, M.D., Vice-President Asheville
Ben W. Dawsev, D.V.M. Gastonia
Samuel G. Koonce, Ph.G. Chadbourn
Oscar S. Goodwin, M.D. Apex
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pines
J. M. Lackey Rt. 2, Hiddenlte
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. j 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 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. Srurletis, M.D. Director, Presonal Health Division
THE HEALTH BULLETIN March, 1967
PROGRAM OUTLINE
EASTERN DISTRICT, N. C. PUBLIC HEALTH
ASSOCIATION AT THE CAROLINIAN,
NAGS HEAD — MAY 25-26
THEME: Public Health and The Public
Thursday May 25
1:00-5:00 P.M. Registration
4:00 P.M. Business Meeting
Tag Along Welcoming Coffee
6:00 P.M. Social hour
7:00 P.M. FIRST GENERAL SESSION
Banquet—Informal Buffet
Dance
Fridav May 26
7:00-8-.?0 A.M. Breakfast
8:00-9:00 A.M. Ref?istration
9:00 A.M. SECOND GENERAL SESSION
Presiding: Dr. Melvin F. Everman. President
"Sarah Wilson"
Panel: Dr. Ralph Boatman. Moderator
Miss Sarah Goggins
Mrs. Jean Lassiter
Mr. William Shaw
Dr. Karl Van Horn
12:00 Noon Lunch
1:30-3:30 P.M. SECTION MEETINGS
Public Health Nurses—Anchor Room
Presiding: Mrs. Rose Pugh
Speaker: Miss Virginia Nelson. Department of Public Health
Nursing, School of Public Health
Subject: Team Nursing
Joint Session—Sanitarians and Health Directors—Cypress Rooom
Presiding: A. K. Glover
Business
Speaker: Charles J. McCotter
Subject: Salt Marsh and Fresh Water Mosquito Control
Secretarial—Statistical Section
—
Gaily Room
Presiding: Mrs. Louise B. Barber
Speaker: Dr. Lynn G. Maddrey, Chief Laboratory Division,
State Board of Health
3:30 P.M. THIRD GENERAL SESSION
Section Reports—Section Officers 1968
Door Prizes
Adjournment
March, 1967 THE HEALTH BULLETIN 15
BX. 2^9
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Raleigh, N. C. 27602
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DATES AND EVENTS
May, 1967 sions, William Hilton Inn, Hilton Head
May 15-16 — National Public Relations Island, S. C.
Institute, Palmer House, Chicago, III. June, 1967
May 17-19 — 37th Annual State-wide June 4-8 — Public Health Symposium on
Industrial Safety Conference, Wins- Program Planning, Philadelphia, Pa.
ton-Salem.
May 18-19 — Western North Carolina
Public Health Association, Grove Park
Inn, Asheville.
May 20-24 - State Medical Society
Meeting, Pinehurst.
May 21 — National Tuberculosis Asso-ciation
Meeting, Pittsburgh, Pa.
May 21-26 — National Conference on
Social Welfare, Dallas, Texas.
May 24 — Conjoint Session of State
Board of Health and Medical Society
of the State of North Carolina, Pine-hurst.
May 25-26 — Eastern North Carolina
Public Health Association, Carolinian
Hotel, Nags Head.
May 26-28 — S. C. Heart Association-
Annual Meeting and Scientific Ses-
June 4-9 — American Water Works As-sociation,
Atlantic City, N. J.
June 11-15 — Air Pollution Control As-sociation,
Cleveland, Ohio.
June 16-17 — American Geriatric So-ciety,
Claridge Hotel, Atlantic City.
June 18-22 — American Medical Asso-ciation
(Annual), Atlantic City, N. J.
June 25-29 — American Society of Med-ical
Technologists, Miami Beach, Fla.
June 25-29—American Veterinary Med-ical
Association, Nev^ Orleans, La.
June 12-16 - Mental Health Workshop,
Pisgah View Ranch, Candler, N. C.
July, 1967
July 2-7 — American Physical Therapy
Association, Miami Beach, Fla.
July 10-13 - Institute: Tuberculosis and
Other Respiratory Diseases (Blue
Ridge Assembly), Black Mountain.
16 THE HEALTH BULLETIN March, 1967
The Officiar Publication Of T
V^V^,^^ Oi^..-^
' UT fifCf/VED
^^L 12 1^57
GOVERNOR DAN K. MOORE is presented a printed copy of the proceedings of
the most successful meeting of the Governor's Conference on Child Abuse which
was held late last year. An attendance of over 650 persons representing many
disciplines working in private, voluntary and public areas attested to the wide
interest and the quality of the program. In the picture taken in the Governor's
Office are (from the left): Dr. Jacob Koomen, State Health Director; Dr. T. D.
Scurletis, Chairman of the Coordinating Committee on Special Needs of the
N. C. Health Council; Governor Moore; and E. N. Herndon, President of the
N. C. Health Council.
Two Percent of Nation's
Counties Hold Key
To Reduce Infant Mortality
More than 30,000 infants a year
might have lived to maturity if each
of the nation's 3,130 counties had
achieved the 18.3 per 1,000 live births
infant mortality rate that 10 per cent
of the counties reached.
This is shown by a county-by-county
study of infant mortality for the period
1956-60 by the Children's Bureau, Wel-fare
Administration, Department of
Health, Education, and Welfare.
The study shows that less than 2
percent (56) of the nation's counties
hold the key to any successful effort to
sharply reduce the nation's infant mor-tality
rate. A third of the deaths over
the 18.3 rate achieved by counties with
the best infant mortality rates occur-red
in these 56 counties, which con-tain
nearly all the densely populated
urban areas in the nation.
Among the 56 counties, the study
found that in 21 of the most populated
areas, including the ten largest cities,
the average per year per city excess
of infant deaths over the 18.3 rate
was 400.
With this knowledge, the Children's
Bureau is focusing its special project
grants for maternity and infant care
on "high risk" mothers-to-be from the
low-income neighborhoods in these key
areas.
The projects were authorized under
the 1963 Maternal and Child Health
and Mental Retardation Planning
Amendments and now number 53. Al-most
200,000 maternity cases have
been served in the projects, most of
them considered "high risk."
"It is among these maternity cases
that studies show the highest rate of
low birth weight infants being born.
almost three times the national aver-age.
Babies born to these mothers also
have the highest infant mortality rates,"
said Dr. Arthur J. Lesser, Deputy Chief
of the Children's Bureau.
"Reports from these projects indi-cate
that they may be having a signi-ficant
effect on infant mortality rates,"
Dr. Lesser continued. "In Chicago, for
example, among 14,380 infants born
in census tracts served by the program
in 1965, the infant mortality rate was
34.5 while among 9,044 births in si-milar
low-income census tracts without
the program, the infant mortality rate
was 57.4."
"Although we are extremely pleased
with the results reported so far to the
Children' Bureau from these special pro-jects,"
Dr. Lesser said, "We know that
much more must be done. These special
projects are only part of a whole struc-ture
of services and programs— includ-ing
medical care, housing, nutrition,
better education and communication,
adequate maintenance, and social wel-fare
services—which must be made
available if we are to make any real
reduction in the rate of infant mor-tality
and of premature births."
Cigaret Testing: The Federal Trade
Commission will begin testing cigarets
for tar and nicotine content within the
next two months, FTC Chairman Paul
Rand Dixon told the House Commerce
Committee. He said the agency has
received excellent cooperation from
the tobacco industry.
Scientists at Tufts University, Med-ford,
Massachusetts, will study the ad-vantages
to the driver of using con-vex
rear-view mirrors and other new
types of rear-view display systems in
an automobile instead of the conven-tional
flat mirror.
THE HEALTH BULLETIN April, 1967
Brains
Across
The Sea
by
Ronald Schiller
Reprinted ivith permission from the
March 1967 Reader's Digest. Copyright
1967 by The Reader's Digest Assn., Inc.
If the United States continues to si-phon
off the best scientific talent from
other countries, the world, sadly out
of balance, may become yet more un-evenly
divided. A dilemma looking
for a solution.
If you are admitted as an emergency
patient to a hospital in Delav^are, New
Jersey, North Dakota or West Virginia,
chances are that you will not be treated
by an American doctor. Over half of
the resident physicians in the accredit-ed
hospitals of those states are foreign-ers
who earned their medical degrees
abroad. In certain hospitals in Illinois,
Maryland, New York and Rhode Island,
you might never even see an American
doctor.
Throughout the United States, 28 per-cent
of all medical internships and resi-dencies
are filled by foreigners—and
a lucky thing for us. Each year our
hospitals need 5500 more physicians
than our medical schools graduate.
Some 11,000 foreign interns and
residents are now serving our nation's
hospitals. Officially, they are here to
further their medical education and to
gain experience that will serve them
when they return to their own coun-tries.
Actually, at least 25 percent of
them end up living here permanently.
Of the physicians admitted to practice
here last year, 1488—almost 17 percent
—were foreigners. To replace them, we
would need 15 new medical teaching
centers, which would cost some $1
billion to build, plus at least $100 mil-lion
a year to operate. This consider-ably
exceeds the medical assistance
that we now dispense to the rest of the
world.
"In effect," says Sen. Walter F. Mon-dale
of Minnesota, "the richest nation
on earth is being subsidized by the
poorer nations."
Particularly disturbing is the fact that
almost 80 percent of our foreign phy-sicians
come from developing nations
whose medical needs are vastly greater
than ours—from India, Pakistan and
Thailand, where there is one physician
per 5000 to 9000 of the population;
from the Philippines, Turkey, Colombia
and Peru, where each doctor serves an
average of 2000 to 3000 people. In
1963, South Korea, half of whose coun-ties
do not boast a single physician,
sent us 207 medical graduates.
Moreover, our importation of phy-sicians
is accelerating. Each year some
18,000 medical graduates throughout
the world pay to take the day-long ex-aminations—
administered twice yearly—
which qualify them to practice in the
United States. Approximately 7000 doc-tors
pass the tests every year, repre-senting
a reservoir of talent that we
can call upon.
April, 1967 THE HEALTH BULLETIN
Widening the Gap. Physicians repre-sent
only one wave in a massive tide
of skilled professionals now sweeping
from the poorer to the richer coun-tries.
The demand for educated talent
among the most advanced Free World
nations is spiraling upward at a rate
faster than all of their fast-growing
universities can meet it, either now or
in the foreseeable future. Thus, last
year alone, the United States wel-comed
5479 graduate engineers and
scientists, 5164 teachers and profes-sors,
1623 accountants, 4247 nurses,
2552 technicians, and tens of thousands
of others with advanced training. These
were permanent immigrants; others en-tered
on working visas.
This "brain drain" has become a
source of increasing anxiety through-out
the world. Ultimately it poses a
threat to world peace. For without
substantial resources of trained and
educated manpower everywhere, the
gap between the rich and poor nations
cannot be narrowed. "Regions failing
intellectually," states scientist Lloyd V.
Berkner, "will remain chronically poor,
in colonial status to more advanced na-tions."
The irony is that no other country
approaches the United States in the
amount of effort and money spent to
educate the people of the developing
nations. Approximately 100,000 stu-dents
come to U. S. universities for ad-vanced
training every year—to be edu-cated
for service in their own coun-tries.
But an estimated 90 percent of
the Asian students, 50 percent of those
from the Near East, Greece and Egypt,
and large proportions from Africa and
Latin America never return home.
Further, by eliminating national quo-tas
and giving piority to professionals,
the U. S. Immigration Act of 1965,
whose commendable purpose was to
end discrimination based on race or
national origin, had the unforeseen ef-fect
of accelerating the brain drain.
The year the new law went into effect,
the number of professionals immigrat-ing
from India jumped from 54 to
1750; from South Korea, from 51 to
400. The influx cancels out the effec-tiveness
of our foreign-aid, technical-assistance
programs.
Put and Take. The United States is
not the only beneficiary of the world-wide
braindrain, nor are the poorer
countries its exclusive victims. Nor-way,
Switzerland, Italy, the Netherlands
and West Germany have been heavy
losers in Europe. In actual numbers,
however, no country has suffered more
than Great Britian. British newspapers
and professional journals blaze with
advertisements from U.S., Canadian,
New Zealand and Australian companies
seeking specialists of every kind. U.S.
firms offer "transportation costs . . .
advanced study in your field . . . op-portunities
for speedy advancement,"
and salaries usually double those that
can be earned in Britain.
In 1964 alone, 5900 British teach-
The Health Bulletin
First Published—April 1886
The official publication of the North Carolina State
Board of Health, 608 Cooper Memorial Health Build-insT,
225 North McDowell Street, Raleigh, N. C. Pub-lished
monthly. Second Class Postage paid at Raleigh,
N. C. Sent free upon request.
EDITORIAL BOARD
Charles M. Cameron. Jr., M.D.. MP H.
Chapel Hill
John C. Lumsden, B CHE.
Jacob Koomen, Jr.. M.D., M.P.H.
Bryan Reep, MS.
John Andrews, B.S.
Glenn A. Flinchum. B S.
H. W. Stevens, M D,, M P H.. Ashevlle
Editor—Edwin S. Preston, M.A., LL,D.
Vol. 82 April, 1967 No. 4
THE HEALTH BULLETIN April, 1967
ers, 4400 nurses, 4200 engineers and
1200 physicians—equivalent to 40 per-cent
of that year's graduates—emigrat-ed.
But sympathy for the nation's
plight is tempered by the fact that in
the same year, Britian acquired 3300
teachers, 1600 engnieers, 1300 nurses
and 300 physicians from less privileged
nations. A startling 40 percent of the
medical personnel serving in the British
National Health Service came from
such areas as Pakistan, India and the
West Indies.
Similarly, France has received more
professors and physicians from her
former colony, the new African nation
of Togo, than she has sent to that
country. France also provides employ-ment
to an estimated 3500 university-trained
South Vietnamese, who are
desperately needed in their own hard-pressed
nation. To compensate for the
flight of their own technologists, the
nations of Western Europe employ more
scientists and engineers from Turkey
and the Arab nations than do their own
countries. And Canada, which lost 920
engineers to the United States in 1964,
admitted 2000 from abroad that year,
including many hired sight unseen
from Spain and Argentina.
Skimming the Cream. More signific-ant
than the quantity is the quality of
the professionals who migrate. "Every
country is short of the brightest people
because God didn't make enough," says
Harry S. Hoff, consultant to the United
Kingdom Atomic Energy Authority. But
it is these very people who are lured
away.
British science will not easily re-place
38-year-old medical reseacher
Ian Bush, who in 1964 left for the
Worcester (Mass.) Foundation for Med-ical
Research with his entire staff of
scientists and technicians. The Japanese
electronic industry suffered an equally
severe setback when Dr. Leo Esaki,
developer of electronic devices used
throughout the world, took a job with
a U.S. firm.
No nation can afford the continual
loss of its most brilliant and productive
minds without suffering severe eco-nomic
consequences. The effect of such
loss on the less developed countries
amounts to "a national catastrophe," in
the words of Charles V. Kidd, President
Johnson's scientific adviser. Many of the
nations of the world are so short of
trained manpower that a university de-partment
may be forced to close when
a professor leaves, children go untaught
when a teacher moves, and thousands
be deprived of medical atention when
a physician migrates. Further, in emerg-ing
nations the professionals contitute
that sliver of the population which pro-vides
leadership. They are the catalytic
agents for improvement without whom
the nation stagnates.
Farewell With Regret. A major moti-vation
in the flight of talent is the
desire for an adequate income. "The
scientist is enabled to study thanks to
the efforts of all his countrymen—farm-ers,
laborers and intellectuals alike,"
Bernardo Houssay, Nobel Prize-winning
biologist, reminded his fellow Argen-tinians.
"He owes it to them to repay
that debt." But the 206 scientists who
left Argentina last year—some of whom
earned less than $2000 annually—felt
they could not afford to heed his plea.
An Italian mfcrobiologist at Massa-chusetts
Institute of Technology wrote
his sponsors in anguish to explain why
he was breaking his promise to return
home: "I do not expect to live in
luxury, but at 32, with two degrees, !
cannot live even decently on the $290
a month offered me in Italy." "I love
Britain, and would like to stay," was
the comment of a 40-year-old heart
surgeon to official pleas that he remain.
"But Britain won't afford to keep me."
April, 1967 THE HEALTH BULLETIN
Yet these countries are not so impov-erished
that they cannot provide a bet-ter
living for their professionals.
A second reason for leaving is the
difference in working facilities. "Al-though
my salary will be doubled,"
said Dr. John Raison, a leader in re-search
on the heart-lung machine, "that
is not the reason I am leaving England.
I have 20 years more work ahead of me
which I cannot do with the facilities
avaliable in Britian." A senior Italian
physicist says, "I myself encourage
young scientists to go. There is nothing
for them to work with here." Yet, he
observes, Italy has the funds; what it
lacks is a belief in the importance of
research.
In several emerging nations, the
problem is underemployment of pro-fessionals.
The enthusiasm with which
governments plunge into ambitious ed-ucational
programs backfires when they
neglect related industrial development.
Jobless engineering graduates of Sud-an's
Khartum University came close to
rioting because there was nothing for
them to engineer. It is estimated that
40 percent of Burma's scientists and en-gineers
cannot find jobs in their pro-fessions,
nor can 35,000 university
graduates in the Philippines. Comments
a Yale University graduate dean: "I find
it difficult to advise an engineer from
India, who is offered a $1 0,000-a-year
job here or in Canada, to go back to his
country where he may be a clerk-typist
for the next ten years."
Imperative: Close the Gap. A drastic
ban on migration or foreign study
would, in effect, be a Western version
of the Berlin Wall. But U.S. agencies
are now making efforts to reduce the
number of foreign students allowed to
remain here after completion of train-ing.
These agencies are also trying to
persuade industry, universities and
hospitals to modify their recruitment
efforts abroad. Another step would be
for foreign countries to require students
to concentrate on courses vital to their
homelands; and to have adequately-paid
jobs waiting for them, permitting
them to make use of the skills acquir-ed.
President Lyndon Johnson has ad-vocated
that we help build multination-al
institutions for advanced training in
science and technology— in South Am-erica,
Africa and Asia—so that fewer
students will have to go to advanced
nations to study. Brazil and Uruguay
have already earmarked funds for the
project. Senator AAondale has urged
that U.S. aid organizations spend more
of their money on projects specifically
designed to use the talents of unem-ployed
professionals abroad.
U.S. private industry is beginning to
establish some of its engineering and
scientific research facilities in Europe
and the Middle East to take advantage
of surpluses of trained manpower there.
This arrangement stands to benefit
everybody. The U.S. company gets re-search
findings; the home country gets
the investment and the salaries paid,
plus the increase in knowledge and
skill acquired by the professionals.
Most important, these professionals are
not lost to their homelands: they may
well be re-employed by local industries
when needed.
"World security, and American secur-ity,
depend on development of the less
privileged countries at sufficient speed
to satisfy at least a portion of their na-tional
aspirations," says Secretary of De-fense
Robert McNamara. If the most
talented members of the poor nations
continue to be absorbed by the rich
societies, we shall never begin to close
the gap that finds the per capita in-come
at $3000 a year in America, while
in more than half of the rest of the
world it averages only $120.
THE HEALTH BULLETIN April, 1967
Day Care Health
Needs Information
Now Available
Detailed information about the health
needs of children in day care is avail-able
for the first tinne in a new pub-lication
of the Children's Bureau, Wel-fare
Administration, Department of
Health, Education, and Welfare.
In announcing the publication, "Chil-dren
in Day Care—with focus on
health," Mrs. Katherine B. Oettinger,
Chief of the Children's Bureau, said to-day,
"A number of excellent textbooks
and pamphlets have been written on
child health in general, but never
before has it been studied specifically
for the child in day care."
Written by Mrs. Laura Dittman of
the Committee on Day Care, Maternal
and Chlid Health Section, American
Public Health Association, the pamph-let
makes it clear that in order to as-sure
comprehensive health care for
each child in a day care program, a
complete picture of that child and his
environment must be obtained. Every
aspect, geographical, socioeconomic,
and physical, which might influence his
development must be considered when
outlining a health plan for him. "Chil-dren
in Day Care," therefore, studies
the special needs of different ages and
groups of children and relates them
to day care.
For example:
—Since an infant is particularly vul-nerable
to infection and disease,
day care workers should check with
the child's parents to make sure
he has received proper preventive
medication including immunization.
—A child's third and fourth years
are crucial in arresting permanent
dental, hearing, and visual defects.
Professional screening should
therefore be an integral part of
every day care program for pre-schoolers.
—Special precautions should be taken
to prevent accidents in a day time
program which cares for children
of school age, for accidents are the
largest single cause of death among
school age children.
—A handicapped child must be given
every opportunity to care for him-self.
Such normally routine activi-ties
as eating, dressing, toileting,
and washing can be of great value
to such a child as physical, mental,
and emotional therapy.
—The child of migrant workers will
require particularly strict nutritional
supervision while in day care. His
regular diet usually consists of
hastily prepared foods, low in nu-tritional
value, and varies as his
parents follow the crops.
Copies of the publication may be
purchased for 50(Zl each from the Su-perintendent
of Documents, U. S. Gov-ernment
Printing Office, Washington,
D. C, 20402.
Thalidomide Charge: Nine officials of
Chemie Grunenthal, the German chem-ical
firm that produced thalidomide,
were charged with deliberately caus-ing
bodily harm and with manslaugh-ter
through neglect. The public prose-cutor
of Aachen charged that the of-ficials
had placed the drug on the
market even though preliminary tests
showed it caused damage to the ner-vous
system. He said about 5,000 chil-dren
had been born with deformities
after their mothers took thalidomide
during pregnancy.
April, 1967 THE HEALTH BULLETIN
National Pesticide Monitoring Site
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Pesticides Monitoring Journ/
57 FISH
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BASKET
SURVEY
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REGIONAL
(i) FOOD COMMODITY • ^^^^^
SAMPLING >^ WILDLIFE
®
I
Vol. I, No. 1, June 1967
Archery Lesson — A Counselor shows Campers how fo hit
the target at Camp Easter-in-the-Pines at Southern Pines.
Imagine Your Other Self
of Camp Eoster-ln-The-Pines
Summer itineraries of many physical-ly
handicapped children in North Caro-lina
are pointing toward Camp Easter-in-
the-Pines at Southern Pines. The at-traction
is the camping program that
will be operated by the North Caroli-na
Society for Crippled Children and
Adults through Easter Seal contribu-tions.
H. L. Hawley, Executive Director of
the Society, announced that dates for
the 1967 camping season are June 18,
to August 10, with three two-week ses-sions
for crippled children. The last two
weeks of the season, beginning July
30, will be given over to a camping
session for handicapped adults.
The Easter Seal Camp, operated by
the Society since 1964, provides re-creation
specially modified and adapted
for the crippled. Stairways are replaced
by ramps; handrails are installed, door-ways
are wide enough to permit easy
passage of wheelchairs, and shower
stalls are easily usable even though
campers may not be able to walk with-out
the aid of special appliances.
But otherwise. Camp Easter-in-the-
Pines is pretty much like any other
summer camp. Children have the chance
to swim, shoot, hike, boat and sleep
under the stars just like children with-out
handicaps.
It may seem impossible to some that
10 THE HEALTH BULLETIN April, 1967
children in wheelchairs, with braces on
their legs, or restricted to crutches
could take part in outdoor activities at
camp. But rehabilitation experts agree
that Camping offers the physically han-dicapped
therapy they could not re-ceive
in a clinic.
The excitement of going to Camp
seems to work wonders on children
who are barred from many normal ac-tivities
at home. Their eagerness to
participate helps them move a little
closer to overcoming their handicaps.
Here, they have the chance to experi-ence
nature first-hand and many are
"on their own" for the first time.
As the needs grow, Camp Easter-in-the-
Pines is being expanded to meet
them. Last year the Society added a
second 4-cabin and bathhouse complex.
But needs are even greater, and plans
call for more improvements next year
so that a stay at Camp Easter may be
possible for more crippled children
and adults.
Anyone who may know of a physi-cally
handicapped child or adult who
would benefit from wholesome out-door
activities at Camp should write
to: Coordinator, Camp Easter-in-the-
Pines, P. O. Box 1099, Southern Pines,
North Carolina.
The first laboratory confirmed case
of dog rabies in more than two years
recently occurred in Surry County. Al-though
no human exposures occurred
from this case, it should serve as a
reminder that rabies remains an en-zootic
disease in wildlife and can
spread to epidemic proportions in an
unimmunized dog population. In Sur-ry
County it was estimated that only
ten percent of the dog population had
been immunized against rabies. Seventy
percent of a community's dog popula-tion
must be immunized against rabies
to preclude the possibility of an epi-demic
situation.
New Drug May
Benefit
Manic-depressive Psychosis
A potentially effective drug treat-ment
for one of the most serious
formis of mental illness was outlined re-cently
by a National Institute of Men-tal
Health scientist. The disorder, man-ic-
depressive psychosis, affects many
people and is present in a sizeable pro-portion
of the Nation's 25,000 suicides
a year.
Dr. William E. Bunney, Acting Chief
of the Institute's Section on Psychoso-matic
Medicine, confirmed the finding
that lithium carbonate, an inexpensive
white powder, effectively controls this
illness in many patients. It checks the
intense manic excitement, and overac-tive,
irritable patients become calm
under its treatment.
Dr. Mogens Schou in Denmark, one
of the principal investigators of the
therapeutic usefullness of lithium, has
recently reported that the drug seems
to act as a preventive of both manic
and depressive attacks. These are prob-ably
two aspects of a single underly-ing
process. Dr. Bunney explained. If
further research bears out present find-ings,
lithium will become an important
weapon in the fight against this very
severe mental illness.
However, in contrast to lithium's ac-tion
in mania. Dr. Bunney said, a ques-tion
remains about its usefulness in
acute depressive episodes. This area
is now undergoing intensive study.
The Institute's research, which ex-tends
the work of earlier investigators—
particularly that of Dr. Schou, was de-scribed
before the Missouri Institute-of
Psychiatry in St. Louis.
April, 1967 THE HEALTH BULLETIN 11
Consider this case:
American
Medical
Associafion
Begins A
New Section
//Medicine
and Religion//
Consider
These Reasons
Physicians have long been troubled
by the knowledge that playing the
role of healer sometimes requires them
to "play God," too.
A 10-year-old Louisiana boy is dy-ing
from kidney disease. The physician
knows it's possible to transplant a kid-ney
from the boy's healthy twin broth-er,
leaving the healthy twin with one
kidney.
Sometimes the operation fails, but in
a number of cases, it succeeds; more
than 500 people are alive today with
transplanted kidneys.
Regardless of whether the sick boy
recovers, however, the physician is
haunted by one thought: suppose some-thing
goes wrong with the healthy
twin's remaining kidney. A person can
live a normal life with one kidney—
that's what supports the theory of
transplantation from live donors—but
one cannot live without any kidneys.
Disease could cut down the boy at any
time.
By deliberately removing a healthy,
functioning part of the boy's body, has
the physician consigned him to possible
future death?
Or are the parents responsible? They
gave permission for the operations. Was
the physician merely a technician, car-rying
out their orders?
And what of the healthy boy? He's a
minor. Does he have any rights in the
matter? Could there be a case in which
parents used unusual coercion on such
a child to save the life of another?
These are some of the questions that
trouble medical men of conscience on
transplantation. Other areas of medicine
present similar questions of ethics and
morality.
This is why the Journal of the Ameri-can
Medical Association is beginning
a new section, "Medicine and Religion,"
designed to discuss these issues. The
first question-and-answer section (on
tranplantation) appears in the April 10
Journal.
12 THE HEALTH BULLETIN April, 1967
Here's part of what Joseph E. Mur-ray,
AA.D., a Boston surgeon, had to say
about the problem of the lO-year-old
twins:
"Organ transplants, as a therapeutic
maneuver to prolong life, are certainly
justified as far as the recipient is con-cerned.
"The source of the kidney, however,
provides a major moral, legal, and
ethical problem," Dr. Murray said. "If
the source is a recently deceased indi-vidual
whose nearest relatives have
voluntarily donated the kidney, there
is no problem. If the source is an elec-tive
(kidney removal) for the benefit
of another human being, and a kidney
is used which would otherwise be dis-carded,
again, there is no problem.
However, when the donor is a living
healthy volunteer, either a member or
a nonmember of the family, a definite
problem arises. Here we are embarking
on a major surgical operation with a
slight, but definite, risk from anesthesia,
operation, or postoperative complica-tions.
"This procedure is not for the bene-fit
of the person being operated on,
but for someone else. All previous
medical and surgical training has been
geared to weighing the advantages and
disadvantages in any one patient of a
proposed therapeutic measure. In this
instance, however, for the donor a
physiological deficit will always occur,
and no possible good can accrue to him
physically."
Dr. Murray pointed out, however,
that the kidney donor may derive "a
certain spiritual benefit" from the do-nation,
which is "probably the purest
form of charity next to the giving of
one's life."
"For a truly unpressured volunteer,
this spiritual satisfaction can more than
compensate for the physical trial of a
nephrectomy."
Hess Gets Federal Award
The National Civil Service League
has named Arthur E. Hess, Deputy
Commissioner of Social Security, as one
of the year's 10 outstanding public
servants in the Nation, Robert M. Ball,
Commissioner of Social Security, an-nounced
today.
"Career Service Awards" are given
annually by the League to recognize
career public employees for outstand-ing
contributions to the general wel-fare,
and to stimulate able young peo-ple
to choose careers in Government.
The National Civil Service League is
a nonpartisan, non-profit citizens' or-ganization
founded in 1881 "to pro-mote
efficiency in Federal, State, and
local government." The Awards pro-gram
was first established in 1954,
with the 130 winners to date constitut-ing
a roster of top excellence in the
Federal service.
Commenting on the award. Commis-sioner
Ball said, "The League's recog-nition
of Art Hess' contributions to the
programs within the responsibility of
the Social Security Administration, and
through them, to the security and inde-pendence
of millions of Americans,
comes as no surprise to those of us
who have worked closely with him over
the years. "Whenever there has ever
been a very big job of implementing
a program just enacted by Congress,
we have had a way of turning to Art
Hess and assigning him a leading role
in transforming the legislative blue-prints
into effective working realities.
This was the case with both the disa-bility
insurance program, first enacted
in 1954, and the medicare program,
passed by Congress in 1965. The
smoothness of the start of each pro-gram,
and their early arrivals at a
level of efficient and economical op-eration
are due in no small measure to
the administrative talent of Art Hess."
April, 1967 THE HEALTH BULLETIN 13
Hess, now 50 years of age, and a
native of Reading, Pa., began his ca-reer
in social security 27 years ago
shortly after his graduation from Prince-ton
University. While engaged in re-search
activities for the agency, he
studied for and earned a law degree
fronn the University of Maryland in
Baltimore, and was accepted as a mem-ber
of the Maryland bar. After 1 1
years as Director of the Bureau of
Disability Insurance, he was named Di-rector
of the Bureau of Health Insurance
in 1965, where he played a leading
role in bringing medicare to over 19
million older Americans. He has just
been promoted to the position of De-puty
Commissioner of Social Security,
where he will continue to have a hand
in the administration of medicare while
also assisting the Commissioner of
Social Security in overseeing the Ad-ministration's
other programs.
Other 1967 "Career Service Award"
winners are: Philip N. Brownstein, De-partment
of Housing and Urban De-velopment;
Horace D. Godfrey, Depart-ment
of Agriculture; Donald G. Mac-
Donald, Agency for International De-velopment;
William H. Smith, Depart-ment
of the Treasury; O. Glenn Stahl,
U. S. Civil Service Commission; David
D. Thomas, Federal Aviation Agency;
Floyd LaVerne Thompson, National
Aeronautics and Space Administration;
Barbara McClure White, U. S. Informa-tion
Agency; and Marjorie J. Williams,
M. D., Veterans Administration.
The awardees will be honored at a
dinner ceremony in Washington, D. C,
on April 21, 1967, at which the prin-cipal
address will be delivered by John
W. Gardner, Secretary of Health, Edu-cation,
and Welfare. In addition to the
League's recognition of their individual
excellence in public service at the Fed-eral
level, the awardees are tendered
a $1,000 tax-free cash award by the
program.
Hess and his wife, the former Nancy
Davis of Wilkes-Barre, Pa., and their
two youngest daughters reside at 4805
Woodside Road, Baltimore, Maryland.
Birth Control: About 11 million wo-men—
at least half of them Americans—
now use oral contraceptives, according
to a report from Planned Parenthood-
World Population.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
Lenox D. Baker, M.D., President Durham
James S. Raper, M.D., Vice-President AsheviUe
Ben W. Dawsev, D.V.M. Gastonia
Samuel G. Koonce, Ph.G. Chadbourn
Oscar S. Goodwin. M.D. Apex
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pmes
J. M. Lackey Rt. 2, Hiddenite
Howard Paul Steiger, M.D. Charlotte
EXECUTIVE STAFF
Jacob Koomen, M.D., M.P.H. State Health Director
\V 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 Health Division
Lynn G. Maddrv, 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, Presonal Health Division
14 THE HEALTH BULLETIN April, 1967
Community Hospitals
Offered Disaster Care Items
A thirty-day supply of critical medi-cal
items for disaster care is being of-fered
to community hospitals in North
Carolina. These items, known officially
as the Hospital Reserve Disaster In-ventory
(HRDI), w\\\ augment normal
hospital shelf inventories to the extent
of providing the acute care medical sup-ply
needs for approximately thirty
days.
it is anticipated that eventually every
hospital in the State v^'ill be eligible to
participate in the HRDI Program. Initial-ly
hospitals participating in this pro-gram
will be selected by the Public
Health Service in accordance with cri-teria
and standards established for
emergency planning and location. To
be eligible for the HRDI Program, com-munity
hospitals must meet the follow-ing
criteria:
1. Be located within fifty (50) miles
of the city limitis of the central
city of a Standard Metropolitan
Statisitical Area (SAASA) having
250,000 or more population,
2. Having fifty (50) or more beds;
and
3. Have the operational capability to
establish a comprehensive disas-ter
program.
The two major advantages in stock-piling
medical supplies in community
hospitals are (1) they will assist the
hospitals in their primary responsibili-ties
of patient care and community
health and will assure the availability
of supplies for a thirty-day period if
regular supply channels are disrupted,
and (2) it provides an opportunity to ro-tate
supplies that might deteriorate in
storage. The hospital will utilize these
emergency supplies in its daily opera-tions
and will continue to purchase
such supplies on its regular schedule
thus maintaining its normal inventory
at the same time.
The North Carolina State Board of
Health is the State agency having pri-mary
responsibility for the Medical
Stockpile program in North Carolina.
Therefore, contracts that are negotiated
between the Public Health Service and
the hospital participating in the HRDI
Program will be coordinated with the
State Board of Health to insure the
continuity of emergency health service
operations both at the State and loCal
level.
At the present time there are fifty
(50) Packaged Disaster Hospitals (PDH)
in North Carolina. These hospitals, on
a selective basis, will be affiliated with
community hospitals. By providing com-munity
hospitals with PDH's as well as
HRDI Units, it will insure the State a
minimum amount of essential stockpile
medical items necessary for any type
of disaster. The plan to assign the re-sponsibility
for each PDH to a com-munity
hospital is a step toward insur-ing
operational capability for each pre-positioned
hospital.
Community hospitals agreeing to af-filiate
with a PDH will be asked to (1)
develop a utilization plan for the PDH,
and (2) rotate pharmaceuticals in a
PDH with their regular stocks, if prac-tical.
The contract covering PDH rota-tion
items and utilization planning will
be between the community hospital and
the Public Health Service.
The contract covering the major
components of the PDH will continue to
be negotiated between the North Caro-lina
State Board of Health and Public
Health Service, and the County Civil
Defense agencies and County Health
Departments with the North Carolina
State Board of Health. The eventual
goal is to have every PDH in the State
affiliated with a community hospital.
April, 1967 THE HEALTH BULLETIN 15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
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DIVISION OF HSALIH A
^^ ^^
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llILl'. H.C.
If you do NOT wish to con-tinue
receiving The Health Bul-letin,
please check here i
| and return this page to '
—
the address above.
Printed by The Graphic Press, Inc., Raleigh, N. C.
DATES AND EVENTS
June 18-21 - N. C. Veterinary AAedi-ical
Association, Durham, N. C.
June 18-22 — American Medical As-sociation
(Annual), Atlantic City, N. J.
June 19-21 — North Carolina Hospital
Association, Annual Meeting, Grove
Park Inn, Asheville, N. C.
June 25-29 — American Society of
Medical Technologists, Miami Beach,
Fla.
July 2 - 7 — American Physical Therapy
Association, Miami Beach, Fla.
July 10-13 — Institute: Tuberculosis
and Other Respiratory Diseases
(Blue Ridge Assembly), Black Moun-tain,
N. C.
Aug. 9- 13 — Sixth Annual Southwide
Lawyers & Physicians' Conference,
Lake Junaluska, N. C.
July 9-12 — American Veterinary
Medical Association, Dallas, Texas.
A baby in the United States today
has less chance for survival than in 14
other countries. And the blame can be
placed on poverty—with its concomit-ants
of inadequate nutrition, lack of
education, early pregnancies, illegiti-macy,
and, especially, premature births.
A computerized analysis performed
at George Washington University
shows that less than 2% of all coun-ties
in this country account for Vs of
the excessive mortality rates.
CONTENTS
Governor's Conference
On Child Abuse 1
Key To Reducing
Infant Mortality 2
Brains Across the Sea 3
Day Care Health Information 7
National Pesticide Monitoring Sites 8, 9
Camp Easter-ln-The-Pines 10
New Manic-depressive
Psychosis Drug 11
New "Medicine-Religion"
Section of AMA 12
Hess Gets Federal Award _• 13
Disaster Care Items 15
16 THE HEALTH BULLETIN April, 1967
[m\^ mmi'nm
tiblicaf-ion Of The North Caroh'no State Board of Health
<^:>,^^ M/^1 /?67
The First Fifty Years of
Public Health in North Carolina
Excerpts from "A History of the N. C. State Board of Health—1877 to 1925"
by B. E. Washburn, M.D.
The year 1909 proved to be an event-ful
one in the history of public health
of North Carolina. In that year, the
General Assembly voted an increase in
the annual appropriation of the State
Board of Health, enabling it to employ
a health officer for his full time.
The State Board had been organized
in 1877 and had been directed by two
part-time secretaries who achieved re-markable
success.
The two secretaries of the State
Board who conducted the pioneer
health work so successfully were Dr.
Thomas F. Wood from 1879 to 1892,
and Dr. Richard H. Lewis from 1892 to
1909. A review of their activities is in-spiring.
During this formative period, the ap-propriations
had been woefully inade-quate,
at times insufficient even to
pay postage on the health literature
they prepared and distributed. Under
their direction, however, the North
Carolina Board became recognized by
health authorities throughout the na-tion;
this is especially true of its or-ganization
which largely removed it
from politics and stresed the impor-tance
of local (county) health organiza-tions.
The Board being appointed joint-ly
by the governor of the State and the
State Medical Society, had been able to
influence the Legislature to enact mea-sures
important to public health.
The recognition that disease preven-tion
is the responsibility of society as
a whole came to North Carolina in
1877 when its State Board of Health
was created.
The history of public health is re-flected
in the progress of disease pre-vention
carried out in North Carolina
under the direction of the State Board
of Health. At the time of the Board's
organization in 1877, disease preven-tion
was sought largely through im-provement
of the environment; but ad-vances
in medicine as they applied to
the control of infectious diseases were
readily adopted. With this came the im-portance
not only of clean surround-ings
but especially the provision of
safe drinking water and sewage dis-posal
by towns and cities. From its be-ginning,
the Board recognized the need
for vital statistics as a means of mea-suring
progress. The inspection of state
schools and institutions was carried out
as well as the inspection of prisons and
mental hospitals.
Immediately following the Civil War,
the State Medical Society discussed the
need of a state board of health and
advocated its provision. In this, the
Society had the support of leading
citizens throughout the State who had
seen the terrible conditions brought
about during the War due to the lack
of organized health work and sanita-tion.
A committee was appointed to place
the matter before the Legislature; the
members of the committee were Drs.
S. S. Satchwell of Pender County; R. L.
Payne of Davidson County; Marcellus
THE HEALTH BULLETIN May, 1967
i*?^
* 4
%
Thomas F. Wood, M.D. 1877-1892
AAay, 1967 THE HEALTH BULLETIN
Whitehead of Rowan County; and
George A. Foote of Warren County.
The committee went to Raleigh in 1877
for the meeting of the General As-sembly
and remained there for most of
the session, being joined by Drs.
Eugene Grisson and M. J. Pittman.
These doctors were successful in secur-ing
the passage on February 12, 1877
of a bill to establish the North Caro-lina
State Board of Health.
The Board of Health, as established
by the General Assembly, was to con-sist
of all the members of the State
Medical Society who were to be the
medical advisers of the State and as
such give advice to the government "in
regard to the location and sanitary man-agement
of public institutions."
An annual appropriation of $100 was
made to meet the expenses of the
Board.
The organization of the State Board
of Health was effected at the following
annual meeting of the State Medical
Society held at Salem on May 23, 1877.
Dr. S. S. Satchwell was elected Presi-dent
and Dr. Thomas F. Wood, Secre-tary
and Treasurer.
The annual appropriation of $100
made by the Legislature was ordered
to be paid to the Treasurer of the State
Medical Society.
On March 14, 1879, the "Act Sup-plemental
to an Act Creating the State
Board of Health" passed both houses;
and the Board thus created has function-ed
ever since with, of course, many
modifications and changes.
Under provisions of the new act, the
Board of Health was to be made up of
nine members. Six of these were to be
chosen by the State Medical Society
from its active members and three to
be appointed by the governor. It was
specified that one of the members ap-pointed
by the governor was to be a
civil engineer.
The members appointed by the Med-ical
Society were to serve two for
six years, two for four years, and two
for two years; while those appointed
by the governor would serve for only
two years. A!l vacancies were to be
filled by the Board of Health. The of-ficers
of the Board were to consist of
a president and a secretary-treasurer.
The latter was to be paid for his serv-ices,
the amount to be fixed by the
Board.
The general duties of this new board
included all the items named in the
1877 act, these being included in the
"Supplemental Act of 1879." In ad-dition,
provision was made for the
publication of bulletins whenever there
occurred an outbreak of disease in epi-demic
proportions, the object being
to inform the public on how to prevent
and stop the spread of dangerous dis-eases.
Chemical examination and an-alyses
of water were to be carried out;
and auxiliary boards of health were to
be organized in each of the 94 coun-ties
of the State.
The Health Bulletin
First Published—April 1886
The official publication of the North Carolina State
Board of Health, 608 Cooper Memorial Health Build-ing,
225 North McDowell Street, Raleigh, N. C. Pub-lished
monthly. Second Class Postage paid at Raleigh,
N. C. Sent free upon request.
EDITORIAL BOARD
Charles M. Cameron. Jr., M.D., M.P.H.
Chapel Hill
John C. Lumsden, B.C. HE.
Jacob Koomen, Jr., M.D., M.P.H.
Bryan Reep, M.S.
John Andrews, B.S.
Glenn A. Flinchum. B.S.
H. W. Stevens. M.D., M.P.H., Ashevlle
Editor-Edwin S. Preston, M.A., LL.D.
Vol. 82 May, 1967 No. 5
THE HEALTH BULLETIN May, 1967
Richard H. Lewis, M.D. 1892-1909
^ay/ 1967 THE HEALTH BULLETIN
The State Board of Health was voted
an annual appropriation of $200 to
carry out these numerous items.
Under the provision specified in the
act, the organization of the State Board
of Health took place on May 21, 1879
just a few weeks after the act had
been passed by the General Assembly.
The members of the 1885 Legislature
were evidently impressed by the ef-forts
being made by the State Medical
Society, especially since the people of
the State were showing interest in the
matter. The General Assembly amend-ed
the laws so as to make the county
boards more efficient; the annual ap-propriation
was increased from $200 to
$2000; and a contingent fund of $2000
was set up to be expended with the ap-proval
of the governor whenever an
epidemic occurred; also, printing privi-leges
not to exceed $250 annually were
extended to the Board.
As a result of the increased appro-priation
and the added printing privi-lege,
the Board began the publica-tion
of a health bulletin, this being the
first publication of this nature in the
United States.
The first issue of the monthly Health
Bulletin appeared in April 1886 and
contained reports from 26 counties,
with tables made up from the reports
of county superintendents of health
giving the conditions of weather, the
prevailing diseases, epidemics, diseases
of domestic animals and the condition
of public institutions, especially of the
jails and poorhouses. The reports of the
latter included, among other things, the
number of inmates, the number who
had been successfully vaccinated, the
kind and the amount of food, the num-ber
who could read and write, and a
report of general sanitary conditions ex-isting
in the county. Along with these
reports were additional articles and edi-torials
to instruct the people in hygienic
matters.
The Bulletin was widely distributed;
being sent to state and county officials,
public libraries and to all members of
the State Medical Society, to mayors and
health officers of cities and towns, and
to any citizens who asked for it. It
was intended to be, and was, the voice
of the State Board of Health. Comment-ing
on the first issue of the Bulletin,
Dr. Jones, President of the Board, said
to the North Carolina Medical Society at
its meeting in 1886: "It will go out as
a monthly messenger of glad tidings
with healing in its wings, with words
of truth and notes of cheer, or sounds
of alarm if danger comes nigh." Dur-ing
its early years, the Bulletin was pre-pared
largely by Dr. Wood who alone
decided what should be printed. Also,
the wrapping and mailing of the peri-odical
was done by the Doctor and his
family. Miss Jane Wood has told of
how she and her brother (later to be-come
Dr. Edward Jenner Wood) helped
their father with this work. She writes,
"We grew to be very proud of the part
we had in making good health a part
of the State's task."*
The favorable reception the Bulletin
received and its success were due large-ly
to the reports of the county super-intendents.
These showed something
of the health conditions existing in the
different counties and enabled interest-ed
officials and citizens to compare
their county with others. At first, the
county superintendents were negligent
in sending in their reports, but in 1893
reports were received from 88 of the
96 counties in the State. Since seven
counties had no board of health, only
one county had failed to report. Dur-ing
the first eight years, up to 1893,
the Bulletin became an indicator of the
progress being made in public health
work in the State. Its articles were re-published
and commented upon in the
state press.
THE HEALTH BULLETIN May, 1967
W. S. Rankin, M.D. 1909-1925
May, 1967 THE HEALTH BULLETIN
The Act of 1893 greatly increased
the status of the State Board of Health,
which reacted with renewed activity. A
well-equipped office was established in
Raleigh for the Secretary who was
given an annual salary of $1,000.
When Dr. Thomas F. Wood of Wil-mington,
the founder and first secre-tary
of the State Board of Health, died
on August 22, 1892, Dr. Lewis was
elected to succeed him. Since the State
Board of Health's annual appropriation
up to 1907 was never more than
$2000, the Board could not afford an
office of its own, and most of its work
was carried on in his office.
The Act of the General Assembly of
1909 providing for the employment
of a State Health Officer for his whole
time made it necessary for Dr. Richard
H. Lewis, the father of the bill, to
culminate 17 years of patriotic devotion
to the health of the people of North
Carolina. At a called meeting of the
Board of Health on March 30, 1909, he
explained the amended law, stating
that he could not afford to surrender
his practice and was therefore tendering
his resignation. The Board, after insist-ing
in vain for the withdrawal of the
resignation, reluctantly accepted it. Dr.
Watson Smith Rankin of Wake Forest
was elected to succeed him on July 1,
1909, at a salary of $3,000 per year.
The annual appropriation of the
Board was increased from $4000 to
$10,500 in 1909.
The General Assembly of 191 1 creat-ed
County Boards of Health to take
the place of the Sanitary Committees.
The new legislation in 1911 enabled
the State Board of Health to increase
the circulation of the Bulletin from 11,-
500 to 20,000 copies per month.
The Genera! Assembly of 1913 also
amended several sections of the exist-ing
health laws and raised the annual
appropriation of the Board from $22,-
500 to $40,500 annually.
In 1916 the monthly circulation of
the Health Bulletin reached 51,000.
Early in 1923, Dr. W. S. Rankin was
invited by the "Committee of Municipal
Health Department Practices" of the
American Public Health Association to
become Field Director in making a study
of municipal health procedures.
The Executive Committee of the State
Board of Health granted the Secre-tary
a year's leave of absence, and on
November 1, Dr. Rankin assumed his
duties and established official head-quarters
in New York City. He con-tinued
this work until November 1,
1924.
A number of changes were made in
1923 in the organization of the State
Board of Health as well as in its per-sonnel.
On March 1, Dr. Cooper made
Assistant Secretary and became official
head of the staff. If it had not been for
his almost total deafness, he undoubted-ly
would have been selected to succeed
Dr. Ranklin when the latter resigned a
short time later.
At the Conjoint Session of the State
Board of Health and State Medical So-ciety
held in Pinehurst on April 29,
1925, Dr. Rankin announced his resig-nation
as State Health Officer, effective
June 1, to accept directorship of the
Hospital and Orphan Division of the
newly created Duke Endowment. On
May 30, at the meeting of the Execu-tive
Committee of the Board, Dr. G. M.
Cooper was unanimously made Assist-ant
Secretary for an indefinite period of
time.
During his public health career. Dr.
Rankin had been President of the Am-erican
Public Health Association; Trus-tee
of the American Hospital Associa-tion;
first Chairman of the Charlotte
Board of Health; Member of the North
Carolina Medical Care Commission;
Trustee of Wake Forest College; and he
received honorary degrees from Duke
University, University of North Caro-
8 THE HEALTH BULLETIN May, 1967
Chas. O'H. Laughinghouse, M.D. 1926-1930
May, 1967 THE HEALTH BULLETIN
lina, Davidson College, and Wake Forest
College. He also received, in 1956, the
Distinguished Citizenship Award from
the North Carolina Citizens Association.
The City of Charlotte named their
new public health building the "W. S.
Ranklin Health Center" and this was
dedicated on Dr. Rankin's 81st birth-day,
January 18, 1960.
Along with the founders of the State
Board of Health, Drs. Thomas Fanning
Wood and Richard Henry Lewis and Dr.
W. S. Rankin, first full-time secretary,
three doctors stand out in the develop-ment
of public health work in North
Carolina; Dr. John A. Ferrell, Director
of the North Carolina Hookworm Com-mission,
1910-14, extended education-al
and treatment campaigns throughout
the State and later directed work which
hastened the advent of county health
departments; Dr. Louis B. McBrayer who
directed and developed activities which
brought about the control of tubercu-losis;
and Dr. George Marion Cooper
who may be called the "family phy-sician"
of the State because of his care-ful
study of health and social ills and
the modern methods he devised to al-leviate
them.
On May 1, 1923, Dr. Cooper was
appointed Assistant State Health Of-ficer
and was made Editor of the Health
Bulletin. He continued as Editor of the
Bulletin until 1942 and was Acting
State Health Officer on four different
occasions. In the reorganization plan of
1950, Dr. Cooper became Director of
the Division of Personal Health.
Highlights of Progress To 1967
Excerpts from Biennial Reports
1926. On June 21 Dr. Charles O'H. Laughinghouse, a member of the Board,
was elected permanent Secretary and State Health Officer to fill the unexpired
term of Dr. Rankin. Dr. Laughinghouse accepted and took ofTice October 1.
1928. The educational work of the Board was of a high order during 1928.
A thirty-two page BULLETIN was issued monthly, and a moving picture machine
with several films on modern health subjects was exhibited in many sections
of the state.
1929. On January 1 Dr. Earnest A. Branch accepted the appointment as di-rector
of the Division of Oral Hygiene.
Expenditures for the Board work this year reached the highest peak in the
history of the Board, totaling about $486,000.
1930. On August 26, Dr. Chas. O'H. Laughinghouse, State Health Officer, died.
Soon after his death, in a meeting of the board. Dr. H. A. Taylor was made
Acting State Health Officer.
1931. A bill was introduced in the Legislature abolishing the State Board of
Health as then constituted. This bill was passed and became law during the
session of 1931. With the enactment of the new law the terms of the members
of the old Board were automatically terminated. Under this new law governing
the state health work, legislative machinery providing for the establishment of
a new organization to carry on the public health work of the state was enacted.
The Board still elects the State Health Officer, but it can only become effective
upon the approval of the Governor. The term of the State Health Officer, along
10 THE HEALTH BULLETIN May, 1967
:^^
James M. Parrott, M.D. 1931-1934
with members of the Board of Health, was restricted to four years.
On May 28, the new Board met and organized. On that day it unanimously
elected Dr. James M. Parrott State Health Officer. Dr. Parrott took the offer under
consideration for a period of two weeks. On June 1 1 the Board met again. Dr.
Parrott accepted the election and agreed to assume office on July 1.
1932. The death rate in North Carolina for 1932 was 9.6 per 1,000 popula-tion.
This is the lowest death rate ever before recorded in North Carolina.
May, 1967 THE HEALTH BULLETIN 11
The infant mortality this year was 66.4 per 1,000 live births. This is so far the
best record the state has ever made.
Expenditures for this year for ail purposes by the Board were $315,276, of
which $262,438 represented appropriations. This amount was just a little more
than half the total expenditures made by the Board of Health for the fiscal year
ending June 30, 1930.
1933. The event of outstanding importance to the Board of Health this year
was the death of Dr. C. A. Shore, which occurred on February 10.
A few weeks after the death of Doctor Shore, Dr. John H. Hamilton, director
of County Health Work, of Vital Statistics, and of Epidemiology, was made di-rector
of the laboratory work.
1934. The event of greatest importance to the State Board of Health and to
the health work throughout the state in this year was the death of Dr. James
M. Parrott and the election of Dr. Carl V. Reynolds as his successor.
Dr. Carl Vernon Reynolds, of Asheville, on November 10, took the oath of
office and immediately assumed his duties as Acting State Health Officer.
1935. At the annual meeting of the State Board of Health, which was held in
Pinehurst May 7, 1935, Dr. Reynolds was unanimously elected State Health Officer.
1937. On December 16, 1937, following Legislative Provision in the 1937
session of the Legislature, $160,000 in bonds were sold for the purpose of build-ing
a new plant for the State Laboratory on the grounds adjacent to the present
State Board of Health building on Caswell Square, Raleigh.
The total expenditures for the State Board of Health during the fiscal year end-ing
June 30, 1937, were $881,484.01. Of this amount $287,747.04 was appro-priated
by the Legislature.
The total expenditures for the State Board of Health for the fiscal year ending
June 30, 1938, were $1,041,895.98. Of this amount $353,953.55 was appro-priated
by the Legislature.
1939. The total expenditures for the State Board of Health for the fiscal year
ending June 30, 1939, were $1,215,056.80. Of this amount $364,506.25 was
appropriated by the Legislature.
1940. The most important item in the field of public health in this State in
1940 was the completion and dedication of the central building known as the
Clarence A. Shore Laboratory of Hygiene.
The circulation of the HEALTH BULLETIN increased from about 52,000 to 60,000
monthly copies during the year.
The total expenditures for the State Board of Health for the fiscal year ending
June 30, 1940, were $1,380,174.90. Of this amount $370,057.67 was appro-priated
by the Legislature.
1942. On January 1, 1942, Dr. G. M. Cooper was retired from the editorship
of the State HEALTH BULLETIN and Dr. John H. Hamilton assumed the duties of
acting editor.
The total expenditures for the State Board of Health for the year ending June
30, 1942, were $1,791,878.11. Of this amount $370,150.59 was appropriated
by the Legislature.
In the autumn of this year the employees of the State Board of Health organ-ized
and established what is officially known as the North Carolina Academy of
Public Health at the State Board of Health. All employees of the State Board of
Health are members of this Academy.
12 THE HEALTH BULLETIN May, 1967
Carl V. Reynolds, M.D. 1934-1948
The total expenditures for the State Board of Health for the year ending June
30, 1942, were $1,791,878.11. Of this amount $370,150.59 was appropriated
by the Legislature.
1943. The total expenditures for the State Board of Health for the fiscal year
ending June 30, 1943, were $1,880,230.62. Of this amount $406,993.29 was
appropriated by the Legislature.
1947. The total expenditures for the State Board of Health for the year ending
June 30, 1947, were $2,814,937.00. Of this amount $561,996.00 was appro-
May, 1967 THE HEALTH BULLETIN 13
priated by the Legislature.
1948. The most conspicuous event taking place during this part of the biennium
was the resignation of Dr. Carl V. Reynolds as State Health Officer effective June
30. Dr. Reynolds retired after serving a little more than 13V2 years.
At the meeting of the State Board of Health in Raleigh on February 24, Presi-dent
Craig read Dr. Reynold's letter of resignation as Secretary and State Health
Officer effective June 30, 1948.
Doctor J. W. R. Norton, native of Scotland County and Chief Health Officer
of the TVA of Chattanooga, Tennessee, was elected State Health Officer.
The total expenditures for the State Board of Health for the year ended June
30, 1948, were $2,648,277.00. Of this amount $794,774.00 was appropriated
by the Legislature.
On July 1, 1948, Dr. J. W. R. Norton assumed his duties as State Health
officer.
1949. The year 1949 was destined to become a turning point in the Public
Health program in North Carolina. The Legislature of that year did more for
Public Health than any of its predecessors. There was a spirit of close cooperation
between Public Health officials, the Governor and members of the General As-sembly.
As an outcome of this, approximately $800,000 in new money was voted
for each fiscal year of the new biennium for local health work, which had only
been receiving $350,000 a year. This meant an increase to $1,150,000 in State
funds for local health during the biennium.
1950. The year 1950 saw not only increased expansion in local health work,
but also re-organization of the State Health Department so as to make operations
less cumbersome. As of February 1, reduced the number of divisions to six,
placed in charge of a director and designated the subdivisions as sections.
1951. The General Assembly, which met early in January, increased the appro-priations
for Public Health to $2,214,591 for the fiscal year of 1950-1952 and
$2,224,982 for the fiscal year of 1952-1953.
On January 19, the State Board of Health confirmed the appointment of Dr.
John H. Hamilton as Assistant State Health Officer, his term to run concurrently
with that of Dr. Norton.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
Lenox D. Baker, M.D., President Durham
James S. Raper, M.D., Vice-President Asheville
Ben W. Dawsey, D.V.M. Gastonla
Samuel G. Koonce, Ph.G. Chadbourn
Oscar S. Goodwin, M.D. Apex
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
3. 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 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, Presonal Health Division
14 THE HEALTH BULLETIN May, 1967
J. W. R. Norton, M.D., M.P.H. 1948-1965
May, 1967 THE HEALTH BULLETIN 15
rHE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
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Printed by The Graphic Press, Inc., Raleigh, N. C.
1954. Following the 1954 Conjoint Session of the State Board of Health and
the State Medical Society the health department was moved from its old building
to its new million dollar headquarters on Caswell Square.
Jacob Koomen, Jr., M.D., M.P.H., assistant director of the Division of Epidemi-ology,
was named Assistant State Health Director to begin that service October
1, 1961. The auditorium of the Laboratory Building was renovated and re-decorated
and dedicated by the State Board as "The John Homer Hamilton
Auditorium".
Edwin S. Preston, M.A., LL.D., was named Editor of The HEALTH BULLETIN in
May 1960 upon the retirement of Dr. John Homer Hamilton.
Dr. J. W. R. Norton relinquished his position as State Health Director effective
December 31, 1965, continuing as Director of the Local Health Division.
Dr. Jacob Koomen, Assistant State Health Director was elected Acting State
Health Director and in May 1966 became State Health Director with the approval
of Governor Dan Moore. Dr. W. Burns Jones was elected as Assistant State
Health Director.
Appropriations for the continuation of existing activities of the State Board of
Health were made in the amount of $6,232,867 for the first year of the biennium,
1967-69, and $6,308,776 for the second year, including amounts to implement
a uniform fee schedule for medical fees and the payment of 90% of hospital
reimbursable costs.
Additional appropriations for special purposes included: Health aid to coun-ties—$
400,000 for each year of the biennium (the first major appropriation for
this purpose since 1949); Salt Marsh Mosquito Control—$70,000 for the first year
and $100,000 for the second; Genetics Counseling Center—$1 00,000 for the
second year; Scallop Inspection Program—$1 1 ,736 for each year; and $42,500
for each year to establish and maintain a Statewide Medical Examiner System.
16 THE HEALTH BULLETIN May, 1967
m!\^ ©raii^u
The Official Publication Of The North Carolina State Board of Health
nr
\
^LTH
A CUTE RASCAL — BUT AN ENEMY
in the article beginning on page 3, "The Insecticide That Turns the Bug Against
Itself", this advice is given: To cope with him and others like him, use the Judo
approach — don't whack away by main force; use the enemy's own strength
against him. Disorganize the insect's growth by making use of the same chemicals
the insect uses to regulate his growth.
Miss Holley Receives Aword
The first nurse to receive an Award
of Merit for Outstanding Contribution
and Meritorious Service in the field of
Public Health and Preventive Medicine
was presented to Miss Elizabeth Hol-ley,
Chief Nurse, North Carolina State
Board of Health, Raleigh, North Caroli-na
at the 35th Annual Meeting of the
Southern Branch, American Public
Health Association held in St. Louis,
Missouri 'as+ week.
Miss Holley, a past president of the
Association and representative to the
national A.P.H.A., was selected frorr.
among the 17,000 public health work-ers
in 1 7 Southern states served by the
Association which has its headquarters
in Birmingham, Aia.
In presenting the award. Dr. H. P.
Hopkins, President, Nashville, Tenn.,
said "Miss Holley symbolizes the dedi-cation
of the public health nurse and
other public health workres in protect-ing
the health of our nation through
programs that prevent and control
disease affecting people in every age
group."
Also elected were: President—Charles
G. Jordan, B.S.C.E., Miami, Fla.; 1st
Vice President—Hugh B. Cottrell, M.D.,
Atlanta, Ga.; 2nd Vice President—John
M. Bruce, M.D., New Orleans, La.; 3rd
Vice President— Fred Ragland, Jackson-ville,
Fla.; Secretary-Treasurer—John S.
Neili, M.D., Tampa, Fla.
Executive Committee—Miss E. Alice
Clark, R.N., M.P.H., Atlanta, Ga.; Miss
Elizabeth Holley, R.N., M.A., Raleigh,
N. C; H. P. Hopkins, Ph.D., Nashville,
Tennessee; William J. Peeples, M.D.,
Baltimore, Md.; Miss Joella Sisler,
Frankfort, Kentucky.
Future annual meetings are sched-uled
for May 28-31, 1968-Roanoke,
Va., and May 20-23, 1969-Oklahoma
City, Okla.
The Health Bulletin
First Published—April 1S86
The official publication of the North Carolina State
Board, of Health, 608 Cooper Memorial Health Build-ing,
225 North ^^cC'o