Annual report - State Board of Health, State of Florida

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STATE
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BOARD
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1958

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IANNUAL REPORT

State Board of Health

State of Ftcda

1958

The following statistical reports will be published separately:
SUPPLEMENT I FLORIDA VITAL STATISTICS, 1958
SUPPLEMENT II FLORIDA MORBIDITY STATISTICS, 1958

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

C- -, 2

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,
1958.

Sincerely yours,

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

May 1, 1959
Jacksonville, Florida

His Excellency, LEROY COLLINS
S Governor of Florida
Tallahassee, Florida

, Sir:

S. I beg to hand you herewith a report of the Florida
State Board of Health for the period January 1, 1958, to
December 31, 1958, inclusive.

Respectfully submitted,

CHARLES J. COLLINS, M.D.
President

May 1, 1959
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, 1958

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 ............... .........James A. Doyle, B.S., M.P.H.

Bureau of Finance and Accounts ..............Fred B. Raglund, B.S.
Purchasing Agent ....................................G. Wilson Baltzell, B.S.

Bureau of Vital Statistics ............................Everett H. Williams, Jr. M.S. Hyg.
Bureau of Local Health Services ..............Wade N. Stephens, M.D., M.P.H.
Assistant Director, Acting ......................Hubert U. King, M.D.
Division of Public Health Nursing .........Ruth E. Mettinger, R.N.
Division of Sanitation ..............................A. W. Morrison, Jr.
Nutrition Services ....................................Mary B. Deaver, M.S.

Bureau of Preventable Diseases ....................Clarence M. Sharp, M.D.
Assistant Director and Epidemiologist ........James O. Bond, M.D., M.P.H.
Division of Industrial Hygiene ......... James R. Reid, 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.
Division of Hospitals and Nursing Homes..John L. Enyart, M.D., A.B.
Division of Chronic Diseases .................Lorenzo L. Parks, M.D., M.P.H.

Bureau of Laboratories ................................. Nathan J. Schneider, Ph.D.
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........Simon D. Doff, M.D., M.P.H.
Assistant Director ...............................Edward L. Flemming, Ed.D.

Bureau of Mental Health ............................Wayne Yeager, M.D., M.P.H.

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

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

Bureau of Sanitary Engineering .................David B. Lee, M.S. Eng.
Assistant Director ................................Sidney A. Berkowitz, M.S., Eng.

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

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

COUNTY HEALTH OFFICERS

(As of December 31, 1958)

Alachua...................................................... Edward G. Byrne, M .D., M .P.H.
Baker-Nassau......................... .................. James C. Loranger, M.D.
Bay.............. ................ ............................A. 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...............................................Terry Bird, M.D., M.P.H.
Charlotte-DeSoto-Hardee..........................James K. Cooke, M.D.
Citrus-Hernando-Levy ...................................Harold F. Bonifield, M.D., M.P.H.
Collier-Lee................................................Joseph W. Lawrence, M.D.
Columbia-Gilchrist-Hamilton... .............Arthur R. Moler, M.D.
Dade................................. .....T. E. Cato, M.D., M.P.H.
Dixie-Lafayette-Suwannee.................. Vacant
Duval................... ...............Thomas E. Morgan, M.D., M.P.H.
Escambia ......................... .... .... 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 ...........................................Vacant
Glades-Hendry-Highlands.............. ... William F. Hill, Jr., M.D.
Hillsborough...............................................rank V. Chappell, M.D., M.P.H.
Holmes-Walton-Washington .............. R. N. Nelson, M.D.
Indian River-Martin-Okeechobee-St. Lucie..Neill D. Miller, Jr., M.D.
Jefferson-Madison-Taylor................ ....... Harold H. Ring, M.D.
Lake.................................................. ..J. B. Hall, M .D., M .P.H.
Leon ........................... .. ....... Joseph M. Bistowish, M.D., M.P.H.
Manatee........................ .. ........ Thomas Dobbins, M.D.
Marion ..................... ........... Patrick H. Smith, M.D.
Monroe.................. ... ..... ..........James L. Wardlaw, Jr., M.D., M.P.H.
Okaloosa....................... ... ...B. R. Provost, M.D.
Orange.............. ........... ... ....J. Harland Paul, M.D., M.P.H.
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.
Santa Rosa..................................................Vacant
Sarasota............................................ William L. Wright, M.D., M.P.H.
Seminole.......................... ..................John H. Thurmond, M.D.
Volusia...................................... ........D. V. Galloway, M.D., M.P.H.

Organizational Chart of the Florida State Board of Health

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66 County Health Departments

TABLE OF CONTENTS

Page

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

Division of Health Information ...-.................... ...------------ 25

Bureau of Local Health Services (including Division of Public
Health Nursing and Nutrition Services) ...................................---. 28

Bureau of Vital Statistics ............................ ----... ---------.... 74

Bureau of Maternal and Child Health ......................................----. 88

Bureau of Preventable Diseases (including Epidemiology, and
Divisions of Industrial Hygiene, Tuberculosis Control,
Venereal Disease and Veterinary Public Health) .................... 94

Bureau of Laboratories ............................. .. .................... 130

Bureau of Special Health Services (including Divisions of
Hospital and Nursing Homes and Chronic Diseases: Heart,
Cancer and Diabetes) .............................................. 146

Bureau of Sanitary Engineering (including Divisions of Water
Supply and Waste Water) ...............--- ...-- --------..... ........ 157

Bureau of Mental Health (including Florida Council on Train-
ing and Research in Mental Health) ......................................... 187

Bureau of N arcotics ........................................................................ .. 200

Bureau of Entomology (including Entomological Research
Center) ......................... ........................... ............... 204

Bureau of Dental H health ............................ .... ...... ..... ................... 217

Bureau of Finance and Accounts (including Purchasing and
Property) .......................................................................................... 223

GENERAL SUMMARY
WILSON T. SOWDER, M.D., M.P.H.
State Health Officer
GENERAL
There have been minor changes in administrative organization
during 1958. A Division of Sanitation was established within the Bureau
of Local Health Services and the Division of Nutrition was transferred
from the Bureau of Special Health Services to Local Health Services. In
the counties changes have been toward the establishment of more single
county units and of smaller multi-county units. Plans evolved during
the year will increase the health units by three to serve the same number
of counties. St. Johns County remains as the only one without service
from a full-time public health unit.
Florida's population continues to expand rapidly with an estimated
increase of 4.6 per cent in 1958 over that of the preceding year. As of
July 1, 1958 the population of the state was estimated to be 4,448,000.
The provisional death rate for 1958 was 9.7 for 1000 population and
the birth rate 24.3 per thousand. There was a very slight increase in
the death rate and a slight decrease in the rate of births as compared
with the preceding year. The three leading causes of death were heart
disease, cancer and "strokes," all diseases particularly common to older
persons. An increasing proportion of aged in the population may be ex-
pected to lead to some increase in death rates. The fourth cause of
death, accidents, took its victims from all age groups and motor vehicle
accidents were common in young adults.
Those employed full-time in public health, or working regularly on
a part-time basis, totalled 1840 employees. Among these there were 63
physicians, 34 engineers, 486 public health nurses, 268 sanitarians and
168 other professional persons such as bacteriologists, entomologists and
psychologists. The remaining employees were predominantly the secre-
tarial, clerical and technical workers and unskilled laborers.
Expenditures for the varied services provided through bureaus and
divisions and health departments were approximately $14,000,000 dur-
ing 1958. Of this, 61 per cent was derived from state appropriations, 27
per cent from local agencies, seven per cent from federal grant funds
and two per cent from grants and donations chiefly for research, while
the remaining three per cent were funds for capital improvement. The
largest single item in the budget was for the consolidated mosquito
control program. An equal amount was provided to cover the cost of
hospital services for the indigent. Expenditures for each of these two
costly programs was at the rate of about $2,000,000 per annum. The
budget for mental health in the counties and as a part of the state pro-
gram as a whole reached a total of over $850,000 including that for
training and research. The other major expenditures were for services
to mothers and children, for communicable disease control (especially
for the prevention of tuberculosis, venereal disease and polio), environ-

2 ANNUAL REPORT, 1958

mental sanitation, and for chronic disease activities (chiefly for heart
disease control, cancer and.diabetes).
During the year the administrative wing of the central offices in
Jacksonville was completed, also facilities for regional laboratories in
Miami and Orlando. Seven health centers and six auxiliary health cen-
ters were constructed in the counties and new quarters were provided
for a ninth county health unit in a court house building. Twice as many
health units were built in 1958 as in any previous year. However, there
is obvious need for 30 more health centers and 52 auxiliary health cen-
ters, for regional laboratory buildings as well as for the completion of
the facilities planned for Jacksonville.
The public health activities have been of three broad types, the
provision of services, education and training, and special studies. The
general nature of these activities in the year under review is summarized
briefly.

HEALTH SERVICES
The reports of the various bureaus and divisions is predominantly
a record of the services provided. The wide variety of services and the
extent of these are striking features.
In local health units the individual is served by physicians, dentists
and nurses in a variety of clinics, children are examined in school and
families are aided in their homes. There are special services for case
finding in tuberculosis and for heart disease and diabetes. The detailed
examination of individuals suspected of having cancer is the work of
other clinics. A major approach to the prevention of serious mental
disease is the effective handling of the behavioral and emotional prob-
lems in the guidance clinics. There is responsibility for the administra-
tive management of the program for the hospitalization of the indigent.
In the laboratory a wide variety of examinations of blood, sputum, feces,
smears, water, milk and food and of animals (which serve as a source of
the spread of disease to man) are conducted for health departments,
physicians and dentists. For the maintenance of a healthful environment
there is constant attention to water and food supplies, to the safe disposal
of human waste, to the control of insects and to the prevention of air
pollution. These indicate the variety of services rendered by health de-
partments.
The volume of service provided, as recorded in the full report, is
impressive. The number of immunizations completed in health depart-
ments, for example, was in excess of 700,000, though the number of in-
dividuals involved was materially less than this. Of these 260,675 indi-
viduals were immunized for polio. The health of every school child is
a concern of the health departments and there were over 600,000 general
or specialized examinations of school children by health department per-
sonnel. There were some 450,000 home visits or office consultations con-
cerned with the health of infants and young children. There were nearly

GENERAL SUMMARY 3

500,000 X-ray examinations of individuals in population groups with a
high incidence of tuberculosis. More than 2,500,000 laboratory examina-
tions of public health importance were performed. A total of 2187 sets
of plans for utilities for water supply and waste disposal were processed,
the construction cost of which will amount to some 87 million dollars.
These are illustrative of the volume of work which is the responsibility
of the state and of county health departments in Florida.
Some activities are so well established and so routine that their im-
portance may be overlooked. There is the recording and preservation of
the official reports of every birth, death, marriage, divorce and adoption,
together with the regular analyses of the accumulated data. Years, rather
than months, have passed without a single recorded water-borne epidemic
and the amount of continuing work involved in maintaining this favor-
able record is substantial, though for the public this is an accepted and
expected service. The continuation of successful on-going public health
programs is the important record of this annual report. Though new or
special activities may be described in greater detail, the basic accepted
activities are of the highest importance.
Three notable advances have involved new staffing plans. Hereto-
fore the dental health program was handicapped due to the lack of avail-
able licensed dentists. The dental preceptorship plan has solved this
problem. Now recent graduates may accept positions to work under
senior supervision. The number of applicants was in excess of the num-
ber of positions available. This major advance is to the credit of the
dental profession and its examining board.
The health needs of the aged and those with chronic disease calls
for an expansion of nursing services in public health. Heretofore in urban
centers, visiting nurses have provided bedside care on the request of at-
tending physicians. The trend has been to integrate or coordinate this
activity with the general public health nursing services. However, for
rural areas there was a clear need for a home nursing service which
would effectively combine the services of the public health and the visit-
ing nurse. This has been established on a trial basis in two counties and
the great advantage and the wide need for this are clearly apparent.
The mental health worker is a recent addition to the family of
public health workers. These are attaining recognition as professionals.
Their primary responsibility is to work within the framework of the
generalized public health program and to gradually help to develop
the whole staff of the department into an effective working public mental
health team. There are now 23 mental health workers and the objective
is to have at least one in each health unit. A unique feature of Florida's
mental health program is the integration of mental health and general
public health so public health workers generally will be a part of the
total mental health team.
The cost of the care of the mentally defective in institutions is a
heavy and increasing tax burden. There is increasing recognition that

4 ANNUAL REPORT, 1958

with guidance and assistance more of these may be cared for better in
the home. The newly organized "Developmental Evaluation Clinic" in
Dade County is an experimental public health approach to this problem.
Its major functions are to provide reliable diagnoses and sound guidance
to parents; it also is a pioneering activity seeking to develop better care
for these handicapped children at materially less public cost.
The licensure of nursing homes and hospitals to assure that they
will be structurally safe, and the service of acceptable quality, is a
relatively new responsibility of public health in Florida. Currently 344
nursing homes with 8617 beds are licensed. During the year three closed
voluntarily, one on court order and five were placed on a probationary
status. The initial survey of all hospitals proceeded during the year. Of
192 surveyed 18 did not meet accepted standards. At the end of the year
licenses had been issued to 119 hospitals and 55 others were under con-
tinuing review. Indicated improvements in these hospitals have been
obtained with no more pressure than persuasion.
During the year, through the Hospitalization of the Indigent Pro-
gram, a total of 19,256 patients were admitted to Florida's hospitals for
a total of 188,256 hospital days. Of those admitted 26 per cent were over
65 years of age and one-half of all were receiving public assistance.
Three new programs concerned with the environment are described.
Air Pollution Control is being developed under the guidance of an of-
ficial Commission. The major problem given attention is that in the
vicinity of the phosphate industries in Polk County. The state and county
health departments gave new attention to the problem of substandard
housing. There was a special training program for sanitarians to enable
them to better carry responsibilities in this field. There was also increas-
ing attention to "radiological health." Water samples were examined for
background data and for evidence of any possible pollution with radio-
active wastes. Plans were developed for a survey of possible unintended
exposures to radiation in the vicinity of X-ray equipment.
Though an old program, the highly important work in the preven-
tion of illicit sale of narcotics warrants emphasis. There were 132 arrests
during the year, 93 for narcotics violation. Of 108 court cases there were
102 convictions. One case involved the illicit possession of 45,000 amphe-
tamine tablets. Marihuana addiction was a particular problem among
non-white young adults in the lower east coast. The illicit trade in heroin
was a relatively new problem and of grave concern.
There is one feature common to most of the reports of bureaus and
divisions. The amount of services requested or needed are beyond that
which can be provided with the budget and by the personnel now
available.

EDUCATION AND TRAINING
The widely distributed work in this field is of three broad types, the
informing of the public on health matters of general and personal interest

GENERAL SUMMARY

and concern, the participation in professional graduate education or
technical training, and in-service training programs for staff members.
Two developments are worthy of special mention in the broad field
of health education. There is a growing expression of interest by county
health departments in adding full-time health educators to their staff.
The responsibility of health departments in enabling the individual and
family to handle their own health problems better is acknowledged. This
is receiving more attention. Also for the first time during the year regular
weekly telecasts were provided by the Board of Health through an Edu-
cational TV Station. Wider use of this channel of education in the fu-
ture is being planned.
The professional educational programs are a cooperative activity.
These are offered with the participation of the Florida Medical and
Dental Associations, the University of Florida and a variety of other
agencies and groups. The favorable acceptance of these programs of high
quality fully justifies the exacting attention to planning. There is no
record of the numbers attending, though in total it is known to be large.
There are a variety of in-service training programs, though these
are particularly well planned for public health nurses, sanitarians and
those in the field of mental health. These important programs are de-
scribed in the full report of these bureaus and divisions. There is a rec-
ognized need for a well balanced program of continuing education to
enable all workers in public health to provide the most effective services
available. Fellowships for one year of graduate training are provided
annually to a small number of carefully selected employees.
The provision of fellowship for the training of physicians, dentists,
and the various disciplines concerned with mental health continued
under the sound guidance of the advisory committees and Council on
Training and Research in Mental Health.

SPECIAL STUDIES
The basic objective of special studies is to make it possible to provide
more and better service at the least practicable cost. The nature of in-
vestigations now in progress have been summarized in a concise descrip-
tion of research which is presented in the full report. The significance
of these studies may be illustrated. Possible exposure to rabies is an in-
dividual, family and community emergency. Laboratory examination is
essential. Previously the most dependable test required six weeks; now
by a new "fluorescent antibody" technic equally dependable findings
appear to be attainable on the same day the specimen is received. Time
devoted to the perfection and evaluation of this test promises to provide
much better procedures which will greatly improve service in the years
ahead.
The special studies for the Governor's Citizens Medical Committee
placed a heavy demand on staff time but the recommendations of the

6 ANNUAL REPORT, 1958

Committee provide guidance for the future development of medical and
health services in the state.
The Entomological Research Center is receiving national and in-
ternational recognition. The sound practical approach of studying the
problems where they occur is acclaimed. The approval of substantial
research grants is an endorsement in dollars of the outstanding quality
of the staff.
Of particular significance is the frequent emphasis by the staff of
different bureaus and divisions of the need for more research.

COOPERATIVE RELATIONSHIPS
To an increasing extent, organized public health in Florida is the
focus for broad cooperative activities. The valuable contribution by
physicians, dentists and their professional societies is acknowledged.
There has been cooperative planning and action with several state
agencies. There has been mutual recognition of the need for close as-
sociation between the work of voluntary and official health agencies.
Consultive assistance from universities has been of high value. Working
with citizens groups is a part of daily responsibilities of those in public
health. The general approach is "together we move forward."

UNMET NEEDS
The repeatedly stated need is for health departments to be able to
grow with a rapidly growing Florida. Each new industry, each added
subdivision and every increase in population places new or additional
responsibilities on state and local health departments. So there are the
requests for more personnel, for additional workers qualified in mental
health, for nurses to provide the needed home nursing services and for
scientists, especially for the Entomological Research Center. There is
emphasis on the need for the completion of the building program in
Jacksonville, for two urgently needed regional public health laboratory
buildings, for environmental laboratories in at least three areas of the
state, and for adequate facilities for the health departments in all coun-
ties. Though this annual report is a record of gratifying progress there
are still unmet needs. Undoubtedly the reports of future years will record
the satisfying of these currently acknowledged needs.
The following section summarizes actions and progress in general
administration.

MISCELLANEOUS
This year will be remembered as the one during which the ad-
ministrative wing of the central office and laboratory building was com-
pleted. For the first time there is available adequate and convenient

GENERAL SUMMARY

space for the State Health Officer and assisting staff. In addition to the
Assistant State Health Officer this has grown to include a health pro-
gram analyst, an internal auditor, full-time attorney and the essential
administrative, secretarial and clerical staff. These now have offices in
close association, adjacent to that of the State Health Officer, a relation-
ship favoring much closer team work.
Though the new building was occupied in the middle of the year
under review, its dedication as the J. Y. Porter Building was scheduled
for early February 1959. On the same day the laboratory wing is to be
designated the Henry Hanson Building. These two wings with a renova-
tion of the space in the older buildings has provided adequately for all
but the Bureaus of Engineering and Entomology. The planned third
wing will include the housing for them and when available will termi-
nate the costly necessity of renting office space elsewhere. Equally im-
portant, it will make possible the closer working relationships needed for
all units of the Board of Health.
In addition to the Commissions, Councils and Committees estab-
lished by legislative acts as outlined in the preceding annual report,
Governor Collins designated in 1958 an Inter-Agency Committee on
Housing with the State Health Officer as one of its three members, and
a Committee on Migratory Agricultural Labor with the Assistant State
Health Officer representing the Board of Health. There was appointed
also a Governor's Citizens Medical Committee on Health with the State
Health Officer as one of its 21 members. At the direction of the Gover-
nor, staff assistance and support was provided by the Board of Health.
The Assistant State Health Officer, as research consultant, devoted a
substantial portion of his time in directing and assisting in studies of
medical and health problems of broad importance to Florida. The report
of this Committee will be published as a separate document.
This and other state agencies were faced with urgent problems in
the early months of 1958 due to the unprecedented series of destructive
freezes. Special medical relief measures were needed and at the suggestion
of the State Health Officer a community work project was adopted for
Immokalee which provided economic relief and greatly improved the
community sanitation. Services to improve housing, sanitation, and
health services for migrant workers, which was given an impetus by the
emergency, have continued as active on-going programs.
Problems related to the procurement of personnel have continued.
At the end of 1958 there were more vacancies for health officers (11)
than have occurred simultaneously in recent years. In part due to need,
the employment of "retired" health officers on less than a full-time basis
has been tried experimentally with promising results. An expansion of
the employment of these and other "senior citizens" in the future is
anticipated.
During the year four directors of bureaus were designated; Wade
Stephens, M.D., as director of Local Health Services, Wayne Yeager,

8 ANNUAL REPORT, 1958

M.D., in Mental Health, Simon Doff, M.D., in Maternal and Child
Health and Nathan Schneider, Ph.D., as director of Laboratories. All
appointments represented advancement from other positions with the
Board of Health. The Division of Sanitation was established and a pre-
vious county health department sanitarian, Mr. A. W. Morrison, Jr.,
was selected as its first director. Miss Marjorie Morrison resigned and
Miss Deaver was appointed as chief of Nutrition Services. This
division, also, was transferred from the Bureau of Special Health Serv-
ices to the Bureau of Local Health Services. Mr. James Doyle was des-
ignated as Personnel Officer.
Senior staff members have been called upon for high office, by
state, national and international organizations. The State Health Officer
was elected to the Governing Council of the American Public Health
Association, a position of high responsibility in that organization. He
was designated also as vice-chairman of the Association of State and
Territorial Health Officers and chairman of its Long-Range Planning
Committee. The Assistant State Health Officer was invited by the World
Health Organization to serve as a consultant, and chairman of a com-
mittee to plan for the study and control of the acute diarrheal diseases,-
conditions which continue to be the major cause of death of infants and
children in wide and populous areas of the world. The chief of the
Heart Disease Control Program, who is the recently designated director
of the Bureau of Maternal and Child Health, is the president of the
Florida Heart Association. The director of Finance and Accounts com-
pleted his term as president of the Florida Public Health Association
and Mr. John Miller as president of the Florida Engineering Society.
Mr. David B. Lee was named chairman, Florida Section of the American
Water Works Association and Mr. Sidney Berkowitz, president of the
Florida Sewage and Industrial Waste Association. Miss Elizabeth Reed
was elected to serve as president of the Conference of State and Terri-
torial Directors of Public Health Education. Others have served various
state and national organizations in responsible positions.
An Employees' House Committee was appointed to advise the State
Health Officer on matters pertaining to environment, furniture and
facilities. The Committee has made a definite contribution to employee
morale through study and recommendations concerning the above items.
ACTIVITIES OF THE BOARD
No changes took place in the membership of the Board during the
year. Also the same officers served throughout the year, Charles J.
Collins, M.D., as President and T. M. Cumbie, Ph. G., as Vice President.
Five meetings were held and the dates, places and the major items
of business that were transacted were as follows:
February 11-Jacksonville
1. Adopted revisions of the Sanitary Code, Chapter IX-Restau-
rant And Eating Places and Chapter XI-Food Processing
Plants.

GENERAL SUMMARY

2. Appointed Mr. Arthur Bailey of Orlando as a member of the
Advisory Committee on Hospital Service for the Indigent to
replace Mr. Pat Groner of Pensacola.
3. Adopted revisions in the Rules and Regulations for the Hospital
Service for the Indigent Program, which included the hospital-
ization of persons with cancer as a part of this program.
4. Discussed the law on naturopathy passed by last Legislature and
approved the appointment of a five-man committee to assist in
screening any controversial applicants for a naturopathic license.
Two members of this committee were to be naturopaths.
5. Discussed the possibility of selling the laboratory buildings in
Pensacola and Tampa and using the funds for building new
buildings. The Attorney General had ruled that the proceeds
from such a sale could be set aside and used to match federal
funds for new construction.
6. Voted to name the new State Board of Health building in
Jacksonville the J. Y. Porter Building in honor of the first
State Health Officer.
7. Approved the State Board of Health's cooperation with the
National Office of Vital Statistics and the National Cancer
Institute in a study on lung cancer.
8. Discussed health problems of migratory laborers in Immokalee
and heard reports on action being taken by the State Health
Officer and staff.
9. Met with county health officers and heard discussions and rec-
ommendations on the creation of a Division of Sanitation.

May 11-Bal Harbour, Miami Beach
1. Discussed future use of Pensacola laboratory building with Dr.
Herbert L. Bryans, former President of the Board, and
authorized the Escambia County Medical Society to use one
room in this building for a public health and medical library
during the immediate future and until permanent plans were
made.

2. Considered request from City Manager of Pensacola that the
laboratory building be returned to the City of Pensacola. The
Board directed that the City Manager be advised that it would
be necessary for the State Board of Health to sell this property
in order to secure funds to construct new quarters.

3. Approved a plan submitted by the State Health Officer for the
future employment of two Assistant State Health Officers.

10 ANNUAL REPORT, 1958

4. Approved the appointment of Dr. Simon Doff as director of
the Bureau of Maternal and Child Health to be effective on,
or about, August 1, 1958.
5. Approved the appointment of Dr. Wayne Yeager as director of
the Bureau of Mental Health on, or about, July 1, 1958.
6. Approved the appointment without pay of Dr. Peter Regan,
head of the Department of Psychiatry, University of Florida
Medical School, as consultant to the Bureau of Mental Health.
7. Approved the appointment of Dr. Wade Stephens as acting
director of the Bureau of Local Health Services.
8. Approved the appointment of Mr. Clarke Nichols as full-time
attorney for the State Board of Health for special work in the
field of migratory labor housing and housing in general.
9. Voted to name the present laboratory building in Jacksonville
in honor of Henry Hanson, M.D., former State Health Officer.
10. Adopted an amendment to the rules and regulations for the
Control of Communicable Diseases on rabies.
11. Voted to create a Division of Sanitation in the Bureau of Local
Health Services; approved an outline of responsibilities and
duties submitted by the State Health Officer.
12. Adopted rules and regulations for the licensing of hospitals.
13. Approved the purchase of gamma globulin for certain purposes
and under certain conditions.
14. Adopted a regulation prohibiting the resale or reissue of pre-
scription drugs or medicine which had been previously issued
and the containers opened.
15. Received, studied and approved a report made by the com-
mittee appointed to assist in the licensing of certain naturopaths
and voted to grant a license to Dr. Harry Raitano.
16. Voted to approve the recommendations of the Advisory Com-
mittee on Medical Scholarships.
17. Authorized the State Health Officer to attempt to purchase two
plots of land adjacent to present headquarters in Jacksonville.
18. Approved awarding of scholarships to certain applicants in the
field of public health.
19. Voted to seek a salary increase for the State Health Officer to
$17,500 in the legislative budget.
20. Reviewed complaints from sandwich manufacturers and dispen-
sers concerning Chapter IX and XI, Sanitary Code, and ap-

GENERAL SUMMARY

proved Dr. Sowder's action in not having filed these revisions
with the Secretary of State in view of complaints. Directed
further study of problem.

June 29-Jacksonville
1. Adopted revisions, rules and regulations of the arthopod control
law.
2. Adopted revision, rules and regulations of the structural pest
control law.
3. Adopted revisions of the Sanitary Code, Chapter VII-Retail,
Dispensing and Handling of Shellfish and Cooked Crustacea
Meat.
4. Repealed revisions of Chapters IX and XI, Sanitary Code,
adopted on February 11 and adopted new revisions.
5. Directed that rules and regulations be drawn up for the licens-
ing of homes for retarded children.
6. Approved awarding dental scholarships to applicants recom-
mended by State Board of Dental Examiners.
7. Heard proposals from bureau and division directors for budgets
for the biennium 1959-61.

September 14-Jacksonville
1. Voted to create a Division of Water Supply and a Division of
Waste Water in the Bureau of Sanitary Engineering.
2. Approved the appointment of Mr. John B. Miller as director of
the Division of Water Supply in the Bureau of Sanitary Engi-
neering.
3. Approved the transfer of Nutrition Services from the Bureau
of Special Health Services to the Bureau of Local Health
Services.
4. Approved the appointment of Dr. Albert V. Hardy as Health
Officer V with permanent status as Assistant State Health
Officer.
5. Approved the appointment of Nathan Schneider, Ph.D., as di-
rector of the Bureau of Laboratories.
6. Approved the appointment of Dr. Wade N. Stephens as director
of the Bureau of Local Health Services.
7. Approved the appointment of Mr. A. W. Morrison, Jr., as di-
rector of the Division of Sanitation in the Bureau of Local
Health Services.

12 ANNUAL REPORT, 1958

8. Approved the appointment of Dr. John Enyart as director of
the Division of Hospitals and Nursing Homes in the Bureau
of Special Health Services.
9. Held hearing on swimming pool problem at Bradenton.
10. Approved with some revisions a budget submitted by Dr. Sow-
der for the biennium 1959-61.
11. Approved certain changes in Bulletin 4-D subject to concurrence
State Department of Education.
12. Approved regulations on mosquito control for Pinellas County
submitted by the Pinellas County Mosquito Control District.
December 14--Jacksonville
1. Adopted Chapter X, Sanitary Code-Rendering Plants.
2. Discussed air pollution program with staff and with Dr. Thomas
Lipscomb, Chairman, Air Pollution Control Commission. Went
on record urging Air Pollution Control Commission to hold
hearings leading to the adoption of air pollution regulations
for Polk County.
3. Adopted revisions of rules and regulations for nursing homes,
including homes for special services.
4. Heard report by Dr. C. M. Sharp, director, Bureau of Prevent-
able Diseases, on prenatal and premarital examinations, and
agreed that no change in existing laws should be made.
5. Approved the permanent appointment of Mr. Clarke Nichols
as attorney and the broadening of his duties to include all legal
matters of interest to the State Board of Health.

PUBLIC HEALTH RESEARCH
ALBERT V. HARDY, M.D., Dr. P.H.
Assistant State Health Officer and
Coordinator of Research
During the year there was a review of special studies under way in
bureaus, divisions and county health departments. In all 52 studies were
listed and described. Of these 19 were in the Entomological Research
Center (the only separate organization for research within the State
Board of Health), including field studies conducted in cooperation with
mosquito control districts or county health departments. There was one
additional entomological study in Polk County. There were 11 sep-
arate studies in the Dade County Health Department of which seven
were conducted during the summer months with the assistance of med-
ical students. There were four additional studies in three other county
health departments. There were five studies in the Bureau of Labora-
tories including one shared with the Division of Veterinary Public

GENERAL SUMMARY

Health. In all other bureaus and divisions there were eight investigations.
The responsibility for one each rested with the State Health Officer and
the Assistant State Health Officer.

All of the entomological studies were conducted by staff devoting
full time to research. Support was derived from a state appropriation
for this research supplemented, as of January 1, 1959 by four research
grants from the Public Health Service which provided over $70,000
research grant funds annually. There was also a further grant of nearly
$30,000 for the construction of an addition to the research facility in
Vero Beach. All five studies in the Laboratory derived their support
from research grants or contracts. These grant funds provided for the
employment of full-time assistants. Most of the laboratory studies were
developed as an integrated part of the bacteriological and virological
diagnostic services, and were directed by the regular senior staff mem-
bers. For the studies in Dade County there was one person only who
could devote full time to three related studies and she was employed
on research grant funds. Most of the medical students who participated
were supported by University of Miami Medical School research funds
and these studies were conducted in close cooperation with the Division
of Preventive Medicine of the Medical School. The success of these proj-
ects in Miami was dependent on the enthusiasm and research ability of
Dr. Michael Takos, whose untimely death was felt to be an irreparable
loss to the Dade County Health Department and the Medical School.

Five studies, one each in Dade, Palm Beach, Volusia, Hillsborough
and Pinellas Counties were supported by special grants amounting to
almost $200,000 per year. All of these have full-time staff devoting full
time to the special projects and all derive additional assistance from the
regular staff of the county health department in which they are located.
There were special grants for special studies which were of particular
interest to the State Health Officer and the Assistant State Health Of-
ficer. All eight of the studies in the other bureaus and divisions, other
than the Laboratory, and two of those conducted in the counties were
the product of the interest of staff members with other full-time respon-
sibilities. All but one of these were developed by the Bureau of Special
Health Services, chiefly in the Heart Disease Control Division.

Research in public health is developing therefore, in part as full-
time research, supported by a state appropriation for entomological re-
search and by supplementary research grant funds, and partially as
part-time studies incorporated with other activities. In addition, there
have been productive studies, as in epidemiology and sanitary engineer-
ing, which were an essential part of control activities.
Except in the Entomological Research Center and in the Laboratory,
all research must be considered to be in an early developmental stage.
During the year under review there was a healthy expansion. In view
of the problem of securing staff and the funds to provide for them, and
with the further need for accumulating training and experience in public

14 ANNUAL REPORT, 1958

health research, a gradual expansion and extension will be a healthy
growth.
The separate studies which were under way in 1958 are listed in
Table I. If the staff concerned is devoting full time to research, the
project is listed as "full-time," whereas if most of the work is conducted
by those with other major responsibilities it is classified as "part-time."
The cost of these studies and the source of funds can only be ap-
proximated. There was $250,000 from research grants, $25,000 from
the categorical federal funds, $155,000 as a state appropriation for the
Entomological Research Center and $3,600 from the University of
Miami (as salaries paid to medical students assigned to the Dade County
Health Department). There was also some $30,000 for research in men-
tal health which was granted during the year by the Council on Training
and Research in Mental Health as grants to various individuals and
agencies in the state.

TABLE 1

RESEARCH IN PUBLIC HEALTH IN FLORIDA DURING 1958

Research in Progress Full-time Location
or Part-time
Personnel

1. Mental health case finding among
school children by school and
health department personnel............Full-time....Volusia County
2. Study of diagnoses of illnesses of
hospitalized civilians to determine
health needs ................... ........ Part-time....Monroe County
3. Study of relationship between con-
genital heart disease and other ab- School for Deaf and Blind,
normalities ............................Part-time....St. Augustine
4. Evaluation of health services for
migrant mothers and children..........Full-time....Palm Beach County
5. Five-year study of hypertension pa-
tients and drugs used in treatment,
outpatient department Duval Med-
ical Center ..................... ....... Part-time....Jacksonville
6. Laboratory studies of diarrheal Okatie Farms
disease in monkeys.................. Full-time....South Carolina
7. Evaluation of rapid laboratory test State Board of Health
procedures for M. tuberculosis ..........Full-time....Jacksonville
8. Study of diarrheal diseases in State Board of Health
Armed Forces ...............................Full-time....Laboratories
9. Study of rabies in wild life..............Full-time....State Board of Health
10. Diabetes detection among relatives
of diabetics .................................. Part-time....Various counties in Fla.

GENERAL SUMMARY 15

TABLE 1 (continued)
RESEARCH IN PUBLIC HEALTH IN FLORIDA DURING 1958
State Board of Health &
11. Tests in diagnosis of tuberculosis....Full-time....University of Miami
12. A community program to assist
persons returning from mental hos-
pitals ................................................Full-time....Hillsborough County
13. Public health program for the
aged .................................................. Full-time....St. Petersburg
14. Evaluation of problems of inmates
of nursing homes................................Full-time...Dade County
15. A study of whether the needs of
inmates of nursing homes are prop-
perly met ......................................--Full-time....Dade County
16. A study of persons living in re-
tirement hotels ..................................Full-time....Dade County

17. Causes underlying deaths from sy-
philis ..................................................Part-time....Dade County

18. A study of individuals with chronic
gonorrhea ..........................................Part-time....Dade County
19. Study of high incidence and death
rate from tetanus................................Part-timeDade County
20. Study of causes of high neonatal
death rates ........................................Part-time....Dade County

21. Survey of patients in Jackson Me-
morial Hospital suffering from
stroke ..................................................Part-time....Dade County
22. Evaluation of treatment and reha-
bilitation of individuals with frac-
tures of the hip..................................Part-time....Dade County
23. Blood tests on a group of mentally
retarded children living at home......Part-time....Dade County
24. Developmental Evaluation Clinic......Full-time....Dade County

25. Determination of services most
needed from the public health
nurse ..................................................Part-tme....Pinellas County

26. Control of biting insects....................Full-time....Entomological Research Center
27. Where and how salt-marsh mos-
quitoes breed ................................Full-time....Entomological Research Center
28. Best method of impounding water
for salt-marsh mosquito control........Full-time....Entomological Research Center
29. The effect of drainage on repro-
duction of sand flies..........................Full-time....Entomological Research Center

16 ANNUAL REPORT, 1958

TABLE 1 (continued)

RESEARCH IN PUBLIC HEALTH IN FLORIDA DURING 1958

30. Effective chemicals to destroy mos-
quito larvae ..-.................------..-- Full-time....Entomological Research Center
31. Effective chemicals for controlling
adult mosquitoes ................................---Full-time....Entomological Research Center
32. Technique for horsefly research........Full-time....Entomological Research Center
33. Distribution and occurrence of
mosquitoes ....................................Full-time....Entomological Research Center
34. Study of mosquito dispersal from
breeding areas .................................Full-time....Entomological Research Center
35. Study of technique of sampling
mosquito population ......................Full-time....Entomological Research Center
36. Testing for most effective house
screening against mosquitoes..............Full-time....Entomological Research Center
37. Habits and living places of salt-
marsh sand flies............................Full-time....Entomological Research Center
38. Food requirements of mosquitoes......Full-time....Entomological Research Center

39. Feeding habits of mosquitoes............Full-time....Entomological Research Center
40. Study of mosquito eggs......................Full-time....Entomological Research Center

41. Develop techniques for determin-
ing age of mosquitoes........................Full-time....Entomological Research Center
42. Study of association of mosquitoes....Full-time....Entomological Research Center
43. Migratory behavior of mosquitoes....Full-time....Entomological Research Center
44. Study of fish that feed on salt-
marsh mosquitoes ........................... Full-time....Entomological Research Center

45. Control of blind mosquitoes..............Full-time....Polk County

46. Differentials in male-female mor-
tality ..................................... Part-time....State Board of Health

47. Organization and administration of
public health research...................Full-time....State Board of Health
48. Three year follow-up study of psy-
chotic children .................................Part-time....State Board of Health
49. Analysis of referrals to Child Guid-
ance and Community Mental
Health Clinics ..............................Part-time....State Board of Health

50. Deaths from acute rheumatic fe-
ver under age five...........................Part-time....State Board of Health

51. Stroke ......................... ................Part-time....Duval County

GENERAL SUMMARY

SCHOLARSHIPS FOR PROFESSIONAL EDUCATION

Scholarships for the study of medicine, dentistry, and the several
disciplines concerned with mental health were created by three separate
acts of the Legislature in 1955.

The medical scholarship act was so amended by the 1957 Legis-
lature as to permit the awarding of scholarships in excess of the 10 each
year originally authorized, from funds that may accumulate as the
result of scholarships of less than four years' duration having been
awarded in previous years. Utilizing the provisions of this amendment,
15 medical scholarships were awarded in 1958. Medical scholarships are
awarded by the State Board of Health 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 1958, consisted of the follow-
ing: Dean George T. Harrell, University of Florida, and Assistant Dean
John C. Finerty, University of Miami, who served as ex-officio members.
The following physicians were members of the Committee: T. Z. Cason,
Jacksonville; Homer L. Pearson, Jr., and John Milton, Miami; James
T. Cook, Jr., Marianna and Melvin D. Simmons, Sarasota.

The statute creating the dental scholarship program was amended
by the 1957 Legislature in the same manner as was the medical scholar-
ship statute. Utilizing the provisions of this amendment, 11 scholarships
were available for award; however, one was withheld in compliance
with the State Budget Commission's emergency requirement that five
per cent of all appropriations be held in reserve. Scholarships for the
study of dentistry are awarded by the State Board of Health upon the
recommendation of the State Board of Dental Examiners. The following
dentists served on that Board in 1958: Frank T. Scott, Chairman, and
R. P. Taylor, Jr., Secretary, Jacksonville; D. J. Zimmerman, Ft. Myers;
Robert Fhoburn, Daytona Beach; F. A. Finley, St. Petersburg; J. N.
Pepper, Pensacola and F. F. Farver, Miami Beach.

Upon the recommendation of the Florida Council on Training and
Research in Mental Health, scholarships or stipends are awarded by the
State Board of Health each year for the training of residents in psy-
chiatry, interns in clinical psychology, psychiatric nurses and psychiatric
social workers.

A fourth scholarship program administered by the State Board of
Health stems from the Federal Social Security Act of 1935. This program
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. Through the years the Board of Health
has utilized this program to further the training of career employees who
show evidence of leadership and professional growth.

18 ANNUAL REPORT, 1958

Persons receiving scholarships in 1958 were:

MEDICAL
Scholarships Awarded in 1958:

Jarrett Charles Black..............Miami
Robert Elliott Blakey..............Orlando
William Edwin Braun......Jacksonville
James Wilson Bridges...............Miami
Karl George Gerlach....St. Petersburg
Ed. R. McDonough......Ft. Lauderdale
Troy E. Overstreet....................Miami
Lawrence Donald Porter........Sarasota

Laurence E. Newman.............Miami
Ralph E. Reed..........................Miami
Earl Taylor ............................Madison
Raymond Charles Walker..........Dania
Carol Jean Whidden..............Orlando
Robert Paul C. Whittier..Vero Beach
George A. Williams......St. Petersburg

Continuing Scholarships awarded prior to 1958:

Awarded 1955:
Russell P. Blanton
Edwin H. Hamilton
Rufus J. Johnson
Robert H. Jenkins
Daniel M. Jacobs
Wilburn R. Jenkins
Daniel H. Miller
Samuel L. Renfroe
Oren R. Smith, Jr.
George S. Trotter

Awarded 1956:
William Henry Hubbard
James A. Johnson
Richard Frank Kuhn
James Milton Marlowe
Glen Mayo
Luther C. McRae
Charles T. Ozaki
Hoke Harold Shirley, Jr.
Arthur Warren Sweat
Robert Aldridge Walton

DENTAL

Awarded 1957:
Robert Edwin Allen, Jr.
Ernest Austin
David Merle Bleech
Hoyt Horne
Edwin Keenan House, Jr.
John Franklin Mason, Jr.
Ronald Joseph Scheib
Leonidas Martin Turner, Jr.
Joseph Albert Walton, Jr.
Richard Burke Welch

Scholarships Awarded in 1958:
Alvin Bayer III................Jacksonville Oran Lloyd Turner, Jr.....Tallahassee
Wilbur Knox Collins............Ft. Myers Raymond Wm. Gage II..Jacksonville
Stephen H. Mills..................Sarasota James E. Thompson........Jacksonville
James Emmett Mongoven..Bradenton Parnick Auston Williams............Perry
Rudolph Robinson .................Miami
Continuing Scholarships awarded prior to 1958:

Awarded 1955: Awarded 1956:
James R. Butler William Gage Boyd, Jr.
Frank Donald Newgard Henry James Johnson
Ralph H. Mandus George E. Carver
Leonard Richard SandersonThomas Marshall Darden
David L. Schofield Joe Holland Dowdy
James W. Williams Wade Burke Hammer
Thomas Henry Callahan Harry Gruen
Dean W. Gordon David Campbell McCoy
Alfred John Phillips
Richard Rafael Souviron
Raymond Edwin Rogers
Donald Spence

Awarded 1957:
Richard Kingsley Ames
Jay Brenner
Robert Hardin Carter
William Howard Filler
Robert Bagner Hayling
Peter B. Mills
Bennie Thompkins
Harold Thomas Wilson
Lester Charles Young
Robert Wylly Butler

MENTAL HEALTH
RESIDENTS IN PSYCHIATRY:

Richard S. Wolf, M.D.............Miami
Evan Katz, M.D.............Coral Gables
Wilford M. Provo, M.D...........Tampa
Martin Rosenthal, M.D...Miami Bch.
Ronald A. Shellow....................Miami
(Started in November)

Ernest O. Herreid, Jr., M.D.....Miami
Lyle B. Kunz, M.D..................Miami
Herbert C. Anderson, M.D.......Miami
Stanley S. NeeDell, M.D...........Miami

GENERAL SUMMARY

CLINICAL PSYCHOLOGY

Thomas D. Prutsman....Ft. Lauderdale
Nathan W. Perry, Jr.....St. Petersburg
John G. Losak....................Gainesville
Vahak Gadarian ..................Shalimar
(June Jan.)

Laurence T. Carroll, Jr...........Miami
Eve Lyn Weeks..............Coral Gables
Betty Whitney ....................Hallandale
Charles F. Williams----..................Miami

PSYCHIATRIC NURSING

Elizabeth Bradley..........Chattahoochee
(June Feb.)
Betty Land ....................Jacksonville

Sixta H. Belmont.....................Miami
Sonia L. King................... Miami

PSYCHIATRIC SOCIAL WORK

H. V. Arcamonte........Miami Springs
Thomas H. Broome, Jr.........Marianna
J. Pomeroy Carter................Live Oak
Stanley D. Davenport........Gainesville
Patsy Nell Hirt..................Tallahassee
Eleanor F. Moore...........Key West
Richard S. Sheffer..............Clearwater
Marilyn S. Waller............Jacksonville

Andre L. Johnston..........Tallahassee
Raymond L. Logue........St. Petersburg
James P. Love, Jr.............Jacksonville
Robert G. Marshall......St. Petersburg
Eldreth Melton............Ft. Lauderdale
Yvonne Moreno ...................Miami
William E. Neet............St. Petersburg
Allan W. Russell..............Jacksonville

PUBLIC HEALTH PERSONNEL
George M. Erickson, M.D.....Health Officer......... .....Dade County
C. Crosbie Flood, M.D............Health Officer.......... .....Bureau of Local Health
Services
Lillian W. Burrows................ Public Health Nurse...........Orange County
Bertha C. King ....... ........ Public Health Nurse...........Hillsborough County
Alice E. Reynolds---....---..... Public Health Nurse...........Volusia County
Violet Williams .....------......Public Health Nurse...........Palm Beach County
Frank J. Boswell.....................Sanitarian.............Leon County
John H. Dame.........................Sanitarian ..................... Polk County
Walter R. Livingstone, Jr......Sanitarian............................Dade County
Walter C. Schumacher...........Sanitarian..... ...........Pinellas County
Don Turner ...........................Sanitarian............---------Bureau of Sanitary
Engineering
Agnes J. Dembek.........-----.Mental Health Worker.......Collier County
Margaret McLendon ..........Bioanalyst.............. Bureau of Laboratories
William Macomber .................Clinical Psychologist..........Volusia County

PERSONNEL OFFICE
JAMES A. DOYLE
Personnel Officer

The Merit System's Pay and Classification Plan, which went into
effect July 1957, continued to operate. All employees work under the
Minimum Implementation Formula which has seen many salary ad-
justments throughout the year.

A new Personnel Officer was appointed in September. The transfer
of the personnel representative of the Bureau of Local Health Services to
the Personnel Office was effected, allowing closer coordination of basic
personnel procedures for all concerned. New staff members were added
accordingly.

20 ANNUAL REPORT, 1958

The much-needed Payroll Manual was developed and has been
placed in effect for both county and state employees. This Manual is
all-inclusive in its outline of Payroll Processing and Examples; Supple-
mental Payrolls; Withholding Tax; Retirement; Social Security; In-
surance; and various information charts. The Payroll Manual was de-
signed specifically as a detailed and "timesaving" instrument for chief
clerks, business managers and administrative assistants, and to minimize
duplication and procession in the Payroll Section of the Personnel Office.
Through recruitment programs, continuous and vigorous efforts are
being made to meet the ever-increasing demand for the much-needed
highly technical and professionally trained staff to carry out public
health programs. There are current needs for health officers, sanitarians,
engineers, nurses, health educators, mental health workers and others.
IBM procedure has been installed in the Payroll Section. The en-
suing year should see further development of this operation applied to
the increasing responsibility of personnel record keeping.
Since the concept of the Classification and Pay Plan, it has become
evident that the specifications of many positions were not completely
accurate in the definition and duties performed. These inequities were
pointed out to the Merit System and to the Merit System Council, re-
sulting in many changes of job descriptions, reclassifications of positions
and pay ranges, and changes in specifications.
Complete records of in-service and postgraduate training of employ-
ees were maintained, and the adherence to regulations governing such
training was insured.

December 31, 1958 shows a six per cent increase in state employees.
There were 1840 state employees (including those in county health de-
partments) and 14 federal employees on loan to this agency. On De-
cember 31, 1957, there were 1735 state employees and 16 federal em-
ployees.

The principal reasons for separations include marriage, pregnancy,
transfer of husbands from the area, completion of projects for which
employed, and acceptance of more profitable employment elsewhere.
(See Table 2a)

Postgraduate training on a stipend basis for one full academic year
was successfully completed during 1958 by two health officers; six public
health nurses; four sanitarians; one sanitary engineer; and one mental
health worker.

Plans for a group life insurance program and new use of IBM ma-
chines in personnel procedures are presently under study. A "Personnel
Procedures" manual is under consideration.

GENERAL SUMMARY 21

TABLE 2

MERIT SYSTEM STATUS, STATE AND LOCAL PERSONNEL
AS OF DECEMBER 31, 1957 AND 1958
Status 1957 1958 Per Cent Change
Permanent & Probationary 1398 1457 + 4.22
Provisional 69 64 7.25
Temporary 0 0
Emergency 25 26 + 4.00
Exempt & Part Time 243 293 +20.57

Total 1735 1840 + 6.05

TABLE 2A

VACANCIES IN BUDGETED POSITIONS AS OF
DECEMBER 31, 1958
Position Vacancies
Total Central Offices County Units
Total 108 33 75
Physicians 11 3 8
Sanitary Engineers 4 4 0
Public Health Nurses 32 6 26
Sanitarians 14 2 12
Health Educators 3 0 3
Mental Health 10 3 7
Other technical or
professional 15 10 5
Clerks & stenographers 19 5 14

TABLE 3
DISTRIBUTION OF PERSONNEL-STATE BOARD OF HEALTH
(OTHER THAN COUNTY HEALTH DEPARTMENTS)
DECEMBER 31, 1958

be >

o a o 2 s a

Grand Total ............................. 553 14 24 16 16 46 22 63 59 181 100 12
Administration SHO ....................................... 18 3 4 1 8 1 1
Personnel.................................... 11 3 8
Total ................................... 29 3 7 1 16 1 1
D mental H health ............................................... 7 5 2
Finance Fiscal....................................... 11 4 7 O
and Purchasing & Property......................... 38 2 1 10 25
Accounts Total ................................... 49 6 1 17 25
Health Information ........................................... 13 4 1 6 1 1
Jacksonville ................................. 62 17 2 23 7 12
Miami. ...................................... 19 6 7 2 4
Orlando ..................................... 6 2 1 3
Laboratories Pensacola ................................... 7 2 2 1 2
Tallahassee .................................. 6 2 1 1 2
Tam pa...................................... 20 6 4 2 8
West Palm Beach .................. ......... 6 2 2 1 1 U1
Total................................... 126 37 2 40 14 32 1
Local (Bureau...................................... 11 3 1 1 6
Health Nutrition.................................... 5 4 1
Services P. H. Nursing................................ 12 10 2
Sanitation ................................... 5 4 1
Total.................................... 33 3 1 5 10 4 10
Maternal and Child Health ................................... 20 1 1 5 4 5 1 3
M mental H health ............................................... 18 1 8 6 3
N arcotics.................................................... 13 9 4
(Bureau..................................... 7 1 1 2 2 1
Industrial Hygiene ......................... .. 6 1 2 1 1
Preventable J Tuberculosis Control .......................... 22 2 10 9 1
Diseases Venereal Disease Control. ..................... 11 3 8
Veterinary Public Health...................... 6 2 1 3
Total.................................... 52 4 1 2 3 1 13 18 9 1
Sanitary Engineering......................................... 53 21 5 6 1 2 15 3
Special J Bureau & Hospitals & Nursing Homes............ 10 2 4 4
Health Chronic Diseases............................. 10 1 1 5 1 2
Services Total ................................... 20 2 1 1 4 9 1 2
Entomology ................................................. 64 1 2 24 2 8 27
Vital Statistics................................................ 56 5 51

GENERAL SUMMARY 23

TABLE 4
DISTRIBUTION OF PERSONNEL IN COUNTY
HEALTH DEPARTMENTS -DECEMBER 31, 1958

COUNTY 0 r J I I |

(1) V C 1P .
Totals.......... 1,287 49 10 252 470 2 3 59 18 260 88 78
Alachua.............. 28 1 5 10 3 5 3 1
Baker................ 3 1 1 1
Bay................. 16 1 4 6 1 2 1 1
Bradford. ............ 6 1* 1 2 1 1
Brevard.............. 25 1* 6 9 1 1 5 1 1
Broward.............. 54 1 2 10 18 5 2 12 4 1
Calhoun .............. 4 1 1 1 1
Charlotte............ 4 1* 1 1 1
Citrus. ............. 4 1* 1 1 1
Clay ................ 7 2 3 1 1
Collier .............. 5 2 1 2
Columbia. ............. 7 1* 2 2 1 1
Dade................ 213 5 3 47 96 1 6 2 36 6 11
DeSoto............... 3 1 1 1
Dixie................. 2 1 1
Duval ............... 34 1 5 12 4 1 5 4 2
Escambia............. 53 1 9 14 1 13 6 9
Flagler................ 2 1 1
Franklin ............. 5 1* 1 1 1 1
Gadsden.............. 12 3 6 2 1
Gilchrist.............. 2 1 1
Glades.............. 1 1
Gulf ................. 5 1 2 1 1
Hamilton............. 4 1 1 1 1
Hardee............... 4 1 2 1
Hendry............... 4 1 2 1
Hernando............. 2 1 1
Highlands. ........... 7 1* 2 2 1 1
Hillsborough. ......... 132 5 1 25 44 1 5 3 25 16 7
Holmes............... 5 1 2 1 1
Indian River.......... 7 1 5 1
Jackson.............. 9 1* 2 4 1 1
Jefferson.............. 7 2 2 2 1
Lafayette............. 3 1 1 1
Lake ................. 14 1 3 6 3 1
Lee. ................. 13 1* 3 5 2 2
Leon ................ 25 1 5 8 7 4
Levy................. 5 1 2 1 1
Liberty............... 2 1 1
Madison.............. 7 1* 1 2 2 1
Manatee.............. 19 1 4 5 2 4 1 2
Marion ............... 12 1 2 5 2 1 1
Martin. .............. 5 2 2 1
Monroe .............. 17 2 6 1 3 3 1
Nassau............... 7 1* 1 3 1 1
Okaloosa. ............ 10 1 3 4 2
Okeechobee ........... 2 1 1
Orange .............. 51 1 8 15 4 5 15 3
Osceola............... 5 1 2 1 1
Palm Beach........... 61 2 1 9 21 5 1 13 3 6
Pasco................ 4 1 2 1
Pinellas... ........... 118 4 2 22 44 1 1 8 1 24 7 4
Polk................. 79 2 1 13 29 5 1 16 7 5
Putnam.............. 11 1* 2 4 1 3
St. Lucie ............. 13 1* 5 2 1 3 1
Santa Rosa........... 8 2 3 1 2
Sarasota.............. 32 1 6 13 2 8 2
Seminole .............. 9 1 2 3 2 1
Sumter............... 5 1* 1 1 1 1
Suwannee............. 5 1 2 1 1
Taylor............... 5 1 2 1 1
Union ................ 3 1 1 1
Volusia .............. 48 2 8 15 1 6 6 8 2
Wakulla .............. 2 1 1
Walton ............... 7 1* 1 2 1 1 1
Washington ........... 5 1 2 1 1
*Serves two or more Counties-See Roster of County Health Officers.

24 ANNUAL REPORT, 1958

TABLE 5

TERMINATIONS AND TURNOVER RATES BY CLASSIFICATION
FOR THE FLORIDA STATE BOARD OF HEALTH AND COUNTY
HEALTH UNITS, CALENDAR YEAR 1958
(FULL-TIME EMPLOYEES ONLY)

SALARY

Un-
CLASSIFICATION Total der 150- 200 250- 300- 400- 00-600- 700- 800- 900
$150 199 249 299 399 499 599 699 799 899 Plus

TERMINATIONS

Total AllEmployees............. 330 0 57 79 64 89 16 4 12 5 2 2
Physicians....................... 9 1 4 2 2
Sanitary Engineers........... 4 1 1 2 0 0 0
Sanitarians... ................... 13 1 11 1 0 0
Public Health Nurses. ............ 69 22 43 4 0 0
Prof. Laboratory Workers. ........ 7 5 0 0 2 0 0
Admin. & Fiscal Professionals...... 1 0 0 1 0 0 0
Other Professionals ............... 28 10 8 2 7 1 0 0
Technical......................... 4 0 2 1 1
Clerical.......................... 121 27 54 33 6 1
All Others....................... 74 0 30 23 7 13 1
TURNOVER RATE (ANNUAL PERCENTAGE)

Total-All Employees............ 19.2 0.048.137.322.713.0 7.3 6.227.626.3 6.3 5.4
Physicians.................... ...14.2 66.7 57.1 9.8 5.8
Sanitary Engineers................ 12.3 16.733.3 13.8 0.0 0.0 0.0
Sanitarians....................... 5.0 9.1 7.5 1.2 0.0 0.0
Public Health Nurses............. 14.6 33.3 12.2 8.3 0.0 0.0
Prof. Laboratory Workers.......... 14.6 27.2 0.0 0.080.0 0.0 0.0
Admin. & Fiscal Professional....... 4.3 0.0 0.0 11.1 0.0 0.0 0.0
Other Professionals................ 23.3 62.518.6 8.030.416.7 0.0 0.0
Technical......................... 5.8 0.0 7.7 6.3 4.7
Clerical........................ 27.9 67.536.619.019.133.3
Others......... .............. 37.1 0.040.559.736.827.111.1

HEALTH INFORMATION

DIVISION OF HEALTH INFORMATION
ELIZABETH REED, R.N., B.S.
Director
Programs over an Educational TV Station were initiated this past
year; a number of county health departments budgeted for a staff health
educator; closer relationships with new programs in other bureaus and
divisions were enjoyed; and the division moved to renovated and more
commodious quarters. A writer was added to the staff, whose principal
duty was assistance with preparing copy for Florida Health Notes.
Health education is being regarded, more and more as a collabora-
tor in all programs, both on the state and local level, rather than as a
separate program. Emphasis is being placed on the employment of
qualified health educators by the county health departments in order to
promote this concept.
The usual pleasant relationships were enjoyed with many voluntary
and official agencies; the harmony demonstrated in these day-to-day
contacts is most rewarding.

AUDIO-VISUAL LIBRARY
This is a perennially popular service, limited only by number of
audio-visual aids and staff available.
The following figures give some indication of its activities:
Number of audio-visual aids
circulated 5,586 (6 per cent increase)
Number of times aids were
used 12,528 (7 per cent increase)
Number of persons in combined
audiences 510,194 (6 per cent decrease)
Twelve films were booked for telecast to an estimated audience of
1,200,000. There was an increase in the use of aids other than motion
pictures with silent filmstrips in the majority.
Supplemental film lists were circulated. No new projection equip-
ment was purchased. During the annual summer review, 105 audio-visual
aids were removed from circulation. Fourteen items were placed on loan
to this library by other agencies during 1958.
An intensive effort was made to promote the return of "report
cards" so that the acceptability and condition of the aids might be
better evaluated. Only three per cent of the borrowers failed to return
reports; a decrease of 18 per cent over the previous year.
The library moved into more commodious quarters which has
improved efficiency and morale.

26 ANNUAL REPORT, 1958

EXHIBITS
The exhibits consultant is called upon for many services not directly
related to exhibits, but which require the use of his specialized knowl-
edge and workshop.

During 1958:
Assisted with exhibits and displays 41
Illustrations 79
Signs 300
Field trips (primarily to county
health departments) 13
Conferences 40

The consultant is now housed with the rest of the division which
makes for much better working relationships. Formerly, his quarters were
in a warehouse apart from the main building.

PRESS SECRETARY
The press secretary prepared and transmitted to the news media
more than one news release a week. He attended and covered a number
of conventions and seminars: Annual Meeting of the Florida Public
Health Association; Obstetric-Pediatric Seminar and Governor's Confer-
ence on Aging. He also prepared or assisted in the preparation of ma-
terial for radio and TV programs, Health Notes, various pamphlets and
booklets and special material requested by outside allied organizations.

HEALTH NOTES
The oldest publication produced by the State Board of Health,
Florida Health Notes, continued its climb to popularity. By the end of
1958 an all-time high in circulation, 13,884, had been reached.
The subjects covered in 1958 (ten issues) were on poison control
centers, aging, mental retardation, garbage, home accidents, the simpli-
fied annual report, premature babies, migrant agricultural workers, tu-
berculosis and tetanus.
The general appearance and format of the publication underwent
a metamorphosis that has met with wide approval.

PAMPHLETS
Approximately 262,938 pamphlets were distributed during 1958. The
most popular categories were preventable diseases, nutrition and mental
health. New publications originating in the division were the Communi-
cable Disease Wall Chart and You Are The State Board of Health, an
employees manual.

HEALTH INFORMATION

LIBRARY
BARBARA J. BECKNER, B.A., M.S.L.S.
Librarian
Now that the State Board of Health has an auditorium, the library
will no longer be used as the meeting place for various groups and it
was possible to attempt to make the library more attractive. The li-
brarian, with the help of Remington-Rand's Library Bureau Specialist,
drew up plans for replacing old furniture and wooden stacks, with up-to-
date functional library furniture. Two new tables, with matching chairs,
one individual study table and two ranges of steel stacks were procured
when it was decided to move the library to the first floor.
The Union List of Periodicals in Medical Libraries of Jacksonville
was completed during the year with the help and cooperation of all
libraries concerned. This list will be of immense help in finding out just
what holdings of a journal are available in the city. The librarian also
spent many hours working with the Hospital Library Committee of the
Jacksonville Hospital Educational Program, Inc. It has been gratifying
to work with the group and see some efforts made to provide better
medical library service in Jacksonville.
Circulation figures for 1958 are as follows: Books, 1735; journals,
8834; indefinite loans, 2063; pamphlets, 70; microfilm, 29; photostats,
59; inter-library loans borrowed, 96; inter-library loans sent, 21. Twenty-
five bibliographies were compiled and 2540 reference inquiries answered.
Most of these figures show a slight increase over those of last year with
the biggest increases occurring in photostats and reference inquiries an-
swered. These are services we have been stressing and we are pleased
our efforts have met with some success.
During the year, 785 books were added to the library bringing the
total number of books in the library to 15,031.

GENERAL INTEREST
The orientation programs were evaluated and conducted twice by
a person outside the division. It was felt that this procedure definitely
strengthened them. A total of eight orientation programs were held,
three being regular three-day affairs and four one-day programs for
special groups (ministers, social work students and student nurses).
Foreign visitors continue to visit the state for varying lengths of
time and for various reasons. Twenty-eight persons from 16 countries
were received in 1958. Many are sent to county health departments for
a first-hand view of local health services. An attempt is made to orient
all of them to the general public health picture in Florida.
An activity that consumed much time and energy of staff members
was the Teachers' Project in Health Education, a cooperative program
concerned with placing teachers in county health departments for uni-
versity credit. (For complete details, see the report of the Bureau of
Maternal and Child Health elsewhere in this volume).

28 ANNUAL REPORT, 1958

BUREAU OF LOCAL HEALTH SERVICES
WADE N. STEPHENS, M.D., M.P.H.
Director
HUBERT U. KING, M.D.
Acting Assistant Director
CHANGES WITHIN THE BUREAU
George A. Dame, M. D., retired as Director on May 1, 1958, after
having served in this capacity for 14 years. Dr. Dame had been
associated with the State Board of Health since 1917. He is an author-
ity on public health and the county health unit system.
On September 14, 1958, Wade N. Stephens, M. D., who had been
acting director since Dr. Dame's retirement, was appointed director
of the bureau. At the same time the Division of Sanitation was organ-
ized within this bureau, with Mr. A. W. Morrison, Jr., as director. Mr.
Morrison was formerly Assistant Director of the Division of Sanitation
of the Dade County Health Department. The Nutrition Services were
transferred to this bureau from the Bureau of Special Health Services,
and Miss Mary Brice Deaver came from North Carolina to direct them.
The Division of Nursing, and the Records Consultant Staff remain a
part of the bureau. Hubert U. King, M.D., was employed September 1
to assist in the bureau on a temporary status.

RECORDS CONSULTATION SERVICE
The two records consultants made a total of 121 visits to county
health departments during 1958. Only two counties were not visited.
The consultants teach the clerks, especially those who are newly em-
ployed, to fill out records properly and file them efficiently. During
1958 they also began to help with problems in office organization,
personnel relations and procedure.
Activities of consultants in other fields will be found in the reports
of the Division of Nursing, Division of Sanitation and Nutrition Services.

COUNTY HEALTH DEPARTMENTS
During 1958 the two-county unit composed of Okaloosa and Santa
Rosa Counties was dissolved, and each county became an independent
unit. At the end of the year there were 21 single county units, seven
two-county units, nine three-county units and one four-county unit.
Two more counties have signified their intention of having independent
health departments during 1959. Although there was some local agita-
tion during the year, St. Johns County remains the only one in Florida
without an approved health department.
At the end of the year there were 1287 employees on the payrolls
of the 66 county health departments, an increase of 71 over last year.
This expansion was made possible by a total budget of $6,899,959, or

LOCAL HEALTH SERVICES

$1.80 per capital, of which $1.21 per capital came from county contribu-
tions and $0.59 per capital from the state. The state contribution was
96.15 per cent of the master formula, a slight decrease in percentage
under last year.

RECRUITMENT
Recruitment of qualified public health personnel continues to be
difficult. In some cases this is due to real shortages; in others, it is
partly attributable to Florida's inability to compete with salaries offered
by other states. Only a few years ago Florida's starting salaries for
some public health personnel were among the highest in the nation.
Now we are often unable to attract qualified people because our starting
salaries are too low.

TRAINING
During 1958, 27 sanitarians from 13 counties were enrolled in the
three months' training course for sanitarians, and eight nurses from seven
counties in the two months' nurses' orientation. These courses are now
well established, and applications usually exceed the number that can
be enrolled.
One physician, four sanitarians and six nurses from county health
departments received their Master of Public Health degrees from schools
of public health in June.
There are now 22 of the county health officers who have received
their Master of Public Health degrees, and nine who are diplomats of
the National Board of Preventive Medicine. The quality of Florida's
local health officers remains high.
Five Florida county health departments are approved by the Ameri-
can Medical Association for two-year residencies in public health. Of
these, three were training residents at the end of 1958.

HEALTH CENTER CONSTRUCTION
County Commissioners have been unusually active during the past
few years in providing modern quarters for their health departments.
Seven new health centers were built during the year, and another health
department was housed in a new court house. This is twice the number
built in any previous year. There are now 36 health departments
adequately housed, leaving 30 that need new quarters. Plans have been
drawn for three more new buildings, and one of these is under
construction.
In addition to the headquarters buildings described above, six new
auxiliary health centers were completed during 1958-twice as many
as in any previous year. Seventeen more such buildings are planned.
There are now 60 adequate sub-centers in the state, and 52 considered
inadequate.

30 ANNUAL REPORT, 1958

Health centers were constructed last year in the following counties:
Franklin, Gulf, Washington, Dade, Escambia, Broward and Sarasota.
One existing building was enlarged (Hillsborough). Six auxiliary centers
were constructed: Wildwood, Sumter County; Immokalee, Collier
County; Tarpon Springs, Pinellas County; Wewahitchka, Gulf County;
Leesburg, Lake County; Plant City, Hillsborough County.

COUNTY HEALTH DEPARTMENT ACTIVITIES
Almost every county had at least one program that has shown
unusual development during 1958. Some of these are discussed in the
following excerpts from county health officers' reports.
ALACHUA: Edward G. Byrne, M.D., M.P.H.
"1958 has been another busy year in Alachua County. During the
year we completed (1) an extensive Public Health Nursing time study;
(2) increased our MHW staff (now have 2 psychologists and MHW
Nurse, counselling personnel of the School system and psychology intern
students from the University of Florida); (3) completely rewrote the
Gainesville Restaurant Code; (4) completed a new rural clinic building
in Alachua (with the help of the local citizens); (5) began a program
of sanitation supervision of the University campus, financed by the
University; and (6) organized all of the school health coordinators into
a countywide association."
BAKER: J. C. Loranger, M.D.
"Community nursing service was started during the year in Baker
County. Bedside nursing care is given by the public health nurses on
written orders of private physicians."
BREVARD: J. Dillard Workman, M.D., M.P.H.
"Besides the great increase in staff, Brevard County is particularly
proud of the remodeled and renovated office in Titusville. This is now
a very beautiful public health office and clinic. Two new X-ray
machines for 14x17 films were installed this year, one in Rockledge
and one in Eau Gallie.
"We have a unique clinic in Eau Gallie. This is a County Health
Department Cardiac Clinic, operated solely by the health department
and approved by the Brevard Hospital Staff. Samuel Wright, M.D.,
cardiologist, of Indialantic, is the clinician. All patients must be referred
by their family physician and a full report is sent to him. He certifies
to their eligibility to attend the Clinic. The common cardiac drugs are
supplied when prescribed by the clinician. A complete social and
physical history of the patient is taken by the nurse. Chest X-rays,
electrocardiogram, sedimentation rate, Hgb, and urinalysis is made.
The clinician examines the patient and his findings are recorded. He
reads the X-rays and EKG's and makes fluoroscopic examinations when
he deems it necessary. The electrocardiograph for the clinic was fur-
nished by the Pan-American World Airways Employees Civic Service
group of Patrick Air Force Base and Cape Canaveral Missile Testing

LOCAL HEALTH SERVICES

Center. The 100 Milliamp X-ray and fluoroscope was purchased by
the County Commissioners. The rest of the equipment was furnished
by the health department. The electrocardiograms are taken on a
special wooden table with foam rubber cover that was made by Correct
Craft Boat Works, Titusville and has no metal in it to disturb the EKG."

BROWARD: Paul W. Hughes, M.D., M.P.H.
"The Broward County Commission approved a new mobile X-ray
unit which will have its own generator. The City of Pompano donated
a piece of land, and the Broward County Commission has approved
a new health center to be built on this land. The main health center
in Fort Lauderdale is now nearing completion, whence we shall transfer
about the first of the year.
"Beginning in May 1958, the Broward County Medical Association
and the Health Department co-sponsored a very successful polio im-
munization program. Immunizations increased at least 400 percent
over a period of four months.
"A medical social worker, employed by the health department, has
organized a committee composed of representatives of the social, wel-
fare, and certain voluntary agencies, to combat some of the social
problems in the prevention and treatment of pulmonary tuberculosis.
"The Board of Health and Welfare has spent $12,000 to have
a scientific survey done by Professor Lansdale, of Florida State Univer-
sity. This survey was done particularly in reference to the care of the
medically indigent. All the recommendations have been forwarded to
the Broward County Commission. The Board of Health and Welfare
will continue its activities, to have these recommendations put into
effect, so that the care of the indigent will be improved.
"Our sanitation department has been highly instrumental in slum
clearance campaigns. The City of Fort Lauderdale has already con-
demned several dozen shacks; the City of Pompano has done likewise;
and the City of Deerfield is now launching a cleanup campaign in
relation to housing and sanitation. Local architects have formed a
Committee to try to have an overall program for Broward County to
prevent the development of blighted areas. Also, we have been very
active in improving conditions in migrant labor camps.
"The cities of Hallandale, Pompano, and Dania are now formaliz-
ing sanitary sewer programs. The cities of Fort Lauderdale and Holly-
wood are rapidly extending their sanitary sewer systems to take care of
the growth. The County Commission has approved a program for
$57,000,000, to provide for the purchase of all the private water and
sewage plants in the unincorporated areas, and expand same. In the
meantime the health department has achieved a closer relationship
with all city and county building departments, to prevent the issuance
of building permits where waste disposal or a certain method of waste
disposal may be a problem.

32 ANNUAL REPORT, 1958

"Ninety-five treatment plant operators from Broward County
completed a course sponsored by the State Board of Health to improve
the operation of these utilities."
CLAY: A. Y. Covington, M.D., M.P.H.
"(1) Clay County pioneered the organization of a combination
nursing service in a rural county. This combined service is the expan-
sion of a generalized public health nursing program to include nursing
care of the sick in the home, such as is provided in urban areas by visit-
ing nurse associations. This program is carried on county-wide and each
of our nurses carries total responsibility in her geographical area.
"The Clay County Public Health Nursing Advisory Council,
organized in December 1957, was incorporated in February. This
council is advisory to the total public health nursing program and
has been of invaluable assistance, not only in its advisory capacity but
also in public relations and health education activities.
"Through active committees of the Council, a loan closet has been
established; a volunteer group maintains and mans the loan closet, pro-
vides transportation for patients, assists with clinics, helps maintain the
health department library, and its members consider themselves respon-
sible for public relations and health education in their own social spheres;
also, a manual for Council members is being prepared.
"Case load has grown slowly, gradually and, we believe, on a sound
basis-in that almost all cases to date have originated from referrals by
private physicians. Fees are charged for the expanded service and all
fees are administered by the Council. This fee system apparently is
understood by families and has been well received.
"This program is enjoyed by the nursing staff. It allows for use
of basic nursing skills and stimulates keeping up with new developments
in therapy. Nursing knowledge and skills have been further enriched
through attendance of a staff member at the Rusk Rehabilitation Center
at Bellevue Hospital, New York, for a three weeks' seminar in physical
rehabilitation methods for nurses. This experience was made possible
through special funds from the State Board of Health.
"(2) Because of the rural nature of our county, our private physi-
cians have voiced their concern about the immunization status of infants
and pre-school children in families remote from physicians' offices and
health center facilities. To meet this need and with full approval of the
medical advisor to our Public Health Nursing Council, a summer im-
munization campaign was planned, with emphasis on rural communities.
"Full scale publicity was obtained with the assistance of the schools,
newspapers, churches and clergy, also posters made by our volunteers.
Immunization clinics were held in churches and other community build-
ings at eight different locations in June, July and August. Clerical
assistance and transportation were provided by our volunteer committee.
A total of 580 completed immunizations resulted from this project;

LOCAL HEALTH SERVICES

these included D P T, polio, tetanus and smallpox, and were given to in-
dividuals who probably would not have been otherwise reached.
"(3) On the request of 15 teen-age girls in a rural school, a health
club, which we think is unique, was organized by the staff nurse in that
district. The girls requested discussion on teen-age problems such as
personal hygiene, dating, and emotional problems. They were also
interested in mother and baby care, home nursing and first aid.
"Participation in the club is voluntary and open to all girls from the
sixth through the ninth grade, provided they have written permission
from their parents.
"The enthusiasm of the girls has continued, with the membership
increasing to 40 within a seven-month period. At their request, the meet-
ings were continued at the Health Center through the summer months.
Many of the mothers have expressed their appreciation of this project,
and are requesting a discussion group of their own."
COLLIER: Joseph W. Lawrence, M.D.
"As everyone knows, Collier County had a great deal of activity
during the early part of 1958. With the help of the people in Immokalee,
Collier County, Florida and other parts of the nation, the newspapers,
radio, television and the combined efforts of our various state agencies,
we were able to take care of the stranded, jobless migrants and other
needy persons during the freeze. Through the efforts of Governor
Collins and the State Cabinet, $30,000 was granted us to carry out
Dr. Sowder's idea of combined health education and a sanitation clean-up
of Immokalee. Our immediate mission was accomplished; the town was
cleaned up, the people fed, and a very nice building was erected in
"Sowder Park" with laundry, shower and toilet facilities for the use of
the migrants. However, our efforts have produced much more lasting
and far-reaching effects. Following our intensive clean-up, our sanita-
rians did a housing survey and condemned the majority of the available
housing for migrants. This act, plus the freeze, finally awakened the
people of Immokalee from their lethargy and as a result we have a
Sanitation Committee formed of local citizens to help us solve our health
and sanitation problems. Through the efforts of this committee and our
sanitarians, two-thirds to three-fourths of the condemned living units
have been brought up to decent standards. Septic tanks and wells are
a vast improvement over what we had last year. I am sure that this
local committee, with the prodding of our sanitarians, will continue to
improve the living conditions in Immokalee.
"Also, we moved into a new air conditioned, heated Health Center
building in Immokalee and it is wonderful. Now we can continue the
health education the migrants and medically indigent of Immokalee
need so much.
"A colored school bus driver in Collier County was found to have
active tuberculosis so we tuberculin-tested the entire student body and

34 ANNUAL REPORT, 1958

X-rayed all adults connected with the school. We found 16.4 per cent
positive reactors and on follow-up found only one case of active tuber-
culosis. However, the finding of this one case, who had no connection
to the bus driver, made the entire survey worthwhile."
COLUMBIA: A. R. Moler, M.D.
"During the past year the Columbia County Health Department
has been watching progress being made on the new quarters in the
Columbia County Office Building. Remodeling should be completed
next spring and we hope to be in our new offices by next summer.
The City of Lake City has approved an addition to their city
sewage lines valued at $500,000 in order to take in a large area of new
housing development."
DADE: T. E. Cato, M.D., M.P.H.
"Our most outstanding new program during 1958 was the establish-
ment of the Developmental Evaluation Clinic. This is a diagnostic and
counseling service for pre-school children in Dade County, with emphasis
on the discovery, treatment and planning for future teaching of those
whose development reflects some degree of mental retardation."
ESCAMBIA: J. C. McSween, M.D.
"The Health Department moved into its new building March, 1958,
a modern structure with room for expansion of program and personnel."
FLAGLER: N. B. Edgerton, M.D., M.P.H.
"Outstanding activities in Flagler County for 1958 are: 100 per cent
of schools have complied with state and county regulations; 100 per
cent of the milk producers have complied with state and county regula-
tions; 85 per cent of restaurants are operating according to state regula-
tions and 15 per cent are being educated. A garbage ordinance was
passed at Flagler Beach. This ordinance provides for regular collection
and prohibits dumping in the city."
GULF: Henry I. Langston, M.D., M.P.H.
"Early in March the Albert L. Ward Health Center was ready for
use. Our work is much easier in adequate quarters."
HAMILTON: A. R. Moler, M.D.
"Parasite infestations have always been a great problem in Hamil-
ton County. During the past year we have worked against them on
three fronts, as part of a continuing program to eventually eliminate
this unnecessary plague from our school children. (1) We have com-
pleted a private premise survey of all dwellings in White Springs and
are working with the city administration towards correcting deficiencies
in sanitation found during this survey. (2) The school parasite detection
survey has drawn fine response in all the county schools with one school
submitting specimens from 100 per cent of its students for laboratory

LOCAL HEALTH SERVICES

examination. Figures have shown a steady decline in parasitic infesta-
tions from year to year as evidenced by a rate of 32 per cent of submitted
specimens being positive this year compared with a rate of 65 per cent
in 1948. (3) Plans are being made at this time to have the manual
arts classes of the Jennings colored school construct and install sanitary
privies in some of the substandard areas of Jennings.
"Hamilton County had three positive cases of rabies in animals this
year, one dog, a fox and a raccoon. As a result of these incidents, the
County Commissioners built a county pound of three kennels, located
in Jasper, for confining and observing suspicious animals. There were
over 500 animals immunized against rabies in our annual clinics during
the spring of this year, and an estimated 150 immunizations were done
by unauthorized persons either to their own pets or to their friends'
pets. We do not recommend administration of immunizations by un-
licensed persons. However, they were administered without our prior
knowledge, which gives us a total of 650 animals immunized providing
a pretty good nucleus of immunized pets. Hamilton County was placed
under quarantine for several weeks in the spring of this year while an
analysis of the rabies situation was being made. We feel this helped
to prevent the spread of rabies at that time.
"The State Board of Health Mobile Dental Unit visited the county
in December of this year and provided excellent dental care for many of
the indigent children of this county.
"The central office building has been painted inside and outside and
several new cabinets have been installed making this clinic one of the
finest small clinics in this section of the state."
HENDRY: William F. Hill, Jr., M.D.
"Our liaison with USPHS personnel for the Brighton and Big
Cypress Indian Reservations has been excellent. Health department
services and facilities are fully utilized. Through a system of referrals
and exchange of information and services, a coordinated effort is being
made to improve the general health of the Indian population."
HILLSBOROUGH: Frank V. Chappell, M.D., M.P.H.
"We have had a number of new or expanded services started this
year, and are about to complete a building program which will provide
an additional 5200 square feet to our building here in Tampa. This new
construction will cost $90,000, provided entirely from local funds.
"One of the most important programs in this department in 1958,
after several years of planning, was the development of a unique
approach to problems in the mental illness field. Twenty-four commu-
nity agencies and organizations, including the Hillsborough County
Medical Association, variously concerned courts of law, health, welfare,
and rehabilitation facilities have formed a voluntary union constituting
coordinated community mental illness program known as the Mental
Health Resource Council of Hillsborough County.

36 ANNUAL REPORT, 1958

"Following considerable recruiting efforts, the staff, composed of
a medical director, M.D., M.P.H., assistant director (Psychiatric Social
Worker) and stenographer, was completed in October. Salary and
equipment expenses for these new members of the Hillsborough County
Health Department are provided by a two-year grant from the National
Institute of Mental Health. Office space in new quarters and opera-
tional expense are the responsibility of the health department.
"The primary purpose of this program is to demonstrate the effects
of coordinated community efforts against mental illness, concomitant
with continuous research and evaluation aimed at improving their
efforts."

LAKE: James B. Hall, M.D., M.P.H.
"1958-59 completes the last year of our second five year plan.
"These ten years have been marked by rising prices and inflation
in every area, yet the millage is the same today in Lake County as it
was 10 years ago. We completed a $35,000 auxiliary health unit in
Leesburg this year. We will be able to build a $25,000 auxiliary unit
in 1959 in Clermont. The lots were given to the county by the respective
cities and, with Hill-Burton aid, we have been able to add these needed
facilities without asking the county for any increased financial assistance.
We call this our painless expansion program.
"We have purchased two bulldozers during the years, and now
operate three stategically located sanitary land fills that meet demands
of a functioning county garbage disposal program. Our dragline team
has dug more than 15,000 linear feet of large drainage canals, thus
eradicating hundreds of acres of mosquito breeding areas. This program
has been instrumental in stimulating the private development of many
areas.
"Our fogging trucks spray approximately one-half million acres
annually. This is our fifth consecutive year without a diagnosed case
of animal rabies. (Five years ago, we had one-half of all the dog rabies
in the entire state!)
"We have had sanitary sewage disposal in all of our labor camps
for years. We are now making a drive on all rental property. During
1957-58 one owner of 25 rental homes replaced 25 outdoor privies with
"inside plumbing."
"A full-time dental preceptorship has been established, adding
momentum to our dental program (which was established three years
ago) by the publication of our 60 page teaching guide for teachers,
Truth about Teeth.
"Our main problem has been surplus-surplus cash that has ac-
cumulated because we were unable to fill our vacancies with qualified
personnel."

LOCAL HEALTH SERVICES

LEE: J. W. Lawrence, M.D.

"The best advance made in Lee County in 1958 was a 50 per cent
increase of the financial contribution to the health department by the
County Commissioners. This is the first increase since 1952 and was
most welcome and necessary. We hope for a similar increase next year.
The Lee County Commissioners are now having an engineering survey
made for county-wide sewerage and water systems. We are praying
that this will result in such systems being established as many of our
headaches will then be removed.
"We tuberculin-tested all the pupils in one of our colored schools,
X-rayed all adults connected with the school, and found 6.2 per cent
positive reactors. These were followed up in the usual manner and no
new cases of tuberculosis were discovered."

MONROE: James L. Wardlaw, Jr., M.D., M.P.H.
"Monroe County has been given the distinction of having the best
program of the eight counties served by the South Florida State Mental
Hospital in relation to pre-admission services for patients, contacts with
families and rehabilitation of discharged patients. During Mental
Health Month, programs and publicity for education of the community
were climaxed by the organization of the Key West Mental Health
Association.

"This department is currently experimenting with a program de-
signed to prevent food poisoning outbreaks. In addition to the regular
restaurant inspections, all organizations offering food to the public for
money, such as church groups, PTA, etc., are required to register with
the health department, and the food handlers within the group are
required to be present at a lecture on food poisoning given by one of
the staff members. Presentation is by means of the flannelboard techni-
que, and the program has been well received.

"In the first part of December, a dental survey was conducted in
the schools. This was done at the request of the Beta Sigma Phi
Sorority and the PTA. The hope was that the results of the survey
would serve as a springboard from which a more realistic program of
dental health might be implemented. Dr. Stallard from the State Board
of Health, conducted the survey which included some 1200 students
from 18 different schools with a total enrollment of 7000. In Key West,
where we have a dental unit in the health department, the children were
brought to the clinic by bus. On the Keys the survey was done in the
schools. Our survey served a double purpose since as the children were
brought to the clinic they were shown dental health films and given talks
by health department personnel. We feel that the survey was well
organized and executed, with volunteers from the Sorority and PTA
groups working closely and efficiently with personnel from the health
department and schools."

38 ANNUAL REPORT, 1958

PALM BEACH: Clarence L. Brumback, M.D., M.P.H.
"Final approval for a new public health center in West Palm Beach
was received from the Florida Development Commission. The estimated
total cost of this building will be approximately $400,000. The building
will have two stories at the present time, but will be built so that addi-
tional floors may be added when required. This is the third public health
center in Palm Beach County to be built with the aid of Hill-Burton
funds.
"There has been a marked increase in construction and improve-
ment of public water systems and sewage treatment facilities. Lantana,
Riviera Beach, Delray Beach, and Belle Glade have completed
water treatment plants. The City of Lake Worth has almost finished
construction of a water treatment plant. A number of subdivisions have
also completed public water treatment systems.
"The City of West Palm Beach has completed its sewage collection
and treatment system, and no raw sewage is now being discharged into
Lake Worth. The Town of Palm Beach has also completed its sewage
collection and disposal system. Belle Glade and Boca Raton have
started construction of their sewage treatment plants and collection
systems.
"The tuberculin-testing program being carried out among kinder-
garten, first, and second grade children started its fourth year in the
fall of 1958. Last year's program yielded 14 positive cases. The program
is given financial support by the local Tuberculosis and Health
Association.
"Public health nurses gave increased attention to work with the
mentally ill and their families. Home visits have been made for patients
and family education, both pre-admission and on trial visit, or after
discharge from the hospital. All cases committed are referred by the
court to the nursing office for collection of data and interpretation of
procedure.
"The Migrant Project completed its second year in 1958. During
the past year more than 500 migrant men, women and children have
received thorough physical examinations in our Migrant Well-Family
Clinics. A special clinic for pediatric problems has been added.
Numerous studies and fact-finding surveys were initiated, including
those concerned with maternity care, migrant housing, health concepts,
nutritional patterns and intelligence."
PASCO: Leo L. Burger, M.D.
"We have a large and more commodious clinic at our disposal in
Zephyrhills. This will enable us to give increased service in the area."
PINELLAS: William C. Ballard, M.D., M.P.H.
"The National Institutes of Health, through the Center for Aging,
has awarded this department a research grant of $41,000 to begin

LOCAL HEALTH SERVICES 39

a study in gerontology, to determine the unmet health needs of the
aged. It is intended that plans will be evolved and initiated to meet
these needs within the framework of the county health department.
This grant will cover the first year of a proposed five year period of
study and planning.
"Water supply and sanitary sewerage improvement programs
continued to be the most outstanding achievements in sanitation.
"Our joint rodent control program with the City of Clearwater
has produced excellent results, and it is planned to establish a similar
program in other communities in the county.
"Growth in population, and expanding programs, necessitated
adding three staff nurses and a mental health coordinator. These addi-
tions have afforded services of a public health nurse supervisor and
a staff nurse, three full days a week, in the County Welfare General
Medical Clinic .... In the school health program there are additional
services to the 10 new public schools . In mental health there are
services to families of admissions at the State Mental Hospital . In
the Visiting Nurse Association program, a part-time physiotherapist is
associated in rehabilitation of handicapped people in the activities of
daily living."

POLK: Chester L. Nayfield, M.D., M.P.H.
"The drive to secure better housing for the health department
district offices continued. The contract for the Haines City office was
awarded and construction was begun in September. The total expendi-
ture for the building and equipment will be in excess of $48,000. The
building should be completed in February 1959.
"After much difficulty, a suitable site was obtained for the Lake
Wales District Office. The architectural plans have been completed
and bids have been advertised. It is expected that construction will begin
on this building early in 1959.

"The City of Winter Haven passed an ordinance covering the
sale of frozen foods, prepared sandwiches, etc. The health department
was authorized to remove from sale and dispose of any frozen foods
in the retail stores which were not in a completely frozen state. Com-
mercially prepared and wrapped sandwiches must be dated and may
not be kept more than 24 hours from the recorded date. If these
sandwiches are refrigerated, they may be sold for a period not exceed-
ing five days from the recorded date.
"The county was divided into four nursing districts and a district
nursing supervisor was employed for each of these districts. The City of
Bartow agreed to underwrite a sanitarian for the city. This will allow
the health department to expand the sanitation activities in the Bartow
area by adding another sanitarian to our staff.

40 ANNUAL REPORT, 1958

"A new program in the schools was begun in September. Two
eye technicians were employed as clinic aides to do vision testing in the
elementary schools. This program was enthusiastically received by the
school personnel and it is planned to be continued in the future.
"The Polk County mobile dental unit was put into operation in
October in the Haines City area. This unit consists of a city bus which
was remodeled to house a complete dental unit including X-ray. It
will be used to provide dental care for the indigent children in the
first two grades in areas which are not readily accessible to the dental
rooms in the Lakeland and Winter Haven offices."
PUTNAM: Norman B. Edgerton, M.D., M.P.H.
"Late in 1958 this department moved to new quarters in an
existing building. Here we will have hot running water, parking facili-
ties, and adequate work space on the ground floor, which we have never
had before."
SUMTER: Leo L. Burger, M.D.
"A $300,000 sewage disposal plant in Wildwood was completed
during 1958."
VOLUSIA: D. V. Galloway, M.D., M.P.H.
"One of the most outstanding things in Volusia County was the
county-wide zoning resolution which was passed by the Board of County
Commissioners and went into effect July 1, 1958. Under this program
the entire county was placed under zoning regulations and under the
Sanitary Code of the State of Florida. This is to provide long-range
planning in regard to the development of subdivisions, public water
supplies and sewerage disposal systems. A county-wide engineering
survey has been ordered by the County Commissioners and is under
way. Data from this survey will furnish a basis for the planning of roads,
streets, subdivisions and other commercial and private developments.
"A city-wide housing survey was made by a private committee and
the City of Daytona Beach. The health department participated in
this survey and as a result of this survey a model housing ordinance
was drawn up and submitted to the City Commissioners. The City
Commissioners tentatively adopted this ordinance, but it was withdrawn
after some opposition from some citizens of the city. A new City
Commission was elected in December and this will be an item of business
for 1959. A county sanitary engineer was added to the department staff
through the assistance of the State Board of Health. He is performing
good work and is in continuous demand. He is in charge of the super-
vision of public water supplies, both public and private sewerage disposal
methods, swimming pool supervision and the approval of subdivisions with
regard to sanitation and water and several other items.
"The sanitary engineer undertook and carried out a water pollu-
tion survey of the Indian River adjacent to New Smyrna Beach. This

LOCAL HEALTH SERVICES

furnished very valuable information which is being used in promoting
an adequate sewerage disposal system for the City of New Smyrna
Beach.
"A water pollution survey is now under way in regard to the
Halifax River, adjacent to Ormond Beach and Holly Hill.
"The City of South Daytona has voted a bond issue for a complete
sewerage system for that city. Construction work will begin immediately.
"The mental health survey and study carried on by the USPHS
was completed in September. Plans have been made to carry on this
work by the County Board of Education and the County Health
Department. The same two schools, Lenox and Corbin Avenue, will
be in the program for the rest of the school year, but we hope to add
additional schools in 1959.
"The staff of the Mental Health Division of the health department
was completed by the addition of a psychiatrist, a psychiatric social
worker and a clinical psychologist. The staff already consisted of a
clinical psychologist and a mental health worker.
"A new dental clinic opened for service all day every Wednesday
in the Deland area. This clinic will furnish services to 30,000 people
who live on that side of the county.
"In addition to the sanitary engineer who was mentioned above,
two new sanitarians and one public health nurse was added to the
staff. An additional public health nurse will be added to the staff in
January 1959.
"The integrated bedside nursing and public health nursing program
which is now three years old, rendered excellent service and is more
and more in demand.
"The public health laboratory rendered especially important services
in checking bacteria on dishes in public eating places, including school
cafeterias."
WALTON: R. N. Nelson, M.D.
"For the first time, we have participated for a full year in the
Hospital Program for the Indigent. Our Board of County Commis-
sioners made this program possible by contributing $7400-the state
matching this amount for the year. This program has taken care of
hospitalization for many indigent citizens of the county as well as
indigent cancer patients who were routed through tumor clinics. A
total of 71 applications for hospitalization have been approved."
WASHINGTON: R. N. Nelson, M.D.
"The Staff of the Washington County Health Department are very
happy now that they have moved to their modern building. The new

42 ANNUAL REPORT, 1958

facilities are comfortable, beautiful and most efficient. The health
standard of the citizens of the county will no doubt be raised in the
years to come as a result of this accomplishment.
"The county participated in the Arthropod Control Program this
year for the first time and the reaction from the public to the ditching
and fogging phases of the program was most favorable.
"A Leadership Workshop was held in this office in November in
which public health nurses of other counties participated. Interpersonal
relations and leadership skills was the subject.
"More school children were inspected for defects and referred for
examination than ever before. The same was true of children placed
in the school for the deaf and blind; placed in special classes; and
placed in the Sunland Training Center at Gainesville."

DIVISION OF PUBLIC HEALTH NURSING
RUTH E. METTINGER, R. N.
Director
The overall activities of the division continue to expand. Change
in emphasis in programs makes necessary a close coordination with all
bureaus, divisions and county health departments in planning and im-
plementing these programs.
Increased population in several counties has necessitated the crea-
tion of additional positions for supervisors; namely, Brevard, Palm
Beach, Dade and Orange Counties; also 32 additional staff nurses have
been employed in the state this year.

IN-SERVICE TRAINING
Nine nurses, representing Okaloosa, Orange, Osceola, Putnam and
Brevard Counties, took advantage of the two months' in-service training
course at the State Field Training Center in Gainesville.
Five state consultants and 13 local public health nursing directors
participated in a five-day work conference on Interpersonal Skills in
Nursing Administration. The leader, from out of the state, was outstand-
ing and was ably supported by members of the Bureau of Mental Health
and faculty of the University of Florida. Financial support for the con-
ference was provided by the Bureau of Mental Health.
Three five-day workshops on Mental Health in Public Health Nurs-
ing for local public health nursing supervisors were sponsored jointly
by this division and the Bureau of Mental Health. Twenty-seven super-
visors participated in this experience.
In four areas of the state (Tampa, Winter Haven, Orlando and
Chipley) a two and one-half day institute on Training in Human Re-

LOCAL HEALTH SERVICES

lations and Leadership Skills was conducted for public health nurses and
allied workers. One hundred and four public health nurses worked in
these institutes.
As time permitted consultants gave leadership to the regular month-
ly in-service study groups throughout the state.
Forty-eight hour orientation visits to the four tuberculosis hospitals
are made periodically, whenever a local area has enough newly em-
ployed nurses to make up a group of eight to twelve. Thirty nurses
have had the orientation this year.
The two-day visit by public health personnel to the two state mental
hospitals is a continuing program. Visits are made on a bi-monthly basis
from September until June. Ninety nurses had this experience in 1958.
Three nursing consultants from the division attended the five-day
seminar on Care of the Premature Infant at Jackson Memorial Hospital
in Miami.
Four public health nurses were granted scholarships by the State
Board of Health for a year's course in public health, or to complete
work for their degree.
Three nurses were granted Title II Federal Funds for advanced
study in public health for one year. An increasing number of public
health nurses are enrolling in extension courses offered by junior colleges
and universities in the local areas.

CONSULTANT FIELD SERVICE
Each of the 67 counties in the state had at least one visit by a
member of the division in 1958. A total of 228 visits were made by the
consultants to counties, the length of visits varying from one-half day
to two weeks.
The midwife consultant visited 16 counties after her return from
educational leave. The trend in midwife supervision now is to work on
individual needs of midwives rather than on a group basis; The number
of midwives dropped from 282 in 1957 to 257 in 1958. This reduction
has been influenced by such factors as old age, honorable discharge, in-
creased medical and hospital services for maternity patients.
Consultation service was given to counties providing public health
field experience for both basic nursing students from the four university
schools of nursing in the state and graduate nurses from Peabody College
and University of North Carolina. Counties offering this experience
were: Bay, Dade, Duval, Gadsden, Jackson, Jefferson, Madison, Pinellas
and Taylor.
Foreign students, two from Pakistan and one from Thailand, re-
ceived orientation in public health nursing in the state during the year.

44 ANNUAL REPORT, 1958

Baker and Clay Counties have begun a combination nursing service.
This program is to be sponsored by the State Board of Health for a
period of two years, under the direct administration of the Division of
Public Health Nursing. A qualified nurse in each county is paid by
the State Board of Health for the two-year period, after which the
administration of the program will be assumed by the counties. Sarasota
and Volusia Counties have been offering this home nursing service in
their program for three years. Osceola, Lake and Polk Counties have
requested assistance in developing a combination service.
One consultant made routine inspections on all nursing homes in
the City of Jacksonville. A series of five classes, at six-week intervals,
were held for nursing home operators in the Jacksonville area. The fol-
lowing subjects were included: How to lift and carry a patient; position-
ing a patient; proper methods of sterilization; improvised equipment
and interpersonal relationships. Four two-day nursing home institutes
were held in Pensacola, Tampa, Orlando and Miami. These were de-
signed to help nurses and sanitarians in their inspections of nursing
homes. A consultant from the USPHS participated in the institutes.
The first National Conference on Nursing Homes was held in Washing-
ton, D. C. in 1958. One consultant attended.

DIVISION OF SANITATION
A. W. MORRISON, JR.
Director
This division, authorized by the State Board of Health in June
1958, was activated in mid-September following appointment of the
director. Two experienced sanitation consultants were assigned to the
division at its inception and a third consultant joined the staff in
December.
The division provides sanitation consultant services to county health
departments and to other bureaus and divisions in the State Board of
Health.
The Sanitarian In-Service Training Program and all sanitarian re-
cruitment activities have been assigned to the division. Additional re-
sponsibilities include assisting county health units in the preparation and
presentation of foodhandler and other sanitation training programs; in
the evaluation of local sanitation activities, and studies to determine and
plan for present and future demands in the field of sanitation.
A large portion of time during the last quarter of 1958 was devoted
to organizational activities and the review of existing rules and regula-
tions covering the field of sanitation.
Evaluations of needed changes were made through extensive surveys
and conferences and have resulted in the preparation of suggested revi-
sions and additions to some areas of the Sanitary Code. Other portions
of the Code are presently under study, or will be in the immediate fu-
ture, and significant changes are expected to be recommended.

LOCAL HEALTH SERVICES

Another major activity of the division was the review of the existing
Merit System classification for sanitarians. Plans were formulated for
continuing study, in conjunction with State Board of Health and county
health department personnel, and suggested revision of the entire series
is expected at an early date.
The following report for 1958 includes many activities taking place
prior to establishment of the division, but which are now included in
the scope of division responsibility.

SANITARIAN IN-SERVICE. TRAINING
During 1958 three Sanitarian In-Service Training Programs, each
of 12 weeks' duration, were conducted. The first eight weeks of training
was held in Jacksonville with the final four weeks consisting of internship
in selected small, medium and large county health departments. Twenty-
six men from 13 Florida counties and two foreign countries attended this
program. The foreign students included one sanitarian from Thailand
and two engineers from the Philippines who were under the sponsorship
of the International Economic Administration of the U. S.

SANITARIAN TRAINEES 1958
County Number County Number
Alachua 1 Lee 1
Bay 1 Orange 1
Broward 2 Palm Beach 1
Collier 1 Pinellas 4
Dade 6 Polk 1
Hillsborough 2 Putnam 1
Jefferson 1 Foreign 3

In February the trainees participated, for a period of two and one-
half weeks, in the emergency project for migrants in Immokalee. The
class assisted in organizing "clean-up" activities and conducted sanitary
surveys of the area.
In October the trainees spent one week in Leon County participat-
ing in the Tallahassee Housing Survey. Aid given in setting up this
survey included designing evaluation forms and planning for the Survey
to be used as a training experience for Florida sanitarians. Personnel
from 32 counties were scheduled, processed, and assigned participating
activities in the Tallahassee Housing Survey.

46 ANNUAL REPORT, 1958

TALLAHASSEE HOUSING SURVEY PARTICIPANTS
(September-November, 1958)

County Number County Number
Alachua 2 Jackson 1
Broward 1 Jefferson 1
Citrus 1 Lee 1
Collier 1 Madison 1
Columbia 1 Marion 1
Dade 2 Okeechobee 1
DeSoto 1 Orange 1
Duval 1 Palm Beach 3
Escambia 1 Pinellas 1
Flagler 1 Polk 2
Gilchrist 1 Putnam 2
Gulf 1 St. Lucie 1
Hamilton 1 Santa Rosa 1
Hernando 1 Seminole 1
Highlands 1 Taylor 1
Hillsborough 1 Volusia 1

Assistance in conducting a one-day course in epidemiology was pro-
vided in Miami, St. Petersburg and Jacksonville. A total of 180 county
health department and 10 State Board of Health employees attended.
Aid was given in the planning of the Florida Public Health Asso-
ciation's Sanitation Section meeting and the three-day general Sanitar-
ians Short Course at Florida State University sponsored by the Florida
Association of Sanitarians and the State Board of Health.

FOODHANDLER TRAINING
During 1958 aid was given in foodhandler training in several of
the counties and at two state tuberculosis hospitals. A series of slides to
be used as training aids for foodhandlers was prepared for use in the
counties. A permanent training course was set up in Escambia County
making three such courses being conducted concurrently in the state.
The counties reported a total of 6467 foodhandlers certified in 1958.
Several counties conducted programs for school lunch supervisors and
other special groups in addition to this total.

FOODHANDLER TRAINING 1958
County Number Certified
Alachua 32
Dade 4381
Escambia 1954
Leon 22
Orange 75
Others 3

LOCAL HEALTH SERVICES

RECRUITMENT PROGRAM
A recruitment program for sanitarians was initiated during the last
quarter of the year. Conferences were held with State University of-
ficials regarding educational programs for sanitarians and means were
discussed for increasing the number of students enrolled and graduating
from Sanitary Science courses.
An increasing number of men interested in the field of sanitation
in Florida have been interviewed and written to by the division. In-
formation relative to all phases of sanitarians' activities, vacancies, and
types of positions has been supplied and numerous applications have been
reviewed. It is anticipated that this program will continue to grow, and,
in conjunction with the training program, result in more professionally
trained men being available for employment as sanitarians. This will
serve to better meet the increasing demands and complexities encoun-
tered in present and future environmental sanitation programs. Work
has been completed on the preparation of a sanitarian's recruitment
brochure which will be available early in 1959.

CONSULTANT SERVICES
The Division of Sanitation has many services available on a con-
sultation basis to health officers and sanitarians in county health de-
partments. Two sanitation consultants are now available for field duties
and it is anticipated that additional consultants will be provided for
this important activity during the coming year.

NUTRITION SERVICES
MARY BRICE DEAVER, M.S.
Director
This has been a year of many major changes. Formerly located in
the Bureau of Special Health Services, during this year Nutrition Serv-
ices was transferred to the Bureau of Local Health Services. The Chief
Nutrition Consultant, Miss Marjorie M. Morrison, resigned in the late
summer and was succeeded by the above incumbent.
This year also saw the establishment of the first position in the
state for a county nutritionist Miss Marian Marotta, who was employed
during the year as a state consultant, transferred to Hillsborough County
as a member of the county health department staff. There was a change
also in one regional position; the nutritionist resigned to be married and
was replaced by a new consultant. The nutritionist on the Migrant Proj-
ect (for further details of this project, please refer to the report of the
Bureau of Maternal and Child Health elsewhere in this volume) and
two of the regional nutritionists continued in the same positions. At the
end of the year, one of the four regional positions was vacant.
Most of the changes took place late in the year and have, of ne-
cessity, caused some fluctuation and change in the operation of the nu-

48 ANNUAL REPORT, 1958

trition services. However, for the first half of the year, continuity of
service as rendered in the past was maintained and the requests for
service increased. It is hoped that in 1959, service can be extended to
some of the counties not yet using the nutritionist and that the under-
standing of the role of nutrition in the general health program can be
broadened. However, until a full staff is available, service must be cur-
tailed because of limited personnel in some areas.
The "Diet Manual for Nursing Homes," which was revised during
1957, was available for distribution and has been widely used both in
this state and in others. Service to nursing homes has grown rapidly and
the diet manual has filled a very real need.
Consultation to institutions has increased each year until it has be-
come almost impossible for the regional nutritionist to answer these
requests and give adequate nutrition consultation to the health depart-
ments in her district. From 88 institutions receiving service in 1957, the
number in 1958 advanced to 111 and this with only a partially complete
staff. While it is most encouraging to have this service recognized and
used, it also points up the necessity for exploring the possibility of having
a consulting dietitian on the staff. Such a person would be able to cen-
tralize the service to institutions and her entire time would be devoted
to institutional consultation, including hospitals, nursing homes, nurs-
eries, children's homes and others employing group feeding.
There has been a steady increase in the group conferences re-
quested: in 1957 there were 152 and in 1958, 226 were reported. In
addition, there has been a decided increase in the individual conferences
in 1958, 560 being reported. Both increases would indicate that the
nutrition services are being used to better advantage by more health
departments. Whereas, considerable time has been spent in the past to
explain and interpret the function of a nutritionist, this is no longer
necessary to the same extent. However, there is still a need for this in
some areas.
In the field of chronic diseases, nutrition plays a most significant
part and many requests were met which concerned one or more of these
diseases, including: in-service education for health department staff,
participation in case conferences at geriatric clinics, regional cardiovas-
cular institutes, television and radio programs, serving on planning com-
mittees for local associations concerned with chronic diseases, programs
for senior citizens, group classes for patients with heart disease and dia-
betes and visits to homes for the aged on food service problems.
In regard to civil defense, one nutritionist served as nutrition co-
ordinator for a county and all assisted local civil defense leaders with
training in mass feeding.
Cooperation with various state agencies continued to be given. As-
sistance with both state and county lunchroom workshops was given by
the entire staff. Material was prepared for the State Department of

LOCAL HEALTH SERVICES

Public Welfare on food budgeting and in-service education was offered
to welfare personnel in some of the counties. Special diet referrals from
the Crippled Children's Commission were received in several areas.
An attempt to give consultation to schools on a faculty group basis
rather than individual teacher assistance was continued. This means that
service can be extended to many more communities and nutrition educa-
tion can be integrated throughout the school program. Some materials
for use in school health were also developed.
Many programs were presented for civic clubs, PTA groups, and
other organizations. Assistance was also given on exhibits for county fairs
and special presentations such as science fairs.
In the area of training, field experience was offered for two grad-
uate students one from the University of Tennessee and one from
the University of Michigan; assistance was given to several schools of
nursing in regard to nutrition teaching; and summer experience was pro-
vided for one undergraduate majoring in foods and nutrition at Florida
State University.
In-service education was made available to health department per-
sonnel, welfare workers, school lunch workers, midwives, food handlers,
nursing home operators and operators of day-care centers.

Interest in weight control is still keen and assistance was given in
many communities on planning and working with groups interested in
weight control. A report of such work was presented to the Florida
Medical Association and will appear in the "Florida Medical Association
Journal" early in 1959.

The bi-monthly publication, "Nutrition in a Nutshell," continued
to be published with all members of the staff contributing information
for its issues.

Little help has been requested in the field of industrial nutrition.
One nutritionist received a request for such service this year and it is
hoped that this service can be extended in the future.

TABLE 6

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service...............
2. Field and Office Visits ..............
3. Hookworm Treatment Given .......
TYPE OF IMMUNIZATION
4. Sm allpox ..........................
5. D iphtheria ........................
6. Whooping Cough ..................
7. Tetanus ...........................
8. Poliomyelitis.......................
9. Typhoid ..........................
10. Rabies-Humans. ...................
11. Rabies-Animals. ....................
B. VENEREAL DISEASE CONTROL
1. Admissions to Service ..............
2. Not Infected.......................
3. Treated in Clinic..................
4. Treated by Priv. Physician..........
5. Ret. to Treatment in this Clinic.....
6. Ret. to Treatment to Priv. Physician..
7. Epidemiologic Treatment Contact of..
8. Patients Interviewed. ...............
9. Contacts Obtained .................
10. ERFs Closed. .....................
11. Field and Office Visits ..............
C. TUBERCULOSIS CONTROL
1. Admission to Service-Case Active.....
2. Adm. to Service-Case Inactive.......
3. Adm. to Service-Contacts & Suspects.

81
94
170

889
2,230
1,744
2,849
7,497
1,143
23
2,024

546
20
336
3
38
0
188
179
221
250
960

37
136
323

371 74 1,819
679 96 2,285
201 15 429

6
10
110

255
265
261
804
1,268
503
0
0

8
1
7
1
0
0
0
1
2
0
17

1
5
33

24 390
25 557
55 80

5 0 49 200 115 39 71
5 0 1,78 361 213 53 120
121 1,037 9 203 112 87 209

695
3,766
3,766
5,069
4,170
3,068
0
0

33
0
33
0
0
0
0
33
3
27
47

13
26
57

3 9
14 242
79 482

4,613
6,213
4,560
8,463
20,259
4,360
0
0

2,692
696
1,937
29
17
3
368
869
1,219
1,525
4,281

159
536
946

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

4 0
f ?A 0
^.A 4 a0 in i
bs 6 0 ,o w 0 4 a

A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service .............. 3 0 1,426 48 12 275 0 115 6 186 40 2,577 12 20 49 133 137
2. Field and Office Visits.............. 6 0 1,426 48 12 326 0 177 8 304 73 2,959 15 30 55 142 137
3. Hookworm Treatment Given........ 343 17C 208 12 656 1,414 202 69 187 21 489 360 18 232 60 78
TYPE OF IMMUNIZATION
4. Smallpox .......................... 62 247 951 49 20 344 134 171 58 186 75 4,779 275 310 927 541 87
5. Diphtheria ....................... 232 195 1,891 170 125 756 256 352 299 186 390 9,575 728 774 2,212 1,003 126
6. Whooping Cough.................. 127 195 528 89 75 756 256 274 208 123 244 5,578 475 478 830 476 80
7. Tetanus .......................... 240 440 2,94 229 148 1,219 296 381 344 342 402 11,187 1,051 1,033 3,627 1,446 227
8. Poliomyelitis ...................... 712 779 5,601 593 247 1,767 742 1,821 599 832 92416,463 1,375 1,472 5,186 1,991 378
9. Typhoid ........................... 3 632 2,611 60 2 1,040 69 87 24 12 11 370 137 515 2,235 455 221
10. Rabies-Humans .................... 0 0 0 0 0 0 0 0 1 1 0 8 1 0 0 1 0
11. Rabies-Animals .................... 0 0 0 0 123 0 513 0 109 0 023,907 0 0 0 342 1
B. VENEREAL DISEASE CONTROL
1. Admissions to Service .............. 13 13 90 0 13 25 17 3 17 5 41 2,237 5 43 42 32 0
2. Not Infected...................... 0 1 15 0 4 9 0 0 1 2 22 873 0 0 2 1 0
3. Treated in Clinic................. ... 12 11 34 0 8 15 15 0 8 2 35 1,272 5 29 41 10 0
4. Treated by Prv. Physician......... 0 0 4 0 2 1 0 0 6 1 1 61 0 2 2 8 0
5. Ret. to Treatment in this Clinic ...... 10 0 0 0 0 3 0 0 17 3 0 0 2 1 0
6. Ret. to Treatment to Priv. Physician. 0 0 0 0 0 0 0 1 0 0 0 2 0 0 2 0 0
7. Epidemiologic Treatment Contact of.. 1 0 37 0 0 0 2 0 3 0 3 180 0 9 5 8 0 C)
8. Patients Interviewed................ 3 9 22 0 8 3 13 2 10 0 34 1,149 5 25 38 20 0
9. Contacts Obtained .................. 5 30 0 12 1 2 1 16 0 24 918 1 25 27 18 0
10. ERFs Closed ...................... 2 1 95 0 5 5 3 0 16 1 23 1,444 0 6 16 28 0 C/
11. Field and Office Visits .............. 34 35 416 0 23 49 27 7 63 12 77 8,234 7 76 107 48 0
C. TUBERCULOSIS CONTROL
1. Admission to Service-Case Active..... 5 4 10 0 1 4 12 5 6 2 5 297 6 12 26 4 2
2. Adm. to Service-Case Inactive....... 4 10 45 4 5 24 20 11 10 7 43 758 12 31 81 8 3 L1
3. Adm. to Service-Contacts & Suspects. 3 21 278 13 26 144 14 13 30 18 98 3,880 62 46 121 19 2

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service. ............
2. Field and Office Visits ..............
3. Hookworm Treatment Given........
TYPE OF IMMUNIZATION
4. Smallpox .........................
5. Diphtheria........................
6. Whooping Cough ...................
7. Tetanus ..........................
8. Poliomyelitis .....................
9. Typhoid ...........................
10. Rabies-Humans ...................
11. Rabies-Animals. ....................
B. VENEREAL DISEASE CONTROL
1. Admissions to Service...............
2. Not Infected ......................
3. Treated in Clinic ...................
4. Treated by Priv. Physician..........
5. Ret. to Treatment in this Clinic......
6. Ret. to Treatment to Priv. Physician.
7. Epidermologic Treatment Contact of..
8. Patients Interviewed...............
9. Contacts Obtained..................
10. ERFs Closed ......................
11. Field and Office Visits ..............
C. TUBERCULOSIS CONTROL
1. Admission to Service-Case Active.....
2. Adm. to Service-Case Inactive.......
3. Adm. to Service-Contacts & Suspects.

S t d
i 5) si -l 0 0 0 c 0
rar l~~

169 69
345 77,
92 8E

460 50 5 194 329 980
580 57 6 198 373 1,074
163 68 123 204 126 432

4 34
18 60
104 68

105
118
161

1,599
2,734
1,801
3,784
5,010
1,511
11
0

90
2
59
17
11
6
9
74
63
17
133

3
4
11

45
139
60
147
500
103
0
0

14
0
10
1
0
1
5
9
6
6
26

8 22 3 68
35 31 10 138
104 200 23 572

771
803
226

224
1,179
305
1,266
2,128
389
0
0

90
40
39
5
0
0
15
44
20
42
123

13 159
25 478
52 468

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

R .d

pi P4 P4 E4 E4 T > P UI E-4

A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service .............. 152 182 41 3 24 67 151 982 64 0 8 240 257 7 0 15,216
2. Field and Office Visits.............. 249 292 43 9 36 97 286 982 64 0 8 642 271 7 0 20,822
3. Hookworm Treatment Given........ 24 844 22 27 92 26 39 166 64 122 112 342 229 294 376 13,207
TYPE OF IMMUNIZATION
4. Smallpox......................... 1377 3,502 478 38 516 659 358 180 63 322 95 331 126 349 176 60,743
5. Diphtheria....................... 2,904 6,318 1,304 75 1,299 980 628 364 494 648 296 267 367 911 734 102,606
6. Whooping Cough................... 2,467 5,362 528 59 962 740 628 266 282 401 180 243 367 759 734 68,504
7. Tetanus .......................... 3.096 6,767 1,555 125 2,008 1,143 721 386 717 880 320 321 872 1,221 1,704 139,875
8. Poliomyelitis....................... 10,38215,833 2,061 615 3,218 1,685 3,148 1,183 1,925 1,936 649 1,590 1,105 2,008 1,821 260,675
9. Typhoid .......................... 299 189 30 45 1,142 69 50 42 404 852 125 42 820 53 247 56.865
10. Rabies-Humans ................... 0 0 0 0 0 0 0 1 4 0 0 93
11. Rabies-Animals.................... 31 0 0 0 0 0 0 110 0 416 0 0 0 0 0 31,655
B. VENEREAL DISEASE CONTROL
1. Admissions to Service ............... 1,055 444 116 40 31 211 363 39 11 39 6 104 15 15 40 38,354
2. Not Infected ....................... 272 94 0 0 0 114 151 9 1 4 0 5 0 2 1 22,454
3. Treated in Clinic ................... 280 282 86 37 12 97 120 23 9 27 6 77 2 10 39 12,737
4. Treated by Priv. Physician.......... 65 16 2 0 12 2 9 0 1 3 0 14 1 0 0 487
5. Ret. to Treatment in this Clinic...... 12 24 6 3 0 42 2 7 0 4 0 1 0 1 20 755
6. Ret. to Treatment to Priv. Physician. 0 2 0 0 1 0 0 0 0 0 0 1 0 0 0 84
7. Epidemiologic Treatment Contact of.. 82 45 11 0 0 1 6 0 0 5 0 2 3 4 1 2,483
8. Patients Interviewed................ 137 131 32 35 13 145 100 30 0 29 4 87 3 6 37 7,846
9. Contacts Obtained ................. 213 123 25 6 9 165 202 15 2 22 2 54 2 3 13 9,373
10. ERFs Closed ...................... 420 154 33 0 0 89 266 18 0 6 0 119 4 7 0 13,408
11. Field and Office Visits ............. 2,992 653 196 113 52 397 572 87 29 67 29 289 20 29 58 77,631
C. TUBERCULOSIS CONTROL
1. Admission to Service-Case Active..... 122 73 16 29 7 31 19 11 9 10 1 55 7 8 13 2,301
2. Adm. to Service-Case Inactive....... 357 236 43 38 14 107 63 10 9 40 3 208 7 29 0 6,894
3. Adm. to Service-Contacts & Suspects.. 554 572 122 103 55 330 191 125 85 31 2 291 24 96 57 17,361

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958 ,

4. No. of Persons X-rayed-
Sp d M P

4. No. of Persons X-rayed-
MiniatureFilms ................... 5,910 9 0 2,451 023,292 0 1,422 0 3,098 3,484 1422,130 0 1,011 0 9,902
5. No. of Persons X-rayed Large Films.. 718 817 625 283 3,488 2,903 75 64 36 100 165 26 6,792 370 46 2,648 1,381
6. Tuberculin Test .................... 427 6 2,968 135 177 648 57 13 12 23 461 70 1,830 6 200 1,089 2,321 _
7. Field Visits ....................... 751 19 103 585 352 3,069 67 100 40 210 131 115 4,364 47 230 1,407 3,099
8. Office Visits ...................... 95 22 313 144 566 1,436 40 16 58 95 247 9625,014 51 103 2,449 601 I'
9. Cases Hospitalized .................. 1 2 15 5 14 70 3 1 0 8 16 2 683 2 2 50 59
D. MATERNITY SERVICE O
1-2 Patients Admitted to Maternity
Medical Service. ................... 348 9 117 95 204 395 0 0 1 60 104 4 3,494 0 41 47 510 H
3. Visits by Antepartum Cases to
Medical Conferences ............... 1,089 19 447 241 435 912 0 0 2 139 415 4 11,260 0 95 77 1,068
4. Patients Admitted to Maternity
Nursing Service ................... 556 99 126 154 266 488 28 4 14 118 149 159 3,999 0 40 256 709 '
5. Field Nursing Visits ............... 1,348 107 201 547 535 446 20 3 19 344 53 305 9,944 0 79 308 2,142 1O
6. Office Nursing Visits ............... 2,074 63 524 142 871 2,204 59 5 4 175 966 386 9,435 0 67 202 1,871
7. Patients given Postpartum l
Medical Examinations ................. 176 2 33 2 52 142 0 0 0 5 35 5 915 0 8 4 154 o
8. Number of Midwife Meetings ........ 22 0 0 0 1 33 0 0 0 0 2 12 10 0 1 0 2
9. Visits for Midwife Supervision........ 5 9 14 51 53 89 2 0 0 11 13 62 113 0 35 0 32
10. No. of Midwife Deliveries Super-
vised by health dept. personnel....... 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 5
11. No. of Individuals Enrolled in Classes
for Expectant Mothers ............. 171 0 0 0 0 0 0 0 0 0 0 708 0 0 0 106
E. CHILD HEALTH SERVICES
2-3. Adm. to Well Child Medical
Service-Infants..................... 245 37 68 98 92 439 0 2 0 44 8 60 4,131 0 15 302 360
1.-b. Adm. to Well Child Medical
Service- 1-4 ...................... 29 63 12 99 3 30 0 0 0 60 1 66 2,756 0 4 104 52
1.-c. Adm. to Well Child Medical
Service 5 over................... 58 34 2 88 2 0 0 0 0 157 2 47 1,534 0 3 69 4
4. Visits to Well Child Medical
Conference: Infants................. 285 51 138 167 103 844 0 2 0 61 16 64 10,424 0 17 569 984
1-4................... 47 108 18 175 4 36 0 0 0 83 5 6612,189 0 10 251 167
5-over ................ 93 44 3 172 2 0 0 0 0 166 2 47 4,345 0 9 87 6

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

d 0

3 8 9 0 14

5. No. of Persons X-rayed Large Films.. 116 92 138 9 86 201 23 50 260 49 323 1,516 85 182 284 37 9
6. Tuberculin Test. .................... 10 22 57 1 53 36 33 7 72 7 183 2,241 119 48 58 14 117 &1
7. Field Visits ........................ 11 19 397 30 83 95 43 69 81 83 181 3,920 75 163 284 50 14
8. Office Visits....................... 18 64 99 2 25 181 60 18 36 48 195 4,767 117 74 279 19 28
9. Cases Hospitalized .................. 1 2 8 0 3 5 8 2 5 1 3 78 3 7 20 4 1
D. MATERNITY SERVICE M
1-2. Patients Admitted to Maternity
Medical Service ................. 73 11 209 9 7 28 26 42 48 18 7 1,981 17 0 158 52 4
3. Visits by Antepartum Cases to
Medical Conferences .............. 233 21 457 14 20 3 35 74 137 3 12 7,230 38 0 180 112 4
4. Patients Admitted to Maternity
Nursing Service .................... 101 12 684 35 15 33 116 60 43 21 9 2,693 36 101 454 73 9
5. Field Nursing Vsiits ................ 125 4 850 111 23 23 357 72 66 22 20 4,588 34 209 906 132 16
6. Office Nursing Visits................ 302 24 1,12 4 11 57 350 124 1 48 2 9,083 67 116 941 134 15
7. Patients given Postpartum ei
Medical Examinations.............. 30 0 1 0 7 0 10 0 0 0 759 5 0 57 9 0
8. Number of Midwife Meetings....... 2 0 10 0 0 0 6 2 0 0 0 0 0 1 4 2 0
9. Visits for Midwife Supervision....... O 3 139 0 0 4 7 4 0 6 1 17 7 22 125 3 4
10o.No. of Midwife Deliveries Super-
vised by health dept. personnel....... 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. No. of Individuals Enrolled in Classes
for Expectant Mothers .............. 0 0 16 0 0 0 0 0 0 0 0 75 0 0 2 0 0
E. CHILD HEALTH SERVICES )
2-3. Adm. to Well Child Medical
Service-Infants..................... 52 2 92 0 1 8 6 3 18 0 8 2,878 27 0 31 51 3
1.-b. Adm. to Well Child Medical
Service 1-4...................... 15 2 62 0 2 3 0 7 6 0 2 5,469 56 0 8 21 6
1.-c. Adm. to Well Child Medical
Service -5 over................... 0 1 16 0 0 4 0 1 0 0 0 6,338 4 0 5 0 2
4. Visits to Well Child Medical
Conference: Infants................. 62 2 113 0 1 8 6 5 20 0 8 6,254 36 0 31 81 5 n
1-4................... 20 2 77 0 2 3 0 7 6 0 2 10,525 63 0 8 24 6
5-over................. 0 1 17 0 0 4 0 1 0 0 0 8,949 5 0 5 0 2

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

o l d g Z
a a ( 0 6 a C b ^ a

4. No. of Persons X-rayed-
Miniature Films ................... 1,270 41 5,445 0 538 2,510 11,434 0 2,496 0 4,325 0 75516,992 2,434 10,940 0
5. No. of Persons X-rayed Large Films.. 466 1,270 822 103 10 115 664 835 119 1,078 179 1,641 53 853 154 2,113 144
6. Tuberculin Test .................... 86 516 272 24 5 51 245 1,320 288 242 3 219 19 1,058 384 6,986 26
7. Field Visits........................ 983 204 737 198 18 209 393 426 164 406 480 339 49 1,297 125 1,658 239
8. Office Visits. ...................... 214 697 319 71 15 167 105 47 94 138 164 246 43 581 84 858 260 I1-
9. Cases Hospitalized................... 24 12 42 2 1 4 20 20 5 5 15 6 1 141 5 88 12
D. MATERNITY SERVICE
1-2. Patients Admitted to Maternity
Medical Service .................... 99 99 127 71 6 60 138 0 0 37 10 16 0 630 94 350 0
3. Visits by Antepartum Cases to
Medical Conferences ................ 231 187 345 178 15 160 268 0 0 80 18 16 0 1,430 209 994 0
4. Patients Admitted to Maternity
Nursing Service ...................... 247 284 351 89 11 152 136 51 17 102 53 91 0 355 100 673 43 -
5. Field Nursing Visits ................ 409 317 1,061 47 19 494 295 144 32 286 137 118 0 615 212 1,738 41 O
6. Office Nursing Visits ............... 292 561 6 183 26 207 507 1 4 390 47 80 0 796 428 556 87
7. Patients given Postpartum U1
Medical Examinations .............. 41 28 15 0 15 21 46 1 0 6 0 1 0 143 43 42 0 o
8. Number of Midwife Meetings........ 0 7 13 0 0 4 3 7 0 3 9 1 0 8 0 31 0
9. Visits for Midwife Supervision........ 19 10 42 13 0 14 7 13 0 3 53 1 0 2 12 11 5
10. No. of Midwife Deliveries Super-
vised by health dept. personnel....... 0 1 0 0 0 0 1 0 0 0 0 0 0 18 0 1 0
11. No. of Individuals Enrolled in Classes
for Expectant Mothers .............. 0 1 0 0 0 0 101 0 0 0 0 0 0 11 0 0 0
E. CHILD HEALTH SERVICES
2-3. Adm. to Well Child Medical
Service-Infants ..................... 42 16 98 5 5 21 42 0 0 6 14 0 0 140 91 267 0
1.-b. Adm. to Well Child Medical
Service- 1-4 ..................... 2 9 51 2 6 2 0 0 0 6 15 1 0 29 24 118 0
1.-c. Adm. to Well Child Medical
Service 5 over................... 1 4 10 2 13 3 0 4 0 6 92 0 0 9 0 113 0
4. Visits to Well Child Medical
Conference: Infants................. 46 29 115 5 5 33 43 0 0 7 14 0 0 247 101 519 0
1-4................... 3 9 61 4 6 8 0 0 0 8 15 1 0 81 31 138 0
5-over ................ 1 5 11 2 13 32 0 4 0 8 92 0 0 33 0 128 0

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

4. No. of Persons X-rayed-
Miniature Films....................
5. No. of Persons X-rayed Large Films..
6. Tuberculin Test....................
7. Field Visits ........................
8. Office Visits.....................
9. Cases Hospitalized .................
D. MATERNITY SERVICE
1-2. Patients Admitted to Maternity
Medical Service. ...................
3. Visits by Antepartum Cases to
Medical Conferences ...............
4. Patients Admitted to Maternity
Nursing Service..................
5. Field Nursing Visits................
6. Office Nursing Visits................
7. Patients given Postpartum
Medical Examinations ..............
8. Number of Midwife Meetings........
9. Visits for Midwife Supervision.......
10. No. of Midwife Deliveries Super-
vised by health dept. personnel.......
11. No. of Individuals Enrolled in Classes
for Expectant Mothers .............
E. CHILD HEALTH SERVICES
2-3. Adm. to Well Child Medical
Service-Infants.....................
1.-b. Adm. to Well Child Medical
Service 1-4 .....................
1.-c. Adm. to Well Child Medical
Service 5 over...................
4. Visits to Well Child Medical
Conference: Infants................
1-4...................
5 over................

0 i
b i t>

24,461
4,229
302
1,399
6,306
84

561
2,033
584
913
2,853
332
0
21
0
34

734
913
588
1,355
1,736
953

Wo

aO

323,762
-44

48,799
34,600 [-q
36,024
51,398
1,812

12,311
36,736
17,869
37,425
46,580
3,690
222 b
1,340
33
1,400 .

11,946 1,
10,714
9,780
Ul
25,192 1
27,235
16,210

I

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

Is a S a
ca B aI a a

6. Admissions to Nursing Service
Infants............... 568 186 128 239 391 834 26 34 25 161 142 128 5,130 2 78 693 896
1-4................. 779 322 204 609 656 44 18 75 56 407 188 291 4,650 35 166 558 171
5-over ......... 1,445 162 634 319 30510,8 0 156 451,350 205 12612102 271 181 5851,30
7. Field Nursing Visits Infants........ 1,17 289 324 620 748 972 41 86 32 391 30 265 ,960 2 105 7 218
1-4................. 1,592 737 469 1,887 1,388 227 32 235 94 1,071 28 379 9,003 45 289 700 731
5-over.............. 1,419 298 996 745 441 2,678 58 366 74 1,019 89 170 6,819 52 288 770 1,654
8. Office Nursing Visits Infants....... 504 42 159 88 126 1,360 11 27 0 67 350 91 7,356 0 33 1,108 1,402
1-4................. 436 89 141 104 68 42 10 34 1 111 388 165 8,488 6 67 639 310
5-over.............. 1,821 191 1,811 117 14817,929 9 140 1 1,575 274 9663,735 280 65 437 3,283
9. Nurse-Teacher Conference........... 1,143 140 1,146 267 343 4,007 75 81 83 741 122 223,510 247 285 4,436 1,995
F. SCHOOL HEALTH
1. Pupils Examined by physician
with parent present................... 51 34 126 313 23 1,882 15 1 74 367 3 53 4,685 0 106 125 47
(b) Referred for Further Diagnosis.. 8 16 4 47 1 195 0 0 5 76 4 14 0 0 6 0 2
(e) Completed Referrals............. 29 1 0 25 0 3 0 0 0 5 2 11 0 0 2 0 12
2. Pupils examined by physician
with parent not present. ............ 23 245 1,004 94 2 8,889 0 0 585 81 3 20719,351 372 38 50 17
(b) Referred for Further Diagnosis... 2 13 76 14 0 2,088 0 0 39 19 0 22 0 152 7 3 6
(c) Completed Referrals ............ 8 2 0 8 0 134 0 0 12 3 0 20 0 9 6 0 0
3. Screening by other health departments
personnel-Visual .................... 868 327 6,525 166 9 19,979 120 0 143 2,448 658 235,741 0 23 10,265 5,253
(b) Referred for further Diagnosis ... 342 35 1,026 33 0 3,739 104 0 24 219 161 1 5,180 0 9 921 1,594
(c) Completed Referrals.............. 191 15 75 13 1 528 43 0 7 77 23 1 906 0 5 623 216
4. Screening by other health department
personnel-Audio-meter Testing...... 1,184 6 846 0 1 423 0 1 1 1 125 032,930 89 0 163 2,189
(b) Referred for Further Diagnosis.... 200 0 20 0 0 57 0 1 0 1 13 0 1,358 9 0 22 505
(c) Completed Referrals ............ 95 0 0 0 0 18 0 0 0 2 0 0 684 1 0 113 99
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 0

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

Id S

M 0I 0

Km P4 ig" No C0

6. Admissions to NursingService -
Infants............. 113 13 759 64 11 20 86 51 30 20 8 3,826 17 149 393 167 65 t-
1-4................. 183 23 1,406 138 2 40 58 61 15 61 9 6,973 31 100 482 179 119
5-over .............. 132 23 344 19 29 148 13 182 111 68 10012,973 221 165 395 199 105
7. Field Nursing Visits Infants........ 126 16 1,085 157 20 26 196 71 58 37 22 3,646 17 294 674 367 117
1-4................. 131 25 1,903 379 2 54 370 75 44 124 19 3,654 51 203 768 161 198
5-over.............. 91 29 618 69 16 130 80 216 65 93 120 6,676 139 225 561 45 198
8. Office Nursing Visits-Infants ......... 101 3 252 0 0 35 67 16 1 14 2 7,311 6 181 136 192 35
1-4................. 205 15 440 0 0 85 28 6 0 15 112,992 15 47 43 250 56
5-over ............. 114 13 250 0 20 575 11 71 102 1 1915,743 396 147 194 185 35 4
9. Nurse-Teacher Conference ........... 19 40 867 6 98 575 467 189 274 43 9010,337 176 310 332 11 51
F. SCHOOL HEALTH
1. Pupils Examined by Physician
with parent present......................... 54 7 340 30 47 208 276 93 274 13 239 2,807 286 273 81 232 1
(b) Referred for Further Diagnosis... 25 2 27 0 1 16 6 17 10 8 45 602 3 1 5 1 0 r
(c) Completed Referrals............. 1 1 0 0 15 0 14 4 0 15 101 1 0 0 1 0
2. Pupils examined by physician with
parent not present................. 9 42 132 13 324 102 445 77 835 520 1,565 5,707 331 36 39 18 131
(b) Referred for further Diagnosis.... 4 40 0 1 5 8 2 0 58 364 1,879 19 0 0 1 0
(c) Completed Referrals ........... 0 0 4 0 1 5 2 2 0 40 112 368 1 5 3 3 0
3. Screening by other health depart-
ments personnel-Visual.............. 429 35 1,912 174 33 319 1 163 137 1,590 3864,007 840 2,339 783 1,315 2
(b) Referred for further Diagnosis.... 148 11 227 20 0 49 2 47 1 161 13 3,656 50 308 71 23 0
(c) Completed Referrals............. 22 5 76 9 0 48 0 25 0 40 0 2,015 28 72 1 23 0
4. Screening by other health department TJ
personnel-Audio-meter Testing.... 333 0 2,005 0 9 385 0 541 0 0 3832,040 5 2,102 136 309 1
(b) Referred for further Diagnosis.... 18 0 199 0 0 18 0 18 0 0 10 4,771 0 103 10 0 0
(c) Completed Referrals ............. 0 0 19 0 0 7 0 18 0 0 0 2,405 1 2 0 0 0
G. DENTAL HEALTH
1. Adm. for Dental Treatment U1
(a) Maternity Patients ............. 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

S 0
aa 0
0 0 0 N P,

6. Admissions to Nursing Service
Infants............... 291 261 412 34 27 160 150 53 103 118 56 78 2 617 137 628 41
1-4 ................. 464 331 408 58 31 98 54 119 296 210 89 124 20 431 323 291 104
5-over............... 608 499 541 157 136 270 366 373 88 733 477 630 69 724 211 3,653 602
7. Field Nursing Visits Infants........ 443 304 1,330 29 44 466 255 122 151 280 104 120 9 899 235 1,991 32
1-4................. 615 398 915 55 58 173 99 250 585 475 170 257 36 1,284 608 890 74
5-over.............. 822 446 1,505 173 174 369 742 501 141 367 304 607 91 2,052 153 3,105 273
8. Office Nursing Visits Infants....... 189 51 2 8 8 156 63 0 26 133 2 27 5 1,446 245 110 36
1-4................. 217 100 8 9 13 50 12 5 96 340 42 143 12 2,532 571 189 99
5-over............. 218 323 67 66 17 432 485 229 70 1,264 658 575 6212,016 432 7,412 1,289
9. Nurse-Teacher Conference ........... 672 142 820 18 21 365 1,188 1,062 121 471 314 278 42 2,301 380 3,676 748
F. SCHOOL HEALTH
1. Pupils Examined by physician
with parent present................. 837 0 434 122 52 8 92 0 63 132 94 5 57 65 209 72 126
(b) Referred for further Diagnosis... 146 0 49 5 3 5 0 0 0 62 1 1 18 2 3 1 5
(c) Completed Referrals. ............ 52 0 0 0 1 0 1 0 0 7 0 0 0 0 0 0 5
2. Pupils examined by physician with
parent not present.................. 8 2 41 591 11 3 10 48 67 397 202 539 3 20 188 38 0
(b) Referred for further Diagnosis.. .. 0 0 5 75 0 1 7 0 6 82 0 25 0 0 0 7 0
(c) Completed Referrals............. 0 0 0 2 0 0 1 0 0 6 0 0 0 0 0 1 0
3. Screening by other health depart-
ments personnel-Visual.............. 2,196 672 7,318 1,562 76 361 3,116 797 117 7,242 987 659 3214,108 9510,496 1,169
(b) Referred for further Diagnosis.. 585 89 1,087 117 3 100 81 136 18 353 126 109 16 1,328 16 1,236 73
(c) Completed Referrals.............. 228 2 300 26 1 9 76 17 0 124 4 119 8 297 2 207 18
4. Screening by other health depart-
ment personnel-Audio-meter Testing.. 614 0 3,701 286 50 0 593 387 4 3,742 0 0 17 295 3 682 2
(b) Referred for further Diagnosis.... 95 0 212 7 2 0 13 40 0 45 0 0 5 84 2 3,027 0
(c) Completed Referrals.............. 18 0 66 1 1 0 7 0 0 15 0 0 1 2 0 31 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 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

6. Adi to sg
S1 0 5) W E

7. FieldNursingVisits Infants ..... 1,317 3,513 360 611 11 308 830 153 84 86 12 61 106 56 51 38 893
1-4................ 1,825 3,926 355 886 51 283 1,190 145 302 138 405 492 183 39 166 44,396
5-over.............. 5,686 4,650 314 17 332 1,242 2,197 115 291 134 249 1,400 169 103 24 56,055
8. Office Nursing Visits-Infants......... 1,886 3,434 127 204 2 11 55 83 105 62 94 30 37 142 44 29,899
1-4................. 2,946 2,474 217 1 4 10 136 152 163 45 111 59 45 110 50 36,258
5-over ............. 11,724 7,323 360 0 842 378 1,098 110 370 65 98 3,014 179 1,216 13 162,193
9. Nurse-Teacher Conference .......... 7,889 6,661 192 0 770 1,371 1,513 141 92 54 3 911 98 132 22 84,976
F. SCHOOL HEALTH
1. Pupils Examined by physician with
parent present..................... 10,687 1,742 184 0 76 54 457 91 1 2 98 275 112 376 329 30,140
(b) Referred for further Diagnosis.... 2,100 159 77 0 43 16 10 65 0 1 5 1 5 32 3 3,965
(c) Completed Referrals............. 1,993 1 14 0 3 10 0 0 0 1 1 129 1 14 3 2,480
2. Pupils examined by physician with
parent not present.................. 5,799 711 49 0 216 162 102 118 29 5 85 67 80 383 224 51,485
(b) Referred for further Diagnosis. .3,689 49 20 0 28 29 7 2 0 0 8 1 2 3 6 8,879
(c) Completed Referrals ............. 2,135 4 0 0 25 22 7 0 0 0 0 3 2 3 5 2,964
3. Screening by other health depart-
ments personnel-Visual.............. 60,211 7,974 907 0 728 8,557 1,731 1,698 159 14 9211,448 671 1,198 125 303,160
(b) Referred for further Diagnosis.... 2,781 633 287 0 66 635 271 129 14 11 57 382 17 245 30 29,206
(c) Completed Referrals.............. 2,018 356 95 0 30 276 135 27 5 6 17 123 12 31 28 9,685
4. Screening by other health depart-
ment personnel-Audio-meter Testing.. 23,084 6,038 2 0 143 5,099 0 129 90 0 14 7,960 0 1,191 0 129,989
(b) Referred for further Diagnosis.... 495 114 0 0 0 176 0 42 7 0 0 109 0 132 0 11,940
(c) Completed Referrals............. 453 27 0 0 0 27 0 0 3 0 0 9 0 81 0 4,206
G. DENTAL HEALTH
1. Adm. for Dental Treatment
(a) Maternity Patients............... 0 23 0 0 0 1 0 0 0 0 0 15 0 0 0 184

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

kH H
S0 H.

Dental Health Cont'd
(b) 1-4 .................. ......... 0 0 0 0
(c) 5 over. ................. ... 2,518 0 0 0 0 925
2. Topical Fluoride Applications
(b) 1 -4.......................... 0 0 0 0
(c) 5 over. ....................... 0 0 0 0 0
3. No. of Children Screened
Dentist........................... 0 251 0 0 0 7,405
(b) Others ....................... 4,718 0 996 230 35 9,698
4. Referrals of Children Screened
Dentist........................... 0 40 0 0 0 3,974
(b) Others ........................ 0 203 32 22 4,378
5. No. of Children who Completed
Referrals Dentist................ 0 10 0 0 0 439
(b) Others ........................ 13 0 0 6 0 142
H. CHRONIC DISEASES
1. Adm. to Cancer Service............. 101 5 111 53 25 167
2. Field Visits Cancer ............... 45 2 148 209 38 213
3. Office Visits-Cancer ................ 216 11 444 60 15 428
4. Adm. to Orthopedic Service.......... 41 5 131 67 88 110
5. Field Visits-Orthopedic Service...... 105 5 413 317 181 267
6. Office Visits-Orthopedic Service...... 40 1 161 125 106 58
7. Admissions to Diabetes Service....... 8 6 21 19 28 23
8. Field Visits-Diabetes Service......... 48 0 80 77 37 116
9. Office Visits-Diabetes Service........ 12 18 105 23 149 132
10. Admissions to Cardiovascular
Renal Disease.................... 16 27 42 70 46 22
11. Field Visits-Cardiovascular
Renal Disease ...................... 31 40 76 227 48 48
12. Office Visits-Cardiovascular
Renal Disease ...................... 8 67 227 136 103 41
J. MENTAL HEALTH
1. Adm. to Service-Children .......... 197 6 0 2 29 371
2. Adm. to Service Patients Furloughed
or Discharged from St. Hospital...... 30 3 59 18 20 90
3. Adm. to Service-Other Adults........ 56 1 1 5 36 340
4. Field Visits with Patients............ 382 9 126 52 67 84
5. Field Visits-About patients.......... 187 4 77 50 89 174
6. Office Visits-With Patients.......... 244 3 5 37 38 1,023

0 M
I I I ~ I
d -
A cc 0 ;3
A RAA A W

L_.

5
13
0
0M
1,854
3,862
966
1,473
258
77
I-.

8 13 28 24 9 65 11 3 7 324
40 32 87 73 11 527 47 6 21 973
9 2 20 47 9 98 7 4 1 652
21 9 50 24 1 27 14 31 29 293
54 24 204 42 3 57 31 46 65 940
52 29 121 19 0 18 7 25 11 38
19 14 8 8 2 15 15 4 6 112
11 47 79 29 2 9 23 2 16 789
96 11 9 48 3 15 7 48 2 101
4 21 44 24 0 59 1 19 17 289
3 4 102 26 0 1,105 1 7 19 2,141
1 79 25 74 0 15 0 55 8 1,226

17 15 67 75 0 1,063 38 10 15 335
1 23 5 15 0 78 3 3 13 88
7 5 34 97 1 191 0 4 16 56
17 32 98 49 0 420 38 16 110 280
65 91 152 218 2 943 55 21 39 338
1 9 22 513 0 3,666 8 4 6 1,734

U0

cO

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

5 ~ 0
U0 Id
-. 0 ;1 a U
o 0
I. d ^ 5 S 5 0 0 2.
S 0 0 0 Q 4 N N N N N N
sI0 s
h tl'S O S tt" tt W t I S

Dental Health Cont'd. U
(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 2,039 0 0 0 0 0
2. Topical Fluoride Applications 0
(b) 1-4 ........................... 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(c) 5-over ...................... 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
3. No. of Children Screened
Dentist... ........................ 0 301 0 0 0 0 2 0 0 0 013,316 0 0 0 0 0
(b) Others......................... 0 0 1,096 0 0 0 0 1 0 610 7914,820 0 0 0 248 0
4. Referrals of Children Screened
Dentist........................... 0 242 0 0 0 0 2 0 0 0 0 8,912 0 0 0 0 0
(b) Others ......................... 0 0 785 0 0 0 0 1 0 70 20 7,129 0 0 0 76 0
5. No. of Children who completed
Referrals Dentist ......... 0 15 0 0 0 0 2 0 0 0 0 1,202 0 0 0 0 0 -
(b) Others ......................... 0 0 9 0 0 0 0 0 0 43 0 1,305 0 0 0 1 0
H. CHRONIC DISEASES
1. Adm. to Cancer Service.............. 5 19 35 11 6 35 20 16 9 1 16 622 43 25 43 10 4
2. Field Visits-Cancer .................... 3 27 126 27 6 66 15 29 9 5 24 584 27 96 134 7 6
3. Office Visits-Cancer ................. 2 37 4 3 4 64 24 23 14 0 4 1,623 77 15 22 6 2 V
4. Adm. to Orthopedic Service.......... 3 50 122 10 1 27 9 31 11 13 13 791 63 35 174 27 16
5. Field Visits-Orthopedic Service....... 19 19 261 18 0 127 3 38 20 21 21 1,041 98 175 169 84 32
6. Office Visits-Orthopedic Service ..... 2 77 89 0 1 54 6 12 7 6 3 219 119 31 377 5 16
7. Admissions to Diabetes Service....... 6 16 30 1 5 13 20 3 7 2 22 705 39 25 22 8 10
8. Field Visits-Diabetes Service.......... 5 19 47 13 13 25 0 1 4 4 10 1,151 7 177 43 7 6
9. Office Visits-Diabetes Service......... 26 100 82 0 3 34 29 2 46 1 123 6,425 246 42 148 13 26
10. Admissions to Cardiovascular
Renal Disease ..................... 1 54 99 2 2 47 40 11 8 7 2 851 22 12 40 2 40
11. Field Visits-Cardiovascular
Renal Disease...................... 0 0 366 19 5 15 1 12 13 1 3 2,941 17 61 133 2 57 W
12. Office Visits-Cardiovascular
Renal Disease ..................... 1 126 223 88 8 145 95 28 49 11 0 1,023 13 7 202 1 21
J. MENTAL HEALTH
1. Adm. to Service-Children......... 18 4 21 0 6 8 0 27 21 14 17 989 14 26 18 0 4
2. Adm. to Service-Patients Furloughed O1
or discharged from St. Hosp.......... 0 14 9 1 0 18 0 0 0 5 4 94 11 9 25 27 4 0
3. Admission to Service-Other Adults.... 3 2 27 2 0 2 0 5 7 0 12 508 24 46 29 0 2
4. Field Visits with Patients. ............ 0 13 60 2 4 5 0 20 19 20 20 755 21 72 62 26 8
5. Field Visits-About Patients........... 9 15 122 2 0 12 0 59 28 72 52 691 27 106 153 9 25
6. Office Visits-with Patients............ 19 3 162 0 1 3 0 9 8 0 15 2,219 17 155 18 16 2

t-4

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

0 P4 00

Dental Health Cont'd.
(b) 1-4 .......................... 0 0 0 0 0 0 0 0 0 0 0 0
(c) 5 over ........................ 0 0 0 0 0 0 77 0 0 0 0 0 0 643 0 2,648 4 -4
2. Topical Fluoride Applications
(b) 1-4... ...................... ...I 0 0 0 0 00 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 T]
Dentist........................... 0 0 0 210 0 0 1 1 0 1,114 0 0 024,549 0 223 6
(b) Others ......................... 0 334 0 0 0 330 0 0 115 28 0 0 0 1,610 3,606 1
4. Referrals of Children Screened O
Dentist. .......................... 0 0 0 177 0 0 1 0 0 52 0 0 011,023 0 91 8
(b) Others ........................ 0 0 0 0 0 16 0 0 20 3 0 0 0 875 1,555 0
5. No. of Children who completed
Referrals-Dentist................... 0 0 0 0 0 1 0 0 0 0 0 0 615 0 861 2
(b) Others. ......................... 0 0 0 0 0 23 0 0 0 0 0 0 0 2 438 1 -
H. CHRONIC DISEASES
1. Adm. to Cancer Service.............. 32 34 31 12 17 20 35 0 15 36 21 16 11 55 9 170 49
2. Field Visits-Cancer ................. 63 58 18 14 9 42 66 0 44 141 71 44 38 16 8 230 17 '0
3. Office Visits-Cancer................. 16 25 174 5 15 26 14 0 9 40 11 15 10 1,478 6 857 54 Ul
4. Adm. to Orthopedic Service.......... 68 28 210 16 26 30 26 101 33 75 17 67 16 56 28 135 93
5. Field Visits-Orthopedic Service....... 157 42 624 24 16 133 39 229 89 142 35 197 88 131 101 599 47 00
6. Office Visits-Orthopedic Service... 27 155 749 5 15 24 5 52 7 44 14 38 9 31 26 37 260
7. Admissions to Diabetes Service....... 37 12 31 10 8 6 49 15 12 58 15 22 10 20 33 70 34
8. Field Visits-Diabetes Service......... 80 14 7 3 16 27 124 36 46 146 50 51 21 17 27 225 6
9. Office Visits-Diabetes Service........ 23 18 192 11 45 44 12 7 10 84 71 83 51 117 98 57 143
10. Admissions to Cardiovascular
Renal Disease..................... 17 3 3 43 43 1 3 0 3 21 28 58 2 24 25 46 31
11. Field Visits-Cardiovascular
Renal Disease ...................... 40 3 8 21 138 23 7 0 8 74 44 93 3 50 13 250 22
12. Office Visits-Cardiovascular
Renal Disease ..................... 14 2 0 116 384 4 0 0 0 9 15 150 0 8 61 20 55
J. MENTAL HEALTH
1. Adm. to Service-Children........... 12 13 207 35 2 1 49 7 4 56 18 22 20 605 8 63 5
2. Adm. to Service-Patients Furloughed
or discharged from St. Hospital .. 11 7 33 16 2 4 42 12 1 35 3 7 0 66 4 226 7
3. Admission to Service-Other Adults.... 3 18 219 16 0 3 19 15 5 89 1 14 2 45 1 132 6
4. Field Visits with Patients ............ 29 44 37 87 1 4 107 30 6 387 18 14 6 123 6 312 28
5. Field Visits-About Patients.......... 34 33 68 222 1 1 416 53 15 431 30 67 45 129 11 444 15
6. Office Visits-with Patients........... 1 18 1,642 7 7 6 90 4 1 118 6 12 1 968 10 89 7

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

Dental Health Cont'd.
(b) 1- 4 ..........................
(c) 5 over. .......................
2. Topical Fluoride Applications
(b) 1 4 ......... ...... .. ...... .
(c) 5 over ............ ............
3. No. of Children Screened
D entist........................
(b) Others .. ........ .............
4. Referrals of Children Screened
D entist ...........................
(b) Others.......................
5. No. of Children who completed
Referrals-Dentist. ...... .........
(b) Others .. ......................
H. CHRONIC DISEASES
1. Adm. to Cancer Service ............
2. Field Visits-Cancer .................
3. Office Visits-Cancer................
4. Adm. to Orthopedic Service..........
5. Field Visits-Orthopedic Service.......
6. Office Visits-Orthopedic Service......
7. Admissions to Diabetes Service.......
8. Field Visits-Diabetes Service.........
9. Office Visits-Diabetes Service........
10. Admissions to Cardiovascular
Renal Disease .....................
11. Field Visits-Cardiovascular..........
Renal Disease ....................
12. Office Visits-Cardiovascular
Renal Disease..................
J. MENTAL HEALTH
1. Adm. to Service-Children..........
2. Adm. to Service-Patients Furloughed
or discharged from St. Hospital......
3. Admission to Service-Other Adults....
4. Field Visits with Patients ...........
5. Field Visits-About Patients..........
6. Office Visits-with Patients...........

I. I i-I' _____ _____ _____

0
0
0
0
0
84
0
53
0
0

22
44
40
50
154
66
10
21
30
1
1
0

13
3
1
10
10
11

0
0
0
0
0
0
0
0
0
0

14
9
20
5
6
6
12
0
54
13
8
25

0
2
0
0
1
1

0
0
0
0
0
168
0
102
0
30

22
31
35
76
108
157
26
60
234
17
9
50

0
.*

115
12,522

4
65,736
55,062 I
37,059 tr
22,317
11,896
2,963

3,487
7,724
8,939
4,370
10,170
4,656
2,242
7,199
11,118
'--4
3,244
14,750 M
7,218 C

5,499
1,568 O1
2,582 L
5,242
7,867
15,177

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

Mental Health Cont'd.
7. Office Visits-About Patients......... 726 4 10 10 69 541 3 9 1 26 321 1 5,326 20 6 11 1,822
8. Mental Health Conferences.......... 575 3 0 5 96 691 5 8 163 8 265 0 218 29 0 2 90
K. MISCELLANEOUS
1. Adm. to Morbidity Service. ......... 160 49 152 281 26 281 7 5 9 229 418 254 121 7 19 17 332
2. Field & Office Visits-Morbidity...... 254 81 606 617 42 821 8 8 60 444 802 388 567 16 124 33 2,929
3. General Medical Examinations ....... 109 9 55 137 44 1,395 47 382 65 45 476 22 2,529 69 11 0 487
4. Health Cards Issued ............... 4,041 197 1,966 431 1,54514,605 102 405 414 502 819 22616,228 441 313 5,747 8,822
5. Visits in the Interest of Vital
Statistics.......................... 23 3 107 70 78 15 6 4 13 31 7 4 67 59 131 83 20
M. NURSING HOMES
1. Number of Nursing Homes
admitted toService................. 3 0 5 1 9 19 0 0 0 1 0 1 91 0 0 13 13
2. Visits to Nursing Homes............ 29 0 16 18 32 321 0 0 0 4 0 6 943 0 0 51 132
P. SANITATION
1. Approved Water Supplies Installed,
Private & Semi-Public........... 178 0 9 0 5 281 0 0 3 1 0 3 0 1 1 890
2. Approved Water Supplies Installed,
New Public Water Connections..... 6 0 1 0 4 8 2 1 1 0 0 17 0 0 19 1,471
3. New Specification Privies Installed... 6 15 0 0 4 4 1 1 0 0 0 1 0 3 0 255 108
4. Percolation Water Table or
Soil Log Test................ ...... 1,574 0 282 89 4,152 310 0 5 7 158 41 61 4 13 16 1,110 123
5. Subdivision Analysis................ 50 0 13 3 170 148 0 1 0 0 1 3 250 2 0 0 15
6. Pollution Survey................... 56 0 22 0 0 224 0 1 0 0 0 0 4 0 0 0 11
7. New Specification Septic Tanks
Installed......................... 770 20 406 78 2,197 5,431 27 253 22 56 155 352 145 66 7 781 2,044
8. Rabies-Number of Animal Bites
Investigated ....................... 338 13 49 30 247 929 3 77 13 80 28 45 3,417 10 5 846 830
9. Field Visits for Rabies Investigation.. 995 13 118 51 371 2,177 2 24 20 272 52 7810,854 11 4 0 2561
10. Complaints Investigated ............ 539 2 209 53 555 1,100 21 81 37 62 140 32 7,495 49 22 2,210 4,185
SNuisances Corrected ................ 250 1 161 31 107 686 17 64 6 34 15 21 3,704 12 12 1,054 3,680
12-19. FieldVisits.................... 11,771 1,387 3,192 171 7,00412,963 284 1,155 486 772 985 1,64234,135 511 162 6,02423,830
5. Sbdiisin Aalyss. ........... 1 0 11 1

01

O
0
tn

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

1 00

8. Mental Health Conferences.... 3 0 185 0 7 2 0 15 18 104 21 1,136 18 53 127 0 3

Ad t Sy Service.......... 125 25 51 89 51 104 426 43 66 8 28 892 21 28 70 1 12
2. Field & Office Visits-Morbidity ...... 339 56 639 224 89 304 938 127 150 34 58 5,165 34 138 133 1 184
3 General Medical Examinations ....... 15 8 119 41 16 11 10 9 37 136 99 745 224 0 47 0 0
4. Health Cards Issued ................ 114 281 9 93 77 372 351 568 516 254 726 38,545 204 476 644 200 25
5. Visits in the Interest of Vital
Statistics .......................... 31 7 304 1 5 88 8 0 23 1 34 4 4 9 55 72 7 t-1
M. NURSING HOMES h-
1. Number of Nursing Homes admitted
to Service ......................... 0 0 0 0 0 0 0 1 0 2 3 26 1 2 0 1 0
2. Visitsto Nursing Homes....... 0..... 0 0 0 0 0 0 15 0 9 16 695 12 57 0 8 0
P. SANITATION
1. Approved Water Supplies Installed,
Private & Semi-Public.............. 3 0 45 0 1 0 0 1 3 2 84 727 2 1 1 1 0
2. Approved Water Supplies Installed,
New Public Water Connections..... 0 0 327 0 1 38 0 3 0 23 1 1,475 4 21 3 1 1
4. Percolation Water Table or
Soil Log Test ...................... 45 20 45 0 4 9 1 0 10 31 49 926 16 105 29 1 3
5. Subdivision Analysis................ 0 0 0 0 1 0 0 0 0 6 115 142 0 13 0 0 0
6. Pollution Survey................... 7 0 1 0 0 0 0 1 0 5 11 0 0 2 0 0
7. New Specification Septic Tanks n
Installed ........................ 32 14 92 39 25 28 9 64 73 26 492 2,977 16 225 32 4 3
8. Rabies-Number of Animal Bites
Investigated...................... 10 12 4 2 4 4 8 9 5 3 47 2,750 10 6 13 7 0
9. Field Visits for Rabies Investigation.. 12 39 10 2 11 1 18 11 17 7 10910,637 7 53 21 9 1
10. Complaints Investigated............ 14 248 76 7 25 11 20 45 80 45 177 5,006 38 58 25 15 2
11. Nuisances Corrected ............... 10 123 1 69 3 3 7 11 31 9 70 2,295 1 0 5 12 2
12-19. Field Visits ......................132 392 796 698 258 511 220 933 631 345 2,760 32,188 169 598 420 392 21

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

Mental Health Cont'd.
7. Office Visits-About Patients.........
8. Mental Health Conferences .........
K. MISCELLANEOUS
1. Adm. to Morbidity Service ........
2. Field & Office Visits-Morbidity .....
3. General Medical Examinations.......
4. Health Cards Issued................
5. Visits in the Interest of Vital
Statistics ........................
M. NURSING HOMES
1. Number of Nursing Homes
Admitted to Service ...............
2. Visits to Nursing Homes ...........
P. SANITATION
1. Approved Water Supplies Installed,
Private & Semi-Public. ............
2. Approved Water Supplies Installed,
New Public Water Connections......
3. New Specification Privies Installed...
4. Percolation Water Table or
Soil Log Test................... ..
5. Subdivision Analysis ...............
6. Pollution Survey ...............
7. New Specification Septic Tanks
Installed ............... ....
8. Rabies-Number of Animal Bites
Investigated. ...................
9. Field Visits for Rabies Investigation..
10. Complaints Investigated ............
11. Nuisances Corrected................
12-19. Field Visits.................. .

SI I i I I I

0 8 -
Ma o s 3 a o I g I g
8 0 0 0 k k5 0 (
0 0 0

4 78 622 14
0 18 152 84

15 8 3
56 22 22

0 153 25
1 254 27

1 5 2
8 56 16

2 186 11 23
0 2,732 5 9

174
330
6
1,246
7

0
0

0
101
9
0
0
3
44
163
243
307
324
4,134

b a
c 0
o 0

1,835 6
240 23

1 151 12 23
5 1831 58 189

8o >
P4
-L

7

48
0
1,519
9 '

I-A
6
33

00

0
80
2
0
122
10
55
42
11
322

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

LO
(

7. Office Visits-About Patients ........ 331 883 3 96 68 289 26 1,008 56 17,830
8.MentalHealthConferences.......... 305 456 23 183 173 193 12 0 928 5 10,046
2. Field & Office Visits-Morbidity 9,062 954 276 0 266 1,224 56 80 254 72 242 2,881 33 200 16 37,246

Mental Health Cont'd.
7. Office Visits-About Patients......... 331 883 3 96 68 289 26 9 3 3 0 1,008 1 56 0 17,830
8. Mental Health Conferences.......... 305 456 23 183 173 193 12 0 0 0 0 928 2 0 10,046
K. MISCELLANEOUS
1.Adm. to Morbidity Service......... 1,244 362 148 0 109 138 29 49 88 42 138 170 11 176 13 8629
2. Field & Office Visits-Morbidity. ... 9,062 954 276 0 266 1,224 72 242 2,881 33 200 16 37,246
3. General Medical Examinations....... 307 97 48 0 15 211 47 1 17 1 49 1,662 29 186 122 10,784
4.Health Cards Issued................ 27,149 4,205 738 1,292 515 2,171 509 552 333 527 75 3,663 273 374 302 165,958
5. Visits in the Interest of Vital
Statisticse.......................... 1 59 1 12 8 114 7 5 15 26 8 380 17 8 3 2,307
M. NURSING HOMES
1. Number of Nursing Homes
admitted to Service.................. 29 23 6 4 0 11 9 1 1 0 0 22 0 0 1 394
2. Visits to Nursing Homes.............. 535 190 24 45 0 74 75 9 10 0 0 266 0 0 7 4,263
P. SANITATION
1. Approved Water Supplies Installed,
Private & Semi-Public ............... 0 3 8 11 2 151 7 0 1 3 2 5 0 17 1 2,610
2. Approved Water Supplies Installed,
New Public Water Connections...... 0 3 3 99 1 33 2 0 0 39 2 9 0 49 0 3,893
3. New Specification Privies Installed... 35 4 1 1 0 5 2 15 3 0 19 13 0 0 0 802
4. Percolation Water Table or
Soil Log Test...................... 4,141 836 100 307 29 385 518 14 48 58 0 176 6 32 0 21,331
5. Subdivision Analysis ............... 44 21 13 12 7 75 52 0 2 2 0 27 0 12 0 1,496
6. Pollution Survey................... 3 7 0 0 0 22 1 3 0 0 0 4 6 0 0 684
7. New Specification Septic Tanks
Installed. ......................... 4,806 1,504 102 252 145 1,507 1,066 36 52 65 28 1,727 4 88 22 37,973
8. Rabies-Number of Animal Bites
Investigated ....................... 266 447 9 59 37 223 39 27 7 21 2 158 15 29 34 13,321
9. Field Visits for Rabies Investigation.. 535 1,018 9 186 53 510 123 85 2 42 1 340 21 30 0 34,149
10. Complaints Investigated. ........... 1,720 494 38 295 53 855 266 39 14 38 10 522 20 131 24 34,131
11. Nuisances Corrected................ 988 347 15 121 6 286 101 27 10 12 6 202 3 36 14 17,460
12-19. FieldVisit .................... 25,953 6,476 296 3,720 1,196 4,923 1,559 611 242 411 1,026 5,292 190 443 19 263,289

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

d c

R. PROTECTION OF FOOD AND MILK
1. Foodhandling Establishments
Admitted to Service ............... 335 53 352 61 297 1,331 19 54 32 109 72 89 5,804 26 11 606 283
2. Field Visits to Foodhandling
Establishments..................... 1,370 495 1,823 549 999 3,245 324 201 107 896 203 37038,318 156 90 2,484 1,749
3. Number of Foodhandlers'
Certificates Awarded ............... 32 0 0 0 0 0 0 0 0 0 0 0 4,381 0 0 0 1,954
4. Dairy Farms Admitted to Service.... 20 3 6 10 1 1 13 1 1 7 0 5 98 4 0 0 65
5. Field Visits to Dairy Farms.......... 225 16 246 48 14 2 279 35 2 69 0 44 1,321 65 0 0 817
6. Milk & Milk Products Plants
Admitted to Service................ 5 0 3 2 4 19 0 0 0 3 0 2 109 1 0 0 3
7. Field Visits to Milk & Milk
Products Plants .................... 62 0 24 17 21 65 0 0 0 28 0 28 3,611 1 0 0 177
8. Cows Tuberculin-Tested ............ 211 0 231 62 1 154 0 0 0 0 0 52 7,148 202 0 0 3,302
9. Cows Bangs Tested................. 4 0 30 62 0 0 0 0 0 19 0 112 0 202 0 0 3,029
10. Dairy Farms under Mastitis
Control Program .................. 15 0 0 0 0 0 0 0 0 7 0 0 0 4 0 0 0
V. HEALTH INFORMATION
1. Meetings Attended ................ 428 51 54 66 298 294 4 14 106 258 192 8 1,213 37 11 158 538
2. Lectures and Motion Pictures
Showings.......................... 351 25 176 16 85 201 10 31 71 110 58 1 1,482 88 12 99 575
4. Radio & Television Programs........ 14 0 0 0 4 0 0 0 0 1 21 18 41 0 0 1 21
5. News Articles Published............. 25 24 0 27 15 0 3 10 11 87 11 0 102 3 37 1 37
6. Exhibits Displayed................. 0 0 6 0 0 0 0 0 0 27 4 2 3 0 0 0 51
X. LABORATORY
1.-21. Specimens Examined............ 12,913 1,910 7,751 2,102 7,83529,386 1,320 1,888 874 1,935 2,792 2,43080,164 1,730 1,71922,63123,776

z
z

0
b-i

O
0
-3

00

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

S o0

1. Foodhandling Establishments
4 3 M 8 42

SAdmittedtoService 0 5 3 056 0
14 > s S o a '4 is .

R. PROTECTION OF FOOD AND MILK
1. Foodhandling Establishments
Admitted to Service................ 35 35 61 4 35 107 23 27 63 19 189 2,484 100 28 292 41 5
2. Field Visits to Foodhandling M
Establishments..................... 56 273 254 135 81 984 193 115 218 59 45629,997 470 41 1,218 263 20
3. Number of Foodhandlers'
Certificates Awarded. ............... 1 0 0 0 0 0 0 0 0 0 0 0
4. Dairy Farms Admitted to Service .... 3 0 8 0 4 1 1 3 3 0 2 106 29 7 33 8 21 -
5. Field Visits to Dairy Farms .......... 17 0 185 0 81 12 2 48 35 0 36 2,494 268 54 381 108 388 ,-3
6. Milk & Milk Products Plants
Admitted to Service ................ 3 0 4 0 0 0 0 0 0 0 5 47 0 1 3 1 0
7. Field Visits to Milk & Milk
Products Plants .................... 3 0 31 0 0 0 0 2 1 0 7 1,414 1 12 27 9 0
8. Cows Tuberculin Tested............. 400 0 232 0 0 44 0 434 0 0 020,101 862 1,111 730 820 707 tn
9. Cows Bangs Tested .............. ...... 0 0 197 0 1 44 0 182 0 0 0 1,956 644 504 730 782 792 M
10. Dairy Farms under Mastitis
Control Program ................... 0 0 0 0 0 0 0 0 0 0 104 1 0 0 8 0
V. HEALTH INFORMATION
1. Meetings Attended.................. 30 11 94 3 44 15 8 67 58 30 66 1,236 43 114 77 42 6 F-1
2. Lectures and Motion Pictures
Showings.......................... 1 14 113 2 14 26 1 50 13 19 25 1,005 26 36 102 66 2 C)
4. Radio & Television Programs ........ 0 0 1 0 0 92 4 0 1 12 1 0 9 0 2 0 0
5. News Articles Published ............. 11 8 3 0 9 3 9 2 15 9 20 68 11 0 7 7 0
6. Exhibits Displayed ................. 0 0 1 0 0 0 0 0 0 0 0 10 0 0 0 0 0 C'
X. LABORATORY
1.-21. Specimens Examined ............ 926 872 4,701 626 690 1,775 4,611 2,636 2,091 823 2,402 111185 2,508 3,250 6,277 1,373 612
--3

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

R. PROTECTION OF FOOD AND MILK
1. Foodhandling Establishments
Admitted to Service ................
2. Field Visits to Foodhandling
Establishments.....................
3. Number of Foodhandlers'
Certificates Awarded.......... ..
4. Dairy Farms Admitted to Service....
5. Field Visits to Dairy Farms..........
6. Milk & Milk Products Plants
Admitted to Service................
7. Field Visits to Milk & Milk
Products Plants ..................
8. Cows Tuberculin Tested.............
9. Cows Bangs Tested ................
10. Dairy Farms under Mastitis
Control Program .................
V. HEALTH INFORMATION
1. Meetings Attended ................
2. Lectures and Motion Pictures
Showings..........................
4. Radio & Television Program.........
5. News Articles Published ............
6. Exhibits Displayed .................
X. LABORATORY
1.-21. Specimens Examined............

a)
,)4 as
is a) a
Id c I

0

52
360
0
9
169
0
0
626
626

0

81
39
10
10
0

3,245110,415120,758 2,066 7131 3,022 9,723

(a
0

0

63
475
0
5
58
0
0
0
0
0

59
47
0
8
0

1,399 4,473 3,6681 2,8751 968110,9791 2,894125,154

z
>

0 -
is

14
--- t

219 Q
726 z

14 -
232
0
0
o 0
1,135
462 C0
0

46
61
1
4
0

2,919

III~ ~

TABLE 6 (continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1958

s |Ii
a 0 | |

R. PROTECTION OF FOOD AND MILK
1. Foodhandling Establishments
Admitted to Service................ 2,394 759 77 280 145 292 84 63 71 86 19 976 18 102 64 22,070
2. Field Visits to Foodhandling
Establishments............. ....11,854 3,936 1032,266 283 720 509 266 491 222 65 3,981 168 251 27 126,513
3. Number of Foodhandlers'
Certificates Awarded................ 0 0 0 0 0 0 0 0 0 0 6,467
4. Dairy Farms Admitted to Service... 0 52 5 4 25 14 2 6 7 0 4 28 0 16 14 835
5. Field Visits to Dairy Farms....... 694 565 47 37 202 1 1 84 78 0 24 739 0 140 14 11 645
6. Milk & Milk Products Plants
Admitted to Service................ 53 2 1 6 0 3 1 0 0 0 0 8 0 4 0 375
7. Field Visits to Milk & Milk
ProductsPlants ................... 728 61 9 41 0, 18 2 0 0 0 0 258 0 21 0 8,378
8. CowsTuberculinTested............. 3,793 1,841 0 240 0 0 0 169 259 0 0 0 0 1,699 519 56,573
9.CowsBangs Tested................. 466 4 0 152 0 0 0 209 152 0 0 0 0 1,046 5 16,908
10. Dairy Farms under Mastitis
Control Program ................ 33 2 0 0 0 0 0 0 0 0 0 0 0 18 0 257

V. HEALTH INFORMATION
1. Meetings Attended.. ............... 615 231 193 77 190 206 51 22 24 59 35 229 15 66 8 9,999
2. Lectures and Motion Pictures
Showings ............... ..... 1,953 636 22 31 54 1 15 3 3 156 46 95 16 11,489
4. Radio Television Programs........ 19 8 4 0 0 2 0 0 1 2 0 6 0 8 0 326
5. News ArticlesPubhshed ............. 123 166 20 2 140 7 19 17 0 1 0 5 0 1,471
6.Exhibits Displayed................. 5 18 1 0 1 3 0 2 1 2 0 1 0 11 2 203
X. LABORATORY
1.-21. SpecimensExamined. ........... 40,52618,975 3,228 2,851 2,284 3,935 1,888 2,737 1,453 1,908 795 6,377 2,639 3,450 1,521 557,426

74 ANNUAL REPORT, 1958

BUREAU OF VITAL STATISTICS
EVERETT H. WILLIAMS, JR., M.S., Hyg.
Director
The functions of this bureau can be grouped into two broad
categories. One of these is referred to as "Vital Records." This includes
all activities connected with the collection, processing, preservation, and
use of birth, stillbirth, marriage, divorce, and death certificates as legal
records. The other functions of the bureau are classified under "Statis-
tics." This includes data processing from vital records and other health
records, analysis of public health data, presentation of reports, and
statistical consultation for all branches of the health department.

VITAL RECORDS
The collection of vital records is more complex than many people
realize. Local registrars in each county are responsible for the proper
filing of birth, stillbirth, and death records within their respective areas.
Except for St. Johns County, county health officers are appointed as
registrars and most vital statistics work is handled by the health depart-
ment personnel. In some areas, persons not employed by the county
health departments are appointed as sub-registrars so that funeral
directors will not be inconvenienced when filing a death certificate and
obtaining the required permit. The local registrars have three main
objectives in the collection of certificates. They are as follows:
1. Every event must be registered.
2. Every certificate should be filed within the time limit pre-
scribed by State Law.
3. All information on the certificate should be complete and
accurate.
Accomplishing these objectives is most difficult since the certificates
are not completed by the registrars themselves. Physicians, hospitals,
midwives, funeral directors, and coroners are responsible by law for
completing and filing these records. The registrar must use education,
tactful persuasion, and as a last resort, prosecution to accomplish his
mission.
An accurate measurement of accomplishment on the first objective
can only be made every decade in conjunction with the federal census.
However, the relative efficiencies of accomplishment by counties on the
second and third objectives are measured and published each year
as a "Vital Statistics Scoreboard" (Table 13). The "Scoreboard" shows
that 92.3 per cent of all birth certificates were filed and forwarded to
the Bureau of Vital Statistics within the prescribed time limit. This
is a good improvement over the figure 89 per cent for the previous
year. Baker County was tops in filing birth records with 100 per cent
filed on time, while one county rated as low as 29.6 per cent. The state

VITAL STATISTICS

record for promptness in registering deaths also improved from 95 per
cent in 1957 to 97 per cent in 1958. Eight counties were perfect in
this measurement (Baker, Martin, Wakulla, Citrus, Hernando, Madison,
Flagler, Liberty) while one county had a low of 66.7 per cent of the
deaths registered within the prescribed time limit. The overall picture
shows that 40 counties improved their score during 1958, one county
remained the same, and 26 counties had a lower score in 1958 than
they had in 1957. The top five counties are to be congratulated on
their superior performance. They are: Baker, Martin, Wakulla, Orange
and Hillsborough.

Last year 204,412 current certificates were registered with the
bureau, an increase of 4.5 per cent over the preceding year. The Current
Registration Section is responsible for processing these records. This
includes: checking certificates to see that they are in proper order,
returning those which do not meet minimum standards, querying others
that are not complete or inconsistent, putting records in proper order
for permanent filing, numbering, microfilming, and having certificates
and indexes bound and forwarded to the vault for permanent storage.
This section also carries on all correspondence with the counties re-
garding collection of records.

The issuance of certified copies of certificates is another of the
large-volume jobs performed by the bureau. Last year, 108,050 requests
for certification were received and processed. The bureau is partic-
ularly proud of the prompt service now being given to applicants for
certified copies of records. For most routine cases, the certified copy
is mailed within 24 hours after receipt of the request. The improvement
in service is mainly due to three factors: (1) a new procedure for flow
of work inaugurated in 1957, (2) a new and faster photostat machine,
and (3) better personnel.

A project has been started for re-indexing all records for years
prior to 1940. This is a long-term project which will take eight or more
years to complete, but the revised indexes will eventually result in
shortening the searching procedures and facilitate the training of new
personnel.

The work of the Amendment Section is probably the most interest-
ing portion of vital records. This section handles all requests for chang-
ing existing records or for the delayed registration of an event which
was not registered at the time of occurrence. In each case the applicant
must submit evidence to substantiate his request. This evidence must
be adjudicated by the bureau personnel and the request processed if
the evidence is sufficient for legal purposes. Many strange and interesting
requests are received each year. The work of the Amendment Section
includes the following: adoptions, legitimations, change of parentage,
legal change of name, corrections, delayed registration of births and
deaths.

76 ANNUAL REPORT, 1958

Last year 4530 adoption decrees were received for processing. This
was a 43 per cent increase over the previous year and has literally
"swamped" the personnel who process them. One person was temporar-
ily transferred from other duties to work on adoptions but there was
a backlog of about 600 adoption decrees not processed at the end of
1958. Two additional persons are now needed on a permanent basis.
The "processing" of an adoption decree consists of the following steps:
1. Report of adoption is received from the clerk of circuit
court or from the attorney.
2. Report must be checked for authenticity and to see that it
contains sufficient data.
3. If necessary, query for additional data.
4. Check for previous correspondence on this child.
5. Go to birth records in vault and locate child's original
birth certificate. If no certificate is on file, instruct applicant
as to method for late registration. Data on original certifi-
cate must check with that in adoption report.
6. Type new birth certificate showing new name and new
parents and replace the original with this new certificate
which does not reveal the fact of adoption.
7. Re-index under new name.
8. Notify adoptive parents that new certificate is now on file.
9. Send photocopy of new certificate to local registrar with
request that he replace his copy of the original and return
it to the state office.
10. Place adoption report, original birth certificate, and local
registrar's copy of original birth certificate in a sealed enve-
lope and file. This can only be opened by court order or by
request of the child when of legal age.
The bureau now occupies the ground floor of the new J. Y. Porter
Building and now has adequate space for personnel and equipment. This
has greatly improved the morale and efficiency of the personnel. The
new building has vault space which should be adequate for the storage
of vital records for at least twenty years.

STATISTICS
This report contains only a brief summary of statistical data for
the year. An analysis of vital statistics data and morbidity data for 1958
in greater detail is presented in Supplements 1 and 2 of this report under
the titles FLORIDA VITAL STATISTICS, 1958, and FLORIDA
MORBIDITY STATISTICS, 1958. Because of the time lag in receipt
of records, figures for births and deaths in this report are labeled "pre-
liminary." Final figures are contained in the above mentioned supple-
ments, and Tables 9a, 10a, and lla contain final figures for 1957.

VITAL STATISTICS 77

POPULATION
The population of the state as of July 1, 1958, was estimated to be
4,448,000, an increase of 4.6 per cent over the figure of 4,250,400 for
the previous year. The white population was estimated to be 3,603,100
persons and the non-white population 844,900.

BIRTHS
In 1958 an estimated total of 107,921 live births occurred in Florida,
making the second consecutive year in which the number of births ex-
ceeded 100,000 in the state. There were 77,979 white and 29,942 non-
white births. The continuing large number of births can be attributed
to the increase in population, since the birth rate per 1000 population
decreased slightly, from 24.4 in 1957 to 24.3 in 1958. This represents a
continuation of the downward trend which started in 1957, and Florida's
birth rate was the same as the estimated rate for the United States
(based on the first 10 months of 1958). The decline was more rapid
for non-whites than for whites, with a decrease of nearly 2 percent from
36.1 in 1957 to 35.4 in 1958. White rates for 1957 and 1958 were 21.7
and 21.6, respectively.

DEATHS
There were 43,099 deaths in Florida during 1958, according to
preliminary tabulations. The death rate, based on estimated mid-year
population, was 9.7 per 1000 population, an increase of 3.2 per cent
over the rate of 9.4 for 1957. The death rate rose for whites from 9.1
per 1000 population in 1957 to 9.5 in 1958. The rate for non-whites
was slightly lower in 1958, decreasing from 10.5 in 1957 to 10.4.
This increase in mortality rate was associated with a rise in the
rates for five groups of diseases: diseases of early infancy (+3.6%),
malignant neoplasms (+2.7%), cerebral vascular disease (+2.1%),
diseases of the heart (+1.7%), and influenza and pneumonia, except
pneumonia of the newborn, (+10.8%), a result of the outbreak of in-
fluenza which occurred during the latter part of 1957.

As in past years, heart disease remained the principal cause of
death in the state, accounting for 15,189 deaths or 341.5 per 100,000
population. Of these, more than two-thirds, or 11,178 were attributed
to arteriosclerotic heart disease. There were 6556 deaths due to cancer,
the second leading cause of death, with a rate of 147.4 per 100,000
population. Cerebral vascular disease had a rate of 114.7 with 5102
deaths. Three important diseases included among the top 10 leading
causes showed almost no change in mortality. Accidents accounted for
2780 deaths, and the rate per 100,000 population of 62.5 remained
almost the same as the figure for 1957. Death rates for general arterios-
clerosis and cirrhosis of the liver decreased only slightly during the year.
Diseases of early infancy were responsible for 2027 deaths, with a rate
of 45.6 compared with a rate of 44.0 for 1957. The rate for diabetes
mellitus increased from 11.9 in 1957 to 13.7, with 610 deaths, giving

78 ANNUAL REPORT, 1958

this disease the rank order of seventh instead of tenth place. The
suicide rate increased from 11.5 to 13.5, a total of 599 deaths, and took
the place of congenital malformations among the 10 leading causes of
death for 1958.

MARRIAGES, DIVORCES AND ANNULMENTS
There were 34,569 marriages in Florida in 1958, a marriage rate
of 7.8 per 1000 population. This compares with the rate of 7.6 for
1957, when there were 32,149 marriages.

The number of divorces and annulments granted during the year
in Florida was 17,604, a decrease of 6.1 per cent over the total of
18,744 in 1957. The rate per 1000 population decreased 11.4 per cent,
from 4.4 in 1957 to 3.9 in 1958. This reduction in the number and rate
for divorces was principally due to the change in the Florida divorce
law, effective in October 1957, requiring six months of residence prior
to the filing of a petition for divorce.

TABLE 7
ACTIVITIES OF THE BUREAU OF VITAL STATISTICS
DURING THE YEARS 1957 AND 1958

Per Cent
Activity 1957 1958 Change

Current certificates filed .......................... 195,587 204,412 + 4.5
Delayed birth certificates filed ................. 4,134 3,542 -14.3
Adoptions decrees received ..................... 3,159 4,530 +43.4
Amended certificates filed for adoptions.... 2,809 3,292 + 17.2
Amended certificates filed for legitimations
and correction of parentage ................ 1,0201 992 2.7
Requests for certifications: ........................
Total ............................... .............. 108,696 108,050 0.6
Fee Paid ......................................... 90,494 87,290 3.5
Free ...................... ..... ............ 18,202 20,760 + 14.1
Photostats made ................................. ........ 105,063 122,550 + 16.6
Birth Registration cards made .................. 27,222 21,937 -19.4
Fees collected and transmitted to
State Treasurer .................................. $136,627.57 $132,242.99 3.2

VITAL STATISTICS

TABLE 8

RESIDENT BIRTHS AND DEATHS WITH RATES PER 1,000

POPULATION, FLORIDA, 1931-1958

YEAR POPULATION BIRTHS BIRTH RATE DEATHS DEATH RATE

1958*
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931

4,448,000
4,250,400
3,897,400
3,643,562
3,481,528
3,111,100
3,006,400
2,901,800
2,797,100
2,692,500
2,587,800
2,483,200
2,378,500
2,273,900
2,196,195
2,125,935
2,055,675
1,985,415
1,915,155
1,853,660
1,795,322
1,736,984
1,678,646
1,620,308
1,585,596
1,554,000
1,530,356
1,502,736

107,921
103,806
97,320
89,112
84,831
80,087
74,219
70,431
64,370
61,642
59,685
60,201
54,347
48,839
49,186
46,783
40,675
37,351
33,696
32,437
31,101
29,529
28,116
28,058
26,722
25,647
27,242
26,789

'1958 data based upon preliminary totals.

24.3
24.4
25.0
24.5
24.4
25.7
29.7
24.3
23.0
22.9
23.1
24.2
22.8
21.5
22.4
22.0
19.8
18.8
17.6
17.5
17.3
17.0
16.7
17.3
16.9
16.5
17.8
17.8

43,099
39,937
36,705
33,295
31,503
30,529
29,136
27,857
26,525
25,317
24,505
24,150
22,750
22,594
23,251
23,213
21,144
21,438
21,458
20,209
19,949
19,825
20,050
19,059
19,518
18,112
17,721
17,291

TABLE 9

RESIDENT DEATHS AND DEATH RATES BY CAUSE, BY RACE, FLORIDA, 1958 (PRELIMINARY)

CAUSE OF DEATH Deaths Rate Per 100,000 Population O
(Numbers in parentheses refer to the International List of Causes of Death) ----- --- ---
Total White Nonwhite Total White Nonwhite
ALL CAUSES................. .................................... ............ 43,099 34,294 8,805 9.7* 9.5* 10.4
Tuberculosis of respiratory system (001-008)................ .............................. 262 184 78 5.9 5.1 9.2
Tuberculosis, other forms (010-019) .................................................... 28 11 17 0.6 0.3 2.0
Syphilis and its sequelae (020-029) ............................................ ............ 97 45 52 2.2 1.2 6.2
Typhoid fever (040)..................................................................... 0 0 0 0 0 0
Dysentery, all forms (045-048) ............................ ........ ........... ...... ...... 11 3 8 0.2 0.1 0.9
Diphtheria (055)................................................................ ........ 3 3 0 0.1 0.1 0
Meningococcal infections (057) ............................................................. 23 15 8 0.5 0.4 0.9
Acute poliom yelitis (080) ............................................................... 6 6 0 0.1 0.2 0
Acute infectious encephahtis (082) ......................................................... 15 9 6 0.3 0.2 0.7
M easles (085) ......... ................. ................... ................... 11 10 1 0.2 0.3 0.1 -
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)... 190 118 72 4.3 3.3 8.5
Malignant neoplasms, including neoplasms of lymphatic and haematopoietic tissues (140-205) ...... 6,556 5,651 905 147.4 156.8 107.2
Diabetes mellitus (260) .................................................................. 610 470 140 13.7 13.0 16.6
Anemias (290-293) .............................................................. 99 66 33 2.2 1.8 3.9
Major Cardiovascular-renal disease ....................... ............................... 22,076 18,446 3,630 496.3 512.0 429.8
Cerebral vascular disease (330-334) ...................................................... 5,102 3,954 1,148 114.7 109.7 135.9
Rheumatic fever (400-402) ..................... .. ...... ...... .... .... ......... .......... 15 10 5 0.3 0.3 0.6
Diseases of the heart (410-443) ........................................................ 15,189 13,120 2,069 341.5 364.1 245.0
Chronic rheumatic heart disease (410-416) ............................................ 470 402 68 10.6 11.2 8.1
Arteriosclerotic heart disease, coronary disease (420)...................................... 11,178 10,195 983 251.3 283.0 116.4
Nonrheumatic chronic endocarditis & Myocardial degeneration (421-422) .................... 1,127 875 252 25.3 24.3 29.8
Hypertension with heart disease (440-443)............................................. 1,644 1,074 570 37.0 29.8 67.5
Other diseases of heart (430-434) ....................................................... 770 574 196 17.3 15.9 23.2
Hypertension without heart disease (444-447) ............................................. 296 203 93 6.7 5.6 11.0
General arteriosclerosis (450) .......................... ...... ........ .... ................. 599 503 96 13.5 14.0 11.4
Other circulatory disease (451-468) ....................................... ................ 522 433 89 11.7 12.0 10.5
Chronic and unspecified nephritis (592-594)................ ............................ 353 223 130 7.9 6.2 15.4 Ul
Influenza (480-483) .............................................. .................... 158 75 83 3.6 2.1 9.8 0m
Pneumonia (490-493)................ .................................... ........ 1,297 875 422 29.2 24.3 50.0
Ulcer of stomach and duodenum (540,541)................................................. 273 238 35 6.1 6.6 4.1
Intestinal obstruction and hernia (560, 561, 570) .............................................. 235 189 46 5.3 5.2 5.4
Gastritis, duodenitis, enteritis & colitis, except diarrhea of the newborn (543, 571, 572)........... 277 146 131 6.2 4.1 15.5
Cirrhosis of liver (581) ... ............................................................... 554 487 67 12.5 13.5 7.9
Acute nephritis and nephrosis (590,591) ....................... ........ ........ 60 34 26 1.3 0.9 3.1
Complications of pregnancy, childbirth and the puerperium (640-652, 660, 670-689)............... 62 24 38 0.6** 0.3** 1.3**
Congenital malformations (750-759)............................................. ....... 507 384 123 11.4 10.7 14.6
Birth injuries, postnatal asphyxia & atelectasis (760-762)...................................... 912 565 347 20.5 15.7 41.1
Infection of the newborn (763-768).......................................................... 160 73 87 3.6 2.0 10.3
Other diseases peculiar to early infancy, and immaturity unqualified (769-776)................... 955 571 384 21.5 15.8 45.5
Symptoms, senility, and ill-defined causes (780-795).......................................... 977 593 384 22.0 16.5 45.5
All other diseases (residual)............................................................. 2,836 2,217 619 63.8 61.5 73.3
Motor vehicle accidents (810-835)......................................................... 1,099 858 241 24.7 23.8 28.5
All other accidents (800-802, 840-962) .................................... ................. 1,681 1,196 485 37.8 33.2 57.4
Suicide and self-inflicted injury (963, 970-979) ................ ............................. 599 574 25 13.5 15.9 3.0
Homicide (964, 980-999) ............................... ...... ........ ....... .......... 470 158 312 10.6 4.4 36.9
Infant mortality (deaths under one year of age) .................................... ...... 3,416 1,910 1,506 31.7" 24.5** 50.3**

*Rate per 1,000 population
**Rate per 1,000 live births

RESIDENT DEATHS AND DEATH RATES BY A b Y KALU, I-LUKILA, I YO/ (UINAL NIrUKea)
Deaths Rate Per 100,000 Population
CAUSE OF DEATH
Total White Nonwhite Total White Nonwhite

TOTAL DEATHS.................................................................... 39,937 31,520 8,417 9.4* 9.1* 10.5'
Tuberculosis of respiratory system (001-008).................................................. 248 161 87 5.8 4.7 10.9
Tuberculosis, other forms (010-019) ......................................................... 9 4 5 0.2 0.1 0.6
Syphilis and its sequelae (020-029) .......................................................... 117 57 60 2.8 1.7 7.5
Typhoid fever (040) ...................................................................... 1 1 0.0 0.0 0
Dysentery, all forms (045-048) ............................................................. 11 2 9 0.3 0.1 1.1
Scarlet fever & strep. sore throat (050, 051).................................................. 5 2 3 0.1 0.1 0.4
Diphtheria (055) ........................................................ ...................... 5 1 4 0.1 0.0 0.5
W hooping cough (056) ................................................................. 3 0 3 0.1 0 0.4
M eningococcal infections (057) ............................................................. 26 18 8 0.6 0.5 1.0
Acute poliom yelitis (080) .................................................................. 6 6 0.1 0.2 0
Acute infectious encephalitis (082) .......................................................... 11 10 1 0.3 0.3 0.1
M easles (085) ........................ ................................................. .. 11 8 3 0.3 0.2 0.4
Typhus & other rickettsial diseases (100-108)................................................ 0 0 0 0 0 0
Infectious & parasitic diseases, N.E.C ........ ... .......... ...... 157 91 66 3.7 2.6 8.3
Malignant neoplasms, including neoplasms of lymphatic & haematopoietic tissues (140-205) ........ 6,101 5,246 855 143.5 152.0 106.9
Benign & unspecified neoplasms (210-239) .................................................. 99 75 24 2.3 2.2 3.0
Diabetes m ellitus (260).................................................................... 506 405 101 11.9 11.7 12.6
Anem ias (290-293) ........................................................................ 97 57 40 2.3 1.7 5.0
Major cardiovascular-renal disease ......................................................... 20,782 17,297 3,485 488.9 501.3 407.9
Cerebral vascular disease (330-334) ....................................................... 4,772 3,685 1,087 112.3 106.8 135.9 -.
Rheum atic fever (400-402) .............................................................. 12 5 7 0.3 0.1 0.9
Diseases of the heart (410-443) .......................................................... 14,272 12,251 2,021 335.8 335.0 252.7
Chronic rheumatic heart disease (410-416) ............................................... 411 353 58 9.7 10.2 7.3 .
Arteriosclerotic heart disease, coronary disease (420) ...................................... 10,422 9,479 943 245.2 274.7 117.9
Nonrheumatic chronic endocarditis & myocardial degeneration (421-422) .................... 1,064 832 232 25.0 24.1 29.0
Hypertension with heart disease (440-443)............................................... 1,616 1,008 608 38.0 29.2 76.0
Other diseases of heart (430-434) ....................................................... 759 579 180 17.9 16.8 22.5
Hypertension without heart disease (444-447).............................................. 275 187 88 6.5 5.4 11.0
General arteriosclerosis (450)............................................................. 589 509 80 13.9 14.8 10.0 C1
Other circulatory disease (451-468)....................................................... 476 409 67 11.2 11.9 8.4
Chronic and unspecified nephritis (592-594)........ ..................................... 386 251 135 9.1 7.3 16.9
Influenza (480-483) ....................................................................... 148 66 82 3.5 1.9 10.3 >
Pneumonia (490-493) ....................................................................... 1,104 680 424 26.0 19.7 53.0
Bronchitis (500-502) ...................................................................... 88 69 19 2.1 2.0 2.4 3
Ulcer of stomach & duodenum (540, 541) .................................................... 2 2234 200 34 5.5 5.8 4.3
Appendicitis (550-553).................................................................... 45 34 11 1.1 1.0 1.4
Intestinal obstruction & hernia (560, 561, 570) .............................................. 270 208 62 6.4 6.0 7.8
Gastritis, duodenitis, enteritis & colitis except diarrhea of the newborn (543, 571, 572 )............ 320 138 182 7.5 4.0 22.8 -
Cirrhosis of liver (581) .................................................................... 534 459 75 12.6 13.3 9.4
Acute nephritis (590-591) .................................................................. 70 50 20 1.6 1.4 2.5
Hyperplasia of prostate (610) ............................... .. 131 107 24 3.1 3.1 3.0 ()
Complications of pregnancy, childbirth & the puerperium (640-652, 660, 670-689)................. 66 19 47 6.4** 2.5** 16.3"
Congenital malformations (750-759).................. .... .............................. 534 401 133 12.6 11.6 16.6
Birth injuries, postnatal asphyxia & atelectasis (760-762) ...................................... 830 534 296 19.5 15.5 37.0
Infection of the newborn (763-768).............. ............... ............................ 125 56 69 2.9 1.6 8.6
Other dis. peculiar to early infancy (769-776)................................................. 916 538 378 21.6 15.6 47.3
Senility, illdefined & unknown causes (780-795)................................................ 651 386 265 15.3 11.2 33.1
All other diseases (residual). ................................................................ 2,119 1,589 530 49.8 46.1 66.3 0
Motor vehicle accidents (810-835) ........................................................... 1,114 858 256 26.2 24.9 32.0
All other accidents (800-802,840-962)......................................................... 1,538 1,103 435 36.2 32.0 54.4
Suicide & self-inflicted injury (963, 970-979).................. ................................ 490 467 23 11.5 13.5 2.9
Homicide (964, 965, 980-999)........................ ............ 415 117 298 9.7 3.4 37.3
Infant mortality (deaths under one year of age) ...................... ... 3,317 1,827 1,490 32.0 24.4 51.6
*Rates per 1,000 population
**Rates per 10,000 live births

82 ANNUAL REPORT, 1958

TABLE 10

ESTIMATED POPULATION AND PRELIMINARY TOTALS OF

BIRTHS, DEATHS, AND INFANT DEATHS,

BY RACE, BY COUNTY, FLORIDA, 1958

Population BIRTHS
COUNTY Estimate--
1958 Total White Nonwhite

STATE....... 4,448,000* 107,921 77,979 29,942

Alachua....... 80,500 1,960 1,287 673
Baker........ 6,800 222 158 64
Bay ........ 63,600 2,100 1,744 356
Bradford.... 12,200 309 205 104
Brevard ..... 86,200 2,736 2,282 454
Broward ..... 265,900 6,348 4,171 2,177
Calhoun...... 7,800 183 132 51
Charlotte..... 7,200 127 113 14
Citrus ....... 8,400 166 117 49
Clay ......... 19,700 523 447 76
Collier ...... 13,900 367 297 70
Columbia..... 18,600 437 254 183
Dade ........ 846,800 19,129 14,119 5,010
DeSoto....... 11,600 215 140 75
Dixie......... 4,400 108 95 13
Duval ....... 427,200 11,996 8,516 3,480
Escambia..... 166,400 5,457 4,055 1,402
Flagler........ 5,300 150 68 82
Franklin.... 5,700 157 108 49
Gadsden...... 50,100 1,122 297 825
Gilchrist ...... 3,300 61 51 10
Glades........ 3,100 49 30 19
Gulf.......... 8,900 264 174 90
Hamilton..... 8,300 205 72 133
Hardee....... 13,600 255 215 40
Hendry....... 7,200 174 103 71
Hernando.... 9,800 285 181 104
Highlands.... 17,400 462 297 165
Hillsborough 359,300 8,885 7,145 1,740
Holmes....... 11,600 207 197 10
Indian River .. 23,100 525 319 206
Jackson....... 34,100 825 507 318
Jefferson...... 9,500 238 51 187
Lafayette..... 2,800 45 33 12
Lake ......... 52,200 1,080 732 348
Lee .......... 40,800 817 560 257
Leon......... 78,000 1,851 1,083 768
Levy......... 9,900 235 127 108
Liberty....... 2,800 79 63 16
Madison...... 14,200 354 152 202
Manatee...... 56,300 1,113 761 352
Marion....... 47,500 1,119 577 542
Martin........ 13,100 361 222 139
Monroe ...... 54,000 1,468 1,303 165
Nassau ...... 14,900 461 317 144
Okaloosa...... 56,500 1,975 1,816 159
Okeechobee.... 5,100 148 108 40
Orange ....... 237,600 5,688 4,499 1,189
Osceola....... 16,300 293 241 52
Palm Beach... 214,300 4,833 3,235 1,598
Pasco ......... 30,800 603 482 121
Pinellas ..... 296,100 5,237 4,051 1,186
Polk ......... 176,000 4,240 3,115 1,125
Putnam....... 33,500 868 512 356
St. Johns...... 31,300 678 412 266
St. Lucie ..... 33,600 996 491 505
Santa Rosa.... 25,200 841 762 79
Sarasota ...... 59,000 1,147 902 245
Seminole...... 46,200 1,195 764 431
Sumter ....... 11,500 260 157 103
Suwannee. .... 14,100 332 211 121
Taylor......... 14,000 322 232 90
Union ........ 10,600 91 57 34
Volusia ..... 102,100 2,272 1,571 701
Wakula ...... 5,100 131 80 51
Walton....... 14,200 314 250 64
Washington.. 10,900 227 154 73

Includes institution populations (16,400).

DEATHS

Total White

43,099 34,294

560 299
52 35
376 288
134 100
595 484
2,367 1,875
69 63
99 88
116 93
126 99
107 81
185 108
7,839 6,843
101 78
45 32
3,558 2,400
1,212 815
54 31
66 41
343 114
30 28
25 15
70 49
81 43
124 112
54 35
112 85
242 182
3,547 2,959
104 97
243 191
292 181
116 42
25 23
596 480
438 333
480 257
123 61
23 18
165 81
764 655
534 322
165 121
286 233
130 84
258 231
56 38
2,078 1,756
291 258
2,116 1,604
399 362
4,890 4,549
1,533 1,241
379 216
312 194
351 240
190 164
762 688
399 242
104 72
168 114
108 68
52 35
1,563 1,319
60 39
148 119
109 91

INFANT DEATHS

Nonwhite Total White Nonwhite

8,805
261
17
88
34
111
492
6
11
23
27
26
77
996
23
13
1,158
397
23
25
229
2
10
21
38
12
19
27
60
588
7
52
111
74
2
116
105
223
62
5
84
109
212
44
53
46
27
18
322
33
512
37
341
292
163
118
111
26
74
157
32
54
40
17
244
21
29
18

3,416

56
7
65
10
78
203
5
3
7
18
14
14
571
4
0
319
177
12
6
61
1
3
9
9
15
10
12
17
286
0
23
25
11
3
40
41
67
7
3
17

42
35
16
30
13
51
6
152
10
180
14
177
119
47
23
43
25
30
58
6
14
11
4
67
6
3
5

1,910

23
2
48
6
55
94
3
3
4
13
12
3
348
2
0
191
85
4
3
10
1
0
4
2
12
6
5
9
199
0
9
12
1
2
22
25
30
1
3
6
19
14
7
16
6
43
4
113
6
68
8
104
70
21
10
16
19
19
27
3
7
5
1
38
3
3
2

1,506
33
5
17
4
23
109
2
0
3
5
2
11
223
2
0
128
92
8
3
51
0
3
5
7
3
4
7
8
87
0
14
13
10
1
18
16
37
6
0
11
23
21
9
14
7
8
2
39
4
112
6
73
49
26
13
27
6
11
31
3
7
6
3
29
3
0
3

VITAL STATISTICS 83

TABLE 10-A

ESTIMATED POPULATION AND TOTALS OF BIRTHS,

DEATHS, AND INFANT DEATHS,

BY RACE, BY COUNTY, FLORIDA, 1957
(FINAL FIGURES)

Population BIRTHS DEATHS Infant Deaths
COUNTY Estimate
1957 Total White Nonwhite Total White Nonwhite Total White Nonwhite
STATE....... 4,250,400* 103,806 74,921 28,885 39,937 31,520 8,417 3,317 1,827 1,490
Alachua....... 66,400 1,900 1,225 675 542 298 244 66 34 32
Baker......... 7,400 192 137 55 47 32 15 6 4 2
Bay.......... 59,600 1,996 1,589 407 384 313 71 42 32 10
Bradford...... 12,600 318 230 88 124 88 36 19 8 11
Brevard....... 72,000 2,200 1,837 363 519 412 107 82 48 34
Broward ..... 249,600 5,860 3,835 2,025 2,051 1,623 428 180 77 103
Calhoun ..... 7,500 199 165 34 65 57 8 4 2 2
Charlotte..... 5,800 109 87 22 95 85 10 4 4 0
Citrus........ 6,600 167 118 49 86 70 16 5 3 2
Clay.......... 18,100 599 512 87 125 92 33 15 12 3
Collier ........ 14,000 317 253 64 97 72 25 14 7 7
Columbia..... 19,900 520 319 201 188 96 92 12 4 8
Dade......... 829,000 18,671 14,033 4,638 7,157 6,197 960 562 340 222
DeSoto....... 10,100 182 120 62 135 96 39 7 1 6
Dixie ........ 4,000 109 84 25 58 44 14 6 5 1
Duval........ 438,600 11,592 8,275 3,317 3,428 2,232 1,196 345 184 161
Escambia..... 157,800 5,583 4,198 1,385 1,245 874 371 215 117 98
Flagler........ 5,300 157 64 93 58 28 30 14 2 12
Franklin...... 5,300 137 100 37 67 43 24 4 1 3
Gadsden...... 44,600 1,149 296 853 357 139 218 61 4 57
Gilchrist..... 3,100 68 53 15 20 14 6 2 1 1
Glades........ 2,400 54 28 26 25 13 12 4 0 4
Gulf.......... 9,500 326 226 100 52 23 29 12 3 9
Hamilton..... 8,600 240 98 142 93 53 40 11 3 8
Hardee....... 12,400 245 201 44 114 103 11 11 6 5
Hendry ....... 6800 204 123 81 58 34 24 6 3 3
Hernando..... 9,000 242 145 97 99 76 23 5 1 4
Highlands..... 18,600 435 285 150 187 144 43 10 5 5
Hillsborough 355,500 8,443 6,794 1,649 3,322 2,742 580 227 150 77
Holmes....... 12,200 219 204 15 114 105 9 9 8 1
Indian River .. 19,500 550 341 209 206 162 44 21 9 12
Jackson....... 36,900 827 498 329 269 167 102 22 8 14
Jefferson...... 9,500 292 87 205 120 45 75 4 0 4
Lafayette..... 3,000 52 44 8 27 23 4 1 1 0
Lake......... 47,800 1,204 814 390 606 486 120 50 28 22
Lee........... 38,700 892 650 242 405 321 84 36 25 11
Leon......... 63,800 1,781 1,043 738 470 237 233 53 24 29
Levy......... 9,300 236 128 108 135 85 50 7 3 4
Liberty ...... 2,600 79 66 13 17 14 3 3 3 0
Madison...... 15,200 373 159 214 154 74 80 14 5 9
Manatee...... 49,500 1,118 756 362 705 600 105 53 32 21
Marion....... 46,200 1,151 588 563 490 319 171 26 11 15
Martin........ 13,100 288 171 117 141 97 44 19 8 11
Monroe....... 54,000 1,373 1,220 153 290 243 47 35 29 6
Nassau....... 16,000 483 333 150 125 78 47 17 10 7
Okaloosa...... 53,000 1,945 1,784 161 263 238 25 48 39 9
Okeechobee.... 4,600 136 105 31 32 20 12 1 1 0
Orange........ 216,400 5,259 4,075 1,184 1,820 1,537 283 123 88 35
Osceola........ 15,400 250 198 52 266 231 35 11 8 3
Palm Beach... 191,000 4,440 2,899 1,541 1,915 1,486 429 170 83 87
Pasco......... 31,100 572 445 127 346 314 32 29 17 12
Pinellas....... 268,100 4,513 3,508 1,005 4,375 4,059 316 150 86 64
Polk.......... 178,700 4,194 3,074 1,120 1,514 1,215 299 137 76 61
Putnam....... 33,000 844 506 338 303 168 135 38 11 27
St. Johns...... 33,700 704 420 284 314 205 109 29 12 17
St. Lucie...... 30,500 900 451 449 288 184 104 40 15 25
Santa Rosa.... 23,100 801 721 80 177 149 28 21 20 1
Sarasota...... 52,800 1,133 895 238 700 634 66 28 18 10
Seminole...... 40,000 1,129 647 482 395 235 160 42 14 28
Sumter....... 11,400 262 146 116 110 80 30 7 2 5
Suwannee..... 14,700 334 194 140 176 116 60 17 8 9
Taylor........ 12,800 381 282 99 89 57 32 10 8 2
Union ........ 7,900 99 58 41 51 36 15 2 1 1
Volusia....... 104,800 2,052 1,443 609 1,434 1,165 269 69 37 32
Wakulla...... 4,900 123 71 52 34 25 9 1 1 0
Walton....... 14,800 337 282 55 154 134 20 8 7 1
Washington... 10,300 266 185 81 109 83 26 15 10 5

*Includes State institutions.

84 ANNUAL REPORT, 1958

TABLE 11

PRELIMINARY TOTALS OF RESIDENT DEATHS FROM CERTAIN

CAUSES BY COUNTY, FLORIDA, 1958

S
o-* S<; 0 ;; -c u 6,556 o0 *" H5 n8 n3 2 3 i t op

STATE............ 62 290 97 11 6 6,556 610 99 1,455 5,102 15,189 853 1,432 1,099 1,681

Alachua............ 0 3 1 0 0 70 8 2 22 116 148 7 17 12 24
Baker.............. 0 0 0 0 0 5 1 0 2 6 13 0 5 7
Bay............... 0 1 1 0 0 47 3 0 15 41 106 2 8 17 19
Bradford........... 0 5 0 0 0 16 1 0 7 18 44 0 4 7 8
Brevard............ 2 2 2 0 0 90 7 0 24 55 196 3 17 21 26
Broward. .......... 2 11 10 0 0 388 29 6 78 240 851 28 80 54 108
Calhoun............ 0 0 0 0 0 8 0 0 6 16 25 0 1 0 1
Charlotte........... 0 1 0 0 0 18 1 0 2 13 43 0 1 1 2
Citrus. ............ 0 0 0 0 0 22 0 0 0 11 49 0 7 5 7
Clay.............. 1 0 1 0 0 9 0 0 4 21 38 1 6 5 7
Collier ............ 0 0 0 0 0 12 1 0 2 11 35 2 3 8 2
Columbia .......... 2 0 0 0 0 16 3 0 5 50 61 1 9 2 11
Dade............ 6 66 24 2 1 1,868 122 20 295 713 2,856 34 222 179 251
DeSoto............ 0 0 0 0 0 20 4 0 1 13 32 3 1 8 4
Dixie.............. 0 1 0 0 0 7 0 0 0 5 20 2 2 1 3
Duval............. 7 46 17 1 0 535 44 9 14 483 1,045 40 126 109 164
Escambia.......... 2 12 2 1 0 156 13 2 48 124 427 10 27 30 56
Flagler............. 0 0 0 0 0 6 0 0 4 5 14 0 3 1 3
Franklin............ 0 0 0 1 0 12 1 0 5 7 24 0 2 0 1
Gadsden........... 3 2 1 0 0 29 8 0 15 43 93 4 8 11 19
Gilchrist........... 0 0 0 0 0 3 1 0 3 3 11 0 3 0 1
Glades.............. 0 0 0 0 0 0 0 0 0 1 6 2 2 2 4
Gulf ............... 0 1 0 0 0 14 0 0 2 10 20 0 4 2 2
Hamilton........... 0 1 0 0 0 4 3 0 6 11 31 0 3 2 7
Hardee............. 0 2 0 0 0 12 1 0 4 11 32 2 10 11 4
Hendry............ 1 0 0 0 0 5 4 0 0 4 15 0 1 2 5
Hernando .......... 0 1 0 0 0 15 1 1 7 16 34 2 4 6 5
Highlands ......... 1 1 1 0 0 38 3 2 5 23 85 3 10 6 13
Hillsborough........ 6 30 6 2 1 501 56 10 74 331 1,202 30 96 88 142
Holmes............ 0 0 0 0 0 10 2 0 1 13 48 0 5 6 6
Indian River......... 0 0 1 0 0 32 3 0 10 21 96 1 10 9 11
Jackson............ 1 3 0 2 0 30 1 0 13 53 86 5 14 12 18
Jefferson .......... 0 0 0 0 0 15 2 0 8 23 34 1 4 3 5
Lafayette .......... 0 0 0 0 0 2 0 0 0 2 16 0 0 0 0
Lake............... 2 2 2 0 0 72 15 1 31 61 223 4 23 13 24
Lee................. 2 5 0 0 0 57 6 2 10 38 151 2 14 13 19
Leon.............. 0 2 1 0 0 61 3 0 25 72 117 7 16 13 28
Levy.............. 1 0 0 0 0 17 1 0 5 19 42 0 6 4 4
Liberty............ 0 0 0 0 0 5 0 0 2 2 9 0 1 0 0
Madison............ 0 0 1 0 0 7 3 1 8 20 67 3 2 1 17
Manatee........... 1 2 0 0 0 99 14 2 33 93 313 5 41 18 17
Marion............. 0 2 2 0 0 55 11 2 27 68 196 11 18 18 28
Martin.............. 0 1 0 0 0 29 0 0 4 25 62 2 3 6 4
Monroe ............ 1 1 0 0 0 53 5 0 13 39 64 2 7 7 14
Nassau............. 0 1 0 0 0 21 4 0 3 25 36 0 4 2 2
Okaloosa........... 0 4 0 0 0 28 1 0 10 24 66 3 7 15 22
Okeechobee......... 0 1 0 0 0 1 0 0 3 6 8 0 1 5 8
Orange............. 8 20 4 0 2 291 32 6 75 263 787 17 71 47 76
Osceola ............ 2 0 0 0 32 2 1 11 39 124 2 17 4 7
Palm Beach........ 4 8 5 0 338 30 5 60 262 740 7 57 76 65
Pasco.............. 1 3 1 0 0 64 7 1 8 48 153 2 21 10 12
Pinellas............. 3 22 9 0 0 904 64 12 126 667 1,944 28 180 57 123
Polk............... 3 6 0 0 1 239 19 6 44 204 559 14 55 45 67
Putnam............ 1 1 0 0 0 50 6 2 12 39 134 19 7 10 22
St.Johns............ 0 2 1 0 0 43 7 0 11 30 107 1 11 6 17
St. Lucie........... 1 0 0 0 0 51 2 1 15 44 114 3 14 13 14
SantaRosa.......... 0 2 0 0 0 16 1 0 7 33 56 4 10 9 8
Sarasota ........... 0 1 1 0 0 127 14 0 19 81 312 5 28 17 23
Seminole ........... 1 1 1 2 1 52 6 2 12 36 136 10 12 9 27
Sumter.............. 0 1 0 0 10 2 1 6 20 40 0 4 1 5
Suwannee .......... 0 1 0 0 0 25 1 0 9 26 57 2 7 4 8
Taylor.............. 0 0 0 0 0 15 0 0 7 23 22 3 4 2 8
Union.............. 0 1 0 0 0 10 1 0 0 6 20 0 2 2 2
Volusia............ 1 6 2 0 0 240 29 2 39 211 613 11 65 39 46
Wakulla............ 0 1 0 0 0 5 1 0 5 1 1 4 0 3 3 4
Walton ............ 3 1 0 0 14 0 0 10 31 48 3 3 5 6
Washington ........ 0 1 0 0 0 10 0 0 3 23 29 0 5 5 8

*Includes all vascular lesions affecting the central nervous system n.

VITAL STATISTICS 85

TABLE 11-A

RESIDENT DEATHS FROM CERTAIN CAUSES,

BY COUNTY, FLORIDA, 1957 (FINAL FIGURES)
Cardio-Vascular-Renal
Diseases

i3 '3 .

Baker ... 1 0 0 0 0 0 2 3 16 2 2 0 4
BayTE.............. 257117 11 6101 6 97 12 477 142703 4 24 116 23
Alachua................1 6 1 0 0 54 8 2 25 82 166 1 13 21 30
Baker.................0 1 0 0 0 5 0 0 2 9 16 2 2 0 4
Bay. ****............ 0 2 0 0 0 53 6 0 12 49 103 4 24 16 23
Bradford ............. 2 0 0 0 11 1 0 7 20 44 1 3 6
Brevard ..... .. 2 1 2 1 0 56 7 2 24 62 172 2 13 21 27
Broward ........... 11 5 0 0 360 28 10 73 195 709 18 78 66 85
Calhoun.............. 1 0 0 0 0 6 0 0 0 19 18 1 1 4 3
Charlotte ............ 1 0 0 0 0 18 2 0 4 19 33 0 2 2 3
Citrus............. .. 0 0 0 0 0 11 0 0 0 14 42 1 1 3 3
Clay................. 1 0 0 0 0 14 1 0 9 16 34 0 7 7 5
Collier............... 0 0 0 0 12 0 0 4 11 26 4 2 6 3
Columbia............ 1 1 0 0 0 22 2 0 6 44 47 0 5 8 6
Dade................ 7 57 25 3 1 1,218 97 12 210 642 2,658 57 232 197 199
DeSoto. ............ 0 1 0 0 0 20 3 0 5 22 46 5 5 1 5
Dixie ............... 0 0 0 0 0 7 1 0 5 10 11 1 2 3 6
Duval ............... 2 44 19 1 0 531 35 12 108 440 1,046 37 136 90 147
Escambia............ 10 0 0 133 14 2 54 141 392 11 31 42 67
Flagler............... 2 0 0 0 0 8 2 0 1 8 9 3 3 1 7
Franklin............. 0 0 0 1 0 8 1 1 0 10 18 0 2 1 8
Gadsden............. 3 3 0 0 0 37 0 1 25 46 107 7 14 10 17
Gilchrist .............. 0 0 0 0 2 0 0 0 3 9 0 0 2 1
Glades............... 0 0 0 0 0 1 0 0 0 2 12 1 1 0 1
Gulf ................. 1 1 0 0 0 6 1 0 1 2 14 1 2 0 4
Hamilton............. 1 2 1 0 0 15 4 0 2 10 33 1 1 1 4
Hardee........ ...... 0 1 1 0 0 17 4 0 7 10 38 1 7 3 6
Hendry ............. 0 0 1 0 0 3 0 0 1 6 23 0 3 3 0
Hernando ............ 0 1 1 0 0 17 2 0 5 14 27 2 4 4 4
Highlands............ 1 1 0 0 0 25 1 0 5 29 64 9 9 1 13
Hillsborough.......... 20 13 0 0 518 39 10 73 300 1,265 33 86 70 120
Holmes. ............. 0 1 0 0 0 20 1 1 1 18 33 1 3 4 9
Indian River.......... 1 2 1 1 0 26 5 2 3 22 69 2 8 10 7
Jackson.............. 1 1 0 0 0 22 1 1 9 45 87 4 10 12 19
Jefferson ............. 0 1 0 0 0 14 2 1 5 22 42 0 4 3 3
Lafayette ........... 0 0 0 0 0 3 0 0 2 2 12 0 1 2 2
Lake.............. ..... 2 4 1 0 0 83 14 1 21 68 226 7 14 22 25
Lee.................. 1 2 3 0 0 65 5 2 12 50 132 1 16 14 11
Leon................. 0 2 1 1 61 14 1 19 74 136 4 19 11 22
Levy ............... 1 0 1 0 0 8 1 0 12 17 63 1 2 3 5
Liberty................ 0 0 0 0 2 0 0 0 0 6 1 1 1 0
Madison ............. 0 0 0 0 23 4 0 7 16 53 1 3 4 9
Manatee............. 2 1 1 0 108 7 1 20 96 273 12 23 8 19
Marion.............. 1 1 2 0 0 72 5 2 13 65 189 6 17 13 19
Martin............... 0 1 0 0 0 15 0 0 10 18 42 0 4 4 11
Monroe ............. 1 2 0 0 0 59 4 0 8 39 78 1 5 13 14
Nassau................ 2 2 0 0 0 13 2 1 3 13 37 0 4 7 5
Okaloosa............. 0 2 0 0 0 23 1 1 14 27 74 5 0 17 30
Okeechobee........... 0 0 0 0 0 9 1 0 0 5 6 1 0 4 0
Orange .............. 2 13 7 0 0 272 19 2 54 223 726 22 63 46 72
Osceola................ 0 0 0 0 25 4 3 9 37 117 2 6 3 4
PalmBeach.......... 2 12 0 1 1 330 34 3 45 211 677 13 59 78 71
Pasco................ 0 1 1 0 0 46 6 0 7 50 123 2 16 10 25
Pinellas. ............. 3 13 7 0 1 763 47 7 92 651 1,833 24 171 55 100
Polk................. 1 8 7 0 0 227 23 1 57 218 527 12 34 46 65
Putnam.............. 1 1 1 0 1 29 2 2 15 36 105 15 11 7 13
St.Johns.............. 1 3 1 0 0 34 1 0 11 57 81 2 21 9 19
St. Lucie............. 2 1 1 0 0 42 3 0 10 36 81 2 6 15 19
Santa Rosa........... 0 2 0 0 0 20 1 0 8 21 70 4 3 7 3
Sarasota. ............. 3 3 0 0 136 9 2 17 70 272 5 25 13 32
Seminole............. 0 3 0 1 1 46 10 1 25 44 129 10 6 17 22
Sumter .............. 0 0 0 0 15 1 1 6 20 42 2 6 5 4
Suwannee............ 0 1 1 0 0 16 1 2 1 35 53 2 8 5 4
Taylor............... 0 0 1 0 0 6 0 1 4 20 25 0 3 4 4
Union .............. 1 0 0 0 6 1 3 5 15 1 2 5 0
Volusia .............. 2 7 1 0 0 235 26 4 37 173 571 15 61 36 49
Wakulla.............. 0 0 0 0 0 3 0 0 0 4 8 0 7 1 3
Walton................ 0 0 1 0 0 23 2 0 3 17 50 2 5 9 7
Washington.......... 0 0 0 0 0 13 1 1 9 18 27 1 4 3 5

86 ANNUAL REPORT, 1958

TABLE 12

MARRIAGES BY RACE, DIVORCES, AND ANNULMENTS

FOR FLORIDA, AND EACH COUNTY, 1958

MARRIAGES
COUNTY --Divorces Annulments
Total White Non-white
STATE.................... 34,569 28,192 6,377 17,418 186
Alachua.................... 441 298 143 117 1
Baker...................... 43 33 10 127 2
Bay ....................... 522 439 83 223 2
Bradford ................... 86 60 26 145 3
Brevard.................... 596 479 117 599 3
Broward.................. 2,081 1,634 447 862 6
Calhoun............... ..28 25 3 30
Charlotte................... 94 82 12 49 1
Citrus...................... 73 57 16 61
Clay....................... 113 96 17 75 1
Collier ..................... 143 128 15 39
Columbia................... 157 129 28 84
Dade...................... 7,509 6,471 1,038 4,071 56
DeSoto .................... 139 117 22 31 1
Dixie....................... 25 23 2 14
Duval ..................... 2,381 1,836 545 1,268 9
Escambia .................. 1,270 981 289 732 16
Flagler..................... 59 40 19 193
Franklin ................... 45 36 9 25
Gadsden ................... 189 73 116 45
Gilchrist................... 47 42 5 7
Glades...................... 29 16 13 7
Gulf........................ 84 64 20 26
Hamilton.................. 42 29 13 17
Hardee .................... 153 137 16 277 5
Hendry..................... 128 99 29 37
Hernando.................. 123 101 22 37
Highlands.................. 166 132 34 85
Hillsborough................ 3,049 2,571 478 1,540 6
Holmes.................... 99 85 14 48
Indian River ............... 211 168 43 28
Jackson..................... 187 138 49 61
Jefferson................... 71 34 37 18
Lafayette................... 21 18 3
Lake....................... 427 328 99 821 11
Lee........................ 376 316 60 159
Leon....................... 408 266 142 228 4
Levy....................... 70 39 31 24
Liberty..................... 8 7 1 9
Madison.................... 53 36 17 31
Manatee.................... 457 385 72 105
Marion .................... 327 225 102 102 1
Martin..................... 142 106 36 26
Monroe.................... 436 384 52 222 2
Nassau .................... 76 66 10 20
Okaloosa................... 312 281 31 235 3
Okeechobee................. 52 49 3 25
Orange..................... 1,768 1,477 291 221 3
Osceola..................... 242 192 50 14
Palm Beach ................ 1,640 1,285 355 654 5
Pasco...................... 296 271 25 125 3
Pinellas.................... 2,399 2,096 303 911 8
Polk....................... 1,467 1,188 279 615 12
Putnam.................... 201 154 47 254 1
St. Johns................... 254 193 61 325 8
St. Lucie. ................... 332 212 120 136 1
Santa Rosa ................. 178 160 18 67 4
Sarasota.................... 510 452 58 262 3
Seminole................... 342 217 125 117 1
Sumter .................... 99 73 26 90 1
Suwannee................... 90 75 15 46
Taylor..................... 100 85 15 24
Union..................... 37 28 9 84
Volusia .................... 874 716 158 426 3
Wakulla ................... .. 37 27 10
W alton .................... 84 73 11 37
Washington................. 71 59 12 25

VITAL STATISTICS 87

TABLE 13

BASED ON PROMPTNESS AND COMPLETENESS OF
VITAL STATISTICS SCOREBOARD
CERTIFICATES FILED IN 1958
Percent of Percent of
Certificates Complete Percent of Total Score Change
COUNTY Rank Filed on Time Certificates Monthly (Maximum from 1957
---- Reports =500) Total Score
Submitted
Births Deaths Births Deaths on Time
Baker................ 1 100.0 100.0 99.4 100.0 100.0 499.4 0.6
Martin............... 2 99.4 100.0 100.0 98.8 100.0 498.2 + 3.2
Wakulla............... 3 98.1 100.0 100.0 100.0 100.0 498.1 + 8.1
Orange ............... 4 98.8 99.2 100.0 99.8 100.0 497.8 + 1.8
Hillsborough .......... 5 97.6 99.6 100.0 99.9 100.0 497.1 + 7.1
Citrus................. 6 96.9 100.0 100.0 100.0 100.0 496.9 + 2.9
Dade. .............. 7 97.4 99.7 99.9 99.7 100.0 496.7 + 4.7
Broward.............. 8 97.7 99.8 99.6 99.3 100.0 496.4 +11.4
Sarasota.............. 9 99.6 99.4 99.2 98.1 100.0 496.3 + 0.3
Jefferson ............. 10 99.6 98.9 99.6 97.9 100.0 496.0 0
Hernando............. 11 98.3 100.0 99.4 98.2 100.0 495.9 + 6.9
Volusia............... 12 97.0 98.3 99.4 99.4 100.0 494.1 + 3.1
St. Lucie............ 13 98.1 96.8 99.6 99.5 100.0 494.0 + 4.0
Semmole.............. 14 95.6 99.7 99.7 98.6 100.0 493.6 + 2.6
Franklhn.............. 15 95.3 98.5 98.7 100.0 100.0 492.5 + 7.5
Duval................ 16 94.3 99.0 99.7 99.4 100.0 492.4 +22.4
Suwannee ............ 17 96.9 93.8 99.7 99.2 100.0 489.6 + 2.6
Osceola............... 18 95.3 96.0 99.2 98.9 100.0 489.4 + 7.9
Gulf.................. 19 93.4 98.4 98.3 98.4 100.0 488.5 + 7.5
Nassau................ 20 94.6 96.3 98.3 99.1 100.0 488.3 +19.3
Pinellas.............. 21 95.7 99.0 99.9 99.8 91.7 486.1 5.9
Madison.............. 22 90.2 100.0 97.0 97.8 100.0 485.0 +11.0
St.Johns.............. 23 97.0 97.1 99.3 99.7 91.7 484.8 +14.8
Manatee............. 24 97.4 97.7 98.9 99.1 91.7 484.8 +22.8
Clay................. 25 92.2 94.6 98.6 98.4 100.0 483.8 +12.8
STATE.......... 92.3 97.0 99.6 99.4 93.2 481.5 + 5.5
DeSoto............... 26 99.3 99.6 100.0 99.2 83.3 481.4 +27.4
Walton................ 27 95.0 87.1 99.7 99.3 100.0 481.1 + 5.1
Polk ................ 28 92.9 97.0 99.8 99.5 91.7 480.9 1.1
Okeechobee ........... 29 92.8 90.2 97.6 100.0 100.0 480.6 -12.4
Gilchrist.............. 30 88.2 91.7 100.0 100.0 100.0 479.9 3.1
Highlands ............ 31 86.7 95.1 99.6 98.4 100.0 479.8 +15.8
Palm Beach............ 32 82.9 96.7 99.7 99.6 100.0 478.9 + 7.9
Hardee............... 33 96.6 98.9 100.0 100.0 83.3 478.8 -16.2
Levy................. 34 92.8 89.8 100.0 94.3 100.0 476.9 5.1
Charlotte............. 35 84.3 96.3 99.1 97.2 100.0 476.9 + 1.9
Putnam .............. 36 91.6 85.8 99.4 100.0 100.0 476.8 + 2.8
Alachua............... 37 93.7 91.8 99.9 99.5 91.7 476.6 +16.6
Escambia............. 38 94.5 99.2 99.7 98.6 83.3 475.3 -12.7
Gadsden.............. 39 80.1 95.1 99.3 99.4 100.0 473.9 + 5.9
Taylor............... 40 89.0 96.1 93.5 95.1 100.0 473.7 +15.7
Lake................. 41 89.4 82.3 99.5 99.7 100.0 470.9 + 2.9
Washington........... 42 85.9 88.5 98.0 98.1 100.0 470.5 -10.5
Holmes............... 43 93.4 92.2 100.0 100.0 83.3 468.9 -22.1
Flagler............... 44 84.3 100.0 97.6 100.0 83.3 465.2 -12.8
Bay................... 45 82.8 84.7 99.3 97.8 100.0 464.6 + 0.6
Monroe .............. 46 75.1 91.0 99.5 98.3 100.0 463.9 -21.1
Brevard.............. 47 89.0 93.2 99.1 99.0 83.3 463.6 + 7.6
Hamilton............. 48 91.6 80.3 98.4 100.0 91.7 462.0 -17.0
Calhoun.............. 49 89.5 85.1 96.8 95.7 91.7 458.8 -11.2
Pasco ................ 50 84.1 93.8 96.7 99.4 83.3 457.3 + 1.3
Dixie................. 51 64.4 93.0 97.8 100.0 100.0 455.2 +12.2
Santa Rosa............ 52 89.9 82.7 97.8 100.0 83.3 453.7 -18.3
Liberty ............... 53 78.6 100.0 100.0 90.9 83.3 452.8 2.2
Columbia............. 54 75.2 86.8 99.1 99.2 91.7 452.0 +29.0
Bradford............. 55 97.3 95.7 99.7 97.4 58.3 448.4 2.6
Lafayette............. 56 55.6 93.3 100.0 100.0 91.7 440.6 +62.6
Jackson.............. 57 79.2 67.9 98.6 99.6 91.7 437.0 +16.0
Glades................ 58 50.0 90.9 100.0 100.0 91.7 432.6 -27.4
Union................ 59 69.8 85.2 93.7 100.0 83.3 432.0 -30.0
Sumter............... 60 65.1 66.7 100.0 100.0 100.0 431.8 -10.2
Leon................. 61 77.9 81.4 98.9 97.8 75.0 431.0 --43.0
IndianRiver.......... 62 93.0 98.0 98.0 99.2 41.7 429.9 -11.1
Manon............... 63 63.8 84.5 97.2 98.9 83.3 427.7 -42.3
Lee.................. 64 42.3 94.7 97.0 97.6 91.7 423.3 -29.7
Okaloosa.............. 65 65.5 79.6 99.1 100.0 75.0 419.2 -12.8
Hendry.............. 66 29.6 89.8 97.2 100.0 100.0 416.6 -16.4
Collier .............. 67 51.3 90.8 98.7 98.3 75.0 414.1 + 1.1

88 ANNUAL REPORT, 1958

BUREAU OF MATERNAL AND CHILD HEALTH

S. D. DOFF, M.D., M.P.H., Director
EDWARD L. FLEMMING, Ed.D., Assistant Director
VITAL STATISTICS

The responsible man needs to know in what direction his efforts
take him. It is out of such knowledge that he is able to determine what
exertions are necessary to reach a particular goal. Among those of us
responsible for community health, this knowledge comes from the collec-
tion, classification and analysis of certain facts regarding births, deaths
and illness.
A crude measure of maternal health is the maternal death rate
which represents the number of women who have died from all causes
related to pregnancy and childbirth. During 1958, 62 women died under
such circumstances, a rate of 5.7 which means that out of each 10,000
live births about six women died from complications of pregnancy or
childbirth. Ten years ago this figure was 17.5. As a result of improve-
FIGURE 1
RATE RESIDENT MATERNAL DEATH RATES (PER 10,000 LIVE BIRTHS)
BY RACE, FLORIDA, 1933- 1958

YEAR

MATERNAL AND CHILD HEALTH 89

ments in medical care during pregnancy and childbirth, 130 women did
not die in 1958. Among the 62 who died, an undertermined number
were preventable.
In 1958 there were 3416 infants who died in less than one year
from birth date, or almost 32 babies out of every 1000 born alive. Re-
gretably, we have not logged much progress in reducing infant mortality
since 1949. Further study of this data may again reveal that this is due
to our inability to prevent diseases causing death in the first month of
life. These are mainly birth deformities, birth injuries, and disease con-
ditions associated with premature birth.

Not reflected in the records of births and deaths are several hundred
infants who are born deaf, blind, brain damaged, mentally retarded or
otherwise chronically ill and who survived as a constant reminder that
greater exertion in new directions is needed.
FIGURE 2
RESIDENT INFANT DEATH RATES (PER 1,000 LIVE BIRTHS)
E BY RACE, FLORIDA, 1933- 1958

YEAR
SCHOOL HEALTH
Under state law the State Board of Health and the county health
departments share responsibility for the health of children in public
schools with our educators. It is estimated, from activity reports, that

90 ANNUAL REPORT, 1958

one-third of public health nursing time is devoted to child health, in-
cluding school health programs, pre-school examinations, immunizations,
vision and hearing screening and environmental sanitation.

The assistant director has conducted workshops on child growth
and development for teachers, school administrators, school health co-
ordinators, public health nurses and parents.

The school health program may be characterized as a "parent
awareness" program, supplementary to, but not a substitute for, the total
health care parents should provide. There is much misunderstanding on
the part of parents, school board members and county school superin-
tendents regarding the legal responsibility of county health departments
in school health matters. It is important also that agencies which have
a legal and moral responsibility for the health of children in schools
understand the goals of the various screening tests which are carried out
in schools, as well as their limitations. We must be aware always that
the newest testing devices are but supplemental to time-honored methods
of ensuring the health of school children, such as teacher and public
health nurse observation followed by examination in the office of the
family physician whenever possible. This bureau and county health de-
partments are continually seeking improved methods of health screening
in the schools.

The health coordinators, (teachers) in schools are finding a firmer
footing. In accordance with accreditation regulations of the State De-
partment of Education, a faculty member is now designated as School
Health Coordinator in each school in the state. These teachers serve as
chairmen of faculty committees charged with the responsibility of giving
continuous attention to the school health program. Such committees
working with county health departments should produce many improve-
ments in our school health program statewide.

MATERNAL HEALTH
The midwife program of the Division of Public Health Nursing is
reported separately. It is mentioned here because midwife supervision
must be credited with a very important assist in reducing our maternal
death rate, now the lowest ever attained in Florida. Midwife super-
vision, of course, consists mainly of regular prenatal visits to county
health departments where physicians provide periodic examinations of
expectant mothers in order to detect evidence of complications which
would make midwife attendance inadvisable. In addition, our nurse-
midwife consultant continually provides opportunities for in-service edu-
cation of licensed midwives.

Hospital services for deliveries and complications of pregnancy
made available from funds provided for hospitalization of the indigent
probably saved additional lives.

MATERNAL AND CHILD HEALTH 91

DEMONSTRATION PROGRAM ON CARE OF
PREMATURE INFANTS
Premature births and associated conditions represent one of the
chief causes for persistence of a high infant death rate. The establish-
ment of a Demonstration Center was made possible in 1950 by a special
grant of funds from the U. S. Children's Bureau. The demonstration
program has now reached maturity and is not only providing the best
possible care for premature infants, in the Miami area, but also post-
graduate courses for physicians and nurses at the Center and crossroads
demonstration clinics.

Two five-day Seminars were held at the Premature Demonstration
Center, Jackson Memorial Hospital, Miami with 70 nurses and 11 phy-
sicians registered. Two one-day demonstrations were presented by a
physician-nurse team at Fort Myers and Fort Pierce. One hundred and
fifty nurses and 19 physicians attended.

During the year incubators were assigned to counties where they
were urgently needed.

Two hundred and seventy-three premature infants from Dade
County, 27 from Broward County and 16 from Palm Beach County were
received at the Premature Demonstration Center. Children's Bureau
funds ($50,000) was provided to defray the cost of hospitalization.

For the first time, funds made available under state laws providing
hospital services for the acutely ill indigent have been used to pay for
the hospitalization of special cases of premature infants.

MENTAL RETARDATION
Among newborn babies there are an estimated 3.4 per cent who
will be mentally retarded. Early in medical history these unfortunate in-
dividuals succumbed from infectious diseases or from the underlying
cause of the mental retardation. Application of medical advances during
the last 20 years has resulted in their survival and the creation of a
steadily increasing load of responsibility for the community.

Seeking improved methods of providing for such individuals, the
State Board of Health, with a grant from the U. S. Children's Bureau,
has organized the Developmental Evaluation Clinic to study problems
related to mental retardation in Dade County. This study group is prov-
ing itself one of the finest teams in the nation among those which have
undertaken such studies.

Since many departments of state government provide services to
the mentally retarded, an orientation program has been planned with
the expectation that their staffs will participate. A public health nurse
working under the direction of this bureau will conduct orientation ses-

	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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