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nourished in bad air, may be spread by contact, or by food handled by those who are sick. People who live in bad air at home mingle with others at church, in moving picture theaters, at school, in the courtroom, and in other public meeting places, which are themselves often poorly ventilated. It is strange that court rooms, where justice is administered, schools where children are prepared for life, and churches where people worship, are so often badly ventilated.
Report on the following:
Is your schoolroom well ventilated? How do you know? What effect does poor ventilation have upon your feelings and your work?
If the law requires school attendance, why should it also require good ventilation of the school?
If the ventilation of your school is not good, what may you do about it? Who is responsible for it?
Observe and report upon the ventilation of the court rooms, moving picture theaters, churches, and other meeting places in your community.
PURE WATER AND HEALTH
Cities go to great expense to get an abundant pure-water supply. It is of the greatest importance in community sanitation Impure water is one of the chief sources of typhoid fever and other diseases of the intestines. About 400,000 persons have typhoid fever every year in the United States, and 30,000 are killed by it; and it is unnecessary. We have from three to five times as much typhoid as many European countries have, and for no other reason than that we are negligent.
PURE FOOD AND HEALTH
Pure, clean, wholesome food is equally essential. We need not dwell upon the importance of the right kinds of food and well- cooked food. Much illness is caused by "spoiled" foods. Disease germs may be carried by food as well as by water. Tuberculosis may be carried by milk, either from diseased cattle, or from victims of the disease who handle the milk at some point in its progress from the dairy farm to the home. The death rate among babies is appalling, especially in cities, because of the use of milk containing germs of intestinal diseases. Typhoid fever may be contracted from milk, green vegetables, and oysters from beds contaminated with sewage.
The food supply of cities passes through many hands before it reaches the consumer. At almost every point it is protected by regulations and inspection. Most of it, however, comes originally from the farm which is beyond the control of the city authorities. The producers and handlers of food products in rural districts therefore owe it not only to themselves but also to their city neighbors to exercise every possible precaution against the spread of disease. Such precautions consist in cleanliness in handling and storing milk, butter, and meats; in the cleansing of milk receptacles with pure water; in the proper location and construction of wells; in protecting springs from surface drainage; in sanitary disposal of sewage and other wastes from the household; in protection of food against flies.
SANITATION IN CITIES
In cities a great deal of attention is given to sanitation. Sewage is carried off by public sewers. Householders are required to place garbage in sanitary cans, whence it is collected and disposed of in such a way as not to pollute the soil. Ashes and refuse are carried away from homes and shops, and the streets are cleaned daily. In rural communities such matters are left almost entirely to the householder.
FLIES AS DISEASE CARRIERS
Exposed garbage, improperly built outdoor toilets, and stable manure are breeding places of flies; and flies are notorious carriers of disease. Yet, out of more than 3000 homes in one county in Indiana only 31 made provision to prevent stable manure from breeding flies, and the same was true of only 1 out of more than 2000 homes in a county in North Carolina, and only 86 out of nearly 5000 homes in an Alabama county.
DANGER FROM MOSQUITOES
Malaria is widespread in the United States and imposes a heavy toll upon the nation's health. It is carried from one victim to another by a certain kind of mosquito, of which it is comparatively easy to get rid by proper drainage of breeding places, by treating the surface of pools with kerosene, by screening, and by seeing to it that rain barrels are covered and that tin cans and other receptacles of water are not left lying around. But flies and mosquitoes do not stop with fences, nor do they recognize city or county boundaries. Hence, individual effort without community cooperation is likely to be useless.
POLLUTED SOIL AND HOOKWORM DISEASE
The terrible hookworm disease so prevalent in our southern states is caused by a minute worm that infests soil polluted with sewage. It penetrates the soles of the feet of those who go barefoot and the palms of the hands of those who work in the soils, finds its way through the blood to the intestines, and thence to the soil again. An investigation in 770 counties in 11 states where hookworm disease is prevalent showed that out of 287,606 farm homes only six tenths of one per cent disposed of their sewage in such a way as to prevent soil pollution.
Out of 305 homes in a little community in Mississippi, only 4 properly disposed of sewage. When the first investigations were made, there were 407 cases of hookworm disease out of 1002 residents. Besides, there had been recently 12 cases of tuberculosis, 47 of typhoid fever, 184 of malaria, and 384 of dysentery.
Safe methods of disposing of sewage were introduced, houses were screened, an artesian well was bored for a public water supply, and the community cleaned up generally. After these improvements the various diseases almost entirely disappeared. Similar results were obtained in 99 other communities in the southern states.
[Footnote: Report of the Rockefeller Foundation, 1917, pp. 136- 138.]
Topics for investigation:
The water supply of farms in your locality. Any recent improvements.
The public water supply (if any) of your community. Its sources. Method of purification. Quality of water. How the people know it is pure or impure. Public or private ownership of the supply. Cost to the householder.
Extent to which the families represented in your class depend upon private wells. How many have had their well water examined to test its purity. How to proceed to have water tested. Who tests it? Who pays for the test? (If possible, visit the laboratory where the tests are made.)
Number of cases of typhoid fever in your community, now or during last year. How the information can be obtained. Is the information likely to be accurate? Whose business is it to keep a record? Why should a record be kept? Why should it be made public?
Causes of typhoid in your community. Are they preventable? How? Observance of quarantine against typhoid.
How may wells become polluted? Give cases of which you may know. Study diagram on page 314.
Methods of sewage disposal in your community. Laws on the subject. Can you suggest improvements?
Regulation of milk production and handling in your community: on the farms where it is produced; in the hands of dealers and distributors; in the home. Who make these regulations?
Outline on a map the area from which your community is supplied with milk. Show on a map cities that are supplied by your county with dairy products, garden vegetables, meats, etc.
Clean-up campaigns in your community.
Progress and methods of fly and mosquito extermination in your community.
The work of the Rockefeller Foundation for the extermination of hookworm disease (see references).
Hospitals that serve your community. Where located. By whom supported (private, city or town, county, state).
NATIONAL CONTROL OF HEALTH CONSERVATION
Health protection, like education, has been considered primarily the duty of the state. But many conditions affecting health have arisen that the state cannot completely control. Chiefly under the power given to it by the Constitution to regulate foreign and interstate commerce (p. 451), Congress has passed many laws that protect health, placing their enforcement in the hands of the several departments of the national government.
HEALTH WORK OF THE DEPARTMENT OF AGRICULTURE
The Department of Agriculture conducts much public health work, through its home demonstration agents, its Office of Rural Engineering, which deals with problems of farm water supply and rural sanitation, its Bureau of Entomology which wages war against flies and other disease-carrying insects, and its Bureau of Animal Industry which inspects cattle, meats, and dairy products. The Department of Agriculture also administers the Food and Drugs Act, the purpose of which is to secure purity of food products and to require that they and medicinal drugs shall be labeled in such a way as to show what they contain. Fraudulent and harmful "cures" and "patent medicines" may thus be exposed.
THE PUBLIC HEALTH SERVICE
The United States Public Health Service investigates diseases and
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