Annual report - State Board of Health, State of Florida

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STATE

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1952

ANN UALREPORiT

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Anuatl Keport

State Board of Health

State of lorida

1952

The following statistical reports will be published separately:
SUPPLEMENTAL I FLORIDA VITAL STATISTICS, 1952
SUPPLEMENTAL II FLORIDA MORBIDITY STATISTICS, 1952

WILSON T. SOWDER, M.D.
STATE HEALTH OFFICER
JACKSONVILLE, FLORIDA

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The Honorable HERBERT L. BRYANS, M.D., President
Florida State Board of Health
Pensacola, Florida

Dear Dr. Bryans:

I herewith submit the annual report of the Florida
State Board of Health for the year ending December
31, 1952.

Sincerely yours,
WILSON T. SOWDER, M.D.
State Health Officer

May 1, 1953
Jacksonville, Florida

His Excellency, DAN MCCARTY
Governor of Florida
Tallahassee, Florida

Sir:

I beg to hand you herewith a report of the Florida
State Board of Health for the period January 1, 1952,
to December 31, 1952, inclusive.

Respectfully submitted,

HERBERT L. BRYANS, M.D.
President

May 1, 1953
Pensacola, Florida

Members of the

FLORIDA STATE BOARD OF HEALTH

HERBERT L. BRYANS, M.D., President
Pensacola

T. M. CUMBIE, Ph.G.
Quincy

ROBERT B. McIVER, M.D.
Jacksonville

EDWARD L. FLYNN, D.D.S.
Tampa

ALBERT L. WARD, M.D.

Port St. Joe

OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH

December 31, 1952

State Health Officer................................Wilson T. Sowder, M.D., M.P.H.

DIRECTORS

Bureau'of Local Health Service................George A. Dame, M.D.
Division of Public Health Nursing..........Ruth E. Mettinger, R.N.
Field Training Center............................Frank M. Hall, M.D., M.P.H.
Field Technical Staff............................James L. Wardlaw, Jr., M.D., M.P.H.

Bureau of Dental Health..........................Floyd H. DeCamp, D.D.S.

Bureau of Preventable Diseases............... Lorenzo L. Parks, M.D., M.P.H.
Division of Venereal Disease Control....William A. Walter, M.D., M.P.H.
Division of Industrial Hygiene................John M. McDonald, M.D.
Division of Cancer Control..................Lorenzo L. Parks, M.D., M.P.H., Acting
Public Health Veterinarian................ James E. Scatterday, D.V.M., M.P.H.

Bureau of Tuberculosis Control..................Clarence M. Sharp, M.D.
Division of Heart Disease Control.......... Simon D. Doff, M.D., M.P.H.

Bureau of Laboratories....................... Albert V. Hardy, M.D., Dr. P.H.
Miami Regional Laboratory....................Dwight E. Frazier
Orlando Regional Laboratory............. Max T. Trainer
Pensacola Regional Laboratory............ Emory D. Lord, Jr.
Tallahassee Regional Laboratory............ Robert A. Graves
Tampa Regional Laboratory.............. H. D. Venters

Bureau of Maternal and Child Health......Robert W. McComas, M.D., M.P.H.
Mental Health.....................Robert W. McComas, M.D., M.P.H.,
Acting

Bureau of Sanitary Engineering................David B. Lee, M.S. Engineering
Division of Entomology........................ John A. Mulrennan, B.S.A.
Bureau of Vital Statistics......... .....Everett H. Williams, Jr., MS Hyg.
Bureau of Finance and Accounts................Fred B. Ragland
Personnel Supervisor........................ Paul T. Baker
Purchasing Agent......... .................... G. Wilson Baltzell

Division of Health Information.................. Elizabeth Reed, R.N., B.S.

Division of Nutrition and Diabetes
Control ................................. .....Edward R. Smith, M.D.

Bureau of Narcotics........................... Marshall H. Doss, Ph.G.

OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH

December 31, 1952

State Health Officer................................Wilson T. Sowder, M.D., M.P.H.

DIRECTORS

Bureau'of Local Health Service................George A. Dame, M.D.
Division of Public Health Nursing..........Ruth E. Mettinger, R.N.
Field Training Center............................Frank M. Hall, M.D., M.P.H.
Field Technical Staff............................James L. Wardlaw, Jr., M.D., M.P.H.

Bureau of Dental Health..........................Floyd H. DeCamp, D.D.S.

Bureau of Preventable Diseases............... Lorenzo L. Parks, M.D., M.P.H.
Division of Venereal Disease Control....William A. Walter, M.D., M.P.H.
Division of Industrial Hygiene................John M. McDonald, M.D.
Division of Cancer Control..................Lorenzo L. Parks, M.D., M.P.H., Acting
Public Health Veterinarian................ James E. Scatterday, D.V.M., M.P.H.

Bureau of Tuberculosis Control..................Clarence M. Sharp, M.D.
Division of Heart Disease Control.......... Simon D. Doff, M.D., M.P.H.

Bureau of Laboratories....................... Albert V. Hardy, M.D., Dr. P.H.
Miami Regional Laboratory....................Dwight E. Frazier
Orlando Regional Laboratory............. Max T. Trainer
Pensacola Regional Laboratory............ Emory D. Lord, Jr.
Tallahassee Regional Laboratory............ Robert A. Graves
Tampa Regional Laboratory.............. H. D. Venters

Bureau of Maternal and Child Health......Robert W. McComas, M.D., M.P.H.
Mental Health.....................Robert W. McComas, M.D., M.P.H.,
Acting

Bureau of Sanitary Engineering................David B. Lee, M.S. Engineering
Division of Entomology........................ John A. Mulrennan, B.S.A.
Bureau of Vital Statistics......... .....Everett H. Williams, Jr., MS Hyg.
Bureau of Finance and Accounts................Fred B. Ragland
Personnel Supervisor........................ Paul T. Baker
Purchasing Agent......... .................... G. Wilson Baltzell

Division of Health Information.................. Elizabeth Reed, R.N., B.S.

Division of Nutrition and Diabetes
Control ................................. .....Edward R. Smith, M.D.

Bureau of Narcotics........................... Marshall H. Doss, Ph.G.

COUNTY HEALTH OFFICERS
(As of December 31, 1952)

Alachua ...................................................Frank M. Hall, M.D., M.P.H.
Baker Nassau ...........................................John W. McClane, M.D.
Bay ...........................................................Albert F. Ullman, M.D.
Bradford Clay Union .......................... A. Y. Covington, M.D., M.P.H.
Brevard Osceola ...................................... James F. Speers, M.D.
Broward .....................................................Paul W. Hughes, M.D., M.P.H.
Calhoun Gadsden Liberty ..................John L. Lincoln, M.D.
Charlotte DeSoto Hardee ..................Robert E. Rice, M.D.
Citrus Levy Hernando ........................Harold F. Bonifield, M.D.
Collier Lee .............................................. Merwin E. Buchwald, M.D.
Columbia Gilchrist Hamilton ..............Joseph C. Weeks, M.D.
Dade ............................................................T. E. Cato, M.D., M.P.H.
Dixie Lafayette Suwannee ................... E. H. John, M.D.
Duval ..........................................................Thomas E. Morgan, M.D., M.P.H.
Escambia Santa Rosa ............................John C. McSween, M.D.
Flagler Putnam ......................................Charles J. Mathes, M.D.
Franklin Gulf Wakulla .........................Terry Bird, M.D., M.P.H.
Glades Hendry Highlands ..................James O. Bond, M.D.
Hillsborough ..............................................Frank V. Chappell, M.D., M.P.H.
Holmes Okaloosa Walton .................... R. N. Nelson, M.D.
Indian River Martin Okeechobee -
St. Lucie ....................................... Ben. F. Wyman, Jr., M.D.
Jackson Washington ................................Henry I. Langston, M.D.
Jefferson Madison Taylor ...............John D. Cross, M.D.
Lake ............................................................J. Basil Hall, M.D., M.P.H.
Leon ............................................................Joseph M. Bistowish, M.D., M.P.H.
Manatee ......................................................John S. Neill, M.D.
Marion ........................................................ Luther A. Brendle, M.D.
Monroe ............................... ...........Raymond J. Dalton, M.D.
Orange ........................................................Leland H. Dame, M.D.
Palm Beach ................................................C. L. Brumback, M.D., M.P.H.
Pasco Sumter ..........................................Leo L. Burger, M.D.
Pinellas ...................................................Robert E. Rothermel, M.D., M.P.H.
Polk ...................................... Chester L. Nayfield, M.D., M.P.H.
Sarasota ............ ......................................William L. Wright, M.D., M.P.H.
Seminole .............................................Frank L. Quillman, M.D.
Volusia ..............................................Robert D. Higgins, M.D., M.P.H.

)

FLORIDA STATE BOARD OF HEALTH

GOVERNOR OF FLORIDA
FIVE BOARD MEMBERS

I State Health Officer I

TABLE OF CONTENTS

Page

General Sum m ary .................................................................................. 1

Finance and Accounts (including Personnel and Purchasing) ........ 9

V ital Statistics ............................ ................................... ......... 23

Local Health Services (including Public Health Nursing, Field
Technical Staff and Field Training.Center) .............................. 35

Preventable Diseases (including Venereal Disease Control, Cancer,
Industrial Hygiene and Veterinary Public Health) .................... 72

Tuberculosis Control (including Heart Disease Control) .............. 106

Laboratory Services ...................................... 128

Maternal and Child Health (including Mental Health) .............. 139

Dental H health ......... ... ......................................................................... 158

Nutrition and Diabetes Control ...................................... 163

Sanitary Engineering (including Entomology) ............................ 172

N narcotics .................................................................................................. 214

Health Information (including Library) .......................................... 216

GENERAL SUMMARY

WILSON T. SOWDER, M.D. M.P.H.
State Health Officer

The year 1952 was another good year in the annals of public health
in Florida. However, the rising cost of supplies, equipment and per-
sonnel prevented any expansion of the public health program and in
some instances worthwhile work could not be carried on for lack of
funds. About" twenty-five positions had to remain vacant in the central
office and in activities other than those of the county health departments.
The Budget Commission agreed to continue the deposit of fees collected
by the agency into a special fund for building purposes until June 30,
1953. Permission was also given for the purchase of a part of the block
between Pearl and Julia Streets and adjacent to First Street for future
building needs. Plans for a new building costing from $350,000 to
$400,000 to be located in Jacksonville neared completion. The source
of funds for the carrying on of our activities during the year were
roughly as follows: 23 per cent-Federal, 34 per cent-Local and
43 per cent-State.
Several important organizational changes were made. A health de-
partment was organized in Collier County which will operate in co-
operation with Lee County. Jefferson County which formerly had a
full time health officer was combined under a health officer serving
Madison and Taylor Counties.
The Heart Disease Control Program was transferred from the Bureau
of Maternal and Child Health to the Bureau of Tuberculosis Control
and a Division of Heart Disease Control established. A school health
consultant was employed in the Bureau of Maternal and Child Health.
The Rapid Treatment Center for venereal disease at Melbourne was
closed and regional prevention and control centers established in Pensa-
cola, Tallahassee, Jacksonville, Tampa, West Palm Beach and Miami.
This step saved about $80,000 per annum of federal funds used for this
purpose.
The quality of personnel employed continued to improve during the
year. Special difficulty, however, was encountered in the employment
of sanitary engineers, dentists and, to some extent, stenographers. The
overall turnover of personnel was about 25 per cent. The turnover of
sanitarians and public health nurses was considerably less in spite of
the fact that it is generally believed that these classifications are poorly
paid. Salary increases were given to most of the personnel during the
year on the basis of merit and longevity although consideration was
given to the constantly increasing cost of living. The training of per-
sonnel was continuously encouraged and stimulated not only through the
Training Center but through seminars, conferences, short courses and

2 ANNUAL REPORT, 1952

stipends for postgraduate work. The morale of the personnel con-
tinued to be good. The specifications for sanitarians were changed to
require that in the future each applicant have a college degree before
employment in this field.
The general health situation in the State was very bright. We had
the lowest maternal death rate in the history of the State but the infant
death rate went up slightly for the second successive year. The general
death rate also was slightly above the lowest recorded, but this can be
expected because of the increasing age of the population. There was
an unusual incidence of poliomyelitis but the cases were spread out
during the year and there was no alarm or disruption of every day life.
As the year closed considerable hope for the future control of poliomyeli-
tis was held out by the discovery that gamma globulin will confer tem-
porary immunity when administered at the proper time. The first case
of malaria since 1948 contracted in Florida was reported. There was
some doubt as to whether this case was contracted in the State. There
was an alarming outbreak of anthrax in cattle in the southern part of
the State and four human cases occurred, but the outbreak was brought
under control although the disease was not eliminated. Many cases of
equine encephalomyelitis in horses occurred and one human case devel-
oped and eleven other cases of encephalomyelitis were reported which
may have been of this type. This disease is known to be transmitted
by certain types of mosquitoes and this fact gave additional reason for
the expansion of the mosquito control program which is planned. There
was an outbreak of vesicular exanthema in swine in several places in
the United States but the disease did not occur in Florida. An embargo
on the importation of swine and pork was invoked by the State Live-
stock Sanitary Board. Although the disease does not affect humans, the
State Board of Health offered its cooperation in efforts to prevent the
disease from occurring in Florida.
The work of the various bureaus and divisions of the State Board of
Health was carried on during the year in the usual efficient manner.
Most of these were handicapped by the necessity of doing the same
job or a greater job with less personnel and less funds.
The Bureau of Finance and Accounts and its sections on Fiscal, Per-
sonnel and Purchasing continued their good work. The necessity for
numerous budgetary revisions and the necessity of keeping expenditures
within our resources constituted a great problem with the Fiscal Section.
The Personnel Officer carried on his duties in a very commendable man-
ner and secured compliance with the various requirements of the Merit
System, the Board and the various counties. The Purchasing Agent as
usual did good work and the purchasing practices and procedures of
the State Board of Health were carried on in such a manner as to meet
the approval of all concerned.
The work of the Bureau of Vital Statistics continued to increase
although it has not been possible to increase the number of personnel
proportionately during recent years. However, the quality of personnel

SUMMARY 3

employed has vastly improved in the past few years. There are now
three well qualified statisticians on duty whereas only a few years ago
there were none. During the year the Board of Health, after many
negotiations with funeral directors, adopted new regulations on the
handling and disposal of dead human bodies.
The Bureau of Local Health Service has done especially well in the
recruitment of physicians. The transfer of the Field Technical Staff
to this Bureau has simplified and coordinated relations with the county
health departments. The appointment of a young and well trained
physician, Dr. James Wardlaw, as director of the Field Technical Staff
has done much to revitalize the work of this unit.
The Division of Public Health Nursing played an important role in
the recruiting, orienting and training of public health nurses for the
county health departments. A good staff of public health nurse consult-
ants played a most important role in the improvement of the quality of
work done by the county public health nursing staffs. The number
of personnel trained at the Field Training Center at Gainesville was
limited because of lack of funds for the purpose. It was necessary, how-
ever, for the State Board of Health to discontinue stipends for county
employed personnel and to rely on the county health departments to
finance this. Some counties were not financially able to do this without
great sacrifice.
The Bureau of Preventable Diseases had a very busy year with the
numerous programs for which it is responsible. Reference has already
been made to the outstanding events in the field of communicable
diseases. The Venereal Disease Control Program was operated even
more efficiently than in recent years because of our good fortune to have
assigned to us Dr. William A. Walter of the United States Public Health
Service.
The Division of Industrial Hygiene was handicapped because of the
lack of an industrial hygiene engineer but nevertheless did a great
number of important investigations.
The Cancer Control Program was handicapped by the lack of ade-
quate funds but was nevertheless able to furnish services to many hun-
dreds of indigent persons with cancer who might otherwise not have
received proper treatment.
The work of the public health veterinarian was particularly important
during the year because of outbreaks of animal-borne diseases. It is a
matter of wonder that the State Board of Health was able until a few
years ago to carry on its duties properly without the help of a well
qualified person in this field. The return of our milk consultant from
a year of postgraduate work has helped to further coordinate the milk
inspection program throughout the state.
The number of specimens examined by the Bureau of Laboratories
increased and the number of tests done was about one-fourth of a mil-

4 ANNUAL REPORT, 1952

lion more than were done during the previous year. Increased funds
and personnel for this Bureau are a necessity if these annual increases
in work continue to occur. During the year a new regional laboratory
was set up at the Tuberculosis Hospital at Lantana in cooperation with
the City of West Palm Beach and the State Tuberculosis Board.
The death rate from tuberculosis reached an all time low of 16.8
per hundred thousand and the work of the Bureau of Tuberculosis
Control in cooperation with the county health departments and the
state and local Tuberculosis Associations undoubtedly contributed sub-
stantially to this decline. The fact that approximately 400,000 persons
received chest X-rays at a cost of around thirty cents each is an out-
standing accomplishment. This program also contributes greatly to the
discovery of lung tumors and heart defects.
The Heart Disease Control Program was still in its infancy but much
important educational work was done and some investigations during
the year. Long range plans were made for future efforts in this field.
Although the Bureau of Maternal and Child Health had three different
directors during the year a great deal of excellent work was done. Dr.
Frances Read resigned in June and Dr. James Wardlaw served as acting
director until the appointment of Dr. Ralph W. McComas on October
15. As stated before, the maternal death rate made a remarkable drop.
Mental health continued to occupy much of the time of the director and
particular efforts were made to collect and use the ideas of all interested
persons and organizations and fields throughout this State. Continued
efforts were made to recruit a psychiatrist to direct the Mental Health
Program and a plan to set up a Division of Mental Health in the Bureau
of Maternal and Child Health was approved by the Board when suitable
personnel for the new division are recruited. Public interest in the field
of mental health was at a high level throughout the year.
The Bureau of Dental Health carried on its usual activities but devoted
special attention to promoting the fluoridation of public water supplies.
Much opposition to this program developed, not only on religious and
legal grounds, but on the basis that such fluoridation may endanger the
health of older people. The State Bureau of Health found no grounds
for this concern.
The distribution of insulin by the Division of Nutrition and Diabetes
Control was further systematized because of the necessity of making the
best use of the limited funds for the purpose. Precautions were taken to
see that persons who could afford to pay for insulin did not receive the
drug free. A check made by an experienced social worker revealed no
evidence to the contrary. The competent staff of nutritionists did excel-
lent educational work in the general field of nutrition in addition to
helping with the diabetes program and giving advice and assistance to
other bureaus and divisions and county health departments.
The volume of work of the Bureau of Sanitary Engineering continued
to grow along with the tremendous building program in the State. Special
problems were created by the tendency to build new suburban sub-

SUMMARY 5

divisions on land not suited for septic tanks. The water supply problem
at Cocoa Beach and vicinity also occupied a great deal of the time and
thought of our engineers.
The Bureau of Narcotics carried on its usual good work and due to
efforts of our narcotics inspectors (during 1952 and previous years) viola-
tions of the laws were at a low level. Investigations in several colleges
of the State showed no evidence that our young college students are being
tempted to use habit forming drugs.
The Division of Health Information did excellent work during the
year not only directly but through assistance given to other bureaus and
divisions and the county health departments. The Public Health Library
is believed to be one of the best in the country and the distribution of
films through our Film Library made an important contribution to the
education of the public throughout the state. Also the continued publica-
tion of our monthly bulletin HEALTH NOTES no doubt contributed
to the better understanding by the public of the health topics covered
in it.
ACTIVITIES OF THE BOARD
The Board under the direction of Dr. Herbert L. Bryans, President,
carried on its usual fine work during the year. In the six meetings that
were held the main attention of the Board (as has been the custom in
the past) was devoted to the fixing of policies, and administrative prob-
lems of major importance. One change in the membership of the Board
occurred during the year, Dr. Albert L. Ward of Port St. Joe replacing
Dr. Mark F. Boyd of Tallahassee.
The Board held a public meeting at the Floridan Hotel in Tampa
on January 18 where various complaints and suggestions were presented
by local officials and private citizens. At the business meeting following
this, the Board:
1. Decided, upon the recommendation of the Bureau of Sanitary
Engineering, not to approve plans for water supply in Cocoa Beach
because of the high saline content of the water. They did, however, out-
line a method by which such approval could be obtained after meeting
certain criteria.
2. Discussed the complaint of a private physician in Lakeland about
the "free" sign on the diabetes trailer and decided to keep the word
"free" on the trailer.
3. Approved of a plan by which employees with thirty years of serv-
ice would be given an emblem for their long and faithful service.
4. Discussed a request from the Orange County Medical Society
that surgical facilities in Orlando be used for indigent children with
congenital heart disease and decided that before such a program is
undertaken it should be approved by the Florida Heart Association and
by the Florida Medical Association.

6 ANNUAL REPORT, 1952

5. Passed a resolution of regrets for the untimely death of Mr. Fred
Safay, sanitarian, who died January 4, 1952.
6. Approved of an economy program which would save enough funds
to permit salary increases on July 1.
7. Had presented to them the results of a study of indigency of can-
cer and diabetes patients served by the State Board of Health.
8. Approved of the appointment of a fourth part-time investigator
in the Bureau of Narcotics for one of the colleges and authorized the
purchase of radio equipment for an inspector employed in that bureau.
9. Passed a resolution concerning the sewage systems in the Sanitary
Districts of Maryland Manor and Virginia Park in Hillsborough County
to the effect that sixty days would be given while efforts to create a more
effective sanitary district were explored.
10. Refused to order the Bureau of Sanitary Engineering to approve
certain applications for the construction of septic tanks in Hillsborough
County.
At a meeting in Jacksonville on February 12 the Board:
1. Further considered the water supply problems at Cocoa Beach
and listened to the problems presented by local officials and realtors. The
Board, however, decided not to change its present policies and standards
until further studies were made.
2. Approved a plan by which the State Board of Health would co-
operate with the Florida Public Health Association in meetings to be
held throughout the state during 1953 in order to present the legislative
program to members of the legislature.
3. Changed the specifications for Stenographer I and II.
At a meeting held in Hollywood, Florida on April 27 the Board:
1. Considered again the sewage problem in Virginia Park and Mary-
land Manor Sanitary Districts in Hillsborough County and adopted a
resolution authorizing the attorney and the State Health Officer to
gather further facts and to take the matter to court if necessary.
2. Approved the reorganization of the Bureau of Maternal and Child
Health removing the Heart Disease Control program therefrom and
making it a Division of the Bureau of Tuberculosis Control.
3. Approved revisions of the specifications for sanitary engineers and
increased the salary ranges. Certain other changes in the classifications,
specifications and salary ranges of other classes were also approved and
also certain salary increases.
4. Approved the awarding of emblems to employees with twenty years
service in addition to those previously approved for employees with thirty
years service. The twenty year service emblems will be of silver and the
thirty year service emblems will be of gold.

SUMMARY 7

5. Approved a leave of absence for Dr. William R. Stinger so that
he could serve as medical director of the Florida Crippled Children's
Commission.
6. Adopted new regulations made necessary by an outbreak of anthrax
in the state.
At a meeting held on June 1 in Jacksonville the Board:
1. Approved the plans for a new building in Jacksonville and re-
quested that the State Improvement Commission draw up the final plans
and ask for bids.
2. Approved certain proposed bills to be presented to the next legisla-
ture.
3. Reiterated its long standing policy of favoring full time employ-
ment of its personnel and forbade outside employment or salary supple-
mentations by professional employees or others in responsible administra-
tive positions.
4. Met with the County Health Officers and heard recommendations
made by that group convened as the Health Officers Conference.
5. Adopted a policy by which physicians when first employed should
not be above the age of fifty-five years unless they have had previous
experience in public health or the particular speciality in which they
are needed.
6. Revised the specifications for sanitarians.
At a meeting held at Ponte Vedra on August 24 the Board:
1. Adopted new rules and regulations governing the transportation,
disinterment, and storage of dead human bodies.
2. Heard a description by Dr. Simon Doff, director of the Division of
Heart Disease Control, of his program and plans and endorsed the same.
3. Discussed again certain legislative proposals and approved certain
bills to be presented to the legislature.
4. Approved a budget to be submitted to the Budget Commission
and to the legislature.
5. Approved modifications in the plan for the distribution of insulin.
6. Disapproved a compensation plan for Merit System employees
because the salary ranges proposed were much higher than those existing
in the State Board of Health.
7. Approved the appointment of Mrs. Avery Guyton of Jacksonville
on the Merit System Council.
8. Approved certain changes in specifications for personnel and
certain salary ranges.
9. Approved the attendance by the State Health Officer and Mr.
John Mulrennan at the First Inter American Congress on Public Health
in Havana, Cuba, September 26-October 2.

8 ANNUAL REPORT, 1952

10. Disapproved of the county health officers having a separate repre-
sentative at the legislature but approved of a plan by which the State
Health Officer would request their assistance if needed.
11. Approved of a plan for the operation of a regional laboratory
at the Tuberculosis Hospital at Lantana in cooperation with the Tuber-
culosis Board and the City of West Palm Beach.
At a meeting at Pensacola on October 26 the Board:
1. Again discussed the water supply problems of Cocoa Beach with
Mr. Thomas Caldwell, superintendent of water of Cocoa Beach.
2. Authorized the State Health Officer to explore the possibility of
acquiring property for the State Board of Health across the street from
its present headquarters.
3. Discussed certain correspondence between the State Health Officer
and the Merit System Director, Mr. Angus Laird.
4. Approved of certain salary increases.
5. Agreed that the State Board of Health should cooperate with the
State Livestock Sanitary Board in the control of vesicular exanthema of
swine, but should not assume responsibility for such control.
6. Approved the inclusion in the minutes of a paper presented by
Dr. W. H. Y. Smith before the Florida Public Health Association entitled
"Florida's First County Health Department."

Articles by staff members:
1. Sowder, W. T. The fragile male. J. Florida M. A. 38:553-554, Feb. 1952.
2. Sowder, W. T. Recruitment and retention of public health personnel in
Florida, 1945-1952. Am. J. Pub. Health 42:1276-1282, Oct. 1952.

FINANCE AND ACCOUNTS 9

BUREAU OF FINANCE AND ACCOUNTS

FRED B. RAGLAND, Director

The Bureau of Finance and Accounts has the responsibility of all
fiscal, personnel, and purchasing and property control matters.
The Bureau is a service organization, handling the business manage-
ment of the Board. Every effort is made to handle efficiently and ex-
peditiously to the best interests of all Bureaus, Divisions, and County
Health Units the payment of salaries, travel expenses, and other obli-
gations; the personnel actions such as recruitment, employment, termina-
tion, reclassification, salary changes, leave records, efficiency reports and
training records; the purchasing by good business methods; and the
control of property.
FISCAL SECTION
The financial transactions of the State Board of Health for the fiscal
year ended June 30, 1952, as reflected by the records of the Bureau,
are presented in the condensed tables that follow. These tables are:
Table 1 Summary of Receipts and Disbursements and Balances
for the Fiscal Year ended June 30, 1952.
Table 2 Schedule of Operating and Capital Expenses by Public
Health Program Activity.
Schedule of Operating and Capital Expenses by Func-
tional Activity.
Summary of Total Operating and Capital Expenses by
Major Functional Levels.
Table 3 Funds received by County Health Units from State Board
of Health and from Local Sources for the Fiscal Year
ended June 30, 1952.
Figure I Proposed Budget for Florida State Board of Health Dol-
lar for 1953.
A detailed financial report for the fiscal year ended June 30, 1952,
has been prepared and distributed to the Governor, members of the
Governor's Cabinet, members of the State Board of Health, and all
Bureaus, Divisions and County Health Units of the State Board of
Health.
The funds received (or appropriated) for the fiscal year ended June
30, 1952, were from the following major sources:
State Appropriations .........................................$2,643,537.77 43.7%
From Local Agencies for County
Health Units .......................................... 2,067,581.82 34.2%
From Federal Grants-in-Aid .............................. 1,307,434.80 21.6%
From Private Contributions .............................. 29,223.46 .5%
TOTAL ..............................................................$6,047,777.85 100.0%

10 ANNUAL REPORT, 1952

Objectively, the expenditures by the State Board of Health in sum-
mary were for:
Personnel Services (Salaries and
Professional Fees) ..........................................$3,766,509.88 66.0%
Contractual Services (Repairs, Utilities,
Travel Expense, Cancer Program-
Fees and Hospitalization) ............................ 932,661.69 16.0%
Commodities (Office, Medical, Laboratory,
Mosquito Control, Educational and
Food Supplies ................................................ 679,601.32 12.0%
Current Charges (Rents, Insurance, Merit
System Costs, Registrar Fees) .................... 119,495.31 2.0%
Capital Outlays (Equipment and
Fixed Assets) .................................................. 222,665.36 4.0%
TOTAL ................................................ ..............$.. .$5,720,933.56 100.0%
In addition to funds reported in the annual financial report and
summarized above, certain other funds and services were made available
by the Public Health Service of the Federal Security Agency to activities
of the Board but were not paid directly to the State Board of Health.
They include:
Value of Penicillin and Streptomycin furnished
by Public Health Service for the Rapid Treat-
ment Center operation........................... $ 9,522.00
Value of Public Health Service Personnel on loan
to the State Board of Health in Preventable
Disease Programs .......................................... 71,503.73
Value of Personal Services and Supplies furnished
by Public Health Service (Communicable Disease
Center) for Malaria and Typhus activities under
the State Board of Health supervision ................ 22,638.04

TOTAL $103,663.77
Fiscal operation followed a budget plan of 115 departmental budgets.
These budgets were frequently revised to meet changing situations. The
majority of the revisions involved County Health Unit budgets primarily
because the fiscal year of the County differs from the fiscal year of the
State. At the time County Health Unit budgets were initially prepared,
it was not known exactly what local funds would be available in each
instance. It was, therefore, necessary to revise a number of the County
Health Unit budgets during the year after the availability of funds from
County sources was determined.

FINANCE AND ACCOUNTS

PERSONNEL OFFICE
PAUL T. BAKER

In conformity with the established policy, continued steps were taken
during the calendar year 1952 to strengthen the Merit System of person-
nel administration in the State Board of Health. Careful attention was
given to insure that all appointments and terminations were made in
accordance with the rules adopted by the Board.
Leave records were developed and maintained and efficiency reports
were obtained and recorded.
Records of in-service and post-graduate training of employees were
maintained and the application of regulations governing such training
was assured. All employees at the main office were encouraged by the
Personnel Supervisor to discuss their employment problems, if any, with
him. At the prescribed times for consideration by the State Board of
Health of salary increases, full information concerning each employee
was made available to the Board in order that employees might be
treated fairly and equitably.
The payrolls for all employees were prepared in the Personnel Office
and forwarded to the State Comptroller for payment. All matters per-
taining to the retirement plan were handled promptly.
Prompt action was taken immediately after Merit System examinations
to regularize the Merit System status of each provisional employee. Em-
ployees were notified promptly upon attainment of permanent status.
During the calendar year our recruiting problems were resolved in
a very satisfactory manner. Little difficulty was encountered in filling our
requirements although Sanitary Engineers, Dentists and Stenographers
were definitely in short supply.
One new County Health Department (Collier) was organized during
the year. At the end of the year sixty-six (66) of Florida's sixty-seven
(67) counties were organized and operating under the Merit System.
On December 31, 1952, there were 1317 State employees and 19
Federal employees on loan to us. On December 31, 1951, there were
1305 State employees and 19 Federal employees.
During the year there were 385 employment and 373 terminations.
The main reasons for terminations included marriage, pregnancy, trans-
fers of husbands from area and acceptance of more profitable employ-
ment.

12 ANNUAL REPORT, 1952

On December 31, 1952 the Merit System status of State Board of
Health employees was as follows:
Permanent and Probational ..........................................1069
Provisional ...................................................... ............... 23
Tem porary -...................................................... ............ 1
Em ergency ............................................. ...................... 0
Exempt and Part-time .................................................... 224

T O T A L .................................................................... 1317
During the year specifications were adopted for 3 new classifications;
specifications were revised for 15 classifications; 1 classification was
abolished and salary ranges for 5 classifications were revised.
Post-graduate training for one full academic year was completed
successfully during 1952 by 4 Health Officers; 3 Public Health Nurses;
1 Sanitary Engineer; 3 Sanitarians; 1 Statistician and 1 Health Field
Worker. In addition post-graduate training was given for a period of
two and one-half months to 1 Chemist.

FINANCE AND ACCOUNTS 13

PURCHASING AND PROPERTY
G. WILSON BALTZELL
Purchasing Agent
During 1952 the Purchasing Agent received 2,276 purchase requests
from the various departments and issued 3,835 purchase orders represent-
ing a total of $606,149.66.
Property records accounting for items of equipment and non-expend-
able property were brought up to date and all new items acquired
during 1952 have been added to the records.
One of the functions of the Purchasing and Property Section is the
processing of automobile accident and liability claims. The State Board
of Health carries insurance on the automobile fleet for public liability,
property damage and comprehensive. The Board acts as self-insuror in-
sofar as collision damage is concerned. During the year the insurance
companies settled 5 claims against the State Board of Health for liability
and property damage in the amount of $149.50 and 3 comprehensive
claims in the amount of $54.91.
Since the Board acts as self-insuror for collision coverage, it might
be stated that $1,320.00 was spent for collision repairs to units of the
fleet. However, $487.09 was reimbursed to the State Board of Health by
individuals and firms who admitted liability.
Fire insurance on buildings and contents is carried by the State
through the office of the State Fire Insurance Commissioner.
BUILDINGS AND GROUNDS
All Central Office Bureaus and Divisions are located either at the
main office at 1217 Pearl Street or in leased space at the General Ad-
ministration Building in the St. Johns Shipyard, Jacksonville, Florida.
The Superintendent of Buildings and Grounds has the responsibility for
maintaining and operating the buildings at both locations. Maintenance
personnel have carried out their duties efficiently during the year.
The Florida State Improvement Commission, having been designated
to act as architect for the State Board of Health in connection with a
new $350,000 building addition, completed during the year preliminary
and detailed construction plans for the project. At year end the plans
were ready to be placed in the hands of contractors and it is hoped
that a construction contract will be let early in 1953.
In planning toward actual construction of the new addition it was
realized that our present warehouse would have to be torn down, there-
fore during December 1952 maintenance personnel constructed at a
minimum cost a temporary warehouse just north of the central labora-
tory. This warehouse will serve during the construction period of the
new addition.
DUPLICATING
This section is a valuable asset and aid to all departments of the State
Board of Health. A considerable saving is effected by this section being
able to supply the majority of the printing and duplicating needs at
costs much less than commercial printing prices.

14 ANNUAL REPORT, 1952

TABLE 1
SUMMARY OF RECEIPTS AND DISBURSEMENTS AND BALANCES
FOR THE FISCAL YEAR ENDED JUNE 30, 1952
RECEIPTS
FROM STATE FUNDS
From State Appropriations:
Salaries .... ................................................................ $ 662,444.68
Expenses ................... .. 556,914.44
County Health Units ........................................ 840,665.66
County Mosquito Control ................................ ............ 350,000.00
Capital Outlay ................................................. 80,000.00
Other:
Medical Laboratory Fee Fund .................................................. 820.00
Emergency Fund-Mosquito Control ................................ 80,000.00
Deficiency Fund-Narcotic Division ...................................... 15,000.00
State Board of Health Trust Fund ..................................... 57,692.99
TOTAL STATE FUNDS ...................................... ... $2,643,537.77

FROM FEDERAL GRANT-IN-AID
Public Health Service:
Rapid Treatment Center ................................... .. $ 204,527.92
General Health .............................................................. 265,838.00
Venereal Disease ....................................... ......................... 272,832.61
Tuberculosis Control ............................................................. 131,859.80
Mental Health ............................................................ 57,731.40
Cancer Control ........................................ ............................. 58,746.00
Heart Disease ........................................ ...................... 32,954.00
W ater Pollution ............................................................................ 21,600.00
Children's Bureau:
Maternal and Child Health ...................................................... 261,345.07
TOTAL FEDERAL GRANT-IN-AID ..........................$1,307,434.80

FROM PRIVATE CONTRIBUTIONS
Commonwealth Fund .........................................................................$ 449.78
Water Pollution Research .................................................................. 19,362.50
Franklin County Marine Laboratory ...................................... 4,411.18
Citrus Canning Waste Research .......... ................................... 5,000.00
TOTAL PRIVATE CONTRIBUTIONS ..............................$ 29,223.46
FROM LOCAL AGENCIES FOR COUNTY HEALTH UNITS....$2,067,581.82
Total Receipts ..................................... ....... ...............$6,047,777.85
Balance July 1, 1951 ................................. ......... ....... 749,079.76
Total Receipts and Balances ........................................................$6,796,857.61

DISBURSEMENTS
OPERATING EXPENSE
Personal Services:
Salaries ..................................... ....... .......................$3,720,377.82
Professional Services and Consulting Services ........................ 46,132.06
Contractual Services:
Coop. Project University of Florida-
Water Pollution Survey ..................................................... 2,750.00
Travel Expenses, including subsistence and lodging ........... 477,101.53
Telephone, Telegraph and Postage .... ....................... 76,148.14
U utilities ................................. ........................... .................. 26,331.14
Printing, Binding, Photographing and Advertising ............ 20,072.97

FINANCE AND ACCOUNTS 15

OPERATING EXPENSE-Continued
Freight and Express ..................................-.....--. 11,179.44
Cleaning, Laundry and Painting ................................. 15,885.63
Repairs to Building and Equipment ....................-...-------. 63,313.95
Subsistence, Care and Support of Persons ........................... 208,656.23
Other Contractual Services ..............................---- ............ 31,222.66
Commodities:
Stationery and Office Supplies .......................................... 69,090.13
Chemicals, Laboratory and Mosquito Control Supplies............ 359,042.67
Medical, Surgical and Dental Supplies ........................... 113,860.05
Gas, Oil and Fuel .................. ......................................... 52,716.48
Cleaning, Laundry, Parts, Fittings and Other Supplies............ 39,750.09
Educational Supplies ...................................... ....... 7,001.21
Food Products ....................... ............................................. 38,140.69
Current Charges:
Rental of Buildings and Equipment .......................................... 47,301.49
Insurance, Dues, Fees, Registration and Bonds ..................... 53,832.21
Merit System ....................18,361.61
TOTAL OPERATING EXPENSES ................................$5,498,268.20

CAPITAL EXPENSES
Office, Household and Mechanical Equipment........................$ 43,278.30
Engineering, Medical and Dental Equipment .................. 91,741.48
Automotive Equipment ..................................... ..... 73,314.81
Books, Educational and Other Equipment.............................. 12,073.93
Buildings and Surroundings ............................................... 2,256.84
TOTAL CAPITAL EXPENSES ....................................$ 222,665.36
TOTAL OPERATING AND CAPITAL EXPENSES .......................$5,720,933.56
NON-OPERATING DISBURSEMENTS
Transfers to Other State Funds ........................................................ 1,009.75
TOTAL NON-OPERATING DISBURSEMENTS ........................$ 1,009.75
TOTAL DISBURSEMENTS ......................................... $5,721,943.31
BALANCES JUNE 30, 1952 ................................................... ..... 1,074,914.30
TOTAL DISBURSEMENTS AND BALANCES ..............................$6,796,857.61

TABLE 2

SCHEDULE OF OPERATING AND CAPITAL EXPENSES
BY PUBLIC HEALTH PROGRAM ACTIVITY
Health services to mothers, infants, preschool and school
children ................................... .............. $1,091,470.15
Statewide venereal disease control, diagnosis and referral of infectious
venereal disease patients to the rapid treatment and prevention
and control centers and operation of centers .......................... 901,882.01
Mosquito and pest control programs, including pest control law en-
forcement .....................-.........--------............... 739,541.46
Statewide sanitary engineering and environmental sanitation ............ 642,403.63
Statewide tuberculosis control, x-ray surveys and follow-up work...... 513,783.76
Statewide cancer control program ...................................... ......... 218,794.35
Mental Health Program ......................................... 105,885.13
Statewide narcotics, drug, medical practice law enforcement .......... 73,759.81
Heart Disease Program ...................................................... 71,388.51
Industrial Hygiene Program ............... ................ 16,879.74
Other health programs and administration ................................... 1,345,145.01
TOTAL OPERATING AND CAPITAL EXPENSES ..........$5,720,933.56

16 ANNUAL REPORT, 1952

SCHEDULE OF OPERATING AND CAPITAL EXPENSES
BY FUNCTIONAL ACTIVITY
General Administration and miscellaneous ..........................................$ 379,330.34
Vital Statistics ............................................................................. 146,754.75
Health Information ................................................................. 52,287.37
Narcotic Enforcement ............... .......................................... 55,644.21
Sanitary Engineering .................................................. 178,224.32
Entomology and Mosquito Control ...................................................... 489,116.14
Laboratories .................... ................................................................. 372,885.70
Tuberculosis Control ...................... ............................. 118,888.43
Preventable Diseases (excluding Tuberculosis) .................................. 382,187.11
Chronic Diseases ........................................ ................................... 305,548.02
Maternal and Child Health ........ ............................................... 125,123.87
Local Health Service ..................... ......................................... 122,550.08
County Health Units .................................................................... 2,992,393.22
TOTAL OPERATING AND CAPITAL EXPENSES ............$5,720,933.56

SUMMARY OF TOTAL OPERATING AND CAPITAL EXPENSES
BY MAJOR FUNCTIONAL LEVELS
State Level Organizational Units
State Funds .................................................... $ 973,344.42
Federal Funds .................................................. 675,722.56
Private Funds ................... .......................... 27,399.38 $1,676,466.36
State Level Special Services
State Funds .................................................... $ 665,155.70
Federal Funds ................................................ 386,918.28 1,052,073.98
*County Health Units
State Funds ....................................................$ 818,037.82
Federal Funds ................................................ 262,147.56
Local Funds .................................................... 1,912,207.84 2,992,393.22
GRAND TOTAL .................................................................. $5,720,933.56

* Total County Health Units expenditures $2,992,393.22 represents expenditure
of $1.19 (33c State Funds, 10c Federal Funds, and 76c Local Funds), based on
population figure of 2,509,125 served by County Health Units. For comparison
with previous years see 1951 Annual Report, Table 2, Page 24 and 1950 Annual
Report, Chart 1, Page 16.

TABLE 3
FUNDS RECEIVED BY COUNTY HEALTH UNITS FROM STATE BOARD OF HEALTH AND FROM LOCAL SOURCES FOR THE
FISCAL YEAR ENDED JUNE 30, 1952

STATE BOARD OF HEALTH LOCAL FUNDS
BOARD OF
TOTAL COUNTY PUBLIC FEES &
COUNTY FUNDS TOTAL STATE FEDERAL TOTAL COMMISSIONERS INSTRUCT. CITIES MISC.

ALACHUA......... 65,696.09$ 26,366.73 $ 20,873.32$ 5,493.41 $ 39,329.36$ 32,065.00 ........ $ 6,600.00 $ 664.36
BAKER............. 13,790.90 7,916.00 7,916.00 ........... 5,874.90 2,799.96 $ 3,033.29 ............ 41.65
BAY................ 46,015.16 20,846.00 17,581.00 3,265.00 25,169.16 24,700.00 ............ ............ 469.16
BRADFORD......... 19,299.14 10,979.00 10,979.00 ............. 8,320.14 4,666.64 1,200.00 2,400.00 53.50
BREVARD.......... 27,354.68 14,563.00 14,563.00 ............. 12,791.68 10,000.00 2,500.00 ............ 291.68
BROWARD.......... 80,884.45 26,876.20 17,300.00 9,576.20 54,008.25 39,760.00 8,700.00 1,160.00 4,388.25
CALHOUN.......... 12,119.00 7,071.00 7,071.00 ............. 5,048.00 5,000.00 ........................ 48.00
CHARLOTTE........ 8,812.25 4,931.00 4,931.00 ............ 3,881.25 1,900.00 1,500.00 ............ 481.25
CITRUS............. 10,886.86 5,787.00 5,787.00 ............ 5,099.86 2,918.36 2,150.00 ............ 31.50
CLAY............... 19,829.00 11,432.00 11,432.00 ............ 8,397.00 3,890.00 2,400.00 2,000.00 107.00
COLUMBIA.......... 19,937.50 12,184.00 12,184.00 ............ 7,753.50 6,600.00 900.00 ............ 253.50
DADE............... 564,054.51 107,330.00 42,777.00 64,553.00 456,724.51 437,819.50 ........................ 18,905.01
DESOTO............ 13,794.39 7,229.00 7,229.00 ............ 6,565.39 5,232.89 1,250.00 ............ 82.50
DIXIE.............. 10,961.57 6,336.00 6,336.00 ............ 4,625.57 4,200.00 400.00 ............ 25.57
DUVAL............. 116,201.17 40,632.00 20,072.00 20,560.00 75,569.17 63,319.25 ........... 11,504.04 745.88
ESCAMBIA.......... 100,447.49 31,565.00 25,205.00 6,360.00 68,882.49 38,750.00 6,000.00 22,467.49 1,665.00
FLAGLER........... 7,212.40 3,801.00 3,801.00 ............. 3,411.40 2,118.10 1,270.80 ............ 22.50
FRANKLIN......... 18,218.19 7,380.00 7,380.00 ............ 10,838.19 8,758.44 500.00 1,530.00 49.75
GADSDEN.......... 39,029.42 19,204.00 13,384.00 5,820.00 19,825.42 13,999.92 3,930.00 950.00 945.50
GILCHRIST......... 8,730.20 5,118.00 5,118.00 ............ 3,612.20 1,800.00 1,800.00 ............ 12.20
GLADES. ........... 6,643.25 3,935.00 3,935.00 ............ 2,708.25 2,700.00 ....................... 8.25
GULF............... 18,359.11 8,540.00 8,540.00 ............ 9,819.11 6,625.86 2,924.75 200.00 68.50
HAMILTON......... 12,107.50 8,052.00 8,052.00............. 4,055.50 1,993.75 1,993.75 ........... 68.00
HARDEE............ 15,788.75 9,234.00 6,234.00 3,000.00 6,554.75 6,481.00 ........................ 73.75
HENDRY........... 10,010.06 5,918.00 5,918.00 ............ 4,092.06 4,060.56 ........................ 31.50
HERNANDO........ 10,012.00 6,362.00 6,362.00 ............ 3,650.00 1,800.00 1,800.00 ............ 50.00
HIGHLANDS........ 21,605.00 12,057.00 12,057.00 ............ 9,548.00 9,400.00 ........................ 148.00
HILLSBOROUGH.... 362,397.33 71,548.07 34,090 00 37,458.07 290,849.26 257,224.87 ............ 600.00 33,024.39
HOLMES............ 18,219.60 10,645.00 10,645.00 ............ 7,574.60 3,750.00 3,750.00 ...........74.60
INDIAN RIVER..... 17,505.75 9,778.00 9,778.00 ............ 7,727.75 6,808.00 800.00 ............ 119.75
JACKSON........... 34,332.00 15,711.00 15,711.00 ............ 18,621.00 14,694.00 3,000.00 600.06 327.00
JEFFERSON....... 15,955.78 11,032.00 11,03200 ............ 4,923.78 3,20000 1,60000 ........... 123.78
LAFAYETTE....... 8,692.59 4,978.00 4,97800............ 3,714.59 1,950.00 1,741.79 ........... 22.80
LAKE............... 73,237.05 24,4 24 ,4 ,434.00............. 48,803.05 39,833.30 ........... 8,495.00 474.75
LEE................. 14,760.34 9,793.66 9,793.66 ............ 4,966.68 4,966.68 ........ ...............

FUNDS RECEIVED BY COUNTY

TABLE 3-Continued
HEALTH UNITS FROM STATE BOARD OF HEALTH AND FROM LOCAL SOURCES FOR THE
FISCAL YEAR ENDED JUNE 30, 1952

STATE BOARD OF HEALTH LOCAL FUNDS
COUNTY BOARD OF
TOTAL COMMIS- PUBLIC FEES &
COUNTY FUNDS TOTAL STATE FEDERAL TOTAL SIONERS INSTRUCT. CITIES MISC.

LEON.............. $ 92,187.80$ 31,512.06$ 19,254.00$ 12,258.06$ 60,675.74$ 59,073.25 $.......... $ 950.00$ 652.49
LEVY............ 17,713.44 10,512.00 7,527.00 2,985.00 7,201.44 3,533.32 3,583.37 ............ 84.75
LIBERTY.......... 9,208.95 4,719.00 4,719.00 ............. 4,489.95 2,562.45 1,912.50 ............ 15.00
MADISON.......... 18,401.58 11,261.00 11,261.00 ............ 7,140.58 3,500.00 3,500.00 ............ 140.58
MANATEE.......... 35,013.00 18,297.25 15,815.00 2,482.25 16,715.75 16,400.00 ....................... 315.75
MARION ............ 38,530.91 21,477.00 18,747.00 2,730.00 17,053.91 17,053.28 ..........................63
MARTIN............ 12,373.98 6,174.00 6,174.00 ............. 6,199.98 6,130.48 .. .... ....... 69.50
MONROE ........... 35,989.51 18,016.00 18,016.00 ............ 17,973.51 8,400.00 3,000.00 4,800.00 1,773.51
NASSAU.... : ....... 28,042.90 13,528.00 7,648.00 5,880.00 14,514.90 10,481.15 3,740.00 180.00 113.75
OKALOOSA......... 21,727.34 12,256.00 12,256.00 ............. 9,471.34 6,747.09 2,400.00 ............ 324.25
OKEECHOBEE...... 7,950.00 4,487.00 4,487.00 ............. 3,463.00 3,445.00 ........................ 18.00
ORANGE............ 96,786.29 35,369.34 20,820.00 14,549.34 61,416.95 40,379.20 10,000.00 2,420.00 8,617.75
OSCEOLA........... 17,797.16 9,890.00 9,890.00 ............. 7,907.16 6,000.00 1,800.00 ............ 107.16
PALM BEACH....... 87,770.72 30,221.61 18,770.00 11,451.61 57,549.11 42,440.00 13,871.00 ............ 1,238.11
PASCO.............. 16,591.00 10,545.00 10,545.00 ............. 6,046.00 3,400.00 2,500.00 ............ 146,00
PINELLAS.......... 311,848.82 61,828.20 31,499.18 30,329.02 250,020.62 227,971.16 ........................ 22,049.46
POLK............... 101,324.24 36,476.57 23,089.00 13,387.57 64,847.67 58,767.10 ........................ 6,080.57
PUTNAM........... 22,032.47 13,633.50 13,633.50 ............. 8,398.97 8,166.72............ ............ 232.25
ST.LUCIE.......... 26,334.05 13,998.00 13,998.00 ............. 12,336.05 12,038.55 ........................ 297.50
SANTA ROSA....... 16,088.92 10,882.00 10,882.00 .............206.92 ................. 5,119.92 ............ 87.00
SARASOTA......... 33,485.65 17,614.00 14,914.00 2,700.00 15,871.65 15,620.00 ........................ 251.65
SEMINOLE......... 27,288.35 15,730.00 15,730.00 ............. 11,558.35 6,500.00 4,800.00 ............ 258.35
SUMTER............ 15,568.19 10,239.00 10,239.00... 5,329.19 1,750.00 3,500.00 ............ 79.19
SUWANNEE........ 30,661.22 13,861.00 11,191.00 2,670.00 16,800.22 16,618.72 ..... ............... 181.50
TAYLOR............ 18,751.06 9,392.00 9,89200............ 9,359.06 9,000.00 250.00 ............ 109.06
UNION.............. 11,569.00 6,736.00 6,736.00 ............ 4,833.00 4,800.00 ............ ....... 33.00
VOLUSIA............ 132,901.91 37,671.03 35,442.00 2,229.03 95,230.88 85,172.63 7,100.00 ............ 2,958.25
WAKULLA.......... 10,453.10 6,425.00 4,015.00 2,410.00 4,028.10 4,000.00 ........................ 28.10
WALTON........... 16,490.50 10,139.00 10,139.00 ............ 6,351.50 3,200.00 3,000.00 ............ 151.50
WASHINGTON...... 16,612.50 10,358.00 10,358.00 ........... 6,254.50 3,722.86 1,750.00 720.00 61.64
TOTALS............ $ 3,170,395.04 $ 1,102,813.22 $ 840,665.66 $ 262,147.566 2,067,581.82 $ 1,762,659.04 $ 126,971.17 $ 67,576.53$ 110,375.08

FINANCE AND ACCOUNTS

PROPOSED BUDGET FOR FLORIDA STATE

BOARD OF HEALTH DOLLAR FOR 1953

TOTAL BUDGETED

$ 5,965,921

GENERAL ADMINISTRATION ANo MISCELLANEOUS $354,290
VITAL STATISTICS $160,220 TUBERCULOSIS CONTROL 109,020
HEALTH INFORMATION 55,740 PREVENTABLE DISfASES :)390,080
NARCOTIC ENFORCEMENT 60,760 CHRONIC DISEASES 302,770
SANITARY ENGINEERING 180,080 MATERHIALaCHILD HEALTH 107,800
INTOnOLOGYnd MOSQUITO CONTROL 380.400 LOCAL HEALTH.SERVICE 124,400
LABORATORIES 393,815 COUNTY HEALTH UNITS 3,346,546
NOTE-Total funds include State Appropriations $2,436,842;Federsl G.rnts-in
Aid,l1,301,077, and Local Countq Health Unit Funds $2.228,002

TABLE 4
DISTRIBUTION OF PERSONNEL STATE BOARD OF HEALTH (OTHER THAN COUNTY HEALTH DEPARTMENTS)
DECEMBER 31, 1952

Finance Local Mat'nl & Sanitary Tuber'losis
and Laboratories -. Child Preventable Diseases En g
Accounts Health Service Health Engineering Control
0 Entomology

Classification 0

I
E SE u ~ >a > >SE-

Physicians .... ........ 1 1 11 1 2 2 2 1 1 1 3 5 2 2 14
Nurses 4 2 17 11 8 8 16
Dentists................... 2 2
Sanitarians............. 2 13 1 1 5 9
essionaanTechnical)... 2810 4 3 310 58 1 1 2 3 2 4 71113 75
Health Educators.......... 1 2 1 1 1 17 17 1 1 24
Nutritionists.......... 4 4
Statisticians...............3 3
Fiscai................. 106 723 483 113163 2 2 2 2 2 4 1 19102 1 3 139 110 40145
Maintenance and Custodial.. 1212 122 4 2 2 2 840 4 2 5 5 1 8 8 9 1 74
Other..................... 1 3 5 6 6 7 1 1818199 9 357
Part-time (AllPe l
Classifications.......... 1 2 1 1 5
Federal Employees......... 2 1 1 5 5 2 2 3 11
TOTAL................. 8 0 6 2238 96320 6 6 621122 4 6 6 622 6 1 712 11 4 4 3 58 17036 8 35437920 22248456

TABLE 5
DISTRIBUTION OF PERSONNEL IN COUNTY HEALTH DEPARTMENTS DECEMBER 31, 1952

Classification fessi l ad

aMedical and Psychiatric So l W s 1 a a

Physicians .............................. 2 1 11 1 15
Nurses ................... .......... 2 310 1 1 2 259 1 1 9 1 1 6 1 1 1 1 224 2 2 1
Dentistsenance and Custodial Workers................... ............... 2 1 2 4 1 1
Sanitary Engineers......................... 1 1 1
Sanitanians. ...... Cla ... .. 1 2 1 1 1 12 4 6 1 2 1 1 1 114 12 21
Laboratory Personnel (Professional and
Technical) .................... ....... 3.
Health Educators...................... 11
Medical and Psychiatric Social Workers....... I1
Statisticians. 1
Clerical, Administrative and Fiscal.......... 1 1 2 1 1 6 2 1 1 1 1 1 26 1 1 6 5 1 2 11 1 1 120 1 1 2 1
Maintenance and Custodial Workers..........2 1 2 4 2 1 12 1
Other.................................... 1 5 2 2 14 1
Part-time (All Classifications) .................. 4 1 2 1 1 1 11 2 3 1 1 1 1 8 1 1
Federal Employees ......................... 1 3 1 1 1
TOTAL............................... 18 313 5 924 4 2 4 6 2 7145 3 2131 28 2 5 18 2 115 4 4 3 2 7102 6 6 10 4

(a) Serves also Osceola County.
(b) Serves also Hernando and Levy Counties.
(c) Serves also Bradford and Union Counties.
(d) Serves also Gilchrist and Hamilton Counties.

(e) Serves also Santa Rosa County.
(f) Serves also Gulf and Wakulla Counties.
(g) One serves also Calhoun and Liberty Counties.
One on Educational Leave.
(h) Serves also Charlotte and DeSoto Counties.

(i) One serves also Glades and Hendry Counties.
One on Educational Leave
(j) Serves also Okaloosa and Walton Counties.
(k) Serves also Washington County.

TABLE 5-Continued

DISTRIBUTION OF PERSONNEL IN COUNTY HEALTH DEPARTMENTS DECEMBER 31, 1952

SnitaryEngneers ............ 41 01 21A1 8 21
((m) (n) () (p) (q) (r)

Laboratory Personnel (Professional and 1 3
Technical) ............................... ..
Health Educators................................. 2
Medical and Psychiatric Social Workers............ 1
lericldinistrative andFiscal........ 2 2 5 1 1 2 2 2 1 2 1 1 1 6 1 7 1 16 6 1 1 2 1 3 1 1 1 1 3 1 1 1171
Maintenance and Custodial Workers ................ 2 3 2 2 2 1 50
Pat-ime(All Classifications 1 1 4 1 1 7 1 4 6 1 1 2 1 3 1 1 84
Federal Employees .............. .... ........ ...... 1 1 1 1 2
SnTOTAL.r.................................... 12 1023 2 6 12 3 8 8 229 8 611 1 338 2 5880
TOTAL................ .........../212 10123 51 611012 3113 88 2132 6133 4168291 8 6111611 4 438558

(1) Serves also Collier County.
(m) Serves also Taylor and Jefferson Counties.
(n) Serves also Baker County

(o) One serves also Flagler County.
One on Educational Leave.
(p) One serves also Indian River, Martin and
Okeechobee Counties.

One on terminal leave.
(q) Serves also Pasco County.
(r) Serves also Dixie and Lafayette Counties.

VITAL STATISTICS 23

BUREAU OF VITAL STATISTICS
EVERETT H. WILLIAMS, Jr., M.S., Hyg.
Director

This report contains a brief summary of preliminary totals for statis-
tical data for the year 1952 and also covers the activities of the Bureau
of Vital Statistics. Final and more detailed statistical data regarding
births, stillbirths, deaths, marriages, and divorces will be published sepa-
rately as a supplement to this annual report under the title, "Florida
Vital Statistics, 1952". Another supplement containing more detailed
data concerning reported cases of disease will be published under
the title, "Florida Morbidity Statistics, 1952".
POPULATION
The population estimate for the State of Florida as of July 1, 1952
is 3,006,400 and is divided by race as follows: 2,378,400 white, and
628,000 non-white. Birth and death rates for the year 1952 are based
on these figures.

BIRTHS
There were 74,098 resident births for Florida during 1952 and the
rate was 24.6 per thousand population. This is the highest number of
births and also the highest birth rate on record for this State. The
white birth rate was 22.5 and the non-white rate was 32.9 per thou-
sand population. Table 6 shows the number of resident births and
birth rates for this State for the period 1931-1952. Preliminary totals
of births by color for all counties and for cities over 10,000 population
are shown in Table 7. More detailed data for the year 1952 is not yet
available. Final figures for 1951 indicate that 98 per cent of the white
and 57 per cent of the non-white births were attended by a physician. A
total of 5,820 illegitimate births were recorded during 1951. Of the white
births, 2 per cent were registered as illegitimate as compared to 24 per
cent for non-white births.

DEATHS
In 1952 there were 29,197 deaths among residents of this State and
the death rate was 9.7 per thousand population. The white death
rate was 9.1 and was 24 per cent lower than the colored rate of 11.8
per thousand population. The trend of resident deaths in Florida for
the years 1931-1952 are shown in Table 6.
For each of the past three years, the death rate has shown a con-
sistent increase of 0.1 over the preceding year. There are two possible
explanations for this increase. One is that the state may be growing
more rapidly than we estimated. An under-estimation of the population
would cause an over-estimation of the death rate. Another possibility

24 ANNUAL REPORT, 1952

is that the increasing death rate is a result of the increasing age of our
population. This latter explanation appears more plausible and is sub.
stantiated by the fact that almost all of the increase is in those dis-
eases which predominantly cause death in the older age groups.
Deaths by race and a comparison of 1951 and 1952 death rates are
shown in Table 9. Heart disease continued to be the leading cause
of death and accounted for 34 per cent of all deaths. Other leading
causes of death were cancer, cerebral hemorrhage, and accidents.
It is gratifying to note the continued decrease in the tuberculosis
death rate. The rate for 1952 was 16.8 as compared to 17.9 per 100,000
population in 1951. Noteworthy improvement was also shown in the
maternal death rate where the rate dropped from 1.2 to 0.8 deaths per
thousand live births. On the other side of the ledger, the infant death
rate increased from 32.9 up to 34.4 deaths per thousand live births.
A preliminary analysis indicates that white infant mortality de-
creased slightly and there was a 15% increase in the non-white infant
death rate. The rise in non-white infant mortality was not confined
to any one geographic area since 44 counties showed a higher rate than
for the previous year. All age groups under 9 months had an increase
in death rates with the greatest increase in those under 1 month. More
than half of this increase was caused by pneumonia and postnatal
asphyxia and atelectasis. Deaths from postnatal asphyxia and atelectasis
were concentrated in the group under four days of age while the
pneumonia deaths were predominantly in those ages over 14 days and
up to nine months.
Among the acute communicable diseases, decreases were recorded
in deaths caused by whooping cough, scarlet fever and streptococcal sore
throat and acute infectious encephalitis. There were 39 deaths attributed
to poliomyelitis.
Motor vehicle accidents remained about the same as for the preceding
year and caused a total of 871 resident deaths. Other accidents de-
creased slightly and accounted for 1147 deaths. Principal causes for
other accidents were falls, fires, drownings, and aircraft accidents. Acci-
dental deaths are the fourth leading cause and constitute a serious
problem in Florida. The continuous high level of accidental mortality
in this State can be observed in Figure 2.

MARRIAGES AND DIVORCES
There were 26,956 marriages in Florida during 1952; 219 fewer
than in 1951. The marriage rate was 17.9 persons married per thou-
sand population. The marriage rate for white persons was 18.0 and
non-white rate was 17.7. More detailed marriage data according to
age, race, place of residence, and previous marital status will be pub-
lished in the Vital Statistics supplement to this report. 1951 data
showed that 88 per cent of the grooms and 92 per cent of the brides
listed a Florida address at the time of application for a marriage

VITAL STATISTICS

license. In 1951, the median age at marriage for brides was 23.7, for
grooms 26.9. It was the first marriage for 62 per cent of the brides and
64 per cent of the grooms.
There were 20,447 divorces and annulments granted in Florida during
1951, an increase of 1772 over the previous year. The divorce and
annulment rate was 13.6 persons per thousand population. Data on
divorces by race and age are not available in this State. It is hoped
that this information can be obtained in the near future.

ACTIVITIES
The addition of an electronic statistical tabulating machine has in-
creased the speed, efficiency and scope of our statistical tabulations.
Statistical data from the cancer central registry has been transferred
to punch cards and this bureau has taken over the task of tabulating
this information. Much data is now available for analysis which could
not have been produced under the previous system.
Additional tables were added to the Vital Statistics Annual Report
for 1951 and the same data will be included in the 1952 report. Prin-
cipal additions were tables of neonatal deaths (infants under 28 days)
according to cause of death and age at death. Tabulations have been
made of birth weights for all children born in the State. Neonatal
deaths are being matched with birth records in order to study the
effect of birth weight in connection with cause of death and length of
life. Considerable work has been done on a study on cause of still-
births occurring in Florida and some results will be published in the com-
ing year.
The work load of this bureau has continued to increase. A com-
parison of the volume of some of our major activities for the past two
years is shown in Table 13. A particularly large percentage increase
was noted in number of delayed birth certificates filed and number
of adoption decrees received for processing. There was a decrease in the
number of free searches requested. This decrease was almost entirely
in number of searches made for veterans. Free searches and certifications
are made for veterans and certain state and federal agencies which
need verifications for official purposes. Free searches during 1952 were
as follows: Veterans-4952, Welfare Boards-7839, Army and Navy
-4100, F.B.I.-728, Others-1643.
The policy of issuing a "Vital Statistics Scoreboard" which compares
the efficiency of birth and death registration among the various coun-
ties was started at the first of the year. These tabulations were made
and distributed after each four month period during the year. Its pur-
pose is to improve the promptness and completeness of vital statistics
registration in this State.
A consolidated "Vital Statistics Scoreboard" for the year 1952 is
shown as Table 12. Counties are listed in order of rank showing their
relative efficiency in birth and death registration. The two columns

26 ANNUAL REPORT, 1952

showing per cent of certificates filed on time are a measure of how
well the local registrars have secured complete and prompt registration
of births and deaths from the attendant at birth and the funeral director.
The two columns showing per cent of complete certificates are a meas-
ure of how well the local registrar has checked certificates filed with him
before forwarding them to Jacksonville. The column showing per cent
of monthly reports submitted on time shows the proportion of monthly
reports forwarded by the local registrar on the 5th of each month. Those
counties near the top of this scoreboard are to be commended on their
excellent results. Counties near the bottom should analyze their de-
ficiencies and take steps to correct them.

FIGURE 2
RESIDENT DEATH RATES. MOTOR VEHICLE AND OTHER ACCIDENTS. FLORIDA. 1933-1951

100 Increase due largely to
accidents Incidental to
Straninng of military
personnel

A hurricane of ACCIDENTS OTHER THAN
SSeptember, 19 3 MOTOR VEHICLE

5
MOTOR VEHICLE ACCIDENTS
gasoline ratlonitg
S 25

1933
1934 1936 1938 1940 1942 1944 1946 1948 1950 1952
YEAR

VITAL STATISTICS 27

TABLE 6

RESIDENT BIRTHS AND DEATHS WITH RATES PER 1,000 POPULATION,

FLORIDA, 1931-1952

POPULATION BIRTHS

3,006,400
2,901,800
2,797,100
2,692,500
2,587,800
2,483,200
2,378,500
2,273,900
2,196,195
2,125,935
2,055,675
1,985,415
1,915,155
1,853,660
1,795,322
1,736,984
1,678,646
1,620,808
1,585,596
1,554,000
1,530,356
1,502,736

74,098
70,431
64,370
61,642
59,685
60,201
54,347
48,839
49,186
46,783
40,675
37,351
33,696
32,437
31,101
29,529
28,116
28,058
26,722
25,647
27,242
26,789

BIRTH RATE

24.6
24.3
23.0
22.9
23.1
24.2
22.8
21.5
22.4
22.0
19.8
18.8
17.6
17.5
17.3
17.0
16.7
17.3
16.9
16.5
17.8
17.8

DEATHS RATE DEATH

29,197
27,857
26,525
25,317
24,505
24,150
22,750
22,594
23,251
23,213
21,144
21,438
21,458
20,209
19,949
19,825
20,050
19,059
19,518
18,112
17,721
17,291

9.7
9.6
9.5
9.4
9.5
9.7
9.6
9.9
10.6
10.9
10.3
10.8
11.2
10.9
11.1
11.4
11.9
11.8
12.3
11.7
11.6
11.5

*1952 data based upon preliminary totals

TABLE 7

PRELIMINARY TOTALS OF BIRTHS BY COLOR FOR COUNTIES AND CITIES
OVER 10,000 POPULATION, FLORIDA, 1952

County or City

Florida.............
Alachua. ..............
Gainesville..........
Baker................
Bay... ............
Panama City....
Bradford..............
Brevard..............
Broward ..............
Ft. Lauderdale......
Calhoun..............
Charlotte.............
Citrus ................
Clay ...............
C ollier................
Columbia ............
D ade......... ........
M iami..............
Miami Beach........
DeSoto ...............
D ixie.................
D uval ................
Jacksonville.........
Escambia.............
Pensacola ..........
Flagler...............
Franklin..............
Gadsden ..............
Gilchrist .............
Glades................
Gulf..................
Hamilton.............
Hardee...............
Hendry...............
Hernando............
Highlands............
Hillsborough ..........
Tampa.............
Holmes. ............
Indian River..........
Jackson...............
Jefferson...............
Lafayette..............
Lake.................
Lee ...............
Ft. Myers...........

Total

I I-- -

74,098
1,471
819
180
1,379
994
307
989
2,491
975
190
81
145
512
186
505
12,226
5,351
515
202
78
9,054
7,391
4,013
2,280
86
131
994
71
33
205
239
231
136
171
320
6,685
5,057
289
303
915
313
69
897
581
367

White Colored
53,419 20,679
875 596
556 263
124 56
1,100 279
747 247
202 105
740 249
1,517 974
637 338
148 42
66 15
89 56
428 84
124 62
305 200
9,563 2,663
4,077 1,274
513 2
131 71
66 12
6,503 2,551
5,099 2,292
3,154 859
1,617 663
29 57
91 40
300 694
58 13
20 13
136 69
108 131
201 30
99 37
116 55
216 104
5,529 1,156
4,143 914
271 18
200 103
550 365
78 235
60 9
629 268
434 147
249 118

County or City Total White

Leon...............
Tallahassee.........
Levy...............
Liberty ..... .....
Madison ..........
Manatee ...........
Bradenton ........
M arion ............
Ocala............
M artin............
M onroe ....... ...
Key West........
Nassau.............
Okaloosa. ..........
Okeechobee.........
Orange.............
Orlando..........
Osceola............
Palm Beach........
West Palm Beach
Lake Worth......
Pasco ............
Pinellas. ...........
St. Petersburg....
Clearwater .......
Polk...............
Lakeland.........
Putnam ............
St. Johns..........
St. Augustine.....
St. Lucie...........
Ft. Pierce........
Santa Rosa.........
Sarasota ..........
Sarasota..........
Seminole...........
Sanford .........
Sumter.............
Suwannee .........
Taylor.............
Union..............
Volusia............
Daytona Beach...
W akulla ...........
W alton.............
Washington.........

! YEAR

1952*
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931

1,311
880
276
80
439
796
33
1,053
406
185
1,063
1,005
384
1,256
108
3,139
1,880
202
2,929
1,247
233
417
2,899
1,639
374
3,412
831
655
603
417
678
547
555
720
508
797
453
278
444
233
125
1,607
716
124
360
292

742
554
161
61
158
483
199
525
239
109
954
898
251
1,189
82
2,388
1,425
168
1,881
908
216
331
2,263
1,183
263
2,514
633
376
376
273
344
235
494
535
335
376
231
166
295
161
82
1,120
458
81
295
198

Colored

569
326
115
19
281
313
134
528
167
76
109
107
133
67
26
751
455
34
1,048
339
17
86
636
456
111
898
198
279
227
144
334
312
61
185
173
421
.222
112
149
72
43
487
258
43
65
94

I

I I I i

I

I

28 ANNUAL REPORT, 1952

TABLE 8

PRELIMINARY TOTALS OF DEATHS BY COLOR FOR COUNTIES AND

CITIES OVER 10,000 POPULATION, FLORIDA, 1952

County or City Total White Colored County or City

Florida............
Alachua .............
Gainesville..........
Baker...............
Bay..................
Panama City........
Bradford.............
Brevard .............
Broward.............
Ft. Lauderdale......
Calhoun ..............
Charlotte............
Citrus ...... ........
Clay. ...............
Collier................
Columbia ............
Dade.................
Miami..............
Miami Beach........
DeSoto..............
D ixie.................
Duval ..............
Jacksonville.........
Escambia.............
Pensacola...........
Flagler...............
Franklin ..........
Gadsden..............
Gilchrist ..............
Glades................
Gulf .................
Hamilton..............
Hardee...............
Hendry ..............
Hernando.............
Highlands ............
Hillsborough..........
Tampa .............
Holmes ..............
Indian River..........
Jackson...............
Jefferson ..............
Lafayette.............
Lake.................
Lee..................
Ft. Myers...........

29,197
527
242
66
329
229
88
309
979
490
60
62
78
122
61
192
4,981
2,774
448
101
37
2,931
2,357
892
473
38
74
317
24
24
62
81
117
70
59
170
2,633
1,780
100
104
303
128
33
413
291
197

21,676
278
145
44
254
164
62
224
686
369
49
52
52
86
35
105
4,273
2,364
447
69
29
1,874
1,423
610
280
23
42
87
22
13
37
44
101
42
45
121
2,102
1,379
87
79
156
37
28
315
218
135

7,521
249
97
22
75
65
26
85
293
121
11
10
26
36
26
87
708
410
I
32
8
1,057
934
282
193
15
32
230
2
11
25
37
16
28
14
49
531
401
13
25
147
91
E
98
73
62

Leon ..............
Tallahassee .......
Levy...........
Liberty..........
Madison .........
Manatee ...........
Bradenton........
Marion............
Ocala............
M artin.............
Monroe ...........
Key West.......
Nassau.............
Okaloosa..........
Okeechobee.........
Orange............
Orlando.........
Osceola............
Palm Beach........
West Palm Beach
Lake Worth......
Pasco...............
Pinellas............
St. Petersburg....
Clearwater .......
Polk...............
Lakeland.........
Putnam...........
St. Johns..........
St. Augustine....
St. Lucie..........
Ft. Pierce.......
Santa Rosa........
Sarasota...........
Sarasota..........
Seminole..........
Sanford .........
Sumter.............
Suwannee.........
Taylor............
Union..........
Volusia............
Daytona Beach...
Wakulla...........
Walton.............
Washington.........

Total White

430 182
288 134
114 67
27 24
157 70
430 344
245 199
454 241
166 89
81 59
233 179
210 159
127 78
188 167
38 30
1,234 998
707 581
213 191
1,289 900
524 364
208 206
291 246
2,558 2,841
1,643 1,493
258 224
1,193 896
338 265
249 143
288 170
201 128
220 132
196 105
128 102
385 327
263 218
325 158
163 78
94 65
169 110
99 54
53 32
972 761
414 312
34 15
146 118
122 95

Colored

248
154
47
3
87
86
46
213
77
22
54
51
49
21
8
236
126
22
389
160
2
45
217
150
34
297
73
106
118
73
88
91
26
58
45
167
85
29
59
45
21
211
102
19
28
27

TABLE 9
PRELIMINARY TOTALS FOR DEATHS BY IMPORTANT CAUSES, BY COLOR, FLORIDA, 1952, WITH DEATH RATES FOR
1952 BY COLOR AND FINAL DEATH RATES FOR 1951

1952

CAUSE OF DEATH Death Rates 1951
(Numbers in parentheses refer to the International List of causes of death) Deaths (Per 100,000 population) Rates

Total White Colored Total White Colored Total

ALL CAUSES................................................. 29,197 21,676 7,521 9.7* 9.1* 12.0* 9.6*

Tuberculosis of respiratory system (001-008) .................................. 475 238 237 15.8 10.0 37.7 16.8
Tuberculosis, other forms (010-019).................. ..... ............... 30 15 15 1.0 0.6 2.4 1.0
Syphilisanditssequelae (020-029).......................................... 183 91 92 6.1 3.8 14.6 6.2
Typhoid fever (040) ........................................... 1 0 1 *** 0.2 ***
Dysentery, all forms (045-048).......................................... 22 7 15 0.7 0.3 2.4 0.8
Scarlet fever and streptococcal sore throat (050-051) ........................... 4 3 1 0.1 0.1 0.2 0.2
Diphtheria (055) .......................................... 8 5 3 0.3 0.2 0.5 0.2
W hooping cough (056) .......................................... 6 1 5 0.2 *** 0.8 0.9
Meningococcal infections (057) .......................................... 27 19 8 0.9 0.8 1.3 0.8
Acute poliomyelitis (080) .......................................... 39 31 8 1.6 1.3 1.3 0.5
Acute infectious encephalitis (082)........................................... 7 5 2 0.2 0.2 0.3 0.5
Smallpox (084) .......................................... 0 0 0 -- -
M easles (085) .......................................... 10 3 7 0.3 0.1 1.1 0.2
Rabies (094) .......................................... 0 0 0 -
Typhus and other rickettsial diseases (100-108)............................ 0 0 0 -***
M alaria (110-117).......................................... 2 0 2 0.1 0.3 -
All other diseases classified as infective and parasitic (030 to 138 with exception of
above causes) .... ...................129 65 64 4.3 2.7 10.2 3.9
Malignant neoplasms, including neoplasms of lymphatic and haematopoietic
tissues (140-205) ................................... ........... ... ... 4,186 3,515 671 139.2 147.8 106.8 129.3
Benign and unspecified neoplasms (210-239) ....... ................... ..... 138 104 34 4.6 4.4 5.4 3.9
Diabetes mellitus (260) .......................................... 422 327 95 14.0 13.7 15.1 12.9
Anemias (290-293) ......................................... 90 61 29 3.0 2.6 4.6 3.3
Vascular lesion affecting central nervous system (330-334)....................... 3,294 2,376 918 109.6 99.9 146.2 113.7
Nonmeningococcal meningitis (340) ...................................... 63 30 33 2.1 1.3 5.3 1.9
Rheumatic fever (400-402)...................................... 27 13 14 0.9 0.5 2.2 0.4
Chronic rheumatic heart disease (410-416).................................... 345 272 73 11.5 11.4 11.6 10.8
Arteriosclerotic & degenerative heart disease (420-422)......................... 6,991 6,052 939 232.5 254.5 149.5 229.4
Other diseases of heart (430-434)......................... ......... 731 544 187 24.3 22.9 29.8 25.6
Hypertension with heart disease (440-443) .................. .......... 1,495 922 573 49.7 38.8 91.2 48.8
Hypertension without mention of heart (444-447)............................ 273 169 104 9.1 7.1 16.6 9.7

TABLE 9-Continued
PRELIMINARY TOTALS FOR DEATHS BY IMPORTANT CAUSES, BY COLOR, FLORIDA, 1952, WITH DEATH RATES FOR
1952 BY COLOR AND FINAL DEATH RATES FOR 1951

CAUSE OF DEATH
(Numbers in parentheses refer to the International List of causes of death)

Other circulatory diseases (450-468) ............................
Influenza (480-483) .............................
Pneumonia (490-493) ............................
Bronchitis (500-502).........................
Ulcer of stomach and duodenum (540-541).............................
Appendicitis (550-553) .............................
Intestinal obstruction and hernia (560, 561, 570) ...........................
Gastritis, duodenitis, enteritis & colitis, except diarrhea of the newborn
(543, 571, 572) ............ ................... ...................
Cirrhosis of liver (581) ............................
Nephritis & nephrosis (590-594)...........................
Hyperplasia of prostate (610) .............................
Complications of pregnancy, childbirth and the puerperium (640-652, 670-689)....
Congenital malformations (750-759)............................
Birth injuries, postnatal asphyxia & atelectasis (760-762)......................
Infection of the newborn (763-768) .............................
Other diseases peculiar to early infancy, and immaturity unqualified (769-776).....
Senility without mention of psychosis, ill-defined and unknown causes (780-795)...
All other diseases (Residual)............................................ .
Motor vehicle accidents (810-835) ............................
All other accidents (800-802, 840-962)....................
Suicide and self-inflicted injury (963, 970-979)........................
Homicide and operations of war (964,965, 980-999)....................
Infant mortality (deaths under one year of age)..............................

Deaths

Total

687
134
776
45
166
58
230
228
331
524
122
61
362
619
95
802
747
1,505
871
1,147
349
340
2,548

Death Rates
(Per 100,000 population

-- I *-I- I- .1 .

White

566
46
408
34
139
33
154
108
280
303
96
26
280
387
38
469
400
1,156
669
787
328
101
1,399

Colored

121
88
368
11
27
25
76
120
51
221
26
35
82
232
57
333
347
349
202
360
21
239
1,149

Total IWhite

22.9
4.5
25.8
1.5
5.5
1.9
7.7
7.6
11.0
17.4
4.1
0.8**
12.0
20.6
3.2
26.7
24.8
50.1
29.0
38.2
11.6
11.3
34.4**

23.8
1.9
17.2
1.4
5.8
1.4
6.5
4.5
11.8
12.7
4.0
0. 5**
11.8
16.3
1.6
19.7
16.8
48.6
28.1
33.1
13.8
4.2
26.2**

Colored

19.3
14.0
58.6
1.8
4.3
4.0
12.1
19.1
8.1
35.2
4.1
1.7**
13.1
36.9
9.1
53.0
55.3
55.6
32.2
57.3
3.3
38.1
55.6**

*Rate per 1,000 population
**Rate per 1,000 live births
***Rate less than 0.05

Z
Z
C
1951
Rates r-

Total m
-U
0
23.0
7.2
24.7
1.7
5.2
2.0
7.5 SO
6.6
9.9 I3
19.1
4.4
1.2**
11.7
19.5
2.9
26.1
25.5
46.4
29.3
40.0
11.4
11.2
32.9**

VITAL STATISTICS 31

TABLE 10
PRELIMINARY TOTALS FOR RESIDENT DEATHS FROM SELECTED CAUSES
BY COUNTIES, FLORIDA, 1952

S 42,720 4 1 7 4 7 144 12 21
COUNTIES I |5 | 1

Broward......... 98,940 125 3 12 .... 49 140 462 2 4
FLORIDA. ........ 3,006,400 2,548 61 505 183 6 910 4,186 14,340 871 1,147

Calhoun... ... ....2.... 3 ........... 1 34 12
Charlotteker .......... 4,310 8.... 1.... 1 9 27 4 4
Bayitru............. 42,720 7 .... ........ .. 4 9 81 1 21
Bradford............ 161,70 20 .... 1 ... 20 52 8 8
Brevard.......... ,2 0 14 2. ....... 3 3 24 18 7
Browardlumbia.......... 18,940 128 3. 12 .... 6 28 2 24 1

Dade .............. 576,340 344 12 84 82 1 103 912 2,848 154 158
DeShoun............ 107,920 14 6 4 .... .... 4 15 2 .... 2
ieCharlotte........... 84,10 32........ 1..... 1 9 27 1 4.....
Ctrual............. 18,040 277 4 97 33 ... ... 102 371 1,39 10 124
Escambia.......... 116,160 125 2 11 1.... 29 104 364 26 54

Flagler............ 8,700 5 14.... 1 ...... .. 4 3 18 1 4
FrankColumbia.......... 800 1 ... 2 ... 2 82 4 1
Daden.............. 76,980 34460 2 1 1 32 19 25 1,3 9 11
GDeSoto........... 610,320 14 ... ..... ... .. .... 4 18 1 2
Glades............. 2,200 2 ... 1... ..... 5 14 1 2
Dual............... 718040 277.. 4 1.... 02 7 24 4 124
EHambiaton.......... 116,10 125... 2 11 .... 29 10 64 26 8
Fagerdee........... 0,700 9 .... .... 1...... 3 18 1 4
HFranin........... 6,440 9 1 ........... 8 81 8
Gadsden..a... 7.. 10980 60 2 1 1 .... 4 12 219 9 2
Gilhrlands .......... 143,10 18 1 .... ... .... 4 18 1 2
lades....borough........ 269,020 214 3 46 1. 1 67 417 1,21 1 2
Holmes............ ,010 .... 2 2 .... 3 8 7 5 2 4
Indialton..River....... 13,100 12 1 2 1 1 1 19 5 44 8
Jacksondee............ 10,770 9 ...1 7 ... .... 25 1 721 10 1
Jefferson............. 6,40 9 1....... .... .... 8 7 69 5 4
Henandoe......... 0 .........0 .. 2 4 18 .... 2
ighlandsk.......... 140,10 18 1 2 4 .... 17 68 201 16 1
ee....orough........ 23,69020 2146 1 46 1 1 6 41 1,218 685 1

Leon ............. 55,140 44 1 14 2 .... 21 45 190 14 26
Holmeevy............ 14,010 9 2 1 1.... 3 13 60 2 7
Indian Rivety ....... 13,180 12 1 2 1 1 94 16 .... 1
Jackson........... 4,210 24 1 7 .... .... 2 20 8 10 1
JeMaerson........... 88,240 1623 ........ .... 8 7 6924 5 49

Marion........... 89,560 57 2 6 3 .... 16 44 208 11 26
Lafayette........... ...... 3 17 8 7. 2
MonroLake............. 40,910 34.. 7 ... 14 83 89 9 10
Lee..assau............ 23,410 13 .... 3 ...1 3 14 54 8 10
Leon..osa........... 325,140 44 1 14........ 420 190 14 26

Okeechobee ......... 3,650 '10 .... .... .... .... 2 4 14 2 ...
OranLevy............. 1 0,920 90 2 1 14 .... 81 185 661 27 4
OLiberty............ 118790 9 ..... 2 2 .. .. 3 26. 121 3 9
PalmdisonBeach........ 121,060 10 1 16 12.... 6 174 659 46 5
Manatsco ............ 238,40 15 .... 6 2 ... 8 61 142 8 11
Marionellas............ 172,270 74 2 27 10 ... 5016 450 1,45208 11 26
PolkMartin............. 129,20 112 2 1 8... .... 28 150 638 7 2
Monroeam............ 26,230 29 .... 7 1 .... 10 33 891 10

St. Johns .......... 26,520 28 1 2 3 .... 15 40 130 11 1i
St. Lucie........... 13,450 24 .... 3 ... 12 20 110 8 10
Santa Rosa....... 19,240 12 1 2 ........ 7 19 65 4 12
Sarasotakeehobee......... 33,160 22 1 4 1... 52 220
SemiOrange........... 127,60 90 21 11 .... 2 16 41 145 11 37 4
Osceola............ 11,720 6 .... 6 19 1 3 9
Palm Beae......... 17,010 105.. 1 1... 8 18 93 1 150
Pasco.............. 1023,40 1... ... 6 14 46 5 211
Pinllas ........... 172,20 94 2 27 1 5 450 1,4506 28 2 61
Polusi.............. 8129,20 112 2 18 5 .. 285 150 637 20 52
Putnam............ 26,230 29 .... 7 2 .... 10 30 123 8 10
St. Johns........... 26,520 28 1 2 3 15 40 130 11 13

St. Luce........... 52,450 24 .... 1 1.. 3 1 120 11
Santa Rosaon ........... 11240 1 1 2 .... .... 7 19 6 4
Sarashington........ 3,160 221 1. 4 1 .... 13 57 5 1
Seminole............ 27,960 44 1 11 .... 2 16 41 145 11 20
Sumter............. 11,720 6...................6 19 5 6 3 1
Suwannee .......... 17,010 156.... 1 1 .... 8 18 93 1 18
Taylor............. 10,400 11 .... 1 1 .... 6 14 46 5 2
Union............. 7,280 2 2 1..... .... 5 6 28 2 3
Volusia............ 81,290 49 2 15 56 .... 5 127 535 20 43
Wakulla........... 5.,480 1.... 1......... 38 1 12 .... 4
Walton.............. 15,110 11 1............... 5 10 73 6 12
Washington......... 11,890 18 3......... 4 13 57 5 2

32 ANNUAL REPORT, 1952

TABLE 11
PRELIMINARY TOTALS FOR MARRIAGES BY COLOR, DIVORCES, AND
ANNULMENTS FOR FLORIDA AND EACH COUNTY, 1952

MARRIAGES
COUNTIES DIVORCES ANNULMENTS
TOTAL WHITE COLORED
FLORIDA......... 26,956 21,412 5,544 20,249 198
Alachua........... 354 230 124 229
Baker............. 33 25 8 238
Bay............... 422 338 84 119 2
Bradford.......... 75 64 11 597 12
Brevard........... 334 265 69 567 8
Broward........... 1,449 1,105 344 563 6
Calhoun........... 20 16 4 42
Charlotte.......... 75 63 12 15
Citrus............. 78 55 23 53
Clay.............. 96 80 16 111
Collier............ 102 85 17 21 1
Columbia........... 141 89 52 85 1
Dade.............. 5,694 4,926 768 5,173 64
DeSoto............ 85 63 22 21
Dixie.............. 23 16 7 14
Duval.............. 2,083 1,635 448 1,102 10
Escambia.......... 680 535 145 788 10
Flagler............. 99 60 39 79 3
Franklin........... 74 58 16 23
Gadsden........... 186 67 119 70
Gilchrist ........... 66 45 21 2
Glades............ 36 24 12 8
Gulf.............. 64 45 19 27
Hamilton.......... 60 26 34 30
Hardee............ 131 120 11 307 2
Hendry............. 120 83 37 31 1
Hernando.......... 100 83 17 26
Highlands......... 151 106 45 114
Hillsborough ....... 2,619 2,267 362 1,396 6
Holmes............ 54 43 11 52
Indian River....... 154 110 44 59
Jackson........... 204 128 76 72
Jefferson........... 71 26 45 16
Lafayette.......... 26 18 8 3
Lake.............. 287 207 80 201 1
Lee............... 277 221 56 138
Leon.............. 366 224 142 315 1
Levy.............. 79 51 28 26
Liberty*........... 20 18 2 7
Madison........... 63 44 19 43
Manatee........... 329 243 86 67
Marion............ 351 221 130 206 3
Martin............ 106 80 26 32
Monroe........... 481 422 59 377 3
Nassau............ 49 43 6 21
Okaloosa.......... 167 152 15 137
Okeechobee*....... 51 36 15 19
Orange............ 1,295 996 299 419 3
Osceola............ 215 165 50 23
Palm Beach........ 1,293 928 365 649 5
Pasco............. 244 216 28 106 3
Pinellas ........... 1,633 1,426 207 664 9
Polk.............. 1,217 955 262 1,040 11
Putnam ........... 199 123 76 508 4
St. Johns.......... 184 148 36 1,034 17
St. Lucie.......... 240 148 92 133 2
Santa Rosa*....... 66 56 10 52
Sarasota .......... 375 323 52 179 8
Seminole.......... 308 195 113 192
Sumter............ 85 61 24 65
Suwannee.......... 104 71 33 70 1
Taylor............ 76 55 21 30
Union............. 36 27 9 17
Volusia............ 608 514 94 1,332 6
Wakulla*.......... 27 18 9 4
Walton............ 82 68 14 63
Washington........ 84 68 16 32 ...

*No December divorce reports received from clerks of circuit court of Liberty, Okeechobee, Santa
Rosa, and Wakulla Counties.

VITAL STATISTICS 33

TABLE 12
VITAL STATISTICS SCOREBOARD
Based on Promptness and Completeness of Certificates Filed in 1952

Percent of Percent of
Certificates Complete Percent of Monthly Total Score
COUNTY RankI Filed on Time Certificates Reports Submitted (Maximum-500)
On Time
Births Deaths Births Deaths
Martin........... 1 100 99 99 99 100 497
Pinellas.......... 2 96 98 100 99 100 493
Wakulla........... 8 98 96 98 100 100 492
Manatee......... 4 95 98 99 99 100 491
Hernando........ 5 92 99 99 99 100 489
Glades........... 6 100 100 100 94 92 486
DeSoto........... 7 96 96 98 95 100 485
Dade............ 8 93 99 99 99 92 482
Sarasota.......... 9 88 99 99 95 100 481
Suwannee........ 10 88 95 99 99 100 481
Franklin.......... 11 93 99 98 97 92 479
Polk............. 12 85 97 98 97 100 477
St. Johns......... 13 96 98 99 97 83 473
Holmes........... 14 94 85 98 94 100 471
Leon............. 15 85 96 99 99 92 471
Orange........... 16 85 92 98 96 100 471
Lake............. 17 85 90 98 97 100 470
Pasco............. 18 80 95 97 98 100 470
Marion........... 19 78 97 98 97 100 470
Bradford......... 20 93 94 97 100 85 469
Volusia........... 21 87 92 99 99 92 469
Okeechobee....... 22 86 89 94 100 100 469
Seminole......... 23 99 97 99 98 75 468
Walton........... 24 86 92 99 97 92 466
Lee.............. 25 72 98 98 98 100 466
STATE........ ...... 84 95 98 98 91 466
Baker............ 26 88 93 90 93 100 464
Brevard.......... 27 88 87 99 97 92 463
Escambia......... 28 68 96 99 99 100 462
Palm Beach....... 29 76 96 98 97 92 459
Washington....... 30 75 90 96 98 100 459
St. Lucie......... 81 80 85 98 95 100 458
Broward.......... 2 85 99 99 99 75 457
Levy............. 33 85 81 95 96 100 457
Sumter........... 34 76 88 95 97 100 456
Dixie............ 35 75 91 95 94 100 455
Hillsborough...... 36 89 98 99 99 67 452
Flagler............ 37 81 82 96 91 100 450
Gilchrist.......... 38 71 79 100 100 100 450
Putnam.......... 39 85 82 95 94 92 448
Santa Rosa....... 40 71 88 98 99 92 448
Columbia......... 41 83 94 99 96 75 447
Duval............ 42 87 97 97 98 67 446
Charlotte.......... 43 84 97 91 82 92 446
Clay............. 44 77 85 95 97 92 446
Gulf............. 45 87 94 97 100 67 445
Union............ 46 72 87 97 95 92 443
Bay.............. 47 65 94 97 95 92 443
Highlands........ 48 65 81 96 99 100 441
Madison.......... 49 86 76 99 96 83 440
Osceola........... 50 61 91 98 95 92 487
Gadsden.......... 51 75 93 97 95 75 435
Nassau........... 52 58 83 95 98 100 434
Okaloosa ........ 53 74 88 99 96 75 432
Jefferson ......... 54 67 87 97 98 83 432
Calhoun.......... 55 63 80 96 92 100 431
Jackson .......... 56 66 74 94 95 100 429
Hardee........... 57 69 95 90 97 75 426
Monroe.......... 58 72 82 99 97 75 425
Alachua.......... 59 75 86 97 97 67 422
Collier........... 60 79 90 94 82 69 414
Liberty........... 61 69 84 88 89 83 413
Lafayette......... 62 50 76 91 90 100 407
Taylor........... 63 29 84 97 94 100 404
Citrus ........... 64 45 92 88 85 92 402
Hamilton......... 65 49 86 90 95 75 895
Indian River...... 66 59 71 97 95 67 389
Hendry .......... 67 32 56 95 92 83 358

34 ANNUAL REPORT, 1952

TABLE 13
ACTIVITIES OF THE BUREAU OF VITAL STATISTICS
DURING THE YEARS 1951 AND 1952

Per cent
Activity 1951 1952 change
Current certificates received...................... 145,234 152,192 + 4.8
Delayed birth certificates filed................... 3,130 4,026 +28.6
Adoption decrees received.......................... 1,262 1,629 +29.1
Amended certificates filed for adoptions.... 1,419 1,543 + 8.7
Amended certificates filed for legitimations
and correction of parentage ............ 456 375 -17.8
Requests for Certifications
Fee Paid ..................................... 59,000 63,700 + 8.0
Free .................................................. 25,296 19,262 -23.9
Photostats made ........................................ 75,273 77,259 + 2.6
Birth Registration Cards made .................... 18,053 21,158 +17.2
Fees collected and transmitted to
State Treasurer ...................................... $90,256.10 $96,705.00 + 7.1

LOCAL HEALTH SERVICE

BUREAU OF LOCAL HEALTH SERVICE

GEORGE A. DAME, M.D.
Director

This report will cover the major activities of the Bureau, but with
particular reference to local health units. Activities of the other di-
visions will be reported by the Directors of Public Health Nursing,
Field Technical Staff and Field Training Center.
The basic and fundamental problem of the county health units is
insufficiency of operating funds. This problem is the father of most
of their other problems, such as inadequate salaries, shortage of per-
sonnel, lack of training, and inability to expand needed programs to
meet the legitimate demands of Florida's citizens. As a result of the
amazing growth in population and the increase in the number of coun-
ties served, funds have been stretched almost to the breaking point.
In 1950 the State's appropriation of $750,000 for health units amounted
to 37.33 cents per person. With the increase of $100,000 in the State
appropriation in 1951, the allocation amounted to only 33.78 cents
per person when budgets were set up for 1952. In 1950 Federal funds
were allocated to county health units at the rate of 8.86 cents per
person. In 1952 Federal funds permitted an allocation of only 7.07
cents per person. It is quite certain that this latter item will continue
to decrease.
As a further indication of the growing crisis of diminishing public
health funds it should be mentioned that in 1950 one public health
nurse was provided for each 7,304 persons. In 1952 this service was
diluted to cover 8,330 persons. In 1950 one sanitarian served a popula-
tion of 13,950 persons. Now the sanitarians are each serving an aver-
age of 15,123 persons. Clerical persons in 1950 averaged one for each
12,795 persons. However, in 1952 there was only enough money to
employ one for each 14,375 persons. Even with the inadequate number
of positions set up for carrying on public health services it has been
difficult to secure a full number of employes to fill them on account of
inadequate salaries. It now requires constant recruitment with a
large and expensive turnover. We are proud of the work being done
in our county health units, but a better job could be done with more
adequate salaries.
One cheerful aspect is the fact that there has been a slow but
gradual increase in county contributions. We all agree that counties
should more and more assume the burden of supporting public health
programs on a local level, but until such time as the counties can
more fully absorb the costs it will be necessary for the State to carry
a reasonable share in order that Florida may have fairly good programs
for the prevention of disease. To the organized county health depart-
ments in sixty-six counties, fourteen counties are contributing more
than $1.00 per capital. One county, Glades, is contributing $1.89 per

36 ANNUAL REPORT, 1952

capital. There are only nine counties now contributing less than fifty
cents per capital. In addition to funds allocated to county health depart-
ments on a formula it should be stated here that the State Board of
Health contributes as freely as its funds will permit to other special
programs in the counties on a regional basis: Venereal Disease Con-
trol, Cancer Control, Mental Health, and others. The State Board of
Health is limited in its resources and is constantly handicapped in its
efforts to supply those necessary services which are requested by county
health departments in ever increasing numbers.
The number of full time health officers employed in local health
units in Florida numbered fifty-one as of December 31, 1952. Thirty-
six of these were directors and eleven were assistant health officers;
three were on out-of-state training to secure their Masters degrees in
Public Health and one was on military leave. There were also twenty-
four physicians employed on a part time basis as clinicians. Of the full
time medical officers nineteen have the degree of Master of Public
Health, and seven are diplomats of the American Board of Preventive
Medicine. Florida apparently has a larger percentage of men holding
the M.P.H. degree than any of the other State Health Departments.
In June three physicians who had completed graduate training re-
turned to the State. Three others began their work in September.
The average age of full time health officers is forty-five, and the
average tenure in Florida public health work is four years and nine
months.
Health officers who resigned during the year were: William M.
Hanrahan, Paul L. Summers, Joseph H. Batsche, E. K. Langford,
A. K. Cox and Robert L. Price. Health officers employed during
the year were: Paul L. Summers, James F. Speers, John L. Lincoln,
Harold F. Bonifield, Charles J. Mathes, James O. Bond and Henry
I. Langston.
Other personnel employed in the local health units have gradually
improved in educational qualifications and experience. Their work is
steadily improving in both quality and quantity. There is a fluctuating
shortage in these categories, particularly in nurses. This can be at-
tributed to inadequate salaries. Many of our sanitarians who are mar-
ried and have children receive less than $250 per month, which is not
conducive to lengthening tenure of employment.
Following the resignation of Doctor Knox E. Miller on October 15,
1952, Doctor James L. Wardlaw, Jr., was appointed Director of the
Field Technical Staff. Some thought is being given to a change in the
title of this Division to more accurately connote its duties and respon-
sibilities, and its relationship to county health units and other activities
in the State Board of Health.
For some years a campaign of education and tactful persuasion has
been waged for the consolidation of the two units composed of the
Madison and Taylor County Health Departments and that of Jefferson
County. This was finally consummated on December 1, 1952 through

LOCAL HEALTH SERVICE 37

the efforts of Doctor John D. Cross who is now the director of the
three county unit. This consolidation has resulted in a more economical
administration and has permitted the employment of an additional
nurse whose district is composed of a portion of territory from each
of the three counties.
On October 15, 1952 the Collier County Health Department was
organized following a year or more of negotiation between the Collier
County authorities and this Bureau. The sincere interest of Mr. Ed
Scott, Clerk of the Circuit Court and of Messrs. Barron and Miles
Collier, should be given credit for this accomplishment. By agreement
between the authorities of Lee and Collier Counties, the Collier County
Health Department and that of Lee County were associated together
as one Unit. Doctor Merwin E. Buchwald is director of the associated
unit. In Collier there is also full time personnel consisting of one
public health nurse, one sanitarian and one clerk. This small pro-
gressive county of 6,488 population came in with an appropriation of
$1.12 per capital.
In each annual report of the Bureau of Local Health Service an
effort has been made to mention some of the outstanding programs that
have been promoted in county health units. The reporting of these
items has been requested of the county health officers. Although, there
are outstanding activities of one sort or another in each of the
counties they are sometimes not reported on account of the shyness,
or lassitude, or fear of publicity on the part of some of the health
officers. However, here are a few that are deemed worthy of mention:
In the Unit composed of the counties of Bradford, Clay and Union
there was an excellent multiphasic survey conducted in the months of
August and September. The survey met splendid response in all three
rural counties, being offered to all persons sixteen years of age and
over. Doctor Aubrey Y. Covington reported that over 5,000 individuals
were X-Rayed, or approximately 15.5 per cent of the total population of
34,686 in the area. Suspicious tuberculosis was found in 1.1 per cent and
other pathology in 1.2 per cent of those examined. Of the seven active
cases of tuberculosis so far proven, five were in tuberculosis sanitoria and
two others were awaiting admission at the time of the report. Of other
pathology two suspicious tumor cases were processed through a tumor
clinic and received lung surgery.

To quote from Doctor Covington's report: "A blood specimen was
also taken on over 4,000 or 88.4 per cent of all examined. Positive serol-
ogy for syphilis was reported on 4.9 per cent. Treatment records were
available in our office of approximately 40 per cent of all positives and
about half of these had adequate treatment already. Approximately 50
cases have been sent to the Prevention and Control Center and treatment
completed in our office. Others are being followed by the health depart-
ment and private physicians. On diabetes testing, 2.9 per cent of all
examined had a history of known diabetes. In addition, a total of 23 new
definite cases were found giving a total of 3.4 per cent (new and old

38 ANNUAL REPORT, 1952

cases). Many others are being followed by private physicians. A total of
76 cases or 1.7 per cent of those tested for hemoglobin were below the
screening level of 11.5 and 12.5 gms."
Here are some quotes from Doctor Robert E. Rothermel's report on
Pinellas County: "A step in the right direction has been taken in
sanitation in the Negro areas of St. Petersburg in a cleanup campaign
which removed 100 extra truckloads of trash and debris. City garbage
department and the health department initiated the project which was
spearheaded by negro leaders. Water supply and sewage disposal,
one of the most expensive and serious of Pinellas County problems,
has been improved in a number of ways. Complete new sewerage sys-
tems have been started or completed in Tarpon Springs and at Madeira
Beach. A subdivision in St. Petersburg has started construction on a
new system. The health department is promoting separate systems for
each new subdivision as the most desirable type of sewage control
program Excellent cooperation between school and health officials
has resulted in the publication of a 'Guide to Teaching Health'. The
handbook for teachers in the elementary schools was prepared by school
and health department personnel and has received state-wide recog-
nition by persons in both fields. The volume of requests has depleted
the supply of complimentary copies." "A Pinellas Health Education
Council was formed in 1952 to coordinate health education activities
in the county. Its membership consists of organizations whose main
job is health education. The group is headed by the full time Health
Educator of the health department. One hundred seventy high
school girls have organized in the sophomore, junior and senior classes of
St. Petersburg High School to form a Future Nurses Club. The school
public health nurse started the new FNC which will study the qualifi-
cations and requirements of all types of nursing and they will work
toward contributing to the health of their school and community. .
School health planning has reached a new high in our county with
four committees working together for a better school health program.
Private doctors, teachers, nurses, health educator, and others have
made constructive recommendations for the next year."
A report on progress of Doctor Robert D. Higgins' program for Mental
Health in Volusia County is quoted: "Following through with visits
from Doctor William Hollister of Atlanta, United States Public Health
Consultant in the Mental Hygiene Program, and Doctor Louis Cohen,
Duke University, Volusia County has become particularly interested in
presenting a completely evaluated statistical report of the mental hy-
giene program which started in 1949. With an extremely limited
staff, we began to find the needs of the school and to realize that with
such an inadequate staff it would be impossible to give a complete
service, which would include handling the children and their parents
and the establishment of play therapy in the three different areas of
this county, Daytona Beach, New Smyrna Beach, and DeLand. With
financial aid from the Volusia County Board of Public Instruction, we
have been able to add a full time clinical psychologist, and a mental

LOCAL HEALTH SERVICE 39

hygiene nurse who has been specially trained during the past year in
this particular type of service; however, she is doing a generalized
piece of mental hygiene nursing."
From Brevard-Osceola Counties comes a report from Doctor James
F. Speers on a Venereal Disease program for which he wishes Mr.
Vance Bell, Health Field Worker to have most of the credit. It is
here quoted: "The Brevard-Osceola Health Unit has inaugurated an
active and comprehensive Venereal Disease program. The most pro-
ductive phase of this program has been the routine testing of all admis-
sions to city and county jails. In the short time since this program
was begun, 94 tests have been taken, of which 14 were positive. 10
of these positive cases had had no previous treatment. Three further
cases have been brought to treatment through investigation of con-
tacts. Educational programs have been presented in several, high
schools, with movies, slides, lectures, and discussion periods. These
have been followed by blood test surveys of the students. The percentage
of positive results in these surveys has been low, but several previously
undiagnosed cases of congenital syphilis have been found. Expansion
of this educational and survey program to include clubs, churches and
other similar groups is planned."
Here are some quotes from a letter received from Doctor J. Basil Hall
of Lake County: "I would like to mention that our local Medical
Society voted to establish a Lake County Medical Library in our pro-
posed new building. We plan to make it a small, complete library for
the use of doctors and nurses in our county. It is felt that this will
be a good medium of contact and will probably be the first such library
in the State. .We have used a fogging machine from a motor
boat in the lakes this year. It is an excellent form of advertisement
and is the most effective way that we have found to lessen the mosquito
nuisance; especially the 'blind' type. Counties with lakes and mos-
quitoes would do well to give consideration to this piece of equipment.
The complete rig costs approximately $2,200.00."
From the Walton-Holmes-Okaloosa Unit comes a report from Doctor
Raymond N. Nelson: "During the year ending 1952, this tri-county
health unit, has, in my opinion, done a number of things to promote
better public health. Among them: Diabetic classes have been organ-
ized; each has been well attended; instructions and discussions given
have been beneficial to all. Health Councils have been organized
and well attended. Rat-extermination programs were promoted in
all parts of the counties. In Walton County alone, over two tons of
rat poison was distributed and paid for by funds donated by county
and city. Closer cooperation with our local American Legion
organizations has made it possible to hold clinics for crippled children
in the department and not elsewhere in the city as has been the practice
in the past."
In Hillsborough County the Visiting Nurses Association has been
more nearly integrated with the county health unit than in any other

40 ANNUAL REPORT, 1952

county. A report from Doctor Frank V. Chappell is quoted: "Begin-
ning July 1, 1952, the long-hoped-for Greater Tampa Visiting Nurses
Association was organized by a group of interested community leaders.
It was finally made possible by the Metropolitan Life Insurance Com-
pany, which made available to the V.N.A. their two home service
nurses for the remainder of 1952. Donations were received from the
city and the county as well as other groups and individuals to get the
project started. It was set up under the supervision of the Hillsborough
County Health Department. The health officer serves in an ex officio
capacity on the Executive Board. Our nursing supervisor is the Ex-
ecutive Director; office space and equipment are provided by the
health department. A third nurse was added; her salary and all
administrative and operational expenditures are paid by State warrant
through the Hillsborough County Health Department. The Association
reimburses the health department for these expenditures at the end
of each month. Beginning January 1, 1953, all the Visiting Nurses will
become members of the health department staff and receive their
salaries by State warrant. We believe this is the first Visiting
Nurses Association in the State organized under this plan. We are
hopeful that this beginning will lead to a combination Public Health-
Visiting Nurse Service, defined by the National Organization for Pub-
lic Health Nursing as 'a service that is jointly administered by both
governmental and voluntary agencies; financed by tax funds, earnings
and contributions, and in which all field service offered by the partici-
pating agencies is rendered by a single staff of public health nurses."
Dr. William L. Wright of Sarasota County writes as follows: "The
most outstanding and newsworthy addition to our local program for
the year 1952 was the establishment of our Visiting Nurse Association.
This project was launched in February through the efforts of interested
citizens who saw the need for such a community service. The VNA
was set up as a separate organization but it was decided that our
county health department supervising nurse would also supervise the
VNA. The county health officer was elected a member of the Medical
Advisory Committee for the VNA. The VNA nurses worked out of the
health department office and used the health department facilities to
carry on their program. The service was supported by public contribu-
tions and by fees charged for the nurses' services. In the Fall the
program was added to the membership of the local Community Chest.
During the year the VNA gave services to 141 individuals. A total of
2181 visits were made by the nurses. The service has proved very
popular with the doctors of the area and with the patients served. There
have been a number of large donations by patients as a result of their
satisfaction with this work."
Doctor Terry Bird and Wakulla County are to be congratulated on
the completion of two public health buildings in 1952. One of these
beautiful and efficient buildings is at Crawfordville, the county seat.
It is used for health department offices and clinic rooms and cost
$125,000, including equipment. The funds were supplied by the Board

LOCAL HEALTH SERVICE

of County Commissioners and the State Improvement Commission under
the Hill-Burton Act. The building at Sopchoppy is for clinics conducted
by the county health department. It was built from funds supplied by the
Board of County Commissioners and cost about $6,000. This puts Wakulla
County with its small population right out front in the support of county
health work.
The people of Indian River County have reason to be proud of their
new, modem, well-located public health headquarters building completed
in 1952.
Holmes County also completed a modem building in Bonifay for head-
quarters for the Holmes County Health Department. Doctor Nelson now
has fine headquarters in each of his three counties at Crestview, De-
Funiak Springs and Bonifay.
Some quotations are given from a report received from Doctor Leland
Dame concerning Orange County: "We are glad to announce that we
shall now be able to greatly expand our mental health clinic. The Orlando
Junior League, composed of young women of the Orlando and Winter
Park area, voted to give us $3,000 during the year for increases in salaries
and expenses. An advisory committee will be formed to plan how to
spend it. .. Another sanitarian was added to the health department
during the year. The salaries of nurses and sanitarians were raised in
July and October, and the sanitarians again received a raise on January
1, 1953. We are beginning plans to better coordinate the work of sani-
tarians and nurses. .... Plumbing sanitation was increased greatly during
the year with better service from cooperation between the plumbers, sani-
tarians, and plumbing inspector. A great deal of sewerage was installed
during 1952 in new subdivisions instead of septic tanks. Through our
efforts a great many septic tanks were removed in the 'City of Winter
Park and sewer connection obtained."
Here is a quotation from a report made by Doctor Paul W. Hughes of
Broward County: "We have finally rounded out a full-time service to all
parts of the county. In other words, we now have sufficient clerical per-
sonnel, in addition to the sanitarians and nurses, so that we actually have
three full-time health units in Pompano, Fort Lauderdale, and Hollywood
respectively. This was made available by an increased clerical staff this
past year. ... A new health center, valued at approximately $65,000, will
have been completed some time in December, 1952. This health center is
being constructed by the new South Broward Hospital District and will be
rented to the local health department. This will enable us to give more
complete service to that fast growing area. The health center in Pom-
pano is new, built in 1949. Our health center in Fort Lauderdale, accord-
ing to public announcement by the County Commissioners, is to be re-
placed this year by a building valued at $75,000 to $100,000. Sixty-five
thousand dollars has been set aside in the county budget to provide for
such a building. It is expected that $35,000 matching funds will be
available. The new Fort Lauderdale health center will either be on the
local hospital grounds or on the grounds of the new court house."

42 ANNUAL REPORT, 1952

The following item is quoted from a report made by Doctor John C.
McSween of Escambia County: "On October 1, 1951, the Board of
County Commissioners passed a resolution, putting the Florida Plumbing
Control Act of 1951 in effect in Escambia County. In this resolution,
the enforcement of this law was put under the direction of the County
Health Department, and one inspector was assigned for enforcement.
Approximately four months later, due to increased building, another
plumbing inspector was added. The number of permits issued between
the period of October 1, 1951, and September 30, 1952 was 1,841. The
audit report covering this period shows that total receipts were $13,-
143.00 and total disbursements were $9,024.49, leaving a balance of
$5,118.51. This has been more than sufficient to take care of inspection
services and expenditures and also build a reserve fund for lean build-
ing periods. The plumbing industry is to be commended in their efforts
to improve sanitary conditions in our county and state."
Doctor Charles J. Mathes reports from Putnam County: "Tubercu-
losis control was given a prominent part in the year's program. The
diagnostic clinic was especially well attended. The Putnam County
Tuberculosis and Health Association purchased an X-Ray unit for the
health department for future control work The sanitation division
presented a rodent control exhibit at the Putnam County Fair and Live-
stock exhibit that was given a Blue Ribbon Award. ... The standard for
foodhandler's cards was set after many years of doing nothing but sero-
logical examinations for these cards. With the acquisition of the X-Ray
machine, it was established with the approval of the County Commis-
sioners and the Putnam County Medical Society that hereafter the appli-
cant would have a serological examination, a stool examination and a
chest X-Ray before obtaining a health card countersigned by the health
officer."

Articles by staff members:
1. Hall, J. B. Epidemiologic importance of man's transportation of mosquito
vectors of malaria. J. Florida M. A. 38:555-558, Feb. 1952.
2. Wilson, J. S., Hughes, P. W., Cronkite, A. E. Management of an outbreak
of anthrax. J. Florida M. A. 39:403-407, Dec. 1952.

TABLE 14
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

IIT I 04) 0 > I
ACTIVITIES B B B U U U d muB- U 6 IS

A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service ...............
2. Consultations and Conferences with
Physicians .........................
3. Field and Office Visits ..............
IMMUNIZATIONS COMPLETED
4. Smallpox.......................
5. Diptheria, (5-7)....................
8. Typhoid Fever....................
9. Whooping Cough, (9-11).............
12. Tetanus .........................
13. Rabies .............................
INTESTINAL PARASITE CONTROL
14. Admissions to Service................
15. Field and Office Visits ...............
16. Treatments Given ..................
B. VENEREAL DISEASE CONTROL
1. Admissions to Medical Service........
2. Visits to Medical conferences.........
3. Field Visits and Epidemiological
Investigations ......................
4. Treatments given (Syphilis,
Gonorrhea, etc.)...................
5. Admissions to Hospitals .............
C. TUBERCULOSIS CONTROL
1. Admissions to Medical Service
(A) Cases....................
( Contacts and Suspects.......
(C) Arrested cases ................
2. Admissions to Nursing Service
(A) Cases.........................
(B) Contacts and Suspects..........
(C) Arrested Cases ...............
3. Number of Persons X-rayed
(A) Miniature Films ..............
(B) Large 14" x 17" Films..........

20 94
18 69
43 232

538 933
607 1,409
293 932

101 42 231
101 80 232
90 43 231

1,893 6,000 0 1,479 0 0
143 69 2,146 97 561 59

9
133
128

309
2,244
3,305
2,246
3,607
3

1,088
1,199
1,088

128
207
196
116
12

14
7
0
14
90
14
1,641
99

81
19
248

1,904
2,908
13,625
415
1,121
0

193 320 251
283 359 251
267 320 245

4,396 14 17 3,277 1,447
31,707 16 22 13,367 2,782
16,799 51 21 3,809 1,360
8,456 6 14 3,260 2,023
0 8 3 142 3

523 13 6 0 112
4,207 4 1 0 291
480 1 0 0 1
898 11 4 150 283
250 1 37 409 454
60 1 0 85 25

12,922 0 025,634 9,972
4,772 140 99 226 1,295

.

s_.,

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

ACTIVITIES r E
.8 a s ,
.,rvme .E ,B s ;id

A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service ............... 3 6 36 3 7 2 16 12 19 0 61 231 9 29 34 19 2
2. Consultations and Conferences with
Physicians ....................... 6 1 28 3 6 5 0 15 15 0 26 191 2 20 14 4 1
3. Field and Office Visits............... 4 6 93 3 7 7 46 16 71 0 94 407 24 36 47 41 3
IMMUNIZATIONS COMPLETED
4. Smallpox .......................... 89 33 1,153 14 14 196 5 137 37 153 41 4,863 147 106 498 557 57
5. Diphtheria, (5-7).................... 318 190 771 420 59 228 470 176 345 136 399 5,245 794 440 2,753 1,611 184
8. Typhoid Fever...................... 436 988 4,363 177 17 1,031 858 46 59 305 29 422 523 900 8,226 3,379 486
9. Whooping Cough, (9-11)............. 234 166 772 73 53 213 473 160 228 34 149 2,562 277 418 930 1,157 191
12. Tetanus ............................ 423 462 2,535 442 65 766 1,558 245 347 293 402 5,382 900 749 3,439 2,559 319
13. Rabies ............................. 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0
INTESTINAL PARASITE CONTROL
14. Admissions to Service............... 169 145 770 260 11 309 598 66 46 864 209 777 408 111 1,258 616 112
15. Field and Office Visits ............... 180 145 770 260 23 333 1,313 66 55 916 209 783 486 138 1,258 625 112
16. Treatments Given ................... 90 145 770 258 11 316 598 63 43 268 206 783 1,113 152 3,780 644 110
B. VENEREAL DISEASE CONTROL
1. Admissions to Medical Service......... 21 57 191 4 14 27 65 5 25 13 149 1,100 10 6 214 30 23
2. Visits to Medical conferences ......... 47 85 320 7 30 54 103 6 70 18 218 3,613 13 7 274 35 26
3. Field Visits and Epidemiological
Investigations ..................... 59 115 553 2 13 189 63 18 22 51 157 5,996 64 75 605 93 1
4. Treatments given (Syphilis,
Gonorrhea, etc.) ................... 23 27 283 3 14 43 62 11 21 9 155 3,273 7 11 357 56 5
5. Admissions to Hospitals ............. 14 11 22 0 4 5 3 0 11 4 11 84 2 10 12 9 0
C. TUBERCULOSIS CONTROL
1. Admissions to Medical Service
(A) Cases ........................ 0 2 5 0 2 2 12 1 1 7 129 2 0 8 3 4
(B) Contacts and Suspects.......... 1 3 4 0 2 0 18 0 4 2 90 1,587 9 1 21 0 7
(C) Arrested cases ................ 0 0 0 0 0 1 2 1 1 1 12 340 1 0 7 0 0
2. Admissions to Nursing Service
(A) Cases ........................ 0 4 28 3 14 7 7 10 8 2 9 250 7 15 41 18 1
(B) Contacts and Suspects......... 14 19 177 20 9 23 27 44 12 53 90 1,479 100 73 125 28 42
(C) Arrested Cases.............. 0 1 6 1 0 5 3 14 0 2 13 192 0 17 25 2 0
3. Number of Persons X-rayed
(A) Miniature Films............... 737 976 5,582 400 0 2,245 925 0 0 0 045,448 0 2,428 0 0 0
(B) Large 14" x 17" Films.......... 12 35 222 28 45 160 116 75 21 56 79 737 79 132 393 38 72

z
z

C

TI-
m
-o

-0
'0

'O
tU

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

ACTIVITIES
ACTIVITIES 3 ..3 >5 3 Z 0 0 2 0 o$ oS

A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service................
2. Consultations and Conferences with
Physicians......................
3. Field and Office Visits..............
IMMUNIZATIONS COMPLETED
4. Smallpox.........................
5. Diphtheria, (5-7)...................
8. Typhoid Fever .....................
9. Whooping Cough, (9-11)............
12. Tetanus..........................
13. Rabies ............................
INTESTINAL PARASITE CONTROL
14. Admissions to Service ...............
15. Field and Office Visits...............
16. Treatments Given ...................
B. VENEREAL DISEASE CONTROL
1. Admissions to Medical Service.......
2. Visits to Medical conferences.........
3. Field Visits and Epidemiological
Investigations.....................
4. Treatments given (Syphilis,
Gonorrhea, etc.).................
5. Admissions to Hospitals...........
C. TUBERCULOSIS CONTROL
1. Admissions to Medical Service
(A) Cases........................
(B) Contacts and Suspects.........
(C)Arrested cases ................
2. Admissions to Nursing Service
(A) Cases.........................
(B) Contacts and Suspects.......
(C) Arrested Cases.............
3. Number of Persons X-rayed
(A) Miniature Films...............
(B) Large 14" x 17" Films..........

16 524
82 553
6 516

170 254 134
170 367 146
170 263 146

504 90 201 93
504 107 280 124
504 82 197 106

935 13,984 2,129 7,204
34 664 62 820

90
29
182
r-
187 O
608
65 n
599 >
608
2 E-

275 3
297 m
536
r-
119 --
250 3
261
7
74
45 M

18
48
6 M
19
129
16
0 U
142

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

ACTIVITIES I I I -
a

A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service ....................
2. Consultations and Conferences with
Physicians.............................
3. Field and Office Visits.....................
IMMUNIZATION COMPLETED
4. Smallpox ................................
5. Diphtheria, (5-7) ........................
8. Typhoid Fever ..........................
9. Whooping Cough, (9-11) ..................
12. Tetanus ................................
13. Rabies..................................
INTESTINAL PARASITE CONTROL
14. Admissions to Service....................
15. Field and Office Visits.....................
16. Treatments Given.......................
B. VENEREAL DISEASE CONTROL
1. Admissions to Medical Service .............
2. Visits to Medical conferences...............
3. Field Visits and Epidemiological
Investigations ..........................
4. Treatments given (Syphilis,
Gonorrhea, etc.) ......................
5. Admissions to Hospitals...................
C. TUBERCULOSIS CONTROL
1. Admissions to Medical Service
(A) Cases..............................
(B) Contacts and Suspects ..............
(C) Arrested cases.......................
2. Admissions to Nursing Service
(A) Cases ............................
(B) Contacts and Suspects..............
(C) Arrested Cases.....................
3. Number of Persons X-rayed
(A) Miniature Films... .................
(B) Large 14" x 17" Films ..............

345 601
435 656
233 582

62 189
78 316
66 210

283 194
300 199
298 194

226 92
245 113
229 94

0 1,228 1,024 13,410
226 60 411 1,348

3,631
2,434
7,165

47,485
65,775
107,380
47,391
86,367
71

20,626
23,990
23,626

20, 94
72,717
53,815
28,436
1,588

1,457
7,837
1,488
3,297
8,834
1,320
265,821
27,564

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

SS 2 a b
I I
ACTIVITIES M S 0 0 U3 3 Z Q a

C. TUBERCULOSIS CONTROL (Cont.)
4. Pneumoperitoneum Refills.......... 255 0 0 0 0 0 0 0 0 37 0 0 2,725 0 0 0 944
5. Pneumothorax Refills ............ .. 33 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 202
6. Visits to Medical Conferences...... 41 29 47 51 44 108 11 62 11 52 2 53 16,878 21 10 0 8,636
7. Tuberculin Test .................. 141 33 233 23 53 1,885 40 78 67 40 0 27 896 8 97 231 75
8. Field Nursing Visits .............. 899 80 368 199 303 1,565 99 235 84 251 0 197 3,629 84 89 1,686 1,368
9. Office Nursing Visits............. 23 71 54 6 93 591 29 77 24 81 0 26 111 0 28 39 156 0
10. Cases Hospitalized.............. 59.. 5 0 43 12 10 37 5 7 7 6 0 12 789 6 3 13 76
D. MATERNITY SERVICE
1. Admissions to Antepartum r-

3-
Medical Service................... 476 43 192 116 108 458 7 11 14 69 0 167 2,752 0 43 43 468
2. Cases Referred to Private Physician... 12 22 49 5 13 35 2 4 3 26 0 0 33 0 0 12 27
3. Admissions to Antepartum X
Nursing Service ....um............ 568 62 193 73 123 529 14 14 21 76 0 171 2,139 0 50 154 544
4. Visits by Antepartum Cases to M
Medical Conferences........... 1,232 91 562 250 281 844 18 24 25 124 0 100 10,420 0 111 121 529
5. Number of Clinic Sessions Conducted.. 214 35 33 21 125 148 9 19 15 53 0 119 430 0 31 22 96 _
6. Field Nursing Visits to Antepartum
Cases .......................... 918 92 107 149 125 269 8 26 35 47 0 71 2,947 0 40 320 318
7. Office Nursing Visits to Antepartum-
Cases...................iits....... 1,786 37 581 61 223 2,074 30 27 13 163 0 432 1,025 0 129 200 1,544
8. Cases given Nursing Service
at Delivery ..................... 0 0 0 1 2 0 0 0 0 0 0 0 0 2 0 0 CAl
9. Cases given Service at Delivery by rM
Certified-Nurse Midwife............ 1 0 1 0 0 0 0 0 0 0 0 0 7 0 6 0 0
10. Cases given Postpartum Medical 0 39 848 0 1 3 109
Examinations ..................... 199 10 79 5 46 88 3 0 3 22 0 39 848 0 1 3 109 <
11. Admissions to Postpartum
Nursing Service ................... 547 48 137 146 124 376 4 18 31 57 0 192 2,543 0 34 152 342
12. Field Nursing Visits to Postpartum 1,246 66 120 37 238 417 1 37 63 55 0 438 6073 0 50 273 33
cases .......................... 1,246 66 120 357 238 417 1 37 63 55 0 438 6,073 50 273 533 'lI
13. Office Nursing Visits to Postpartum 4 4 27 0 10 66 0 4 21 109
cases ............................ 175 8 99 15 52 84 4 4 5 27 0 10 66 0 4 21 109
14. Admissions for Midwife Supervision... 18 15 2 6 24 8 3 2 3 7 0 9 18 0 3 2 15
15. Attendance of Midwives at Meetings. 35 22 19 36 25 68 1 0 2 4 0 55 200 0 8 0 101
16. Visits for Midwife Supervision........ 67 71 39 36 71 52 20 20 20 28 0 14 32 0 28 15 112
17. Attendance at Maternity Classes..... 0 0 14 0 12 25 0 0 0 0 0 0 35 0 14 0 0 N
18. Cases Hospitalized.................. 14 0 1 0 1 4 0 0 0 7 0 0 19 0 0 0 7

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952
co

ACTIVITIES

C. TUBERCULOSIS CONTROL (Cont.)
4. Pneumoperitoneum Refills............ 0 0 0 0 0 0 0 0 0 0 0 174 0 16 0 0 0
5. Pneumothorax Refills ................ 0 0 0 0 0 0 0 0 0 0 0 43 0 12 0 0 0
6. Visits to Medical Conferences ........ 5 6 12 0 7 3 41 1 100 12 112 3,548 17 4 22 4 25
7. Tuberculin Test .................... 9 22 15 80 281 11 22 159 30 313 498 89 14 35 4 61
8 Field Nursing Visits ................ 30 37 502 81 39 134 65 62 34 216 184 2,412 283 237 297 74 106
9. Office Nursing Visits ................ 2 22 10 35 12 13 16 83 13 119 82 87 108 72 33 14 75
10. Cases Hospitalized ................. 0 6 44 1 1 11 17 8 0 5 0 86 11 6 0 5 3
D. MATERNITY SERVICE
1. Admissions to Antepartum
Medical Service.................. 35 9 392 13 13 11 47 0 37 8 21 1,504 16 1 217 29 25
2. Cases Referred to Private Physician... 1 5 16 3 0 3 2 0 0 4 3 18 0 1 24 5 0
3. Admissions to Antepartum
Nursing Service.................... 34 17 467 39 4 7 58 4 8 12 31 1,934 39 35 428 116 39
4. Visits by Antepartum Cases to
Medical Conferences .............. 82 14 910 24 40 8 71 0 115 16 36 5,303 24 1 291 45 48
5. Number of Clinic Sessions Conducted.. 51 12 184 21 27 13 44 0 45 14 12 248 14 0 71 16 20
6. Field Nursing Visits to Antepartum
Cases............................ 9 13 240 119 4 13 68 4 9 19 38 1,605 38 38 275 58 28
7. Office Nursing Visits to Antepartum
Cases............................ 96 64 1,085 13 4 33 162 1 0 24 20 6,587 43 37 878 255 96
8. Cases given Nursing Service
at Delivery....................... 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 1 0
9. Cases given Service at Delivery by
Certified-Nurse Midwife............ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
10. Cases given Postpartum Medical
Examinations..................... 16 0 118 2 0 0 9 0 0 2 1 867 12 0 80 0 3
11. Admissions to Postpartum
Nursing Service................... 2 22 431 39 8 6 59 12 7 7 15 1,399 36 41 318 134 43
12. Field Nursing Visits to Postpartum
Scases............................. 14 21 769 95 7 11 96 13 6 21 17 2,090 69 72 465 223 57
13. Office Nursing Visits to Postpartum
cases............................. 16 7 135 0 1 0 2 1 1 2 2 945 13 3 106 12 15
14. Admissions for Midwife Supervision... 6 4 16 1 2 4 6 0 0 1 4 14 5 9 2 18 1
15. Attendance of Midwives at Meetings. 2 3 122 0 0 5 13 0 0 0 0 20 3 9 27 44 0
16. Visits for Midwife Supervision........ 8 20 192 1 19 6 6 0 0 1 29 29 37 35 150 27 15
17. Attendance at Maternity Classes...... 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0
18. Cases Hospitalized .................. 0 0 5 1 0 0 0 0 0 2 0 728 0 0 0 0 0

Z
Z
C

r-

m
0

0
-I

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

i

ACTIVITIES ^ j i l l Z J 0 0 8

C. TUBERCULOSIS CONTROL (Cont.)
4. Pneumoperitoneum Refills............ 0 0 275 0 0 0 0 075 6 0 00 1,014 0 336 0
5. Pneumothorax Refills ............... 0 0 75 0 0 19 0 0 0 25 0 0 0 3 0 11 0
6. Visits to Medical Conferences ......... 10 160 36 3 1 144 29 14 6 123 52 17 0 1,017 17 521 94
7. Tuberculin Test.. ................. 73 175 178 38 0 29 263 49 29 47 154 127 11 192 34 208 104
8. Field Nursing Visits ................. 639 110 726 175 45 73 613 647 87 297 477 274 39 1,426 96 1,080 125
9. Office Nursing Visits ................ 45 202 37 14 0 115 83 24 14 129 183 58 12 498 49 108 276 0
10. Cases Hospitalized.................. 27 12 58 9 1 15 28 27 13 10 18 9 0 61 3 78 15
D. MATERNITY SERVICE
1. Admissions to Antepartum Medical
Service .......................... 73 73 342 42 16 87 94 1 0 62 18 35 11 386 37 421 24
2. Cases Referred to Private Physician... 4 3 57 2 0 8 12 0 6 12 9 1 1 5 5 8 12
3. Admissions to Antepartum
Nursing Service................... 166 86 189 64 18 77 108 24 10 68 68 34 29 167 37 192 30
4. Visits by Antepartum Cases to I'
Medical Conferences............... 153 154 749 80 33 285 208 0 0 120 35 52 15 1,108 41 910 56
5. Number of Clinic Sessions Conducted.. 50 71 77 45 33 86 25 0 0 30 15 30 14 163 27 123 39
6. Field Nursing Visits to Antepartum r
Cases........................... 421 2 325 32 26 1 158 23 13 55 173 35 17 294 55 429 19 -4
7. Office Nursing Visits to Antepartum 3
Cases............................ 43 208 29 82 43 241 188 22 8 152 36 65 29 19 76 379 73
8. Cases given Nursing Service
at Delivery....................... 0 0 0 0 0 0 2 0 0 0 0 0 0 2 2 0 0 Cf
9. Cases given Service at Delivery by M
Certified-Nurse Midwife........... 0 0 8 0 0 0 0 0 0 0 0 0 0 0 2 0 0
10. Cases given Postpartum Medical
Examinations .................... 42 23 129 2 0 27 48 0 0 22 3 7 0 149 18 150 0 <
11. Admissions to Postpartum
Nursing Service.................. 211 72 400 86 18 142 82 8 11 62 80 32 10 333 46 355 18
12. Field Nursing Visits to Postpartum
cases............................. 588 81 990 129 31 138 133 82 20 82 172 44 10 408 85 829 18 mr
13. Office Nursing Visits to Postpartum
cases............................. 9 48 2 4 3 18 34 0 1 14 11 10 6 4 22 33 3
14. Admissions for Midwife Supervision... 5 3 19 8 0 7 5 17 1 2 8 1 1 4 0 12 2
15. Attendance of Midwives at Meetings.. 0 6 115 12 0 56 52 141 0 1 29 0 0 29 0 46 18
16. Visits for Midwife Supervision......... 33 7 23 17 0 79 37 17 3 50 123 10 1 16 0 46 15
17. Attendance at Maternity Classes...... 0 0 0 0 0 0 79 0 0 0 0 0 0 4 0 0 0 '
18. Cases Hospitalized .................. 0 0 14 0 0 0 1 0 0 0 0 0 4 1 0 48 1

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

W >

ACTIVITIES 3 W3 43 0 0 Z

C. TUBERCULOSIS CONTROL (Cont.) r
4. Pneumoperitoneum Refills ................ 738 0 0 0 0 0 0 0 0 0 0 418 0 0 0 6,938
5.Pneumothorax Iefills...................... 118 0 0 0 0 0 0 0 0 0 0 35 0 0 0 853
6. Visits to Medical Conferences............. 2,257 257 40 12 13 28 18 13 45 117 29 159 2 144 14 35,367
7. Tuberculin Test ........................ 1,371 226 815 8 1 19 23 39 187 75 4 428 14 28 14 10,033 m
8. Field Nursing Visits...................... 1,820 1,207 208 202 123 419 272 112 79 129 66 1,645 39 168 81 29,428
9. Office Nursing Visits...................... 684 383 72 40 16 7 15 80 84 153 12 598 61 145 21 6,423
10. Cases Hospitalized ....................... 136 135 27 8 5 22 29 12 8 7 3 53 4 9 3 2,134 Q
D. MATERNITY SERVICE
1. Admissions to Antepartum Medical --I
Service............................... 460 280 107 121 23 23 82 47 123 33 45 69 37 39 47 10,603
2. Cases Referred to Private Physician......... 43 49 2 112 7 8 88 6 5 2 1 1 1 10 2 817
3. Admissions to Antepartum -
Nursing Service......................... 524 330 126 195 28 28 143 79 135 33 66 230 40 41 74 11,442
4. Visits by Antepartum Cases to
Medical Conferences.................... 1,605 660 193 264 25 47 252 73 376 67 113 318 82 64 53 29,951 01
5. Number of Clinic Sessions Conducted....... 120 76 58 35 24 10 24 59 22 25 43 63 23 39 33 3,644
6. Field Nursing Visits to Antepartum
Cases................................. 704 225 39 121 6 44 275 74 84 14 197 522 61 20 45 12,559
7. Office Nursing Visits to Antepartum
Cases.................................. 2,080 551 247 303 33 48 111 87 404 83 14 340 21 155 200 24,093
8. Cases given Nursing Service
at Delivery ............................ 0 1 0 2 0 0 0 0 0 0 0 0 1 0 0 18
9. Cases given Service at Delivery by
Certified-Nurse Midwife................. 0 0 0 0 0 0 0 3 0 0 0 0 0 0 29
10. Cases given Postpartum Medical
Examinations .......................... 187 27 32 0 7 9 33 4 3 3 11 51 4 36 19 3,611
11. Admissions to Postpartum
Nursing Service ........................ 311 161 51 72 11 20 256 99 118 10 45 290 79 60 94 10,968
12. Field Nursing Visits to Postpartum
cases. ................................. 681 252 39 76 16 32 386 155 249 25 46 652 178 63 171 20,874
13. Office Nursing Visits to Postpartum
cases ................................. 205 11 32 13 3 5 22 18 9 10 1 50 5 57 36 2,643
14. Admissions for Midwife Supervision ........ 11 3 23 0 2 1 6 4 6 7 1 8 9 8 4 416
15. Attendance of Midwives at Meetings........ 28 0 114 0 8 5 8 0 39 25 0 10 21 34 25 1,646
16. Visits for Midwife Supervision ............ 5 44 19 3 14 9 97 30 14 44 1 68 25 52 12 2,114
17. Attendance at Maternity Classes........... O 0 19 0 0 22 0 0 19 0 0 0 0 0 0 862
18. Cases Hospitalized....................... 61 0 0 0 0 2 1 0 0 0 0 43 2 0 0 967

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

S 2 a 2 2 *l j.

ACTIVITIES t a a a .I I o 0 a a
M a a a U U U U U 0 n

E. INFANT & PRESCHOOL HYGIENE
INFANT
1. Admissions to Medical Service...... 281 61 52 88 115 375 9 39 6 50 0 112 2,719 0 25 369 290
2. Admissions to Nursing Service....... 764 112 148 198 239 869 18 43 49 81 0 321 3,176 0 59 794 766
3. Visits to Medical Conferences........ 394 102 63 129 173 812 9 43 7 75 0 352 7,040 0 34 1,167 743
4. Field Nursing Visit. ................ 1,905 249 187 568 411 1,059 21 88 108 104 0 659 8,588 0 101 1,099 931
5. Office Nursing Visits ............... 459 36 122 28 179 1,189 7 37 4 84 0 127 1,134 0 31 1,346 1,545
PRESCHOOL
6. Admissions to Medical Service...... 379 121 29 77 112 1,082 20 131 2 153 0 172 2,902 33 79 917 69 0
7. Admissions to Nursing Service....... 1,604 434 152 690 461 1,646 20 148 69 157 0 1,000 2,320 0 159 1,823 1,060
8. Visits to Medical Conference......... 496 346 47 84 192 1,082 37 163 3 158 0 433 5,088 33 80 2,258 97 '
9.FieldNursing Visits................ 2,763 995 214 1,389 703 159 7 285 131 111 0 1,447 3,550 0 121 2,595 1,348
10. Office Nursing Visits................ 450 102 54 17 265 2,164 20 177 5 94 0 0 475 0 72 2,848 918
11. Attendance at Infant and Preschool
Classes.......................... 2 19 0 0 0 0 15 0 0 0 0 0 0 0 0 667 0
12. Number of Infant-Preschool Clinic
Sessions Conducted............... 185 40 30 22 114 87 7 38 8 59 0 140 290 5 28 126 88
13. Cases Hospitalized................. 1 0 0 0 2 6 0 0 1 0 0 0 6 0 0 14 0 r
F. SCHOOL
1.Pupils Inspected .................. 2,167 1,075 1,073 697 629 3,901 116 377 288 822 0 31108,117 13 142 3,199 5,425 '
2. Pupils Examined................... 2,087 670 2,528 98 724 601 168 82 247 231 0 2,422 18,868 766 382 166 1,197
4. Admissions to Nursing Service....... 1,208 246 254 99 253 1,109 107 206 50 243 0 34 10,367 29 207 218 1,921 "
5. Field Nursing Visits ................ 1,076 272 439 195 223 475 162 817 51 86 0 34 3,581 54 254 468 807
6. OfficeNursing Visits................ 1,236 193 188 8 567 1,761 108 138 15 324 0 0 27,117 5 18 2,305 3,616
7. Number of Corrections Secured...... 12 16 75 226 7 373 32 39 18 193 0 0 5,443 0 3 78 54 C/
8. Cases Hospitalized................. 0 0 6 0 6 1 0 1 1 1 0 0 5 0 0 3 5 m
G. ADULT HYGIENE-MEDICAL ?;
EXAMINATIONS (1-4)............. 2,902 142 1,307 389 1,095 3,392 108 258 33 509 3 1,235 6,401 224 320 7,402 5,162 <
H. MORBIDITY 7
3. Field and Office Medical Visits....... 1,328 133 34 177 41 817 5 2 11 89 0 512 0 0 93 0 56
4. Field and Office Nursing Visits....... 167 136 38 51 80 2,451 42 39 115 47 0 754 259 0 132 140 428 rn
5. Cases Hospitalized................. 0 1 2 0 9 30 1 1 0 1 0 0 0 0 0 3 0
J. CANCER CONTROL
1. Admissions to Service .............. 146 14 40 49 15 109 8 23 6 23 2 24 49 19 19 394 242
2. Field Visits........................ 8 17 126 71 26 198 48 68 41 41 1 5 267 116 17 31 341
3. Office Visits ....................... 267 18 9 37 17 362 5 38 6 36 2 94 1 18 17 383 257
4. Cases Receiving Ambulatory
Treatments only.................. 2 12 58 7 9 230 81 35 4 33 0 6 0 6 0 4,789 40
5. Cases Hospitalized............... 32 3 9 12 2 46 5 1 1 16 1 11 0 0 1 449 84

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

ACTIVITIES
E0 w u u u a

E. INFANT & PRESCHOOL HYGIENE
INFANT
1. Admissions to Medical Service....... 37 3 260 30 12 0 69 0 15 1 31 1,662 30 9 76 4 19
2. Admissions to Nursing Service........ 39 40 564 77 8 66 69 21 6 27 71 2,590 71 104 358 206 90
3. Visits to Medical Conferences ........ 98 3 464 43 14 0 101 0 23 1 47 4,355 36 9 105 4 25
4. Field Nursing Visits ................. 22 36 1,139 222 7 99 145 23 7 72 113 2,682 132 157 486 447 128
5. Office Nursing Visits ................. 76 39 523 1 1 16 13 6 6 18 17 4,442 24 109 130 60 125
PRESCHOOL
6. Admissions to Medical Service........ 23 4 90 95 37 2 216 56 60 2 233 2,453 56 3 116 5 43
7. Admissions to Nursing Service........ 68 8 756 232 8 68 141 97 8 71 64 3,159 143 124 118 161 176
8. Visits to Medical Conferences ........ 36 4 155 142 38 4 400 60 74 2 273 5,787 68 5 116 5 44
9. Field Nursing Visits ................ 52 5 1,334 667 8 103 338 90 8 249 89 2,072 202 174 119 276 247
10. Office Nursing Visits ................ 58 8 183 0 1 9 29 19 3 25 3 5,739 39 116 63 56 260
11. Attendance at Infant and Preschool
Classes .......................... 0 0 0 176 32 0 0 55 0 0 172 0 1 180 0 0 0
12. Number of Infant-Preschool Clinic
Sessions Conducted................ 51 5 103 47 8 1 96 2 20 1 22 371 22 13 39 2 18
13. Cases Hospitalized .................. 0 0 3 1 0 0 0 0 0 0 0 4 0 4 0 2 0
F. SCHOOL
1. Pupils Inspected ................... 939 867 1,835 3 161 521 98 73 265 11 1,02321,006 73 1,021 1,402 20 106
2. Pupils Examined.................. 217 218 396 906 384 103 933 198 538 407 68314,737 765 655 108 8 434
4. Admissions to Nursing Service....... 703 60 113 8 53 138 2 88 162 18 208 3,233 217 534 540 5 116
5. Field Nursing Visits ................ 21 65 482 18 10 210 0 69 29 155 191 2,942 151 594 99 9 56
6. Office Nursing Visits ............... 1,422 43 345 1 67 800 2 33 155 45 116 3,411 184 198 660 6 363
7. Number of Corrections Secured....... O 2 78 0 57 19 0 0 61 8 5 4,588 3 31 4 0 10
8. Cases Hospitalized .................. 0 0 0 3 0 0 0 0 0 0 0 3 0 11 0 0 0
G. ADULT HYGIENE-MEDICAL
EXAMINATIONS (1-4)............... 162 436 535 427 89 301 657 479 408 204 466 28,198 398 104 987 56 126
H. MORBIDITY
3. Field and Office Medical Visits........ 24 251 20 0 19 10 694 0 54 4 65 24 14 3 48 8 30
4. Field and Office Nursing Visits........ 24 68 550 581 6 424 389 5 42 13 150 1,510 30 237 31 128 78
5. Cases Hospitalized ................. 0 0 3 1 0 2 0 0 0 0 2 4 0 9 1 0 0
J. CANCER CONTROL
1. Admissions to Service............. .. 4 38 38 15 1 22 26 20 7 3 22 619 53 19 31 11 16
2. Field Visits ........................ 4 24 97 17 0 93 18 14 1 14 90 103 12 59 47 17 16
3. Office Visits......................... 7 66 5 34 1 20 25 31 12 10 9 1,326 82 7 19 2 28
4. Cases Receiving Ambulatory
treatments only................... 18 2 0 8 1 10 0 0 3 220 20 8 20 3 0
5. Cases Hospitalized................... 1 11 30 5 0 8 3 0 5 2 2 184 12 0 17 2 5

U,
lh)

Z
Z

C

ri4

-o .
0

--

(h

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

ACTIVITIESi l a
-i t-i -) ^-i >-2 z; 0 0 0 0 9< 0,

E. INFANT & PRESCHOOL HYGIENE
INFANT
1. Admissions to Medical Service........ 39 25 191 5 7 93 111 0 3 46 47 30 2 357 42 379 20
2. Admissions to Nursing Service........ 364 84 494 123 31 222 124 35 77 110 174 62 8 486 155 483 54
3. Visits to Medical Conferences ......... 48 38 229 5 8 172 165 0 3 58 95 40 2 681 51 741 29
4. Field Nursing Visits................ 1,037 86 1,296 203 77 139 282 71 170 124 314 122 10 582 218 1,231 32
5. Office Nursing Visits ................ 23 68 108 5 14 193 32 17 13 115 82 51 4 59 160 249 49
PRESCHOOL r-
6. Admissions to Medical Service........ 8 51 237 1 0 202 223 149 55 48 219 102 1 1,481 106 117 52 Q
7. Admissions to Nursing Service........ 881 65 758 156 40 251 367 58 123 178 341 86 13 795 491 97 118
8. Visits to Medical Conferences ......... 11 65 269 1 0 474 430 149 56 105 556 106 1 2,300 234 181 83 0
9. Field Nursing Visits................. 1,271 37 1,390 264 79 12 370 100 438 201 695 214 27 1,107 595 185 38
10. Office Nursing Visits ................ 44 65 61 0 1 611 91 33 25 364 409 24 0 41 450 226 168
11. Attendance at Infant and Preschool r
Classes............................ 0 0 4 0 0 0 0 28 0 3 0 16 0 0 19 0 147
12. Number of Infant-Preschool Clinic
Sessions Conducted................ 28 61 67 5 0 87 39 7 18 50 43 29 0 232 39 149 68
13. Cases Hospitalized.................. 3 2 3 0 0 0 1 1 0 1 1 0 0 0 0 10 4 mI
F. SCHOOL >
1. PupilsInspected................... 3,762 127 2,210 569 186 382 2,395 1,901 268 3,007 5,959 1,912 173 7,016 234 4,725 737 r
2. Pupils Examined.................... 118 1,136 643 115 72 702 271 643 252 444 2,894 931 361 2,112 238 364 1,040 -4
4. Admissions to Nursing Service........ 538 128 299 11 9 6 405 172 0 120 298 299 37 1,287 92 1,126 225
5. Field Nursing Visits ................. 582 38 802 17 90 206 485 465 0 194 558 365 45 1,943 152 1,982 222
6. Office Nursing Visits ................ 176 139 5 0 29 92 225 189 0 889 837 140 11 1,678 140 4,025 227
7. Number of Corrections Secured ...... 101 1 166 0 23 19 22 14 11 349 105 38 5 96 8 247 28 y)
8. Cases Hospitalized .................. 0 1 0 0 0 0 4 15 2 2 0 621 11 2 29 21 r
G. ADULT HYGIENE-MEDICAL
EXAMINATIONS (1-4)............... 52 1,191 3,149 395 81 388 2,012 933 166 1,567 501 843 202 1,301 501 225 581
H. MORBIDITY
3. Field and Office Medical Visits........ 1 116 807 13 7 2 30 0 0 1,653 9 37 10 74 20 314 87
4. Field and Office Nursing Visits........ 263 127 10 136 452 2 180 14 8 1,280 248 194 60 134 365 698 150 mr
5. Cases Hospitalized .................. 0 1 0 0 0 14 0 0 11 47 0 4 2 0 34 9
J. CANCER CONTROL
1. Admissions to Service ................ 17 21 71 14 10 48 31 0 22 47 28 30 13 53 12 138 34
2. Field Visits ......................... 44 28 54 18 20 13 72 0 22 84 148 31 35 2 24 80 18 L
3. Office Visits. ..................... 6 25 8 6 8 71 2 0 17 120 12 29 6 150 9 400 61 C
4. Cases Receiving Ambulatory
treatments only................... 1 4 27 2 0 64 31 0 2 16 3 16 7 95 1 104 24
5. Cases Hospitalized .................. 1 5 19 6 10 39 15 0 13 12 9 11 4 52 0 43 21

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

ACTIVITIES i

E. INFANT & PRESCHOOL HYGIENE
INFANT
1. Admissions to Medical Service .............
2. Admissions to Nursing Service .............
3. Visits to Medical Conferences ..............
4. Field Nursing Visits ......................
5. Office Nursing Visits......................
PRESCHOOL
6. Admissions to Medical Service .............
7. Admissions to Nursing Service............
8. Visits to Medical Conferences ............
9. Field Nursing Visits .....................
10. Office Nursing Visits....................
11. Attendance at Infant and Preschool
Classes................ ............
12. Number of Infant-Preschool Clinic
Sessions Conducted .....................
13. Cases Hospitalized......................
F. SCHOOL
1. Pupils Inspected.......... ... .........
2. Pupils Examined..........................
4. Admissions to Nursing Service............
5. Field Nursing Visits ....................
6. Office Nursing Visits......................
7. Number of Corrections Secured.............
8. Cases Hospitalized ......................
G. ADULT HYGIENE-MEDICAL
EXAMINATIONS (1-4) ....................
H. MORBIDITY
3. Field and Office Medical Visits............
4. Field and Office Nursing Visits.............
5. Cases Hospitalized............. .......
J. CANCER CONTROL
1. Admissions to Service.....................
2. Field Visits ................. .........
3. Office Visits ........................
4. Cases Receiving Ambulatory
treatments only.........................
5. Cases Hospitalized ..... ......... .

51 623

22 230
1,024 204
99 2

2571 187

137 43| 8
44 11 6
2 0 0

9,813
18,735
21,623
34,742
17,673

15,211
27,599
26,782
38,256
22,510
1,558
3,800
90

279,845
82,763
36,833
32,570
63,806
18,522
837

931 208 702 449 96,799

0 511 0 30 10,672
0 616 0 9 17,049
0 1 0 0 310

133 18 26 23 3,538
79 10 7 28 3,363
209 17 29 28 5,581
44 10 22 13 6,365
29 1 15 16 1,458

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

ACTIVITIES .

K. DIABETES
1. Admissions to Service ................ 5 12 32 0 17 51 4 9 9 11 4 23 5 1 16 6 56
2. Field Visits ......................... 8 7 7 0 90 101 16 14 21 16 0 1 12 1 17 12 61
3. Office Visits......................... 3 72 123 0 40 113 30 56 16 15 4 100 0 0 38 1 184
4. Instruction Class Enrollment ......... 0 0 1 0 0 2 0 26 0 0 0 0 0 0 7 0 0
I--
L. CRIPPLED CHILDREN
1. Admissions to Service................ 125 27 163 32 43 109 11 41 20 21 0 26 12 22 15 11 195 O
2. Field Visits......................... 319 32 135 112 99 246 70 118 27 82 0 30 25 32 55 17 398
3. Office Visits ........................ 11 17 21 6 23 52 4 58 3 19 0 1 0 2 9 0 70
4. Clinic Visits........................ 424 27 208 77 17 2 39 42 1 51 0 0 0 0 9 0 77
5. Cases Hospitalized ................. 29 0 17 3 3 2 1 1 3 4 0 1 0 4 0 1 1
M. DENTAL HYGIENE
1. AdmissionstoService................ 544 0 124 0 0 0 0 21 1 70 0 0 471 5 73 86 187
2. Preschool Inspections ................ 0 0 0 0 0 0 0 1 70 0 0 6 5 0 0 0
3. School Inspections................... 0 0 205 0 0 0 0 0 84 0 0 013,158 0 2017,132 518 m
4. Inspections (Other) .................. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Individuals Completed ............... 0 67 0 0 0 0 25 0 0 0 0 198 0 53 16 32
6. FluorideTreatmentsCompleted....... 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
-1
P. SANITATION X
1. Approved Water Supplies Installed
(A) Private and Semi-Public........ 0 8 2 0 3 210 0 2 0 1 0 91 112 1 0 28 284
(B New Public Water Connections.. 1 3 0 1 72 1 1 0 1 0 0 5 480 0 0 382 824 C)
(C) Approved Drinking Fountains r
Installed....................... 0 0 0 3 0 6 0 0 0 5 0 0 18 0 0 0 0
2. New Specification Privies Installed.... 253 8 57 5 3 80 6 1 1 0 0 25 0 0 6 8 15
3. Privies Restored to Sanitary
Condition ........................ 5 2 40 6 0 277 0 0 10 0 0 27 0 0 0 4 2
4. Percolation Water Table or Soil
Log Tests........................ 105 0 35 24 33 239 0 4 5 92 0 9 22 5 0 1,964 467
5. New Specification Septic Tank rn
Installed......................... 205 20 406 40 319 2,939 50 6 26 85 0 478 898 9 13 1,555 1,072
6. Septic Tanks Restored to Sanitary
Condition........................ 35 2 4 23 10 48 8 2 6 9 0 48 326 1 2 33 35
7. New Public Sewer Connections........ 0 9 35 3 16 8 1 1 0 9 0 13 4 2 1 1 14
FIELD VISITS (8-17)................. 4,777 355 4,414 634 1,394 14,204 419 369 598 1,015 98 1,940 51,036 235 238 8,26011,887 (3

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

AITi-

A T
ACTIVITIES | 0 I 0
6 0 0 x x x

K. DIABETES
1. Admissions to Service ...............
2. Field Visits .......................
3. Office Visits ........................
4. Instruction Class Enrollment.........
L. CRIPPLED CHILDREN
1. Admissions to Service................
2. Field Visits..................... ..
3. Office Visits. .......................
4. Clinic Visits. ............... ......
5. Cases Hospitalized..................
M. DENTAL HYGIENE
1. Admissions to Service ...............
2. Preschool Inspections................
3. School Inspections ..................
4. Inspections (Other).................
5. Individuals Completed..............
6. Fluoride Treatments Completed......
P. SANITATION
1. Approved Water Supplies Installed
(A) Private and Semi-Public........
(B) New Public Water Connections..
(C) Approved Drinking Fountains
Installed ....................
2. New Specification Privies Installed ...
3. Privies Restored to Sanitary
Condition .......................
4. Percolation Water Table or Soil
Log Tests .......................
5. New Specification Septic Tank
Installed. ......................
6. Septic Tanks Restored to Sanitary
Condition ......................
7. New Public Sewer Connections.......
FIELD VISITS (8-17) ...............

327 28 16
69 28 37
1,128 313 43
143 63 0

2
0
8
0

133
79
112
201
1

939
0
939
0
99
303

0
0
0
4
3
19
43
0
0
498

Z
z
C

7 r
4
51
0
m
.-o
28
130 O
14
33
5 --I

0
0o
0
0 )
o

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

A UTVTw

ACTIVITIwS 0 A j 0 l l
iE AEz o b

K. DIABETES
1. Admissions to Service..............
2. Field Visits......................
3. Office Visits ...................
4. Instruction Class Enrollment.........
L. CRIPPLED CHILDREN
1. Admissions to Service ...............
2. Field Visits .. ......................
3. Office Visits ........................
4. Clinic Visits ...........
5. Cases Hospitalized ..................
M. DENTAL HYGIENE
1. Admissions to Service...............
2. Preschool Inspections................
3. School Inspections..................
4. Inspections (Other).................
5. Individuals Completed .............
6. Fluoride Treatments Completed......
P. SANITATION
1. Approved Water Supplies Installed
(A) Private and Semi-Public.......
(B) New Public Water Connections.
CApproved Drinking Fountains
Installed .....................
2. New Specification Privies Installed....
3. Privies Restored to Sanitary
Condition. ................... .
4. Percolation Water Table or Soil
Log Tests......................
5. New Specification Septic Tank
Installed ......................
6. Septic Tanks Restored to Sanitary
Condition........................
7. New Public Sewer Connections.......
FIELD VISITS (8-17)................

25 13 6
80 1 18
5 98 9
0 0 0

13 54 10
1 162 21
49 9 2
0 0 0

12
8
40
0

32
99
9
3
5

158
0
498
o
2
0

0
0
0
4
1
80
231
9
118
2,016

12
25
20
5

26
131
2
24
0

0
0
0
0
0
0

0
0
0
0
0
0
0
0
1
326

11
6
59
2
r-
89 0
119
15
124
15

0
0
12 m
0
0
o
-I

11
rT1
0
2
2 -
2
m
43
10
3 ,
688 N

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

ACTIVITIES ~ l
5, ( US 2 2 c 0 1

K. DIABETES
1. Admissions to Service ....................
2. Field Visits .............................
3. Office Visits............................
4. Instruction Class Enrollment...............
L. CRIPPLED CHILDREN
1. Admissions to Service ....................
2. Field Visits ...........................
3. Office Visits............................
4. Clinic Visits ...........................
5. Cases Hospitalized .......................
M. DENTAL HYGIENE
1. Admissions to Service .................. ..
2. Preschool Inspections......................
3. School Inspections .......................
4. Inspections (Other) .......................
5. Individuals Completed....................
6. Fluoride Treatments Completed............
P. SANITATION
1. Approved Water Supplies Installed
(A) Private and Semi-Public............
(B) New Public Water Connections.......
(C) Approved Drinking Fountains
Installed ...............................
2. New Specification Privies Installed..........
3. Privies Restored to Sanitary
Condition. ...........................
4. Percolation Water Table or Soil
Log Tests ...........................
5. New Specification Septic Tank
Installed ..............................
6. Septic Tanks Restored to Sanitary
Condition ..............................
7. New Public Sewer Connections............
FIELD VISITS (8-17)......................

2,912 1,323 140 186
51 293 0 4
168 810 4 13
12.739 6.512 889 1.166

824 257 15 29
385 26 4 2
167 1 0 16
2.722 1.627 223 740

1 2931 3 645) 258 6

1,318
1,855
4,943
318

3,694
7,565
1,040
4,431
468

10,493
365
63,360
1,949
7,698
3,324

1,936
5,512
101
1,063
1,051
9,037
23,342
1,523
3,392
215,475

2,2 1,2 22 74 1 29 3 641 28 111 5

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF IOCAL HEALTH UNITS DURING 1952

ACTIVITIES | e | ~ | 0
SM U U LU U U U 0 0 0

R. PROTECTION OF FOOD AND
MILK
1. Food-Handling Establishments
Registered for Supervision .........
2. Field Visits to Food-handling
Establishments...................
3. Food Handler's Courses Conducted...
4. Number of Certificates Awarded
Persons.........................
5. Number of Certificates awarded
Establishments ..................
6. Dairy Farms Registered for
Supervision ......................
7. Field Visits to Dairy Farms ........
8. Milk and Milk Products Plants
Registered for Supervision .........
9. Field Visits to Milk and Milk
Products Plants .................
10. Cows Tuberculin Tested.............
11. Cows Bangs Tested ................
S. MOSQUITO CONTROL
1. Surveys and Field Visits............
2. Buildings Mosquito Proofed.........
3. Drainage-Linear Feet Completed....
5. Mosquito Breeding Places Eliminated
6. Breeding Places Controlled-Acres...
8. Structures Sprayed with D.D.T......
T. RODENT CONTROL
1. Premises Rat-proofed...............
2. Premises dusted, trapped or poisoned.
5. Field Visits ......................
V. GENERAL ADMINISTRATION
1. Visits in the interest of Vital
Statistics ............... ..........
2. Lectures, Talks and Motion
Picture Showings ................
4. Radio Talks Delivered ............
5. News Articles Published ...........
X. LABORATORY-Specimens
Examined (1-23)................

0 0
0 47
2 130

3.8391 9.0601 8.1611 4.564116.8491 1.0311 8561 1.8281 7.862

5,002
35,635
213
2,932
0
92
1,803
83
3,293
15,100
48

0
0
0
0
0
0

0 181
0 13,094
0 16,025

617
529
7
159

167,279

7831 1,461122,581

368
874
2
40
0
3
103
590
10
133 "
3,364 mI
2,014

152 -I
0
0
1
18 C)
3 m

0<
149
170
m

256
251
6 lA
35 %0

24,806

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

ACTIVITIES U ~
E S u u u u a a a B Ea E fi 2

R. PROTECTION OF FOOD AND
MILK
1. Food-Handling Establishments
Registered for Supervision..........
2. Field Visits to Food-handling
Establishments..................
3. Food Handler's Courses Conducted....
4. Number of Certificates Awarded......
Persons. ......................
5. Number of Certificates awarded
Establishments ...................
6. Dairy Farms Registered for
Supervision. ..... .............
7. Field Visits to Dairy Farms.........
8. Milk and Milk Products Plants
Registered for Supervision .........
9. Field Visits to Milk and Milk
Products Plants ..................
10. Cows Tuberculin Tested .............
11. Cows Bangs Tested................
S. MOSQUITO CONTROL
1. Surveys and Field Visits.............
2. Buildings Mosquito Proofed .........
3. Drainage-Linear Feet Completed.....
5. Mosquito Breeding Places Eliminated..
6. Breeding Places Controlled-Acres....
8. Structures Sprayed with D.D.T......
T. RODENT CONTROL
1. Premises Rat-proofed ..............
2. Premises dusted, trapped or poisoned..
5. Field Visits........................
V. GENERAL ADMINISTRATION
1. Visits in the interest of Vital
Statistics. .......................
2. Lectures, Talks and Motion
Picture Showings ................
4. Radio Talks Delivered...............
5. News Articles Published .............
X. LABORATORY-Specimens
Examined (1-23) ..................

0 0
0 14
0 19

I 1,4011 3,622110,6861 5481

0 0 0 26 0
0 0 49 74 1
0 0 82 48 0

5741 8,9621 2,5131 1,4901 1,2101 1,8491 2,916183,5581 3,0541 1,3931 6.771

Z

Z.
c

24 15 >
141 74
0 0 ;
rn
0 0 -
1 0 0 0
S 9 26
140 243 --1
1 0
-.a
6 0
317 141 %0
309 1,122 (0

1 0
0 0
0 0
0 0
0 0
0 0

1 0
7 0
16 0

11 18
43 41
0 0
S 5 10

1,556 963

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952.

00
u JS

., 0
0 0 a s 0
ACTIVITIES 0 0 0 0 s z
OW2 zowo o o

R. PROTECTION OF FOOD AND
MILK
1. Food-Handling Establishments
Registered for Supervision .........
2. Field Visits to Food-handling
Establishments ...................
3. Food Handler's Courses Conducted....
4. Number of Certificates Awarded
Persons .................... .
5. Number of Certificates awarded
Establishments....................
6. Dairy Farms Registered for
Supervision. ........... .........
7. Field Visits to Dairy Farms..........
8. Milk and Milk Products Plants
Registered for Supervision..........
9. Field Visits to Milk and Milk
Products Plants ..................
10. Cows Tuberculin Tested.............
11. Cows Bangs Tested ................
S. MOSQUITO CONTROL
1. Surveys and Field Visits.............
2. Buildings Mosquito Proofed..........
3. Drainage-Linear Feet Completed.....
5. Mosquito Breeding Places Eliminated..
6. Breeding Places Controlled-Acres ....
8. Structures Sprayed with D.D.T.......
T. RODENT CONTROL
1. Premises Rat-proofed................
2. Premises dusted, trapped or poisoned..
5. Field Visits ........................
V. GENERAL ADMINISTRATION
1. Visits in the interest of Vital
Statistics ........................
2. Lectures, Talks and Motion
Picture Showings..................
4. Radio Talks Delivered ..............
5. News Articles Published .............

X. LABORATORY-Specimens
Examined (1-23)............ ...... 3,591

2 0 0 0
530 0 376 267
1,056 0 639 180

8.916125.0781 8.5171 9821 2.7481 7.0991 4.5291 1.6571 7.040110.8881 3.8451 1,442 8 .225114, 101 2,898

0 0
0 646
8 671

161
598

O
4
0 >
5 -
54
0 I
rn
0
0
0 *n
o >

0 (-
0
0

0
<

41
159 Ir

27
12
0 0
45 -

0 0
0 1,378
0 2,341

0 0
0 0
0 24

8.916125.0781 3.5171 9321 2.7481 7.0991 4.5291 1.6571 7.040110.8381 3,8451 1,442

3,225114,101

2,898

TABLE 14 (continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1952

0 ACTIVITIES
ACTIVITIES o Q
B< ~ ~ (4 12 .2 (O

R. PROTECTION OF FOOD AND
MILK
1. Food-Handling Establishments
Registered for Supervision................
2. Field Visits to Food-handling
Establishments. ................... ..
3. Food Handler's Courses Conducted.........
4. Number of Certificates Awarded
Persons................ ............
5. Number of Certificates awarded
Establishments. ........................
6. Dairy Farms Registered for
Supervision..........................
7. Field Visits to Dairy Farms.............
8. Milk and Milk Products Plants
Registered for Supervision ..............
9. Field Visits to Milk and Milk
Products Plants........................
10. Cows Tuberculin Tested ..................
11. Cows Bangs Tested. ....................
S. MOSQUITO CONTROL
1. Surveys and Field Visits...................
2. Buildings Mosquito Proofed ...............
3. Drainage-Linear Feet Completed..........
5. Mosquito Breeding Places Eliminated.......
6. Breeding Places Controlled-Acres .........
8. Structures Sprayed with D.D.T.............
T. RODENT CONTROL
1. Premises Rat-proofed.....................
2. Premises dusted, trapped or poisoned........
5. Field Visits ............................
V. GENERAL ADMINISTRATION
1. Visits in the interest of Vital
Statistics. ..............................
2. Lectures, Talks and Motion
; Picture Showings........................
4. Radio Talks Delivered....................
5. News Articles Published...................
X. LABORATORY-Specimens
Examined (1-23).... ...................

53 0
2,636 13
3,434 13

3 1,489 146
3 57 0

7,4791 4.9611 2,051

Z
=-w

C

17,586 ,-
99,404
293 ;
5,631 -0
179 O
1,024
11,340
349
8,035 "
47,822
16,431 I

49,307
15,420
100,541
1,683
32,507
11,702

305
21,708
26,059

4,490
7,523
135
1,855

623,746

LOCAL HEALTH SERVICE 63

DIVISION OF PUBLIC HEALTH NURSING
RUTH E. METTINGER, R.N., Director

The Division of Public Health Nursing has tried to be mindful of the
opportunity to assist the bureau and division directors in planning nursing
programs in each service.
Even though there is an acute shortage of nurses in the country,
Florida has been fortunate in being able to fill most of her vacancies.
There were only nine vacancies in the State at the end of the year.
As of December 31, 1952, 353 nurses were employed by official
health agencies, 47 by non-official agencies, 14 by boards of education
and 8 by the Florida Crippled Children's Commission, making a total of
422

IN-SERVICE EDUCATION PROGRAM
A series of four 5-day institutes were held in the early part of 1952
on infantile paralysis. To encourage nurses from all fields to attend the
institute, the State Hospital Association and the State Nurses' Associa-
tion were asked to have representatives on the planning committee in
addition to the two field representatives for the National Foundation
for Infantile Paralysis, the Director of Preventable Diseases and the Di-
rector of Public Health Nursing. The institute was under the auspices
of the National Foundation for Infantile Paralysis. Two representa-
tives from the Joint Orthopedic Nursing Advisory Service gave theory
and demonstration.
The great need for further information on the care of the premature
infant prompted two institutes on this subject. These were held in
Miami and Jacksonville, with approximately 150 institutional, public
health, and private duty nurses in attendance. A representative from
the Children's Bureau gave the nursing aspects of the care of the pre-
mature.
The Director assisted the Duval County Cancer Society in planning a
cancer institute which was held in Jacksonville for nurses in the northern
part of the State. Dr. Vera Fry, New York University, was one of the
main participants in the program.
The Bureau of Maternal and Child Health of the State Board of
Health sponsored a seminar on obstetrics, to which public health nurses
from South Carolina, Georgia, and Florida were invited. A special ses-
sion was held during the seminar for public health nurses, with two of
the outstanding participants giving newer methods in the care of ob-
stetrical patients.
It has been impossible to secure a sufficient number of nurses with
public health training and experience to cover the counties, but the
Field Training Center has served as a means of giving the unprepared

64 ANNUAL REPORT, 1952

nurses an orientation so that they will have some knowledge of how to
carry out a generalized program.
Interest in the regular monthly in-service study group meetings has
continued to increase. Many of the study programs would compare
favorably with a college extension course. Due to the distance involved
in getting a class of eight or more together, there are one or two areas
not yet organized in study groups.
One consultant taught three instructor classes of the Red Cross
course, "Home Care of the Sick". This has helped the nurses to under-
stand how to improvise in the home and teach the patients how to care
for themselves and their families.

ADVANCED EDUCATION
Six nurses enrolled in the six-weeks summer course at Florida State
University, studying some of the basic subjects which are included in
the approved course in public health nursing. These carried 6 credits
that can be applied to courses in public health nursing offered by uni-
versities.
Public Health Nurses were encouraged to attend the two-weeks course
in Audiology at the University of Florida, conducted by Roger Bertram
Mass, Ed.D., Hearing Consultant and Supervisor of Exceptional Chil-
dren, Marathon County Schools, Wausau, Wisconsin. Seven nurses regis-
tered, having their expenses paid by the Bureau of Maternal and Child
Health which sponsored the course.
Four scholarships were given to nurses for a year's program of study
in public health nursing. Nurses were permitted to select a university
offering an approved course in public health nursing. Several others, at
their own expense, have completed the program of study in Public
Health Nursing or obtained a Bachelor's Degree in public health nursing.

SCHOOL PROGRAM
The number of invitations to participate in the two weeks' pre-school
conferences attests to the increased interest in improving the school
health programs. The Nursing Division personnel attended as many of
these as time would permit.

NURSING MANUAL
The policy and procedure manual for public health nurses was revised
this year. Committees, representing local supervisors and staff nurses,
worked diligently to bring the material up-to-date. This Division then
assumed the responsibility of organizing, editing the material, and pub-
lishing.

LOCAL HEALTH SERVICE 65

MIDWIVES
Three hundred and sixty-five midwives were licensed for the year of
1952, which was fifty eight less than last year. This no doubt is due to
additional hospital beds, cases being referred to private physicians, re-
tirement of older midwives and the receiving of old-age pensions. If, in
the opinion of the health officer additional midwives are needed in his
county, younger women are selected, interviewed by the midwife teacher,
and a course of instruction is given.
The state midwife teacher conducted 26 institutes, visited 22 counties,
and revisited 11 of the counties which required additional work with
midwives who were unable to attend the institutes. At these institutes,
demonstrations were given on the conduct of normal home delivery and
care of the newborn, including the premature infant. Midwives were
required to participate in the demonstrations. Visual aids included films
on normal delivery, nutrition during pregnancy and mental health.
The state midwife teacher was invited to participate in a meeting of
the President's Commission on the Health Needs of the Nation.

FIELD VISITS TO COUNTIES
In conformity with the established policy of the nursing division, work
during the calendar year continued to place emphasis upon the strength-
ening of existing county public health nursing programs, the introduc-
tion of new nurses to county health departments, the newer trends in the
field of public health nursing, the interpretation of public health policies,
and assistance with inservice staff study group meetings; maternal
and child health programs; more and earlier care for prenatal patients,
health supervision of infants, and more demonstrations of nursing care.
The more effective use of the nurses' existing teaching tools and the
development of new teaching methods was also stressed.
A total of 90 visits to 51 counties were made.

FIELD EXPERIENCE
Emory University requested three months' field experience for six
student nurses completing their Bachelor's Degree in nursing. This
school hopes to be accredited by the National League for Nursing for first
level positions in public health nursing, therefore it is required that they
have this experience. Three of the county health departments accepted
these students.
Vanderbilt University, George Peabody College for Teachers, and the
University of North Carolina have continued to send graduate students
to three county health departments for field experience.
Field experience for the senior students in the diploma schools for
nursing, has been a problem. At the annual meeting of the State League
for Nursing, a committee was appointed to work out plans whereby better

66 ANNUAL REPORT, 1952

experience would be given over shorter periods of time, distributed
throughout the 3 years of training.

VISITING NURSE ASSOCIATIONS
The director has been called upon to assist with the promotion of ad-
ditional Visiting Nurse Associations. Two associations (Hillsborough and
Sarasota Counties) were organized during 1952 as coordinated services
with the county health department. This makes a total of seven Visiting
Nurse Associations in the State.

CIVIL DEFENSE
Classes in Nursing Aspects of Atomic Warfare have been taught by
two of the state consultants. To date, more than 1,000 nurses have taken
the course, and are giving this instruction to other nurses in their respec-
tive communities.
Representatives from the nursing division assisted a committee in com-
piling an instructor's manual on Nursing Aspects of Atomic Warfare.
This was approved by the State medical director on Civil Defense and
mimeographed by the state Civil Defense office.

LOCAL HEALTH SERVICE 67

FIELD TECHNICAL STAFF
J. L. WARDLAW, JR., M.D., M.P.H.,
Director

During 1952 there were several changes in the personnel of the Field
Technical Staff. In October Dr. J. L. Wardlaw, Jr., assumed the full-
time directorship of the Division, relieving Dr. K. E. Miller, the acting
director, who retired. The Staff now has its full strength with a director,
two nursing consultants, two sanitation consultants and two record con-
sultants.
The purpose of the Field Technical Staff is purely consultative, ad-
visory and demonstrative, and the Staff has no regulatory authority. Ex-
cept for those to new employees, visits are made almost entirely at the
request of local health units. The accomplishments of the Staff in this
type of program are difficult to measure but some idea of the scope of
activities is given by the following data:

TABLE 15

Counties Number TYPE VISIT PERSONS SERVED
CONSULTANT Visited of Visits Routine Request Old New Health Group Other
Employee Employee Officer
Record......... 56 89 64 25 54 19 5 3 8
Sanitation..... 51 78 25 53 38 8 33 31 11
Nursing........ 27 40 13 27 24 12 13 19 4
TOTAL........ 207 102 105 116 39 51 53 23

The difference between the numbers of counties visited and visits made
by the nursing consultants and those of the record and sanitation con-
sultants is accounted for by the fact that the nurses were working in re-
stricted districts while the other two types of consultants were working
throughout the state as a whole. In addition to the visits enumerated
above, personnel of the Staff participated in and assisted the counties
with the preparation of evaluation schedules, and restaurant and other
specific types of surveys in various counties.
In addition to his duties with the Field Technical Staff the director
has been assigned the duty of coordinating the State Board of Health's
activities in civil defense and in its portion of the program of hospital
and health center construction and hospital licensure.

CIVIL DEFENSE
In Florida the functions of public health and of medical care have
been separated. The following are some of the major items allocated to
the health department in the civil defense field:
1. Conduct of routine and added public health functions.

68 ANNUAL REPORT, 1952

2. Responsibility for radiological training and monitoring.
3. Responsibility for the blood program.
4. Responsibility for identification of victims and the disposal of
the dead.
5. Stockpiling and storage of biologicals and drugs.
Due to a restricted staff and urgency of the normal public health func-
tions it has not been possible to devote as much time to the civil defense
activities as we would have liked but there has been some activity in the
first four of the above fields. However, because qualified personnel were
available, the main civil defense activity in the past year has concentrated
on radiological training and monitoring.
In the first courses set up, in an effort to utilize the technical personnel
available in the state, a series of lectures for civil defense personnel were
held at five universities in Florida. The objective of these courses was to
train local personnel from each county, who, after receiving the instruc-
tion, could organize and conduct training courses in their local communi-
ties. Instruction was given both by members of the State Board of Health
and professional personnel from the respective universities. Courses were
held at University of Florida, Florida State University, John B. Stetson
University, University of Tampa and University of Miami.
The institutes were not well attended, and those who did attend were
for the most part county health department personnel.
In view of this and of the fact that local health department person-
nel are accustomed to health education methods, it was decided to utilize
them more fully in training civil defense workers in radiological tech-
niques. To this end a series of twelve meetings were held, set up on a
regional basis. Only five of the sixty-six organized counties failed to send
representatives. The meetings were held primarily for the sanitarians
although the health officers in the areas were urged to attend. The
courses were of one day duration and the instruction was given by person-
nel of the State Board of Health.
These institutes resulted in the broadest coverage of the civil defense
health services on a statewide basis ever achieved.

HOSPITAL CONSTRUCTION AND LICENSURE
Although in Florida it is the State Improvement Commission that is
responsible for the program of hospital and health center construction,
the State Board of Health has been given the responsibility of hospital
licensure. Only those hospitals constructed with the aid of federal funds
are required to be licensed. It has not been the policy to license state-
owned institutions. The following hospitals were licensed in 1952:
Suwannee County Hospital, Live Oak.......................... 37 Beds
Bay County Hospital, Panama City.............................. 66 Beds
Walton County Hospital, DeFuniak Springs................ 23 Beds
Tallahassee Memorial Hospital, Leon County............150 Beds

LOCAL HEALTH SERVICE 69

American Legion Hospital for Crippled Children,
St. Petersburg .............. .................................. 61 Beds
Duval Medical Center, Jacksonville.............................. 40 Beds
Variety Hospital for Children, Miami............................ 80 Beds
St. Lukes Hospital, Jacksonville.............................. 28 Beds
Washington County Hospital, Chipley.......................... 28 Beds
Baptist Hospital, Pensacola................ ............ 125 Beds
Orange Memorial Hospital, Orlando............................ 43 Beds
St. Joseph's Hospital, Tampa.................. ................. 73 Beds
Gadsden County Hospital, Quincy................................ 69 Beds
Jackson Memorial Hospital, Miami................................ 95 Beds
West Orange Memorial Hospital, Winter Garden........ 35 Beds
Indian River Memorial Hospital, Vero Beach.............. 30 Beds
Manatee Veteran's Memorial Hospital, Bradenton......100 Beds
Santa Rosa County Hospital, Milton............................ 23 Beds
The following Health Centers were completed:
Holmes County Health Center, Bonifay
Okaloosa County Health Center, Crestview
Wakulla County Health Center, Crawfordville
Several other counties have displayed interest in health center con-
struction and it is hoped that this latter list will be longer in the 1953
report.

70 ANNUAL REPORT, 1952

FIELD TRAINING CENTER, GAINESVILLE, FLORIDA
FRANK M. HALL, M.D., Director

The Training Center activities during 1952 are represented by the
following data showing the number of each type of personnel trained:
health officers (7), sanitarians (23), nurses (6), hospital nurse affiliates
(20), and clerks (2).
All expense of salaries and stipends of attending personnel was borne
by the respective counties where employed, with the exception of the
first group of sanitarians. This represented a departure in policy from
previous years when these monies came from the State budget. The
county health units acceptance of this policy was very satisfactory.
The training period, methods of training, and course instruction of-
fered for the various categories experienced little or no change over pre-
vious years. A period of instruction on industrial hazards, disaster and
civil defense sanitation has been included in the sanitarian's schedule.
All personnel, assigned during the year were, with few exceptions, well
qualified, and possessed an interested attitude and philosophy towards
public health as a career. It is believed that they derived a real pleasure
from the activities offered in the programs. The quality of men selected
as sanitarians continued to show improvement. One group of sanitar-
ians was composed entirely of young college graduates interested and
most capable of learning. During the year the Merit System revised the
minimum educational qualifications for sanitarians, now requiring a col-
lege degree. This is considered a forward step that will eventually reflect
in better results and a more favorable opinion by the people throughout
the State. Working with good students makes the instructors even more
conscious of the need for careful student selection. The trainee who has
at least some practice in the field and who has developed the need and
desire for training appears to be the best qualified to realize the greatest
benefit while in attendance.
More personnel could have been trained in field experience in all cate-
gories except sanitation, had they been available. There has not been
an oversupply of applicants for public health positions available in the
State. It is our feeling, however, that those who were here during the
year will definitely contribute a service to the State of far greater value
than the cost of the training.
No real progress has been made in the training of clerks. The large
turnover of clerical personnel in the counties, together with the cost in-
volved in sending them to the Center has long discouraged health offi-
cers in accepting this training opportunity. The need is realized and it
is hoped the service can be made available and assistance furnished by
the State Board of Health.

LOCAL HEALTH SERVICE 71

The training staff has remained intact during the year. No major
changes have been made, which lends to a stable program and a sounder
instruction regime. The use of many individuals for instruction from
the State office has continued, with their willing participation being
highly commendable.
In summary, the two greatest needs of the Training Center are:
(1) A small laboratory fully equipped whereby laboratory studies
could be better integrated with the teaching and training work at the
Center and (2) a further emphasis should be made to encourage local
health officers to send or to provide proper training for clerical personnel.

72 ANNUAL REPORT, 1952

BUREAU OF PREVENTABLE DISEASES
L. L. Parks, M. D., M. P. H., Director

The Bureau of Preventable Diseases is responsible for the control of:
Cancer, Venereal Diseases, Other Communicable Diseases, Industrial
Hygiene, Veterinary Public Health and Milk Sanitation.
It is believed that diseases of major importance, such as diptheria,
typhoid fever, and poliomyelitis, are reported in most instances, al-
though communicable diseases as a whole are not accurately reported by
private physicians. There are also many unreported cases of communi-
cable diseases in which a physician was not in attendance. However,
Table 16 gives a picture of the prevalent diseases for the year.
For the first four months of the year a nurse epidemiologist from the
Communicable Disease Center in Atlanta was assigned to the Bureau
of Preventable Diseases, but this service was discontinued when she re-
signed. In general, epidemiological investigations have been made by
the county health departments along with their regular duties. In special
instances investigations have been made by a representative of the Bureau
of Preventable Diseases and on some occasions assistance has been given
by representatives of the Communicable Disease Center in Atlanta. Three
examples of aid from Atlanta are as follows: special studies of psitta-
cosis; encephalomyelitis investigations; and assistance from the Virus
Laboratory of the U. S. Public Health Service in an outbreak of a dis-
ease in Central Florida which resembled poliomyelitis. The psittacine
studies have been outlined under the Veterinarian's report.
There were seventy-two cases of encephalomyelitis reported among
horses, and one human case which was found to be of Eastern Equine
origin. Special studies were made to determine the number of equine
encephalomyelitis cases, although the correlation, if any, between the
human case and the animal cases of this disease was not determined.
Potentialities of the possible spread of this disease from horse to man
through the mosquito vector which exists in this state is definitely known.
Anthrax was reported among cattle in five counties during the year,
however, no human cases were reported.
According to the number of cases reported, our records for whooping
cough for 1952 show a decided drop over the previous year, although
this is one of the diseases which is not reported as accurately as others.
There were 291 cases reported during the year, whereas 920 cases were
reported in the previous year. The number of deaths also dropped from
25 in 1951 to a total of 6 in 1952. The breakdown of these cases by age
group, sex and color is shown in Table 17. Both case rates and death
rates for this disease were higher in the colored population.
Poliomyelitis showed a very marked increase over the previous year
in the number of cases reported. However, the case rate was less than it

PREVENTABLE DISEASES 73

was in our peak year of 1946 (when we had 577 cases). The cases of
poliomyelitis were distributed over the state. The southern counties,
however, had a higher case rate; this may be due to better reporting
or it may be an indication of a higher incidence. It is interesting to note
that out of the 663 cases reported, 87 per cent occurred among the white
population. Fifty-eight per cent of all the cases occurred in children
nine years of age and under. Table 17 shows the breakdown of the cases
by age group, sex and color. It is noted that this disease is found in all
age groups but it occurs most frequently in persons under thirty-five
years of age.
There were fifty cases of malaria reported for the year. However,
forty-three of these were veteran returnees from Korea, and six other
cases were not laboratory confirmed. There was one laboratory con-
firmed case of malaria in Hillsborough County which undoubtedly origi-
nated in the State. (See Division of Entomology report elsewhere in this
volume.) It is believed that this is the only case of malaria which has
originated in the State since about 1948. Efforts have been made to
have every reported case of malaria confirmed by an approved labora-
tory, but this has been impossible in a few cases. The diagnosis of malaria
by blood smear is dependable if the examination is done by a competent
person.
The number of cases of typhoid and paratyphoid fever increased from
thirty-one cases for 1951 to forty-six in 1952. This may be expected since
there are unknown carriers of these diseases, and home sanitation is not
what it should be in many communities. The slight increase in cases of
this disease, over the previous two years, indicates the need for a con-
tinuous program of supervision of food and water supplies in the state.
The unknown typhoid carrier remains a problem in the handling of
food. A typhoid carrier file is maintained in the central office. There are
eighty-six known carriers in the state and only two new ones were added
during the year. Known carriers are supervised by the county health
departments and records are submitted to the central office. As long as
they remain carriers these individuals are not permitted to work in any
establishment in which they may handle food that is to be served to the
public.
Two new cases of Hansen's disease were reported during the year. All
active cases of this disease are hospitalized in Carville, Louisiana, as
soon as a diagnosis is made.
There was an outbreak of dysentery at one of the state universities
during the year. One hundred and seventy-eight cases were laboratory
confirmed as being dysentery sonnei and there were estimated to have
been over 3,000 cases. In most of the cases no laboratory diagnostic
work was done. Undoubtedly the source of this outbreak was due to a
food handler who was found to be a carrier. The detailed report of this
outbreak is to be presented to the Health Officers' Society at its meeting
in Hollywood in April, 1953.

74 ANNUAL REPORT, 1952

Table 17 shows the breakdown of diptheria cases by age group, race
and sex, and indicates that there was a general increase in cases. It is
noted that seventy-four per cent of the cases reported were in white chil-
dren. Forty-one per cent of the cases reported were in children four
years of age and under. Seventy-eight per cent of the cases were among
children nine years of age and under. This emphasizes the need of im-
munizations against this disease early in life.
There was a noticeable increase in the number of cases of tularemia.
Only six cases were reported in 1951, as compared with 18 cases in 1952.
The majority of these cases were found to be in Dade County and almost
all of the patients had handled rabbits captured in that area.
There was some increase in the number of cases of tetanus over the
previous year, but from all indications this disease is not well reported,
and it is believed that many more cases occurred than these figures indi-
cate. There was a noticeable increase in the number of cases of catarrhal
jaundice. Two hundred and thirty-six cases were reported for the year as
compared with 46 cases for the previous year.
One case of trachoma was reported in a colored man, 58 years of age,
from Monroe County. There was one case of this disease also reported
during the year 1951, but the records show that no cases of this disease
had previously been reported in Florida for many years.
There has been a steady increase in the number of immunizations
given against diptheria, whooping cough, and smallpox, as well as teta-
nus for the past five years. There has been a continual immunization
program against typhoid fever by the county health departments; how-
ever, there was a slight drop in the number of immunizations given in
1952 as compared with the previous years. The State Board of Health
has supplied biologicals for immunizations against diptheria, smallpox,
tetanus, typhoid, and whooping cough. These biologicals are available
to the county health departments but are not available to private physi-
cians if they make a charge for their services. Diptheria antitoxin is still
available; however, tetanus antitoxin is not.
Physicians, who are beginning medical practice in Florida, are now
mailed regulations pertaining to the control of communicable diseases.
This procedure was started during the year and undoubtedly will help to
stimulate the reporting of communicable diseases.
In summary, it will be noted that there have been no significant com-
municable disease problems during 1952. An evaluation of the communi-
cable disease rate is difficult to make, inasmuch as it is impossible to de-
termine whether any variation is due to an increase in incidence or to
better reporting by the physicians. It is anticipated that through con-
tinued control measures, our communicable disease rates will show an
ultimate decline.

TABLE 16
TOTALS OF REPORTED CASES OF NOTIFIABLE DISEASES, BY COUNTIES, FLORIDA, 1952 AND STATE TOTALS FOR
1950 AND 1951

N E E ;I

0.-3
Year 1952 e '

1950 5,090 248 1,945 65 113 97 113 50 9 15 30 45 14,185 446 10,051 235 27 34 7 2,499
1951 5,057 317 2,603 90 60 66 88 47 17 8 10 214 12,709 417 6,561 584 46 40 23 2,431
1952 5,333 462 1,261 72 143 82 161 235 12 13 82 304 11,809 233 6,611 218 236 120 50 4,072

Alachua................ 60,230 68 6 6.... ...... 1 4 1.... ........ 1 962 8 271 1..... ..... .... 100
Baker................... 6,320 10 1....... .... .... ..... .... ... ... .... .. ..... 4 1 87 ... ... ... .
Bay.... ........... 42,720 48 ..... 20 .......... 2 4 6 1 .... .... 55 153 ..... 152 11 3 .......... 125
Bradford. .......... 11,770 10 ..... 2 .... ...... 1 ..... ..... ......... .... ..... 42 .. 294 ..... 5 ........... 6
Brevard................ 25,570 45 14 5 .... ...... .... 3 1.... .... .... 3 77 11 73 3 5 4 1 1
Broward............... 98,940 203 4 36 .... ...... 1 7 ..... 2 .... 3 ..... 107 4 101 3 3 5 .... 63
Calhoun................ 7,920 9 ...... .. ...... ... ...... .... ... .. .. ...... ........... .
Charlotte............... 4,310 10 ............ ...... .. .... ............ .... ......... ..... 33 ................... 6
Citrus................. 6,380 7 ..... ....... ... ...... .... ..... 1 ... .. .. .
lay................... 16,270 26 1 261............... 1 13 ... 1 11 1 17
Collier................. 7,200 4 1 .. 1 1 .... .... .... .. 7 3 1 1 ..... ..... .... 36
Colum bia .............. 18,670 46 1 ........... .......... 1 ..... .... ... .... ..... 74 1 1 ..... ..... .. 1 ..
Dade ................. 576,340 1,134 43 390 9 130 1 88 5 2 2 .... 73 1,806 10 3 35 51 15 2 1,738
DeSoto............... 10,320 28 ..... ....... ........ ..... ............... ....6 ..... 18 .....................
Dixie .................. 3,900 7 ................ ...... ........ ... ..... ... ..... 5 ... 2 .......
Duval................. 318,040 484 190 100 1 1 4 16 7.... 4 50 2 1,931 62 221..... 21 53 9 274
Escambia ............. 116,160 131 27 15 .... 1 .... 1 4 1 .... 2 61 1,115 2 77 21 31 7 5 33
Flagler.................. 3,700 2 ..... 1 .... ...... ... ..... ..... .... .............. 3 ..... 7 ....... .25
Franklin ............... 5,800 28 2 ....... .... ..... .... ..... ................. 1 35 ..... 115 ..... 1... .... 13
Gadsden ............... 38,980 41 4 4 .... 2 3 ..... .................... 228 3 29 .......... ..... 1.....
Gilchrist............... 3,610 7 ..... 4 .......... .. ..... ..... .... .... .... .... 2 ............................... 80
Glades ................. 2,200 3 1 ....... .... .......... ..... ............. .... ..... 10 2 1 .. ....... ...
Gulf................... 7,730 9 1 ....... .... ....... 1 ...... ...... ... .............. 1 ..... 156 ........ .. .. 1 ..
Hamilton............... 9,100 8 ................ ............... 2 ........ .... ...... 43 ..... 4 .... ......... 2 1
Hardee................. 10,770 19 ..... 1 .1............. .... 4 ..... 70 ..... ..... ..... ......... .
Hendry................. 6,440 9 ............ ..... 1.. 3 ..... ................. 21 4 2 1..... ..... ... 2
Hernando .............. 7,100 14 ............... ...... ............................... 2 .... 1.
Highlands.............. 14,510 30 ..... 15 2 ... 2 .... ...... .... 1.... 6 112 2 ......... 6 1 .... 5
Hillsborough........... 269,020 547 35 194 6 ...... 20 5 7 .. 1 3 17 1,094 14 104 74 29 4 11 417
Holmes................. 14,010 17 .... 1..... ..... ..... ...... ....... .. .... .. 6 ..................... 13

TABLE 16-Continued

TOTALS OF REPORTED CASES OF NOTIFIABLE DISEASES, BY COUNTIES, FLORIDA, 1952 AND STATE TOTALS FOR
1950 AND 1951

a. a a "
.2 E a$ 4. a S

Year 1952
,So .g o S 4) S)

m S p p p w 0 50 w

Indian River............. 13,130 13 4............................... 11 1 .............1................ 8
Jackson ................ 34,700 46 1 .............. 1 ............... 1 240 ............... 2 ......... 4
Jefferson ............... 10 400 10 ..... 7 ..... .... 2 ..... 1 ........ .. 20 16 .. 451 ..... .............. 3
Lafayette...............3,440 8
Lake...................:40, 7 ...........119 ......... 2 2 2 ....... i 42 3..... 248 ... 2 115
Lee ................... 23,410 40 ..... 2 ........ 9 5 ............ ....... 34 1 2 1 1 1 1 2
Leon .................. 55,140 80 23 30 .. 1 2 ... 190 1 .... 1 20 644 13 507 4 6 .... 1 36
Levy................... 10,920 10............ ..... :. ... ..... ..... .... .... .... ..... 4 ... 404...... .
Liberty ................ 3,180 8 .. ......... 1 ..... .. .. .. .... .. .. ... ... ... .... 84 ..... 2 ................
Madison ............... 14,210 23 2 1 .... 1...................... 1 75 489 12 .............. 14
Manatee .............. 38,240 63 3 1 .... ...... 1 ... ... ........ ..... 183 ..... 174 ..... 1..
Marion ................ 39,560 44 4 5.. 1 ... 1 ......................... 235 2 94 .... 3.... 35
M artin................. 8,620 24 ..... ....... .....4 1 6 ..... ..... ..... .... 4
M onroe ................ 34,910 45 1 99 .......... 2 ..... .......... 1 ... 1 246 ....1 1 ..... 1 2 70
Nassau ................. 13,760 21 3.... ........... 1 ............................. 7 3 ............................... 3
Okaloosa. .............. 32,640 28 2 ................ 1.................... 140 1 361 11 ..... 1.... .136
Okeechobee ............. 3,650 6 ... .. ... ...... .... ..... ..... .... .... .... ..... 8 .... 92 .........................
Orange................ 127,670 209 3 67 8 3 2 1 ........ .... 1 207 4 15..... 12 .... 5 101
Osceola............ 11,790 37 ..... 4 14 .......... 8 ..... ....... .... ..... 12 .... 91 ............ .. 1 22
Palm Beach............ 121,060 186 62 45 .............. 1 1 1............. 379 54 ........ 1 1 18 .... 51
Pasco .................. 23,640 56 1 6 27 ...... 1 2 .. .... .. .. ..... 53 1 63 ..... 5 ........... 57
Pinellas ............... 172,270 463 8 45 .. ...... 2 1 4 1 1 20 6 291 2 118 1 .......... 2 106
Polk ...... ......... 129,320 186 4 2 2 2 10 ..... 2 ............ 2 172 6 295 15 7 1 ... 26
Putnam............. 26,230 48 .... 4 .. ...... .. ... ..2 ... ........ 2 164 .... 9 1 ..... 1 ... 31
St. Johns ............. 26,520 39 3 ....... ...... ......... ..... ..... 105 1 8 ..... 1 1 ...........
St. Lucie ............... 23,450 28 1 .......... 2 ......... 1 .... .... 1 28 3 ........ ..... ......... 1
Santa Rosa............. 19,240 28 ..... 26 ... .... .. ... 1 ....... 1 5 5 .... 364 12 4 ........ 48
Sarasota.. ............. 33,160 51 2 2 ..... .............. 128 .... 43 ...
Seminole ............... 27,960 43 4 28 3...... 1.......... .... 1 ... 6 146 4 9 1 7 1 1 49
Sumter ................. 11,720 23 1 7 .................... 1 ......... ..... 70 1 176 4 .............. 15
Suwannee ............ 17,010 29 1 .......................... ............. ......... .. 115 1 ................................
Taylor ................ 10,400 25 ..... .......... 1......... ........... ........... ... ..... 198 ..... .... ..... 1 18
Union .................. 7,280 15 1 ........... .............. ................. 13 2 45 .............................
Volusia ................ 81,290 276 2 16 ..... ... 4 ......... 1...... ..... 83 5 49 1 1 2 ... 35
Wakulla ................ 5,340 4 4 .. ..........................59 46..... 1 ......... 58
Walton ................ 15,110 21 .. .. 17 .... 36 ....... ..................
Washington............. 11,890 23 ... .. 1 ......... 14 .... 303 ..... 1..............69

TABLE 16-Continued
TOTALS OF REPORTED CASES OF NOTIFIABLE DISEASES, BY COUNTIES, FLORIDA, 1952, AND STATE TOTALS FOR

1950 AND 1951

Sa Other Diseases

Year 1952 i 1 3 i i

a 0

1950........................... 53 1,452 22 13 624 471 38 26 191 86 10,738 43 2,337 18 30 34 36 96 471 3 1
1951.................... .. 92 2,101 14 8 727 362 11 112 395 61 9,445 34 2,590 6 23 20 10 95 920 5 2 2
1952........................... 88 1,985 20 10 707 663 20 68 412 48 10,824 46 2,603 18 36 11 10 75 291 2 1

Alachua........................ 2 39 4 .......... 4 .... 6 1 .... 178 .... 49 1 2 ......... 1 .....................
Baker.................................... ............... ............ ........ 1 6 ... 1 ....... .... ..........
Bay ........................... 3 32 .... ... 7 15 1 12 50 ... 20 ................. ... 2 ..................
Bradford....................... 1 11 1 ... 3 ................... .... ... 31 .... 9 ........ ....... ... 5 ..................
Brevard........................ 1 10.... .... 1 8 1..... 2 ... 241 1 24 ............ ....1 8 ................
Broward...................... ..... 27 1 .... 5 77 ......... 2 .... 440 7 88 1 ............. 9 8 ................
Calhoun....................... ...... ....... .... .... ..... ... .... ..... ...... .... ... 8 ........
Charlotte ...................... 1 3 ............... 5 .................. 11.... 3..
Citrus ................................................ 1.................. 6... 6...............................................
Clay................. .. ... .. ........... ............... ..... 1......... ... 38 .... 13 .... 2 .............. 1 ...................
Collier......................... 1 3 ........ 1. 1. .. 2 22 .. 1 .... ............. ......................
Columbia ..................... .... 1 .... .... 1 1.... ..... ..... 82 2 17 .... 1........ 5........
Dade ................. .. 11 611 7 1 328 240 .... 13 51 35 1,814 8 507 8 7 1 14 80.... ............
DeSoto............................ ....... 1 ... .... 1 1 ..... ... 43 .... 7 ........ ... ..... .... 2 ..................
D ixie .......................... ............. ..... ........ 10 ... 2 ...
Duval ...................... 13 244 1 5 27 38 1 13 53 7 2,080 5 384 3 4.... 1 8 17 ... 1.
Escambia ...................... 1 40 1 .... 35 22 .... 1 19 .... 203 1 55 .... 8 ....... 3 1 ........
Flagler.............................. 1 26 ........ ..... ..... 3 ..... .......... 30 .... 5 ......................... ........
Franklin....................... .... 1 ....... ............. .... .............. 31 1 6 .... 1 ........... .............. ......
Gadsden.......................... 1 1 .. 5 ..... 245 1 26* .... 1 ............. 5 ..............
Gilchrist .................2 .................. .... .......................................................... .... 2.......................
Glades....................................................................... 6 ... 3...... ....................
Gulf............................ ........................... 1 1. ...... ... 31 .... 6 ........
Hamilton ................................. .... ........... ........ .. .. 26 .... 6............ ..
Hardee......................... ... 1............ 7 .. .. ..9 ... 5.... 1 1 ...............
Hendry ................... ........ 2 .... 42 .. ....... ..............................
Hernando........................... ...... .... ... 1 .... ................... 21 .... 7 .... ........ 1..........................
Highlands .. ....................... 11... ... 2 4 ......... 2 ... 96 .. 10 2 1...... 5 1........
Hillsborough................... 20 163 1 3 204 23 4 4 88 ... 636 4 246 .... 1 1 1 16 9..............
H olm es........................ .... 1 ... .. ...... 1 1 .......... .... 9 ..9 3 .... .... 2 .. ... ........................
Indian River .................. .... 16 .... ......... 15 .... 2 ..... .. 87 ... ........... 1 ........... ....
Jackson....................... 3 1 ........ 1 1 .. 1 .... 1 58 1 24 .... 1 ............ ...................

TABLE 16-Continued
TOTALS OF REPORTED CASES OF NOTIFIABLE DISEASES, BY COUNTIES, FLORIDA, 1952, AND STATE TOTALS FOR N
1950 AND 1951 co

.. a Other Diseases

Year 1952 .8 0
a z

a .o" a o S a s .S .
S o a

Jefferson ........................... 3 ................... 4 ... 25 ... 1 .............. .. 5 ..............
Lafayette ................................ ......... 8... 2 ............................................ mn
Lake .............. ..... : .... .... 5 2 2 .... ... 143 1 20 .... .. ........ 2 46 ..
Lee.................. ........ .... 8 ....... 2 ....... 1..... ... 142 ... 26..
Leon ............................ 4 ........ 13 8 1 1 29.... 207 1 36.... 1.... .... 1.. ... O
Levy ....................... ........... ..... .... 23 .. 7 ..... ........ ........
Liberty.... ....... .... 3
Madison.......................... .... .......2 1............. 3515................ 1 4................
Manatee .................. ....... .... ..... .. 7 19 .... .. ... .... ..... ... ........ ....
Marion............. .......... 3.... ...... 2 ....... 1 .... 733.... 1 1.........
M martin ......................... .. 12 ......... .. ...... ..... .... 64 .. .... ..... .. .... .. ... ..
Monroe. ..................... 3 45 .... 4 14 ... 1 9 .. 98 19........ .... 1
Nassau ..................... .. .... ..... ......... 1 2... 13 ..................... ... .... .
Okaloosa....................... 31 ........ 3 1 1 .... ....4 26 .. 14.......... .... ........... ....... t
Okeechobee .................. ... .... 3........... .....................................
Orange .......... ........... 2 235 ....... 1 11 .... 8 49 ... 400 1 101 1 ... ... 1 ... 9 .... ...
Osceola............................ 14 .... ......... 1 1 ..... 3 .. 23 ... 8 .1 .... 11 ........
Palm Beach.................... 1 40 1 1 1 39 .... ..... 4 .... 582 3 111 1 1 .... 1 ... 1 .. .
Pasco......................... 2 1 ........ 10 4 1 2 ....... 89 3 14 1 ... 1 .. 5 2 ......
Pinellas ....................... 1 21.... ......... 39 1 7 11 1 373 ... 263 .... 1........... 6 ..........
Polk.......................... 4 39 2 .... 41 32 ......... 10 1 439 1 104 ........ ....... .... 7 ........ .
Putnam ........................ 1 2 ......... 3 ........ 4 ... 108 ... 27 .... .... .... .... 4 .. .... ....
St. Johns ....................... 1 ............. ..... 3 ........ 1 ... 161 .... 24 .... .. .......................
St. Lucie ...................... ... 2 .... .... .. .. .. ............. 71 1 17 .............. .... ......... ...
Santa Rosa........................ 70 ....... 1..... ... ..... ........ 14 .. 6 .... .... 3 .. 1 .... ...
Sarasota....................... 1 ....... .... .... 1 2 .5 ... .7 .... 18 ... 55 ..... 17 ........................
Seminole ....................... 4 28.... ..... 1 3 ... ..... 9 ... 247 1 14 .................... 6 ..............
Sumter. ........................ 2 28 .... .... .. ... ..... 1. 3 .. 3 ............. 1 12 ..............
Suwannee.......................... .. ...... .. .... 1........ 3. ... 42 1 14 ..................
Taylor.............. ................. 85 ... 4 ....1...... ... .. ........
Union .......................... 1 5**.............. .. 5 ................... ,
Volusia......................... 1 23............. 1 1 4 1 252 .... 52........... .1 7 6...............
W akulla ....................... .... 3 ........ ...................... 1 ....... 9 .... ........................ ... ........
W alton........................ ... ............... ..... 1...... 19 .... 6 .. .. ... .....................
W ashington.................... 2 2 ..... ..................... ..... 14 .. 9..... ..... .......
*Florida State Hospital.................. ........... .. .. ..... .. 14 .....................
**Florida State Prison.............................. ..............................22 ........................

TABLE 17
REPORTED CASES OF DIPHTHERIA, POLIOMYELITIS AND WHOOPING COUGH BY RACE, SEX AND AGE, FLORIDA 1952

AGE IN YEARS

DISEASE RACE & SEX TOTAL
ALL Under Not
AGES 1 1 2 3 4 5-9 10-14 15-24 25-34 35+ Stated

TOTAL ................ 82 1 7 10 8 8 30 5 8 1 3 1 r
White Male............... 27 1 1 4 2 4 10 1 2 .. 2
White Female............ 34 .. 5 3 2 1 12 2 6 1 1 1
Diphtheria......... Colored Male............ 12 .. 1 3 1 3 4 ..
Colored Female........... 9 .. .. .. 3 .. 4 2 .. .. ... Z
NotStated .............. 0 .. .. .. .. .. ... .. i .. .
TOTAL ................. 663 34 47 55 51 37 162 71 69 91 34 12
White Male.............. 310 12 15 26 27 20 87 38 26 40 16 3
White Female............ 270 10 14 17 15 14 62 31 42 46 15 4
Poliomyelitis....... Colored Male............ 49 6 11 8 8 2 6 1 .3 2 2
Colored Female.......... 28 6 6 4 1 1 6 1 1 2 .. .
Not Stated .............. 6 .. 1 .. .. .. 1 .. .. .. 1 3
TOTAL................ 291 52 33 33 39 22 76 16 5 2 1 12
White Male............... 75 12 11 7 14 3 18 7 1 .. 2
White Female............ 83 9 4 9 9 11 27 9 2 2 .. 1 C/)
Whooping Cough... Colored Male............ 67 18 10 7 8 4 17 .. .3 r
Colored Female.......... 62 13 8 9 8 4 14 .. 2 3
Not Stated.............. 4 .. 1 .. .. .. ..... .. 3
(n
C)
t/

80 ANNUAL REPORT, 1952

VENEREAL DISEASE CONTROL
WILLIAM A. WALTER, M.D., M.P.H., Director
In 1952 the Melbourne Rapid Treatment Center was discontinued as
a diagnostic and treatment center. This represents a major change of a
fundamental practice in venereal disease control. The services which
were supplied by this inpatient facility are now a function of a network
of outpatient clinics each of which goes under the name of Prevention
and Control Center.
The factors that led to this transfer from one inpatient center to seve-
ral outpatient facilities were discussed in the annual report of 1951 al-
though at that time there was no plan nor was there any thought that a
revision of policy could or would be conceived, implemented, and com-
pleted in the short period of a few months. The change is a result of the
application of practical public health measures in conformity with the
increased information made available through progress in the medical
sciences. This newer knowledge has resulted in shortened treatment
schedules, greater therapeutic efficiency, simplified methods of adminis-
tering the therapeutic agents, decreased hazard of treatment for the
patient, and lower cost per patient treated. Therefore, it seemed un-
necessary for the State Board of Health to continue to maintain a costly
inpatient facility when ambulatory treatment would be more acceptable
to patient and physician alike, and since the same services could be of-
fered at a large financial saving by utilizing outpatient clinics.
There are now six Prevention and Control Centers in operation. Each
one serves the designated counties in its region. Each one is a product
of the combined efforts of the State Board of Health, the Health Unit
of the County in which it is located, and the County Health Units
within the area it serves. That such a system was started, made work-
able, and is now functioning stands as a tribute to the scope, enthusiasm,
and ability of county health units in Florida. Thus Florida has been the
leader in making the initial move of returning basic venereal disease con-
trol activities to local health units where they logically belong and ulti-
mately will rest. The six Centers are now operating in: Jacksonville,
Miami, Pensacola, Tallahassee, Tampa, and West Palm Beach.
The optimism for the eventual success of the syphilis control program
as expressed at the close of 1951 can be carried through 1952. Although
the total syphilis morbidity was slightly greater than the previous year
there is no reason to believe that the problem is increasing. Total mor-
bidity is weighted by the large numbers of latent cases which were dis-
covered by means of selected blood testing surveys and which represent
disease contracted four or more years prior to diagnosis and reporting.
Newly acquired syphilis is best represented by the number of persons
reported as having primary and secondary syphilis. An examination of
the following statistical tables will reveal that fewer persons acquired
new syphilis in 1952 than at any time in the recent past.
The other venereal diseases have not shown any particular evidence

PREVENTABLE DISEASES 81
of being on the wane. These so called minor venereal diseases must re-
ceive much more attention than is given them at the present time. Granu-
loma inguinale showed a sizable decrease in number of cases, but further
observation is necessary before valid conclusions can be made.
In an effort to make a more intelligent approach to the control of
gonorrhea a special project has been established at the Jacksonville Pre-
vention and Control Center. This project is a combined effort of the
Bureau of Laboratories and the Venereal Disease Division and has for
its purposes the establishment of better laboratory diagnostic aids, formu-
lating more precise methods of gonorrhea control by public health pro-
cedures and establishing the etiology, incidence, and treatment of choice
for the non-gonorrheal urethritis.

Since 1952 saw the end of the Inpatient Rapid Treatment Center in
the State and the change over to Outpatient Prevention and Control
Centers, we would like to record a brief summary of the history of the
Rapid Treatment Centers in Florida.
In 1943 Centers were opened at Ocala, Wakulla, and Jacksonville for
rapid treatment of syphilis cases utilizing the multiple drip and heat
therapy methods. The Ocala and Wakulla Centers were located in
former CCC Camps with a two hundred bed capacity each and were
used for white female patients only. The Jacksonville Center was located in
the City-County Hospital with a forty bed capacity and was used for
white, colored, male, and female patients. In the latter part of 1943,
Ocala opened a substation at Deer Lake for the treatment of colored
females only, with a bed capacity of one hundred and fifty. In 1944
another Center was opened at Pensacola and during the year penicillin
became available for use in Rapid Treatment Centers. These Centers
operated through June, 1946. On July 1, 1946, the Ernest Hinds Hospi-
tal Ship was acquired from the Army and set up as a Rapid Treatment
Center at the foot of Hogan Street on the St. Johns River in Jackson-
ville. This was an emergency measure and although the ship was un-
satisfactory in many ways, a total of 6,861 patients were treated on it
during the eight months' period from July 1, 1946, through February 22,
1947, when due to lack of funds it was necessary to close this Center.
The State was without a Rapid Treatment Center for four months. July
1, 1947, the Melbourne Center was opened at the former Melbourne
Naval Air Station Hospital with a five hundred bed capacity, for the
diagnosis and treatment of all venereal disease patients.
This facility was in continuous operation until its closing on July 1,
1952. Of the total of 58,643 persons admitted to all Rapid Treatment
Centers during their period of operation 1943-1952, the Melbourne Cen-
ter admitted 29,039. Of the total of 46,725 cases of syphilis treated at
the Rapid Treatment Centers during this same period, 22,152 were
treated at Melbourne.
*
To control the venereal diseases there is only one of the basic elements
of communicable disease control to work with, that is the destruction of

82 ANNUAL REPORT, 1952

the organism. The means to destroy the organism is available, but only
after the organism is found. Thus the control efforts must be concen-
trated on finding the organism. To date the best proven technique to
accomplish this is through use of the interviewer-investigator method.
The division has twenty-eight trained interviewer-investigators assigned
throughout the state. These persons are working at Military Installations,
County Health Units, and Prevention and Control Centers. They inter-
view known cases of venereal disease to obtain information regarding
source and spread contacts. They follow-up and investigate the contacts
in an effort to have the contacts examined and treated when necessary.
Other activities carried out by the interviewer-investigators are educa-
tional programs in the schools, with civic organizations, military organi-
zations, and other lay groups, as well as doing mass blood testing surveys
in selected areas and groups.
The Central Registry Unit processes all venereal disease morbidity
reports and contact referrals for the entire state. Reports from this unit
are used in pinpointing areas of high prevalence and to assist in general
the direction of the control program throughout the state.

PREVENTABLE DISEASES

TABLE 18
NUMBER OF VENEREAL DISEASE CASES REPORTED IN FLORIDA
BY DISEASE AND YEAR 1948- 1952

Granuloma Lymphopathia
Year Syphilis Gonorrhea Chancroid Inguinale Venereum

1948 15,395 18,820 388 773 197
1949 12,405 15,388 343 827 127
1950 10,738 14,185 248 446 34
1951 9,445 12,709 317 417 40
1952 10,824 11,809 462 234 120

TABLE 19
NUMBER OF DIAGNOSTIC OBSERVATIONS COMPLETED IN CLINICS
AND PER CENT FOUND TO BE INFECTED
1948-1952

Diagnostic Observations Results of Observation Per Cent Found
Year Completed Infected
Not Infected Infected

1948 137,998 102,442 35,556 25.8
1949 156,394 118,268 38,126 24.4
1950 159,666 130,674 28,992 18.2
1951 163,054 144,984 18,070 11.1
1952 132,360 118,384 13,967 10.2

TABLE 20
TOTAL NUMBER OF SYPHILIS CASES REPORTED BY STAGE OF INFECTION, PREGNANCY STATUS, RACE AND SEX,
SOURCE OF REPORT, AGE GROUPS, BY COUNTIES, FLORIDA, 1952

STAGE OF INFECTION RACE AND SEX SOURCE OF AGE GROUP
REPORT

WHITE' COLORED

COUNTY

E- Z :I E4

o I I I I n z
A U3 0 U H x 4. 0 a o 3

TOTAL........................ 10,824 3923933,8705,730439783 1,173 1,174 3,405 4,879 193 5,1335,570 121 17 16 196 1,917 2,5802,140 1,447 799469 1,243
Alachua.. .........................45 4 11 2 107 4 157 21... 11 6 61- 49 24 19 6 1 10
Baker ............................. 19 1 1 7 10 ... 5 1 1 10 7 12 ... ......... 3 6 4 2 1 2 1
Bay............................... 50 3 .. 31 12 4 ... 4 8 8 30.. 46 4..... .. 2 2 1 11 9 31 1 2
Bradford........................... 31 1 1 7 16 6 ........ 6 18 6 1 25 6.. ..... 3 6 3 8 3 .. 4 ...
Brevard............................... 241 8 11 103 114 5 22 18 14 95 112 2 112 129..... 2 44 63 56 33 21 8 13
Broward ........................... 440 27 15 198 186 14 66 45 54 113 219 9 121 319 ... .. .. 4 89 127 80 60 21 9 50
Calhoun. ................. ......... 3 ...... 1 2 ... ... ..... ..... 1 2 ... 2 1 ............ .... 1 1 ..... ... 1 ....
Charlotte .......................... 11 ... ... 3 8 ... 1 1 3 1 6 ... ...... 11 ....... ... 1 3 3 3 ... ... 1
Citrus......................... ...... ... ... 2 4. 2 ..... 1 2 3... 3 3 .... .... ... 2 1 1 1 ... ..
Clay .............................. 38 1 ;. 9 25 8 5 2 3 11 22... 26 12 ....... 2 1 12 10 2 5 5 1
Collier.............................. 22 ... 2 6 13 1 2 1 .. 8 12 1 10 12 ..... ... 3 3 5 8... 1 2
Columbia.......................... 82 ... 2 20 57 3 11 8 9 31 33 1 47 351... 1.. 1 13 16 16 14 11 6 4
Dade.............................. 1,814 70 28 4581,208 50124 336 346 458 620 54 756 1,058... 1 2 16 221 454 400 273 157 75 215
DeSoto............................ 4 1 1 9 31 1 4 11 9 10 10 3 16 27 ... .... .... 7 4 5 11 5 4 7
Dixie.............................. 10 ... 3 4 3... 1 1 2 1 6.. 8 2 ..... ..... 5 1 2 1... 1.
Duval............................. 2,080 52 721,036 874 46 97 151 159 65511,096 19 812 1,267 1 3 2 11 259 430 407 249110 65 544
Escambia.......................... 203 17 17 69 77 23 16 18 30 69 85 1 183 20 ..... 1 7 61 56 39 25 5 4 5
Flagler........................... 30 ... 1 12 17 ... 1 2 ..... 11 17 .. 17 131 ..... .. ... 4 9 4 6 4 3 ....
Franklin .......................... 31 3... 12 10 6 4 3 8 5 13 2 22 9 ... 1.. 4 8 8 4 2 2 1 1
Gadsden .......................... 132 5 9 56 57 5 9 4 3 41 82 2 73 59 ..... ... 33 25 22 14 8 2 27
Gilchrist........................... 2 ..... 1 ... .......... 1 ... 2 ..... ... ... ... ..... 1...... 1.........
Glades.......................... 2..... 4 .. 1 ..... 1 1 4 ... 4 2 ... .... ... 1 3 1 1 ..........
Gulf............................... 31 1 1 5 20 4 ... 3 2 9 17 ... 21 10 ........... 8 5 3 5 ... 1 9
Hamilton .......................... 26...... 8 18... 6 1 2 9 14... 15 11....... ... 5 7 7 3 2 1 1
Hardee ............................ 9 ... ... 2 7 ...... 3 1 2 3 ... 2 7 ..... ... 1 1 4 1... 1 1
Hendry ............................ 42 11 15 24 1 6 1 ..... 21 20.. 26 16...... 12 13 6 6 4 .....
Hernando.......................... 21 11... 8 12... 7 1 2 4 14 ... 9 12.......... 9 4 6 1 1 ..
Highlands.......................... 96 1 1 36 55 3 6 7 7 34 46 2 19 72 5 .. .. 2 12 27 26 15 9 3 2
Hillsborough ....................... 636 28 13 170 388 37 32 113 93 169 250 11 343 275 18 5 .. 23 128 156 108 102 58 35 21
Holmes............................ 9... 3 1 1 4 ... 1 4 1 2 1 7 2.... ... 5 1... ... 1
Indian River....................... 87 4 ... 27 56 ... 4 3 14 28 42 ... 21 66 ... .. .. 2 10 26 28 12 5 4 .....
Jackson............................ 58 3 ... 25 24 6 4 5 3 34 16 ... 29 28 1 1 9 23 10 8 2 3 2 .....
Jefferson ........................... 25 ... 2 11 111 13 ..... 1 4 20 ... 18 7 ...... .. ... 13 5 6 1 .....
Lafayette .......................... 8 ... 2 2 4 ... 1 2 1 2 3 .... 4 4 ... ........ .. .... 3 1 ....
Lake .............................. 14 3 5 48 82 5 13 12 21 51 58 1 46 97. ..... .. 2 27 20 37 32 12 7 6

TABLE 20-Continued

TOTAL NUMBER OF SYPHILIS CASES REPORTED BY STAGE OF INFECTION, PREGNANCY STATUS, RACE AND SEX,
SOURCE OF REPORT, AGE GROUPS, BY COUNTIES, FLORIDA, 1952

STAGE OF INFECTION RACE AND SEX SOURCE OF AGE GROUP
REPORT

WHITE COLORED

COUNTY

z W S 22

Lee............................... 142 7 10 52 65 8 4 5 10 49 77 1 127 15 ... 2.. 2 49 35 22 18 9 4 1
Leon.............................. 207 1911 77 8713 2 14 17 56 9921 108 81 18.... 8 60 45 32 16 12 5 29
Levy........................... 23...... 5 17 1 6 1..... 9 13 ... 13 10 .......... 4 6 4 1 5 2 1
Liberty.......................... ... ..... .. 3 1 ... ..... 1 2 ... 3 1.......... 1 2 ............. 1...
Madison .. ............. 35 1 ... 13 17 4 6 3 20 ... 14 21 ... .. .. 11 11 6 4 2 ..
Manatee........................... 74 7 2 27 31 7 3 8 6 31 28 1 47 27 ... .. .. 3 20 12 20 3 9 4 3
Marion............................ 179 3 9 68 85 14 21 12 16 59 91 1 99 80 ... .. .. 6 48 42 23 28 11 12 9
Martin ............................ 64 ... 3 10 45 6 2 1 ..... 29 32 2 60 4 ...3 .. 3 5 15 12 5 4 7 10
Monroe ........................... 98 8 11 27 50 2 2 17 16 34 30 1 52 46 ... .. ..... 27 22 19 13 9 4 4
Nassau. ........................... 45 2 1 21 21 ...... 1 5 17 22 ... 18 27 .... ....... 8 6 9 5 9 1 7
Okaloosa........................... 26 3 3 8 7 5 2 4 2 7 13 ... 21 3 2 .... 3 12 5 3 ..... 3 .. ....
Okeechobee........................ 24 1 ... 11 12 ... 3 2 4 4 12 2 17 7 ... .. .. ... 3 8 2 6 5 ...
Orange........................... 400 12 37 132 206 13 1 43 59 114 175 9 137 260 3 .... 4 67 95 85 43 38 30 38
Oseeola ............................ ...... 6 15 2 2 4 7 2 10 ... 15 8 ... .. .. ... 7 5 2 6 ... 2 1
Palm Beach........................ 582 24 23 215 297 23 18 30 26 304 220 2 386 196 .....4 14 109 187 108 79 41 24 16
Pasco............................. 89 1 1 21 49 17 7 9 7 35 38 ... 51 38 ..... 1 13 9 22 20 13 7 1 3
Pinellas........................... 373 7 10 55 290 11 30 90 42 87 146 8 187 186 ... .. 1 6 45 75 67 49 51 39 40
Polk .............................. 439 15 15 173 226 10 36 36 51 124 210 18 157 282 ... .. .. 4 85 107 87 58 26 22 50
Putnam............................ 108 8 9 27 61 8 19 3 2 31 70 2 54 54 ... .. .. 2 27 32 19 9 12 5 2
St.Johns.......................... 161 31... 76 71 11 14 10 3 64 84... 119 411 .... 1 46 39 20 23 9 2 21
St.Lucie........................... 71 2 2 17 43 7 15 3 3 19 46 ... 24 47 ... .. .. 1 20 17 15 10 3 1 4
Santa Rosa......................... 14 ...... 7 3 4 ... ..... 5 1 8... 13 1... .... ... 6 1 2 1 1 2 1
Sarasota........................... 55 8 1 16 30 ... 1 6 3 15 26 5 26 29 ... ....... 13 13 11 2 5 1 10
Seminole........................... 247 11 22 103 106 5 33 8 9 96 133 1 34 213 ... .... 4 43 59 55 26 17 9 34
Sumter............................. .. 35....... 17 11 7 5..... 1 13 21 ... 20 15... ....6 8 5 6 4 41 1
Suwannee.......................... 42 ... 6 10 18 8 5 6 8 10 181... 28 141.....1 7 8 9 8 5 31 ....
Taylor............................. 23 59 3 8 5 13 20 47 ... 14 71 ... .. .. 1 12 19 17 14 4 9 9
Union ............................. 31 2 2 17 4 1 4 1 8 17 1 29 2 ... .... 4 2 5 6 6 2 5 1
Volusia............................ 252 11 7 78 153 3 23 34 21 88 107 2 105 147 ... .. .. 1 33 61 56 47 22 10 22
W akulla ........................... 9 ... ... 6 3 ... ..... ..... 4 ... 8 1 ... .. ... .. 3 2 1 .
Walton ........................... 19 3 ... 6 5 5... 4 6 4 5 ... 15 4....... 9 2 1 3..
Washington ........................ 14 1 ... 4 9 ... 1 3 4 3 4 ... 5 9 ... ....... 3 3 4 2... 2 ...
State Hospital...................... 113 2 9 40 61 1 ... 21 5 45 40 2 113..... ........... 7 19 32 27 1214 2
State Prison ....................... 78 ... ... 29 49 ... 1 20 ..... 48 10 ... 5 1 72 .. ..... 11 31 24 7 ....

TABLE 21
TOTAL ADMISSIONS TO MELBOURNE RAPID TREATMENT CENTER BY DISEASE AND STAGE OF INFECTION DURING
PERIOD OF OPERATION JULY 7, 1947 JULY 1, 1952

TABLE 22
ADMISSIONS TO PREVENTION AND CONTROL CENTERS BY DISPOSITION
July December 1952

PERSONS EXAMINED

OBSERVATIONS

EPIDEMIOLOGIC
TREATMENT* DIAGNOSTIC

PREVENTION TOTAL POST
AND TREATMENT PERCENT
CONTROL NOT FOUND
CENTER Syphilis Gonorrhea TOTAL INFECTED INFECTED INFECTED

Jacksonville........................... 10,236 114 334 2,677 7,111 5,354 1,757 24.7
Miami ............................... 8,117 4 49 1,410 6,654 5,584 1,070 16.1
Pensacola............................. 5158 4 280 278 4,596 4,023 573 12.5
Tallahassee............................ 5,637 2 155 383 5,097 4,614 483 9.5
Tampa .............................. 16,966 16 60 636 16,254 15,651 603 3.7
West Palm Beach...................... 1,694 10 40 306 1,293 971 321 24.8
TOTALS ......................... 47,808 150 918 5,690 41,005 36,197 4,807 11.7

*Treatment given to individuals who have been exposed to proved infectious cases, but who have not been diagnosed as infected.

PREVENTABLE DISEASES

CANCER CONTROL
L. L. PARKS, M.D., M.P.H., Acting Director

Cancer was the second leading cause of death in Florida in 1952. Pre-
liminary data indicates that 4,186 Floridians died of this disease during
the year. .Cancer is a reportable disease in Florida by regulation of the
State Board of Health, and there were 5,333 cases reported for the year
1952. The number of cases reported comes primarily from the tumor
clinics and death certificates. Fifty-four per cent of all cases were ob-
tained from death certificates and 28 per cent were reported by tumor
clinics and health departments. The cases of cancer which are seen by
private physicians for treatment and are cured are not reported as accu-
rately as they should be; therefore, the number of cases reported for
last year is far from being complete. Only 12 per cent of the total cases
were reported by private physicians.
The Cancer Control Program has continued to operate along the gen-
eral lines which were adopted in 1947 when the State Legislature en-
acted the Cancer Control Bill and provided funds for this service. The
purpose of the program is to provide cancer diagnostic services, treat-
ment facilities for the indigent cases, and a general education program
not only for the physicians but also for the general public.
In order for a patient to receive any assistance under the State Cancer
Control Program it is necessary for the patient to be seen first by a regu-
lar practicing physician. If the patient is medically indigent an applica-
tion is made out by the attending physician. This application is signed
by the patient as well as the physician and at the same time the patient
gives certain information pertaining to his finances. The application is
then approved by the county health director or welfare worker in the
county in which he lives and is forwarded to the Cancer Control Divi-
sion of the State Health Department. If the application is in order the
patient is then referred to one of the nearest Tumor Clinics.
Tumor Clinics were in operation in the following cities during the
year:
Jacksonville (2), Pensacola, Orlando, West Palm Beach, Tallahassee,
Ocala, Tampa, Ft. Lauderdale, Miami (2), Daytona Beach, Gainesville,
Lakeland, and St. Petersburg.
The Tumor Clinics are staffed by private physicians, and none of the
physicians taking part in the Tumor Clinics receive any pay for their
services from the Cancer Control Division or other sources. The only
person receiving a salary at the Tumor Clinic is the secretary or nurse,
or both in some of the larger clinics. The full time personnel at the
Tumor Clinics is paid, as a rule, by the State Board of Health, but in
some of the clinics the secretary or part-time secretary is paid from funds
made available by the American Cancer Society, Florida Division. The

88 ANNUAL REPORT, 1952

State Cancer Society furnishes expendable supplies to the Tumor Clinics,
such as postage, dressings, phone service and numerous other items.
Funds from the State Board of Health are made available to the
Tumor Clinics for diagnostic purposes, and hospitalization of cases in
which there is a reasonable hope of recovery. A minimum fee is made
available from the State funds for the payment of the radiologist's fee
for x-ray therapy; radium rental fees; and the anesthetist is also paid a
fee, provided this person is not a member of the hospital staff. Those
hospitals that wish to accept State aid cancer cases for hospitalization
are required to submit a per diem cost statement. When this statement
is submitted the State Board of Health pays the hospital accepting these
patients a fee not exceeding $15 per day. This fee covers all diagnostic
procedures, treatment and operating room services during hospitalization.
At present no fees are paid the surgeon as was done prior to October 1,
1951. The per diem which was paid to hospitals varied from $11.02 to
$15 per day. Twenty-eight hospitals accepted state aid cancer cases
during the year.
Any physician in the state may take a biopsy from his patient and send
it to any of the pathologists in the state, using the mailing containers
made available by the laboratories of the State Board of Health. The
pathologists agreed on January 1, 1951, to make the tissue examination
on indigent patients free of charge, provided the attending physician
made no charge for his services. If the attending physician charges for
the taking of the biopsy then the pathologist expects his fee. The purpose
of this service is to encourage every physician to make use of the tissue
diagnostic service and establish a diagnosis as early as possible.
In establishing the Tumor Clinics the State Board of Health adopted
the standards of the American College of Surgeons. A representative of
the American College of Surgeons visited most of the Tumor Clinics
during the year. Approval was given all of the Tumor Clinics visited
except the one in Orlando. A representative of the American College of
Surgeons is expected to visit the Orlando Tumor Clinic early in 1953,
and no doubt it will then be approved, as this Clinic is carrying on a
very fine service. The Tumor Clinic in the Dade County Hospital which
was approved in 1951 did not develop, and the approval of this Clinic
was withdrawn by the State Cancer Council during 1952. During the
year a second Tumor Clinic was organized in Jacksonville, at St. Vin-
cent's Hospital.
A professional educational program was conducted along the same
line as in previous years. A three-day Seminar was held in Tampa,
with 225 physicians in attendance. Nine out-of-state speakers took part
in the Seminar. The Cross-Roads Seminars were held in eight places
during the year, and at each of these a speaker from out of the state
discussed various phases of cancer. These meetings were held at De-
Funiak Springs, Marianna, Live Oak, Fernandina, St. Augustine, Eustis,
West Palm Beach and Key West. The total attendance was 230 physi-
cians. Films on the diagnosis of cancer were shown at the State Medi-

PREVENTABLE DISEASES 89

cal Association meeting in Hollywood. The lay educational program was
limited to the showing of cancer films and to talks to various civic
groups on cancer. Both types of Seminars were jointly sponsored and
financed by the State Board of Health and The American Cancer So-
ciety, Florida Division.
The Director of the Division of Cancer Control continues to be a
member of the Executive Committee of the American Cancer Society,
Florida Division. The relationship with the American Cancer Society
has been very profitable to both agencies as it insures close cooperation
and coordination of an official agency and a voluntary agency. Prob-
lems of education of the lay as well as professional groups, financial
support of tumor clinics and other mutual problems are easily solved by
the close association of the two organizations.
The Florida Cancer Council which was organized in 1951 continued
to function during the year and held three meetings. The purpose of
this Council is to co-ordinate all cancer services in the State. The Coun-
cil consists of two members of The Cancer Committee of the State Medi-
cal Association, two members of The American Cancer Society, two
members of The State Board of Health, and a representative of The
American College of Surgeons. The Cancer Council passed a rule dur-
ing the year that each of the Tumor Clinics should submit annually a
statement of their financial operation, and that each Tumor Clinic
should have the approval of their local Medical Society annually. In
this way each of the Tumor Clinics will continue to have the approval of
the local Medical Society, as it is believed this will insure a higher type
of service in each of the clinics. Because of the rather low attendance
at the Cancer Seminars it was decided not to have any annual three-day
Cancer Seminars in 1953, but to try to work out some plans whereby
more emphasis may be placed upon cancer at the regular County Medi-
cal Societies' meetings by providing speakers for their regular meetings.
The Cancer Council adopted a leaflet on cancer which is to be dis-
tributed to physicians for them to give to their private patients, en-
couraging the patients to seek early diagnosis. This leaflet has been ap-
proved by the Board of Governors of the Medical Association and will
be made available during the coming year.
Private patients may be seen in ten of the Tumor Clinics if they ale
referred there by their attending physician. The purpose of the Tumor
Clinic is not just to diagnose and treat patients but also to provide
a learning experience for the staff. In this way a number of patients
are brought together, and there is an opportunity for those physicians
in attendance to see a variety of cases, and to observe and follow up
treatment results. There were 1,673 patients approved for State aid
during 1952.
During the year the Director of the Division of Cancer Control was
appointed one of the consultants for the Oak Ridge Institute of Nuclear
Studies, Oak Ridge, Tennessee. The Institute hospital accepts patients

90 ANNUAL REPORT, 1952

with selected types of cancer, if they meet certain requirements. This
is a small research hospital, and before any patient can be accepted an
application must be processed through a medical school. Inasmuch as
Florida did not have a medical school at the time this program was
started, the State Board of Health, Cancer Control Division was asked
to act in place of the medical school as a clearing house for the selected
types of cancer patients that can be accepted at Oak Ridge. This In-
stitute is interested in accepting the following types of cases: Multiple
Myelomas, Leukemias, Bone metastases (from the prostate or breast),
Primary osteogenic sarcoma, Polycythemia vera, Patients with ascites or
pleural effusions due to metastatic lesions, and Thyroid carcinoma.
These patients are provided hospitalization without cost. However, ar-
rangements have to be made to take care of their transportation. This
item may be taken care of by the American Cancer Society, Florida
Division, providing no other source of funds is available. In 1952 eight
patients were referred from Florida to this institution.
The cancer case records on file in the central office have become so
numerous that during the year the record system was changed from the
McBee Card System to that of the I B M System. The new plan will
be much more satisfactory as it will permit a detailed study of the types
of cases being rendered services. This system will permit an easier evalu-
ation of the follow-up accomplishments.
We are interested in seeing the results of the assistance given the
patients. At the same time through this study we are able to help some
of the delinquent patients return for further treatment or re-examination
to determine the progress or retrogression of the disease.
A summary of data obtained from the cancer registry is shown in
Tables 23-27. These are the first figures produced from the machine
tabulation system which was initiated in the latter part of 1952. It was
necessary to code and prepare punch cards on all data obtained by the
cancer registry since its beginning late in 1946.
A total of 1673 persons were approved for state aid during 1952.
This is about the same number that were approved in each of the two
preceding years. The number of approvals was smaller in 1949 because
many eligible persons were denied state aid due to the lack of available
funds. The number of white and colored persons accepted for state aid
were in about the same proportion as the population of this state.
During 1951, 55 per cent of all persons approved for aid were diag-
nosed as having cancer (see Table 23). Preliminary totals for 1952 indi-
cate about 48 per cent with cancer and 21 per cent with diagnosis un-
known. Many of the 1952 cases with an unknown diagnosis entered the
program late in the year and a diagnosis will be obtained in the near
future. Later tabulations will increase the per cent of persons diagnosed
as having cancer in 1952.
An examination of the age distribution of those persons diagnosed as

	Front Cover
	Title Page
	Letter of transmittal
	Members of the Florida state board...
	Official staff Florida state board...
	County health officers
	Florida state board of health
	Table of Contents
	General summary
	Finance and accounts
	Vital statistics
	Local health services
	Preventable diseases
	Tuberculosis control
	Laboratory services
	Maternal and child health
	Dental health
	Nutrition and diabetes control
	Sanitary engineering
	Narcotics
	Health information

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