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cent of the persons convicted within a



year were convicted of the offense named
in their indictments.

Arrests on serious charges occur in the
city on an average of one every eleven
minutes; 48,109 were made in the year
studied (June 1937-June 1938) in con-
nection with the 71,856 serious offenses
known to have occurred. Burglary is the
most profitable crime from the criminal's
standpoint, yielding an average income
of $225 and a 50-50 chance of escape.

Self -Discipline A new wrinkle in cou rt
procedure was recently introduced in a
Brooklyn court where five men arrested
on vagrancy charges pronounced their
own sentences. Since all the men were
unemployed, the magistrate decided they
might like a "nice warm" place to spend
the winter, so he put it up to them to fix
the length of their jail terms. Two of
the men, who had no homes, chose sixty
days. The other three, who had given ad-
dresses, chose fifteen days, ten days and
five days.

The School vs. Delinquency Par-
tial blame for the development of the de-
linquent student is laid at the door of
the schools, in a recent report of a com-
mittee of the New York City Board of
Education. To prevent the positive role
played by the school in the making of a
maladjusted personality the report, pre-
pared by a joint committee on maladjust-
ment and delinquency, suggests a definite
program to include extension of the
school health system, a technically trained
personnel for helping the child avoid fail-
ure in school work, greater provision for
the application of remedial procedures,
classes for the handicapped (particularly
mentally retarded children and those with
speech defects), establishment of residen-
tial camps under school auspices. Point-
ing out that dull children can learn, the
committee emphasized the importance of
specialized programs for the retarded
with the warning that school activities
must correspond to the child's abilities.

Seedlings Juvenile delinquency cases
coming before the courts in 1937 have
reversed the general downward trend
which has occurred since the peak year,
1930, according to the reports of twenty-
eight courts to the U. S. Children's Bur-
eau. The bureau, however, discounts this
reversal as a cause for pessimism because
of the many non-significant factors that
affect the court reports. One of these is
change in court procedures; another,
change in policies of agencies in referring
cases to the courts.

More significant, perhaps, are the di-
visions of delinquency. While since 1930
there has been a gradual decrease in the
number of white children brought before
the courts, there has been a gradual in-
crease in cases of Negro children. In
1937, white children's cases increased 10
percent, while Negro children's increased



15 percent. In the same year, 27 percer
of all the juvenile delinquency cases dealt
with in the twenty-eight reporting courts
were those of Negro children.

In a sex division, boys represent the
bulk 85 percent of the delinquency
cases. Their number increased 12 percent
from 1936 to 1937 but decreased 16 per-
cent from 1930, their peak year, to 1937.
Girls' cases, which decreased 26 percent
from their peak year of 1929 to 1937,
showed an increase in the latter year of
7 percent over 1936. Half the boys' cases
involved stealing; one fourth, the com-
mission of acts of carelessness or mischief.
Most of the girls' cases 66 percent
involved running away, ungovernable
conduct or sex offenses.

Birth Control

'TPHE first state birth control organ-
* ization sponsored by Negroes is the
West Virginia Maternal and Child
Health Council which completed its
formation in late summer. Prof. E. S.
Jamison, director of the department of
health and physical education of the
West Virginia State College, is the chair-
man. Members of the board include
social workers, ministers, educators, doc-
tors and nurses. The new council will
cooperate with the West Virginia Ma-
ternal Health Federation in extending
educational work among Negroes and
furthering the organization of birth con-
trol clinics for Negro mothers.

No Appeal The fight of the Birth
Control League of Massachusetts to
maintain mothers' health services has
taken a new course since the decision
of the U. S. Supreme Court which, in
mid-October, dismissed the appeal of
four workers attached to the North
Shore Mothers' Health Office, Salem,
from a decision of the Massachusetts
supreme court upholding the validity of
the state's rigid law banning the dis-
tribution of contraceptives. The law,
enacted in 1879, provides for the punish-
ment of any person who "sells, lends,
gives away, exhibits or offers to sell"
any contraceptive devices or drugs. The
case on which the Supreme Court has
just ruled had its origin last year in the
arrest of a doctor, nurse and two social
workers. That incident was followed by
a raid on the league's office in Boston,
the arrest of Mrs. Leslie D. Hawks-
worth, league president, and Caroline
Carter Davis, educational director, and
the seizure of a supply of pamphlets enti-
tled, "To the Welfare Workers of Massa-
chusetts," which gave the addresses of the
league's seven offices to which social
workers might refer clients who, for rea-
sons of health, needed birth control in-
formation. The higher court's dismissal
was based on lack of jurisdiction.

All local and state court decisions on
all the cases were adverse to the league



390



SURVEY MIDMONTHLY



which then carried the Salem cases to the
highest tribunal on the ground that the
old state law "was not intended to apply
to prescriptions by duly qualified physi-
n.iii>, when necessary for the preserva-
tion nt life or health." In its ruling the
state supreme court noted that in most
places it is accepted modern practice for
physicians to prescribe contraceptives
under certain conditions, but added that
the 1879 statute was plainly valid and
all-inclusive and that "relief . . . must
be sought from the law-making depart-
ment and not from the judicial depart-
ment of government."

Latest development in the battle is a
tightening of the league's aims to a more
specific goal that of allowing "duly qual-
ified physicians ... to provide contracep-
tive help for married women when it is
a question of their health or life." Mrs.
Hawkins and Mrs. Davis have with-
drawn an appeal to the superior court so
that a new test case involving such an is-
sue might be introduced. The hope is that
court interpretation of the 1879 law
might be more liberal toward its appli-
cation to "a particular doctor" attending
a particular "case where pregnancy might
mean death to the mother or death or
disease to the child."

Won Victory smiled toward the birth
control movement in a recent legal bat-
tle involving the U. S. Customs' seizure
two years ago of copies of the magazine,
Marriage Hygiene, published in India
and sent to a college professor, American
editor of the publication. In its decision,
the circuit court of appeals held that im-
ported birth control books and pamphlets
might be received in this country by qual-
ified persons other than physicians who
"would not abuse the information." The
case is now closed as the time allowed
for appeal to the Supreme Court has ex-
pired.



Hospitals



"THE largest general hospital in the
world, Chicago's Cook County, has
been dropped from the approved list of
both the American Medical Association
and the American College of Surgeons.
It was dropped from the medicos' list
last summer, and from that of the sur-
geons' in mid-October. This double ac-
tion followed years of discussion of the
hospital's deficiencies by medical and civic
groups. Several studies and surveys have
been made and placed on file. In the lat-
est, a study made in 1937 by a commit-
tee of hospital superintendents appointed
by the Board of Commissioners of Cook
County, dissatisfaction again crystallized
into definite recommendations for im-
provement, chief of them the appoint-
ment of a trained and experienced hospi-
tal administrator.

The Cook County Board has offered



the position of warden, as it is called, to
several men of high professional stand-
ing, but it has gone begging because it
otters no security of tenure. The state
law makes the post an appointive office,
renewable each year. It was refused on
these terms last July by Dr. Benjamin
W. Black, of Oakland, Calif. Discour-
aged by Dr. Black's refusal, the board
appointed Brig. Gen. Manus McClosky
as warden of the hospital. The action of
the doctors' associations followed.

The withdrawal of professional ap-
proval is a serious blow to the hospital,
staffed by some of Chicago's best physi-
cians and surgeons, and long a coveted
training ground for promising interns.
Members of the county board and doc-
tors from the hospital staff have risen
hotly to its defense. But the AMA and
AC of S have refused to reopen the issue
until a well qualified medical adminis-
trator or, at very least, a full time medi-
cal assistant to General McClosky is
appointed. Experts disagree as to the
means by which the position might be
made attractive to a qualified man. Some
people hold that a state constitutional
amendment would be necessary; others
that the post of warden could be brought
under civil service without such an
amendment.

Council "Both private and governmen-
tal interests" are represented in the new
Hospital Council of Greater New York.
Formed to coordinate the hospital and
health facilities in the city with the ob-
ject of improving service, the council sup-
ersedes the mayor's Hospital Council of
the City of New York, and is the result
of recommendations growing out of a re-
cent city-wide hospital survey. Although
it will act as an independent community
agency its membership of seventeen agen-
cies includes the City of New York.

Going Up Construction on the $2 mil-
lion cancer hospital, training and research
center to be built in New Jersey by the
Curie Institute will begin in 1939. . . .
The cornerstone for a new $1,500,000
building for the New York Medical Col-
lege and Flower Hospital was recently
laid in New York City. . . . PWA funds
will build a new $600,000 tuberculosis
unit at Freedman's Hospital in Wash-
ington. The unit will not only provide
necessary facilities for the diagnosis and
treatment of the disease but also will af-
ford experience to interns in a hospital
which graduates about 50 percent of the
country's Negro physicians.

Supply The South's economic position
is reflected in a report of the U. S. Pub-
lic Health Service which shows it to have
less hospital facilities in relation to pop-
ulation than any other area. Most favor-
able are the facilities of those states in
the Rocky Mountain and Pacific areas
and on the middle Atlantic seaboard. Al-



together there are 4841 registered gener-
al and special hospitals in the United
States, representing a total capacity of
451,000 beds. Half the hospitals have less
than fifty beds each. Largest in average
size are the mental hospitals, the 597 in
the United States having over a million
beds, but often operating beyond rated
capacity.

According to a compilation of the Na-
tional Tuberculosis Association there are
92,786 beds in 749 institutions for tuber-
culous patients in the United States and
its territories, representing an increase of
5869 beds since 1934. In continental Uni-
ted States there are 78 federal, 399 state,
county and municipal, 71 private and 184
semi-private institutions housing the tu-
berculous.

Who Pays Ten years have reversed
the percentages of public and private
money financing hospital buildings accord-
ing to a recent study. In 1927, over 71
percent of the $134 million spent on con-
struction went from private resources to
voluntary hospitals. Today, the govern-
ment furnishes three fourths of the money
going into hospital buildings.

Insurance Latest figures show two and
a quarter million persons enrolled in hos-
pital care insurance plans throughout the
country, an increase of nearly a million
enrollees in less than a year. Largest
plan is New York City's with a member-
ship just past a million; next is Minne-
sota's with some 209,000. Ten new plans
are awaiting the approval of the Ameri-
can Hospital Association.

To Read Pictographs at their best ap-
pear in "You and Your Hospitals," a
fifty-nine-page booklet recently published
by the United Hospital Fund of New
York, 370 Lexington Avenue. Facts about
the voluntary and municipal hospitals
found in a recent survey sponsored by the
United Hospital Fund are here presented
in first-reader simplicity. Statistical com-
parisons show the need of expansion of
out-patient departments, medical social
services, ward facilities, prepayment plans ;
the economic waste in unused private
rooms. Coordinated planning is recom-
mended to save the voluntary hospital
system from being supplanted by govern-
ment owned facilities.

The Public's Health

TXT" II I LE national plans for a wide-
spread health program seem dead-
locked by disagreement between its pro-
ponents and organized medicine, empha-
sized by reiterated convictions in a recent
closed session of the President's Interde-
partmental Committee and a committee
of the AMA, interest in medical care
plans grows apace within the states. In
Massachusetts, a four-point program is
recommended by the New England Jour-



DECEMBER 1938



391



nal of Medicine. The suggestion includes
the establishment in each community of
a well equipped and staffed hospital, a
hospital insurance service, a medical care
insurance service, and a health service
council to coordinate a medical program
for the indigent.

The services of a bureau of medical eco-
nomics, established by the Oregon State
Medical Society, are available to the
state's local medical societies for help in
developing plans for medical care of low
income and industrial groups. At the re-
quest of any society, bureau representa-
tives and legal counsel will be sent to
make a local survey and offer advice. De-
veloped plans must be submitted to the
council of the State Medical Society. The
bureau is also helping the Oregon Asso-
ciation of Hospitals in developing a hos-
pital insurance plan.

New An obstetrical consultant service
has been set up by the bureau of mater-
nal and child health, Michigan State De-
partment of Health, to cooperate with
the county maternal health committees
and the district medical societies. Head
of the new service, available to all physi-
cians, is Dr. Clair Folsome, instructor in
obstetrics and gynecology at the Univer-
sity of Michigan.

Group Medicine News of the grow-
ing fleet of medical cooperatives [see Sur-
vey Midmonthly, October 1938, page
325] includes the launching of a new
health group in Superior, Wis., with the
"bon voyage" of the local medical society.
Piloting the venture is a committee com-
posed of medical association and lay rep-
resentatives. . . . The Wage Earners
Health Association in St. Louis braves a
threatening financial cloud by suggesting
two proposals for increased dues for the
consideration of its members: first, a 50
cent blanket rise; second, extra charges
for operations, deliveries, home and hos-
pital calls, infant care.

A Chance to Live A recognized gap
in the nation-wide anti-tuberculosis
program is the lack of rehabilitation fa-
cilities for the arrested case. Discharged
from the sanatorium with instructions to
get a light, outdoor job which he discov-
ers to be non-existent, the patient too
often drifts back into the industrial world
for a short period before being returned
to the sanatorium in a relapsed state.
Notable as an attempt to fill this gap is
the work of the Committee for the Care
of the Jewish Tuberculous, in New
York. A review of the committee's first
twenty-three years (1913-1936) recently
has been released in sixty-five pages en-
titled "Life and a Living" which show
the encouraging results that can be ob-
tained from a concentrated rehabilitation
program. The work of the committee,
like the booklet, has been divided into
two parts, though the second is merely a



phase of the first. Naturally, the "cure"
comes first, which includes arranging for
the proper care of a patient either in a
sanatorium or, in special instances, at
home, with social service offered to his
family, where indicated, so that his cure
will not be retarded by worry. The latter
is carried on into the "after-care" pro-
gram, where an important part is played
by the Altro Work Shops, a garment fac-
tory created to provide employment un-
der ideal conditions for patients dis-
charged from sanatoria. In this factory
time clocks are used to keep an employe
from overworking, and hours are ar-
ranged according to the workers' physi-
cal condition. Neverthless, the factory is
run on a business basis, wages (at the
highest prevailing rate) being paid ac-
cording to the work done. Discharge
comes when a patient is found to be in a
condition to be fully self-supporting. It
would be interesting, if it were possible,
to compare the statistics which show that
49 percent of the patients are well and
working ten to twenty years after leav-
ing the factory to statistics concerning
discharges from sanatoria that offer no
follow-up care.

Negro Health Negro physicians and
dentists have recently organized the Penn-
sylvania Institute for Negro Health un-
der the leadership of Dr. Frederick M.
Hopkins of Philadelphia. The institute
will cooperate with public health depart-
ments in sponsoring projects to induce
health habits in Negro children and in
spreading health information among Ne-
groes. It also proposes to interpret the
aims of the Negro physicians and den-
tists throughout the state.

Worth a Pound of Cure A grant of
$84,000 from the Commonwealth Fund
will be used to develop a new department
of preventive medicine at the New York
University College of Medicine to cover
a four-year curriculum. New York City's
Lower East Side Health Center will be
used for teaching and research. Purpose
of the department, proposed fifteen years
ago by a faculty committee, is "to stimu-
late the interest of the entire faculty in
the preventive aspect of medicine ... so
that every student . . . would have an at-
titude favorable to appreciation and par-
ticipation in the modern public health
movement."

Against Cancer State and PWA
have matched funds to produce the $900,-
000 Ellis Fischel Cancer Hospital for
Indigents now under construction in Co-
lumbia, Mo. The eight-story building will
have a capacity of eighty-three beds. . . .
Georgia, receiving an average of seven
applications per day for state aid in can-
cer treatment, now has ten state-aided
cancer treatment centers. . . . Though the
cancer deathrate in Massachusetts has
doubled since 1900 a recent statistical



study shows that the increases in those
cities which have state-aided cancer clin-
ics were smaller than in the state as a
whole. . . . The National Advisory Can-
cer Council, created by the Cancer Act
[see Survey Midmonthly, August 1937,
page 260] has so far approved sixteen
applications for grants-in-aid for re-
search, totaling $125,000.

In Print Los Angeles County Health
Report, a clearly written 137-page report
of the functioning of a county health de-
partment in the fiscal year ending June
1938, is a bright example of the possi-
bility of producing such material in a
readable manner. Vivid photographs and
generously distributed pictographs help
keep down the weight. . . . Maternal
Mortality by Place of Residence: U. S.
1935, Volume 5, Number 50 of Vital Sta-
tistics Special Reports, published by the
Bureau of Census, Washington. Com-
piled by a WPA project, the report enu-
merates by counties and states all deaths
from puerperal causes, showing another
angle of the South as the nation's number
one problem.

Just what its name implies, "Health
Insurance: A Brief Study Guide," has
been prepared by the American Nurses
Association and the National Organiza-
tion for Public Health Nursing. Price 10
cents from either organization, 50 West
50 Street, New York.

Professional

^TRAINING on the job is part of the
educational program for staff nurses
of the New York City Department of
Health. Teaching laboratories at two of
the department's health centers provide
opportunities for observation and discus-
sion, and the testing of practices and pro-
cedures. The educational project, made
possible through social security funds,
embraces programs for regular staff
nurses, for newly appointed nurses, and
for new supervisors. One of its main pur-
poses is to help develop the nurse's ability
to carry out her teaching role among the
families she serves.

In Chicago, public health and social
problems are the topics under discussion
in three groups of lectures for graduate
nurses, sponsored by the Tuberculosis In-
stitute of Chicago and Cook County at
the University of Illinois, the University
of Chicago and Grant Hospital.

Concerning Motherhood Cleveland
will be the scene next year of the first
congress in this country called for the
consideration of problems associated with
childbirth. Sponsored by the American
Committee on Maternal Welfare, Inc.,
the meeting, September 11-15, will be
called the American Congress on Ob-
stetrics and Gynecology. The membership
of the committee includes the American



392



SURVEY MIDMONTHLY



Public Health Association, the U. S.
Children's Bureau, and the U. S. Public
Health Service as well as hospital, nurses'
and physicians' associations.

The National Council for Mothers
and Babies, recently evolved from the
meetings of a group of people called to-
gether in Washington by Katharine F.
Lenroot, chief of the U. S. Children's
Bureau, includes representatives of fifty-
eight national organizations. Purpose is
to build up enlightened public opinion
regarding public health measures for
mothers and babies throughout the na-
tion ; method involves two national meet-
ings a year, two conferences in each state.

Demand Employment of public health
nurses rose 7J4 percent in the first nine
months of 1938 over 1937 according to
figures of the U. S. Public Health Ser-
vice and the U. S. Children's Bureau.
Must of the 1615 new nurses were added
to the staffs of local agencies.

Employers and Employes Per-
sonnel practices and policies of six Jew-
ish case work agencies, affiliated with the
New York Federation of Jewish Chari-
ties, are being surveyed by the Council
of Jewish Federations and Welfare
Funds. In the agencies under study, pro-
fessional workers are placed on a three
to six months probationary period before
receiving permanent employment. . . .
Strikes of government employes were
outlawed by the State, County and Muni-
cipal Workers of America, CIO, at the
recent New York State convention. The
union, which represents many public wel-
fare workers, aims to achieve its princi-
ples, including the forty-hour week,
through the milder methods of "negoti-
ation, legislation and education."

Conference Action The Georgia
Conference on Social Work has opened
headquarters in Atlanta to further its
campaign for a civil service system
throughout state, county and city govern-
ments. The conference, of which Fred T.
Athearn of the Atlanta Travelers Aid
Society is president, also is promoting ac-
tively the further strengthening of adop-
tion laws and more adequate provision
for general assistance for persons who
miss the categories. . . . The Indiana
Conference of Social Work, at its recent
meeting in Indianapolis, adopted an ex-
pansion program which includes the
establishment of regional conferences and
the employment of a full time, paid sec-
retary, both by the end of next year. The
Indianapolis meeting made an attendance
record of 1070 with all of the states'
ninety-two counties represented. Nearly
700 persons were registered in the two-
day study sections. Allen Bloom, secretary
of the Indianapolis Jewish Community
Center Association, was elected president,
succeeding Emma Puschner. ... At its
recent biennial convention, the United



Lutheran Church in America approved a
i institution for a new agency, the Board
of Social Missions, in which will be com-
bined the work of the Inner Mission
Board through which most of the church's
social welfare activities have operated,
the committee on moral and social wel-
fare and the committee on evangelism.

Schools The Graduate School of Pub-



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