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including limited diagnostic, X-ray and
laboratory work. Both plans provide for
the free choice of physicians from a
panel of those agreeing to serve the asso-
ciation. It is said that a bill will be intro-
duced into the legislature in January
which would remove any legal obstruc-
tion to the functioning of the proposed
cooperative.

Meantime the Kings County (Brook-
lyn) Medical Society is sponsoring a
"mutual non-profit cooperative associa-
tion to facilitate employment of medical
service." Taking a leaf from the highly
successful Associated Hospital Service
and its 3-cents-a-day plan for insuring
hospital care, the proposed Associated
Medical Service of New York would
provide "insurance against unusual and
costly doctor's bills" through an annual
subscription of $14.60. Illness involving
less than $10 expense to the patient
would not be covered.

In Cleveland, a proposal from the eco-
nomics committee of the Academy of
Medicine, already approved by the acad-
emy's board of directors, follows the hos-
pital insurance plan even more closely.
It provides for the members of the Cleve-
land Hospital Association, by payments
of $7 to $9 annually, insurance of $6 a
day up to twenty-one days against

325



doctors' bills incurred in the course of
hospitalization. There is no provision for
home medical care.

To meet the demand for some sort of
prepayment system for medical care for
employed families with low incomes, the
county medical society of Denver, Colo.,
has approved a proposal for a central
medical service bureau. Dr. Paul J. Con-
nor heads a committee to work out details
of the bureau. The society's decision to
launch the project followed a survey of
low income groups and of employers to
determine the need for and the extent of
interest in any new form of medical
practice.

Evidence of the rising lay interest in
group medicine are the negotiations under
way between the United Mine Workers
of America and the Good-Will Fund, Inc.
of Boston, for the financing of a study to
determine in what form group medicine
might be feasible for the union's members.

The Public's Health

T^HE stork is expected to deliver at
* least a dozen packages at the 1939
World's Fair in New York, and the
fair's Department of Medicine and Pub-
lic Health is making full preparation for
their reception. The expectancy rate is
based on statistics of Chicago's Century
of Progress Exhibition where the bird
dropped around six times. Childbirth is
only one of the medical emergencies en-
visoned by the farsighted health depart-
ment which plans to equip the fairgrounds
with ten first aid stations, a large corps
of physicians and surgeons, a hundred or
so nurses, ten motor ambulances and a
mobile X-ray truck.

Research The minute mosquito is
under more minute scrutiny at the new
Henry Carter Memorial Laboratory of
the U.S. Public Health Service at Savan-
nah, Ga., dedicated to the study of ma-
laria control. Investigating both the life
cycle of the mosquito under different
breeding conditions and the local preva-
lence of malaria in its relation to the
use of prophylactics, the laboratory aims
at securing the lowest cost malaria con-
trol by biological rather than engineering
methods. The work is under the direction
of U. S. Surgeon L. L. Williams, Jr.

The new Squibb Institute for Medical
Research at New Brunswick, N. J., is
the first to be founded in the pharmaceu-
tical industry. In addition to conducting
research activity in experimental medi-
cine, pharmacology, bacteriology and virus
diseases, and organic chemistry, the insti-
tute will operate biochemical and medi-
cinal chemistry laboratories and will
maintain a free hospital ward of fifteen
or twenty beds to provide clinical facili-
ties for the staff. Among the studies al-
ready begun are investigations of surgical
shock, measles, vitamin B n and vitamin
K. The institute, which will establish fel-



lowships in medical schools for the study
of cancer, syphilis and hormones, is under
the direction of Dr. George A. Harrop,
former associate professor of medicine in
Johns Hopkins University.

Research on healthful working condi-
tions conducted by a committee of the
National Association of Manufacturers
will be directed by Dr. Victor G. Heiser,
formerly of the Rockefeller Foundation.
Plans are to make a survey of plant con-
ditions and to establish an information
service for approximately 80,000 factories
employing from 25 to 2000 workers each.

Various and Sundry Hot pancakes
as treatment for open wounds, spider
webs for sore eyes and similar "anti-
social superstitions that militate against
health" will be educated out of New
York's "less-informed persons" if the
WPA and the Board of Education have
their way. In twelve neighborhood centers
a joint attack is being made on old no-
tions, not only by means of health classes
but by consultation services that aim to
aid mothers distracted by unruly children
and adolescents distracted by "old fash-
ioned" parents.

A Bureau of Social Hygiene has been
formed by the Jersey City Health De-
partment to carry on educational and
epidemiological work as well as to super-
vise the clinics of the Jersey City Medical
Center. Dr. Edmund Daly is acting
director.

Blood transfusions for persons unable
to pay a professional donor or to obtain
the needed blood from relatives or friends
are being made available in Baltimore
through the American Red Cross Blood
Transfusion Bureau directed by Dr.
Charles C. W. Judd. Enrolling healthy
volunteers between the ages of twenty-
one and forty-five, the bureau aims to
dispatch a suitable donor promptly in
response to a request by a physician.

Venereal Disease Big attraction at
the Illinois State Fair was the offer of
free blood tests for syphilis accepted by
more than 4000 persons including farm-
ers and city folk, family groups, courting
couples, cowboy performers, barkers from
the Midway, and practically every other
type of human being likely to be found at
a state fair. Popular interest in the war
on venereal disease was further evidenced
at the nine-day fair by the daily attend-
ance ranging between 5000 and 10,000 at
the exhibit on syphilis.

July, the first month of the enforce-
ment of the law requiring premarital
examination for syphilis, brought a 41
percent decrease in marriages in upstate
New York from the same month last
year. While another new law providing
for an interval of seventy-two hours be-
tween application for license and mar-
riage undoubtedly was a large factor in
the falling off of marriages of non-resi-
dents, it would hardly affect those of



residents, which show a decrease of 23
percent with the blood test law as the
only apparent cause. In New York City
where there was a corresponding drop in
July marriages after a June boom, Au-
gust statistics veered back to normal.
Figures and charts indicate that lack of
knowledge of the requirements of the law
and the inconveniece entailed were the
chief reasons for the July drop.

Population, the extent of venereal dis-
ease and the financial resources of the
states were the bases of the federal
allotments of funds under the venereal
disease control act of 1938. The Virgin
Islands received the smallest grant, $949,
and New York State the largest, $193,-
724. The smallest state allotment was
Nevada's $2475. Second largest was Penn-
sylvania's $165,082; third, Illinois' $125,-
299. These are for the fiscal year ending
June 30, 1939.

Trailers and Health The New York
City Board of Health is taking special
measures to protect the health of persons
coming to the 1939 World's Fair in trail-
ers. While ample parking space will be
provided adjacent to the fairgrounds,
trailers may not be used as living quar-
ters while parked there. Private trailer
camps in the city which are used for liv-
ing purposes will be closely supervised by
the health department, ensuring proper
water supply, lighting, and sanitary con-
ditions.

A new use for trailers is being de-
veloped as a project of the WPA and
National Youth Administration. WPA
workers and students are constructing
"tubercular trailers," small, white, porta-
ble, one-room cottages, to be used by
patients on hospital waiting lists and con-
valescents, or wherever temporary isola-
tion quarters are needed. The cottages
may be loaded onto trucks and trans-
ported to the very backyard of the pa-
tients. Most of the projects are spon-
sored by counties or by state health
associations which supervise the distribu-
tion of the cottages and care of patients.
Near Little Rock, Ark., a group of
trailer-patients has formed a cooperative
camp. A hundred such "trailers" are in
use in that state.

Deaths and Births For fifteen months
the deathrate among policy holders of
the Metropolitan Life Insurance Com-
pany has been dwindling. In July of this
year the lowest rate ever recorded for
any July was registered seven deaths
per thousand. Likewise the cumulative
rate for the first seven months of 1938
was lower than any previously recorded
for a similar period.

The lowest weekly deathrate in the
records of the New York City Depart-
ment of Health, 7.5 per 1000 of popu-
lation, introduced the month of Septem-
ber. At the same time another city record
crashed with the passing of the eighth



326



SURVEY MIDMONTHLY



successive week lacking a diphtheria
death. This is attributed to the depart-
ment's renewed immunization drive. [See
Survey MidmontHly, September 1938,
page 293. J

Over 15 percent of the Californians
born in the last ten years are of Mexi-
can parentage though the rate since 1928
has steadily decreased from over 16J4
percent to less than 13 percent in 1937.
Infant mortality rates among Mexicans
are high, accounting for a third of all the
infant deaths in California.

Cancer The fight against cancer, sec-
ond only to heart disease as a cause of
death, has received consideration from
only seven state legislatures those of
Connecticut, Georgia, Illinois, Missouri,
Ma^achusetts, New Hampshire, New
York. Although state interest in cancer
dates back to the last century, legislative
progress was slow until 1937 when three
of the seven authorized their first cancer
appropriations. The creation of the Na-
tional Cancer Institute a year ago will,
it is believed, stimulate further state
legislation. In 1937 a total of $2,012,000
was appropriated by the states for can-
cer clinics, education, hospitalization and
research to fight an enemy that destroys
approximately sixteen lives an hour.

New York City plans an intensive
cancer campaign for November. On the
program is the award of the Clement
Cleveland Medal to the person who has
made the most valuable contribution to
the educational work in cancer during the
year, and a preview of the World's Fair
Cancer Exhibit at the Museum of Science
and Industry.

Grants Allotments of the $8 million
sum appropriated for the current fiscal
year under the social security act for as-
fisting public health services throughout
the country give New York the lion's
share of $537,843. Pennsylvania receives
the next largest amount, $464,856, with
Texas, Illinois, Ohio and North Carolina
each coming in for well over $300,000.
Wyoming squeezes in at the bottom of
the list with $28,998.

Among the Hospitals

TPHE Federated Trades Council of
Milwaukee is taking steps toward the
establishment of a cooperative hospital
to offset the existing hospital ban on the
physicians of the Milwaukee Medical
Center. [See Medical Rift in Milwau-
kee, by Andrew and Hannah Biemiller,
Surrey Graphic. August 1938.] The last
hospital in Milwaukee to admit the phy-
sicians of the center recently notified them
that the policy would be discontinued be-
cause of the American Medical Associa-
tion's warning that the hospital's rating
for interneship might be taken away.

OCTOBER 1938



The feasibility of establishing coopera-
tive hospitals is being considered in Wash-
ington, D. <.'., Oklahoma City, Kansas
City and in Clay County, Mo. Clay
County has but one private hospital of
forty beds to serve a population of more
than 20,000.

A Hospital Interprets A veritable
clearing house for troubles, the social
service department of a city hospital may
have unique opportunities to show a com-
munity where its inadequacies lie. Medi-
cal social workers in the Louisville, Ky.
City Hospital, harassed by the continual
nag of patients' unmet needs, found them-
selves becoming frustrated and embit-
'tered by the situation. The result was
discontent with their jobs and unsatisfac-
tory relations with other social agencies.

When the department staff got together
to talk it over, workers were surprised to
discover that all their problem patients
fell neatly into two groups: those known
to social agencies but receiving inadequate
relief; those for whose needs the com-
munity made no provision. Concentrating
their attention on the latter group, staff
members combined to produce an infor-
mal survey of cases. The results, when
tabulated, pointed out the gaps in com-
munity resources which were behind the
difficulties. The figures told, for exam-
ple, how many patients were "waiting for
old age assistance" or "found assistance
inadequate," were employable but not
eligible to WPA, had "income inadequate
to maintain health," and how many per-
sons in each household were affected.

After a series of illustrative case stories
had been worked out to accompany the
figures, the story was ready for telling.
Needs of all the city's relief agencies were
reflected in the acute troubles which
reached the hospital as breakdowns due
to inadequate food, preventive work
blocked by lack of necessary relief funds,
medical care wasted because the patient
had no means of "carrying on" when dis-
charged. The social service department
found ready voices to tell its story. News-
papers, a public hearing, a citizen's com-
mittee of ministers, the League of Wo-
men Voters, the publicity committee of
the American Association of Social
Workers joined in the chorus.

"At a city hospital, clients from all
agencies meet in the great cauldron of
human illness," said Mathilda Mathisen,
director of the department which made
the survey. "The social worker there
knows clients from all agencies and many
who never have gone below the line of
self-maintenance until sickness shoved
them over. ... On the other hand, these
social workers must know the intake poli-
cies of the various social agencies in their
city and must be able to use whatever
resources are available. For that reason
they are peculiarly fitted to see the gaps
between relief-giving agencies and to col-
lect data to show the amount of suffer-



ing brought on by these gaps. ... It is
obvious that such a study as this is only
one of many types of studies that could
be made both to help the community
understand the hospital and the hospital
the community."

A Decade Another medical social ser-
vice department to find itself concerned
with inadequate relief is that of the Mt.
Sinai Hospital in New York which re-
cently issued a ten-year review (1927-
1937) containing the statement: "A
particularly noticeable factor is the in-
creasing need of our patients for material
relief," complicated by "delays in receipt
of public relief funds, difficulty in proving
eligibility, legal restrictions which prevent
relief agencies from supplying certain nec-
essary expenses." The report gives a
lucid, if brief, explanation of the services
rendered by a professional staff of thirty-
five in the clinics and wards of the hos-
pital, and should be prescribed for any
skeptic who still wonders about the value
of the medical social worker.

Getting Together Cooperation be-
tween public library and hospital has
expanded the services being offered to the
patients of the Hospital for Joint Dis-
eases in New York City. In a year, four-
teen volunteers served a total of 530
hours distributing books to the wards and
to semi-private patients, obtaining them
not only from the hospital's library but
also from the New York Public Library
which sends a librarian to the hospital
once a week to supply the patients with
books of special interest.

Maternity Homes Catholic matern-
ity homes generally are larger than others
according to a report of the U.S. Chil-
dren's Bureau. During 1937 the average
number of women under care in Catholic
homes was 156 while the average for
Salvation Army homes was 140, for Flor-
ence Crittenton homes ninety-two, and
for all others sixty-three. Of the eighty-
five maternity homes reporting to the
bureau nineteen were Florence Critten-
ton homes, twenty-one were Salvation
Army homes, seventeen were Catholic,
and the remaining twenty-eight were
under various auspices, religious denomi-
nations, non-sectarian boards, and public
agencies.

Discontinued Word from Washing-
ton refusing to sanction further the con-
tinued employment of relief workers in
jobs that should be city-financed recently
forced the withdrawal of 3289 WPA
workers from assignments in twenty-six
New York City municipal hospitals.
These included physicians, nurses and
orderlies, who during the past five years
had become so ingrained in the work of
the hospitals that Dr. S. S. Goldwater,
commissioner of the Department of Hos-

327




pitals, feared the department would be
"seriously crippled."

During its operation the project spon-
sored 91,000 treatments in out-patient
clinics, 155,000 physiotherapy treatments,
33,000 shaves and 4000 haircuts for bed
patients, the compounding of 50,000 pre-
scriptions, and the investigation of 150,-
000 cases to determine eligibility for free
hospital service. All but the fifty-four
workers who lacked relief status were
promised jobs on other projects.

People and Things

"^OVEMBER will bring a new execu-
^ tive director to the Social Security
Board, Oscar M. Powell to succeed
Frank Bane, re-
signed. Mr. Powell,
a regional director
of the board since
its formation, a
member of the
American Bar As-
sociation, comes
from San Antonio
OSCAR M. POWELL where he has held
chairmanships of the Bexar County Re-
lief Committee and of the Texas Regional
Labor Board.

Mr. Bane's resignation came with the
completion of his third year in what he
terms "a strenuous and interesting job."
During his service with the board, public
assistance and unemployment compensa-
tion programs have been adopted by all
the states and old age insurance began
functioning on a national scale. Mr. Bane
is to become executive director of the
Council of State Governments, which has
its headquarters at Chicago.

Working with Mr. Powell as the new
assistant executive director of the Social
Security Board will be Geoffrey May,
formerly with the division of public
assistance.

Nurses After thirty-five years as di-
rector of the School of Nursing at the
Presbyterian Hospital, Chicago, M.
Helena McMillan has retired. . . . Ap-
pointed as director of nurses at the Allen-
town, Pa. Hospital, May L. Crouch
leaves the Henrotin Hospital in Chicago
where she has held a like position for the
past two years. ... If Chicago has lost
a nurse educator it gains another in
Mary Dunlap, now an instructor in pub-
lic health nursing at the University of
Chicago, formerly educational director
of the Visiting Nurse Association, Oma-
ha, Neb. . . . Wilkie Hughes, former
superintendent of nurses at the Ball
Memorial Hospital, Muncie, Ind., is now
general secretary of the New Jersey
State Nurses Association.

New Jobs for Old The American
Birth Control League, now stressing the
social work approach in community or-



ganization, has added to its field staff
Elinor B. Hixenbaugh, former case con-
sultant of the Family Bureau in Colum-
bus and executive director of the Ohio
Welfare Conference, and also Martha
Mumford, former field representative for
the Florida State Employment Service.
. . . Ruth Davis, former case worker in
the Philadelphia Family Society, has been
appointed field representative for the
welfare department of the Association of
Junior Leagues of America. . . . The
Connie Maxwell Orphanage of Green-
wood, S. C., has created the position of
director of case work for Kate Bullock,
former case worker in the social service
department. . . . Frances Schmidt, pre-
viously with the Associated Charities of
Cincinnati, has joined the staff of district
secretaries of the Brooklyn Bureau of
Charities. . . . Resigning as director of
the Wisconsin State Bureau of Person-
nel, A. E. Gary has become civil service
counsel for the American Federation of
State, County and Municipal Employes.
. . . Helene P. Gans, former agent for the
Bureau of Labor Statistics of the U. S.
Department of Labor succeeds Felice J.
Louria as executive secretary of the Con-
sumers' League of New York. Mrs.
Louria now heads the New York State
Department of Labor's bureau of en-
forcement of the division of women in
industry and minimum wage.

Chest Folk Community Chests and
Councils, Inc. is preening itself these days
as well it might on having enticed
Ruth Lerrigo from the editorial staff of
Survey Midmonthly and Survey Graphic
to its own editorial department. Miss
Lerrigo was a member of the Survey
family for years, first as a field represen-
tative, later as assistant editor. At the
CCC she succeeds Lisbeth Parrott who
resigned in August on account of matri-
mony, but who, as Mrs. Henry B.
Sanders of Chicago, has a hand in the
campaign publicity of the Evanston Com-
munity Chest. . . . That chest has a new
executive, Lyman S. Ford, for five years
with the Kansas City, Kan. chest. Carl
Warmington of the St. Paul chest has
gone to Mr. Ford's former post. . . . Back
in the community chest fold is John B.
Dawson of New Haven who withdrew
two years ago to take a flyer in business.
Business was all right, says he, but he
couldn't seem to put his heart in it. He
has gone to Dayton as executive of the
Bureau of Community Service succeed-
ing Arch Mandel, now with the Greater
New York Fund, Inc.

Educators Resigning as chief of the
home economics education service of the
U. S. Office of Education, Florence Fall-
gatter has become head of the department
of home economics education at Iowa
State College. ... To fulfill the two-fold
job of assistant professor in the depart-
ment of home economics and director of



the nursery school in the Institute of
Child Welfare, Dr. Catharine Landreth
goes to the University of California. She
was formerly director of the Cooperative
Nursery of the University of Chicago. . . .
Heading the newly established depart-
ment of social work in the University of
Kentucky's College of Arts and Sciences
is Vivien M. Palmer, assistant professor
of sociology. ... At the invitation of the
Carnegie Foundation comes a professor
of economics in the University of Stock-
holm, Karl Gunnar Myrdal, to conduct
a two-year study of the Negro problem
in the U. S.

Fall Moving Winthrop D. Lane re-
signed recently as secretary of the New
Jersey Juvenile Delinquency Commission
and at the same time resigned the post of
director of probation in the State Depart-
ment of Institutions and Agencies from
which he has been on leave for the past
two years while engaged in the work of
the commission. . . . Lillian A. Quinn,
who has been director of Joint Vocational
Service since 1927, has resigned to become
executive secretary of the Westchester
County, N. Y. Council of Social Agen-
cies. . . . Margaret Barnard, identified
for several years with the New York
Relief Administration, has by grace of
civil service been appointed area director
of the State Department of Social Wel-
fare with headquarters in Binghamton.
. . . Dr. Christopher L. Mengis, formerly
director of the Franklin Parish health
unit, Louisiana, has been appointed di-
rector of the new division for services to
crippled children under a bureau of the
State Board of Health. . . . Estelle Nes-
bitt is in charge of the newly established
nutrition division of the bureau of ma-
ternal and child health of the Indiana
State Board of Health. Miss Nesbitt has
recently returned from China where for
four years she was chief dietitian at
Peiping Union Medical College. . . .
Florence Taylor has resigned as assistant
secretary of the American Association of
Social Workers with which she has been
identified since 1927. Newcomer on the
AASW staff is Elizabeth Parker Mills,
erstwhile case worker with the New
York COS.

Deaths

I. MALINDE HAVEY, for a number of



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