Annual report - State Board of Health, State of Florida

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FLORIDA

STATE BOARD
OF
HEALTH

1957

IANNUAL REPORT
I I

State Board of Health

Stetie o 7^towa

1957

The following statistical reports will be published separately:
SUPPLEMENT I -FLORIDA VITAL STATISTICS, 1957
SUPPLEMENT II -FLORIDA MORBIDITY STATISTICS, 1957

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

6/4

C '* .

The Honorable CHARLES J. COLLINS, M.D. President,
Florida State Board of Health,
Orlando, Florida

Dear Dr. Collins:

I herewith submit the annual report of the Florida
State Board of Health for the year ending December
31, 1957.

Sincerely yours,

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

May 1, 1958
Jacksonville, Florida

His Excellency, LEROY COLLINS
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, 1957,
to December 31, 1957, inclusive.

Respectfully submitted,

CHARLES J. COLLINS, M.D.
President

May 1, 1958
Orlando, Florida

Members of the
FLORIDA STATE BOARD OF HEALTH

CHARLES J. COLLINS, M.D., President
Orlando

T. M. CUMBIE, Ph. G.
Quincy

F. P. MEYER, SR., D.D.S.
St. Petersburg

SULLIVAN G. BEDELL, M.D.
Jacksonville

JOHN D. MILTON, M.D.
Miami

OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH

December 31, 1957

DIRECTORS

State Health Officer...............................Wilson T. Sowder, M.D., M.P.H.
Assistant State Health Officer.................Albert V. Hardy, M.D., Dr. P.H.
Personnel Officer.......................................Robert G. Carter, B.S., Acting

Bureau of Finance and Accounts...............Fred B. Ragland, B.S.
Purchasing Agent........................................G. Wilson Baltzell, B.S.
Bureau of Vital Statistics..............................Everett H. Williams, Jr., M.S. Hyg.

Bureau of Local Health Service...............George A. Dame, M.D.
Assistant Director.........................................Wade N. Stephens, M.D., M.P.H.
Division of Public Health Nursing............Ruth E. Mettinger, R.N.
Field Training...............................................George A. Dame, M.D., Acting
Bureau of Preventable Diseases....................Clarence M. Sharp, M.D.
Division of Industrial Hygiene..................John M. McDonald, M.D.
Division of Tuberculosis Control...............Clarence M. Sharp, M.D.
Division of Venereal Disease Control.......Clarence M. Sharp, M.D., Acting
Division of Veterinary Public Health.......James E. Scatterday, D.V.M., M.P.H.
Bureau of Special Health Services..............Lorenzo L. Parks, M.D., M.P.H.
SDivision of 'Hospitals and Nursing Homes....Lorenzo L. Parks, M.D., M.P.H.,
Acting
Division of Chronic Diseases....................Lorenzo L. Parks, M.D., M.P.H.,
Acting
Division of Nutrition.......................... Lorenzo L. Parks, M.D., M.P.H.,
Acting
Bureau of Laboratories............ .......Nathan J. Schneider, Ph.D., Acting
Miami Regional Laboratory...................Warren R.'Hoffert, Ph.D.
Orlando Regional Laboratory................Max T. Trainer, M.S.
Pensacola Regional Laboratory.................Emory D. Lord, Jr., B.S.
Tallahassee Regional Laboratory................Robert A. Graves, M.S.
Tampa Regional Laboratory.......................H. D. Venters, B.S.
West Palm Beach Regional Laboratory....Lorraine Carson
Bureau of Maternal and Child 'Health..........Edward L. Flemming, Ed.D.,
Acting
Bureau of Mental Health.......................Melvin P. Reid, Ph.D., Acting

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

Bureau of Entomology............................ John A. Mulrennan, Sr., B.S.A.

Bureau of Sanitary Engineering................... avid B. Lee, M.S., Engineering

Bureau of Narcotics.......................................Frank S. Castor, Ph.G.

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

COUNTY HEALTH OFFICERS

(As of December, 1957)

Alachua.......................................................dward G. Byrne, M.D., M.P.H.
Baker-Nassau.................................................... George A. Dame, M.D., Acting
Bay.................................................................Albert F. Ullman, M.D.
Bradford-Clay-Union......................................A. Y. Covington, M.D., M.P.H.
Brevard-Osceola...............................................J. Dillard Workman, M.D., M.P.H.
Broward .............................................................Paul W. Hughes, M.D., M.P.H.
Calhoun-Jackson...............................................George A. Dame, M.D., Acting
Charlotte-DeSoto-Hardee.................................Bertram R. Provost, M.D.
Citrus-Hernando-Levy................. ...............Harold F. Bonifield, M.D., M.P.H.
Collier-Lee.........................................................Joseph W. Lawrence, M.D.
Columbia-Gilchrist-Hamilton.............................George A. Dame, M.D., Acting
Dade............................... ............. .. ... ........ T. E. Cato, M .D., M .P.H.
Dixie-Lafayette-Suwannee.............................Patrick H. Smith, M.D.
Duval.............................................................. Thomas E. Morgan, M.D., M.P.H.
Escambia................................ John C. McSween, M.D.
Flagler-Putnam...............................................Norman B. Edgerton, M.D., M.P.H.
Franklin-Gulf-Wakulla....... ..........................Henry I. Langston, M.D., M.P.H.
Gadsden-Liberty............................................ Wayne Yeager, M.D., M.P.H.
Glades-Hendry-Highlands..........................William F. Hill, Jr., M.D., Acting
Hillsborough................................. ...............Frank V. Chappell, M.D., M.P.H.
Holmes-Walton-Washington........................ N. Nelson, M.D.
Indian River-Martin-Okeechobee-St. Lucie..Neill D. Miller, M.D.
Jefferson-Madison-Taylor................ ...Harold H. Ring, 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., M.P.H.
Marion.................... ............. ....Frank J. DiTraglia, M.D.
Monroe....................................... James L. Wardlaw, Jr., M.D., M.P.H.
Okaloosa-Santa Rosa................................. L. Turnage, M.D., M.P.H.
Orange ..............................................................Wade N. Stephens, M. D., M.P.H.
Acting
Palm Beach.................. ........ ... ..C. L. Brumback, M.D., M.P.H.
Pasco-Sumter................................................Leo L. Burger, M.D.
Pinellas........................................................William C. Ballard, M.D., M.P.H.
Polk.................... ................. ...... ...........Chester L. Nayfield, M.D., M.P.H.
Sarasota.................................................. William L. Wright, M.D., M.P.H.
Seminole ................................ Terry Bird, M.D., M.P.H.
Volusia.............................. ....... D. V. Galloway, M.D., M.P.H.-

ORGANIZATIONAL CHART OF THE FLORIDA STATE BOARD OF HEALTH

GOVERNOR

STATE BOARD OF HEALTH
Five Members

TABLE OF CONTENTS

Page

General Summary (including Activities of the Board, Legisla-
tion, Public Health Research, Scholarships and Personnel)....... 1

Division of Health Information ............................................................ 18

Bureau of Local Health Service (including Division of Public
H health N ursing) ...................................................................... ...... 23

Bureau of Vital Statistics .......................... ......- ........... ................ 65

Bureau of Maternal and Child Health ................................................ 74

Bureau of Preventable Diseases (includes Epidemiology, and
Divisions of Industrial Hygiene, Tuberculosis Control,
Venereal Disease and Veterinary Public Health) ...................... 78

Bureau of Laboratories ............................................................................ 116

Bureau of Special Health Services (including Divisions of
Hospital and Nursing Homes, Chronic Diseases: Heart,
Cancer, Diabetes, and Nutrition) .................................................. 134

Bureau of Sanitary Engineering ............................................................ 147

Bureau of Mental Health (including Council on Training and
Research in Mental Health) .......................... ........................... 190

Bureau of Narcotics .................................................. ...................... 203

Bureau of Entomology (including Entomological Research
C enter) .................................................................................................. 207

Bureau of Dental H health ........................................................................ 221

Bureau of Finance and Accounts (including Purchasing)................ 227

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

The ability of an organization to keep abreast of changing times and
trends and their effect on the public health, testifies to its progressive-
ness. The State Board of Health, it is hoped, has this ability. The
appointment of a Coordinator of Research late in 1956, and the ex-
pansion of our research projects in 1957, shows our concern for more
accurate background information on which to base new public health
programs or to expand old ones. (A listing of the research projects in
the State Board of Health will be found elsewhere in this section of
the Annual Report).
The State Legislature has increasingly made the State Board of
Health an advisor to, or an activator of, various programs in which
it is interested and in which there are public health aspects. Many of
these programs have advisory committees. The names of those serving
on these various committees in 1957 will be found throughout this
Report, according to their respective interests. The following are set up
by legislative acts: Florida Air Pollution Control Commission, Florida
Council on Training and Research in Mental Health, Dental Scholarship
Advisory Committee, Hospital Licensure Advisory Council, Medical
Scholarship Advisory Committee, and Advisory Committee for Hospital
Service for the Indigent.
Many of the above groups require that the State Health Officer
participate in their meetings or otherwise aid them in their problem
solving. Also added to his other responsibilities are numerous requests
from state and voluntary agencies and professional societies to attend
their meetings. It has become increasingly obvious that the State Health
Officer needed assistance, so the Board of Health approved the appoint-
ment of the Coordinator of Research as Assistant State Health Officer.
His primary responsibilities, in addition to coordinating research, are:
to assist bureau and division directors, county health officers and others
in program development, especially in new fields; evaluate old programs
and assist the State Health Officer in determining relative emphasis to
be placed on all programs; review training activities; and to foster
personnel recruitment.
The Merit System Classification Plan and Salary Schedule went
into effect on July 1, 1957. Numerous inequities were protested. The
attendance at Merit System Council meetings and the voluminous cor-
respondence required to put the plan into operation have required much
of the State Health Officer's time and effort. However, many problems
concerning the Plan were resolved in 1957. The employment of a per-
sonnel technician, and a personnel officer in the Bureau of Local Health
Service assisted greatly.
Employees of the State Board of Health and the County Health De-
partments were given the opportunity to participate in Federal Social

2 ANNUAL REPORT, 1957

Security which was included with State Retirement. Approximately
1174 of our employees chose to participate.
The communicable disease receiving the most attention in 1957 was
Asian influenza. Florida was one of the first states to have laboratory
confirmed cases of this strain of the disease. Apparently, about 10 per
cent of Florida's population was affected. The epidemic was not as
severe in Florida as elsewhere as the total recorded deaths for September,
October, November, and December were not in excess of the number
expected.
Four new health centers were completed during 1957, as compared
to seven during 1956. However, 14 were under construction at the end
of the year (including one regional laboratory). Attractive, efficient
offices are most important aspects of a County Health Department's
administrative set-up, for dingy, poorly located quarters do not enhance
the public's opinion of this phase of local government.
The following are projects completed last year under the Federal
Hill-Burton Hospital and Health Center Construction Program:
Projects Completed During 1957 Location Federal Grant Total Cost
Lakeland Health Center Lakeland $ 33,441.60 $ 83,604.00
Calhoun County Health Center Blountstown 39,299.47 63,794.80
Escambia County Health Center Pensacola 222,620.35 472,729.93
Walton County Health Center Defuniak
Springs 42,250.00 65,105.00

ACTIVITIES OF THE BOARD
During the year two changes occurred in the membership of the
Board. John D. Milton, M.D. of Miami was appointed by the Governor,
effective July 10, 1957 to replace Herbert L. Bryans, M. D., who had
been a member of the Board for 16 years and its President during
most of that period. Sullivan G. Bedell, M.D. of Jacksonville, a prac-
ticing psychiatrist, and for several years a member of the Council on
Mental Health Training and Research, was appointed by the Governor
effective July 17, 1957, to succeed Carl C. Mendoza, M.D. of Jackson-
ville.
Five meetings were held during the year. The date, place, and
business transacted were as follows:
January 12-Key West
1. By resolution authorized and directed the State Health Officer
to proceed with the construction of a new regional laboratory in
Orlando.
2. Approved methods of computing priorities for grants under
Public Law #660; under which law the Federal Government
gives grants to municipalities for sewage treatment plant con-
struction.

GENERAL SUMMARY 3

3. At a public ceremony received a historic watch from the J. Y.
Porter family which was given to J. Y. Porter, M.D., the first
State Health Officer, by the Jacksonville Auxiliary Sanitary
Association in 1889.
4. Discussed septic tank problems in Monroe County with local
citizenry.
February 12 Jacksonville
1. Discussed and approved proposed Bills to be presented to the
Legislature.
2. Discussed fees collected in county health departments; a com-
mittee of County Health Officers met with the Board to discuss
the various types of fees collected.
3. Discussed revision of formula for determining state contributions
to local health units for basic health services; whereby county
contributions which are to be matched by State and Federal
funds will include only the local funds from official local
agencies.
4. Discussed the Palm Beach property owned by the State Board
of Health and the furnishing of office space to the Board in
the proposed West Palm Beach Public Health Center.
May 5- Hollywood Beach
1. Approved proposed applicants for postgraduate training.
2. Discussed purchase of electroencephalographs for Duval Medical
Center Clinic and Baptist Hospital Clinic. Lack of funds made
purchase impossible.
3. Discussed educational requirements for local mosquito control
directors.
4. Discussed the additional $125,000 needed for the completion of
the new building in Jacksonville to be inserted in the Appro-
priations Act.
July 28- Jacksonville
1. Discussed the principal enactments of the 1957 Legislature af-
fecting public health, the most significant of which was the
substantially increased appropriation to the Board of Health,
an increase of 58 per cent.
2. Discussed plans for budgeting new monies which included a
number of new positions, salary increases and additional services.
3. Discussed the responsibilities and limitations of the State Board
of Health in the administration of the Naturopathic Act of
1957.

4 ANNUAL REPORT, 1957

4. Discussed the duties and responsibilities of the State Board of
Health and the Air Pollution Commission in regard to the Air
Pollution Act of 1957.

5. Discussed the Indigent Hospitalization Program and the right
of the Board to review the recommendations of the Advisory
Committee on the Hospital Service for the Indigent.

6. Discussed the Hospital Licensing Program and the Nursing
Home Licensure Program for the 287 nursing homes licensed
in the state.
7. Discussed proposed amendments, rules and regulations in the
Mosquito Control Program.

8. Approved Dr. Edward Flemming as Acting Director of the
Bureau of Maternal and Child Health in the absence of Dr.
R. W. McComas who was granted leave of absence.
9. Approved Dr. Melvin Reid as Acting Director of the Bureau
of Mental Health upon the resignation of Dr. Laney Whitehurst.
10. Discussed and approved additions to the methods of computing
priorities for grants under Public Law #660.
11. Signed agreement with Palm Beach County Commissioners re-
garding State Board of Health Building there.

October 13 Jacksonville

1. Approved the appointment of Dr. Albert V. Hardy as Assistant
State Health Officer for a period of one year and appointed
Dr. Nathan Schneider as Acting Director of Laboratories in
Dr. Hardy's absence from the Laboratory.

2. Approved the transfer of the Personnel Office and all its activi-
ties from the Bureau of Finance and Accounts to the Office
of the State Health Officer.
3. Approved the appointment of Mr. Robert Carter as Acting
Personnel Supervisor upon the resignation of Mr. Paul T. Baker.

4. Granted a one year leave of absence for Mr. John Wakefield,
Sanitary Engineer V, so he could become Director of Water
Resources under the Board of Conservation.
5. Discussed the recent Audit Report #4651 made by the State
Auditor's Office. Approved the recommendation made by the
State Auditor that the position of Internal Auditor presently
set up in the Bureau of Finance and Accounts be transferred
to the Office of the State Health Officer.

GENERAL SUMMARY 5

6. Discussed and approved proposed revision of regulations of the
Structural Pest Control Act of 1947 (as amended Chapter
482, Florida Statutes 1955).
7. Discussed change in policy under methods of computing priorities
for grants under Public Law #660.
8. Discussed nominating procedure by the Florida Hospital Asso-
ciation in regard to membership on Advisory Committee on
Hospital Service for the Indigent.

LEGISLATION
The 1957 Legislature enacted a number of bills which directly con-
cerned public health, and was interested in many others in which
public health has an interest, such as acts affecting divorce proceedings,
adoption proceedings, commitment proceedings, mental health and its
several aspects, all drainage control districts, sanitation districts, mos-
quito control districts, etc;
A summary of legislation which was passed in 1957 which was
pertinent to the State Board of Health follows:
Amendments to the Medical Scholarship Law.
Amendments to the Dental Scholarship Law.
Granting to the State Board of Health the power of eminent domain.
Amendments to the Mosquito Control Law.
Authorizing construction of insecticide research building at Vero
Beach and providing for its construction.
Granting injunctive relief in the enforcement of Chapter 381.
Granting injunctive relief in the control of water pollution problems.
Authorizing the construction of a stream sanitation lab and providing
an appropriation for its construction.
Amendments to the Narcotic Control Law.
Providing for the Control of Barbiturates and Amphetamines by the
Bureau of Narcotics.
Repealing certain sections of Chapter 462 pertaining to the practice
of Naturopathy and transferring the authority and duties of the
Board of Naturopathic Examiners to the State Board of Health.
Affecting Naturopathic physicians with military service and GI
training.
Establishing an Air Pollution Control Commission within the State
Board of Health.

6 ANNUAL REPORT, 1957

Appropriating $150,000 for the purchase of Salk vaccine and polio-
myelitis immune serum globulin.
It should also be noted that:
1. Our biennial appropriation for mental health purposes was in-
creased from $320,000 to $1,002,000.
2. State matching funds for the support of county health units
were increased from $2,500,000 to $3,500,000.
3. The program, "Hospital Service for the Indigent" which was
created by the 1955 session of the Legislature with a $500,000
appropriation for the express purpose of establishing the adminis-
tration of the program, was adequately financed with a $4,000,000
appropriation for the coming biennium. This will allow the
State Board of Health to match county funds, dollar for dollar,
for the hospital care of indigent as provided by the law.

PUBLIC HEALTH RESEARCH
ALBERT V. HARDY, M.D., DR. P.H.
Assistant State Health Officer and
Coordinator of Research

A Coordinator of Research for the State Board of Health was
designated late in 1956. This is the report of gradual but satisfying
developments during 1957.
The major activities to be reported are those of planning. For this
purpose there were three conferences. Early in the year a Committee
on Research met for a general discussion of possible plans. This was
attended by staff members from the National Institute of Health and
included representatives from the state's major educational institutions.
In April, there followed a comparable conference for the discussion
of Research in Mental Health. These together provided a stimulus
with direction.
Attention was devoted first to the development of an interest in, and
plans for, the development of research in some of the county health
departments. Dr. T. E. Cato of the Dade County Health Department
established a Division of Research and Program Development with Dr.
Michael Takos as Chief. (Dr. Takos was previously the chief of the
general clinical service). In that county there has been gratifying
progress. Through the cooperation of Dr. Eugene Flipse of the Univer-
sity of Miami Medical School, six medical students for the three summer
months were the first employees on the research program. Under Dr.
Takos' guidance they began the assembling of data required for the
Study of Inmates of Nursing Homes in Dade County. Simultaneously,
they gave attention to other delimited problems; for example, Tetanus
in Dade County, to the advantage of the county health department
and with educational benefit to the student. Additional support

GENERAL SUMMARY

for the major project was provided by the Bureau of Mental
Health, making available temporarily a social worker and the half-time
services of a clinical psychologist. Gradually the plan for a three year
study matured and at the end of the year this was being prepared for
submission (as a research grant request) to the National Institutes of
Health. Pending action on this, Dr. Takos received an allocation of
"Demonstration Funds" from the Bureau of States Services of the U.S.
Public Health Service and a second one from a private agency wishing
to have the benefit of the Study in selected homes for Jewish inmates.
Due to a leave of absence for graduate study by a member of the
Dade County Health Department staff, Dr. Takos during a portion of
the year was serving as epidemiologist, in addition to his work as
Chief of the newly formed division of Research and Program Develop-
ment of the Dade County Health Department.
There was also an important development of a "Demonstration
Project" to explore the means of providing better service to the mentally
retarded in their homes. The total budget for this exceeds $40,000
annually. The responsibility for the organization and guidance of this
was placed in the Division of Research and Program Development. At
the close of the year the needed staff was being assembled.
There were active developments also in Pinellas County. It was
agreed in the first research conference that problems of the aged warrant-
ed particular attention in Florida. Soon thereafter the Pinellas County
Health Department agreed to assume responsibility for initiating studies
in this field. Dr. Waldo Treuting, Professor of Public Health Adminis-
tration, School of Public Health, Tulane University, agreed to serve in
a consultant capacity. The earliest decision was that an Assistant Health
Officer, experienced in public health but active in gerontology or
geriatrics should be found, (if possible) and employed to provide the
needed leadership for the development of a service and study program
to satisfy better the health needs of the aged. Through fortunate circum-
stances, Dr. Howard Carter became available in October and took on
the assigned task. In December, a two-day planning conference took
place at the Health Department in St. Petersburg and from that time
definitive plans began to take form. It is hoped that the needed budgetary
supplements are obtained through a NIH research grant.
Developments in Hillsborough County followed an entirely different
line. In that area, there was wide community concern for evolving an
effective integrated plan for the rehabilitation of the mentally ill. The
Coordinator of Research contributed only in a limited manner. This was
distinctly a community agencies' project. Consultive assistance of Mr.
George Landsman, psychiatric social worker from the regional office of
the USPHS was much appreciated. An organizational meeting to
activate formulated plans is to be held early in 1958.
Lack of a well-qualified Assistant Health Officer in Palm Beach
County has prevented research developments there as planned and
desired by the Health Officer. This is the fourth large county in which

8 ANNUAL REPORT, 1957

the local organization can advantageously consider the development of
a substantial research program.
Looking to the future there is a recognized need and opportunity in
Alachua County but adequate basic support can hardly be expected
through the regular county health department budget. There is also
an obvious need for public health research in a rural setting. Here
also some means of providing the basic support will need to be found.
The Coordinator of Research continued to maintain close contact
with research projects in the Bureau of Laboratories. The study of
pulmonary disease due to Atypical Acid-Fast Bacilli proved particularly
interesting and productive. It represented a joint effort of the Board of
Health and the State Tuberculosis Board. Another cooperative study
in tuberculosis involved the Miami Regional Laboratory and the Chest
Unit of Jackson Memorial Hospital. (The various studies involving
the Bureau of Laboratories are described elsewhere in this volume).
The Entomological Research Laboratory at Vero Beach is an out-
standing research activity. It was given some support by the Coordinator
of Research who was able to arrange for Dr. Dale Lindsay to visit it twice
in an advisory capacity. An entomologist by training and currently the
Assistant Chief of the Division of Research Grants of the National
Institutes of Health, he was able to advise and assist effectively on a
variety of matters.
It is recognized that certain other bureaus and divisions are also en-
gaged in research or demonstration projects which are described in their
respective reports.
The Coordinator of Research has served the Council on Training
and Research in Mental Health. It has been his responsibility to receive,
review and report on proposed studies. To date, six projects with an
annual budget of $29,150 have been approved. (See report of the
Council elsewhere in this volume).
In the latter part of 1957, the National Institutes of Health pro-
vided a grant of $22,140 annually to aid in the Organization and Initia-
tion of Public Health Research in Florida. To date, this has been used
to cover the cost of some consultants, travel, (including that to visit other
Health Departments concerned with public health research) and for
selected salaries where this will favor a desired development. Funds
provide for a physician or scientist to obtain training and experience
in public health research but there has been no selection for this position
to date.
Articles by State Health Officer and Assistant State Health Officer:
Sowder, W. T. Responsibilities of state agencies and voluntary
agencies in providing services for the aged In Report of the
Seventh Annual Southern Conference in Gerontology. 1957.
Hardy, A. V., Dublin, T. D. Research in State and Local Health
Departments, J. A. M. A. 165: 1808-1813, Dec. 7, 1957.

GENERAL SUMMARY

RESEARCH AND DEMONSTRATION PROJECTS WITH
APPROPRIATE ANNUAL COSTS BY
AGENCY PROVIDING FUNDS

Virological Etiology of Acute Enteric Infections
National Foundation for Infantile Paralysis $ 15,000
Armed Forces Epidemiological Board 6,000
Laboratory
Rabies in Bats and Other Wild Life
NIH U.S. Public Health Service 18,000
Laboratory and Veterinary P.H.
Infections due to Atypical Acid Fast Bacilli
School of Aviation Medicine 5,000
State TB Board 12,000
Laboratory and Epidemiology 6,000
Laboratory Surveillance of Poliomyelitis and Asian Influenza
U.S. PHS (CDC) Contract 10,800
Laboratory
Aerosol Technic in Bacteriological Diagnosis of Tuberculosis
NIH, U.S. PHS 5,500
University of Miami Medical School
Laboratory
Rapid Bacteriological Diagnostic Procedures
School of Aviation Medicine Contract 5,000
Laboratory
Influenza in Pinellas County
Epidemiology 1,000
Pinellas County Health Dept.
Entomological Research Laboratory Basic Studies
Entomology 155,000
Experimental Analysis of Migratory Behavior
NIH, U.S. PHS 20,000
Entomological Research Laboratory
Comparative Analysis of Gregarian Behavior
NIH, U.S. PHS 19,500
Entomological Research Laboratory
Biology of Brackish-Water Larvivorous Fish
NIH, U.S. PHS 14,000
Entomological Research Laboratory
Prevalence of Congenital Heart Disease among children in
State School for Blind
School of Aviation Medicine, Pensacola
Heart Disease Control 2,500
Therapy in Ambulant Hypertensive Patients
Duval Medical Center
Heart Disease Control 3,600
Incidence of Recurrence in known Rheumatics with and without prophylaxis
Florida Heart Association 600
Heart Disease Control 2,500
Mental Health Research
Council for Training and Research in Mental Health 29,000
Various agencies
Volusia County School Mental Health Demonstration
National Institute of Mental Health 17,000
Mental Health and Volusia County H.D.

10 ANNUAL REPORT, 1957

Home Care of the Mentally Retarded Child
Children's Bureau 40,000
Dade County Health Dept.
Health Service for Migratory Agricultural Laborers
Children's Bureau 54,900
N.C.H. and Palm Beach County Health Dept.
Demonstration Program for the Care of the Premature Infant
Children's Bureau 50,000
M. C. H. and Jackson Memorial Hospital
The Characteristics of Nursing Home Populations
University of Miami Medical School 3,600
Dade County Health Dept.
Bureau of Mental Health 7,000
Time and Cost Studies of Public Health Nursing
Regional Office U.S. PHS consultation
Nursing Division, Alachua & Pinellas
County Health Depts. 1,000
Differentials in Male-Female Mortality
NIH, U.S. Public Health Service 10,000
Administration
Organization and Administration of Public Health Research
NIH, U.S. PHS 22,000
Administration

SCHOLARSHIPS FOR PROFESSIONAL EDUCATION
The Florida State Legislature, in 1955, created three scholarship
programs which are administered by the State Board of Health.

Ten scholarships for the study of medicine are awarded each year
upon the recommendation of a scholarship committee consisting of the
deans of Florida's two medical schools and five physicians, designated
by the President of the Florida Medical Association. This committee,
in 1957, consisted of the following: Dean Homer F. Marsh, University
of Miami; and Dean George T. Harrell, University of Florida, who
served as ex-officio members. In addition, the following physicians were
members of the Committee: T. Z. Cason, Jacksonville; Homer L.
Pearson, Jr., Miami; John Milton, Miami; James T. Cook, Jr., Mari-
anna; and Melvin D. Simmons, Sarasota.

Ten scholarships for the study of dentistry are awarded each year
upon the advice of the State Board of Dental Examiners. The following
dentists (members of the Board of Examiners) served on the 1957 com-
mittee: Frank T. Scott and R. P. Taylor, Jr., Jacksonville; D. J.
Zimmerman, Ft. Myers; Richard Chace, Orlando; F. A. Finley, St.
Petersburg; J. N. Pepper, Pensacola and F. F. Farver, Miami Beach.

Upon the recommendations of the Florida Council on Training and
Research in Mental Health, scholarships or stipends, may be awarded
each year for the training of five residents in psychiatry, six interns in
clinical psychology, five psychiatric nurses and thirteen psychiatric social
workers.

GENERAL SUMMARY 11

A fourth scholarship program administered by the State Board of
Health stems from the Federal Social Security Act of 1935. This pro-
gram makes available federal funds to provide stipends to employees
of the State Board of Health and its affiliated county health departments
for specialized professional training. Great emphasis has been placed
for many years on the training of the Board's permanent employees who
show promise of professional growth.

Persons receiving scholarships in 1957 were:

MEDICAL

Robert E. Allen, Jr. ...Ft. Lauderdale
Ernest Austin ..................Lake Wales
David M. Bleech ..................Pahokee
Hoyt Horne ......................Lake City
Edwin K. House, Jr ....Pomona Park
John Franklin
Mason, Jr. ...................Jacksonville

Ronald J. Scheib ..............Hollywood
Leonidas M. Turner, Jr. ........Tampa
Joseph A. Walton, Jr. ..Crescent City
Robert A. Walton..Fernandina Beach
Richard B. Welch ..West Palm Beach

DENTAL

Richard K. Ames ........Daytona Beach
Jay Brenner ..................Coral Gables
Robert H. Carter .................Tampa
William H. Filler ..................Miami
Robert B. Hayling ............Tallahassee

Peter B. Mills ............................Miami
Bennie Thompkins ....Daytona Beach
Harold T. Wilson ................Pensacola
Lester C. Young ................Tallahassee
Robert W. Butler ...............Live Oak

MENTAL HEALTH

RESIDENTS IN PSYCHIATRY
Richard S. Wolf, M.D.
Wilford M. Provo, M.D.

RESIDENT IN CHILD PSYCHIATRY
Evan Katz, M.D.

CLINICAL PSYCHOLOGY

Laurence T. Carroll, Jr. ........Miami
John G. Iosak ....................Gainesville
Ann S. McColskey ............Gainesville
Shirley Miller ....................... Miami

Thomas D. Prutsman..Ft. Lauderdale
Eve Lyn Weeks ............Coral Gables
Betty Whitney ..................Hallandale
Charles F. Williams ..............Miami

PSYCHIATRIC NURSING

Elizabeth W. Bradley....Chattahoochee
Alfreda R. Clark ..................Miami
Margaret Dairwinn ....Chattahoochee

Betty Land ......................Jacksonville
Tressa Roche ..........................Bartow

PSYCHIATRIC SOCIAL WORK

First Year
Allan W. Russell..............Jacksonville
James P. Love ................Jacksonville
Robt. G. Marshall........St. Petersburg
William E. Neet ............St. Petersburg
Andre L. Johnson ............Tallahassee
Yvonne Moreno ........................Miami
Eldredth Melton ........Ft. Lauderdale
Raymond L. Logue ....St. Petersburg
Carolyn Collins ................Jacksonville

Second Year
Arthur W. Bothman ....St. Petersburg
Lillian R. Craigo ....................Ruskin
David N. Hansen, Jr...Ft. Lauderdale
Naomi Knepper ....................Sarasota
Donald Steiss ...........................Tampa
Martha Watkins ...................Sebring
Grace Bivans ............................Miami

12 ANNUAL REPORT, 1957

PUBLIC HEALTH PERSONNEL
David L. Crane, M.D................Health Officer...............Dade County
Charles W. Long, Jr., M.D..........Health Officer...............Bureau of Local Health
Service
*T. W. Weeks, Jr., M. D.............Health Officer...............Highlands-Glades-Hendry
Margaret H. Dorman...................Public Health Nurse.....Pinellas County
Grace M. Gallagher......................Public Health Nurse.....Dade County
Hazel A. Key...............................Public Health Nurse.....Sarasota County
Lola Lee Lake................................Public Health Nurse.....Polk County
Virgie M. Pafford..........................Public Health Nurse.....Alachua County
Anna J. Sawyer..............................Public Health Nurse.....Monroe County
William J. Farrell.......................Sanitarian................St. Lucie County
Charles W. Holmes.......................Sanitarian................Sarasota County
John O. Welke...............................Sanitarian........... .....Dade County
Jack R. Wilson.....................Sanitarian............ Pinellas County
Vincent D. Patton.........................Sanitary Engineer..........Bureau of Sanitary
Engineering
Esther J. Smith..........................Mental Health Worker.Bureau of Mental Health
Withdrew 11/18/57 on account of ill health.

PERSONNEL OFFICE
ROBERT G. CARTER,
Acting Personnel Officer

The year 1957 was a significant one for the Personnel Office, with
the advent of the Merit System's new Pay and Classification Plan going
into effect on July 1. Continuing progress in the field of personnel
administration was noted during the year. In keeping pace with the
rapid growth of the organizational strength of the State Board of
Health, the Personnel Office expanded in size and function so as to
maintain the utmost efficiency and service to all units of the agency.

Colonel Paul T. Baker retired after twelve years of diligent service
as the State Board of Health's first official Personnel Officer. His
thoughtfulness and willing manner will be missed by all.
The Personnel Office increased its staff with a new Personnel Techni-
cian and the placement of a new Personnel Officer in the Bureau of
Local Health Service to meet the increasing needs of the county health
units.

The Merit System's new Pay and Classification Plan was put into
effect on July 1. All employees working under the Merit System at that
time were brought into the new plan with the Minimum Implementation
Formula, which was designed to adjust salaries in accordance with the
new class specifications for each position.
A referendum regarding Federal Social Security was held on Novem-
ber 25, 1957 for all state employees participating in the State' and

GENERAL SUMMARY 13

County Officers' and Employees' Retirement System. The referendum
passed by a majority vote, thereby bringing about the inclusion of
Federal Social Security with State Retirement. All employees were
given the opportunity of choosing between State Retirement with Social
Security and State Retirement without. Approximately 1,174 of our
employees chose to include Social Security with their State Retirement,
and employees of that group who were participating in the Retirement
System on January 1, 1956 received Social Security coverage retroactive
to that date.
Recruitment was vigorous throughout the year, thereby enabling the
State Board of Health to obtain much needed professionally trained
personnel to staff our expanding organizational structure in line with
Florida's rapidly increasing population. However, some vacancies were
existent during the year in the various professional classifications: health
officers; psychiatrists; clinical psychologists; mental health workers;
psychiatric social workers; public health nurses; sanitary engineers and
sanitarians. Shortage in these classifications was created by lack of
qualified applicants and the existing salary ranges in competition with
the wage scale of private industry. Fortunately, the sub-tropical climate
and other advantages of this state are attracting large numbers of new
residents and our recruiting problems are considerably less difficult than
is the case in many neighboring states.

During the latter part of the year, the Personnel Office was trans-
ferred from the Bureau of Finance and Accounts to the office of the
State Health Officer because of the increasing importance of personnel
administration and the responsibility of the Personnel Officer to the
State Health Officer.
Throughout the year, personnel records were continually kept on
employment and terminations, classifications, service ratings, leave,
history data, and various other functions pertaining to personnel matters.

Records of in-service and postgraduate training of employees were
maintained and the application of regulations governing such training
was insured.
Prompt action was taken after each Merit System examination to
regularize the Merit System status of each provisional employee. Em-
ployees were notified without delay, upon attainment of permanent
status.
At the end of the year, sixty-six of the state's sixty-seven counties
had organized county health departments, which were operating under
the Merit System.
On December 31, 1957, there were 1735 state employees (including
those in county health departments) and 16 Federal employees on loan
to this agency. On December 31, 1956, there were 1584 state employees
and 17 Federal employees.

14 ANNUAL REPORT, 1957

During the year, there were 555 employment and 404 separations,
including part-time personnel. The principal reasons for separations
include marriage, pregnancy, transfer of husbands from the area, com-
pletion of projects for which employed and acceptance of more profitable
employment elsewhere.

TABLE 1

NEW EMPLOYMENT, SEPARATIONS, AND

TURNOVER RATES BY CLASSIFICATION

New
Classification Employment Separations Turnover

Total 555 404 24.34%
Health Officers 22 25 39.68%
Sanitary Engineers 9 2 7.14%
Sanitarians 47 25 11.06%
P. H. Nurses 101 59 13.35%
Clerical 157 143 35.48%
Other 219 150 29.01%o

*Turnover Rate-Separations Divided by Average Number of Employees

On December 31, 1957 the Merit System status of
of Health personnel was as follows:

Permanent and Probational
Provisional
Temporary
Emergency
Exempt and Part-time
TOTAL

the State Board

1,398
69
0
25
243
1,735

Postgraduate training on a stipend basis for one full academic year
was successfully completed during 1957 by 4 health officers; 4 public
health nurses; 4 sanitarians; 1 health educator; 1 biologist; and 1
statistician.

TABLE 2
DISTRIBUTION OF PERSONNEL-STATE BOARD OF HEALTH
(OTHER THAN COUNTY HEALTH DEPARTMENTS)
DECEMBER 31, 1957

i.- U :

Bureau or Division
40 ox r- '

e o the State Health

officer .. ... .. ... ........... 3 9 1 2 15
Administration Personnel ..................... ........ 9 19
Total ................................ 3 18 1 24
Dental Health ...................................... 2 1 1
Finance Fiscal .............................. 11 1
Accounts Total ................................. 19 14 8 41
Health Information ................................... 1 1 2

Orlando ............................ 3 3 7
Laboratories Pensacola ..3.. 1 2 6
STallahassee ....... 3 1 2 6
Tampa ..........................10 2 6 1 19
West Palm Beach .................. 4 1 1 6
Total 77 15 31 4 1 129
rBureau ............ 3(a) 2 7 12
Local Health PH Nursing .................... 5 2 7
Service Inservice Training .. ......1 1 1 3
Total ............................. 3 6 3 10 22
Maternal and Child Health .......................... 4 1 1 4 1 2 4 17
Mental Health ................................. .... 7 9 2 19
Narcotics .3 8 11
(Bureau ........... .............. 2 1 5
Industrial Hygiene .............. .... 2 1 4
Preventable )Tuberculosis Control ................. 1 9 12 22
Diseases Venereal Disease Control ............ 3 4 9 16
Veterinary Public Health............. 2 2 1 1 6
Total ............................... 4 2 2 17 18 10 53
Sanitary Engineering .................... ......21 6 4 14 7 1 1 54
Bureau and Hospitals and 2 1 6
Special Health Nursing Homes ..................... 2 1
Services Chronic Diseases ..................... 5 1 2 9
Nutrition ............................ 5 1 6
t Total ............................... 1 5 8 3 3 1 21
Entomology .........................................2 2 1 7 5 49 66
Vital Statistics 3 43 11 57
Grand Total ........................... ... 11 11 2 23 14 84 4 5 3 172 51 123 16 12 531
(a) One on Academic Leave

16 ANNUAL REPORT, 1957

TABLE 3

DISTRIBUTION OF PERSONNEL IN COUNTY HEALTH
DEPARTMENTS DECEMBER 31, 1957

COUNTY

0
o -o a *s^

10>
L7 r i 0 4.
S~ gg a -i l e-
~~" Z0~- -
B "~~ 5 *3 Ln "w u
a o.% ti *8 *a o a 8

.& I .00 f -- g O
iU) U) ui~ a i_

Alachua ........... 2 13 5 6 1 3 4 34
Baker ............. 1 1 3
Bay ............. 1 7 4 2 3 1 18
Bradford .......... 2 1 1 1 5
Brevard ........... 1* 6 2 1 2 2 14
Broward ..........1 15 1 1 8 10 1 7 3 47
Calhoun ........... 1 1 1 1 4
Charlotte .......... 1 1 1 3
Citrus ........... .. 1 1 1 2 1 6
Clay .............. 1* 3 2 1 1 8
Collier ............ 1 2 1 1 5
Columbia .......... 2 2 1 1 6
Dade ............. 6(a) 89 1 3 43 1 35 5 6 13 1 203
DeSoto ..1 1 1 1 4
Dixie ............. 1 2
Duval .............1 12 6 1 4 1 7 4 36
Escambia ..........2 13 8 12 1 4 6 1 47
Flagler ............ 1 1 3
Franklin 1. 1 1 1 1 5
Gadsden ........... 1* 5 2 2 1 1 12
Gilchrist ..........1 2
Glades ........... 1
Gulf ..............2 1 1 1 5
Hamilton .......... 1 1 1 1 4
Hardee ............ 1* 2 1 1 5
Hendry .........1 1 2
Hernando ...1 1 2
Highlands ......... 2* 2 2 1 1 8
Hillsborough ....... 5 43 1 2 23 1 23 16 24 9 147
Holmes ....2 1 1 1 5
Indian River ...... 3 1 1 5
Jackson ........... 5 2 2 1 10
efferson .......... 1 1 1 1 4
Lafayette ..1 1 1 3
Lake .............. 1 5 3 2 1 12
Lee ............... 1 5 2 2 1 11
Leon .............. 2 8 4 7 2 8 1 32
Levy .............. 2 1 1 1 5
Liberty ............ 1 2
Madison ........... 1 2 1 2 1 7
Manatee .......... 1 4 3 1 4 3 1 17
Marion ............ 1 4 2 2 1 1 11
Martin ............ 2 1 1 4
Monroe ........... 1 6 2 3 2 2 1 17
Nassau ............ 3 1 1 1 6
Okaloosa .......... 1 3 2 2 1 9
Okeechobee 1 1 2
Orane ........... 14 1 7 12 12 3 49
Osceola ........... 2 2 1 1 6
Palm Beach ....... 1 17 1 1 9 13 2 9 3 2 58
Pasco .............1 2 1 1 5
Pinellas.:::::: : 4 38 1 1 21 1 1 24 3 6 2 102
Polk ............... 2 25 1 1 10 1 13 1 5 5 64
Putnam ........... 1 3 1 1 3 9
Santa Rosa ........ 3 1 1 2 7
Sarasota ........... 1 10 5 5 2 1 24
Seminole .......... 1 3 2 1 2 9
St. Lucie .......... 1* 2 4 2 1 1 11
Sumter ............ 1 1 1 1 4
Suwannee ......... l* 2 1 1 1 6
Taylor ..... 1 1 1 1 4
Union .. .......... 1 1 1 3
Volusia ............ 1 16 1 6 1 5 2 7 2 41
Wakulla ......1 1
Walton ............1* 2 1 2 1 1 8
Washington ........ 2 1 1 1 5
Total ......... 50 432 8 9 223 4 4 238 39 122 87 4 1220
*Serves two or more counties-See Roster of County Health Officers.
(a) One on Academic Leave.

GENERAL SUMMARY

TABLE 4

TERMINATIONS AND TURNOVER RATES BY CLASSIFICATION
FOR THE FLORIDA STATE BOARD OF HEALTH AND COUNTY

HEALTH UNITS, CALENDAR YEAR 1957

(FULL-TIME EMPLOYEES ONLY)

SALARY

CLASSIFICATION Un-
Total der 150- 200- 250- 300- 400- 500- 600- 700- 800-
150 199 249 299 399 499 599 699 799 Plus
TERMINATIONS 1957
Total All Employees...... 341 6 85 74 64 73 14 3 9 6 7
Physicians ................ 17 5 5 7
Sanitary Engineers ........ 2 1 1
Sanitarians .............. 24 7 15 2
Public Health Nurses...... 55 27 25 3
Prof. Laboratory Workers.. 13 2 6 4 1
Clerical, Admin. & Fiscal.. 128 52 53 16 7
All Others ................ 102 6 33 19 8 22 8 3 3
TURNOVER RATE (ANNUAL PERCENTAGE)
Total All employees...... 21.8 52.2 54.3 30.8 20.0 13.6 9.7 5.8 28.6 25.5 14.1
Physicians ................ 28.1 62.5 52.6 16.3
Sanitary Engineers ........ 6.7 15.4 18.2
Sanitarians ............... 10.7 29.2 11.1 3.8
Public Health Nurses...... 12.9 18.3 12.4 12.8
Prof. Laboratory Workers.. 15.4 12.9 41.4 14.8 7.7
Clerical, Admin. & Fiscal.. 31.4 73.8 31.5 15.8 13.1
All Others ................ 30.8 57.1 41.3 35.5 24.6 32.4 19.0 15.0 20.7

18 ANNUAL REPORT, 1957

DIVISION OF HEALTH INFORMATION

ELIZABETH REED, R.N., B.S.
Director

There is more interest than ever before in health education and in
employing health educators for the staffs of county health departments.
At the end of the year two vacancies for health educators in county
health departments existed, and several more counties made inquiries
concerning the feasibility of employing one. The concern with chronic
disease and mental health programs has pointed up the fact that only
when health education is considered an integral part of the program, will
they be successful.
An intensified effort was made to be of more service to the various
bureaus and divisions this year and to complement their activities with
this division's special services.
It is hoped that eventually the mental health worker program will
be more closely allied to the activities of this division, since many of
their opportunities lie in the field of health education. Assistance was
given them in the supplying of certain materials, as well as orienting
them to the services available to them. This desirable liaison will be
further strengthened in 1958.

AUDIO-VISUAL AIDS
An increasing amount of time was given to assisting various personnel
of the State Board of Health and the county health departments in plan-
ning specific sanitarian trainee and orientation programs, technical
assistance to TV programs, and previewing new materials. The heart
disease control program was assisted by the circulation of professional
materials for physicians. A more efficient method of record keeping
was instituted in an effort to meet the constant demand for audio-visual
materials.
The following figures give an indication of the activities:
Number of aids circulated 5,264 (3 per cent increase)
Number of times aids were
used 11,671* (5 per cent decrease)
Number of persons in
audiences 651,888* (2 per cent decrease)
Estimated. Report cards are not received from all borrowers.
Not included in the above figures are:
13 films used in telecasts seen by an estimated 500,000.
44 radio transcription discs heard by approximately 1,800,000.

HEALTH INFORMATION

An effort was made to stimulate interest in audio-visual materials
other than 16mm films. However, motion pictures still constituted 89
per cent of the total circulation.
The budget for audio-visual aids is still not a realistic one. Over
50 per cent of all films in 1957 were purchased by other bureaus and
divisions. Since all of these were categorical funds, the inevitable con-
sequence is that some subjects are much better represented in the
library's collection than are others who do not have the benefits of such
"windfalls."
Repairing and cleaning of projection equipment and loaning items
to State Board of Health and county health department personnel con-
sumes much time. Over 300 requests were made for this service.
As usual, the summer months are spent in cleaning up and inventory
and 40 aids were removed from circulation because they were damaged,
obsolete, surplus or recalled by the agency issuing them.

EXHIBITS CONSULTANT
During the past year the exhibits consultant averaged better than
one-per-day-of-work units consisting of exhibits, displays, signs, charts,
maps, etc. (total of 296) plus 40 conferences, 16 field trips, assisting
with exhibits at 11 fairs and meetings. This was in addition to talks,
movie showings, assisting with a television series and other routine duties.
Activities were stepped up because the consultant took over many of
the duties of the part-time artist who resigned and whose position was
abolished. Free lance artists do special assignments.

HEALTH NOTES
There seems to be an ever-increasing interest in Florida Health Notes,
a monthly bulletin (10 times a year). The mailing list continues to
grow. During 1957 the following subjects were discussed: mental health,
overweight, chemistry laboratory, health of school children, vital statistics,
meat, trailer parks, civil defense, county health departments and a sim-
plified annual report.
A writer was employed to assist with Health Notes as well as other
publications. It is hoped that even more attractive and useful materials,
through the use of effective modern methods of layout and design, will
be the result of his employment.

LIBRARY
BARBARA J. BECKNER, B.A., M.S.L.S.
Librarian
Highlights of 1957 were the arrival of a long-awaited charging desk
and the formation of a library committee to act in an advisory capacity

20 ANNUAL REPORT, 1957

to the librarian. Decisions reached by the committee were:
1. Limit holdings of any journal to the last 25 years.
2. Defined the purpose of the library.
3. Assigned to the various bureaus and divisions specific amounts
of money that could be spent in purchasing special interest
library materials.
Monthly list of additions to the library were sent to all bureaus and
divisions and county health departments .. Medical Library Exchange
of duplicate journals and books were mailed to 36 states and six foreign
countries for a total of 896.
Circulation for 1957 was: books, regular loan, 1511; indefinite
loan, 1830; periodicals, 9914; pamphlets, 126; total, 15,481. The library
borrowed 72 items from other libraries and loaned them 19 items. The
National Library of Medicine loaned this library 16 microfilms and 10
photostats.
Answering all types of questions from "Can you give me the address
of Dr. Blank in Savannah, Georgia?", to "Please prepare a bibliography
of all the articles written in the past 10 years on the tranquilizing drugs,"
kept the staff busy. Over 1760 reference questions were answered and
35 bibliographies compiled.
A total of 1163 books were cataloged and added to the library last
year. Various bureaus and divisions were asked to check over the books
in their field that were in the library and pull out those they thought
were too old to be of any value to the library. Thanks to their splendid
cooperation, 876 books were withdrawn. Added to the vertical file, were
314 pamphlets. The number of books and bound journals in the library
at the end of 1957 was 14,274.

PAMPHLETS
Pamphlets are still a popular source of health information, and it is
hoped, of assistance to health education, since approximately 250,000
were distributed in 1957. Mental health leads the list as it has done now
for several years. New pamphlets are added as the need arises. Approxi-
mately 10 "standard" pamphlets were revised and reprinted in 1957.

PRESS SECRETARY
The duties of the press secretary are, as the title implies, to handle
relations between the State Board of Health and the news media repre-
sented by the newspapers, wire services, and television and radio stations.
Besides writing news releases for general distribution and for selected
publications, the press secretary was called upon a number of times to
cover or assist in such meetings as the Florida Public Health Association
Convention and the Postgraduate Obstetric-Pediatric Seminar in Day-

HEALTH INFORMATION 21

tona. Assistance was also given in the preparation of Health Notes,
the Florida Intelligencer (a newssheet for personnel), various pamphlets
and radio and TV scripts. The press secretary gave a number of
talks on press relations before orientation groups and sanitarian classes.
A large number of photographs were taken. Several articles were pre-
pared on request for technical publications.

OTHER ACTIVITIES

ORIENTATION PROGRAMS
Mrs. May Pynchon, part-time health educator on the staff of the
Bureau of Maternal and Child Health, reviewed and revised the orienta-
tion program during the latter part of the year. An endeavor was
made to improve the format and presentation of these highly valuable
sessions. A long waiting list is now on file of employees of county health
departments and the State Board of Health, and related agencies, who
wish to attend. Four orientation programs of three days, and two
one-day affairs were held.

WORKSHOPS
Two of the staff assisted the psychologist-consultant of the Bureau
of Maternal and Child Health in the conduct of a number of workshops
on human relations and leadership training. (See the report of this
Bureau elsewhere in this volume.)

TEACHERS' PROJECT
The second "Teachers' Project" was initiated in the summer of
1957. (See the 1955 Annual Report). Mrs. May Pynchon headed up
this activity, assisted by members of this division's staff. Twenty-six
teachers from 14 counties participated, attending one of the following
universities: Florida State University, University of Florida or Univer-
sity of Miami. During the four-weeks' project, the participating teachers
spent over two weeks in their home counties, learning about the activities
of the county health department and related health agencies in their
communities. Plans were made to expand this program in 1958.

FOREIGN VISITORS
Twenty-four visitors from foreign countries were received last year.
Assistance was given in planning for their experience or trips while in
the state. These students came from fifteen different countries and
presented a variety of public health backgrounds.

22 ANNUAL REPORT, 1957

TV
The division jumped into the TV-producing field by being re-
sponsible for seven one-half hour shows on a newly-opened station and
assisting and consulting with those responsible for the six other programs
in the 13-week schedule. The disproportionate amount of time required
to use this media caused it to be abandoned temporarily while the staff
caught its breath. Plans have been made to use the new community
station in Jacksonville (WJCT) when it opens in the spring of 1958,
as well as to use the commercial stations for one-shot infrequent pre-
sentations.

RADIO
Radio transcription discs were prepared with 24 spot announcements
on them concerned with a variety of Florida's health problems. The
voices were members of this division's staff. They were then offered
to specific county health departments. Apparently they have had wide
usage. It is anticipated that more will be prepared in 1958.

MISCELLANEOUS
As usual, the director and the staff health educator engaged in
many other activities. They attended meetings of voluntary and official
health agencies, professional organizations, PTA's, educational asso-
ciations, teachers' groups, civic clubs, etc. The director appeared
before numerous groups as a speaker. Consultative visits were made
to the five local health educators. A meeting was held with this group
in February and it is planned to make it an annual affair.
Articles by staff members:
Reed, Elizabeth. Continuity in Nursing Care. R.N. 20:58-59, June
1957
Fulton, David K. Quarantine with Shotguns. Dickey Data. Vol.
17 #1

LOCAL HEALTH SERVICE 23

BUREAU OF LOCAL HEALTH SERVICE

GEORGE A. DAME, M.D., Director
WADE N. STEPHENS, M.D., M.P.H.,
Assistant Director

ORGANIZATION
The organization of the county health units remains the same as
it was last year. There are nineteen single county units, eight two-
county units, nine three-county units and one four-county unit. St.
Johns County remains the only one of the sixty-seven that does not have
a health department. In late 1956 and early 1957 a sanitarian and a
stenographer were employed by St. Johns County. This is a great step
forward, but it is not a county health department under the meaning
of the enabling act.
At the end of the year there were twelve hundred sixteen employees
on the payroll of the sixty-six county health departments. This repre-
sents an increase of seventy-one over last year.

INCREASE IN FUNDS
This increase in the number of employees resulted in improved
public health programs throughout the state. It was made possible by
larger state and local appropriations.
An increase in funds by the legislature from $1,250,000 to $1,750,000,
earmarked for county health units, resulted in allocations to the counties
on a basis of 101.36 per cent of the master formula, a gain of 22.86
per cent over the previous year.
The total budget for all county health units amounts to $6,302,367
or $1.647 per capital, of which the counties contributed $4,084,479 or
$1.067 per capital, the state $2,022,832 or 52.8 cents per capital (includes
State Mental Health Funds), and federal funds amounting to $195,056
or 5.09 cents per capital. The population estimate used was prepared
by the Bureau of Vital Statistics as of July 1, 1957.

MERIT SYSTEM
The new Merit System was installed July 1, 1957. Almost every
employee received a salary increase at this time. The difficulties that
are inherent in changing over from a Merit System based largely on
individual ability to one based on allocation of positions with reference
to population served and number of employees were encountered. In
spite of the salary increases, the fact that promotion was made more
difficult resulted in a great deal of discontent among county health

24 ANNUAL REPORT, 1957

department employees. Some resigned on this account. For example,
four county health officers resigned to take positions in other states, and
one to go into private practice. Two of these gave Merit System regu-
lations as their reason for leaving, and the others named this as a contri-
butory factor. These were all among our better men. Three of them had
received Master's degrees in Public Health at state expense.
The new Merit System provides less flexibility in starting salaries
than was possible under the old system. This has resulted in increased
difficulty in recruitment in practically all categories. At the end of 1957,
for example, there were four county health units without health officers.
The Columbia-Hamilton-Gilchrist Unit has been vacant since June 30,
1957; Calhoun-Jackson since July 8; Orange since September 1; Nassau-
Baker since October 1. The principal reason for delay in filling the
positions is that starting salaries were too inflexible.
As this report is being written, increased starting salaries for most
health officers have been granted by the Merit System. There is every
indication that as times goes on other controversial points will be settled
by discussion, and the Merit System will protect both employee and em-
ployer as was intended by the Governor and the Legislature.

MIDWIVES ON THE DECREASE
When the last midwife in Citrus County ceased to practice during
1957, there were seven counties in the state without midwives. These
counties have enough doctors and hospitals to take care of all the
births. It is hoped that eventually the same will be true of all the
counties.

TRAINING
During 1957 three groups of sanitarians were given the twelve week
training course which a year earlier had been moved to Jacksonville.
There were seven, four and seven sanitarians respectively in the classes
from the following twelve counties: Alachua 2, Dade 4, Duval 1,
Escambia 1, Flagler 1, Madison 1, Orange 1, Osceola 1, Pinellas 1, Polk
3, Seminole 1, Volusia 2. In addition a sanitarian from the Kingdom of
Jordan spent a short time training with one of the groups.
The first eight weeks of training were in Jacksonville. During this
time one of the sanitation consultants devoted full time to training
activities. The other two staff sanitation consultants and selected mem-
bers of the Board of Health staff helped to make the training fruitful.
The final four weeks of training were used as an internship for the
sanitarian trainees. Each one spent two weeks in a large county, a week
in a medium sized county and a week in a small county. During the
period in the counties the trainees operated as members of the health
units, profiting from the association with the unit staff members. Six

LOCAL HEALTH SERVICE

counties cooperated: Dade, Levy, Palm Beach, Pinellas, Polk and
St. Lucie.
During the year permanent quarters, adequately furnished, were
provided for the sanitarians training course for the first time. In
addition more adequate living allowances were given the trainees.
Adjustments were made in the format of the training to give the sani-
tarians in training more basic science to cover gaps in their previous
academic pursuits.
Eight nurses attended the training center in Alachua County in two
groups of three and five respectively. They were from the following
seven counties: Alachua 1, Bay 1, Escambia 2, Hillsborough 1, Lake 1,
Nassau 1 and Polk 1.
Special training was provided for the nurse director of training
and for the staff nurses of the Alachua County Health Unit in order
to improve the quality of teaching. This was accomplished with the
assistance of the University of Florida Center for Clinical Services.
The training program was changed to allow the director to work
more closely with individual Nurse trainees to increase the potential of
their native skills. Instruction in human relations and participation in
specialized programs were emphasized, remaining always within the
framework of the generalized public health nursing program. The use
of trainees to provide Services was reduced.
There was no organized pre-employment or on-the-job training for
health officers during 1957. It. is hoped to remedy this deficiency in
1958.

HEALTH OFFICERS CONFERENCE
The tenth annual Health Officers Conference with the State Board
of Health was held February 11, 12 and 13. The following officers
were elected for the coming year: Dr. Chester L. Nayfield, Chairman;
Dr. James F. Speers, Vice-Chairman, Dr. Warren T. Weathington,
Secretary. The following Chairmen of Committees were appointed:
Dr. Edward G. Byrne, State-Local Relations; Dr. Norman B. Edgerton,
Preventable Diseases; Dr. Wayne Yeager, Maternal and Child Health;
Dr. Warren T. Weathington, Records; Dr. Merwin E. Buchwald,
Environmental Sanitation; Dr. Frank DiTraglia, Public Health Nursing;
Dr. William C. Ballard, Special Health Services; Dr. Henry I. Langston,
Mental Hygiene.

POSTGRADUATE TRAINING
The following health officers received the degree Master of Public
Health in June, 1957: Dr. William C. Ballard, Tulane University; Dr.
J. Dillard Workman, University of North Carolina; Dr. Johnson L.
Turnage, Tulane University; Dr. John S. Neill, Johns Hopkins Univer-
sity.

26 ANNUAL REPORT, 1957

There are now 23 county health officers and two assistant health
officers who have had this training.
In September these health officers left to take postgraduate training:
Dr. Charles W. Long, University of North Carolina; Dr. T. W. Weeks,
University of North Carolina; Dr. David L. Crane, Tulane University.
Dr. Weeks was forced to leave school in November because of poor
health.
Four sanitarians are currently taking postgraduate training in public
health leading to the Master of Public Health degree and will return
to their respective counties in June 1958.
Six nurses are currently taking postgraduate training at schools of
public health and will return to their respective counties in June 1958.
In addition one nursing consultant from the Division of Public Health
Nursing is currently attending a school of public health.

NEW DIPLOMATS
During 1957 Dr. Paul W. Hughes, Dr. Chester L. Nayfield and Dr.
Wade N. Stephens received certificates from the National Board of
Preventive Medicine. Twelve of Florida's county health officers are
now diplomats.

RESIDENCIES IN PUBLIC HEALTH
Palm Beach County was approved as a residency training area
November 1, 1957. There are now five counties in Florida where young
doctors can receive approved early on-the-job training in public health.

NEW DEVELOPMENTS IN THE BUREAU
The Food Handlers Training Program was transferred from the
Bureau of Sanitary Engineering to this bureau on July 1, 1957. The
first course under the direction of the consultant staff was given at the
Southwest Florida Tuberculosis Hospital on December 10, 1957. It is
hoped to develop a flexible and modern course for food handlers,
organized and staffed locally with materials and consultation from this
bureau.
Five counties are already operating permanent training courses for
food handlers. A total of 5653 food handlers were issued certificates for
attendance at these schools during the year.
The consultant staff, in cooperation with the nursing consultants,
the Bureaus of Laboratories and Mental Health, undertook an evaluation
of all services given by the Volusia County Health Department at the
request of its director. The report is not yet complete. This study will
be used as the basis for developing a plan for making short reviews
of individual health departments on request. The health officer can use
such a report to excellent advantage in future planning.

LOCAL HEALTH SERVICE 27

On September 1, 1957, Dr. Wade N. Stephens was appointed as-
sistant director of this bureau. He received his Master of Public Health
degree from Tulane University in 1953 and is a diplomat of the Ameri-
can Board of Preventive Medicine. He has been county health officer
in Flagler, Putnam and Orange Counties. Mr. Herman Leslie High was
employed as Personnel Officer in the bureau in October. He holds a
Master of Arts degree in Counseling Psychology from Florida State
University. These two new employees are already of great benefit to
the bureau.

COUNTY HEALTH DEPARTMENT ACTIVITIES
Many county health department directors reported unusual or out-
standing achievements during 1957. Some of these are included below.
It is worthy of note that many of these show increasing support for
higher sanitation standards by local governing bodies.

BRADFORD: A. Y. Covington, M.D., M.P.H.

"For the past twelve years our greatest problem in sanitation has
been an open garbage dump for the City of Starke. This situation was
corrected the past year through instigation of a Bradford County
Mosquito Control Program in cooperation with the State Arthropod
Program. With funds appropriated by both the City of Starke and the
Bradford County Commission, adequate equipment including a TD9
tractor, was purchased. We now have a sanitary landfill in the city,
operated in an approved manner. These funds also resulted in the
expansion of the present Mosquito Control Program.
The second largest problem has been inadequate sewage disposal.
This has been reduced by extension of present sewer lines for more
than six thousand feet in the City of Starke and installation of a new
lift station. A filter bed sewage system was installed in a new large
tourist court.
The town of Hampton started a sanitary landfill for garbage dis-
posal, financed by municipal funds under private contract. This project
will be improved during the next year in cooperation with the County
Mosquito Control Program.
Prior to 1957, there were no swimming pools in Bradford County,
but as of December there are now five approved filter tank type pools."

BROWARD: Paul W. Hughes, M.D., M.P.H.

"Major activities during the past year indicate a greater public in-
terest in health services on a wide front. Plans are being discussed by
leaders to provide public water, sewers, garbage collection and incinera-
tion on a county-wide basis. The largest city has now begun a multi-
million dollar expansion of its sanitary sewer system. Two cities are
actively concerned with slum clearance.

28 ANNUAL REPORT, 1957

Local health appropriations increased approximately 50 per cent.
A new expansile-type health building is to be constructed in 1958. The
Mobile Health Unit is operating full time serving outlying areas of the
county including a special program for migrant farm workers.
A Board of Health and Welfare was created in 1957. This board
meets regularly every three months to advise on policy matters."
CITRUS: Harold F. Bonifield, M.D., M.P.H.
"The County Health Department with offices in Inverness, is con-
tinuing to show evidence of public support. The Tuberculosis Association
and Cancer Society jointly purchased a film projector and screen, and
the Inverness Lion's Club has purchased a light meter. These will be
used in a continuing health education program.
The year 1957 ended the midwife program in the county. The last
two midwives have been retired because medical and hospital facilities
are now adequate. The county now participates in the state program for
Hospitalization of the Indigent.
The prospect of a sewage treatment plant for Inverness looks very
good at the present. The public, on a referendum, voted in favor of the
plant. A federal grant has been obtained and as soon as the final finan-
cial arrangements are made, construction should begin."
CLAY: A. Y. Covington, M.D., M.P.H.
"After prolonged study and many conferences, Clay County accepted
the offer of the State Board of Health to begin a combination nursing
service as one of the demonstration programs scheduled for three selected
rural counties in Florida. A Public Health Nursing Advisory Council
with county wide representation has been organized and is preparing
for incorporation. As soon as an additional qualified public health nurse
can be secured, nursing services will be expanded to include bedside
care in the home."
COLLIER: Joseph W. Lawrence, M.D.
"Through the cooperation of the State Board of Health, the Bureau
of Mental Health, the Collier County Health Department, the Collier
County School Board and the Collier County Mental Health Association,
we are hiring a Clinical Psychologist, full time, for the Collier County
Health Department. With the help of the present mental health worker,
we should be able now to give unusual service in the mental health field
in this County.
Through the cooperation of the Bureau of Maternal and Child
Health we have been able to employ a full time clerk, three nurses,
a local physician (on a fee basis) and an interpreter for our Immokalee
Office. We are now able to give much better service to this area of
Collier County and to its vast migrant population."

LOCAL HEALTH SERVICE 29

DADE: T. E. Cato, M.D., M.P.H.
"The Division of Research and Program Development was instituted
within this County Health Department on March 1, 1957. Dr. Michael
J. Takos, formerly Director of the Venereal Disease Control Division,
was appointed director.
Several projects are well under way. Some of them are as follows:
(1) An epidemiologic study of the inmates of Dade County nursing
homes; (2) Investigation of the causes underlying syphilis deaths in
this community; and (3) Epidemiologic study of coronary heart disease.
In November 1957, the Children's Bureau approved funds for
establishing the Dade County Clinic for Mentally Retarded Children.
This will be essentially a service program, but we expect to do research
studies in the area of mental retardation.
In the course of their regular visits to food warehouses, process-
ing plants, bakeries and other food establishments, sanitarians examine
food products for contamination, spoilage and insect infestation. Foods
found to be 'unfit for human consumption' are destroyed. Dade
County sanitarians condemned 291,028 pounds of various foodstuffs
during 1957. More than two-thirds of this total consisted of flour
and cereal products. Insect infestation, both larval and adult stages,
was the major reason for condemnation.
'Are You Safe In Your Home,' a project jointly sponsored by the
County Health Department and Board of Public Instruction reached
a climax during the month of December. Every sixth grade child (ap-
proximately 15,000) in our public schools received a leaflet having the
above title. With the assistance of their parents, the children used the
check list in the leaflet to inspect their homes for hazardous conditions."

ESCAMBIA: J. C. McSween, M.D.

"The County Health Department, as part of its educational program,
sponsors a weekly television program, 'Your Child', WEAR TV, 10
A.M., Monday, Channel 7. The program is conducted by Dr. Elsie
Broussard, who presents various phases of child growth and development.
Members of the Parent-Teachers Association, who attend four such
sessions, receive study group credit toward certificate of improvement in
their Association. Dr. Edward Flemming conducted two workshops,
prior to the beginning of the television series, on Child Growth and
Development for public health nurses who serve as resource consultants
to parent groups, the other on Group Discussion Leadership Techniques
for members of the local Parent-Teachers Association.
Miss Floreine Marshall of this department has been coordinator
of the Joint Rehabilitation Committee for Mental Health, sponsored
by the Escambia County Mental Health Association. Its aims are to
coordinate community agency services, both public and private for the

30 ANNUAL REPORT, 1957

mentally ill in this County. This should result in more comprehensive
rehabilitative services than would be possible by individual agencies
and avoid duplication of services. Represented on this committee are
the Mental Health Association, Health Department, Public Welfare
Department, Vocational Rehabilitation, Alcoholic Rehabilitation, State
Employment Service and the Veterans Administration."
HIGHLANDS: William F. Hill, Jr., M.D.
"There are several programs of which Highlands County is proud.
First is the intensive diphtheria immunization program throughout the
county as a result of several cases reported in the early part of this
year. Second is a blood typing and serology program among the colored
people for the establishment of a blood bank roll which was badly
needed, and third is an intensified school health program in the high
schools, including professional dental exams."
HILLSBOROUGH: Frank V. Chappell, M.D., M.P.H.
"By recognizing that patients from the State Mental Hospital, on
trial visits home, need the coordinated services of many health and
welfare agencies, we entered into a cooperative, coordinated planning
with the medical profession, the variously concerned courts of law and
other health and welfare agencies to meet regularly to discuss the role
that each plays with the patient, his family and his rehabilitation needs.
Through consultation service provided by the State Hospital, State
Vocational Rehabilitation Service, Florida State University, Florida
State Board of Health and U. S. Public Health Service, this
plan has evolved into a clearly defined organizational pattern to enter
into a demonstration project to be known as the Mental Health Resource
Council of Hillsborough County."
INDIAN RIVER: Neill D. Miller, M.D.
"The City of Vero Beach adopted the U. S. Public Health Service
Ordinance Regulating Eating and Drinking Establishments, and em-
powered the County Health Department to inspect and approve septic
tank installations before a certificate of occupancy is issued.
Through the combined efforts of our active Mental Health Associa-
tion and the Board of County Commissioners, an office was added to
the health department and the services of a part-time mental health
worker obtained. The nursing staff and the mental health worker
sponsored a Human Relations Workshop in which teachers, social work-
ers, hospital nurses, public health nurses and nursing home operators
participated. Mental Health was also the theme for the year for the
nurses monthly in-service study group."

JACKSON:
"A rural indigent heart clinic was initiated May 16, 1957 through the
interest of Dr. S. D. Doff, Director of the Heart Disease Control

LOCAL HEALTH SERVICE

Program, State Board of Health, Dr. James T. Cook, a private physician
of Marianna and Dr. Henry I. Langston, who was at that time Director
of Jackson County Health Department. Physicians on the staff of
Jackson Hospital are assisting in this program and the Board of County
Commissioners has furnished limited funds for the provision of free
medications to the clinic patients.
Indigent and medically indigent patients are admitted to services on
referrals by private physicians in the county or by the county health
officer. Services consist of a careful diagnostic evaluation and develop-
ment of a treatment regimen which is supervised by the public health
nurse under the direction of the physicians in charge of the clinic.
This clinic is held every Wednesday morning from 8 to 12 o'clock.
Follow-up of the patients is being done by the public health nurses."
LAKE: J. Basil Hall, M.D., M.P.H.
"This County Health Department has received much publicity during
the year. A paper published in the March 1957 issue of Medical Eco-
nomics and given the 1956 National Medical Economics Award, entitled
'We Pack'em In' was written by the director. Doctor Hall also had a
paper published in Volume 5, December, 1957 Nursing Outlook, entitled
'The Nurse in Environmental Sanitation'."
LEE: Joseph W. Lawrence, M.D.
"We are expanding our health department to four nurses, a nurse
supervisor and three sanitarians. This is improving our services to the
community and county.
We have an X-ray unit in the Ft. Myers office and can now X-ray
all tuberculosis contacts and health card applicants. This is a big
advance in our food sanitation program."
MANATEE: John S. Neill, M.D., M.P.H.
"1957 has been a banner year for the Manatee County Health De-
partment. Of many outstanding programs, two should be enumerated
as the most outstanding:
The creation of a License Board for Day Nurseries and Foster Board-
ing Homes should improve the condition of the children of this county.
We also embarked on a tuberculin testing program of the school
personnel followed by a chest X-ray of the positive reactors. This was
a gratifying joint effort of the Tuberculosis Association, school authori-
ties, private physicians and the health department.
We hope that this study will result in requiring teachers to have an
annual definitive check for tuberculosis.
We are also very proud of the nucleus of the Manatee County Public
Health Library which was made possible through a private gift.

32 ANNUAL REPORT, 1957

The addition of a Mental Health Worker to our staff should con-
tribute a great deal to our public health efforts."
MARION: Frank DiTraglia, M.D.
"The greatest contribution was in the extension of clinic services to
the rural area. On December 4, 1957, we opened the first rural clinic
in Marion County at Dunnellon, Florida. Plans are in existence to open
a rural clinic in the Reddick, Citra and Oklawaha areas."

MARTIN: Neill D. Miller, M.D.
"One of the foremost additions in the field of sanitation has been the
influx of large dairies from the Dade and Palm Beach County areas
resulting in our county becoming a leading dairy county in South
Florida. Careful supervision of barn construction and production of
milk has been maintained throughout the expansion.

The City of Stuart has empowered the health department to inspect
and approve septic tank installations before a certificate of occupancy
is issued."
MONROE: James L. Wardlaw, M.D., M.P.H.
"A Future Nurses Club was organized at the Key West High School
by the nursing division, and a course in mother and baby care was
taught to the group. It is a very popular activity and now has twenty
members.

Additional funds were secured and two additional nurses were added
to the staff in addition to the replacement for the senior nurse while she
is taking advanced training. An additional sanitation position is au-'
thorized but remains unfilled. A mental health worker was also added
to the staff.

Although funds were not available as anticipated for the construc-
tion of two health centers in the Keys, space was rented in the Marathon
Medical Center and a sub-center established there."

NASSAU:
"Plans for a sewer and water system for the City of Callahan moved
another step forward when the Nassau County Circuit Court on De-
cember 17, validated $350,000 in revenue bonds for financing the
project. The Federal Government has approved a grant of $38,790 to
be used toward construction of a primary treatment plant and pumping
station, and the city has accumulated about $40,000 from a utility tax
to apply toward the construction. Barring unforeseen delays the project
should be completed during 1958 and will be the culmination of ten
years of untiring effort by public spirited citizens of Callahan, the
County Health Department, and the Bureau of Sanitary Engineering.

LOCAL HEALTH SERVICE 33

The City of Fernandina Beach this year passed an ordinance out-
lawing all outdoor privies where water under pressure is available, and
by the end of 1958 the outdoor privy in Fernandina Beach should be a
thing of the past."
OKEECHOBEE: Neill D. Miller, M.D.
"This small county is rapidly becoming a leading milk producing
county because of the influx of large dairy herds from the Dade and
Palm Beach County areas. Careful supervision of barn construction
and the production of milk has been maintained throughout the year.
Milk production has increased 1400 per cent in this county during
the past year and we anticipate an even larger growth during the next
twelve months."

ORANGE:
"In late August 1957 the roof of the County Court House fell into
the Health Department Clinic Room during the noon hour, but no
one was injured. As a result the County Health Department has moved
twice, causing confusion and inefficiency in every program.
An existing school building was bought and extensively remodeled.
Now the health department has comfortable, modern quarters, with room
for considerable expansion.
The County Commissioners increased the health department appro-
priation by one-tenth of a mill, thus allowing the employment of more
personnel, with corresponding improvement in service."
PALM BEACH: C. L. Brumback, M.D., M.P.H.
"The Migrant Project got under way when the team was completed.
This team is composed of two public health nurses, a health educator,
a medical social worker, a nutritionist, a liaison worker and a secretary.
Dr. Earl Koos is the chief consultant, and together with Dr. R. W.
McComas, and local participants developed the plan which is now
being carried out with frequent additions and revisions. The project
is financed by the U.S. Children's Bureau, and representatives of
that agency, as well as the U.S. Public Health Service have taken an
active interest.
A special act passed the legislature providing for a countywide milk
ordinance based on the ordinance already in effect in West Palm Beach.
Another countywide ordinance was passed regulating frozen desserts,
including ice cream and related products.
Considerable work was done with other county representatives in
connection with the establishment of county zoning in May 1957.
Through these cooperative efforts a requirement was established through
which approval of a building site with regard to sewage disposal must
be obtained from the county health department prior to issuing a
building permit.

34 ANNUAL REPORT, 1957

The City of West Palm Beach completed its sewage treatment plant
and the town of Palm Beach completed its collection system and
ocean outfall. Voters in Belle Glade approved a sewage treatment
program which will overcome a major septic tank problem in that city.
Three large subdivisions completed the first phase of their sewage
disposal systems. Preliminary plans for sewage disposal systems have
been submitted by Riviera Beach and Lake Worth. These programs
have resulted from a great deal of educational work done during
recent years."
PINELLAS: William C. Ballard, M.D., M.P.H.
"Our plans this year, other than the promotion of the basic program,
including specific studies to determine if our county is meeting its needs
in mental health, tuberculosis, gerontology and public health nursing.
Many meetings, conferences, and studies were conducted. These will
continue in 1958.
We were fortunate in obtaining nine new employees. This includes
a dentist and a dental assistant and climaxes a long term promotion for
a second dentist.

The Visting Nurse Association extended its coverage to the Seminole
area in Pinellas County, leaving only Tarpon Springs without bedside
nursing care.
Plans were completed for the construction of a new, modern health
center in Tarpon Springs.
Eleven different communities in the county began, or completed,
new sewerage systems, or additions to existing ones. A new sanitary
landfill to serve the lower section of the county was inaugurated.
Through cooperation with PTA, church and other groups, adequate
control of home cooked goods and public suppers has been established."
POLK: C. L. Nayfield, M.D., M.P.H.
"The County Health Department organized a new district in the
Auburndale-Polk City area. The City of Auburndale purchased a
building which the Polk County Commissioners are remodeling as a
new district office for the area. The staff for this office will consist of
one sanitarian, two public health nurses and a clerk-typist.
Another new district was created when the Mulberry office was
opened July 1. This office staff consists of two public health nurses, one
sanitarian and a clerk-typist.
In the present budget the Polk County Commissioners included funds
for the construction of two new district offices. These will be located
in Haines City and Lake Wales. The contracts for these buildings should
be awarded in the near future as the necessary Hill-Burton funds have
also been approved."

LOCAL HEALTH SERVICE 35

PUTNAM: N. B. Edgerton, M.D., M.P.H.
"'No milk or milk products shall be sold to the final consumer except
pasteurized milk properly labeled' thus reads the new milk ordinance
for the City of Palatka. Putnam County Health Department had been
striving for ten years to get such an ordinance passed."
ST. LUCIE: Neill D. Miller, M.D.
"A local bill was passed by the State Legislature to govern building
and zoning. Under this act the health department has been designated
as the authority to inspect and approve septic tank installations in the
county. Similarly the City of Fort Pierce has empowered the health
department to inspect and approve septic tank installations in the city
before a certificate of occupancy is issued.
Following the adoption last year of the U. S. Public Health Service
Ordinance Regulating Eating and Drinking Establishments, the health
department has maintained an extensive restaurant permitting program
in the City of Fort Pierce resulting in highly improved restaurant sanita-
tion.
A highly successful Salk vaccine program was carried on throughout
the schools of the county as well as in the health department.
Late in the year a tuberculosis clinic was started in the health de-
partment staffed by a local pediatrician. The clinic is conducted for
the purpose of case finding, diagnosis, and treatment of infants and
children."
SARASOTA: William L. Wright, M.D., M.P.H.
"The county now has countywide electrical, building, and plumbing
inspections. The Southern Building Code has been adopted with some
amendments. No permit may be issued for any building requiring
sanitary facilities unless such facilities have first been approved by the
County Health Department. In two areas where approval was withheld
the people have held referendums and taxed themselves to provide
adequate drainage.
A local bill was passed by the Legislature requiring all water and
sewage systems serving more than one hundred to obtain a franchise
from the County Commission.
The county subdivision regulations now require a letter of approval
with recommendations regarding fill and drainage from the county
health departments."
UNION: A. Y. COVINGTON, M.D., M.P.H.
"Outstanding was the completion and opening of a new modern,
consolidated elementary school for the Negro children. All children
in the county were transported to this one school and for the first time in

36 ANNUAL REPORT, 1957

their lives the Negro children had the advantage of electricity, lighting,
ventilation, and approved water supply and sewage.
Through cooperative efforts of official agencies and private indi-
viduals, the mental and physical health of Union County was given a
boost by development of a public beach in Lake Butler. The area sur-
rounding a portion of the Lake was cleaned, extensive docks were built
with recreational equipment, and a picnic area was developed with
approved water and sewage.
The medical care program was greatly improved by the county
participation in the State Indigent Hospitalization Program and expan-
sion of the hospital facilities in Lake Butler."
VOLUSIA: D. V. Galloway, M.D., M.P.H.
"A full time dentist was employed to work with problems among
the school children on dental hygiene. This program began only in
October, so we are not ready to report on it.
We have selected the Health Department Health Survey made by
the State Board of Health as one of the outstanding events of 1957.
It seemed to bring the activities of the health department closer together
and to help us find the most important objectives in this county."
WALTON: R. N. Nelson, M.D.
"A sewage treatment plant has been installed in DeFuniak Springs
and such installation is ample to care for approximately 20,000 people.
DeFuniak Springs' population at this time is between 5,000 and 6,000.
A new 12-inch well, 868 feet deep, 12 inches in diameter with a
capacity of 650 gallons of water per minute has been added to our
city water supply which increases the supply and pressure to meet the
needs of the city.
An additional extension to our water system is now serving nineteen
new families and one dairy."
WASHINGTON: R. N. Nelson, M.D.
"As we, the personnel of the County Health Department review
the accomplishments of the past year, 1957, and look forward to 1958,
we have renewed hope of greater possibilities for the future. Our
new sixty thousand dollar health department building should be ready
for occupancy by March 1, 1958. The modern building and the modern
equipment, we feel sure, will inspire all of us to do a better job in the
future than we have in the past."

LOCAL HEALTH SERVICE

DIVISION OF PUBLIC HEALTH NURSING

RUTH E. METTINGER, R.N.,
Director

This division has coordinated the nursing service with all bureaus and
divisions for the purpose of assisting the county units in improving the
overall public health nursing program.

INSERVICE EDUCATION:
A. Considerable time has been spent on the inservice study groups
with emphasis on the mental health program as it is integrated in all
phases of public health nursing.
B. The 48-hour visits to the state mental hospitals continue to be
most helpful; especially, in the follow-up of patients released on "trial
visit." Fifty-nine public health nurses and five health officers made the
visit to the hospital in Chattahoochee. It was necessary to discontinue
the program in June due to a change in hospital personnel; however,
plans were made in December to resume the visits in January 1958.
A similar program was initiated in August at the hospital in Holly-
wood. Patients are admitted to this institution from eight counties only.
Approximately 30 public health nurses and five health officers visited
the hospital during the two orientation periods, August and September.
C. Orientation of public health nurses in the state tuberculosis
hospitals has changed somewhat. Most of the nurses have made the
48-hour visit. Groups are now returning to the hospital for a one-day
orientation program to observe newer treatment methods and visit
patients from their county. The hospital nursing personnel continues
to visit the health departments for a two-day orientation.
D. A follow-up workshop on leadership, planned jointly by this
division and the Bureau of Mental Health, was conducted at the Univer-
sity of Florida. The same nurses and, insofar as possible, the same
faculty, who attended the original workshop in 1956, participated.
A five-day intensive workshop on better nurse-patient relationship
was held in Gainesville at the training center. In addition to resource
people invited from the University of Florida faculty, the U. S. Public
Health Service Regional Office, and the Bureau of Mental Health,
we were fortunate in securing the services of Miss Ruth Von Bergon
from the School of Public Health, University of Minnesota. Each
participant brought with her a record verbatim interviews with a
patient which was used as a basis for detailed discussions regarding
the reactions of both the nurse and patient in their contacts.

38 ANNUAL REPORT, 1957

E. Personnel from this division attended a series of institutes
sponsored by the Crippled Children's Commission. Two days were de-
voted to theory, review and demonstrations. Six weeks later, there was a
two-day follow-up session, which included group discussion and reports
on use of information from first session.
F. The third series of biennial heart disease institutes was held
in six areas. A new approach was initiated; instead of formal lectures,
a case study was used. The patient and his physician were present; the
case history was used as the basis for discussion by the physician. A panel
consisting of all branches of nursing, a nutritionist, social worker, and
rehabilitation worker discussed informally the contribution each could
make in the care of a cardiac patient.
G. A major change in the inservice training program in Gainesville
for nurses is the emphasis on intensive work with a small number of
families. The program is primarily for nurses without formal prepara-
tion and with little or no experience in public health nursing; however,
nurses with years of experience have requested permission to take
advantage of the two-month's intensive preparation. Ten nurses were
oriented in 1957.

ADVANCED EDUCATION:
A. Five nurses were given scholarships for the year's program of
study in public health nursing by the State Board of Health (1957-58).
Three nurses received Title I and II Traineeships from the U. S. Public
Health Service.
The state midwife teacher received a Title II Traineeship from the
Children's Bureau to obtain her Master's degree in Maternal and Child
Health.
B. Several nurses, financed by voluntary agencies: Tuberculosis As-
sociation, Heart Association and Cancer Society attended the six weeks'
summer course at the University of North Carolina.
C. The Division of Heart Disease Control gave three scholarships to
public health nurses for the three-weeks' course in rehabilitation at
Rusk Institute.

COMMUNITY NURSING SERVICE:
Discussion at the annual supervisors' conference centered around
community nursing services and clinical field experience for students.
Miss Abbie Watson, Director, Richmond, Virginia, Combination Service,
pointed out the advantages of the nursing service in a community being
rendered by only one agency.
Tentative plans have been made and approved for demonstrating
the advantages of the official agency rendering a complete nursing
service. Three rural and semi-rural counties have been selected for this

LOCAL HEALTH SERVICE

demonstration project. In one county a citizen's advisory committee to
the health unit has been organized, and will be responsible for fees
collected for the home nursing services. The Sarasota County Visiting
Nurse Association, which was coordinated with the health department,
has combined, thus reducing the size of each nurse's district and
eliminating any overlapping of travel and visits. There is a total of
three combination services, a trend which is spreading throughout
Florida.

FIELD EXPERIENCE:
A. Field experience has been provided for students attending the
four university schools of nursing in Florida; also, graduate student
nurses from the University of North Carolina, Peabody College and
Vanderbilt University.
B. At the request of the U. S. Public Health Service, students from
the Philippines and Costa Rica were assigned to county units for both
staff and supervisory experience.

RESEARCH:
In two of the key counties a research project in nursing was begun;
the entire staff of both counties participated in collecting data for the
time study, which should give some indication of community needs,
strengths and weaknesses in the total nursing program and assist in deter-
mining how to meet those needs. Expert consultation is being given by
Dr. Marion Ferguson, Regional Consultant, U. S. Public Health Service.

CONSULTANT FIELD SERVICE:
A. Each consultant participates in the nursing home program.
One consultant devoted additional time toward planning and conducting
an educational program for the operators and supervising staffs of
nursing homes; and has appeared before various groups to acquaint
them with the needs of the nursing homes.
B. Special attention was given to counties by consultants where
nurses were unable to attend the inservice training center and had no
previous experience or formal education in public health. Emphasis
was placed on planning and implementing the generalized public health
nursing program. Many visits were for basic orientation and supervision.
C. The counties have profited by securing the services of better
prepared nurses, graduating from the university schools of nursing,
which include the approved course in public healt-hnursing. According
to the count requested by the U. S. Public Health Sevice biennially,
thirty-one per cent of the 510 nurses employed have had theapproved
course in public health; 32 graduates from the university schools of
nursing are now employed.

40 ANNUAL REPORT, 1957

MIDWIFERY PROGRAM:
The state midwife consultant was a participant at the Seventh
American Congress on Maternal and Child Welfare in Chicago; she dis-
cussed the supervision and organization of the untrained midwives in
Florida.
The number of licensed midwives has been reduced by 16 in 1957.
In 1956, a total of 299 were licensed and in 1957 a total of only 283
requested renewals through the county health units. More adequate
hospital facilities and low-cost hospital planning make it possible for
the low income patients to be delivered in hospitals. Twenty-six coun-
ties were visited to follow-through on the midwife program and sixteen
revisits to several of the counties were made on behalf of projects
initiated by local personnel in midwife supervision.

TABLE 5

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

d 1 -d
0 F 11

-. o a dd
41 )s) R 04

A. COMMTNICABLE DISEASE
CONTROL
1. Admissions to Service ............... 114 245 4 177 83 1,408 1 87 228 257 24 0 206 180 99 63 81
2. Field and Office Visits............... 144 311 8 275 104 1,826 2 99 228 366 25 0 999 410 315 105 154
3. Hookworm Treatment Given........... 154 317 338 117 21 232 223 50 228 42 45 867 24 191 90 134 229
TYPE OP IMMUNIZATION
4. Smallpox ........................... 1,121 62 964 269 276 1,117 145 122 100 228 262 507 16,683 336 57 1,400 4,086
5. Diphtheria .............. .......... 2,154 179 1,805 666 608 1,469 285 161 214 355 373 2,370 10,254 310 254 3,991 4,593
6. Whooping Cough .................... 1,440 179 1805 541 472 1,319 269 111 159 267 198 2,370 10,251 193 233 2,905 3,895
7. Tetanus .......................... 2,630 179 3,321 883 620 2,015 357 220 660 471 381 3,277 10,518 517 465 4,760 6,044
8. Poliomyelitis ........................ 11,004 1,253 10,510 2,985 7,160 11,561 1,022 963 1,399 3,353 981 5,440 70,014 2,126 878 9,006 26,105
9. Typhoid ........................... 1,436 167 6,080 148 531 323 201 4 280 5 74 2,762 418 19 631 211 6,240
10. Rabies-Humans ..................... 19 0 0 12 0 0 0 0 0 0 0 0 2 0 0 2 0
11. Rabies-Animals ...................... 1,796 0 0 42 0 0 0 0 0 343 0 0 0 0 0 0 0
B. VENEREAL. DISEASE
CONTROL
1. Admissions to Service ............... 1,427 11 203 41 78 359 5 8 2 56 36 178 6,951 11 9 16,832 2,298
2. Not Infected ........................ 124 4 96 10 16 40 0 0 2 16 5 5 4,668 3 0 14,496 909
3. Treated in Clinic ................... 801 5 102 26 50 254 4 0 0 20 12 173 1,663 5 9 2,426 1,429
4. Treated by Priv. Physician ........... 1 1 0 2 4 25 0 3 2 9 4 0 1 0 0 26 4
5. Ret. to Treatment in this Clinic...... 312 0 0 2 3 28 0 0 0 4 3 2 143 0 0 142 54
6. Ret. to Treatment to Priv.
Physician ........................... 0 2 0 2 5 23 0 0 0 0 0 0 0 1 0 0
7. Epidemiologic Treatment
Contact of, ...................... 427 0 9 2 12 36 0 0 0 8 8 0 632 1 0 682 829
8. Patients Interviewed ................. 498 5 48 26 21 255 0 0 2 18 19 32 1,268 6 17 1,249 625
9. Contacts Obtained .................. 588 3 78 15 20 164 1 1 1 9 14 2 1,714 1 5 1,695 955
10. ERFs Closed ........................ 658 4 144 6 30 193 0 0 0 34 14 9 2,628 5 10 2,520 1,128
11. Field and Office Visits .............. 2,323 18 363 68 116 1,232 25 8 3 150 61 240 15,880 34 40 26,327 2,562
C. TUBERCULOSIS CONTROL
1. Admission to Service-Case Active .... 47 2 22 20 27 103 2 6 7 13 13 17 599 5 1 77 163
2. Adm. to Service-Case Inactive ...... 158 3 104 11 38 276 4 11 11 14 12 23 905 1 15 228 341
3. Adm. to Service-Contacts & Suspects.. 281 13 149 107 76 446 47 33 11 58 58 38 4,348 11 20 171 833

TABLE 5 (continued)
tO
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

P, I 1 2

A. COMMUNICARB.1E DISEASE
CONTROL
1. Admissions to Service ............... 16 22 269 7 41 353 0 310 2 132 78 558 36 17 39 76 26 M
2. Field and Office Visits .............. 25 22 269 7 41 508 0 312 2 179 80 608 40 26 51 80 26 IP
3. Hookworm Treatment Given.......... 19 244 111 122 40 591 1,129 268 15 225 40 294 408 8 226 29 103
TYPE OP IMMUNIZATION
4. Smallpox ........................... 75 212 443 18 10 285 16 150 30 117 84 4,552 386 311 877 275 81 W
5. Diphtheria .......................... 246 198 1,101 147 43 416 187 423 144 184 877 6,432 684 555 1670 549 141
6. Whooping Cough .................... 148 193 520 106 40 413 -187 351 107 130 237 4,118 538 332 1,034 336 125
7. Tetanus ............................ 286 458 1,679 189 60 718 224 455 155 379 957 7 715 808 670 3,050 715 215
8. Poliomyelitis ........................ 560 728 6,271 1,094 401 2,157 2,725 3,401 1,039 2,154 3,418 43,156 1,834 2,304 7,027 2,665 798
9. Typhoid ............................ 7 257 1,085 31 7 886 50 31 9 7 76 340 122 228 3,133 872 155
10. Rabies-Humans ..................... 7 0 0 0 0 0 0 0 0 0 13 3 0 0 0 3 0
11. Rabies-Animals ...................... 31 0 1,000 0 110 0 0 0 75 0 930 0 0 0 0 881 12
B. VEEIEqEAL DISEASE
CONTROL
1. Admissions to Service ............... 23 20 176 0 3 38 25 9 7 9 17 2,365 18 37 84 83 2
2. Not Infected ........................ 0 5 5 0 0 4 0 2 0 2 9 1,158 2 3 8 6 1
3. Treated in Clinic ................... 19 15 98 0 2 34 20 5 5 3 48 1,145 12 30 74 33 3
4. Treated by Priv. Physician ............ 0 0 0 0 0 0 0 2 0 4 1 0 0 2 0 3 0
5. Ret. to Treatment in this Clinic...... 2 0 6 0 1 0 5 1 1 0 8 12 0 1 0 8 0
6. Ret. to Treatment to Priv.
Physician ........................... 0 0 0 0 0 0 0 1 0 0 3 1 0 0 0 0 0
7. Epidemiologic Treatment
Contact of, ......................... 2 0 77 0 0 0 0 1 1 0 8 194 0 13 8 14 0
8. Patients Interviewed ................. 6 10 48 0 0 6 0 6 10 2 42 1,220 9 25 56 52 0
9. Contacts Obtained .................. 12 6 75 0 0 13 0 1 4 0 41 1439 12 16 21 18 0
10. ERFs Closed ........................ 2 2 155 0 0 38 0 4 1 1 44 1,660 2 8 11 67 3
11. Field and Office Visits .............. 45 28 661 0 7 104 40 33 15 13 95 11,251 33 75 169 112 20
C. TUBERBCLOSIS CONTROL
1. Admission to Service-Case Active .... 1 11 16 0 0 14 15 2 6 6 12 343 2 3 27 1 4
2. Adm. to Service-Case Inactive ...... 8 7 51 4 4 6 9 13 3 1 30 642 7 31 82 9 1
3. Adm. to Service-Contacts & Suspects.. 26 27 215 3 10 68 20 31 14 35 152 3,332 85 22 87 12 20

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

0 0

91 t
ri to gH a 8O

A. COYMUNICABLE DISEASE
CONTROL
1. Admissions to Service ............... 167 74 129 38 13 334 867 758 152 166 207 108 10 401 5 186 569
2. Field and Office Visits................ 329 102 142 38 13 350 1,000 887 156 210 283 108 12 456 15 383 598
3. Hookworm Treatment Given.......... 43 94 110 144 196 140 88 268 7 3 169 141 14 391 98 31 299
TYPE OP IMUN3IZ&TION
4. Smallpox ........................... 79 932 1,269 254 40 492 528 924 615 1,062 1,153 1055 13 3411 197 4,227 166
5. Diphtheria .......................... 232 858 745 475 211 1,060 855 353 621 1,125 1,639 2,313 49 4,796 680 8,432 401
6. Whooping Cough .................... 194 405 733 307 142 875 620 383 323 475 1,368 1,651 31 3424 551 3158 336
7. Tetanus ............................ 246 1,038 1,706 858 331 1,532 1,072 493 692 1,976 1534 3251 49 6,535 702 11,714 453
8. Poliomyelitis ........................ 7,004 1580 7376 1,438 728 3,234 4,064 10,623 1,723 2,902 3,474 6,706 995 15434 2,466 22,442 4,331
9. Typhoid ............................ 81 214 1,574 766 225 2,627 137 1,315 241 1,411 3,478 2,453 22 5121 152 2,540 0
10. Rabies-Humans ..................... 0 0 51 0 0 0 0 0 0 0 0 1 0 0 0 0 0
11. Rabies-Animals ...................... 0 0 0 0 26 499 2,385 0 0 0 361 0 0 0 0 0 0
B. VENEREAL DISEASE
CONTROL
1. Admissions to Service ............... 31 96 1,573 30 5 27 328 760 63 134 10 143 16 708 58 475 52
2. Not Infected ........................ 2 7 178 8 0 0 149 154 2 38 0 2 1 212 1 11 32
3. Treated in Clinic ................... 6 70 974 4 5 19 130 415 23 84 9 150 11 469 53 409 15
4. Treated by Priv. Physician............ 8 54 1 1 0 0 2 7 3 3 3 0 2 11 0 30 2
5. Ret. to Treatment in this Clinic...... 0 5 48 0 0 0 20 12 8 3 4 36 1 9 5 9 0
6. Ret. to Treatment to Priv.
Physician ......................... 1 0 0 0 0 0 2 2 1 1 0 0 0 4 0 5 0
7. Epidemiologic Treatment
Contact of........................ 0 0 372 10 0 9 46 79 4 53 0 19 6 22 17 88 2
8. Patients Interviewed ................. 4 28 420 1 0 27 77 509 21 61 13 89 8 44 38 202 18
9. Contacts Obtained ................. 7 35 739 1 0 21 87 312 17 33 1 63 7 39 41 266 15
10. ERFs Closed ........................ 24 41 817 18 0 11 208 468 24 60 9 21 11 244 19 485 22
11. Field and Office Visits............... 88 167 4,533 48 8 36 463 1,551 132 449 92 183 65 1,607 137 1,606 107
0. TUBERCULOSIS CONTReOL
1. Admission to Service-Case Active .... 33 37 48 3 3 19 50 26 10 16 12 13 2 167 14 193 30
2. Adm. to Service-Case Inactive ...... 76 70 99 22 3 13 62 60 26 49 27 10 9 270 15 366 23
3. Adm. to Service-Contacts & Suspects.. 137 272 218 66 11 102 106 121 35 73 132 66 60 524 38 522 190

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

b.

~ 00

P, P, W M t W l Wl E4 0 13 E04

A. COMMTUNICAB-.E DISEASE
CONTROL
1. Admissions to Service ............... 256 340 136 7 42 43 57 752 241 204 64 200 28 197 1 11,991
2. Field and Office Visits............... 380 487 137 18 66 60 117 752 244 226 92 394 29 210 1 15,942
3. Hookworm Treatment Given.......... 64 1,168 30 10 171 31 88 73 379 208 56 124 31 285 717 12,845
TYPE OP IMMUNIZATION
4. Smallpox ........................... 991 3,342 801 13 379 417 82 442 74 173 86 550 109 443 161 60,137
5. Diphtheria ......................... 1,832 6,278 1,233 84 1,195 613 350 774 376 504 486 639 269 802 592 84,910
6. Whooping Cough .................... 1,711 5,368 821 83 938 519 337 487 261 367 209 507 256 753 591 63,706
7. Tetanus............................ 1,931 6,923 1,572 109 1,722 707 375 776 469 798 502 796 499 1,019 966 109, 397
8. Poliomyelitis ....................... 34,051 32,553 2,520 5,276 3,794 484 4,650 2,063 3,877 2,006 949 8,550 900 3,435 2,320 451,440
9. Typhoid ............................ 292 274 133 34 2,197 53 36 157 507 1,881 64 286 625 87 231 56,040
10. Rabies-Humans ..................... 0 0 0 0 0 0 3 0 0 0 0 0 4 0 0 120
11. Rabies-Animals ...................... 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 8,984
B. VENEREALi DISEASE
CONTROL
1. Admissions to Service................ 858 500 240 35 52 220 134 55 122 2 2 5 1224 105 29 60 26 38,412
2. Not Infected ........................ 174 30 26 0 19 111 21 9 8 1 0 14 2 75 0 22,886
3. Treated in Clinic ................... 320 354 114 34 26 103 93 41 115 36 3 63 11 29 26 12,739
4. Treated by Priv. Physician............ 96 20 0 0 1 2 4 1 0 0 1 9 0 2 1 358
5. Ret. to Treatment in this Clinic...... 5 29 106 1 1 8 4 4 0 0 0 3 1 0 4 1,064
6. Ret. to Treatment to Priv.
Physician ........................... 0 3 3 0 0 0 1 0 0 0 0 2 0 0 0 63
7. Epidemiologic Treatment
Contact of .......................... 66 122 10 0 1 3 16 0 0 13 0 16 14 10 4 3,966
8. Patients Interviewed ................. 91 177 24 26 41 98 49 46 8 34 0 105 5 33 23 7,901
9. Contacts Obtained .................. 114 167 25 10 8 95 62 32 17 27 0 62 5 24 13 9269
10. ERFs Closed ........................ 379 269 270 0 0 44 110 24 16 9 0 111 16 40 5 13,156
11. Field and Office Visits............. 3,145 1,030 333 118 84 338 470 92 229 99 19 478 36 126 35 80,055
C. T'UBERBCUOSIS CONTROL
1. Admission to Service-Case Active .... 116 76 12 16 25 27 28 5 19 18 1 74 3 7 4 2 694
2. Adm. to Service-Case Inactive ...... 395 216 15 38 14 72 21 9 16 19 7 199 4 23 2 5,313
3. Adm. to Service-Contacts & Suspects.. 630 465 32 78 112 142 130 45 35 57 7 343 32 81 0 15,721

z

ci

0
O

,o
Ln
Nq

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

B3 B

0. TUBERCT.OSIS CONTROL
(Cont.)
4. No. of Persons X-rayed-
Miniature Films ................. 5,477 12 15,918 0 0 60,159 1,619 0 0 1 3,626 17 24,235 3,625 0 37,121 13,086
5. No. of Persons X-rayed
Large Films ........................ 799 16 865 276 1,618 1272 81 40 30 81 50 64 6,793 47 21 2,415 1,376 O
6. Tuberculin Test .................... 169 1 1,497 146 259 2,209 4 115 5 7 38 28 1,442 3 8 627 1,773
7. Field Visits ......................... 522 17 115 380 255 3,312 125 172 44 125 74 189 4,017 72 46 1,273 2,551 C
8. Office Visits ........................ 54 28 309 72 222 1,458 12 46 46 82 124 48 16,541 23 68 2,549 597
9. Cases Hospitalized ................... 17 1 16 9 11 83 3 2 5 5 5 8 702 3 1 23 62
D. MATERNITY SERVICE
1-2. Patients Admitted to
Maternity Medical Service............ 438 28 141 83 199 339 9 0 3 82 52 8 3,447 0 59 53 532
3. Visits by Antepartum Cases to
Medical Conferences ................ 917 41 363 181 474 826 '12 0 4 208 104 8 12,074 0 156 131 785 M
4. Patients Admitted to
Maternity Nursing Service .......... 594 87 150 121 287 405 20 3 26 85 81 209 4,084 0 55 318 539
5. Field Nursing Visits ................. 1330 122 183 415 470 424 15 3 42 304 39 369 10,164 0 63 511 1,434
6. Office Nursing Visits................. 1,858 45 432 102 686 1,762 25 1 4 211 283 309 11,269 0 189 259 1,445
7. Patients given Postpartum
Medical Examinations ............... 203 5 28 0 52 128 1 0 0 7 3 8 955 0 17 13 289
8. Number of Midwife Meetings........ 13 3 0 0 0 21 2 0 0 0 1 11 10 0 5 0 4
9. Visits for Midwife Supervision........ 20 9 8 21 80 83 9 0 11 11 8 61 140 0 60 2 40
10. No. of Midwife Deliveries
Supervised by health dept. personnel.. 15 0 0 0 0 30 0 0 0 1 0 0 0 0 1 0 0 C2
11. No. of Individuals Enrolled in
Classes for Expectant Mothers........ 108 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 7
E. CHILD HEALTH SERVICES
2-3. Adm: to Well Child
Medical Service-Infants .............. 609 53 58 75 59 549 11 4 2 93 10 25 3,698 0 39 335 300 i-
1.-b. Adm. to Well Child
Medical Service 1-4 ............... 100 248 13 62 4 42 25 0 9 58 3 24 1,776 0 34 135 4
1.-c. Adm. to Well Child
Medical Service 5 over............ 97 384 6 42 2 4 28 0 2 75 2 17 793 0 47 109 0
4. Visits to Well Child Medical
Conference: Infants ................ 643 87 131 131 75 1,089 11 4 2 112 11 27 9,020 0 51 715 926
1 -4 .................. 114 455 15 112 7 45 25 0 9 101 4 24 8,358 0 45 264 7
5-over ............... 132 599 6 70 2 5 28 0 2 93 2 18 2,414 0 68 132 0 4.
~___ __------------- U'1

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

4 9

| a I I I w s I I

C. TIUBERVULOSIS CONTROL
(Cont.)
4. No. of Persons X-rayed-
Miniature Films .................... 0 0 0 0 553 0 0 2,156 1,670 0 3,886 77,508 1 0 0 0 0
5. No. of Persons X-rayed
Large Films ........................ 63 127 114 13 20 131 32 45 55 68 142 1,224 135 146 236 40 13
6. Tuberculin Test .................... 18 15 73 5 0 68 25 69 2 47 23 725 84 8 95 13 12
7. Field Visits ......................... 43 23 444 17 16 187 62 95 9 71 225 3,640 126 182 210 4 19
8. Office Visits ....................... 69 74 178 3 14 164 71 51 35 88 143 3,606 104 50 107 23 28
9. Cases Hospitalized ................... 1 4 14 1 2 20 5 5 2 3 13 66 5 4 13 2 3
D. MATERNITY SERVICE
1-2. Patients Admitted to
Maternity Medical Service............ 75 13 423 6 19 16 27 42 48 12 16 1,650 11 0 151 41 15
3. Visits by Antepartum Cases to
Medical Conferences ................ 184 16 892 11 33 16 40 131 100 20 29 6,026 11 0 181 99 29
4. Patients Admitted to
Maternity Nursing Service .......... 101 19 600 45 7 18 73 60 0 18 2 2,131 25 116 471 62 28
5. Field Nursing Visits.................. 143 6 782 157 1 44 172 62 0 36 3 3,782 23 253 1,151 98 29
6. Office Nursing Visits ................ 239 26 1,030 13 9 31 193 168 0 20 1 7,772 48 98 950 137 46
7. Patients given Postpartum
Medical Examinations ............... 19 2 98 1 0 4 19 12 1 4 1 663 4 0 38 12 0
8. Number of Midwife Meetings........ 4 0 9 1 0 0 7 2 0 0 0 1 0 0 11 2 0
9. Visits for Midwife Supervision........ 3 8 125 0 0 6 25 4 0 6 4 21 15 29 124 1 9
10. No. of Midwife Deliveries
Supervised by health dept. personnel.. 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0
11. No. of Individuals Enrolled in
Classes for Expectant Mothers........ 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
E. CHILD HEALTH SERVICES
2-3. Adm. to Well Child
Medical Service-Infants .............. 95 0 142 0 4 1 1 14 6 5 5 2,403 34 2 59 46 9
1.-b. Adm. to Well Child
Medical Service 1-4............... 27 1 71 0 1 3 3 1 3 0 2 4,721 81 0 27 5 6
1.-c. Adm. to Well Child
Medical Service 5 over............ 0 2 226 0 1 6 0 76 3 0 0 8,779 19 0 5 2 3
4. Visits to Well Child Medical
Conference: Infants ................ 110 0 204 0 5 1 1 14 6 6 7 5,692 55 2 59 72 11
1-4 .................. 31 1 90 0 1 3 3 1 4 0 2 9957 100 0 27 6 6
5-over ............... 0 6 227 0 1 6 0 76 3 00 15,307 23 0 8 2 3

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

0 ;

Sg s 0 c I

C. TUTBERCULOSIS CONTROL
(Cont.)
4. No. of Persons X-rayed-
Miniature Films ................... 17,491 12,566 22,145 5 0 0 1,119 0 0 6,018 0 0 0 27,161 0 11,522 5,272 -
5. No. of Persons X-rayed
Large Films ....................... 308 984 739 88 9 99 660 809 107 403 180 1,308 56 811 181 1892 116
6. Tuberculin Test .................... 38 649 148 30 4 73 711 53 36 107 1 88 45 1 359 51 5,670 45
7. Field Visits ......................... 536 233 522 167- 21 171 375 502 146 241 500 235 78 1,099 171 1,775 362
8. Office Visits ........................ 123 1,050 329 56 1 129 206 55 32 183 119 70 77 1,302 98 1,053 263
9. Cases Hospitalized ................... 19 18 39 2 1 14 15 24 8 4 15 12 1 78 7 115 14
D. MrATERN I T SERVICE
1-2. Patients Admitted to
Maternity Medical Service............ 114 71 129 79 14 59 170 0 0 36 11 12 0 671 76 427 4 1
3. Visits by Antepartum Cases to
Medical Conferences ............... 218 123 398 156 25 124 529 0 0 92 16 14 0 1,317 200 1,002 4 t
4. Patients Admitted to
Maternity Nursing Service ......... 248 264 318 87 7 156 176 72 16 100 108 69 0 206 98 394 34
5. Field Nursing Visits.................. 321 302 686 56 21 393 223 205 37 174 205 114 0 433 217 1,417 24 -4
6. Office Nursing Visits.................. 251 405 15 125 36 138 513 3 1 157 99 97 0 310 378 560 70
7. Patients given Postpartum
Medical Examinations ............... 37 21 22 0 20 15 66 0 0 13 1 17 0 129 27 111 1
8. Number of Midwife Meetings........ 1 0 10 0 0 5 2 3 1 8 13 1 0 4 0 31 2
9. Visits for Midwife Supervision....... 21 1 31 11 0 15 5 30 11 6 63 5 0 5 15 19 0
10. No. of Midwife Deliveries
Supervised by health dept. personnel.. 0 0 0 00 0 0 0 0 0 0 1 0 0 4 0 0 0
11. No. of Individuals Enrolled in T
Classes for Expectant Mothers....... 0 2 0 0 0 0 106 0 0 0 2 3 0 1 0 0 0
E. CHILD HEALTH SERVICES
2-3. Adm. to Well Child
Medical Service-Infants ............. 33 22 119 10 31 14 50 64 0 24 92 16 0 346 45 212 0 -
1.-b. Adm. to Well Child
Medical Service 1-4.............. 3 1 52 1 14 3 4 69 1 19 320 1 0 77 2 41 0
1.-c. Adm. to Well Child b
Medical Service 5 over............ 1 49 4 4 8 10 6 51 94 3 400 4 0 110 0 48 0
4. Visits to Well Child Medical
Conference: Infants ............... 42 70 124 11 31 21 58 76 0 27 212 16 0 389 51 416 0
1- 4 .................. 3 1 60 1 16 3 4 69 1 37 775 1 0 346 8 44 0
5 over ............... 1 52 5 6 10 11 7 53 94 4 1,388 14 0 264 0 69 0 1
,N

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

0 Q

g 4 5 0 i
PI P4 f m m W W t T H > 0 A i E

C. TUBERCULOSIS CONTROL
(Cont.)
4. No. of Persons X-rayed-
Miniature Films .................. 21,292 15,612 0 0 3,516 0 9,150 2,379 67 0 8 0 0 2,908 0 408,901
5. No. of Persons X-rayed
Large Films ........................ 3,163 1,521 1,030 90 79 624 315 47 67 57 25 5,821 21 131 59 40,248
6. Tuberculin Test .................... 207 640 121 33 86 103 21 27 46 11 2 1,341 23 44 12 21,438
7. Field Visits ........................ 1,070 1,970 156 354 379 613 448 37 88 155 30 1,628 27 141 15 32,949
8. Office Visits ........................ 4,409 800 28 138 127 83 196 94 143 115 29 760 28 268 16 39,467
9. Cases Hospitalized ................... 71 63 15 14 8 16 14 3 11 5 1 34 3 3 2 1,768
D. ITATERNITY SERVICE
1-2. Patients Admitted to
Maternity Medical Service............ 525 838 109 184 0 76 81 1 33 53 57 98 57 66 40 12,129
3. Visits by Antepartum Cases to
Medical Conferences ................ 1,716 2,216 232 708 0 255 243 1 46 112 148 521 178 152 50 34,898
4. Patients Admitted to
Maternity Nursing Service .......... 561 916 184 236 2 72 410 117 50 77 59 220 59 67 93 16,316
5. Field Nursing Visits................. 807 2,306 213 372 4 346 1,162 142 51 112 86 645 133 77 108 34,022
6. Office Nursing Visits ................. 2,030 3,585 383 889 3 237 238 83 89 170 147 618 45 241 170 41,747
7. Patients given Postpartum
Medical Examinations ............... 138 285 26 0 0 28 20 0 7 10 6 57 13 22 25 3,704
8. Number of Midwife Meetings........ 0 4 9 1 0 0 1 1 0 3 0 11 1 5 6 230
9. Visits for Midwife Supervision........ 36 23 3 0 0 0 107 42 5 7 1 39 22 19 11 1,496
10. No. of Midwife Deliveries
Supervised by health dept. personnel.. 0 3 0 0 0 0 0 0 0 1 0 1 0 0 1 60
11. No. of Individuals Enrolled in
Classes for Expectant Mothers........ 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 813
E. CHILD HEALTH SERVICES
2-3. Adm. to Well Child
Medical Service-Infants .............. 684 874 43 59 60 51 0 3 11 27 41 218 19 59 45 12,018
I.-b. Adm. to Well Child
Medical Service 1-4............... 1,047 100 39 0 0 53 0 0 6 3 52 405 4 46 37 9,889
1.-c. Adm. to Well Child
Medical Service 5 over............ 714 20 3 0 20 49 0 0 5 8 34 526 1 71 89 13,062
4. Visits to Well Child Medical
Conference: Infants ................ 1,293 1,212 49 126 60 187 0 3 11 35 80 533 22 89 49 24,573
1-4 .................. 1,814 220 43 0 0 67 0 0 7 5 158 1,036 5 54 47 24,642
5 over ............... 1,031 52 3 0 20 63 0 0 5 9 203 1,203 5 101 123 24,029

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

I 4) .i -

D A A e A 44

E. CHILD HEALTH SERVICES
(Cont.)
6. Admissions to Nursing Service
Infants ................ 471 113 126 210 312 594 18 26 25 154 59 96 4,083 0 57 764 764
1-4 .................. 1,087 317 162 566 525 53 92 84 52 272 114 208 4,045 6 66 793 170
5-over ............... 1,120 108 585 338 329 7,619 91 218 30 1,155 79 66 9,601 51 113 773 1,170
7. Field Nursing Visits-Infants......... 980 178 303 598 498 855 27 48 34 389 43 166 9,084 0 71 1,095 1,417
1-4........... 1,917 658 398 1,618 990 218 110 166 91 720 45 292 7,372 0 82 1,185 334
5-over........ 1,663 195 942 838 291 2,169 141 320 41 616 48 97 6,139 54 163 1,306 1,046
8. Office Nursing Visits-Infants ........ 439 30 148 17 85 1,170 10 10 0 114 102 68 6,545 0 61 825 1,515
1-4 ........ 521 47 42 43 71 391 24 32 6 118 198 125 6,364 6 56 615 60
5-over ..... 865 90 2,253 73 234 10,233 73 100 2 1,396 88 47 59,011 28 113 421 3,750
9. Nurse-Teacher Conference
5-over ..... 738 111 1,613 360 181 3,033 61 72 82 549 65 5 22,657 191 266 4,916 1,870
F. SCHOOL HEALTH
1. Pupils Examined by physician
with parent present ................. 99 70 167 251 12 746 9 61 112 335 0 31 5,969 14 98 113 9
(b) Referred for Further Diagnosis... 23 9 12 29 2 168 2 12 5 77 0 9 0 8 21 29 0
(c) Completed Referrals ............ 10 0 0 14 0 4 0 0 1 4 0 7 0 6 13 0 9
2. Pupils examined by physician
with parent not present ............. 9 91 770 33 2 3,051 51 34 301 157 2 40 24,507 147 298 5 246
(b) Referred for Further Diagnosis... 6 4 83 6 0 727 44 1 42 19 1 2 0 72 38 3 23
(c) Completed Referrals ............ 8 0 2 4 0 22 0 0 0 4 0 2 0 6 24 0 297
3. Screening by other Health depart-
ments personnel-Visual ............. 296 931 2,637 156 1 21,905 0 12 72 1,461 38 62 29,433 4 175 15,653 5,559
(b) Referred for Further Diagnosis... 72 31 295 35 0 3,107 0 7 22 157 2 4 3,816 4 40 949 832
(c) Completed Referrals ............ 42 7 109 26 0 838 0 7 10 36 0 4 922 0 29 839 286
4. Screening by other health de-
partment personnel-Audio-
meter Testing ..................... 221 81 3,749 0 0 1,676 0 1 0 0 1 0 24,285 0 14 47 841
(b) Referred for Further Diagnosis.. 122 0 173 0 0 69 0 1 0 0 1 0 292 0 2 4 102
(c) Completed Referrals ............ 30 0 4 0 0 27 0 1 0 0 1 0 468 0 1 2 16
G. DENTAL HEALTH
1. Adm. for Dental Treatment
(a) Maternity Patients .............. 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

E. CHILD EHEALT SERVICES
(Cont)
Admissions to Nursing Service
infants ........to .... 105 13 562 62 27 20 35 48 0 25 10 3,287 19 114 337 155 55
1 4 .......... .... 116 12 863 122 17 17 9 41 2 57 8 51777 22 89 249 115 137
5 over ............. 107 49 323 7 63 115 47 362 99 57 55 20,381 71 175 293 20 173
7. Field Nursing Visits-Infants......... 127 20 796 174 7 22 89 58 0 882 23 254 734 287 82
1-4 ........... 71 14 1,449 438 6 41 51 48 2 107 11 2420 31 143 477 139 170
5-over ........ 122 77 449 69 32 172 72 111 12 140 63 4,552 61 179 333 23 124
8. Office Nursing Visits-Infants........ 103 6 329 9 50 23 44 18 0 8 06,198 4 100 97 194 30
1-4 .. 147 7 812 25 64 8 15 9 8 27 3 10,553 14 45 29 132 34
5 over ... 153 35 554 2 34 436 99 276 98 1 21 37,176 93 74 169 13 143
9. Nurse-Teacher Conference
5 over ..... 38 25 918 2 60 479 201 320 39 37 72 7,347 166 4 201 4 51
F. SCHOOL. HEALTH
1. Pupils Examined by physician
with parent present 108 8 696 51 48 132 191 117 176 292 258 1,637 334 216 42 175 26
(b) Referred for Further Diagnosis... 84 2 52 1 1 14 6 15 6 11 53 508 7 0 6 3 0
(c) Completed Referrals ........... 5 2 6 1 0 13 0 14 1 0 61 214 2 0 3 0 0
2. Pupils examined by physician 3 3 2 8
with parent not present ............. 77 24 301 192 95 154 328 154 239 677 489 4,743 403 96 93 52 168
(b) Referred for Further Diagnosis... 45 0 16 1 2 12 1 7 1 41 44 1,667 3 0 25 12 0
(c) Completed Referrals ........... 1 0 3 1 0 12 0 4 0 33 1 328 0 0 0 2 0
3. Screening by other Health depart-
ments personel-Visual ........... 126 98 1,106 431 4 884 0 281 13 409 118 43,841 212 2,539 182 48 0
(b) Referred for Further Diagnosis... 2 33 81 21 1 102 0 30 1 102 25 2783 10 9 87 4 0
(c) Completed Referrals ............ 1 9 34 2 1 86 0 23 0 6 1 992 6 30 10 2 0
4. Screening by other health de-
partment personnel--Audio-
meter Testing e..................... 3 93 1,497 0 0 7 0 0 0 0 32 38875 7 608 105 94 0
(b) Referred for Further Diagnosis... 1 0 112 0 0 0 0 0 0 0 6 5,406 1 0 8 0 0
(c) Completed Referrals ............ 0 0 13 0 0 0 0 0 0 0 2 1,146 0 2 1 0 0
G. DENTA. HEALTH
1. Adm. for Dental Treatment
(a) Maternity Patients .............. 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

Sa a o

t 5 i i 3O O O Oap Pi

E. CHILD HEALTH SERVICES
(Cont.)
6. Admissions to Nursing Service
Infants ............ 276 255 320 36 24 135 101 91 105 103 110 67 14 362 132 596 27
1-4 ................. 291 355 349 61 22 86 34 156 298 174 133 133 15 305 353 223 91
5 -over .............. 353 427 471 155 17 116 804 294 144 257 445 584 85 395 135 3,460 1,492
7. Field Nursing Visits-Infants......... 367 357 750 42 43 316 123 212 229 232 180 118 26 810 232 1,636 17
1-4........... 306 475 670 54 76 218 74 322 880 409 213 204 21 1,109 713 756 65
5-over....... 385 410 708 126 63 211 350 489 312 424 330 438 82 1,507 179 2,303 259
8. Office Nursing Visits-Infants........ 123 36 6 4 18 31 57 0 26 185 127 50 11 480 235 151 26
1-4 ..130 60 1 15 26 45 8 3 98 430 97 67 11 945 524 154 71
5-over ..... 161 226 34 92 23 156 843 105 43 1,218 2,359 385 60 4,119 403 6,779 1,736
9. Nurse-Teacher Conference
5-over ..... 256 109 287 53 30 47 1,148 851 43 304 255 211 23 1,583 364 2,448 527

P. SCHOOL. HEALTH
1. Pupils Examined by physician
with parent present ................. 874 9 347 106 33 2 170 108 3 24 130 639 54 64 137 1 215
(b) Referred for Further Diagnosis... 121 0 18 1 1 2 2 0 2 13 0 23 21 1 14 1 2
() Completed Referrals ............ 10 0 0 0 0 0 2 0 0 2 0 0 0 1 1 0 0
2. Pupils examined by physician
with parent not present ............. 12 2 32 807 59 3 8 25 42 96 411 574 0 232 39 3 133
(b) Referred for Further Diagnosis... 0 0 25 29 0 0 0 0 2 10 0 27 0 6 8 4 2
) Completed Referrals ............ 0 0 0 0 0 1 34 0 0 0 0 0 0 5 0 7 0
3. screening by other Health depart-
ments peronnel-Visual ............. 1,352 363 2,860 462 87 256 1,720 283 2 3,049 160 2,846 25 8,791 234 6,474 339
(b) Referred for Further Diagnosis... 384 45 420 44 1 66 89 64 2 158 15 378 10 830 23 354 40
c) Completed Referrals ............ 5 39 142 38 0 2 18 22 0 62 2 10 9 203 31 232 35
4. creeping by other health de-
partment personnel-Audio-
meter Testing ....................... 124 0 2,413 363 30 0 37 122 2 297 0 0 0 4,742 1 342 0
(b) Referred for Further Diagnosis... 1 0 157 15 0 0 8 5 1 74 0 0 0 335 1 8 0
(c) Completed Referrals ............ 0 0 24 3 0 0 9 1 0 2 0 0 0 47 0 3 0
G. DENTAL HEALTH
1. Adm. for Dental Treatment
(a) Maternity Patients .............. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

,o-
0

1 a 0 0 d
d % d -

E. CHILD HEALTH SERVICES
(Cont.)
6. Admissions to Nursing Service
Infants ............... 802 1,289 147 221 36 94 426 167 118 78 80 202 105 97 78 19,440
1 -4 ................. 1,473 923 223 263 12 52 673 185 424 38 121 193 232 59 132 24,344
5-over ............... 3,958 1,507 228 28 1,008 519 1,367 77 488 82 62 1,557 99 214 47 66,718
7. Field Nursing Visits-Infants......... 1,486 2,208 230 463 33 239 1,042 202 159 109 151 554 201 107 95 34,358
1-4........... 1,713 2,517 315 496 20 155 1,382 184 607 95 288 518 397 37 173 37,276
5 over ........ 4,711 3,882 330 49 279 888 2,469 90 374 161 170 1,287 127 77 116 46,246
8. Office Nursing Visits-Infants ........ 1,642 2,591 115 148 3 20 43 109 59 68 80 26 28 172 27 25,049
1-4 ........ 2,559 1,708 156 2 1 30 128 141 95 65 159 98 9 84 31 28,602
5 over ..... 9,241 5,720 384 0 904 129 1,151 96 328 59 215 2,045 27 265 57 157,517
9. Nurse-Teacher Conference
5 over ..... 6,136 3,964 95 0 453 999 1,581 125 125 105 5 1,232 105 134 33 70,392
F. SCHOOL HEALTH
1. Pupils Examined by physician
with parent present ................. 8,823 1,772 197 0 152 34 237 80 245 0 77 561 12 457 199 28,365
(b) Referred for Further Diagnosis... 651 163 132 0 29 12 44 60 0 3 2 3 0 95 3 2,594
(c) Completed Referrals ............ 422 43 5 0 34 8 0 0 0 0 0 49 0 75 0 1,042
2. Pupils examined by physician
with parent not present ............. 8,324 944 107 0 366 266 170 94 588 0 123 8 84 243 84 51,908
(b) Referred for Further Diagnosis... 1,978 120 67 0 32 35 0 3 14 1 5 0 0 43 5 5,364
c) Completed Referrals ............ 824 45 2 0 104 26 0 0 9. 0 1 1 0 52 3 1,868
3. Screening by other Health depart-
ments personnel-Visual .............. 42,457 4,558 415 0 165 227 1,047 1,556 272 827 98 8,574 96 464 55 218,801
(b) Referred for Further Diagnosis.. 3,397 589 8 0 32 363 206 88 23 26 16 268 2 44 38 20,875
(c) Completed Referrals ............ 1,281 182 26 0 29 128 49 35 8 3 3 99 0 68 30 7,149
4. Screening by other health de-
partment personnel-Audio-
meter Testing ...................... 29,416 368 22 0 0 447 0 3 1 759 0 5,523 0 15 0 117,264
(b) Referred for Further Diagnosis... 572 67 4 0 0 120 0 3 0 0 0 89 0 6 0 7,766
(c) Completed Referrals ............ 190 10 0 0 0 81 0 2 0 0 0 80 0 3 0 2,169
0. DENTAL HEALTH
1. Adm for Dental Treatment
(a) Maternity Patients .............. 0 54 0 0 0 10 0 0 0 0 0 0 0 0 0 68

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

4! B N U n n n n N

G. DENTAl HEALTH (Cont.)
(b) 1-4 .......................... 0 0 0 0 0 0 0 0 0 17 0 0 0 0
(c) 5 -over ........................ 3,286 0 0 0 373 364 0 0 0 0 0 0 966 0 0 275 166
2. Topical Fluoride Applications
(b)1-4 ........................... 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0
(c) 5 over ......................... 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0
3. No. of Children Screened
Dentist ............................ 4,564 59 0 0 0 882 0 1 0 189 23 0 0 0 1 19,589 1,702
(b) Others ......................... 0 0 844 188 685 3,697 8 43 322 8 0 0 2,972 0 295 0 2,683
4. Referrals of Children Screened
Dentist ............................. 18 0 0 0 0 365 0 1 30 75 23 0 0 0 1 11,066 1,083
(b) Others ......................... 0 0 155 17 389 1,322 5 41 0 2 0 0 1,258 0 228 0 1,841
5. No. of Children who Completed
Referrals-Dentist ................... 19 0 0 0 0 1,077 0 51 5 0 0 0 0 0 1 561 37
(b) Others ......................... 0 0 0 3 0 40 0 12 0 0 0 0 492 0 0 2 418
B. CHIROMC DISEASES
1. Adm. to Cancer Service ............ 66 3 98 50 21 131 19 27 18 42 30 15 50 24 4 2 240
2. Field Visits-Cancer ................ 16 1 193 183 30 304 17 89 40 83 86 18 494 48 10 4 843
3. Office Visits-Cancer ................ 207 2 521 50 15 398 8 24 24 26 36 15 142 20 6 1 511
4. Adm. to Crippled Children Service.. 62 5 100 47 60 62 15 19 22 34 14 10 12 9 21 32 207
5. Field Visits-Crippled Children....... 190 13 305 337 99 286 48 41 23 118 27 15 30 6 85 69 586
6. Office Visits-Crippled Children...... 161 1 55 98 79 33 4 25 14 78 21 10 3 4 17 6 41
7. Adm. to Diabetes Service ............ 10 9 14 15 33 40 4 18 9 8 10 0 4 2 7 2 87
8. Field Visits-Diabetes ............... 19 0 58 38 51 203 4 15 23 24 26 0 6 5 16 8 1,032
9. Office Visits-Diabetes .............. 6 23 74 14 115 110 8 58 18 3 62 0 0 1 104 2 1
10. Admissions to Heart Disease Control.. 5 24 13 46 4 4 2 8 14 19 7 0 56 6 8 7 211
11. Field Visits-Heart Disease .......... 24 13 44 97 2 31 3 11 3 31 4 0 1,465 11 10 21 1,419
12. Office Visits-Heart Disease.......... 3 82 35 292 3 22 0 8 60 8 8 0 96 0 18 10 784
J. MENTAL HEALTH
1. Admissions to Service ............... 48 7 39 12 12 34 4 25 6 47 16 4 666 28 14 18 344
3. Cases Closed ........................ 3 1 0 0 0 1 0 0 0 29 15 1 312 0 1 2 258
4. Testing ............................. 8 10 0 0 0 5 1 4 0 4 2 0 172 6 2 0 337
5. Counselling ......................... 3 3 0 17 9 31 3 9 22 39 54 0 528 0 23 11 3
6. Local Therapy ..................... 0 0 0 0 0 53 0 0 0 0 0 0 723 0 2 0 81
7. Referred for further Service.......... 14 0 2 0 4 14 1 0 0 7 9 1 55 2 5 5 56

trl

1-4
t-
<,
1-

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

G. D NElTAL REALTH (Cont.)
b 1-4 ........................... 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
S)5- over......................... 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0
2. Topical Fluoride Applications
(b) 1 4 ............................ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(c) 5 over ......................... 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. No. of Children Screened
Dentist ............................. 0 0 0 0 0 0 0 0 0 0 0 3,413 0 1 0 0 0
(b) Others ........................ 0 1 2,122 0 0 0 0 0 0 533 33 8,634 0 0 132 36 0
4. Referrals of Children Screened
Dentist ............................. 0 0 0 0 0 0 0 0 0 0 0 2,221 0 1 0 0 0
(b) Others ......................... 0 1 1,025 0 0 0 0 0 0 6 9 2,625 0 0 0 6 0
5. No. of Children who Completed
Referrals-Dentist .............. 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0
(b) Others ...................... 0 0 2 0 0 0 0 0 0 6 0 447 0 0 0 0 0
H. CEM ONZC DISEASES
1. Adm. to Cancer Service ............ 8 21 39 15 4 26 18 27 11 5 18 535 58 17 36 6 5
2. Field Visits-Cancer ................ 7 56 123 41 11 125 1 44 10 11 63 1,183 9 36 102 7
3. Office Visits-ancer ................ 8 65 8 7 5 62 34 24 21 1 17 2048 98 23 10 1 0
4. Adm. to Crippled Children Service.. 4 3 86 7 4 29 7 16 8 8 25 634 61 38 170 24 36
5. Field Visits-Crippled Children. 9 5 254 38 6 168 59 15 6 27 18 969 101 1 120 58 59
6. Office Visits-Cripled Children... 1 52 86 0 1 36 11 8 6 0 19 84 92 20 176 31 30
7. Adm. to Diabetes Service ............ 4 13 34 2 0 23 18 3 9 1 20 541 29 22 13 12 7
8. Field Visits-Diabetes ............... 0 61 64 17 0 45 23 1 0 6 5 1,320 17 110 34 12 1
9. Office Visits-Diabetes .............. 30 108 76 0 0 54 51 3 40 5 98 5,243 242 27 142 80 2
10. Admissions to Heart Disease Control.. 3 23 72 9 2 40 33 5 2 2 3 494 16 2 25 5 33
11. Field Visits-Heart Disease C ....... 2 11 613 27 72 26 165 14 0 1 4 2,214 20 14 53 2 30
12. Office Visits-Heart Disease ......... 4 84 103 200 2 148 142 18 39 2 1 949 7 7 133 15 23

J. .NTA-L ErEAr.x
1. Admissions to Service............... .. 73 11 71 0 0 10 1 48 0 4 3 504 16 61 21 612 7

3. Cases Closed ........................ 0 0 34 0 0 0 0 2 0 0 0 378 1 17 5 0 0
4. Testing ............................. 69 0 0 0 0 0 0 0 296 0 1 1 0 0
5. Counselling ........................ 5 9 222 0 0 0 1 9 0 11 2 1,766 0 83 3 6 5
6. LocalTherapy..................... 0 0 0 0 0 0 0 0 0 133 0 3 0 0 0
7. Referred for further Service.......... 2 8 39 0 0 7 0 0 0 0 0 161 1 16 2 0 0

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

M 0

d a a

G. DENTAL HEALTH (Cont.) t-i
b) 1 4 ........................... 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
(c) 5 over ........................ 0 0 0 0 0 0 66 0 0 0 0 0 0 906 0 2,568 0 O
2. Topical Fluoride Applications
(b) 1-4 ........................... 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(c) 5 over ......................... 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. No. of Children Screened
Dentist ............................. 0 0 0 0 12 0 1 0 0 1,739 0 0 0 19,894 7 107 3
(b) Others ......................... 2 11 0 385 0 0 2,135 4 0 1 0 122 0 0 34 3,776 260
4. Referrals of Children Screened
Dentist ............................. 0 0 0 0 10 0 1 0 0 865 0 0 9,199 7 246 3
(b) Others ......................... 2 6 0 13 0 0 549 4 0 1 0 10 0 0 0 1,849 4
5. No. of Children who Completed 1
Referrals-Dentist ................... 0 0 0 0 0 0 1 0 0 31 0 0 0 687 0 880 3
(b) Others ......................... 0 0 1 0 64 0 0 0 0 0 0 0 4 541 0
H. CHRONIC DISEASES t71
1. Adm. to Cancer Service ............ 27 39 72 8 20 22 32 11 11 44 19 5 9 49 6 125 82 -
2. Field Visits-Cancer ................ 33 61 12 17 7 37 122 7 10 170 40 11 22 13 3 97 91
3. Office Visits-Cancer ................ 8 28 161 2 18 23 26 13 11 110 18 2 9 790 4 780 69 :
4. Adm. to Crippled Children Service.. 52 30 294 4 15 18 46 79 23 33 29 40 21 56 33 116 52
5. Field Visits-Crippled Children....... 93 13 288 8 17 106 79 233 77 104 53 175 90 117 119 343 97
6. Office Visits-Crippled Children...... 28 15 938 1 10 13 8 12 12 70 9 17 8 23 41 21 165 CO
7. Adm. to Diabetes Service............. 25 19 30 11 9 13 49 101 21 12 16 25 10 29 14 41 30 -r
8. Field Visits-Diabetes ............... 65 26 13 4 10 22 179 67 87 105 67 47 17 9 59 136 15
9. Office Visits-Diabetes .............. 11 189 193 13 61 84 17 107 17 190 106 116 63 68 81 42 92
10. Admissions to Heart Disease Control.. 8 2 1 25 4 4 3 0 0 7 25 13 0 2 1 240 16
11. Field Visits-Heart Disease .......... 13 2 1 16 3 5 5 0 0 26 38 48 0 5 3 412 27
12. Office Visits-Heart Disease.......... 1 0 0 40 56 11 0 0 0 3 32 5 0 1 4 175 30 -
J. MENTAL HEALTH (*
1. Admissions to Service ............... 6 2 312 15 5 8 19 14 3 34 23 24 0 447 2 105 13
3. Cases Closed ........................ 0 0 226 1 0 0 0 0 0 0 15 1 0 544 0 3 2
4. Testing ............................. 0 0 142 0 5 0 5 0 0 0 30 0 0 379 0 0 1
5. Counselling ......................... 0 1 875 23 0 14 8 0 0 34 7 3 0 84 0 28 15
6. Local Therapy ..................... 0 0 1,102 0 0 0 0 0 0 0 0 0 0 263 0 1 0
7. Referred for further Service.......... 1 1 39 0 1 2 9 12 3 1 7 0 0 2 0 24 6
-

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

10

2. Topical Fluo e A s
S8 e a is

G. DEHTAI HEALTH (Cont.)
(b) 1-4 ..............69 1 0 0 0 1 0 0 0 0 0 1 0 0 90
(c) 5 -over .......................... 608 989 0 0 1 5 0 0 0 0 0 379 0 0 11,157
2. Topical Fluoride Applications
(b) I 4 .......... ................. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
(c) 5 over ......................... 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 358
3. No. of Children Screened
Dentist ........................... 42,229 3,778 0 0 0 2 0 0 0 0 0 3,590 0 0 0 101,786
(b) Others ......................... 0 298 4 0 54 176 0 197 0 0 0 13 0 0 0 30,708
4. Referrals of Children Screened
Dentist ............................. 22,902 2,806 0 0 0 13 0 0 0 0 0 2,363 0 0 53,299
(b) Others ......................... 0 174 4 0 20 130 0 106 0 0 0 0 0 0 011,802
5. No. of Children who Completed
Referrals-Dentist ................. 4,132 650 0 0 0 7 0 0 0 0 0 486 0 0 8,725
(b) Others ......................... 0 0 1 0 0 4 0 7 0 0 0 0 0 0 2,044
H. CHRONIC DISEASES
1. Adm. to Cancer Service ............ 268 420 34 9 79 49 15 42 8 27 10 159 3 19 37 3,449
2. Field Visits-Cancer ................ 626 205 67 27 61 220 26 76 18 75 15 438 6 14 37 6,960
3. Office Visits-Cancer ................ 623 1,352 10 4 67 39 6 55 3 17 9 167 1 15 60 8,914
4. Adm. to Crippled Children Service.. 28 95 49 33 76 35 30 41 53 77 5 89 25 79 22 3,569
5. Field Visits-Crippled Children....... 67 404 137 120 94 117 157 92 118 267 9 309 58 135 83 8,510
6. Office Visits-Crippled Children...... 7 73 7 22 172 13 11 31 17 82 8 9 6 95 86 3,393
7. Adm. to Diabetes Service ............ 49 110 10 2 25 30 8 18 29 25 10 84 8 27 5 1,918
8. Field Visits-Diabetes ............... 186 662 49 8 34 76 22 13 6 101 8 1,984 57 48 10 7,436
9. Office Visits-Diabetes .............. 454 167 5 0 83 29 5 26 49 69 50 290 29 198 42 9,768
10. Admissions to Heart Disease Control.. 105 20 12 1 10 44 9 9 31 2 8 15 53 9 6 1,888
11. Field Visits-Heart Disease .......... 1,148 20 35 18 28 376 25 7 11 18 15 78 7 14 12 8,724
12. Office Visits-Heart Disease........... 138 20 5 2 10 8 2 13 63 0 42 2 81 11 24 4,085
J. MENTAL HEALTH
1. Admissions to Service ............... 47 354 97 50 32 90 14 2 8 18 1 260 0 27 10 4,203
3. Cases Closed ....................... 6 278 0 28 0 36 0 0 1 0 0 290 0 0 0 2,491
4. Testing ............................. 0 262 83 0 0 37 1 0 1 0 0 129 0 0 0 2,003
5. Counselling ......................... 12 681 24 117 12 121 7 0 3 2 1 66 0 0 6 5,021
6. Local Therapy ..................... 0 7 0 6 0 5 0 0 0 0 0 23 0 0 0 2,403
7. Referred for further Service........ .... 7 91 3 23 8 41 2 2 0 9 0 1 0 7 4 717

z

0
O

-0

Ul
^I

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

0 R 0 i Ii 0 &1 1 4

J. 3EENTAl HEALTH (Cont.)

X. MISCELLANEOUS
1. Adm. to Morbidity Service........... 244 83 151 177 18 97 5 7 22 149 85 122 91 0 72 5 394
2. Field & Office Visits-Morbidity.... 392 143 642 478 40 568 8 8 161 241 250 189 474 0 303 15 2,246
3. General Medical Examinations....... 213 17 56 106 44 1,093 20 483 65 53 2 48 2,627 140 42 1,026 611
4. Health Cards Issued ................ 2,712 178 2,033 314 1,330 10,608 124 527 406 589 794 614 15,129 689 328 7,558 8,393
5. Visits in the Interest of
Vital Statistics ...................... 2 4 29 39 42 18 1 45 12 46 6 2 64 42 115 16 24
3L NURSING HOMES
1. Number of Nursing Homes
Admitted to Service.................. 4 0 5 0 6 5 0 1 0 1 0 4 94 0 0 12 23
2. Visits to Nursing Homes.............. 44 0 48 0 18 120 0 10 0 1 0 9 850 0 0 89 145
P. SANITATION
1. Approved Water Supplies Installed,
Private & Semi-Public ............... 1 0 0 1 12 280 0 0 0 2 11 2 13 0 1 1 768
2. Approved Water Supplies Installed,
New Public Water Connections....... 56 0 0 0 1 6 1 0 0 1 2 0 26 0 1 5 1,224
3. New Specification Privies Installed.... 10 0 1 1 0 0 1 1 0 0 0 0 0 0 0 20 185
4. Percolation Water Table or Soil
Log Test .......................... 1,067 0 323 19 5,400 428 0 3 0 185 25 81 2 0 36 1,213 92
5. Subdivision Analysis ................ 31 0 8 1 61 145 0 0 1 0 0 3 234 0 1 4 75
6. Pollution Survey .................... 5 0 11 0 0 209 0 6 0 1 0 1 25 0 0 89 74
7. New Specification Septic
Tanks Installed ..................... 727 26 457 67 3,037 7,317 29 369 33 74 158 371 293 41 26 1,141 2,709
8. Rabies-Number of Animal
Bites Investigated ................... 200 4 36 30 157 589 5 37 2 51 28 22 2514 16 0 663 754
9. Field Visits for Rabies Investigation.. 557 14 60 45 233 1,325 7 7 171 53 66 7,884 19 0 64 1,822
10. Complaints Investigated ............. 634 2 233 41 303 975 18 122 27 77 208 25 6,938 105 33 2,381 2,569
11. Nuisances Corrected ................. 289 1 275 27 61 445 13 77 10 29 66 19 4,303 13 18 948 2,213
12-19. Field Visits ...................... 2,744 1,584 3,581 154 9,440 12,710 285 1,307 570 686 890 1,914 30,707 676 194 6,874 18,945

0
n
C)

C-3

C)

1:1

u,

TABLE 5 (continued) L
co

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

4 z
g a R 0 z

o .. M

J. MENTAL HEALTH (Cont.)
8. Family Conferences ................. 49 15 126 0 0 21 1 19 0 26 1 786 28 133 40 11 11
9. Conferences-Other Agencies ......... 20 0 222 0 0 7 0 63 0 58 0 229 4 141 7 0 0
E. MISCE.LLANEOUS
1. Adm. to Morbidity Service........... 55 55 31 106 42 66 268 52 43 6 32 781 11 37 36 1 54 O
2. Field & Office Visits-Morbidity...... 211 192 443 269 92 330 1,836 116 85 62 49 3,595 12 92 94 1 122
3. General Medical Examinations....... 18 38 13 25 5 2 20 4 32 113 191 690 286 0 7 23 1
4. Health Cards Issued................. 106 402 831 121 83 379 404 523 496 311 984 39,231 183 864 506 256 8
5. Visits in the Interest of
Vital Statistics ...................... 24 7 361 1 0 31 9 0 35 5 23 0 0 11 38 15 1
M. NURSING HOMES
1. Number of Nursing Homes o
Admitted to Service ................. 0 0 1 0 0 0 0 1 0 2 5 23 0 2 0 1 0
2. Visits to Nursing Homes.............. 0 0 1 0 0 0 0 36 0 6 9 515 0 20 0 16 0 U1
P. SANITATION ".
1. Approved Water Supplies Installed,
Private & Semi-Public ............... 3 0 48 0 0 0 0 9 2 0 102 111 0 0 1 3 0
2. Approved Water Supplies Installed,
New Public Water Connections....... 1 2 324 0 0 54 0 4 3 0 5 1,548 2 1 2 1 0
3. New Specification Privies Installed.... 0 0 131 0 0 0 0 1 5 0 0 149 2 0 14 10 4
4. Percolation Water Table or Soil
Log Test ............................ 27 10 22 2 9 6 6 0 6 4 45 115 4 20 13 10 21
5. Subdivision Analysis ................. 4 1 2 0 0 0 0 0 0 0 25 21 0 7 3 0 0
6. Pollution Survey .................... 6 0 27 0 2 0 23 0 7 0 6 22 0 0 0 1 0
7. New Specification Septic
Tanks Installed ...................... 30 27 128 77 8 42 23 66 48 53 375 3,108 27 252 23 10 11
8. Rabies-Number of Animal
Bites Investigated ................... 3 12 7 2 10 4 7 2 4 0 81 1,878 7 8 15 22 0
9. Field Visits for Rabies Investigation.. 4 34 17 7 13 4 13 5 10 1 694 8,212 4 38 28 57 0
10. Complaints Investigated ............. 38 433 99 5 26 13 10 56 94 39 391 4,062 41 99 12 68 2
11. Nuisances Corrected .................. 8 265 221 5 10 2 1 14 32 20 157 1,891 23 31 7 54 5
12-19. Field Visits ...................... 178 482 790 788 168 560 371 893 510 424 3,591 28,482 192 569 527 774 40

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

0

J. MCBTA-- HEA XTH (Cont.) 0
8. Family Conferences ................ 4 1 6 26 1 16 26 26 11 44 54 29 0 1238 3 183 13
9. Conferences-Other Agencies ........ 0 3 44 31 0 3 35 30 2 61 61 19 0 1,927 3 85 12
r. MIMCELLNEOUS
1. Adm. to Morbidity Service.......... 17 123 39 92 81 2 32 406 13 170 101 309 15 19 22 285 43
2. Field & Office Visits-Morbidity ..... 28 224 48 400 713 3 85 409 34 407 202 1,573 23 129 81 1,253 100 t
3. General Medical Examinations....... 30 18 34 139 66 1 406 256 0 28 3 234 0 10 52 139 5
4. Health Cards Isued ................ 952 2,627 3,529 683 157 211 2,269 2,148 0 772 711 1,115 58 585 355 5,159 2,509
5. Visits in the Interest of
Vital Statistics ..................... 13 0 6 10 1 8 9 3 14 21 46 28 0 4 2 18 45
M. NUasXNG HOMES
1. Number of Nursing Homes
Admitted to Service .................. 14 5 3 1 0 1 2 1 0 0 1 13 21 7
2. Visits to Nursing Homes............. 30 12 19 11 0 16 81 6 12 0 0 0 8 124 34 152 44 -
P. SANuTJATKOI O
1. Approved Water Supplies Installed,
Private & Semi-Public ............... 3 1 0 0 0 4 1 93 24 0 1 0 1 96 32 0 0
2. Approved Water Supplies Installed, CnA
New Public Water Connections....... 0 0 3 0 0 0 4 0 58 0 0 31 2 176 4 0 0
3. New Specification Privies Installed.... 0 0 7 0 0 101 30 0 2 6 1 0 8 0 0 0
4. Percolation Water Table or Soil
Log est ..... .................. 133 9 14 1 0 6 117 160 207 0 44 277 10 1,618 45 260 9
5. SudivisionAnalysis................. 13 2 2 0 0 5 4 3 0 0 3 37 0 76 14 10
6. Pollution Survey .................... 5 3 328 0 0 1 3 12 3 7 0 1 0 40 0
7. New Specification Septic 98
Tanks Insalled ...................... 787 433 432 65 2 18 61 328 299 23 159 330 21 4,705 165 2,325 98
8. Rabies-Number of Animal M
Bites Investigated ................... 30 93 248 10 1 17 182 187 4 138 1 95 31 408 38 246 13
9. Field Visits for Rabies Investigation.. 80 174 737 29 1 44 393 3 4 218 37 69 40 534 41 25 32
10. Complaints Investigated ............. 184 102 298 14 6 36 337 603 103 285 29 219 7 1,981 124 765 57
11. Nuisances Corrected ................. 0 28 60 10 0 11 261 410 29 331 2 116 6 767 59 433 13
12-19. Field Visits ..................... ... 2,075 1,007 1,917 849 168 481 2,369 1,553 844 3,958 685 2,928 222 22,765 94810,916 361 L1
I I_ I_ I_ I_ 1 %0

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

a a

W e M 1 i E

J. MENTAT. *A.TH (Cont.)
8. Family Conferences ................. 125 508 72 210 60 143 62 3 18 16 1 552 0 86 29 8,972
9. Conferences-Other Agencies ......... 13 155 62 377 58 197 24 1 7 8 0 291 0 50 6 5,081
X. IOCELLANEOUS
1. Adm. to Morbidity Service........... 1,141 528 133 1 161 171 46 34 83 28 78 254 18 98 17 7,958
2. Field & Office Visits-Morbidity...... 10,448 1,728 262 1 414 1,433 90 46 381 92 194 4,072 87 166 31 38,916
3. General Medical Examinations....... 205 28 23 0 52 214 16 0 0 2 58 559 21 144 179 11,036
4. Health Cards Issued................ 24,090 254 1,045 1,228 349 2,710 714 666 311 511 83 2,635 383 660 327 157,820
5. Visits in the Interest of
Vital Statistics ....................... 0 231 1 4 28 99 15 6 14 17 14 79 10 2 6 1,822
M. NI SINrG BOMES
1. Number of Nursing Homes
Admitted to Service ................. 30 13 11 4 0 10 11 1 1 0 0 19 0 0 1 377
2. Visits to Nursing Homes..:.......... 545 171 21 27 0 50 50 9 3 0 0 267 0 0 11 3,640
P. SAbITATION
1. Approved Water Supplies Installed,
Private & Semi-Public ............... 0 4 21 17 3 131 6 0 0 7 0 12 0 30 11 1,869
2. Approved Water Supplies Installed,
New Public Water Connections....... 2 3 18 220 1 14 0 0 0 40 7 2 0 49 0 3,904
3. New Specification Privies Installed.... 3 4 3 1 0 4 9 0 32 0 26 34 0 4 0 812
4. Percolation Water Table or Soil
Log Test ........................... 2,940 622 120 476 189 1,281 497 2 7 17 0 215 0 0 0 18,470
5. Subdivision Analysis ................. 5 12 15 4 6 134 28 0 1 0 0 17 0 7 0 1,025
6. Pollution Survey .................... 18 4 0 2 3 17 0 0 0 1 6 5 0 0 0 974
7. New Specification Septic
Tanks Installed ...... ........... 5,192 1,158 102 479 82 1,788 568 13 21 62 36 1,301 1 95 40 42,372
8. Rabies-Number of Animal
Bites Investigated ................... 171 310 21 42 26 123 66 18 13 22 2 174 22 8 14 9,944
9. Field Visits for Rabies Investigation.. 356 691 16 66 27 208 192 48 2 36 0 319 54 12 0 25,961
10. Complaints Investigated ............ 1,916 560 63 174 44 447 311 16 14 21 2 414 40 159 20 29,530
11. Nuisances Corrected ................. 632 374 6 141 7 149 92 10 12 14 2 182 6 33 18 15,857
12-19. Field Visits ..................... 19,357 5,332 310 1,395 594 6,037 1,725 453 332 498 986 1,901 201 613 53 26,433

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

0 2 e

A cc Ii I I

B. PROTECTION OF FOOD
AND MaLK
1. Food-handling Establishments
Admitted to Service ................ 453 18 214 80 59 799 23 25 29 108 65 555,646 16 12 846 455
2. Field Visits to Food-handling
Establishments ...................... 2,530 364 1,564 732 209 1,723 295 326 123 819 268 335 36,231 129 99 2,209 2,197
3. Number of Food-handlers'
Certificates Awarded ................ 0 0 0 0 0 108 0 0 0 0 0 0 5,386 3 0 0 0
4. Dairy Farms Admitted to Service.... 23 7 6 5 3 1 12 2 1 3 0 5 81 4 0 0 51
5. Field Visits to Dairy Farms.......... 238 10 133 63 11 6 276 47 3 68 0 43 1,444 122 0 0 681
6. Milk & Milk Products Plants
Admitted to Service ................ 6 0 8 2 1 2 0 2 0 2 3 1 108 1 0 0 3
7. Field Visits to Milk & Milk
Products Plants .................... 86 0 39 21 20 54 0 2 0 24 18 26 3,718 2 0 0 166
8. Cows Tuberculin Tested ........... 946 0 75 1 4 0 0 0 95 0 0 0 5,086 325 0 0 4,956
9. Cows Bangs Tested ................. 5 0 74 82 4 0 0 0 95 0 0 0 0 162 0 0 5,007
10. Dairy Farms under Mastitis
Control Program .................... 23 0 3 0 0 0 0 2 0 0 0 0 0 0 0 0 0
V. HEALTH INFORMATION
1. Meetings Attended .................. 578 25 51 55 58 211 18 45 83 153 103 5 1,316 64 27 186 589
2. Lectures and Motion Pictures
Showings ........................... 373 61 152 43 52 459 22 38 48 54 48 2 1,747 46 27 191 588
4. Radio & Television Programs ........ 6 1 1 0 4 4 0 0 0 0 20 0 29 0 0 1 7
5. News Articles Published ............. 28 15 0 21 2 34 1 10 4 78 10 2 103 0 31 0 45
6. Exhibits Displayed .................. 1 0 1 0 2 0 0 0 3 2 3 0 8 0 0 0 0
X. LABORATORY
1-21. Specimens Examined ............. 12,898 1,395 8,426 1,697 5,555 18,198 1,313 2,373 1,695 2,103 1,376 3,741 81,206 2,550 1,832 22,074 26,196

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

B. PROTECTION" O FOOD

Admitted to Service ................ 13 26 70 4 18 97 32 55 25 14 196 2,642 64 66 122 52 7
R. PMOTECTXTON OF FOOD
AND MILK
1. Food-handling Establishments
Admitted to Service ................. 13 26 70 4 18 97 32 55 25 14 196 2,642 64 66 122 52 7
2. Field Visits to Food-handling
Establishments ...................... 40 244 191 160 55 815 309 189 155 67 501 20,027 630 104 861 365 57
3. Number of Food-handlers'
Certificates Awarded ................. 0 0 0 0 0 0 0 0 0 0 0 58 0 1 0 0
4. Dairy Farms Admitted to Service.... 1 0 8 1 8 1 1 18 3 0 4 102 14 8 35 9 22
5. Field Visits to Dairy Farms.......... 2 0 159 5 91 18 11 73 41 0 35 2,651 271 88 345 137 393
6. Milk & Milk Products Plants
Admitted to Service ................ 0 0 0 0 0 0 0 1 2 0 2 19 0 4 6 1 0
7. Field Visits to Milk & Milk
Products Plants .................... 0 0 28 0 0 0 0 0 2 0 19 1,192 0 24 30 1 0
8. Cows Tuberculin Tested ............ 4 0 452 0 0 0 0 372 0 0 0 20,770 492 702 0 964 191
9. Cows Bangs Tested ................. 3 0 3,682 0 0 0 0 0 0 0 0 2,841 752 482 0 827 1,159
10. Dairy Farms under Mastitis
Control Program ................... 0 0 0 0 0 0 0 2 0 0 0 102 3 0 0 0 0
V. HEALTtH INPOIMATION0
1. Meetings Attended .................. 32 12 179 2 31 44 21 105 44 11 32 601 21 39 36 55 13
2. Lectures and Motion Pictures
Showings ........................... 1 1 131 9 2 142 12 19 43 5 10 584 44 20 95 106 12
4. Radio & Television Programs ........ 0 0 1 0 0 48 0 3 0 1 3 11 34 0 0 0 0
5. News Articles Published ............. 25 1 26 0 5 4 4 2 14 2 15 56 33 13 4 23 9
6. Exhibits Displayed .................. 0 1 2 1 0 0 18 0 0 0 0 0 0 1 0 0 0
X. LABORATORY
1-21. Specimens Examined ............. 925 938 4,462 592 684 2,810 2,669 2,769 1,712 654 2,478 109749 2,602 3,588 5,514 2,085 860

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

B. PROTECTION OF FOOD
AND MILK
1. Food-handling Establishments
Admitted to Service ................ 123 282 366 34 9 69 240 189 118 140 19 102 32 561 89 545 208
2. Field Visits to Food-handling
Establishments ...................... 311 684 2,079 96 106 339 711 611 560 532 218 410 99 2,158 338 1,590 560
3. Number of Food-handlers'
Certificates Awarded ................ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Dairy Farms Admitted to Service.... 13 7 13 1 0 9 30 18 4 0 3 2 4 0 4 41 10
5. Field Visits to Dairy Farms.......... 42 77 126 5 0 183 112 232 35 0 14 38 32 0 30 326 186
6. Milk & Milk Products Plants
Admitted to Service ................ 4 1 10 1 0 1 3 6 3 6 2 2 1 0 0 33 0
7. Field Visits to Milk & Milk
Products Plants ................... 7 26 79 13 0 1 35 77 10 36 15 4 3 0 0 1,405 0
8. Cows Tuberculin Tested ............ 833 488 1,124 0 0 164 3,995 1,623 1,190 0 0 0 236 0 0 8 1,108
9. Cows Bangs Tested ................. 528 186 1 0 0 216 657 1,150 779 0 0 85 236 0 0 0 373
10. Dairy Farms under Mastitis
Control Program .................... 0 0 0 0 0 00 17 3 0 1 1 0 0 0 0 0
V. HEALTH INFORMATION
1. Meetings Attended .................. 38 40 15 35 14 65 491 29 52 226 46 35 6 59 74 468 17
2. Lectures and Motion Pictures
Showings ........................... 14 15 61 68 27 35 320 146 29 153 159 47 10 711 7 604 61
4. Radio & Television Programs ........ 2 0 8 0 0 2 6 1 0 1 5 1 0 0 0 4 0
5. News Articles Published ............. 0 1 177 0 1 11 44 19 2 34 49 4 2 49 0 17 2
6. Exhibits Displayed .................. 0 0 1 0 2 4 0 0 1 18 1 0 0 0 1 0
X. LABORA0TORB
1-21. Specimens Examined ............. 3,094 8,713 22,529 3,784 989 2,592 10,766 5,822 1,177 4,508 3,542 3,536 639 10,949 2,555 20,623 3,467

TABLE 5 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1957

d 0

o 0 l

B. PROTECTION Or FOOD
AND MILE
1. Food-handling Establishments
Admitted to Service ................ 2,479 886 46 196 67 270 141 65 83 79 23 1,043 24 114 53 21,101
2. Field Visits to Food-handling
Establishments ..... .........12,028 4,342 107 1,345 228 965 679 271 593 262 69 3,465 186 336 373 111,574
3. Number of Food-handlers'
Certificates Awarded ................ 0 25 0 0 0 0 0 0 0 1 0 1 0 0 0 5,583
4. Dairy Farms Admitted to Service.... 36 54 9 4 27 16 8 8 8 0 4 27 0 8 33 840
5. Field Visits to Dairy Farms.......... 709 589 53 27 199 153 45 72 113 5 32 75 0 79 220 11,274
6. Milk & Milk Products Plants
Admitted to Service ................ 66 10 1 6 0 6 2 1 0 0 0 13 0 2 1 355
7. Field Visits to Milk & Milk
Products Plants.................... 599 71 6 32 0 46 5 1 0 0 1 39 0 10 2 7,995
8. Cows Tuberculin Tested ............ 5,574 4,681 0 246 1 108 0 52 326 0 0 0 0 938 522 58,652
9. Cows Bangs Tested ................. 595 347 0 244 0 0 0 52 339 0 0 0 0 926 493 22,382
10. Dairy Farms under Mastitis
Control Program .................... 38 54 5 0 0 0 0 0 0 0 0 0 0 8 0 262
V. HEALTH XINORMATZON
1. Meetings Attended .................. 654 317 81 57 105 314 50 11 60 87 34 90 0 56 10 8,481
2. Lectures and Motion Pictures
Showings ......................... 1,651 490 48 12 22 511 41 18 76 88 9 62 0 63 11 10,756
4. Radio & Television Programs ........ 18 18 35 0 0 11 2 0 1 0 0 1 0 17 0 307
5. News Articles Published ............. 186 109 16 0 2 114 3 21 11 9 19 146 0 37 0 1,705
6. Exhibits Displayed .................. 2 6 0 0 0 5 0 2 2 13 0 1 0 48 0 150
E. .LABO &TORY
1-21. Specimens Examined ............. 40,619 6,691 2,599 2,376 2,131 2,739 1,502 2,174 5,651 2,073 932 5,417 1,506 4,094 2,591 542,099

VITAL STATISTICS 65

BUREAU OF VITAL STATISTICS

EVERETT H. WILLIAMS, JR., M.S., Hyg.
Director

A summary of the activities of the Bureau of Vital Statistics and a
brief analysis of statistical data based on preliminary tabulations are
given in this text. An analysis of vital statistics and morbidity data for
1957 in greater detail is presented in Supplements 1 and 2 of this re-
port under the titles FLORIDA VITAL STATISTICS, 1957, and
FLORIDA MORBIDITY STATISTICS, 1957.

POPULATION
The population of the state as of July 1, 1957, was estimated to be
4,238,200, an increase of 8.7 per cent over the figure of 3,897,400 for
the previous year. The white population was estimated to be 3,439,000
persons and the nonwhite population 799,200.
These population estimates were prepared by the Bureau of Business
and Economic Research of the University of Florida by a method which
is essentially Census Method II. Under this method the population
enumerated in 1950 is increased by resident births, decreased by resident
deaths, and adjusted for an estimated amount of in or out migration for
the period from April 1, 1950 to July 1, 1957. This method was applied
to individual counties, the state total representing the sum of the in-
dividual county estimates.
Data on births and deaths were supplied by this bureau. Estimates
of migration were based on school attendance data supplied by the State
Department of Education.

BIRTHS
Provisional birth figures for the first time topped the 100,000 mark.
There were 104,134 births in 1957 compared with 96,969 in 1956, a
rise of 7.4 per cent. White births increased from 69,557 in 1956 to 75,136
in 1957, and nonwhite births from 27,412 to 28,998. The white increase
represents a rise of 8.0 per cent compared with the nonwhite rise of 5.8
per cent.
Estimated birth rates were as follows: white, 21.8; nonwhite, 36.3;
and total, 24.6; per 1,000 population.

DEATHS
Provisional tabulations indicate a total of 39,964 deaths for 1957
compared with 36,876 for 1956. Percentagewise, the increase in births
was not as great as the increase in deaths. Deaths increased 8.4 per cent

66 ANNUAL REPORT, 1957

compared with a 7.4 per cent increase in births. Provisional death rates
per 1,000 population for 1957 are: total, 9.4; white, 9.2; nonwhite, 10.5.
Chronic illness again accounted for the largest part of the mortality
in 1957. Deaths from the combined grouping of major cardiovascular-
renal disease (including diseases of the heart, blood vessels and kidneys)
totaled 20,787. Over half (52 per cent) of the deaths in 1957 were
included in this category.
Within the grouping of cardiovascular-renal disease, heart disease
was the largest component, with 14,269 deaths attributed to this cause
with a rate of 336.7 per 100,000 population. Cerebral vascular disease
deaths totaled 4,777 and deaths due to general arteriosclerosis, 580.
Rates for these causes were 112.7 and 13.7 per 100,000. There were
only 14 deaths from rheumatic fever, but 408 deaths were attributed
to chronic rheumatic heart disease.
Another major cause of death in the chronic illness category was
cancer. The cancer death rate was 143.1 per 100,000 population. There
were 6,065 deaths.
The number of deaths included under the major title of Infective
and Parasitic Diseases, increased from 587 in 1956 to 608 in 1957. The
rate in 1957 was slightly lower, however, 14.3 compared with 15.1 in
the previous year, indicating that the rise is accounted for chiefly by a
rise in population.
On the basis of the preliminary figures, there were 260 tuberculosis
deaths in 1957 compared with 244 in 1956. Preliminary rates per 100,000
population in both years are: 1957, 6.1; 1956, 6.3.
Syphilis mortality also continued to decline. There were 121 deaths
due to syphilis and its sequelae in 1957 with a rate of 2.9 per 100,000.
This may be compared with 12*6 deaths in 1956 and a rate of 3.2.
In 1957, there were 26 deaths attributed to meningococcal infections
compared with 19 in the previous year. Deaths from this cause exceeded
the number from several other infective diseases including poliomyelitis
(6 deaths) and diphtheria (5 deaths).
Other important causes of mortality in 1957 were: accidents (1,087
motor vehicle and 1,561 other), suicide (493 deaths), homicide (421
deaths), cirrhosis of the liver (537 deaths), congenital malformations
(524 deaths), and diseases of early infancy (1,868 deaths).

MARRIAGE AND DIVORCE
Marriages increased slightly from 31,666 in 1956 to 32,288; an in-
crease of 2 per cent. Divorces and annulments decreased, possibly due
to the introduction of more stringent requirements for divorce in October
1957. There were 18,800 divorces and annulments in 1957 compared
with 20,245 in 1956. There were 58 divorces per 100 marriages.

VITAL STATISTICS

ACTIVITIES
The year 1957 was a year of major changes in the Bureau of Vital
Statistics. During the year a complete survey of work procedures was
made and a chart prepared of the revised procedures. As a result, there
was a major change in the routing of applications for certified copies
which has resulted in speedier service to the general public. A new
section was formed in the bureau for processing mail and fee accounting,
which is another factor in the improvement of service to the general
public. It has also created a better control over fee accounts. These
changes have naturally created many administrative problems and the
process of rewriting all work procedures is not yet completed.
During the year the bureau discontinued the use of the U. S. Public
Health Service forms for birth notifications. New forms were designed
and are mailed to new parents with a picture of the child's birth certifi-
cate. These pictures are obtained at a very low cost by making prints
from microfilm copies. The purpose of this procedure is to give the
new parents an opportunity to view the birth certificate and make sure
all items are correct before the certificate is bound in our records.

The statistical section of our office has had many administrative
problems resulting from the great expansion of IBM tabulating equip-
ment in the preceding year. In addition to all of the functions which
were first processed by machine in 1956, the administrative payroll was
added. The statistical section also processed tabulations and analyses
for several special studies for other bureaus which will be described
elsewhere in this report. The numerous problems caused by so many
new procedures being placed on tabulating equipment has natural-
ly resulted in many of our statistical reports being published somewhat
later than usual. This is a temporary problem and will be straightened
out in the near future.
The routine work load of the office has continued to increase. (See
"Activities During the Years 1956 and 1957"). A tremendous increase
resulted from a change in policy concerning amendment of certificates.
This office is now operating as a quasi-judicial unit in making decisions
on corrections of records in some cases which formerly required the
decision of a court of competent jurisdiction. This has resulted in a
37.3 increase in the number of amended certificates filed for correction
of parentage and legitimation.
A consolidated VITAL STATISTICS SCOREBOARD is shown as
Table 12. Counties are listed in order of rank showing their relative
efficiency in birth and death registration. It is gratifying to note the
improvement which has taken place in some counties. On the other
hand, it is discouraging that the state average has shown little change.
It is hoped that the county health departments will take remedial action
in those counties which are at the bottom of the list and have shown little
or no improvement. Proper registration of births and deaths in each
county is the responsibility of the county health officer.

68 ANNUAL REPORT, 1957

Articles by staff members:
Thorner, Robert M., Population Growth in Three South Florida Coun-
ties Mimeographed by State Board of Health.
Thorner, R.M., Bond, J.O., Pertussis in Florida, Pub. Health Rep.,
72:795-800, Sept. 1957.

TABLE 6
ACTIVITIES OF THE BUREAU OF VITAL STATISTICS
DURING THE YEARS 1956 AND 1957

Per Cent
Activity 1956 1957 Change

Current certificates filed .......................... 186,384 195,587 + 4.9
Delayed birth certificates filed................... 4,202 4,134 1.6
Adoption decrees received ........................ 2,889 3,159 + 9.3
Amended certificates filed for adoptions .... 3,002 2,809 6.4
Amended certificates filed for legitimations
and corrections of parentage ............ 743 1,020 + 37.3
Requests for certifications
Total ...................................................... 105,479 108,696 + 3.1
Fee paid .......................................... 90,600 90,494 0.1
Free .................................................. 14,877 18,202 22.3
Photostats made .................................... 96,683 105,063 9.0
Birth registration cards made .................... 29,683 27,222 8.3
Fees collected and transmitted to
State Treasurer .................................... $134,084.69 $136,627.57 + 1.9

TABLE 7
RESIDENT BIRTHS AND DEATHS WITH RATES PER 1,000
POPULATION, FLORIDA, 1931 -1957
YEAR POPULATION BIRTHS BIRTH RATE DEATHS DEATH RATE
1957* 4,238,200 104,134 24.6 39,964 9.4
1956 3,897,400 97,320 25.0 36,705 9.4
1955 3,643,562 89,112 24.5 33,295 9.1
1954 3,481,528 84,831 24.4 31,503 9.0
1953 3,111,100 80,087 25.7 30,529 9.8
1952 3,006,400 74,219 29.7 29,136 9.7
1951 2,901,800 70,431 24.3 27,857 9.6
1950 2,797,100 64,370 23.0 26,525 9.5
1949 2,692,500 61,642 22.9 25,317 9.4
1948 2,587800 59,685 23.1 24,505 9.5
1947 2,483,200 60,201 24.2 24,150 9.7
1946 2,378,500 54,347 22.8 22,750 9.6
1945 2,273,900 48,839 21.5 22,594 9.9
1944 2,196,195 49186 22.4 23,251 10.6
1943 2,125,935 46,783 22.0 23,213 10.9
1942 2,055,675 40675 19.8 21,144 10.3
1941 1,985415 37,351 18.8 21,438 10.8
1940 1,915155 33,696 17.6 21,458 11.2
1939 1,853660 32,437 17.5 20,209 10.9
1938 1,795322 31,101 17.3 19949 11.1
1937 1,736,984 29,529 17.0 19,825 11.4
1936 1,678,46 28,116 16.7 20,050 11.9
1935 1,620,308 28058 17.3 19,059 11.8
1934 1,585,596 26,722 16.9 19,518 12.3
1933 1,554,000 25,647 16.5 18,112 11.7
1932 1,530,356 27,242 17.8 17,721 11.6
1931 1,502,736 26,789 17.8 17,291 11.5
1957 data based upon preliminary totals.

TABLE 8
DEATHS AND DEATH RATES BY CAUSE, BY RACE, FLORIDA, 1957 (PRELIMINARY)

CAUSE OF DEATH Deaths Rate Per 100,000 Population
(Numbers in parentheses refer to the International List of Causes of Death) Total White Colored Total White Colored
Total White Colored Total White Colored
ALL CAUSES .......... ............................. ..................... 39,964 31,554 8,410 9.4* 9.2* 10.5*
Tuberculosis of respiratory system (001-008) .......... ..................... .............. 251 162 89 5.9 4.7 11.1
Tuberculosis, other forms (010-019)....................................................... 9 4 5 .2 .1 .6
Syphilis and its sequelae (020-029)........................................... .......... 121 58 63 2.9 1.7 7.9
Typhoid fever (040) ..............................1 1 0 ** *** .0
Dysentery, all forms (045-048)............... ...................................... 11 2 9 .3 .1 1.1
Diphtheria (055) .......................... .. ...... ...... ...... .......... ....... .. 5 1 4 .1 *** .5
Meningococcal infections (057) ........................................................ 26 18 8 .6 .5 1.0
Acute poliomyelitis (080) ................................... 6 6 0 .1 .2 .0
Acute infectious encephalitis (082) ............... ................................. .... 9 8 1 .2 .2 .1
M easles (085) ... .............. ................................. ................ 11 8 3 .3 .2 .4
Typhus and other rickettsial diseases (100-108)............................................ 0 0 0 .0 .0 .0
All other diseases classified as infective and parasitic
(030 to 138 with exception of above causes)....................... ............ ... 158 88 70 3.7 2.6 8.8
Malignant neoplasms, including neoplasms of lymphatic and
haematopoietic tissues (140-205) ..................................................... 6,065 5,216 849 143.1 151.7 106.2
Diabetes mellitus (260) ....................... ........................................ 505 406 99 11.9 11.8 12.4
Anemias (290-293) ....................................................................... 94 54 40 2.2 1.6 5.0
Major cardiovascular-renal disease ............................................. 20,787 17,300 3,487 490.5 503.1 436.3
Cerebral vascular disease (330-334) .................................................. 4,777 3,688 1,089 112.7 107.2 136.3
Rheumatic fever (400-402) ................... ..................................... 14 8 6 0.3 0.2 .8
Diseases of the heart ............. ............................................... 14,269 12,244 2,025 336.7 356.0 253.4
Chronic rheumatic heart disease (410-416) .......................................... 408 349 59 9.6 10.1 7.4
Arteriosclerotic heart disease, coronary disease (420).................................... 10437 9,492 945 246.3 276.0 118.2 3
Nonrheumatic chronic endocarditis & myocardial degeneration (421, 422)................ 1062 827 235 25.1 24.0 29.4
Hypertension with heart disease (440-443)... ...................................... 1,613 1,003 610 38.1 29.2 76.3
Other diseases of heart (430-434) .................................................. 749 573 176 17.7 16.7 22.0
Hypertension without heart disease (444-447) .......................................... 276 189 87 6.5 5.5 10.9
General arteriosclerosis (450) ........................................................ 580 503 77 13.7 14.6 9.6
Other circulatory disease (451-468)................................................... 488 419 69 11.5 12.2 8.6
Chronic and unspecified nephritis (592-594) ...................... .................. 383 249 134 9.0 7.2 16.8 -
Influenza (480-483) ....................................... ........................... 142 61 81 3.4 1.8 10.1
Pneumonia (490-493) .......................................... 1,122 696 426 26.5 20.2 53.3
Ulcer of stomach and duodenum (540-541)................................ 226 194 32 5.3 5.6 4.0
Intestinal obstruction and hernia (560, 561, 570)......................................... 260 200 60 6.1 5.8 7.5
Gastritis, duodenitis, enteritis & colitis, except diarrhea of the newborn (543, 571, 572)........ 314 135 179 7.4 3.9 22.4 -4
Cirrhosis of liver (581) ......................... ....................................... 537 461 76 12.7 13.4 9.5
Acute nephritis and nephrosis (590, 591) ................................................ 68 47 21 1.6 1.4 2.6
Complications of pregnancy, childbirth and the puerperium (640-652, 660, 670-689)............ 62 17 45 .6** .2** 1.6**
Congenital malformations (750-759) .................................................... 524 395 129 12.4 11.5 16.1
Birth injuries, postnatal asphyxia & atelectasis (760-762).................................... 825 534 291 19.5 15.5 36.4
Infection of the newborn (763-768) ........................................................ 125 57 68 2.9 1.7 8.5
Other diseases peculiar to early infancy, and immaturity unqualified (769-776)............... 918 541 377 21.7 15.7 47.2 rc
Symptoms, senility, and ill-defined causes (780-795)................................ 688 415 273 16.2 12.1 34.2
All other diseases (residual) .................................................... ..... 2,532 1,913 619 59.7 55.6 77.4
Motor vehicle accidents (810-835) ......................................................... 1087 838 249 25.6 24.4 31.2
All other accidents (800-802, 840-962) ................................................. 1,561 1,131 430 36.8 32.9 53.8
Suicide and self-inflicted injury (963, 970-979) ............................................ 493 469 24 11.6 13.6 3.0 O0
Homicide and operations of war (964, 965, 980-999) ....................................... 421 118 303 9.9 3.4 37.9 '0
Infant mortality (deaths under one year of age)..................... ........ ............. 3,312 1,834 1,478 31.8** 24.4** 51.0**
Rate per 1,000 population
** Rat n,-p 1 nnn 1f., .- h.

70 ANNUAL REPORT, 1957

TABLE 9

ESTIMATED POPULATION AND PRELIMINARY TOTALS OF
BIRTHS, DEATHS, AND INFANT DEATHS, BY RACE,
BY COUNTY, FLORIDA, 1957

Population BIRTHS DEATHS INFANT DEATHS
COUNTY Estimate
1957 Total White Colored Total White Colored Total White Colored
STATE ........ 4,238,200 104,134 75,136 28,998 39,964 31,554 8,410 3,312 1,834 1,478
Alachua ....... 66400 1,903 1,235 668 536 296 240 64 33 31
Baker ......... 7,400 196 141 55 48 33 15 6 4 2
Bay ........... 59 600 1,993 1,591 402 384 314 70 42 32 10
Bradford ....... 12600 317 230 87 124 90 34 17 8 9
Brevard :...... 72 000 2,323 1,942 381 517 412 105 83 51 32
Broward ....... 249,600 6,009 3,925 2084 2,061 1,634 427 181 77 104
Calhoun ....... 7,500 197 164 \33 65 57 8 4 2 2
Charlotte ..... 5800 103 80 23 95 85 10 4 4 0
Citrus......... 6,600 165 116 49 86 69 17 5 3 2
Clay ........ 18 100 613 525 88 126 93 33 15 12 3
Collier ........ 14000 299 238 61 96 72 24 14 7 7
Columbia ...... 19 900 532 321 211 186 97 89 12 4 8
Dade.......... 82000 18,672 14,036 4,636 7,171 6,208 963 560 340 220
DeSoto ........ 10100 182 121 61 136 97 39 7 1 6
Dixie .......... 4,000 116 90 26 58 44 14 6 5 1
Duval ......... 438,600 11,662 8,315 3,347 3,440 2,238 1,202 347 186 161
Escambia ...... 157800 5,575 4191 1,384 1,259 888 371 215 117 98
Flagler ....... 5,300 158 65 93 58 28 30 14 2 12
Franklin 5,300 140 104 36 68 43 25 4 1 3
Gadsden ....... 44,600 1,133 290 843 351 136 215 63 5 58
Gilchrist ....... ,100 69 54 15 21 14 7 2 1 1
Glades ......... 2,400 51 26 25 23 12 11 4 0 4
Gulf ........... 9,500 328 225 103 51 22 29 12 3 9
Hamilton ...... 8,600 255 100 155 94 56 38 9 3 6
Hardee ........ 12,400 244 203 41 114 103 11 11 6 5
Hendry ........ 6800 201 123 78 59 34 25 6 3 3
Hernando ..... 9000 248 149 99 99 76 23 5 1 4
Highlands .. 18,600 431 280 151 187 142 45 11 5 6
Hillsborough .. 355,500 8,451 6,785 1,666 3,320 2,737 583 226 149 77
Holmes ....... 12,200 218 204 14 114 105 9 8 7 1
Indian River.. 19,500 558 343 215 210 166 44 21 9 12
Jackson ....... 36,900 824 491 333 261 159 102 19 7 12
efferson ...... 9,500 289 85 204 120 45 75 4 0 4
afayette ... 3 56 47 9 28 24 4 1 1 0
Lake.......... 47,800 1,214 823 391 608 479 129 50 26 24
Lee ........... 38,700 883 643 240 402 318 84 35 24 11
Leon .......... 63,800 1,828 1,080 748 467 235 232 53 24 29
Levy .......... 9,300 240 131 109 135 87 48 8 4 4
Liberty ....... 2,600 83 69 14 17 14 3 3 3 0
Madison 15,200 367 153 214 152 73 79 14 5 .9
Manatee 49,500 1,149 775 374 712 604 108 56 34 22
Marion ........ 46200 1,147 584 563 491 323 168 25 11 14
Martin ........ 13,100 289 172 117 143 98 45 19 8 11
Monroe ....... 41,800 1,279 1,138 141 276 234 42 32 28 4
Nassau ....... 16,000 478 329 149 123 78 45 17 10 7
Okaloosa ....... 53000 1,878 1,728 150 265 242 23 48 40 8
Okeechobee .... 4,600 139 107 32 33 21 12 1 1 0
Orange ........ 216,400 5,253 4,071 1,182 1,825 1,546 279 119 87 32
Osceola ....... 15,400 248 196 52 266 231 35 11 8 3
Palm Beach .. 191000 4,576 3,021 1,555 1,911 1,486 425 167 82 85
Pasco .......... 31,100 585 457 128 346 314 32 29 17 12
Pinellas ........ 268,100 4,432 3,436 996 4,363 4,047 316 150 86 64
Polk .......... 178,700 4,189 3,077 1,112 1,525 1,223 302 139 77 62
Putnam ........ 33,000 851 511 340 306 169 137 39 12 27
St. Johns ..... 33,700 697 416 281 315 206 109 29 12 17
St. Lucie ...... 30,500 901 453 448 289 185 104 40 15 25
Santa Rosa .... 23,100 798 717 81 180 153 27 22 21 1
Sarasota ...... 52,800 1,136 898 238 695 629 66 28 18 10
Seminole ....... 40,000 1,140 652 488 398 235 163 42 14 28
Sumter ........ 11,400 264 147 117 107 78 29 7 2 5
Suwannee .. 14,700 335 194 141 171 111 60 16 8 8
Taylor ......... 12,800 394 290 104 95 62 33 14 10 4
Union ......... 7,900 98 58 40 51 36 15 2 1 1
Volusia ........ 104,800 2,035 1,438 597 1,429 1,162 267 70 38 32
Wakulla ....... 4,900 126 73 53 34 25 9 1 1 0
Walton ...... 14,800 332 282 50 158 137 21 9 8 1
Washington .... 10,300 259 182 77 110 84 26 15 10 5

VITAL STATISTICS

TABLE 10
PRELIMINARY TOTALS OF RESIDENT DEATHS FROM

CERTAIN CAUSES, BY COUNTY, FLORIDA, 1957

Cardio-Vascular-Renol Diseaes

8u I I a S IIEes l-4 i la 1 M

STATE .... 62 260 121 11 6 6,065 505 94 1,264 4,777 14,269 383 1,358 1,087 1,561
Alachua .... 1 6 1 0 0 53 8 2 25 79 168 1 13 20 31
Baker ......0 1 0 0 0 6 0 0 3 3 16 2 2 0 4
Bay ........ 0 2 1 0 0 52 6 0 11 49 107 4 21 14 25
Bradford ... 0 2 0 0 0 11 1 0 8 20 45 1 3 5 4
Brevard .... 2 1 1 1 0 56 7 2 23 60 173 2 14 21 26
Broward ... 4 11 5 0 0 359 27 10 74 197 710 18 78 66 88
Calhoun ...1 0 0 0 0 6 0 0 0 19 18 1 1 4 3
Charlotte .. 1 0 0 0 0 17 2 0 4 20 33 0 2 2 3
Citrus ..... 0 0 0 0 0 10 0 0 0 12 42 1 1 3 5
Clay .......1 0 0 0 0 14 1 0 10 16 35 0 6 7 3
Collier .....0 0 0 0 0 12 0 0 4 10 25 3 3 6 3
Columbia ... 1 1 0 0 0 22 2 0 5 43 48 0 3 7 7
Dade ...... 7 57 25 3 1 1,206 97 11 214 646 2,654 58 234 194 198
DeSoto .... 0 1 0 0 0 21 3 0 5 22 44 4 6 2 5
Dixie ......0 0 0 0 0 7 1 0 5 10 11 1 2 2 7
Duval ......2 44 20 1 0 531 35 12 115 437 1,047 38 139 83 151
Escambia ... 4 10 6 0 0 136 14 1 54 144 394 10 33 41 67
Flagler ..... 2 0 0 0 0 8 2 0 1 9 9 1 3 0 8
Franklin ... 1 1 0 1 0 8 1 1 0 9 18 2 2 1 8
Gadsden ... 3 3 0 0 0 37 0 1 23 46 102 7 14 10 16
Gilchrist ... 0 0 0 0 0 1 0 0 0 3 10 0 0 2 1
Glades ..... 0 0 0 0 0 1 0 0 0 3 10 1 1 0 1
Gulf ....... 1 0 0 0 0 6 1 0 1 1 14 1 1 0 4
Hamilton .. 1 2 1 0 0 17 4 0 1 11 34 1 1 1 4
Hardee .... 0 1 1 0 0 16 4 0 7 10 39 1 8 3 6
Hendry .... 0 0 1 0 0 3 0 0 1 6 23 0 2 3 1
Hernando ..0 1 1 0 0 17 2 0 5 14 27 2 4 4 3
Highlands .. 1 1 0 0 0 24 1 0 6 30 64 9 9 1 13
Hillsborough. 4 20 14 0 0 518 39 10 71 299 1,266 35 86 70 116
Holmes .... 0 1 0 0 0 20 1 1 1 18 34 1 2 3 9
Indian River 2 1 1 0 25 5 2 3 22 68 2 9 13 7
ackson .... 1 0 0 0 24 1 1 6 42 91 4 12 11 16
efferson ... 0 1 0 0 0 15 2 1 5 23 41 0 2 2 3
afayette... 0 0 0 0 0 3 0 0 2 2 11 0 1 2 3
Lake ...... 1 5 2 0 0 82 14 1 22 70 221 7 16 23 25
Lee ....... 1 2 3 0 0 65 5 2 10 51 132 1 15 12 11
Leon ...... 0 0 2 1 1 58 4 1 21 74 136 4 19 11 22
Levy ....... 1 0 1 0 0 8 1 0 12 16 63 1 1 3 5
Liberty .... 0 0 0 0 0 2 0 0 0 0 5 1 2 1 0
Madison .... 0 0 0 0 0 24 4 0 7 16 52 1 3 3 10
Manatee ... 2 4 1 1 0 108 7 1 22 96 277 12 24 8 19
Marion .... 1 1 2 0 0 71 4 2 12 66 189 6 18 13 21
Martin .... 0 1 0 0 0 16 0 0 10 18 43 0 4 5 10
Monroe .... 0 2 0 0 0 54 4 0 8 38 76 1 4 10 16
Nassau ..... 2 2 0 0 0 13 2 1 4 13 37 0 4 4 5
Okaloosa ... 0 2 0 0 0 23 1 0 14 27 74 5 0 18 32
Okeechobee. 0 0 0 0 0 9 1 0 1 5 7 1 0 3 0
Orane .... 1 14 7 0 0 276 20 2 52 224 730 23 63 45 73
Osceola .... 0 0 0 0 24 4 3 8 37 118 2 6 4 5
Palm Beach.2 12 0 1 1 327 34 3 46 212 677 13 62 77 71
Pasco ..... 0 1 1 0 0 46 6 0 7 50 122 1 16 9 27
Pinellas ... 3 13 7 0 1 756 46 7 92 654 1,824 23 175 55 101
Polk ...... 2 8 7 0 0 225 23 1 59 220 531 11 34 46 66
Putnam .... 1 1 1 0 1 30 2 2 13 36 107 16 12 7 14
St. Johns .. 1 3 1 0 0 33 1 0 12 57 82 3 21 9 19
St. Lucie ... 2 1 1 0 0 42 3 0 10 36 81 1 6 16 19
Santa Rosa 0 2 0 0 0 21 1 0 9 22 69 4 3 7 3
Sarasota ... 0 3 3 0 0 132 9 2 20 70 266 5 24 11 35
Seminole .. 0 3 0 1 1 46 10 1 25 45 132 9 7 17 21
Sumter .... 0 0 0 0 0 14 1 1 6 20 40 2 6 5 4
Suwannee .. 0 1 1 0 0 15 2 2 13 34 52 2 8 5 4
Taylor .... 0 0 1 0 0 5 0 1 5 21 25 0 3 5 4
Union 2 1 0 0 0 6 0 1 3 5 15 1 2 4 1
Volusia... 1 7 0 0 235 26 4 35 170 569 14 64 34 53
Wakulla ... 0 0 0 0 0 2 0 0 1 4 8 1 7 1 3
Walton .... 0 1 1 0 0 23 2 0 3 18 51 1 6 9 8
Washington. 0 0 0 0 0 12 1 1 9 17 27 0 5 4 5
Includes all vascular lesions affecting the central nervous system.

72 ANNUAL REPORT, 1957

TABLE 11

PRELIMINARY TOTALS OF MARRIAGES BY COLOR,

DIVORCES, AND ANNULMENTS FOR FLORIDA, AND

EACH COUNTY, 1957

MARRIAGES
COUNTY Divorces Annulments
Total White Nonwhite
STATE ................... 32,149 25,952 6,197 18,596 147

Alachua ................... 417 278 139 171 2
Baker .................... 37 24 13 360 2
Bay ...................... 444 334 110 176 3
Bradford ................. 62 43 19 337 2
Brevard ................. 469 369 100 586 3
Broward .................. 2,035 1,539 496 873 6
Calhoun ................. 26 20 6 56
Charlotte ................. 68 59 9 29
Citrus .................... 76 58 18 30
Clay ..................... 79 65 14 59
Collier ................... 145 130 15 30
Columbia ................ 127 88 39 68
Dade ..................... 7,933 6,859 1,074 4,593 56
DeSoto ................... 90 71 19 29
Dixie ..................... 22 17 5 28
Duval .................... 2,048 1,605 443 797 4
Escambia ................. 962 785 177 768 16
Flagler ................... 51 30 21 237 2
Franklin ...............41 34 7 16 1
Gadsden .................. 147 52 95 54 2
Gilchrist .................. 39 30 9 6
Glades .................... 15 6 9 4
Gulf ... .............. 78 45 33 27
Hamilton ................. 36 23 13 34 1
Hardee ................... 137 123 14 225 2
Hendry ................... 123 99 24 40
Hernando ............. 108 82 26 34
Highlands ................ 185 113 72 102
Hillsborough .............. 2,887 2,437 450 1,423 8
Holmes ................... 78 72 6 67
Indian River ............. 186 137 49 27
ackson .................. 159 105 54 iO 1
efferson ................. 61 20 41 14
afayette ................. 16 16 2
Lake ..................... 392 291 101 661 2
Lee ..................... 344 274 70 170
Leon ..................... 333 226 107 257 1
Levy ..... .............. 69 44 25 15
Liberty ................... 12 11 1 13
Madison .................. 59 39 20 35
Manatee ................. 441 359 82 106
Marion ................... 313 198 115 137 2
Martin .................. 138 103 35 10
Monroe .................. 470 409 61 263
Nassau ................. 59 49 10 14
Okaloosa ..... ..... 293 273 20 180 1
Okeechobee .............. 52 44 8 14
Orange .............. 1,545 1,240 305 340
Osceola .183 128 55 21
Palm Beach ............... 1,586 1,211 375 703
Pasco ............. 288 250 38 121 1
Pinellas ...........2,013 1,760 253 865 6
Polk .............. 1,425 1,141 284 773 8
Putnam ................. 189 133 56 347
St. Johns ... .....182 138 44 650 6
St. Lucie ....... 304 195 109 110
Santa Rosa .............. 128 116 12 72
Sarasota ................. 520 450 70 202 1
Seminole ................ 271 175 96 153
Sumter ................... 106 80 26 124 2
Suwannee .............. 98 80 18 52
Taylor ................... 63 52 11 29
Union .................... 30 24 6 281
Volusia .................. 689 562 127 440 5
Wakulla .................. 37 22 15
Walton ................... 64 57 7 45
Washington ............... 66 50 16 11

VITAL STATISTICS 73

TABLE 12

VITAL STATISTICS SCOREBOARD
BASED ON PROMPTNESS AND COMPLETENESS OF
CERTIFICATES FILED IN 1957

Percent of Percent of Percent of
Certificates Complete Monthly Change Total Score
COUNTY Rank Filed on Time Certificates Reports from 1956 (Maximum
Submitted Total Score =500)
Births Deaths Births Deaths on Time
Baker ............... 1 100 100 100 100 100 500 + 6
Sarasota ............. 2 99 99 99 99 100 496 1
Orange .............. 3 99 99 99 99 100 496 1
efferson ............ 4 98 100 98 100 100 496 -13
Martin .............. 5 99 96 100 100 100 495 6
Hardee .............. 6 99 98 99 99 100 495 -18
Citrus ............... 7 94 100 100 100 100 494 -10
Okeechobee .......... 8 97 97 99 100 100 493 1
Dade ............... 9 97 97 99 99 100 492 2
Pinellas .............. 10 95 99 99 99 100 492 17
Volusia ............. 11 96 97 99 99 100 491 0
Seminole ............ 12 95 99 99 98 100 491 +22
Holmes ............. 13 98 93 100 100 100 491 +26
Wakulla ............. 14 100 95 100 95 100 490 -10
St. Lucie ............ 15 97 95 99 99 100 490 +10
Hillsborough ......... 16 92 99 100 99 100 490 5
Hernando ........17 97 94 99 99 100 489 4
Escambia ........... 18 92 98 99 99 100 488 I
Suwannee ........... 19 95 96 99 97 100 487 23
Franklin ............ 20 92 98 100 95 100 485 +2
Monroe .............21 90 98 99 98 100 485 +3
Broward ............ 22 92 97 98 98 100 485 7
Gilchrist ............ 23 92 91 100 100 100 483 5
Polk ................ 24 88 96 99 99 100 482 2
Levy ................ 25 91 91 100 100 100 482 13
Osceola ............. 26 87 98 99 98 100 482 34
Gulf ................ 27 93 92 98 98 100 481 9
Washington .......... 28 89 94 98 100 100 481 19
Hamilton ........... 29 92 91 97 99 100 479 54
Flagler .............. 30 96 92 100 98 92 478 38
STATE ........... 89 95 99 99 94 476 + 4
Walton .............. 31 95 85 99 97 100 476 +18
Charlotte ............ 32 96 100 99 97 83 475 5
Madison ............ 33 84 99 95 96 100 474 3
Putnam ............. 34 92 89 98 95 100 474 10
Leon ................ 35 86 91 99 98 100 474 -18
Santa Rosa .......... 36 91 83 99 99 100 472 19
Palm Beach ......... 37 76 97 99 99 100 471 6
Clay ................ 38 82 93 98 98 100 471 -17
Marion .............. 39 78 94 99 99 100 470 4
Duval ............... 40 84 98 98 98 92 470 +1
St. Johns .......... 41 94 95 99 99 83 470 +7
Calhoun ............. 42 92 88 100 98 92 470 16
Nassau ..............43 94 96 100 96 83 469 4
Gadsden ............ 44 83 88 99 98 100 468 3
Lake ................ 45 90 81 99 98 100 468 +12
Bay ................. 46 81 86 99 98 100 464 -13
Highlands .. ......47 79 95 100 98 92 464 7
Manatee. 48 91 98 99 99 75 462 7
Union ............... 49 89 84 97 100 92 462 13
Alachua ............. 50 79 91 99 99 92 460 2
Glades .............. 51 80 87 100 93 100 460 +60
Taylor .............. 52 72 96 93 97 100 458 23
Brevard .............53 80 86 99 99 92 456 -
Pasco ............... 54 83 94 97 99 83 456 +26
Liberty .............. 55 100 80 100 100 75 455 3
DeSoto .............. 56 85 96 99 99 75 454 +4
Lee ................. 57 62 94 99 98 100 453 4
Bradford ............ 58 99 97 99 98 58 451 0
Dixie ............... 59 53 91 99 100 100 443 -10
Sumter .............. 60 73 71 100 98 100 442 1
Indian River ........ 61 93 100 99 99 50 441 -32
Hendry ............ 62 49 95 99 98 92 -433 6
Okaloosa ............ 63 58 85 99 98 92 432 +19
Columbia ........... 64 71 79 100 98 75 423 +64
ackson ............. 65 71 70 98 99 83 421 -24
Collier .............. 66 59 91 98 98 67 413 -53
Lafayette ............ 67 32 93 95 100 58 378 -68

74 ANNUAL REPORT, 1957

BUREAU OF MATERNAL AND CHILD HEALTH

R. W. McCOMAS, M.D., M.P.H., Director
E. L. FLEMMING, Ed.D., Acting Director
S. D. DOFF, M.D., M.P.H., Medical Consultant
EARL LOMON KOOS, Ph.D., Social Scientist
During 1957 this bureau has had several staff changes. Dr. McComas
served until mid-summer at which time he left the State Board of Health.
Dr. Flemming, the Consultant on Child Growth and Development, was
named acting director of the bureau and at the end of the year continued
in that position. A medical consultant was added to the staff in October
and the part-time health educator has continued to increase her re-
sponsibilities. A vacancy still remains for a second physician on the
staff.
Considerable time and effort were expended in developing a special
research project on mental retardation, but this had not received
approval from the sponsoring agency, the U. S. Children's Bureau, at
the time the year ended.

MATERNAL HEALTH
Provisional figures indicate a decrease in the maternal death rate
from 6.4 per 10,000 live births in 1956 to 6.0' in 1957, continuing the
FIGURE 1

RESIDENT MATERNAL DEATH RATES (PER 10,000 LIVE BIRTHS)

BY RACE, FLORIDA. 1933- 1957.

0 i ' '-' i-
1933 1935 1940 1945 1950 1955
YEAR

MATERNAL AND CHILD HEALTH 75

downward trend noted for some years. There were 62 deaths associated
with pregnancy, childbirth, and the puerperium in 1957 of which 17 were
white and 45 nonwhite. The white rate was 2.3 per 10,000 live births
and the nonwhite 15.5.
Although this bureau is jointly responsible for the supervision of the
mlidwife program with the Division of Public Health Nursing, the report
of the program will be found in this volume under the latter. Briefly,
the number of midwives licensed during the year continues to decrease
with a total of 283 for 1957 as compared with 299 during the previous
year. Nine new midwives were licensed in areas of determined need
and an equal number were retired during the year.
Continued emphasis has been placed upon the development of low
cost maternity plans through private physicians and some progress has
been made in the utilization of funds for the medically indigent to care
for abnormal obstetrical cases.
For the seventh consecutive year an Obstetric and Pediatric Seminar
for physicians and nurses was held in Daytona Beach. Alabama has now
become associated with Florida, Georgia and South Carolina. This
meeting is now called the Postgraduate Obstetric-Pediatric Seminar and
is sponsored by the Bureaus of Maternal and Child Health of the four

FIGURE 2

RESIDENT INFANT DEATH RATES (PER 1,000 LIVE BIRTHS)

BY RACE, FLORIDA. 1933-1957.
100

= 75
I-\-

S.... NON-WHITE

S 50O-. -H..E ..

= NON-WHITE ": \

S... ........ ...........

76 ANNUAL REPORT, 1957

State Health Departments and the Maternal Welfare Committees of the
four State Medical Associations. The program, which featured nationally
known authorities in obstetrics and pediatrics, was enthusiastically re-
ceived. Attendance at this seminar has shown a consistent increase with
a total of 401 persons attending the 1957 meeting. A breakdown by
state and category shows: Florida 271, Georgia 75, South Carolina 25,
Alabama 20, other states 10; physicians 278, nurses 118, others 5.

CHILD HEALTH
In 1957 there were 3312 infant deaths compared with 3090 in 1956.
The increase is chiefly a reflection of the increased number of births
in the state; the provisional 1957 rate of 31.8 per 1,000 live births was
identical to the final 1957 rate. The white rate in 1956 was 24.4 per
1000 live births and the non-white 51.0. There were 1834 white infant
deaths and 1478 nonwhite.
The special project for care of premature infants at the Premature
Demonstration Center, Jackson Memorial Hospital, Miami continued
under a special grant from the U. S. Children's Bureau. The annual
report of the Center is not available at this time, but our records indicate
that 268 premature infants from Southeast Florida were cared for under
this program.
A number of standard and specialized incubators were distributed to
various county health departments to provide better service for pre-
nature infants. This equipment was placed in local hospitals on in-
definite loan from the local health departments.
It has been possible to maintain the four positions established in 1956
for increased service to retarded children in selected child guidance
clinics. These positions are supported through special Children's Bureau
funds and are located in Escambia, Orange, Sarasota-Manatee and Palm
Beach Counties.
A series of workshops on Child Growth and Development have been
held in nearly all counties in the state. They have focused on the normal
growth process and reports from both parents and professional persons
suggest that these experiences do much to facilitate a healthy home life.

SCHOOL HEALTH
Cooperatively with the State Department of Education and a group
of voluntary health agencies, the bureau carried forward a program of
in-service training for school health coordinators. Dr. George T.
Stafford, Professor of Health and Physical Education, University of Illi-
nois, was brought to Florida to conduct clinics within easy access of each
school in the state. During 1957 school and health departments pooled
their efforts in arranging these clinics during which school health coordi-
nators in every county were oriented to the duties and responsibilities
of their newly created positions. To evaluate the effort and plan for the
next steps in developing Florida's School Health Program, a group of

MATERNAL AND CHILD HEALTH 77

approximately 100 outstanding health and education leaders of the state
met June 13-14 at the University of Florida. The proceedings of this
conference were compiled and published in a booklet "Action with
Purpose", with assistance from this bureau. It is being widely distributed
to serve as a guide to future plans and programs.
To assist in carrying forward in Florida the national program of
Fitness and Youth, representatives of the bureau met in conference
with members of the State Department of Education, Florida Medical
Association and other health and civic groups. Out of these conferences
grew a blueprint for a Council on Health and Fitness for Florida's
Youth.
Special equipment in the form of audiometers and illuminated Snellen
charts inas uten distributed to county health departments for use in their
school health programs.

HEALTH SERVICES FOR MIGRATORY AGRICULTURAL
WORKERS
The special project of the Children's Bureau on migrant workers
in Palm Beach and Collier Counties has become an operational entity.
It is now fully staffed with six public health nurses, a medical social
worker, nutritionist, health educator, liaison worker, sanitarian, two
clerks, and part-time medical consultants. Comprehensive health services
are being offered to the migrants while the team engages in its action
research.
The Legislature made available some $20,000 on the recommendation
of the Governor's Advisory Committee on Migrant Labor. These funds
were used to employ a nurse in Dade County, a sanitarian in Palm
Beach County, two nurses in Collier County, and part-time physicians in
Dade, Broward and Collier Counties. All of these persons are employed
for direct health services to migrants.

OTHER ACTIVITIES
Bureau staff members have made many talks to lay and professional
groups. The television series on Child Growth and Development has
been continued. The acting director was elected to the National
Education Committee of the National Association for Mental Health.
Pamphlets on mental retardation were made available for distribution
to the Florida Council for Retarded Children. A staff member was
temporarily assigned the task of developing a new format for employee
orientation programs. The first session under the revised plan was
tried on an experimental basis before the close of the year.
Booklet by staff member:
Koos, E. L. They Follow the Sun. Florida State Board of Health.
1957.

78 ANNUAL REPORT, 1957

BUREAU OF PREVENTABLE DISEASES

C. M. SHARP, M.D., Director
JAMES O. BOND, M.D., Epidemiologist

For the first time in several years, a communicable disease other
than poliomyelitis received the major attention of the staff of the Epi-
demiology Office. More influenza cases were reported to the State Board
of Health by private physicians and county health officers than any
other single communicable disease. This was in large part due to the
widely heralded epidemic of Asian influenza which swept over most
of the United States. Florida was one of the first states to have lab-
oratory confirmed cases of this disease in July 1957. Prior to this a
statewide alert had been set up, with special laboratory facilities made
available to all private physicians and hospitals in the state.

The first cases to enter the state apparently were students returning
from a conference at Grinnell, Iowa, in June. In July," cases in Chilean
airlines personnel landing in Miami were confirmed as Asian influenza
by the Virus Diagnostic Laboratory, Variety Children's Hospital, Miami.
They obtained the first actual isolates of virus typed as antigenically
similar to the A/Japan/305/57 prototype. During the month of August,
there were several scattered outbreaks in colored communities, throughout
the state. The largest one occurred in St. Petersburg, and was investi-
gated thoroughly as the first community wide outbreak in Florida. The
results were reassuring, in that the incidence of complications was re-
markably low, although over 3000 cases occurred in a community of
16,000 individuals. Attack rates were 18.7 per cent for the total popu-
lation, and within the population female rates were higher than male
and the highest rates by age were in the 5-14 group. There was no
indication that infants or the elderly were attacked any more frequently,
although once taken ill, the elderly had a more severe course.

After the opening of schools in September, the epidemic rapidly
gained momentum, following a pattern of spread from colored schools
to white high schools to white elementary schools to the remainder of the
community. The peak of reported cases occurred during the second
week of November, and considering the normal 10-14 day lag from the
occurrence of a case to its final report arriving in Jacksonville, the
actual peak of cases probably occurred in the last week of October. A
total of 16,358 cases was actually reported by December 31. This
probably represents 50 per cent of the total cases occurring in the state,
which means approximately 10 per cent of the total population was
affected. The general impression that the epidemic was not as severe
in Florida as elsewhere was confirmed by a study of total deaths re-
ported for September, October, November and December. The total
recorded deaths were not in excess of the numbers expected, based
on the trend for the past five years for each of the months. This finding

PREVENTABLE DISEASES

contrasted with national figures where a definite excess of deaths for
the epidemic months was demonstrated.

The epidemiology office assisted in obtaining laboratory specimens in
suspected outbreaks of influenza, and in maintaining a surveillance
of the occurrence by laboratory confirmed cases. Such cases occurred
in 26 different counties for Asian influenza (A/Japan/305/57) and
17 different counties for A/Denver/57 influenza, a closely related
strain.

Twenty-nine isolations of a virus typed as A/Japan were made by
the Virus Diagnostic Laboratory of the State Board of Health. One
isolation of a strain typed as A/Den/57 was made and one strain isolated
was provisionally described as Florida A, since it was not identical to
either the A/Japan or Denver strains. Although 80-90 per cent of
individual sera tested showed evidence of past infection with a B strain
of influenza virus (B/GL/54) only one individual gave evidence of
recent infection on examination of paired sera, and only one isolation
of B strain virus was made in the state. The laboratory studies therefore
served to detect the introduction of Influenza A into Florida and con-
firmed it as the etiologic agent responsible for most of the local out-
breaks.

In contrast to the major efforts toward diagnosis and epidemiologic
surveillance, minor efforts were directed toward control measures. This
was due in large part to the opinion of the State Board of Health
that the only available preventive measure, namely vaccination, would
arrive too late and in too small a quantity to have an appreciable effect
on the course of the epidemic, and that the predicted severity of the
epidemic, both for the individual and community, was insufficient to
warrant heroic measures. Fortunately, both of these preliminary surmises
were confirmed by the course of events. Immunizations were recom-
mended for persons responsible for the care of the sick, maintenance of
essential community functions, and persons with chronic cardio-respir-
atory diseases. Personnel at the State Board of Health were offered
influenza vaccination in line with these recommendations and a study
made of their reaction rates. The results of this study are shown in
Table 13.

The educational efforts consisted primarily of keeping professional,
medical and public health personnel informed of the course of the
epidemic, the status of the vaccine, and nuances of laboratory diagnosis.
Public information programs were directed toward relieving anxiety
with facts, promoting good nutrition, better home nursing, and keeping
the schools open. The widespread distribution of the influenza virus
was rivaled only by the magnitude of the distribution of newsprint con-
cerning it.

80 ANNUAL REPORT, 1.957

POLIOMYELITIS
Reported cases of poliomyelitis continued their dramatic fall, which
began in 1955. One hundred thirty-four cases were reported in 1957,
compared to 364 in 1956, and 466 in 1955. Paralytic rates dropped
63 per cent from the preceding year (2.7/100,000 to 0.95). That this
drop in reported cases is not entirely due to the widespread use of Salk
vaccine is evidenced by the equally dramatic decrease in numbers of
non-paralytic cases whose occurrence the Salk vaccine theoretically
does not influence.
The federal program to provide Salk vaccine to the states ter-
minated on July 1, 1957, and Florida resumed the purchase and dis-
tribution of the vaccine. At that time, records kept during the federal
program allowed fairly accurate estimates to be made of the size of the
immunized population. For June 1957 these estimates were that for
the population under twenty, 39 per cent had had a full course of
3 injections, and 83 per cent had at least one injection. The age group
5-9 had the best protection with 60 per cent having completed the
course. Only 10 per cent of the teen agers had completed the course,
and only two per cent of the young adults aged 20-39. Thus, there is
still an ample reservoir of unimmunized persons in Florida in whom
an epidemic of poliomyelitis could occur.
Special surveillance for safety and effectiveness of the Salk vaccine
was maintained in conjunction with the Virus Diagnostic Laboratory.
Table 14 shows the vaccination status of reported cases of polio, and
Table 15 the laboratory results on those vaccinated cases which were
tested for evidence of infection. These tables are somewhat biased,
in that special efforts were made to obtain reports and laboratory speci-
mens on all cases and suspect cases occurring in triply vaccinated indivi-
duals. Persons who had one or two injections were given special attention
only if onset of their disease was within 30 days of the last injection.
Unvaccinated persons were not given special attention for laboratory
confirmation of the clinical diagnosis. It is seen from these tables that
approximately one-third of the total paralytic cases were reported to
have occurred in vaccinated individuals. However, seven of the nine
reported cases of paralytic polio occurring in the triply vaccinated indi-
viduals were subjected to laboratory investigation, and only two gave
evidence of recent infection with polio virus. Of the total of 38 vaccinated
cases tested, only 12 were confirmed as polio by the laboratory. There is,
of course, some error in the laboratory diagnosis of polio, but this largely
represents the alertness of private physicians in reporting for surveillance
any case remotely resembling polio in whom previous Salk vaccine in-
jections had been given.

FOOD-BORNE OUTBREAKS
An attempt was made to obtain and stimulate better investigation
and reporting of outbreaks of food-borne disease. Three major such

PREVENTABLE DISEASES 81

events occurred. One in Jacksonville involved 120 persons eating lunch
aboard a ship in the harbor. The cause was traced to enterotoxin pro-
ducing staphylococci contaminating salads and meats served at the
meal. A second major outbreak involved employees and staff of a large
Miami hospital. Over 50 persons were infected with a Shigella organism
traced to a turkey salad prepared by a food handler with these organisms.
In Tampa, over 40 cases of severe vomiting and diarrhea were observed
in individuals eating pre-packaged Cuban sandwiches. One person
with a pre-existing disease died as a result. The cause was traced
reasonably accurately to whole hams used as source meats, which were
contaminated with enterotoxin producing staphylococci.

In order to stimulate better reporting and investigations of food-borne
outbreaks, a sample kit for carrying out such investigations was pre-
pared and distributed to the counties. This was done in cooperation
with the Bureaus of Laboratories, Sanitary Engineering and Local Health
Service.

ROUTINE MORBIDITY SURVEILLANCE
Tetanus remains a major cause of death from communicable diseases,
and Florida leads the nation in rates for both total and neonatal deaths.
Preliminary data indicate 29 deaths and 64 cases occurred in 1957. The
problem is largely one of the non-white population (10-1 ratio for
deaths) and in the southeast coastal counties. Special plans to step up
tetanus immunization of pre-natal cases and other adults are underway.
Salmonella infection reports continued to rise. This can only partially
be attributed to efforts to have all cases diagnosed by state laboratories
included in the reports, since this was carried out in 1956 also. The
laboratory reports indicate the most frequently found types are, in
order, Salmonella typhimurium, S. montevideo, S. oranienburg, S.
newport, S. muenchen and S. berta. The level of reported cases of
typoid fever remained the same in 1957, as it has over the past several
years (Table 18). Efforts to have all new cases and carriers phage typed
were continued, and this aided in the solution of one epidemiologic
puzzle in Dade county.
Reported diphtheria cases showed a comfortable reduction in 1957
(Table 18). Duval county, and more particularly the colored sections
of Jacksonville, continued to lead the state in occurrence of cases. An
outbreak in this area involving 12 children out of approximately 40
attending a day nursery was investigated. It was found that approxi-
mately 50 per cent of the children had a natural immunity, and all
were under six years of age. This corresponded with the almost total
lack of evidence of clinical diphtheria in children with positive cultures.
It was concluded that there is a reservoir of endemic diphtheria in the
area, resulting in a sizable degree of natural immunity. It is of further
interest that practically all of the diphtheria organisms typed during 1957
were in the mitis group.

82 ANNUAL REPORT, 1957

Arthropod borne diseases were distinguished again by their relative
absence compared to a decade ago. Of the 14 reported malaria cases,
none that were confirmed by smear were acquired in Florida. Of the
five typhus cases, three were part of an outbreak in Miami related to
a fire in a feed warehouse which presumably drove the rats into the
surrounding area. Despite a sizable epidemic of Eastern Equine
Encephalitis in the horse population of the state, only two laboratory
confirmed cases occurred in humans. One enigmatic isolation of Saint
Louis Encephalitis virus was made from the spinal fluid of a transient
in Hillsborough county.
Infectious hepatitis case reports experienced a slight rise, the first
in two years. An attempt to relate this to the large number of polio
inoculations given with multiple dose syringes failed to incriminate this
potential source. A controlled study of the efficacy of mass gamma
globulin prophylaxis, using different dosages, was carried out at the
Sunland Training Center in Gainesville. Final reports are not available
pending the 12 month follow-up.
Streptococcal and meningococcal infections showed substantial in-
creases which are thought to be related both to better reporting and the
occurrence of the influenza epidemic.

SPECIAL STUDIES
During 1957 a special epidemiologic study of patients with a typical
acid-fast bacilli resembling M. tuberculosis was undertaken. Forty-seven
individual interviews were obtained, most of whom were with patients
hospitalized in Florida Tuberculosis Hospitals. From these the following
preliminary conclusions were made. These infections were selective for
older white males in the hospital population. There were significantly
few such cases found among colored patients. There was suggestive
evidence that a particular variety termed the non-photochrome has a
regional concentration in the Southeastern United States, and in Florida,
more cases appeared to occur in the central portion of the state. This,
however, might be wholly or in part explained by the increased diagnostic
facilities and alertness in tuberculosis hospitals in these areas. There
was no evidence of contact spread of these infections. There was little or
no evidence that these organisms were the result of previous chemother-
apy in the patients themselves or in tuberculous contacts. One signi-
ficant cluster of four cases occurred in the small rural community of
Bowling Green. These patients gave no history of personal contact prior
to isolation of their organisms. These studies are continuing on the 100-
odd patients so far identified as having these organisms.
Use of tuberculin testing as an epidemiologic tool was the subject
of special study during the year. A Tuberculin Testing Guide was
prepared and distributed to each county health department. Assistance
was given to pilot surveys conducted in Palm Beach, Duval and
Escambia county schools. A special tuberculin and histoplasmin skin
test survey on 2000 prisoners admitted to the Raiford State Prison

PREVENTABLE DISEASES 83

during the year was carried out under the supervision of the epidemiolo-
gist. Such a testing program will gain wider usefulness as the incidence
of tuberculosis steadily falls.
The growing problem of staphylococcal infections in hospital new-
born nurseries received preliminary attention. Assistance was given to
the laboratory in a special study conducted at a large hospital in
Jacksonville. All mothers and their infants admitted during a seven-
day period were cultured on admission and discharge for the presence
of staphylococci. Phage typing and antibiotic sensitivity patterns were
used in an attempt to trace the course of these infections. A six-week
follow-up after hospital discharge was also carried out. One baby de-
veloped pustular dermatitis during hospitalization, and seven during the
six-week follow-up. Seventy-four babies were included in the study.
Similar outbreaks in another Jacksonville hospital and in a foundling
nursery were investigated, but less extensively so. These studies, it is
hoped, will furnish the information for an effective program to report,
investigate and control these occurrences.
The special research project studying the causes of the increasingly
unfavorable male mortality rates in relation to female rates was
continued. Most of the work was performed by a special research
assistant, Miss Doris Hurnie, who prepared the following summary:
The Fragile Male Project, designed to study the widening gap be-
tween male and female death rates, is engaged in a survey of mothers
of heterosexual twins as to their child raising attitudes. In the past year,
a total of 78 mothers of twins, born between 1940-51, were interviewed.
This included six non-whites, later excluded from the Project.
The interview form of 150 items contained questions relating to the
twins' personal record of accident-illness and maternal attitudes on
accident-illness, expectation and repression-expression. Responses were
analyzed statistically to determine if a significant sex difference was
present.
Twelve sets of twins, born in 1940-42,. were obtained by contacting
officials in Duval county junior and senior high schools. Because of
the small number, those sets born outside the county, regardless of length
of residence locally were included. Sixty sets, born in 1943-51, were ob-
tained from Duval county birth certificates.
Original subjects of the study were 30 mothers of five, six and seven
year olds, born.in 1949-51. Results from this age group were used as
bases for comparison with the other age levels. Next, the 12 mothers of
the 14, 15 and 16 year olds were questioned. Finally, 28 mothers of the
8 through 13 year olds, born 1943-48, were interviewed. In the latter
study each mother was asked to examine also 30 stick figure drawings
and to indicate which of her twins was represented by the drawing on
the card. The 30 cards were prepared to correspond with 30 items in
the questionnaire. Analysis of answers on cards and corresponding
questions was made.

84 ANNUAL REPORT, 1957

A plan to interview fathers as well as mothers of twins to obtain
cross attitudes of each parent on child rearing was discontinued and
replaced by a new study to question 80 year old women and young
twin mothers on their ideals and child training practices evolved from
these ideals.

A number of consultants from statistical, sociological and psychologi-
cal fields have conferred with The Fragile Male Committee. In addi-
tion, a bibliography is being prepared and presently contains nearly
300 references.

A tabulation of the preliminary findings in 1957 is given in Table 16.

*

Finally, the special project concerned with the epidemiology of
accidental poisoning was continued. A total of 1315 reports have been
processed by the epidemiology staff since the inception of the program
in July 1956. A summary of the 736 cases reported for the year July
1956 July 1957 is given in Table 17. A significant result of the
activities of this program in 1957 was the discovery of several cases of
poisoning due to a thallium containing insecticide which probably would
have gone unnoticed, due to their dispersal over the state. The program
also furnished statistical facts for the continuing program of public
education in the prevention of accidental poisoning in children.

Article by staff member:
Bond, J.O. The Fragile Male, Geriatrics 12:489-493, Aug. 1957.

TABLE 13
REACTIONS TO INFLUENZA VACCINE, BY SEX-
MONOVALENT ASIAN STRAIN, 200 cca/cc DOSE Icc
SUB-CUTANEOUS OR INTRAMUSCULAR 162 ADULT
EMPLOYEES- FLORIDA STATE BOARD OF HEALTH,
SEPTEMBER 1957

MALES FEMALES TOTAL
No. % No. % No. %
Fever ................................... 2 3.2 17 15.8 19 11.8
Chills ................................... 2 3.2 11 10.2 13 8.0
Aching, Headache, etc. .................. 6 11.0 23 21.4 29 17.8
Drowsiness or Gen. Malaise ................ 8 14.8 19 18.6 27 16.6
H ives ................................... 1 1.8 3 2.8 4 2.4
Local reactions (redness, pain, swelling) .. 23 42.5 61 56.5 84 51.5
No reactions ............................ 23 42.5 33 30.5 56 34.5
Total ................................... 54 100.0 108 100.0 162 100.0

PREVENTABLE DISEASES 85

TABLE 14

REPORTED CASES OF POLIOMYELITIS BY
VACCINATION STATUS, FLORIDA, 1957

Paralytic Status (Initial Report)
No. of Injections
Paralytic Non-Paralytic Unspecified All
Unknown .............. 3 3
One ................... 3 2 5
Two .................. 4 10 3 17
Three ................. 9 10 2 21
All Vaccinated ........ 13 26 7 46
Others* ................... 26 31 31 88
Total .................. 39 57 38 134
No statement was received with morbidity card indicating presence of
vaccination, therefore, individual was assumed to be non-vaccinated.

TABLE 15
RESULTS OF LABORATORY INVESTIGATION OF REPORTED
CASES OF POLIO OCCURRING IN VACCINATED
CHILDREN, FLORIDA 1957
No. of Paralytic Non-Paralytic Unspecified All
Injections Tested Confirmed Tested Confirmed Tested Confirmed Tested Confirmed.
Unknown 3 2 3 2
One 2 1 2 0 4 1
Two 1 0 9 2 3 1 13 3
Three 7 2 9 3 2 1 18 6
Total 8 2 23 8 7 2 38 12

TABLE 16
NUMBER AND PERCENT OF MALE AND FEMALE
RESPONSES TO QUESTIONNAIRE BY 72 WHITE MOTHERS,
BY AGE GROUP, OF THEIR TWINS

AGE GROUP AND SEX OF TWINS
Category: Ma 5 7 8 13 14 16
ategoMale Female Male Female Male Female
Fact: Number
Accident-Illness 263 184 236 94 82 67
Attitude of Mother:
Behavior Expected 198 226 220 187 91 105
Repression and
Expression 137 88 159 153 49 45
Accident-Illness 182 127 157 39 68 50
Fact: Percent
Accident-Illness 58.8 41.2 71.5 28.5 55.0 45.0
Attitude of Mother:
Behavior Expected 46.7 53.3 54.1 45.9 46.4 53.6
Repression and
expression 60.9 39.1 51.0 49.0 52.1 47.9
Accident-Illness 58.9 41.1 80.1 19.9 57.6 42.4

86 ANNUAL REPORT, 1957

TABLE 17

736 REPORTED CASES OF ACCIDENTAL POISONING
7/1/56 to 7/1/57

15 FLORIDA POISON CONTROL CENTERS

Florida Pediatric Society Florida State Board of Health

Florida Chapter American 15 County Health Departments

Academy of Pediatrics

Internal Medicines ...... 307
Including:
Aspirin ................ 129
Barbiturates ............ 56
Other sedatives
and relaxants ......... 32
Laxatives ............... 11
Other .................. 79

SUBSTANCES INGESTED
External Medication .... 38
Including:
Iodine .................. 12
Alcohol ................. 7
Camphor ............... 7
Other .................. 12

Petroleum Products ...
Including:
Kerosene ............
Gasoline ...............
Other ................

Insecticides Rodenticides.. 105
Including:
Roach Poison .......... 42
Rat Poison ............. 12
Ant Poison ............. 11
Parathion, Chlordane,
DDT ................ 7
Other .................. 33

Miscellaneous ........... 173
Including:
Cleaning Agent .......... 81
Turpentine ............. 13
Toad Stool .............. 9
Tung Nut .............. 6
Cosmetics.............. 5
Other .................. 59

AGENT

EPIDEMIOLOGIC
TRIANGLE
INDIVIDUAL ENVIRONMENT

White Males ........... 289
White Females ........ 304
Colored Males .......... 59
Colored Females ........ 52
Unknown .............. 32
Total ................. 736
Age 0-4 .............. 530
5-9 ............... 33
10-14 .............. 5
15-19 .............. 13
20 ............. 127
Unknown .......... 28
Total ............. 736
Intent
Accidental .............. 575
Suicide ................. 73
Overdose ............... 60
Unknown .............. 28

No. Reported by Each Center
Miami ................ 189 W. Palm Beach ........ 18
acksonville ............ 166 Ft. Myers .............. 17
ensacola .............. 79 Ocala .................. 18
Gainesville ............ 68 Lakeland ............... 13
Tampa .. ......52 Orlando ................ 5
Sarasota ............. 37 Daytona ................ 2
Panama City .......... 36 Tallahassee.............
Ft. Lauderdale ....... 32 Unknown ............... 4
Room Where Substance Found (214 cases)
Kitchen ................ 77 Living Room .......... 24
Porch .............. 10
Bedroom ............... 63 Garage ................ 7
Bathroom .............. 27 Dining Room ......... 6
Person Watching Child (280 cases)
Mother ............... 227 Maid/sitter ............ 5
Grandparents ........... 28 Friend ................. 5
Older Sibling .......... 11 Father ................. 4
Warning Label on Container (262 cases)
Yes .................... 111 No .................... 151

PREVENTABLE DISEASES 87

TABLE 18

CASES OF CERTAIN REPORTABLE DISEASES, FLORIDA,

1947- 1957

DISEASE 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957

Anthrax ................ 0 0 0 0 5 0 1 0 0 0 0
Brucellosis .............. 67 74 86 36 10 10 10 9 12 12 17
Cancer ... ......... 1,025 1,880 4,394 5,090 5,057 5,333 5,717 5,640 5,852 6,591 4,599
Chancroid .............. 745 388 343 248 317 462 328 344 388 273 186
Dengue Fever ........... 0 1 0 0 1 0 2 0 0 0 0
Diarrhea of Newborn .... 67 191 134 113 60 143 96 106 158 288 200
Diphtheria .............. 283 327 206 97 66 82 114 114 99 102 87
Dysentery, Amebic ...... 59 153 135 113 88 161 177 102 144 139 180
Dysentery, Bacillary .... 16* 219* 77 50 47 235 53 48 68 83 79
Encephalitis, Viral ...... 4 5 10 9 17 12 9 13 19 15 22
German Measles ......... 64 56 43 45 214 304 305 126 190 205 84
Gonorrhea ........... 20,160 18,820 15,388 14,185 12,709 11,809 11,459 11,84112,146 10,991 9,725
Granuloloma Inguinale .. 271 773 827 446 417 233 109 71 69 73 66
Hansen's Disease ....... 2 11 0 3 2 2 1 2 2 2 0
Hepatitis, Infectious .... 24 66 4 27 46 236 301 303 262 152 198
Hookworm ..... 4,605 5,008 6,636 10,051 6,561 6,611 4,206 4,772 3,551 2,659 2,197
Influenza .............. 1,083 366 258 235 584 218 1,406 279 157 219 16,358
Leptospirosis ............ 0 0 0 1 1 0 1 1 1 0 2
Lymphopathia Venerea .. 216 197 127 34 40 120 96 55 51 55 58
Malaria ................ 135 111 43 7 23 50 19 11 13 11 14
Measles ................. 1,315 4,802 3,753 2,499 2,431 4,072 1,316 10,766 1,495 5,186 6,149
Meningococcal Infections. 49 48 41 53 92 88 102 96 88 69 75
Mumps ............. 914 1,329 1,791 1,452 2,101 1,985 1,112 1,516 1,933 4,353 2,112
Ophthalmia Neonatorium. 30 26 11 22 14 20 7 17 16 22 7
Poliomyelitis ............ 111 285 282 471 362 663 733 1,777 466 364 134
Rabies, Animal ......... 438 332 75 38 11 20 58 84 77 62 122
Rocky Mt. Spotted Fever 2 0 0 0 2 2 0 2 1 0 0
Salmonellosis** ......... 132 135 150 39 120 78 91 63 223 156 239
Scarlet Fever*** ........ 441 485 384 277 456 460 592 632 726 647 1,397
Syphilis ................. 16,653 15,395 12,363 10,738 9,445 10,824 6,722 6,894 5,541 7,182 5,514
retanus ................ 27 73 71 43 34 46 44 59 53 47 64
rachoma ............... 0 0 0 1 0 1 1 0 1 0 0
Tuberculosis ............ 4,335 3,313 3,198 2,337 2,590 2,603 2,424 2,461 2,253 2,453 2,414
Tularemia .............. 8 19 29 18 6 18 7 3 5 2 2
Typhoid Fever .......... 66 103 51 30 23 36 41 31 56 60 54
Typhus Fever ........... 340 166 123 34 20 11 10 5 11 6 5
Whooping Cough ........ 1,861 731 191 471 920 291 209 339 1,080 547 221
Includes other and unspecified.
** Includes Paratyphoid Fever.
*** Includes Streptococcal Infection.

DIVISION OF INDUSTRIAL HYGIENE
JOHN M. McDONALD, M.D., M.P.H.
Director
LABORATORY
Again, as in 1956, air pollution control provided a considerable
number of samples requiring analysis in the industrial hygiene laboratory.
Air contamination by fluorides accounted for 54 samples. In addition,
numerous field tests were made for sulfur dioxide, relative humidity,
and other physical conditions.

Industrial hygiene work required 648 analyses, of which 290 were
for the determination of lead in blood or urine, or in air samples from
industrial environments. It should be noted here that the chemists not
only performed the laboratory analyses, but also made field trips to

88 ANNUAL REPORT, 1957

collect samples, conduct industrial hygiene surveys and consult with
industrial management. Approximately one-third of their time was spent
in the field.

AIR POLLUTION
At its 1957 session, the Florida Legislature passed the Florida Air
Pollution Control Law. One provision of this law required the creation
of an Air Pollution Control Commission within the State Board of Health.
This commission has already been appointed and has held its organiza-
tion meeting. This division has begun to assist the Commission in its
search for information on air pollution control, and looks forward to
increased cooperation in the future.
Members of the Commission presently serving are: Thomas H. Lips-
comb, M.D., Chairman, and Albert V. Hardy, M.D., Jacksonville;
Willard D. Miller, M.D., Ruskin; E. T. Casler, Bartow; Arthur Crago,
Brewster; E. R. Henrickson, Ph.D., Gainesville, Vice-Chairman; A. P.
McIntosh and B. R. Fuller, Jr., Tallahassee; George Westbrook, Ph.D.,
Winter Haven. David B. Lee of the Bureau of Sanitary Engineering
serves the Commission as secretary.
The stack sampling of phosphate processing plants which was begun
last year has been continued in an effort to determine the amount of
fluorine compounds discharged to the atmosphere by each plant stack.
While this work, including travel time and laboratory procedures, has
required a large number of man hours, it has been encouraging to
observe that practically every plant has installed new equipment to
recover fluorides from stack discharges. Recovery of fluorides has been
further stimulated by the opening of a small plant in the area where
fluorides from plant effluents are collected and further processed for use
in refining of aluminum.
Operation of oil fired boilers gave rise to several complaints of air
pollution. In one case a boiler was furnishing steam to operate a power
generator mounted on a barge. Workers on nearby docks complained
of eye and throat irritation which was shown to be due to sulfur
dioxide and other products of combustion in the stack discharge from
the boiler. Corrective measures were suggested. Faulty operation of the
automatic feed on oil fired boilers in laundries often causes intermittent
emissions of smoke. In two cases the smoke nuisance was corrected by
adjustments of the burner mechanism.
Complaints of discolored house paint came from an area near a
small oil refinery. The complainants blamed the refinery for the dis-
coloration. Upon investigation it was found that the offending material
was sand which had been deposited by a windstorm during the night.

EDUCATION
Brief talks were given to five orientation groups. Three half-days
were spent discussing industrial hygiene and air pollution control with

PREVENTABLE DISEASES

three classes of county health department sanitarians in the field training
program. A group of engineering students from the University of Florida
came to the division for an afternoon's discussion of air pollution
investigation and control. Three physicians in public health training
were shown several industrial plants to illustrate the work in industrial
hygiene. One lecture on dust diseases of the lungs was presented to
junior medical students of the University of Miami School of Medicine.

SPECIAL STUDIES
One of the major undertakings of the year was cooperation with the
U.S. Public Health Service in making a preliminary industrial hygiene
study of working conditions in the phosphate processing plants. The
director spent about four weeks in making the preliminary contacts and
accompanying USPHS officials in setting up arrangements for the
study. One chemist spent four weeks and another three weeks full
time in taking air samples in these plants as part of the study. Results
of the study are not yet available.
Dust studies were made in two ferrous foundries at the request of
the respective managements. Included in this were silica dust exposures
and carbon monoxide hazards covering a total of 214 employees. A
study was also begun in a concrete block plant to investigate potential
dust exposures from sand blasting and block grinding. Another study
was made in a phosphate rock processing plant at the request of plant
management in order to teach their technical staff modern methods
of dust counting. The data thus obtained were used as a basis for
selecting suitable air pollution control devices. At the same time it was
shown that no silicosis hazard was present in this operation.
Although lead poisoning has been recognized for at least 2500 years,
it is still a threat to some industrial workers. Both blood lead and urine
lead determinations were done on 70 employees in a large airplane
maintenance shop because of potential exposures to tetraethyl lead in
the high octane gasoline used in modern airplane engines. No case
of abnormal lead absorption was found. A similar study was made of
the employees in a lead smelting plant. Abnormal lead absorption was
found in seven out of eleven employees. Recommendations were made
for control of the lead poisoning hazard.
Of special interest were two studies of dust exposures in plants
making stucco mixes which are used for the exterior finishing of houses
constructed of concrete blocks. In one plant dust counts were well
below maximum allowable concentrations. In the other plant a definite
silicosis hazard was found and the process is now being re-designed to
reduce the exposure to silica dust.

PERSONNEL
In preparation for an expected increase in division staff, some time
was spent in writing specifications for additional personnel, as well as

90 ANNUAL REPORT, 1957

the position classification questionnaires required by the Florida Merit
System. Mr. R. L. Hebblethwaite returned from sick leave on May 15
after an absence of nine months.

COOPERATION WITH OTHER AGENCIES
At the request of the U.S. Public Health Service Radiation Sur-
veillance Network, the division resumed operation of the high volume
air sampler in May. This coincided with the start of the Nevada tests
conducted by the Atomic Energy Commission. Filters were changed
seven days a week and monitored for radioactivity. Background radia-
tion counts were made twice a day. The filters and reports of monitor-
ing were then forwarded to the USPHS Surveillance Laboratories in
Washington, D.C. for the final evaluation of radioactive particles col-
lected.
In July a precipitation collector was placed in operation. Samples
of rain water were evaporated to dryness and the residue checked for
radioactivity by the USPHS laboratories. Operation of the precipitation
collector ceased on December 1. Operation of the high volume air
sampler was continued on an intermittent basis.
Considerable public interest was aroused by newspaper articles con-
cerning the risk of possible poisoning to small children by the lead
content in paints on imported toys. As a result, the chemists of the
division were requested to analyze the paint from a number of these
toys. Toys were received from various department stores, public groups
and private individuals. Approximately two weeks were spent by
division personnel on this project. This was part of a nationwide study.
On the basis of the pooled findings of many investigations, the USPHS
issued a statement to the effect that the amounts of lead found were so
small that children could play with these toys without any risk of injury
to their health.

MISCELLANEOUS ACTIVITIES
Among the meetings attended were the American Conference of
Governmental Industrial Hygienists and the American Industrial Hygiene
Association held in St. Louis; Industrial Wastes Workshop, Lakeland;
Sanitary Engineering Conference, Gainesville; American Chemical So-
ciety, Miami; and the Florida Air Pollution Control Commission at
Tallahassee. Two legislative committee meetings on air pollution were
attended.
Consultation was provided for the design of the new laboratory in
Orlando. Individual conferences were held with three physicians en-
gaged in industrial medical practice. With the assistance of other staff
physicians, the division continued to furnish First Aid for employees.

PREVENTABLE DISEASES 91

TABLE 19

SUMMARY OF INDUSTRIAL HYGIENE ACTIVITIES
JANUARY DECEMBER, 1957

FIELD ACTIVITIES
Number of industrial establishments given service ........................... 65
Number of workers affected by services .................................................. 2,729
Number of other places and areas visited ........................ ............. 14

Number of Field Visits Made:
Planned or self-initiated ........ 31
Requests or complaints ............ 19
Agency referrals ..................... 12
Revisits ................................... 45
Total............ 107
No. of
Plant Environmental Services Visits
Routine inspection ............ 12
Industrial hygiene surveys .... 19
Technical study of hazards .... 15
Consultation only ................... 6
Follow-up ................................ 4
Discuss report ........................ 13
Other ............................- .... 14
Total........... 83
Other Technical Investigations
Air pollution ....................... 17
Radiation surveys (non-indus.) 3
Non-occupational problem ...... 1
Total............ 21

Environmental Recommendations:
Number made ........................ 6
Number complied with ............ 4

Field Determinations:
Atmospheric contaminants .... 25
Physical conditions .. ......... 30
Radiation monitoring .......... 319
Total............ 374

Samples Collected: .................... 134

Samples Received: .................... 304

Laboratory Analyses:
Routine ............................. 302
Air pollution ........................... 58
Biological ....................... 288
Total............ 648

RELATED ACTIVITIES

Office consultation services and inquiries handled .......................................... 61
Lectures given ........ 6 Demonstrations ...... 6 Climatology letters.. 133
Meetings attended .. 14 Attendance .............. 177

DIVISION OF TUBERCULOSIS CONTROL
C. M. SHARP, M.D.
Director

Florida continues to make favorable strides in tuberculosis control.
The adequate provisions for hospitalization of all patients needing treat-
ment as well as the extensive use of anti-tuberculosis drugs has continued
to make itself felt in the decreased stay of patients in hospitals, as well as
lowering the hospital census. It is noteworthy, however, that more cases
were discovered and hospitalized during 1957 than in any other previous
year.

	Cover
	Title Page
	Letter of transmittal
	Members of the Florida state board...
	Official staff Florida state board...
	County health officers
	Organizational chart of the Florida...
	Table of Contents
	General summary
	Division of health information
	Bureau of local health service...
	Bureau of vital statistics
	Bureau of maternal and child...
	Bureau of preventable diseases
	Bureau of laboratories
	Bureau of special health servi...
	Bureau of sanitary engineering
	Bureau of mental health
	Bureau of narcotics
	Bureau of entomology
	Bureau of dental health
	Bureau of finance and accounts

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