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 Cover
 Title Page
 Letter of transmittal
 Members of the Florida state board...
 Official staff Florida state board...
 Directors of county health...
 Table of Contents
 General administration
 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


PALMM UFSPEC



Annual report - State Board of Health, State of Florida
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Permanent Link: http://ufdc.ufl.edu/AM00000243/00030
 Material Information
Title: Annual report - State Board of Health, State of Florida
Series Title: Publication - Florida. State Board of Health
Physical Description: v. : ill., ports. ; 23-29 cm.
Language: English
Creator: Florida -- State Board of Health
Florida -- State Board of Health
Publisher: State Board of Health.
Place of Publication: Jacksonville Fla
Creation Date: 1960
Frequency: annual
regular
 Subjects
Subjects / Keywords: Public health -- Periodicals -- Florida   ( lcsh )
Genre: government publication (state, provincial, terriorial, dependent)   ( marcgt )
serial   ( sobekcm )
 Notes
Dates or Sequential Designation: Ceased in 1968.
Numbering Peculiarities: Report year for 1893/94 ends Mar. 31; for 189<7>-1968, Dec. 31.
Numbering Peculiarities: Reports for 1923-32 combined in one issue.
General Note: Reports for 1910-<17> issued as its Publication.
 Record Information
Source Institution: Florida A&M University (FAMU)
Holding Location: Florida A&M University (FAMU)
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 01569394
lccn - 07039608
System ID: AM00000243:00030
 Related Items
Succeeded by: Annual report - Division of Health, Department of Health and Rehabilitative Services, State of Florida

Table of Contents
    Cover
        Cover
    Title Page
        Page i
    Letter of transmittal
        Page ii
        Page iii
    Members of the Florida state board of health
        Page iv
    Official staff Florida state board of health
        Page v
    Directors of county health departments
        Page vi
    Table of Contents
        Page vii
    General administration
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
        Page 12
        Page 13
        Page 14
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
        Page 24
    Division of health information
        Page 25
        Page 26
        Page 27
    Bureau of local health services
        Page 28
        Page 29
        Page 30
        Page 31
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
        Page 45
        Page 46
        Page 47
        Page 48
        Page 49
        Page 50
        Page 51
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
        Page 57
        Page 58
        Page 59
        Page 60
        Page 61
        Page 62
        Page 63
        Page 64
        Page 65
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
    Bureau of vital statistics
        Page 73
        Page 74
        Page 75
        Page 76
        Page 77
        Page 78
        Page 79
        Page 80
        Page 81
        Page 82
        Page 83
        Page 84
    Bureau of maternal and child health
        Page 85
        Page 86
        Page 87
        Page 88
        Page 89
        Page 90
        Page 91
        Page 92
        Page 93
        Page 94
        Page 95
    Bureau of preventable diseases
        Page 96
        Page 97
        Page 98
        Page 99
        Page 100
        Page 101
        Page 102
        Page 103
        Page 104
        Page 105
        Page 106
        Page 107
        Page 108
        Page 109
        Page 110
        Page 111
        Page 112
        Page 113
        Page 114
        Page 115
        Page 116
        Page 117
        Page 118
        Page 119
        Page 120
        Page 121
        Page 122
        Page 123
        Page 124
        Page 125
        Page 126
        Page 127
        Page 128
        Page 129
        Page 130
        Page 131
        Page 132
        Page 133
        Page 134
        Page 135
        Page 136
        Page 137
        Page 138
        Page 139
    Bureau of laboratories
        Page 140
        Page 141
        Page 142
        Page 143
        Page 144
        Page 145
        Page 146
        Page 147
        Page 148
        Page 149
        Page 150
        Page 151
        Page 152
        Page 153
        Page 154
    Bureau of special health services
        Page 155
        Page 156
        Page 157
        Page 158
        Page 159
        Page 160
        Page 161
        Page 162
        Page 163
        Page 164
        Page 165
        Page 166
        Page 167
        Page 168
        Page 169
        Page 170
        Page 171
        Page 172
    Bureau of sanitary engineering
        Page 173
        Page 174
        Page 175
        Page 176
        Page 177
        Page 178
        Page 179
        Page 180
        Page 181
        Page 182
        Page 183
        Page 184
        Page 185
        Page 186
        Page 187
        Page 188
        Page 189
        Page 190
        Page 191
        Page 192
        Page 193
        Page 194
        Page 195
        Page 196
        Page 197
        Page 198
        Page 199
        Page 200
        Page 201
        Page 202
        Page 203
        Page 204
    Bureau of mental health
        Page 205
        Page 206
        Page 207
        Page 208
        Page 209
        Page 210
        Page 211
        Page 212
        Page 213
        Page 214
        Page 215
        Page 216
    Bureau of narcotics
        Page 217
        Page 218
        Page 219
        Page 220
    Bureau of entomology
        Page 221
        Page 222
        Page 223
        Page 224
        Page 225
        Page 226
        Page 227
        Page 228
        Page 229
        Page 230
        Page 231
        Page 232
        Page 233
        Page 234
        Page 235
        Page 236
    Bureau of dental health
        Page 237
        Page 238
        Page 239
        Page 240
        Page 241
        Page 242
        Page 243
    Bureau of finance and accounts
        Page 244
        Page 245
        Page 246
        Page 247
        Page 248
        Page 249
        Page 250
        Page 251
        Page 252
        Page 253
        Page 254
        Page 255
Full Text



FLOi
STATE
0
HEl


IIDA
BOARD
F
LTH


1960


ANNUAL I~ REPORT~)













State Board of Health

State of 7orieda



1960



The following statistical reports will be published separately:
SUPPLEMENT I FLORIDA VITAL STATISTICS, 1960
SUPPLEMENT II FLORIDA MORBIDITY STATISTICS, 1960

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


JACKSONVILLE, FLORIDA


RepoAt


,4"uae



















The Honorable John D. Milton, M.D., President
Florida State Board of Health
Miami, Florida


Dear Dr. Milton:

I herewith submit the annual report of the Florida
State Board of Health for the year ending December 31,
1960.

Sincerely yours,

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

May 1, 1961
Jacksonville, Florida



















His Excellency, Farris Bryant
Governor of Florida
Tallahassee, Florida


Sir:

I beg to hand you herewith a report of the Florida
State Board of Health for the period January 1, 1960, to
December 31, 1960, inclusive.

Respectfully submitted,

JOHN D. MILTON, M.D.
President

May 1, 1961
Miami, Florida




















Members of the
FLORIDA STATE BOARD OF HEALTH

JOHN D. MILTON, M.D., President
Miami

T. M. CUMBIE, Ph.G.
Quincy

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

SULLIVAN G. BEDELL, M.D.
Jacksonville

W. S. HORN, D.O.
Palmetto











OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH


December 31, 1960


DIRECTORS

State Health Officer........... ..........................Wilson T. Sowder, M.D., M.P.H.
Assistant State Health Officer..................Albert V. Hardy, M.D., Dr. P.H.
Assistant State Health Officer..................Clarence M. Sharp, M.D.
Personnel Officer........................................Miles T. Dean, M.A.
Division of Health Information...................Elizabeth Reed, R.N., B.S.
Bureau of Finance and Accounts............... .Fred B. Ragland, B.S.
Assistant Director.........................................Paul R. Tidwell, B.B.A.
Purchasing Agent .................................... G. Wilson Baltzell, B.S.
Bureau of Vital Statistics.............. .....Everett H. Williams. Jr., M.S., Hyg.
Bureau of Local Health Services....................Wilfred N. Sisk, M.D., M.P.H.
Assistant Director ...................... 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.....................James O. Bond, M.D., M.P.H.
Division of Radiological and
Occupational Health.......................... ...Edwin G. Williams, M.D.
Division of Tuberculosis Control.............Dwight J. Wharton, M.D.
Division of Epidemiology..........................James F. Molloy, M.D., Acting
Division of Veterinary Public Health.......James E. Scatterday, D.V.M., M.P.H.
Bureau of Special Health Services...............Simon D. Doff, M.D., M.P.H.
Division of Hospitals and Nursing Homes..
Division of Chronic Diseases..................James E. Fulghum, M.D., Acting
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..........Lorenzo L. Parks, M.D., M.P.H.
Assistant Director ........................................Edward L. Flemming, Ed.D.
Bureau of Mental Health.......................... Wayne Yeager, M.D., M.P.H.
Assistant Director ............ ........ ....Melvin P. Reid, Ph.D., S.M. Hyg.
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.
Division of Water Supply...........................John B. Miller, B.S., M.P.H.
Division of Waste Water.........................Ralph H. Baker, Jr., M.S.S.E.
Bureau of Narcotics....................................Frank S. Castor, Ph.G.











DIRECTORS OF COUNTY HEALTH DEPARTMENTS

(As of December 31, 1960)


Alachua............................. .........................Edward G. Byrne, M.D., M.P.H.
Bay.....................................................................A. F. Ullman, M.D.
Brevard......................................................... Albert Rossi, M.D.
Broward.........................................................Paul W. Hughes, M.D., M.P.H.
Collier......................... .................. Clarence R. Pearson, M.D.
Dade.................................................T. E. Cato, M.D., M.P.H.
Duval................................ ...................... Thomas E. Morgan, M.D., M.P.H.
Escambia.................................. ................... J. C. McSween, M.D.
Hillsborough..........................................John S. Neill, M.D., M.P.H. (Acting)
Jefferson.................................................... Thomas S. Englar, M.D., M.P.H.
Lake... ................... .......... ------................ Basil Hall, M.D., M.P.H.
Lee............................. .............................Joseph W. Lawrence, M.D.
Leon.......................... ..... ............ Joseph M. Bistowish, M.D., M.P.H.
Manatee..........................................................Frederick K. Allen, 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............................. .............. .......W. N. Sisk, M.D., M.P.H. (Acting)
Palm Beach......................................................C. L. Brumback, M.D., M.P.H.
Pinellas.........................................................William C. Ballard, M.D., M.P.H.
Polk ........-.............------------- ..----- .-- Chester L. Nayfield, M.D., M.P.H.
St. Johns..........................................................Charles L. Newberry, M.D.
Santa Rosa..............................----------...... -- A. E. Harbeson, M.D.
Sarasota------................................ ----- William L. Wright, M.D., M.P.H.
Seminole...................................................... Clyde L. Brothers, M.D.
Volusia.......................................................D. V. Galloway, M.D., M.P.H.
Baker-Nassau...................................................James C. Loranger, M.D.
Calhoun-Jackson.........................................Terry Bird, M.D., M.P.H.
Flagler-Putnam..................................................James R. Sayers, M.D.
Gadsden-Liberty.............................................B. D. Blackwelder, M.D., M.P.H.
Madison-Taylor................................................Charles L. Mattes, Jr., M.D.
Osceola-Indian River.......................................C. C. Flood, M.D., M.P.H.
Pasco-Sumter...................................................Charles E. Gill, M.D., M.P.H.
Bradford-Clay-Union......................................A. Y. Covington, M.D., M.P.H.
Charlotte-DeSoto-Hardee...............................E. J. McLaughlin, M.D.
Citrus-Hernando-Levy..................................... Harold F. Bonifield, M.D., M.P.H.
Columbia-Gilchrist-Hamilton......... ............W. N. Sisk, M.D., M.P.H. (Acting)
Franklin-Gulf-Wakulla............. ...................Henry I. Langston, M.D., M.P.H.
Glades-Hendry-Highlands................................Raymond P. Srsic, M.D.
Holmes-Walton-Washington.............................W. N. Sisk, M.D., M.P.H. (Acting)
Martin-Okeechobee-St. Lucie..........................Neill D. Miller, M.D.
Suwannee-Dixie-Lafayette................................J. Harland Paul, M.D., M.P.H.









TABLE OF CONTENTS
Page
General Administration (including Activities of the Board,
Research Coordination, Scholarships, Personnel and Gen-
eral Data Processing Unit) ..................................................... ...... 1

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

Bureau of Local Health Services (including Divisions of Public
Health Nursing and Sanitation; Nutrition Services).................... 28

Bureau of Vital Statistics ........................................................................ 73

Bureau of Maternal and Child Health .........................................-.. 85

Bureau of Preventable Diseases (including Divisions of Epide-
miology [Venereal Disease Control], Radiological and Occu-
pational Health, Tuberculosis Control and Veterinary Public
H health) .................................... ............................ ............................ 96

Bureau of Laboratories ............................................................................ 140

Bureau of Special Health Services (including Division of Hos-
pitals and Nursing Homes; Accident Prevention Program;
Civil Defense; Division of Chronic Diseases: Cancer, Dia-
betes, Heart; Hospital Services for the Indigent Program) ..-.... 155

Bureau of Sanitary Engineering (including Shellfish and
Crustacea Program; Bedding Act Administration; Polk-
Hillsborough County Air Pollution Control District; Divi-
sions of Waste Water and Water Supply) .................................... 173

Bureau of Mental Health (including Florida Council on Train-
ing and Research in Mental Health) ............................................ 205

Bureau of Narcotics .................................................................. 217

Bureau of Entomology (including Entomological Research
Center) .................... ..................--------------- .. ................ .................... 221

Bureau of Dental Health ........................................................................ 237

Bureau of Finance and Accounts (including Purchasing and
Property) ............................................................................................ 244








GENERAL ADMINISTRATION 1

W. T. SOWDER, M.D., M.P.H., State Health Officer
A. V. HARDY, M.D., Dr. P.H., Assistant State Health Officer
C. M. SHARP, M.D., Assistant State Health Officer

ADMINISTRATIVE ORGANIZATION
The organizational chart (Fig. 1) of the Florida State Board of
Health summarizes plans for the administration of public health services
in Florida. The 5-member Board, the State Health Officer and members
of major advisory committees or councils are usually designated by the
Governor or by the Board for specified periods. The Board, for which
the State Health Officer serves as secretary, with the advice of advisory
committees and councils, carries the authority for the establishment of
policy. The responsibility for administrative operation rests with the State
Health Officer, with the aid of 2 assistant state health officers, 2 attorneys
(1 part-time), an auditor and 2 analytical assistants. The Bureau of
Finance and Accounts, the Division of Health Information, the Personnel
Office and the General Data Processing Unit serve also as essential com-
ponents in the general administrative program.
Four of the 7 advisory committees or councils relate closely to pro-
grams conducted by 'specific bureaus. Their deliberations are described
with the work of the bureau concerned. The provision of medical and
dental scholarships and training stipends recommended by the Council
on Training and Research in Mental Health is considered as a part of
the administrative program of the State Health Officer.
Administrative operation is guided and determined by the policy
decisions of the State Board of Health. Following the record of the
actions of the Board in 1960, there is a general description of the ad-
ministrative actions involved in carrying out the policies of the Board
and guiding the work of the total State Board of Health.
ADMINISTRATIVE OPERATION
Administrative operation centers in the office of the State Health
Officer. The day-after-day activity involves voluminous correspondence
averaging some 15 letters a day to outside agencies, plus many memo-
randa to the directors of bureaus and divisions and to county health
departments. There are numerous telephone calls involving consultations
on local, state and national problems. Some of those brought to the
attention of the State Health Officer in correspondence, consultation or
conference may be assigned to appropriate staff members for farther
study or for handling.
Much of the time of the State Health Officer is utilized in con-
ferences with staff members, county health officers, state representatives
and senators, leaders of voluntary health organizations and citizens de-
siring to be heard. There are important conferences with the budget
director and hearings with the State Budget Commission, the State Merit
System Council or Personnel Board, and with legislative committees.






Organizational Chart of the Florida State Board of Health to



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(Library) 1-

FINA CE PERSONNEL
AND ACCOUNTS OFFICE 0


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L O ITOR ITR L LOCAL HEALTH ATE UEU OF
H E AL T II ( a e Rl o nal I -G IN E E R I N G H AL T H S E R V IC E S A N D C H I L D ( R e se- h RCe n t er P R E E N T A B L E D E N T L
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SC"IIETER SUPPLO L00.o. orD In orII. .II D.


67 County Health Departments








GENERAL ADMINISTRATION


There are the contacts with the Office of the Governor. In these ad-
ministrative activities requiring the attention of the State Health Officer,
staff assistance as needed, is provided by those most familiar with the
problem at hand.
During the year, decisions as to the best assignment for senior per-
sonnel were required. Dr. Lynn Parks was designated as director of the
Bureau of Maternal and Child Health, Dr. Simon Doff as director of
the Bureau of Special Health Services, Dr. Wilfred Sisk as director of the
Bureau of Local Health Services, and Dr. Wade Stephens as director of
the Kellogg Project. In each instance, a re-assignment was involved. The
best arrangement for specific programs received detailed study. The
organization of the radiological health work, for example, was carefully
examined by staff with consultive assistance. There resulted a more
specific assignment of responsibility to the Division of Radiological and
Occupational Health, the Bureau of Sanitary Engineering and the
Bureau of Laboratories. During the year, also, the operation of the
Hospital Service for the Indigent Program received substantial attention
by the State Health Officer and his staff. For a portion of the year, this
program was operated under the immediate direction of the State Health
Officer aided by an Assistant State Health Officer (Dr. C. M. Sharp).
Two health emergencies occurred during the year. The extensive
damage caused by Hurricane Donna resulted in a disruption of sanitary
facilities and health services which required immediate action. Staff
members were assigned specific functions in the early rehabilitation
period. The influx of Cuban refugees to south Florida also received
emergency attention. Funds were re-allocated to provide for special
clinic services and to make it possible to employ a professional Cuban staff
to minister to the medical and health needs of their own people. Though
initiated on an emergency basis, it has become apparent that this will be
a continuing need.
The State Health Officer and/or assigned representatives attended
the various advisory committees and councils. These meetings ordinarily
involved preparation by staff of detail data for consideration. The State
Health Officer attended scientific meetings in an official capacity, includ-
ing the American Public Health Association, the American Medical
Association, Florida Medical Association, the Florida Public Health
Association, the American Association of Public Health Physicians, the
National Health Council and the State and Territorial Health Officers'
Association. The State Health Officer, during 1960, served as president
of the Association of State and Territorial Health Officers, continued
his service as a member of the Executive Board of the American Public
Health Association, was a delegate at large to the National Health
Council serving as a member of its Medical Care Committee, he was
elected as chairman of the Section of Preventive Medicine of the Ameri-
can Medical Association and in the Public Health Service was a member
of the Board of Editors of Public Health Reports and a consultant on
chronic diseases and the health of the aged. He carried international








4 ANNUAL REPORT, 1960

responsibility also, serving during the year as a member of the U. S.
Delegation to the annual meeting of the World Health Organization in
Geneva, Switzerland.
The Assistant Health Officers, in addition to aiding the State
Health Officer as requested in the study of many problems, each are
designated specific areas of responsibility. One (A. V. Hardy, M.D.)
serves concurrently as coordinator of research, coordinator of training
and provides leadership to studies of program development and evalua-
tion. In the latter the major portion of the detailed work is carried by
the staff of the Kellogg Project. He also has responsibility for the plan-
ning of regular staff meetings. The other (C. M. Sharp, M.D.) serves
as director of the General Data Processing Unit, assists in the administra-
tion of the Hospitalization for the Indigent Program and, for a portion
of the year, was acting director of the Bureau of Local Health Services.
In part, the administrative work is carried by committee action.
During the year, a Budget Committee was designated, composed of the
Assistant State Health Officers and the director of the Bureau of Finance
and Accounts. These 3 devoted many hours to consultation with bureau
and division directors. The budget, as finally presented and approved
by the Board of Health, was the product of the estimate of needs by the
program directors, and the recommendation of the Budget Committee,
modified by decisions of the State Health Officer. Committees were
designated also to select trainees to be recommended for support during
an academic year of graduate study. In a less formal committee struc-
ture, the development of research involved group consultation and
planning.
For a number of the administrative problems, legal advice and
assistance is required. For this purpose, the service of 1 part-time and
1 full-time attorney is available. The year 1960 was the first in which
the latter was available to provide general legal assistance. He joined
the Board of Health in December 1959. The first 3 months he spent in
local county health departments becoming fully familiar with the nature
of their organization and problems. Additional time was required to be-
come orientated to the varying problems of the different bureaus and
divisions. Throughout the year, the service of the attorneys has been
requested in the handling of a variety of problems, chiefly in the
county health departments, the Bureau of Sanitary Engineering, the
Bureau of Entomology, the Division of Sanitation and the Division of
Hospitals and Nursing Homes. During the latter part of 1960, legal
advice was provided in the field of air pollution and radiological health.
To a lesser extent, the resident attorney provided guidance and advice
in other administrative problems.
The internal auditor serves under the immediate direction of the
State Health Officer. It is his major responsibility to assure that all
financial matters are handled in conformity with state law and regulation.
To this end, he conducts administrative reviews of financial records to
determine that the actions of the bureaus, divisions and county health








GENERAL ADMINISTRATION


departments are being carried out in accordance with the policies and
procedures established by the State Board of Health, as well as with
state and local laws. He serves in an advisory capacity to the directors
of bureaus, divisions and county health departments on matters relating
to budget, fee collections, internal control, purchasing, property control,
the development and amendment of procedures manuals and other
financial management matters.
A health program analyst assists the State Health Officer in a staff
capacity with a wide variety of problems. During the past year, for
example, he assisted in developing a group life insurance program which
already is proving of substantial benefit to State Board of Health and
County Health Department employees. He aided in extending the benefits
of Blue Cross to our employees. He worked with representatives of the
Florida Medical Association in further defining and developing medical
care programs of mutual interest and concern. In response to need, he
cooperated with particular program directors, as, for example, in de-
veloping a proposal to encourage churches to assume greater responsibility
for the provision of services to the aged. He represented the State
Board of Health on a State Milk Commission and provided staff assis-
tance to the State Medical Advisory Committee. He gave major attention
to legislative matters, aiding in reviewing and drafting bills and, more
importantly, in effectively explaining these to state representatives and
senators.
An additional member of the administrative staff, with a broad
background in reporting and writing, assists with publicity related to
administration, such as meetings of the State Board of Health. In addi-
tion to other staff responsibilities, she serves as historian. The American
Public Health Association has urged that all State Health Departments
maintain historical records of public health in their individual states,
and accumulate past historical data of significance. Prior to this, a com-
mittee, of which the State Health Officer was chairman, had functioned
in drawing together a history of the Florida Public Health Association.
This already has been distributed to the members of the Association
and others interested. The ongoing activities of the historian is to extend
the historical research through drawing together information from pri-
vate, public and institutional libraries and through interviews with indi-
viduals or their relatives who played important roles in the development
of public health in Florida. This material is being filed preparatory to
publishing a historical record illustrated with material either owned,
loaned or donated to the State Board of Health. A part of that already
collected has been prepared as an exhibit and was shown at the meeting
of the Florida Public Health Association in 1960 and, on request, will be
shown at the Southern Branch of the American Public Health Associa-
tion. Thus, the heritage from the pioneer public health workers in
Florida, to those presently in public health, is recorded and is being
used.








6 ANNUAL REPORT, 1960


ACTIVITIES OF THE BOARD
There were no changes in the personnel of the Board during the
year 1960. Five meetings were held and the dates, places and the major
items of business transacted were as follows:
February 9-Jacksonville
1. Adopted amendments to the Rules and Regulations governing
administration of the Indigent Hospitalization Program.
2. Adopted rules or procedure for hearings in connection with the
Hospital Licensure Program.
3. Adopted a minor amendment to Chapter VIII of the Sanitary
Code.
4. Heard representatives of the Florida Optometric Association
concerning screening and referral of school children for eye
defects.
5. Adopted regulations for the control of toxic pesticides.
6. Adopted amendments and new rules pertaining to the Struc-
tural Pest Control Program.
7. Approved the employment of an architect to draw plans for a
laboratory building for the Entomological Research Center at
Vero Beach.
8. Met with the county health officers and heard their problems.
9. Reviewed the report of the State Auditor.
10. Approved a group insurance plan for employees and authorized
the State Health Officer to enter into an agreement with the
insurance company on this matter.
11. Approved agency membership by the State Board of Health
in the American Public Health Association.
12. Decided to adhere to a long standing policy against the free
distribution of scientific literature and periodicals to physicians.
13. Confirmed previous oral approval of a project on oral polio vac-
cine in Dade County.
14. Approved a proposed trip by Dr. Sowder, the State Health
Officer, to Geneva, Switzerland as a member of the U. S.
Delegation to the World Health Assembly meeting, May 3-
20.

March 26-27-Entomological Research Center, Vero Beach

1. Heard explanations of the work of the Center given by Mr. John
Mulrennan, director of the Bureau of Entomology, State Board
of Health, and by Dr. Maurice Provost, director of the Ento-
mological Research Center.








GENERAL ADMINISTRATION 7

2. Following this, the Board spent the afternoon of March 26 tour-
ing the building and grounds and hearing staff members.
3. On March 27 the Board adopted revised regulations for the
Cancer Control Program.
4. Approved rules and regulations submitted to the Board by the
State Board of Beauty Culture except for 1 minor item.
5. Confirmed a long standing policy to the effect that death rec-
ords in the Bureau of Vital Statistics should be considered con-
fidential.
6. Approved changes in Chapter XX of the Sanitary Code and
also adopted a new section, Chapter XXXV, of the Sanitary
Code.
7. Designated Albert V. Hardy, M.D., as Acting State Health
Officer during Dr. Sowder's absence in Europe, April 14-
May 23.
8. Approved certain persons (listed elsewhere) for postgraduate
training in public health during the academic year 1960-61.

June 19-Jacksonville

1. Adopted revision to Chapter XVI of the Sanitary Code on
trailer camps.
2. Decided that cancer patients should continue to be hospitalized
under the general program for the hospitalization of all types of
indigent persons and that the State Board of Health should not
seek separate funds for the hospitalization of cancer patients.
3. Heard a brief report by Dr. Hardy on the oral vaccine project
in Dade County.
4. Decided not to use an Advisory Committee on Nursing Home
Licensure at the present time.
5. Discussed a financial crisis in connection with the Indigent Hos-
pitalization Program and approved a plan to hold a meeting
with the county commissioners on this subject.
6. Approved plans for shifting certain key staff members within the
organization.
7. Heard a report from the Chairman of the Air Pollution Control
Commission and discussed air pollution control problems.
8. Adopted revisions of the Toxic Pesticide Regulations.
9. Authorized the State Health Officer to accept the low bid for
the construction of the laboratory building at Vero Beach.
10. Approved the placement of responsibility for enforcement of the
amended law on Food, Drugs, and Cosmetics in the Bureau of
Narcotics.








8 ANNUAL REPORT, 1960


11. Authorized Dr. Doff through the Bureau of Maternal and
Child Health to spend up to $2000 of funds available from the
U.S. Children's Bureau for the purchase of Lofenalac. This
special food is used to prevent mental retardation in certain
cases.
12. Approved the assumption by Dr. Brumback, Health Officer of
Palm Beach County, of broader duties including certain welfare
functions and the administration of outpatient clinics for medi-
cally indigent persons, administration of the county hospitals,
etc.

August 27-Jacksonville

1. Approved basic rules for the State Board of Health's participa-
tion in seminars developed by Dr. Sharp.
2. Approved the appointment of Wilfred Sisk, M.D., as director
of the Bureau of Local Health Services.
3. Approved a proposed budget submitted by Dr. Sowder for the
Biennium 1961-63.
4. Reiterated a long standing policy not favoring the supplementa-
tion of salaries of employees and adopted a resolution to this
effect.

November 19-Dade County Health Department, Miami

1. Toured the Dade County Department of Public Health and the
Regional Laboratory of the State Board of Health.
2. Heard explanations of work by staff members of the Dade
County Department of Public Health and by the State Board
of Health's Regional Laboratory and regional personnel of the
Bureau of Narcotics.
3. Discussed in some detail a recently passed federal bill to aid the
states in the medical care of the aged. This bill is known as the
Mills-Kerr Bill or Public Law 86-778.
The Board instructed the State Health Officer to continue
to study this bill and to work with other state agencies and the
Legislative Council's Committee on Health and Welfare in de-
veloping appropriate plans for Florida's participation in this
program.
4. Heard a report from Drs. Milton, Cato and Sowder concerning
the Cuban refugee problem in Miami.
5. Discussed certain items of proposed legislation which were to be
developed and presented at a future Board meeting.








GENERAL ADMINISTRATION


RESEARCH COORDINATION
A. V. HARDY, M.D., Dr.P.H.
Assistant State Health Officer and
Coordinator of Research
Detailed reports on research in progress during 1960 are included
as a part of the record of the bureau or division engaged in these studies.
This is a summary report.
The Entomological Research Center in Vero Beach has continued its
highly effective studies. During the year, facilities were expanded with
the construction of a unit designed specifically to extend the studies of
control procedures. There was added attention to the development of the
related studies in Polk County. The Center received further recognition
through the designation of its director as a member of the Study Section
on Tropical Diseases and Parasitology of the National Institutes of
Health.
A major research activity of 1960 was conducted in Dade County
through the cooperation of the Health Department, the Medical Society
and the Department of Preventive Medicine of the University of Miami
Medical School. In this, the practicability of the wide-scale use of oral polio
vaccine was examined, and the efficacy of the preparation available for use
was evaluated. This investigation was under the immediate leadership of
Drs. Eugene Flipse and George Erickson. Within a period of approximately
10 weeks, oral vaccine was administered to more than 400,000 residents,
chiefly those under 40 years of age. The efficacy of the vaccine was
examined by extensive serological studies and by exacting epidemiological
observations. Though the general incidence of poliomyelitis was low in
1960, it appeared of significance that following the extensive use of
vaccine, no case of poliomyelitis occurred throughout the remaining 7
months of the year. Moreover, virological studies, which prior to the
campaign readily revealed the presence of polio virus in the community,
gave negative findings in the months following the wide administration
of the vaccine. In this study, particular attention was given to an exami-
nation of the factors which determined acceptance or rejection of a
preventive medical procedure which was made readily and freely avail-
able. Preliminary findings of this study were presented at the second
World Conference on oral polio vaccine convened by the World Health
Organization. While the evidence encourages the belief that oral polio
vaccine will be a highly effective procedure in the prevention of paralytic
poliomyelitis and enteric infections due to polio viruses, nevertheless, it
also became apparent that further progress to this end must await the
availability in the United States of a duly licensed vaccine.
The Sarasota County Health Department embarked upon studies
of an entirely different nature. It is increasingly recognized that alco-
holism is a public health problem of substantial significance. The
Florida Alcoholic Rehabilitation Program has demonstrated effectively
the role of an inpatient therapeutic program, of outpatient clinic services








10 ANNUAL REPORT, 1960

and of related educational activities. There is no experience, however, to
guide county health departments in the evolution of effective programs
for the control of chronic alcoholism. Through the year, this health
department gave substantial attention to planning a pilot control program
and investigation of this problem. With the consultative assistance of the
State Board of Health social scientist, a psychiatric social worker from
the Public Health Service, the director of the Alcoholic Rehabilitation
Program and others, plans for the investigation were evolved and pre-
sented as a project grant request to the National Institute of Mental
Health. Concurrently, a small study to provide baseline observations was
planned and initiated, supported in part by a small grant from the Flor-
ida Council on Training and Research in Mental Health. It is antic-
ipated that studies of this problem in Sarasota County will be a major
productive demonstration project for several years.
Studies in Pinellas County, looking towards the development and
evaluation of sound public health programs to meet the health needs of
the aged, have progressed satisfactorily. Of particular significance, the
community leaders are becoming increasingly aware of needs, and better
organized to satisfy them. It appears evident that the activities underway
are becoming an important ongoing service in the Pinellas County
Health Department, which undoubtedly will continue after the supple-
mentary support through a research grant is no longer available.
The second year of the investigation in Hillsborough County de-
signed to lead to the most effective means of rehabilitating those re-
turning from mental hospitals has been completed. The present program
is operating smoothly. The effectiveness of the trial procedures are being
critically evaluated through interviews of patients at the end of their
first post-hospital year. Matched controls in Duval County, where no
special program is underway, are being similarly studied.
Other studies in the counties include the Migrant Labor Project
in Palm Beach County, the Developmental Evaluation Clinic for studies
of the mentally defective and the long continued premature project in
Dade County, all described in the report of the Bureau of Maternal
and Child Health. There is also the School Mental Health Project in
Seminole County, which is a responsibility of the Bureau of Mental
Health. A number of small studies are in progress, such as that of the
residents of retirement hotels in Dade County and an investigation of
occupational therapy under volunteer leadership in a psychiatric ward
of a general hospital. The combined product of these studies in health
departments has not only provided new knowledge of particular im-
portance in program development, it has also cultivated an inquiring
approach to all public health activities.
At state level, there has been a continuation of the investigation
of rabies, as described under the work of the public health veterinarian.
This is a small but prolonged study. In 1960 plans were developed for
experimental observations which will be initiated early in 1961. The
investigation of infections due to unclassified mycobacteria was in its
second year. Of particular significance is the increasing number of these








GENERAL ADMINISTRATION


infections being identified, including extra-pulmonary infections, acute
pulmonary disease, as well as the chronic tuberculosis-like pulmonary
disease which is relatively resistant to chemo-therapeutic agents available
for tuberculosis. Observations to date appear to establish that these
infections are not spread from human to human and, presumably, are
derived from some source in the environment. The soil is suspected, but
bacteriological studies to date have failed to identify from this source
mycobacteria with the characteristics of those isolated from human
disease.
There has been a continuing interest in arthropod-borne virus in-
fections. During the year, plans were developed looking towards a study
of 3 or more years of these infections in Florida. A grant request was
submitted, but at the time of writing no decision concerning this has
been reported.
The fluorescent antibody diagnostic procedures continue to be an
activity of interest in the Bureau of Laboratories. Its reliability in rabies
has been so clearly established that the test has been recommended as a
routine to replace animal inoculation. Since findings can be- reported
quite promptly, this test will serve to give an early indication of an urgent
need for immunization, or the probable lack of need for these inocula-
tions.
The Bureau of Sanitary Engineering has not undertaken investiga-
tions designated as research; however, many activities have involved
special studies. This is particularly true in the air pollution control pro-
gram and biological studies related to stream pollution.
The federal supplement to funds to be utilized for the improvement
of care provided in nursing homes made it practicable to consider the
development of studies in this area. During the latter part of the year,
there was a series of conferences directed towards the planning of a
comprehensive study of nursing needs in nursing homes. It is anticipated
that these studies will be initiated during the first part of 1961 with funds
currently available; however, studies may assume proportions requiring
supplementary support through a research grant.
The studies of public health administration, supported through
funds provided by the Kellogg Foundation, progressed during the year.
Major attention was directed to the development, in association with pro-
gram directors, of long-range plans for state level activities. Looking to the
future, procedures for evaluation of programs at the local level received
consideration. In this, the study group was aided substantially through
a consultative visit by Miss Evelyn Flook of the U. S. Public Health
Service.
A research training grant was initiated during the year, this cur-
rently providing for 2 trainees, 1 serving a public health residency and
the other completing a public health residency and proceeding to a
school of public health. The latter will return to Dade County to assume
responsibility as chief of research activities in that county.








12 ANNUAL REPORT, 1960


During the latter half of the year, the research program was sub-
stantially strengthened through the availability of Dr. John Wright,
Professor of Public Health Administration, University of North Carolina
School of Public Health. Though his interest and responsibility extended
much beyond research projects, he gave generously of his time and the
benefits of his experience, particularly in the development of studies
under the Kellogg grant.
Articles by State Health Officer and Assistant State Health Officer:
Erickson, G. M., Flipse, M. E., Menzin, A. W., Clayton, L. B.,
Markush, R. E., and Hardy, A. V. "Preliminary report of
epidemiological surveillance in a mass field trial with oral polio
vaccine," in Second International Conference on Live Polio-
virus Vaccines. Washington, D.C.: Pan American Health Or-
ganization and World Health Organization, 1960. Pp. 445-56.
Flipse, M. E., Erickson, G. M., Hoffert, W. R., Sigel, M. M.,
Schneider, N. J., Clayton, L. B., Menzin, A. W., Markush,
R. E., Howell, F. Jr., Crossley, M. T., Cato, T. E., Hardy,
A. V., and Evans, F. J. "A preliminary report on a large-
scale field trial with oral Cox-Lederle attenuated poliomyelitis
vaccine in Dade County (Miami), Florida, in Second Inter-
national Conference on Live Poliovirus Vaccines. Washington,
D.C.: Pan American Health Organization and World Health
Organization, 1960. Pp. 435-44.
Hardy, A. V. The Public Health Laboratory-Looking to the
Future. Amer.J.Public Health, 50: 927-32, July 1960.
Sowder, W. T. Fragile male? or more durable female? The
All Florida Weekly Magazine, 8: 3, 10, Feb. 28, 1960.

SCHOLARSHIPS FOR PROFESSIONAL EDUCATION
The 1955 session of the Legislature created scholarships for the
study of medicine, dentistry and the several disciplines concerned with
mental health. Each program requires that the scholarship be repaid by a
period of compensatory practice in an area that is in need of the
scholarship recipient's professional training.
Forty thousand dollars a year is appropriated for scholarships for the
study of medicine. The scholarships are awarded by the State Board of
Health upon the recommendation of a 7-man advisory committee au-
thorized by statute. The deans of Florida's 2 medical schools are exofficio
members. The remaining 5 members are designated by the President of
the Florida Medical Association. The 2 exofficio members were Dean
George T. Harrell of the University of Florida and Assistant Dean John
C. Finerty of the University of Miami. The 5 physicians designated by the
Medical Association were Richard C. Clay, Miami; James T. Cook, Jr.,
Marianna; Homer L. Pearson, Jr., Miami; Melvin M. Simmons, Chair-
man, Sarasota; and Richard F. Sinnott, Fort Pierce. Eleven new scholar-
ships for the study of medicine were awarded in 1960 and 29 previously
awarded scholarships were continued.








GENERAL ADMINISTRATION


Forty thousand dollars is appropriated annually for the award of
scholarships for the study of dentistry. The statute provides that the
State Board of Health award dental scholarships upon the recommenda-
tion of the State Board of Dental Examiners. The following dentists
served on that Board in 1960: F. F. Farver, Miami Beach; Rupert H.
Gillespie, West Palm Beach; S. Rush Haven, Executive Director, Jack-
sonville; J. M. Pepper, Chairman, Palm Beach; Frank T. Scott, Jackson-
ville; Robert Thobur, Daytona Beach; R. P. Taylor, Jr., Secretary-
Treasurer, Jacksonville; and C. J. Zimmerman, Vice Chairman, Ft.
Myers. Nine new scholarships for the study of dentistry were awarded
in 1960 and 22 scholarships awarded previously were continued.
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.
Through the Federal Social Security Act of 1935, the State Board
of Health receives federal funds which are used to provide stipends to
the employees of the State Board of Health and its affiliated county
health departments for specialized professional training. These stipends
are awarded by the State Board of Health to its career employees who
evidence potential for growth and service in specialized areas of public
health.
Persons receiving scholarships in 1960 were:

MEDICAL
Scholarships Awarded in 1960:


Sylvester Barrington ..............Sanford
Robert Maurice Blow........Monticello
Mirion Perry Bowers..............Bascom
Rodney Lee Brimhall........Jacksonville
Robert Whelchel
Miles .....................Chattahoochee


John Agustine Moore..............Miami
Cupid R. Poe........................Sarasota
Frederick Oliver Smith..St. Petersburg
Paul Vincent Sullivan..Ft. Lauderdale
Shirley Rose Simpson............Ft. Pierce
Tommie Lynn Thomas............Bushnell


Continuing Scholarships Awarded Prior to 1960:


Awarded 1957:
Robert Edwin Alien, Jr.
Hoyt Home
Edwin Keenan House, Jr.
John Franklin
Mason, Jr.
Ronald Joseph Scheib
Richard Burke Welch


Awarded 1958:
Jarrett Charles Black
Robert Elliott Blakey
William Edwin Braun
Karl George Gerlach
Edward Richard
McDonough
Lawrence E. Newman
Troy E. Overstreet
Lawrence Donald Porter
Ralph E. Reed
Earl Taylor
Raymond Charles
Walker
Robert Paul Whittier
George Alien Williams


Awarded 1959:
Robert Allen Boudet
Gordon Thomas Couch
James Edward Davis
Francis Thomas Greene
Everett Norwood
McCormick
William Michael McGaw
Howard Wayne Ramsey
John Wayne Ross
Wilbur Williams, Jr.
Lawrence Delano Kelley









14 ANNUAL REPORT, 1960

DENTAL
Scholarships Awarded in 1960:


Teddy Wallace Brown......Jacksonville
Edward Martin Clayton....Monticello
Harold Glennwood Gregg....Mt. Dora
Emmet Alfred
Kirksey ................West Palm Beach


Lorenza Laws ............Ormond Beach
Charles H. Ritter .............Marianna
Earl Thomas Sherman........Gainesville
Allen R. Treadwell..West Palm Beach
Theodore C. Wilson............Wildwood


Continuing Scholarships Awarded Prior to 1960:


Awarded 1957:
Richard Kingsley Ames
Peter B. Mills
Bennie Thompkins
Harold Thomas Wilson


Awarded 1958:
Alvin Bayer, III
Wilbur Knox Collins
Raymond William
Gage, II
James Emmett Mongoven
Van Rudolph Robinson
Oran Lloyd Turner, Jr.
Parnick Austin Williams


Awarded 1959:
George W. Alexander
Parris Brown
Robert A. Brown
Gene Watkins Eng
Robert G. Fountain
Paul Vonbose Ladd
Daniel Gordon Noland
Thomas Melvin Scott
Marlin Drant Walker
Norman H. Hudon
Harold D. Jordon


MENTAL HEALTH
RESIDENTS IN PSYCHIATRY


Wilford M. Provo
(Comptd. Nov. 1960)............Miami
Theodore M. Wolff
(Started Nov. 1960) ............Tampa
Martin Rosenthal .............Miami
Herbert C. Anderson ................Miami


William H. Geiger ....................Miami
Ronald A. Shellow ..................Miami
Paul B. Hamilton ...............Miami
Ralph O. Maercks ........Coral Gables
William L. Gustafson ................Miami


CLINICAL PSYCHOLOGY


Morris Lee Eady ..............Bushnell
William G. Murdy ............Gainesville
Alan W. Rusnak ............Miami Beach
Eve Lyn Weeks ............Coral Gables


Donald B. Clark..........Ft. Lauderdale
Nathan W. Perry, Jr.........Tallahassee
Benjamin F. Gillis..............Tallahassee
Charles G. Wood......................Tampa


PSYCHIATRIC NURSING
Martha Beth Hicks........St. Petersburg Elma E. Kykes .........................Miami
Hattie Bessent ...............Jacksonville Joan M. O'Brien ...............Tallahassee
Helen G. Kocik ......................Miami
PSYCHIATRIC SOCIAL WORK


First Year
Roy L. Allen...................... Bartow
Carol Sue Brady ....... .......Orlando
Barbara E. Holland....................Miami
Veda Joeger .......................Lakeland
Norman G. Middleton, Jr.........Miami
Elizabeth M. Pickel............Ft. Myers
Donald M. Snyder ............Tallahassee
James W. Strayer ................Lakeland
Alfred J. White............St. Petersburg
Eldred R. Bratsen ....................Miami


Second Year
Edwin C. Bowers ............Tallahassee
Annabel M. Brantley............Key West
Ellen May Ellis.......... .......Lakeland
Robert R. Furlough...........Tallahassee
Allyn D. Gibson ..................Lakeland
William A. Proctor......Ft. Lauderdale








GENERAL ADMINISTRATION 15

PUBLIC HEALTH PERSONNEL
William F. Hill, M.D....-Health Officer II......................Highlands
N. C. Alexiou, M.D.......Health Officer III....................Maternal & Child Health
Lewis Clayton, M.D........Health Officer II......................Dade
H. S. Hudson, M.D........Health Officer III....................Pinellas
R. E. Kaufman, M.D......Health Officer I.......................Palm Beach
D. R. Miller, D.D.S........Public Health Dentist I............Volusia
Harriet Brooks, R.N........Public Health Nurse II.............Citrus
Louise Yopp, R.N............Public Health Nurse III...........Pinellas
E. Dorothy Mullen, R.N...Public Health Nurse II.............Pinellas
Caroline Kennedy, R.N...Public Health Nurse II.............Sarasota
Ada E. Larkins, R.N.......Public Health Nurse II.............Hillsborough
Mary L. Card, R.N.........Public Health Nurse II... .......Seminole
Kenneth Manuel..............Sanitarian II...............................Polk
Howard Patton...............Sanitarian II...............................Broward
James F. Spade................Sanitary Engineer I..................Dade
James E. Santarone.........Sanitary Engineer I....................Sanitary Engineering
J. F. Gorman...................Psychiatric Social Worker IV...Mental Health
Kent S. Miller.................Clinical Psychologist IV............Leon


PERSONNEL
MILES T. DEAN, M.A.
Personnel Officer
Under the general direction of the State Health Officer, the Person-
nel Office is responsible for the administration of the personnel program
of the State Board of Health. This includes advising administrative
officers concerning personnel practices and development; putting into
effect procedures for carrying out approved personnel policies; participat-
ing in the preparation and administration of the approved Classification
and Compensation Plan; administering the leave regulations; maintain-
ing adequate personnel records on all persons employed in the agency;
acting as liaison official with the Florida Merit System involving requests
for certificates and reporting on the selection of eligibles, promotions,
salary advancements, salary adjustments, demotions, transfers, dismissals,
lay-offs and resignations; providing and administering a service rating
system; and the preparation of necessary reports both state and federal.
Payroll operation, also a responsibility of this office, includes the admin-
istration of leave accounting, employee insurance program, retirement
and Social Security, as well as the preparation of the administrative
payroll and distribution of warrants. Preparation of the salary portion
of the legislative and operational budgets is also a responsibility of the
personnel office.
Problems in connection with salary administration continued to be of
great concern during the year. Pay range recommendation changes were
submitted to the Merit System. After pay survey information was ob-
tained, pay ranges were again reviewed in detail with the Merit System
Office, including presentation to the Merit System Council.
The restriction on salary advancements placed upon each position
was one of this office's biggest problems during the year. Difficulties








16 ANNUAL REPORT, 1960


arose, not only from the restriction on salaries, but also from the restric-
tion on the number of positions. Position limitation was especially binding
upon the county health departments that received additional monies
from local sources for increase in staff during the biennium. Necessary
work in connection with salary restrictions of the Appropriations Act
consumed much time of the personnel office and staff.
Classification problems continued to be at a high level and several
revisions and additions were made to the Classification Plan.
During the year, considerable change and improvement was made
in the employee insurance coverage. A survey was completed at the
beginning of the year changing the Blue Cross insurance coverage to
a $14.00 a day hospital room allowance. Before this was completed, the
campaign to enlist enrollment in the group life insurance was com-
menced and this insurance program became a reality. Prior to the com-
pletion of all the needed action covering this addition, the Blue Cross-
Blue Shield coverage was increased to include preferred and extended
coverage.
A great deal of time was given during the year to payroll revision
and consolidation. With the cooperation of the Data Processing Unit,
procedures were developed for changed payroll procedure. Additions to
be made in this connection will be in personnel statistics and leave ac-
counting on a current basis.
Terminations during the year increased to 453; employment papers
for 609 new employment were processed.
Postgraduate training was completed by 11 employees and 17 addi-
tional persons were placed on postgraduate training status.

TABLE 1
NUMBER OF EMPLOYEES IN THE STATE BOARD
OF HEALTH AND COUNTY HEALTH UNITS
AS OF DECEMBER 31, 1951 -1960

Year State County Health Total
(As of Dec. 31) Office Departments Employees
1960 604 1534 2138
1959 586 1396 1982
1958 558 1321 1879
1957 528 1234 1762
1956 481 1127 1608
1955 442 1057 1499
1954 421 980 1401
1953 439 928 1367
1952 458 895 1353
1951 434 831 1265




TABLE 2

DISTRIBUTION OF PERSONNEL-STATE BOARD OF HEALTH

(OTHER THAN COUNTY HEALTH DEPARTMENTS)

DECEMBER 31, 1960




ADMINISTRATIVE UNIT '0

o 0 3 a O


Grand Total...................................................... 604 20 16 30 22 118 181 217
SHO..................................... 21 5 8 8
Administration: Personnel......................................... 12 9 3
Data Processing ............... ... .......... 17 7 10
Total....................................... 50 5 24 21
Dental Health..................................................... 7 2 5
Finance and [Fiscal.......................................... .......... 12 7 5
Accounts: Purchasing and Property ............................ 39 5 34
Total. ................... ................... 61 12 39
Health Information .................. ................................ 13 6 7
Central (Jacksonville) .............................. 60 39 7 14
M iami.................................... 21 15 2 4
Orlando. ................................. 7 3 1 3
Laboratories: Pensacola......................................... 8 4 1 3
Tallahassee .................... ................... 6 3 1 2
Tam pa............................................ 19 10 2 7
West Palm Beach.................................. 6 4 1 1
Total...................................... 127 78 15 34
Bureau......................... ....... ...9 1 1 1 6
Local Health Nutrition............................... .......... 5 1 4
Services: Nursing ......................... .. .. ... .. 15 13 2
Sanitation.................... ....... .....8 6 2
Total ....................................... 37 1 7 1 13 11 4
Maternal and Child Health .................. ..................... 24 5 2 6 1 4 6
Mental Health. ................................... ............... 19 1 1 8 9
Narcotics.......... .......................................... 14 3 11
Bureau............................................ 7 2 3 2
Radiological and Occupational Health ................ 8 1 1 4 2
Preventable Tuberculosis Control ............................... 23 2 9 12
Diseases: Venereal Disease Control ........................... 10 3 7
Epidemiology ...................................... 2 2
Veterinary Public Health ............................ 5 2 2 1
Total ....................................... 55 5 2 1 7 20 20
Sanitary Engineering ........................................... 63 2 27 11 17 6
Special Health fBureau and Hospitals and Nursing Homes............. 16 1 9 6
Services: Chronic Diseases ............................. .... 10 2 1 2 1 3 1
1 Total................................... 26 3 1 2 1 12 7
Entom ology................... ....................... ......... 75 2 1 20 10 42
Vital Statistics..................................................... 43 37 6







18 ANNUAL REPORT, 1960

TABLE 3

DISTRIBUTION OF PERSONNEL IN COUNTY

HEALTH DEPARTMENTS-DECEMBER 31, 1960





COUNTY W s r s
3 S E0
r 0


Grand Total.......... 1,534 76 290 15 522 5 322 304
1. Alachua.......... 37 3 6 12 6 10
2. Baker............ 3 1 1 1
3. Bay.............. 15 1 3 4 2 5
4. Bradford.......... 5 1 2 1 1
5. Brevard.......... 33 2 6 1 9 11 4
6. Broward.......... 70 2 13 2 22 18 13
7. Calhoun.......... 4 1 1 1 1
8. Charlotte......... 5 2 2 1
9. Citrus............ 7 1 1 2 1 2
10. Clay............. 7 1 2 2 1 1
11. Collier............ 12 1 1 4 3 3
12. Columbia.......... 6 2 2 1 1
13. Dade............. 238 11 52 3 104 44 24
14. DeSoto............ 5 1 1 1 1 1
15. Dixie............. 3 1 1 1
16. Duval............ 44 1 7 14 10 12
17. Escambia......... 54 2 10 15 17 10
18. Flagler........... 4 1 1 1 1
19. Franklin.......... 6 1 1 1 1 2
20. Gadsden.......... 14 1 3 6 2 2
21. Gilchrist......... 2 1 1
22. Glades........... 1 1
23. Gulf............. 5 1 2 1 1
24. Hamilton......... 4 1 1 1 1
25. Hardee........... 5 1 2 2
26. Hendry........... 7 2 3 2
27. Hernando......... 2 1 1
28. Highlands........ 9 1 2 2 1 3
29. Hillsborough...... 160 8 31 2 54 1 29 35
30. Holmes........... 5 1 2 1 1
31. Indian River...... 11 1 2 5 2 1
32. Jackson........... 14 1 2 5 2 4
33. Jefferson.......... 7 1 1 1 1 3
34. Lafayette......... 4 1 1 1 1
35. Lake............. 18 1 3 7 4 3
36. Lee.............. 14 1 3 5 3 2
37. Leon............. 33 2 5 9 8 9
38. Levy............. 5 1 2 1 1
89. Liberty........... 2 1 1
40. Madison.......... 7 1 1 2 2 1
41. Manatee.......... 20 1 5 6 4 4
42. Marion........... 15 1 3 5 2 4
43. Martin........... 5 2 2 1
44. Monroe ........... 17 1 2 5 4 5
45. Nassau ........... 13 1 2 3 3 4
46. Okaloosa ......... 15 1 2 4 2 6
47. Okeechobee....... 3 1 1 1
48. Orange........... 76 2 12 1 22 19 20
49. Osceola........... 5 1 2 2
50. Palm Beach....... 74 6 12 1 23 15 17
51. Pasco............. 5 1 1 2 1
52. Pinellas........... 131 5 24 2 49 3 26 22
53. Polk............. 77 3 13 1 27 14 19
54. Putnam.......... 11 1 2 4 3 1
55. St.Johns......... 10 1 2 3 2 2
56. St. Lucie.......... 15 1 5 2 3 4
57. Santa Rosa....... 10 1 2 3 1 3
58. Sarasota.......... 42 2 8 1 13 12 6
59. Seminole.......... 16 1 3 6 2 4
60. Sumter........... 4 1 1 1 1
61. Suwannee......... 9 2 3 3 1
62. Taylor........... 4 1 1 1 1
63. Union............. 3 1 1 1
64. Volusia........... 54 2 9 1 17 1 7 17
65. WakulUa.......... 2 1 1
66. Walton........... 6 1 2 1 2
67. Washington....... 5 1 2 1 1








GENERAL ADMINISTRATION 19

TABLE 4
TURNOVER BY CLASSIFICATION OF THE FLORIDA STATE
BOARD OF HEALTH-STATE & COUNTY
CALENDAR YEAR 1960

TERMINATION TURNOVER RATE
Physicians ......................... .............. 19 23.8%
Sanitary Engineers ................................ 3 7.1%
Sanitarians ....................................... 15 5.3%
Public Health Nurses ............................. .. 104 19.8%
Laboratory Workers (Prof. & Tech.)................ 11 9.2%
Clerical ................. ... ............... 140 20.9%
All Others (Including Laborers) .................... 161 30.5%
Total ................. .......... ... ......... 453 21.9%
Based upon employment at mid-year (July 1960)
1960 turnover rate 21.9%
Average monthly turnover 37.8
Monthly turnover rates are available


GENERAL DATA PROCESSING UNIT
ARNOLD KANNWISCHER, B.S.
Procedures Director
This unit consists of 3 sections: the statistical section, the IBM
machine section and the inactive records section. It serves all other
bureaus and divisions within the State Board of Health. Its function is to
assemble raw information, process it and then produce refined statistical
and fiscal information.
The varied and expanded health programs within the State Board
of Health, as well as the rapid growth of Florida, have led to an equally
large production and accumulation of paper work. This has required a
continuing increase in the mechanization of many of the manual record
keeping procedures. This unit now processes approximately 94 programs
in the IBM and Statistical Sections. These include 1 or more programs
for almost every bureau or division of the State Board of Health.
The following are some of the major activities and services rendered
by the General Data Processing Unit:

VITAL STATISTICS
The processing of all the vital records included in 1960, 115,610
births, 47,719 deaths, 39,315 marriages, and 19,511 divorces and annul-
ments. Information from these records were coded and transferred into








20 ANNUAL REPORT, 1960


punch card format, from which are derived the statistics compiled and
published in the Annual Report, the Vital Statistics Annual Report,
Supplement No. I, and the Monthly Vital Statistics Report.
During the course of a year the State Board of Health receives
countless outside requests for statistical information which is channeled
to this unit and released upon the approval of the director of the Bureau
of Vital Statistics.
BUREAU OF PREVENTABLE DISEASES
The above bureau received during 1960, 83,422 communicable
disease reports. All these reports were processed by this unit and the data
developed were published in the following major reports: the Weekly
Morbidity Report, the Monthly Communicable Disease Notes and the
Annual Morbidity Report, Supplement No. II.

SPECIAL HEALTH SERVICES AND INDIGENT
HOSPITALIZATION PROGRAM
During 1960, 28,237 approved applications for indigent hospitaliza-
tion were processed. From this fiscal information many statistical tables
were requested, such as age of patients, length of hospitalization, average
cost per admission, etc. Also tabulated for this bureau are monthly list-
ings of cancer deaths, rheumatic fever deaths, reportable diseases and the
semi-annual poison control register.
RESEARCH AND SPECIAL STUDIES
Listed below is a brief summarization of some of the major studies
undertaken or completed in 1960.
Hospital Survey: Data on all patients 65 years or over who were
hospitalized on November 10, 1960 in Florida. Also requested were
data on this age group who were discharged from Florida hospitals
during the week of August 14-20, 1960. This required the processing
and analyzation of data on 3450 patients.
Physician Survey-Dade County: 2 phases of a 4-phase study were
processed in this office in 1960. This study will require the processing
of over 12,000 survey forms.
Pinellas County Gerontology Study: The General Data Processing
unit processed approximately 8000 forms related to the individual
health status of the aged in this community.
Epidemiological Investigation of Atypical Acid-fast Infection: A
complete series of cross-tabulations was performed on approximately
500 cards. This is a continuing study of cases of this disease in the
Florida population which are being subjected to detailed analysis.
Jackson County Immunization Survey: A survey of 550 persons
of this community was made to determine the immunization level
for poliomyelitis and smallpox.








GENERAL ADMINISTRATION


Neonatal Study: This is a matching study begun in 1960, which
will compare birth and death records for neonatal deaths occurring
in 1960.
Live Oral Polio Vaccine Study-Dade County: This unit assisted
in this study which was designed to determine the underlying
sociological and economic factors effecting the take or non-take
pattern of this community.

PERSONNEL DIVISION
A major conversion of records processing took place in this division
in 1960. All payroll calculations and tabulations as well as leave account-
ing and personnel statistics were programmed for IBM machine handling.

NARCOTICS
The work for this bureau consisted mainly of 2 large registration
procedures: the registration of 9396 practitioners of the healing arts and
the mailing and processing of applications for registration of approxi-
mately 12,000 manufacturers of drugs, cosmetics and devices.

FINANCE AND ACCOUNTS
The work processed for this bureau included reports on workman's
compensation, salary budget projections, tabulations on expenditures,
travel and county receipts. Property inventory was successfully converted
to punch card methods during this year.

MENTAL HEALTH
The reports submitted by the Child Guidance and Community
Service Mental Health Clinics on patients clinically discharged are proc-
essed on a monthly basis by this unit. From these reports, calendar year
as well as fiscal year statistical data are prepared. More than 7000 dis-
charges were processed in 1960.

LOCAL HEALTH SERVICE
Numerous requests for statistical information for specific counties
and communities were prepared during the year. A major undertaking
of this unit was the study of the feasibility of automating the daily activ-
ities reporting of the various disciplines in the county health depart-
ments.

MATERNAL AND CHILD HEALTH
A monthly maternal death listing as well as an annual listing is pre-
pared for this bureau.








22 ANNUAL REPORT, 1960

SANITARY ENGINEERING
Installation of a new filing system was undertaken this year. This
unitized-geographic system consolidated the search for documents to 1
file location rather than the 10 or more locations under the old system.

DENTAL HEALTH, HEALTH INFORMATION, ENTOMOLOGY
No major studies or machine work was performed for these bureaus.
Graphic representations show the distribution of machine utilization
by bureau (Figure 2) and man-hour distribution of all General Data
Processing Unit personnel by bureau (Figure 3) for the year.
The Inactive Records Section has undertaken the responsibility of
establishing a microfilm program. This has already afforded the State
Board of Health a substantial savings, especially since no new equipment,
such as cameras, had to be purchased. Formerly, most of the microfilming
work was sent out and done on a contractual basis; whereas now, all of
it is performed within the State Board of Health.









GENERAL ADMINISTRATION



FIGURE 2
DATA PROCESSING MACHINE UTILIZATION BY BUREAU
FOR THE YEAR 1960


Bureau


Vital Statistics ....................................... ..........
Indigent Hospitalization Prog. .................................
Personnel ....................................... .......
Preventable Diseases .................................... ............
Narcotics ................................................ ...................
Finance & Accounts ...................................... .........
Research & Special Studies ..........................................
M ental Health ......................................... ............ ..
All others ................................................................

Total..................


Man Hours
10,222.6
1,416.3
1,053.9
1,006.4
951.1
701.3
673.8
387.8
370.4

16,783.6


Percent
60.9
8.4
6.3
6.3
5.7
4.2
4.0
2.3
2.2

100.0









24 ANNUAL REPORT, 1960


FIGURE 3
GENERAL DATA PROCESSING UNIT
TOTAL MAN HOUR UTILIZATION BY BUREAU
FOR THE YEAR 1960


Bureau


1


Vital Statistics .................... .........................................
Preventable Diseases ................ ................................
Special Health & Indigent Hosp.........................
Research & Special Studies ......... .........................
Personnel-------------..........-----------------------------------
Personnel ................ ................. ............
N narcotics ............................................................................
General Data Processing Unit............................
Finance & Accounts...........................................................
Mental Health .............----........................----- .............
Health Information ................. .............. ............
Sanitary Engineering .............. .........................
Maternal & Child Health ... ......................
Receptionist Service ...................................................
All other ............ ........................ ...............

Total.............................


Man Hours
16,107
4,027
1,901
1,759
1,323
1,216
1,182
868
423
316
278
232
205
450

30,287


Percent
53.2
13.3
6.3
5.8
4.4
4.0
4.0
2.9
1.4
1.0
.9
.8
.7
1.5

100%


--








HEALTH INFORMATION


DIVISION OF HEALTH INFORMATION
ELIZABETH REED, R.N., B.S.
Director
TOMMA PASTORETT, B.S., M.A.
Librarian
The function of this division is to assist in the initiation, implementa-
tion and evaluation of the health education aspects of programs de-
veloped by bureaus and divisions, and county health departments; to co-
operate with schools (on all levels) and with official and voluntary
agencies; and to serve as a resource to the general public.
The division is concerned with optimum use of staff health edu-
cators on the local and state level; with exhibits, audio-visual aids,
pamphlets, publications, press releases, the medical library as well as other
media. Orientation of lay and professional persons to public health prob-
lems is also a major activity.
Bureaus and divisions and county health departments are constantly
stimulated to have a greater appreciation of health education as an inte-
gral part of their total program. More time was spent in consultation
with directors of the above than in previous years. Nine counties (Pinel-
las, Hillsborough, Manatee, Sarasota, Polk, Brevard, Palm Beach, Dade,
Broward) have 10 positions for local health educators. One was not
filled at the end of the year (Dade). A health educator was also assigned
to the Florida Cervical Cytology Project. Assistance was given to the
Florida Alcoholic Rehabilitation Program in the employment and orienta-
tion of a health educator for their staff, and to the health educator
assigned to the Florida Cervical Cytology Project (see report of Division
of Chronic Diseases elsewhere in this volume.) A great deal of corre-
spondence was carried on with health educators inquiring about positions
in the state. Unfortunately, the present pay ranges in Florida do not
attract a large number of well-qualified candidates.
The exhibits consultant was unable to answer all of the increasing
number of requests made of him for assistance in planning and designing
displays as well as servicing those shown at statewide meetings. Forty-
one displays or exhibits were constructed, 318 signs, charts, maps, layouts,
and 114 illustrations completed and 50 planning conferences were held.
He traveled to 22 different parts of the state.
Audio-visual aids continued their brisk circulation with aids other
than 16 mm films (filmstrips, slides, tape recordings, etc.) continuing to
rise in popularity. These constituted 10 per cent of all aids circulated-
total 6149-which were shown 11,220 times. Over half a million persons
viewed these aids to health education. Several films were shown to tele-
vision audiences which totalled approximately three-quarters of a million.
A new catalog was prepared and distributed. Projection equipment was
booked by State Board of Health personnel 269 times. Much time is
spent in instructing borrowers how to care for this equipment correctly.







26 ANNUAL REPORT, 1960


Pamphlets continue to be popular with over 250,000 distributed
during the year, in spite of the fact that quantity distribution is now
restricted and free ones must be ordered directly from the publisher (ex-
cept for sample copies). Mental health and nutrition are the two most
popular subjects, although pamphlets on safety and adolescent problems
are frequently requested. Child care and development continues to hold
interest for many as do the chronic diseases.

A present problem is the inquiries received from 8th and 9th grade
students for information on such subjects as child psychology, multiple
sclerosis, genetics, how to do a skin graft. These apparently are the result
of assignments by teachers or interest in science fair projects.

Florida Health Notes continued to attract a steady stream of new
readers. Approximately 13,500 copies were distributed every month (ex-
cept July and August). Subjects covered in 1960 included Migrant
Project 1959, the Brevard County Story, Sick Child in School, Radiation,
Stroke, Food Fads, Swimming Pools, Poison, Help for the Troubled Mind
and a simplified Annual Report.

The mailing list was cleared in the fall. Over 53 per cent of the
readers asked to be retained on the mailing list. New names were
solicited from the county health departments and the revised list will
eventually exceed the old in the total number of persons receiving this
publication. The majority of readers are lay persons.

Assistance was given with the editing and distribution of the Annual
Report. The Florida Health Intelligencer was issued 4 times. It is a
mimeographed bulletin primarily concerned with news of individuals in
Florida's public health circles. Some assistance was given to bureaus and
divisions in the preparation of 3 other publications: Timely Topics, Liv-
ing in Later Years and Nutrition in a Nutshell.

A total of 100 press releases-statewide, regional and local-were
prepared and distributed. Arrangements were made for television, radio
and press coverage of many meetings, conventions, seminars and con-
ferences held principally in Jacksonville. The information consultant
encourages reporters to write their own stories and then puts them in
touch with State Board of Health resource persons.

The medical Library continued to serve an increasing number of
persons. State Board of Health personnel form the largest number of
users followed by physicians in the Jacksonville area. Statistically, 2678
books were loaned; 10,451 journals were circulated; 2838 reference ques-
tions answered. Forty-one bibliographies were prepared.

A new project was begun in 1960: compilation of a bibliography
of articles written by State Board of Health personnel. As of this date
over 350 titles have been listed.








HEALTH INFORMATION 27

Duplicate books and journals were offered to other libraries through
the Medical Library Association Exchange. A total of 1590 journals and
31 bound volumes was sent to 145 libraries, 19 of these in foreign coun-
tries. Additional material was sent to the International Library at
Kenitra, Morocco.
Three regular and 1 special orientation programs were held with
approximately 200 persons attending. Staff members participated in the
State PTA Institute and local PTA workshops.
Many talks were made to lay and professional organizations. A num-
ber of bureaus and divisions were assisted in arranging workshops and
meetings. The division participated in the Teachers Project which is held
each summer (see report of the Bureau of Maternal and Child Health
elsewhere in this volume). Contacts are maintained with official and
voluntary agencies which have an interest in health, as well as various
professional groups (medically-related and others). Visits have been
made to many educational institutions. Lectures were given to all stu-
dents in health education classes at Florida State University.
Expansion seems indicated as brought out in preliminary studies of
a long range plan for the division. Included are: more consultative
assistance should be offered the bureaus and divisions and the county
health departments. The latter might best be served by the employment
of a field consultant and regional health educators. There should be
acceleration of health career recruitment. The purchase of a health ex-
hibits trailer should be considered. Additional assistance should be given
to the audio-visual library in view of the many requests which cannot
be met, both in the purchase of additional aids, as well as the employ-
ment of an additional technician. Regular programs and news spots
should be prepared for educational and commercial television stations.
Regional workshops are suggested to explore the environmental and
cultural factors of people within these areas which influence the health
education methods and techniques used. The 24 community colleges
should be aided in identifying local public health problems and in
locating resources for studying them.
Article by staff member:
Westbrook, L. F., Reed, E. Airport sanitation. Public Health Rep.
75: 835-839, Sept. 1960.








28 ANNUAL REPORT, 1960


BUREAU OF LOCAL HEALTH SERVICES

Director: (See staff changes below)


BUREAU ACTIVITIES
Primary responsibility for the organization and supervision of county
health departments rests with this bureau. Its director acts as supervisor
and consultant to the county health officers. The degree of local auton-
omy in each health department varies from county to county and is
contingent upon the size of the community, the local staff, and the
latter's training and experience.
The Bureau of Local Health Services is administered by the director
and an assistant, and it consists of the Division of Nursing, Division of
Sanitation, a Nutrition section (now a division) and 2 records con-
sultants. The various disciplines represented within the bureau are
responsible for the recruitment, orientation and training of their counter-
parts in the county health departments, and are available for consultation
at the local level. The bureau as a whole serves as liaison between local
health departments and the State Board of Health.
During 1960 the services of 77 full-time physicians were required to
staff our local public health programs, of which 42 were directors and
35 were assistant health officers. Also, 10 part-time physicians served in
various clinical activities, and 4 public health residents were employed.
During the year 5 local directors resigned and 7 were employed, leaving
2 vacancies at the end of the year.
The same difficulties were encountered as in years past regarding
efforts to recruit well-qualified public health personnel. It is hoped that
the salary adjustments which have been proposed will be approved and
that sufficient funds to implement these adjustments will be appro-
priated at the next session of the legislature.

STAFF CHANGES
Wade N. Stephens, M.D., served as director of the bureau until
September 1, at which time he was appointed director of the Community
Health Administration Study (Kellogg Grant). Wilfred N. Sisk, M.D.,
who was in charge of this program, was transferred to the Bureau of
Local Health Services as director. Doctor Sisk served in this capacity
until December 31 when he resigned to become director of the Orange
County Health Department. At this time, C. M. Sharp, M.D., Assistant
State Health Officer, was appointed acting director of the bureau.
Hubert U. King, M.D., served as assistant director during the entire
year. In July, Enrico A. Leopardi, M.D., was assigned by the U.S. Public
Health Service to the bureau as resident in public health administration
for 1 year.








LOCAL HEALTH SERVICES


TRAINING
Study of the orientation and training programs for health officers
was continued during the year. It is expected that this study will continue
during the coming year with the hope that improved orientation and
other inservice training programs will result. A 3-day seminar jointly
sponsored by the Health Officers' Association and the State Board of
Health was held in Miami in December. Opportunities were provided for
local health officers to attend various meetings and seminars at the
central office, and a 5-day orientation program for new health officers
was held at the State Board of Health in September.
During the year 4 health officers matriculated in schools of public
health to take postgraduate work leading to the Master of Public Health
degree. One local health officer became a diplomat of the American
Board of Preventive Medicine.
Training programs for nurses and sanitarians are discussed in the
reports of their respective divisions.

RECORDS CONSULTATION SERVICE
During the year the 2 records consultants, along with other bureau
staff members, continued to work closely with the State Records Com-
mittee and the Records Committee of the Health Officers' Association in
the review and revision of records. A large portion of the consultants'
time was spent in implementing the change in medical and nursing
records recommended by the above committees in 1959. In essence, the
new system will centralize all medical and nursing records in a single
family folder. The records consultants accompanied the nursing con-
sultants to 17 counties to assist local staffs in adopting this new record
system.
In addition to the above major activity, these consultants made
numerous visits to the counties to assist local personnel with clerical
problems. The consultants assisted in the orientation of 16 new clerical
personnel.

COUNTY HEALTH DEPARTMENTS
In October, St. Johns County reorganized its local public health
program to become affiliated with the State Board of Health. The staff
consists of a director, 3 public health nurses, 2 sanitarians and 2 clerical
personnel. All 67 counties in Florida now have public health programs
under supervision of the State Board of Health. In October, the Collier-
Lee Health Unit was reorganized into 2 separate single-county depart-
ments. In 1960 there were 42 county health units, which includes 26
single-county, 7 bi-county and 9 tri-county units.

STAFFING AND FINANCING
In December 1960 there were 1534 employees on the staffs of the
county health departments. This number represents an increase of 162








30 ANNUAL REPORT, 1960

persons (10.5 per cent) over 1959. County health department budgets
totaled $8,555,818 for the year, or $1.80 per capital. Of this amount 72
per cent or $6,182,361 ($1.30 per capital) came from local contributions,
and 28 per cent or $2,373,457 ($0.50 per capital) came from state and
federal funds.

HEALTH DEPARTMENT HOUSING
1960 was a banner year for health center construction over the
state. New health centers were completed in 9 counties: Columbia,
Seminole, Brevard, Santa Rosa, Liberty, Jefferson, Levy, Hendry and
Palm Beach. In addition, new auxiliary quarters were secured in Escambia,
Duval, Pinellas, Lee and Brevard Counties. There are a total of 151
health centers throughout Florida. Sixty-seven of these are headquarters
of which 60 are considered adequate. The remaining 84 are auxiliary
centers, of which 72 are adequate. Thirty-seven of the health departments
have their own separate headquarters buildings, while 44 of the auxiliary
centers are separate structures.

TRENDS IN LOCAL PUBLIC HEALTH PRACTICE
A number of trends in county health department programs and
administrative practice have become evident in the past few years. Per-
haps the most recent of these is an increasing interest on the part of
county health officers in their own training and in better communication
between themselves. The December seminar in Miami is an example of
this. Two issues of a Health Officers' Bulletin have been published, for
which the local health officers supplied much of the material.
Research is gradually becoming recognized as an important aspect
of good public health administration. A number of research projects and
studies were underway in various counties during the year (see Research
Coordination under Administration elsewhere in this Report).
Screening tests as casefinding tools are receiving more widespread
use. Tuberculin screening tests were used in 65 counties. In 17 of these
there were mass programs carried out on selected groups, which repre-
sents a 50 per cent increase over last year. The relatives of known
diabetics were screened for diabetes in 13 counties, an 18 per cent in-
crease over 1959. Following intensive publicity by the Bureau of Maternal
and Child Health, a program of testing for phenylketonuria in infants
was inaugurated in 22 counties. This activity, aimed at the early recog-
nition of this metabolic defect, will aid in preventing severe mental
retardation which ensues in untreated cases.
By the year's end 7 county health departments had bedside nursing
programs, compared to 5 in 1959 (40 per cent increase). In view of the
enthusiastic patient, physician and community support of this activity,
extension to other counties is expected.
Nine dental preceptors were employed and there were 11 organized
dental programs during the year. The white mobile dental unit of the








LOCAL HEALTH SERVICES 31

State Board of Health gave dental care in 12 additional counties and
the colored unit in 6 counties.
The number of mental health workers assigned to counties increased
during the year from 26 to 27. While mental health clinics showed no
increase in number, more personnel were employed and services have
increased in proportion.
Accident prevention and the chronic diseases are beginning to re-
ceive more attention at the local level. The demand for services in these
fields grows constantly.
There is an increasing use of volunteer workers in county health
departments. The Red Cross (School) Gray Ladies are now contributing
their services in 7 counties, primarily in the school health program.

COUNTY HEALTH DEPARTMENT ACTIVITIES
The statistical report of county health department activities (Table
6) indicates the number and types of various programs conducted at the
local level. Although all the health departments were active in the basic
public health programs, some have reported noteworthy or unusual
achievements which are abstracted in the following paragraphs.

GRASS ROOTS HIGHLIGHTS

HURRICANE DONNA
This disaster, the most costly in Florida's history, struck on Septem-
ber 9, 1960. Damage was widespread along the Keys, most severe in
Islamorada and Marathon. The Monroe County Health Department was
especially active working in concert with other official and voluntary
health agencies. Nurses aided in medical care and immunizations. Ty-
phoid immunizations were given to those affected by the breakage of the
aqueduct which serves the Key West area. Together with engineering
and sanitation consultants from the State Board of Health, the health
department supervised the emergency sanitation program. An emergency
portable bacteriological laboratory was established with the assistance of
a bioanalyst from the Bureau of Laboratories.
Collier County was among the hardest hit. The health department
staff worked night and day to protect water supplies and to give immu-
nizations. Over 12,000 typhoid and 1200 tetanus immunizations were
given immediately following the hurricane. Some 683 water samples were
tested, of which 112 (16 per cent) were found to be unfit for consump-
tion. With assistance from the State Board of Health, this CHD was
able to do an excellent job of protecting its citizens following this
disaster.
The Broward County mobile health unit, health director and public
health nurses aided Everglades City in the tidal wave disaster following
Donna. The public health nurses gave 15,000 typhoid injections to per-
sons living in areas where septic tanks had overflowed.








32 ANNUAL REPORT, 1960


The Charlotte CHD was also busily involved following this disaster.
The results of testing water supplies showed there was gross water con-
tamination in the county. By the use of millipore filter technique the
health department staff tested its own water samples at a great saving
of time and expense and will continue this as a part of the routine service
of the health department.

RESEARCH FOR THE AGED
Pinellas County, with its high proportion of senior citizens, is an excel-
lent place to study their health needs. A research program in the health de-
partment designed to develop more efficient service to the aged is now
in its third year. Four surveys have been completed: a population survey
of 2544 non-institutionalized residents over 65; two surveys of all
patients visited by public health nurses and welfare workers; a survey of
records and medical care in nursing homes. Based on the accumulated
data, plans are being made for pilot programs to begin in 1961.
The Tampa Bay Council for research in gerontology was originally
sponsored by the Pinellas CHD. This has brought together individuals
interested in this research from the Pinellas and Hillsborough CHD, the
University of South Florida, Mound Park Hospital Foundation and the
Veterans Administration. This council, representing the best minds and
facilities available in the area, should give continued stimulation to re-
search in this field.

IMMUNIZATION ACTIVITIES
The Dade County Community Polio Program (immunization with
live vaccine), which received national recognition, was sponsored by the
University of Miami School of Medicine, Dade County Department of
Public Health and Dade County Medical Association. Truly a commu-
nity effort, the campaign was supported by many individuals and or-
ganizations. Without the wholehearted support of practicing physicians,
public health workers, school teachers and communications media, the
program would not have been possible. Without the assistance of phar-
macists, automobile dealers, industries, churches and various voluntary
health, fraternal and civic organizations, the task would have been
exceedingly difficult. The effectiveness of the extensive professional, edu-
cational and publicity programs conducted by the county medical asso-
ciation is indicated by the fact that approximately 425,000 persons under
40 years of age received the live Cox-Lederle oral vaccine during a 13-
week period. Although insufficient time has elapsed to accurately evaluate
the degree of protection provided by this vaccine against paralytic polio,
some presumptive evidence of its effectiveness is suggested by the follow-
ing: From May 31 through December 31, 1960 no cases of paralytic
poliomyelitis occurred in Dade County (population 920,000).
A communitywide immunization survey was conducted by the Hills-
borough CHD. Immunization histories were obtained on all children in
the elementary schools through the cooperative efforts of school and








LOCAL HEALTH SERVICES 33

health department personnel. This survey showed that, though the im-
munization level is generally high in the county, areas in the low socio-
economic strata need concentrated attention.
Mass polio immunization clinics using Salk vaccine were conducted
cooperatively for labor groups by the Hillsborough CHD, the County
Medical Association, Red Cross and the AFL-CIO and CSA (labor
unions).
The director and staff of St. Johns CHD are quite pleased with the
outstanding cooperation given the school immunization program by the
county medical society and school officials. The result of this activity is
that an unusually high percentage of school children have completed
their routine immunizations.


PUBLIC HEALTH NURSING

The Clay County Citizens Advisory Council, organized in 1958,
has been working in full partnership with the Clay CHD. This organiza-
tion, although intended to develop and promote the combination nursing
service, has proven invaluable to the county's entire public health pro-
gram. The nursing services' caseload has grown steadily and physicians
are referring all types of cases. Volunteer services have been exceedingly
valuable in maintaining a loan closet which was widely used. The com-
bination nursing service has contributed greatly to close working relation-
ships with the local physicians and the new hospital. Hospitalization time
has been reduced through early discharge and a continuation of nursing
care at home.
The Baker County Community Nursing Advisory Council has pro-
moted better public relations and better public health for the county.
Its loan closet may be used by anyone in the county and its transportation
committee has been providing services for patients attending the various
clinics in Jacksonville. The combined nursing program, well accepted by
the community, appeals to the patients since the same nurse visits the
home whatever the need may be.
In August 1960 the West Volusia County area, with headquarters at
DeLand, was organized to bring this service of the Volusia CHD to a
population of 30,000, bringing the total population covered by combina-
tion nursing service in the county to approximately 100,000.
As a consequence of the low cost maternity plan jointly sponsored
by the Clay CHD, the county hospital's medical staff and hospital admin-
istration, the number of mid-wife deliveries are being reduced. Patients
attending the health department clinics are delivered in the hospital.
For this latter service they pay in advance a small weekly fee. If mother
and baby are normal 24 hours postpartum they are discharged for home
care. Copies of prenatal clinic records are sent to the hospital and orders








34 ANNUAL REPORT, 1960

for home care are copies from hospital records for the public health
nurse.

SANITATION
The Sarasota CHD distributed notices of its septic tank policies to
better inform the public about health department recommendations
regarding septic tank installations.
Volusia County's commissioners, through encouragement by the
health department, appointed a citizens' committee to appraise the
feasibility of a countywide sewerage program. Also, the health depart-
ment's swimming pool program achieved high standards for the more
than 100 public swimming pools in the county.
Every municipality in Pinellas County not having an adequate sewer-
age system is constructing or actively planning such a facility. Voters in
the developed unincorporated communities have approved sanitary
districts and 2 more such districts are being planned elsewhere.
A countywide zoning resolution was adopted by Martin County
Commissioners becoming effective August 1960. Thus the entire county
is under the Sanitary Code of the State of Florida which provides long
range planning for the development of public water and sewage dis-
posal systems. Also, a long needed sewerage expansion program for the
City of Stuart is now under way. Stuart's modern sewage treatment
plant, when expanded to include commercial and residential areas, will
greatly decrease sanitary nuisances and river pollution.
A permanent Food Service Training School was organized by the
Orange CHD. This is the second such school to be established in the
state. The first was developed in Escambia County in 1958.
Five municipalities organized rodent control programs in coopora-
tion with the Pinellas CHD.
Due to the leadership of the Putnam CHD the citizens of Palatka
presented a united front against insanitary conditions existing in certain
areas of the city and county. Home surveys in the blighted areas revealed
that the main defects were insanitary privies, absence of modern sinks
and running water, lack of garbage cans, and weeds and trash on the
premises. An important factor in the success of the program was the
publicity provided by the local newspaper. On many occasions re-
porters made joint inspections with sanitarians. Leading citizens, including
PTA members, school principals, ministers, city and county officials and
representatives from civic groups worked with health department repre-
sentatives. "Block captains" were appointed to direct clean-up activities
in their block. This idea has spread and meetings have resulted in other
communities uniting to remedy their problems. The health department
has already been instrumental in securing a number of corrections with
the support of these community groups. Surveys for intestinal parasites
of children in slum areas revealed that 25 per cent were infested with
roundworm. As a result of this effort a Negro health committee has been








LOCAL HEALTH SERVICES 35

organized for general public health promotion. It consists of a central
committee, zone commanders and block or area captains. It is hoped that
this movement will improve living standards, promote better personal
hygiene and in general improve healthful living for the Negro population.

TUBERCULOSIS CONTROL
Much work has been done in the tuberculosis program of the St.
Johns CHD with routine chest x-rays being replaced by routine tuber-
culin testing of foodhandlers.
During the fall a tuberculin screening test program was conducted
by the Pinellas CHD among some 2000 students at the county schools to
evaluate the use of the Sternneedle technique as a mass screening
procedure.
During the year special mass tuberculin surveys were conducted
cooperatively by the Research Epidemiologist from the State Board of
Health and the health departments in the following 6 counties: Martin,
Okeechobee, Pasco, Orange, Lake and Dixie. These studies, which com-
pleted their second year, utilized simultaneous skin tests with both "Stand-
ard" and "Battey" strains of "purified protein derivative." They are
supported by a grant from the National Institutes of Health for the study
of the unclassified mycobacterial infections in Florida.

DENTAL HEALTH
During the year a dental survey in Santa Rosa County was completed
with 5880 school children examined. Results showed that 13.2 per cent of
the children had severe or very severe dental caries; 52.5 per cent had
no "unfilled dental cavities." With the incorporation of dental facilities
at the new health center it is hoped that a dentist can be added to the
staff when funds are available.
A new child dental clinic was opened at the New Smyrna Beach
center in October, thereby expanding the dental program to cover all
areas of Volusia County.
One of the schools in a rural community in Baker County has
developed a new approach for improving the problem of dental care
for indigent children. Since an estimated one-third of the school children
are unable to afford dental care, a plan was developed whereby the PTA
paid one-half the cost of dental repair for such children and the parents
paid the balance. In addition the local dentist provided his services at a
reduced fee. This program was well received by parents and community.
The program is being continued and another rural school is starting a
similar program.

GLAUCOMA CLINIC
A Glaucoma Clinic inaugurated in 1960 is jointly sponsored by the
Sarasota CHD and Sarasota Hi-Noon Lions Club. This clinic is con-
ducted 1 evening weekly at the health center and is intended primarily








36 ANNUAL REPORT, 1960

for persons over 40 years of age who have not had an examination for
glaucoma during the past 2 years. Appointments for the clinics are made
through a local telephone answering service and are limited to the first
50 phone calls made during any 1 week. The staff consists of local
ophthalmologists who donate their services; volunteer nursing assistants
provided by the county nurses' association; and volunteer clerical help by
the Lions Club members and their wives. The nursing staff of the health
department makes follow-up home visits.

INDIAN HEALTH
With the assistance and cooperation of the U. S. Public Health
Service the Glades and Hendry County Health Departments have ac-
cepted responsibility for providing outpatient medical services, public
health nursing care and general sanitation services for the Seminole
Indians at Brighton and Big Cypress Indian Reservations. These services
to the Indians supplement the medical care and hospitalization which is
also provided by the federal government by contract with local physicians
and hospitals.

RADIOLOGICAL HEALTH
Surveys of medical and dental facilities and radiological consultation
were made in 7 counties during 1960. This enterprise was conducted
cooperatively by a team from the State Board of Health's Division of
Radiological and Occupational Health and the health departments of
Hillsborough, Monroe, Broward, Palm Beach, Dade, Hendry and High-
lands Counties.

IN MEMORIAL
Hillsborough County and public health in Florida suffered a great
loss in the death of Dr. Frank Chappell, veteran public health officer,
in November.








LOCAL HEALTH SERVICES


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

This division has the responsibility to plan, promote, develop and
administer statewide public health nursing services through the county
health departments and to correlate and coordinate these services with
the nursing aspects of the programs of other bureaus, divisions and
agencies.
The division carries on its activities with a staff consisting of a direc-
tor of nurses, 5 generalized public health nursing consultants, a nurse-
midwife consultant, a secretary and a stenographer.
The consultants are assigned to geographic districts and spend ap-
proximately 75 per cent of their time in their districts assisting in and
promoting the general public health nursing programs of the county
health departments. In addition to the broad generalized public health
nursing responsibilities, each consultant is assigned and has received
training in a specific specialized public health nursing responsibility:
nursing homes, staff education, inservice training, supervision of mid-
wives, civil defense and safety. These specialized activities are carried
out on a statewide basis.
One of the continuing areas of activity is in the field of recruitment.
As of December 31, 1960, there were 656 public health nurses in Florida.
There were 104 terminations of service in the county health departments
representing a turnover rate of 19.8 per cent in this group. At the end of the
year there were 19 public health nurse vacancies in the county health de-
partments. Forty per cent of the public health nurses in the counties have
received less than 1 year public health nursing preparation, emphasizing
the constant need for training.
The inservice training program for nurses without previous academic
preparation or experience in public health has been less active this year
because of the employment of many graduates from the collegiate schools
of nursing, who have been prepared for first-level public health nursing
positions. (A total of 61 are currently employed.)
Promoting and assisting in the implementation of inservice education
programs in some of the smaller counties have been given additional
emphasis this year. Hesitation on the part of the staff nurses in small
counties to assume leadership roles has meant that more direct partici-
pation in programs by the consultants has been indicated. However, an
increasing responsibility is being assumed by the groups. Regular monthly
inservice education programs are routine in most counties.
At the request of Peabody College, Tennessee, the division made
arrangements for 5 students to receive the required 3-months' field
experience in a county health department having a combination service.
Seven county health departments provided clinical experience in public








38 ANNUAL REPORT, 1960


health nursing for basic nursing students from the following collegiate
schools: University of Florida, University of Miami, Barry College,
Florida State University and Florida A & M University. Southern
Missionary College students, who receive their clinical experience at the
Florida Sanitorium, receive public health experience at the Orange CHD,
integrating their field work with clinic work in the Sanitorium.
Consultants made a total of 230 request visits to the county health
departments, working with the nurses, enabling them to meet the ever
increasing demands for improvement, change and inclusion of activities
for which they have not been adequately prepared. New nurses are
taught how to practice within a public health setting.
A few of the phases of public health nursing which have been given
emphasis by the consultants through the past year are: organizing and
teaching mother and baby care classes; care of patients from hospitals for
the mentally ill; care of those with chronic diseases; use of new types of
equipment designed to conserve nursing time and strengthen practice;
techniques and activities enabling them to create situations whereby in-
dividuals and families may be motivated to assume responsibility for their
own health needs.
The consultant responsible for the nursing home program continues
to act as resource person. She assisted the nursing home division person-
nel in making necessary state-level inspections of nursing homes in the
counties; assisted the nursing home division staff in planning and imple-
menting programs of study on nursing homes; participated in planning for
a workshop for nursing home administrators; and assisted in preparation
of the nursing home manual. She also attended a national workshop in
Washington and was a member of the committee reporting to the White
House Conference on Aging.
The consultant with the specific responsibility of civil defense and
safety programs prepares and assembles materials and visual aids for con-
ducting classes and demonstrations in the nursing aspects of civil defense.
At the request of nursing staffs in county units she plans and conducts the
classes. She attended the 5-day course sponsored by the National Office
of Civil Defense Mobilization held in Michigan.
The inservice education program conducted by 1 of the consultants
consists of study groups held by the counties in various areas of the state.
She prepares and assembles materials, recruits personnel for program
participation and plans workshops in cooperation with other bureaus and
divisions.
One consultant worked as key person on a committee (consisting of
nursing supervisors of county units) in preparation of the manual of
procedures and policies for organization of the combination service.
The nurse-midwife consultant holds educational classes for licensed
midwives. In counties where recruits are to be trained for replacement of
retired and deceased midwives, she supervises their training and works








LOCAL HEALTH SERVICES


closely with the local public health nurse. Two-thirds of the 228 licensed
midwives were reached through educational meetings and individual
home visits. In 1960 there were 10 less midwives licensed than in 1959.
Eleven counties have discontinued the licensure of midwives.
Three consultants were assigned to areas affected by Hurricane
Donna, assisting the local public health nurses.
Further emphasis was given to the organization of combination
services. Factors leading to improved patient care are: 1 nurse visiting a
family to meet all their needs; reduction of administrative costs in such
a combination; the increased scope of the lay board's community pro-
gram; and the greater service satisfaction for nursing personnel were dis-
cussed with many groups in the state. Seven combined services are now
in operation.
Public health nursing in our changing society requires continuing
self-evaluation and adaptation to change in programs at all levels. This
requires a new learning or relearning, a change of attitude and/or a
different pattern of practice. In order to understand as well as to meet
the various demands for service and consultation, it is necessary to know
more than the schedule for the day. To this end, nursing personnel of
this division have attended short courses and made themselves acquainted
with new community facilities and attended professional meetings and
conferences with division directors and specialists in health and related
fields.
Surveys and time studies were made in 3 counties to assist the public
health nurses in evaluating and planning their work.
The institution of the new family record system was done coopera-
tively with the records consultants.
Cooperative programs with Gray Ladies, organized by the Red Cross,
local boards of education and county health departments, now function
in the schools. These programs are becoming increasingly popular. The
volunteers enhance the school health program and free nurses for duties
for which they are especially prepared.
During the summer of 1960, the public health nursing faculty of the
University of Florida undertook a project which was designed to aid the
nursing staff of Alachua County in their selection of maternity patients
for intensive nursing care. Planning and designing the project was
shared by county and college personnel. The analysis was done by the
social anthropologist of the College of Nursing. Results gave some clues
as to what guide lines may be used in selection of people who can benefit
from public health nursing service.








40 ANNUAL REPORT, 1960

DIVISION OF SANITATION
A. W. MORRISON, JR.
Director

The functions of this division were carried out by a staff consisting
of: the director, 5 sanitation consultants and 2 clerical personnel.
Activities were focused toward the development and improvement
of effective sanitation programs designed to serve local needs in all coun-
ties of the state. Major emphasis was directed toward providing high
quality consultation services for the county health departments. Train-
ing and recruitment activities were pursued with vigor and specific pro-
gram functions were in process of being brought up-to-date in all counties.
Contacts were maintained with other state and federal agencies in all
areas of mutual interest and responsibility throughout 1960.
A study on trailer parks was completed and a recommended revision
of regulations was prepared. The regulations were adopted by the State
Board of Health in June. Studies on food service and abattoir regulations
were nearing completion at the end of December. Preliminary work on
food processing was also initiated during the year. These and other proj-
ects concerning State Sanitary Code regulations will be continued during
the coming year.
Seven sanitation forms were revised and 2 additional forms were
added. The revised forms have been distributed to the county health
departments for use in the pertinent programs. Considerable work in
connection with the preparation of a manual of procedures for county
health department sanitarians was done by the entire consultant staff. A
draft of this manual will be submitted to the counties for review in early
1961.
In cooperation with the Bureau of Laboratories, a proposal for
scientific studies in the field of "potentially hazardous foods" was explored.
The necessary plan and procedure for such a study has been formulated
and it is hoped that a research grant will be obtained to carry out this
project during the coming year.

CONSULTANT SERVICE
Staff members made a total of 352 field visits to the county health
departments in 1960. Assistance was provided to the health officers and
sanitarians in all facets of environmental sanitation. Two county sani-
tation programs were evaluated during the year. One of the evaluations
included a time study of specific sanitation activities. Both included a
review of program records and coverage with an analysis of program
effectiveness. Recommendations consistent with local requirements were
submitted to the counties involved.
Emergency assistance to county health departments in connection
with recurring flooded conditions in central and south Florida and the








LOCAL HEALTH SERVICES


disaster created by Hurricane Donna in September, was provided by
staff members. Two consultants were dispatched to Monroe County and
1 to the southwestern counties immediately following the hurricane. One
spent a week in the upper Keys and the other remained in the Marathon
area for a period of 3 weeks. These sanitarians, working with county
health department and Civil Defense officials, examined food supplies;
supervised removal and disposal of damaged foodstuffs; checked emer-
gency water supplies, feeding facilities and waste disposal; and approved
the re-opening of public food establishments when water and power
became available. The third consultant transported medical supplies
and served as a communication link with mainland counties which fell
in the path of the hurricane. He also participated in various sanitation
activities in these counties for several weeks following the storm.

SANITARIAN INSERVICE TRAINING
A total of 93 local health department sanitarians plus 4 foreign
students, sponsored by federal grants, have completed the inservice train-
ing program during the past 5 years. Two courses were conducted the
first year and 3 courses have been held in each of the subsequent years.
The 12-week course consists of an 8-week period of classroom and labora-
tory instruction in Jacksonville with 4 weeks of internship in selected
county health departments. Each of the staff consultants participates in
the instructional phases of this program. Sixteen sanitarians from 12
counties completed the course in 1960. They were distributed as follows:
Dade-2, Orange-2, Pinellas-3 and 1 each from Alachua, Duval,
Gadsden, Hillsborough, Indian River, Marion, Martin, Okaloosa and
Volusia.

FOODHANDLER TRAINING
Efforts were continued to broaden the coverage of foodhandler
training opportunities through the presentation of courses for specific
groups. Staff consultants worked with county health department sani-
tarians in designing, planning and presenting this type of program for
school lunchroom personnel, institutional workers and other groups
throughout the year. Fifteen counties, including 8 which recorded no
activity during the previous year, presented foodhandler training pro-
grams.
Alachua, Baker, Bay, Brevard, Escambia, Gadsden, Hillsborough,
Holmes, Jackson, Nassau, Okaloosa, Orange, Pinellas, Polk and Taylor
Counties reported a total of 2723 foodhandlers certified in the standard
6-hour courses. Several hundred additional foodhandlers attended courses
of shorter duration in 1960.

OTHER TRAINING
Staff members provided instructional assistance in a number of
training programs during the year. Two consultants participated in school








42 ANNUAL REPORT, 1960


custodian clinics held in 4 separate counties. One assisted a county
sanitarian in conducting a series of safety programs. The director served
as an instructor in the annual training course for local school board main-
tenance supervisors and participated in programs at the Poultry Institute
and a bottled water seminar. Planning assistance was provided for sani-
tarian short courses at the state universities and several State Board of
Health training programs.
One consultant attended a United States Public Health Service
training course on environmental radiation surveillance and all staff
members attended various short courses, seminars and other training
programs.

RECRUITMENT
Recruitment activities were directed toward obtaining qualified
personnel with sufficient science background to effectively fill sanitarian
positions in the county health departments. A scarcity of new positions,
due to severely limited budgets, resulted in few vacancies until the last
quarter of the year. Several counties obtained additional local funds in
October which enabled them to provide long needed staff increases.
Contacts with the colleges and universities were maintained and re-
cruitment brochures were distributed. A slide series on the activities of
sanitarians was presented at several group meetings. Approximately 100
interested persons were interviewed and several score inquired about sani-
tarian positions by telephone or mail during the year.

SPECIFIC SANITATION PROGRAMS
This division functions in a number of specific sanitation program
areas. In 5 of the programs, the division is responsible for issuing a State
Board of Health license or permit. Another program involves recommen-
dations from the division for required federal certification. All of the
field activities related to divisional program areas are carried out by the
county health departments. Local sanitarians visit establishments and
facilities to maintain proper compliance with sanitary practices and pro-
cedures. Performance of various field tests plus the collection of certain
specimens for laboratory analysis coupled with the proper interpretation
of test results constitutes an integral part of program activities. Staff
consultants provide assistance to the counties in each of the sanitation
program areas.

TRAILER PARKS
Considerable activity was again devoted to this growing program in
all sections of the state. County health departments submitted several
hundred recommendations covering new parks, expansion of existing
parks, facilities not previously permitted and changes in ownership. The
466 new permits issued represents a net increase of 218 parks for the year.








LOCAL HEALTH SERVICES 43

A total of 2528 trailer parks providing in excess of 80,000 trailer spaces
were operating under current State Board of Health permit at the close
of 1960.

FOOD PROCESSING PLANTS
The number and variety of food processing plants continues to ex-
pand. County health departments are providing additional attention to
the sanitation factors of these operations. An increase of 76 plants was re-
corded bringing the total to 358 food processing plants permitted in 1960.

CAMPS
Major emphasis was given to the improvement of migrant labor
camp facilities throughout the year. The rapid expansion of activities
in this program has resulted in the elimination of many insanitary con-
ditions. A number of new living units have been constructed and hun-
dreds of others have been repaired or remodeled to provide satisfactory
housing for migrant workers. Upon the recommendation of county
health departments, 167 migrant labor camps were licensed during the
period of July 1-December 31, 1960.
An additional 21 recreational and educational camps were operating
under current permit at the end of the year.

BOTTLED WATER PLANTS
This program covers plants in 18 counties and the out-of-state plants
which ship bottled drinking water into Florida. Continuous sampling and
laboratory analysis of these bottled waters is maintained to insure that
consumers receive a high quality product. A total of 34 bottled water
plants were permitted in 1960.

RENDERING PLANTS
Increased county health department activity in the sanitation of
rendering operations was noted during the year. The number of approved
plants remained static with 7 rendering plants operating under State
Board of Health permit.

COMMON CARRIER CERTIFICATION
The transfer of responsibility for railroad and vessel watering point
sanitation to the division in January resulted in considerable expansion
of activities in this USPHS cooperative program. These common carrier
facilities now include: 35 airline catering and watering points, 10 airline
servicing areas, 4 railroad commissaries, 21 railroad watering points and
62 vessel watering points. County health departments conducted field
activities and submitted reports to the division in this program. These








44 ANNUAL REPORT, 1960

reports served as the basis of our semi-annual recommendations to
USPHS for official Interstate Carrier Classification Lists.

FOOD ESTABLISHMENTS
All counties continued major food sanitation activity directed toward
the prevention of food-borne diseases. Several counties prepared investi-
gation kits containing necessary equipment and supplies to facilitate the
proper handling of food-borne disease outbreaks. Increased emphasis
was given to the proper handling, preparation and storage of potentially
hazardous foods in all control programs. Local sanitarians made 149,799
visits to the 24,849 food establishments of all types under their juris-
diction.

SCHOOLS
Operational aspects of the school sanitation program were conduct-
ed by the county health departments. Escambia, Alachua, Hillsborough
and Orange County Health Departments prepared and distributed bound
copies of complete sanitation survey reports on the schools of their respec-
tive counties. Staff consultants participated in a comprehensive school
health evaluation project at a Duval County high school and in a main-
tenance and operation survey of Marion County schools.

HOUSING
Several county health departments engaged in housing survey activity
during the year. Projects were undertaken in Pinellas, Escambia and
Putnam Counties while Leon and Hamilton Counties continued work
previously begun. A number of additional counties have indicated strong
interest in constructive housing programs. Two staff consultants spent
a week observing county health department operated housing programs
in Georgia to secure additional information in this growing field of
interest.

OTHER PROGRAMS
All county health departments continued to function in a variety of
additional sanitation programs: the control of private water supplies,
private sewage disposal, garbage disposal and sanitary nuisances. Other
programs relating to rabies control, child care centers, nursing homes,
institutions and recreational areas were widely conducted throughout the
state. Staff consultants provided assistance to the counties in all of these
programs.











LOCAL HEALTH SERVICES 45







TABLE 5

PERMITTED ESTABLISHMENTS AND FACILITIES-1960


Food Bottled
County Trailer Processing Camps Water Rendering
Parks Plants Plants Plants
Alachua ........................... 80 .......... .......... 1 ...
Baker.............................. 2 ... .

Broward ............................. 106 21 8 1 ....
Calhoun ............................ 2
Charlotte ................... ........ 13 . .
Clay... ................... ........ 18 .... 3 ........ 1
Collier. ............. ................ 18 1 38 ......
Columbia ............................ ...... ......
Dade................. .... ... 95 75 88 4 2
Dixie.......................... 5
Duval.................. .. .......... 1 1
Escambia ............... 11 1 .......... .... ..
Flagler .... ......................... 8 ......... .......... ............
Gadsden....... .............. ...... 7 ..... ... .. .....
Glades........... .......... ............... 2 ... 5 .. .
Gulf...... ......................... 4 ..... ..... ...
Hamilton ..................... ... .... 8 .......... ..............
Hardee............... .......... 3 .. .......
H endry. ......... .. ..... ....... .. .. .... ...... 4 .. .. ..
Highlands................... ...... 6
Hillsborough..................... ... 222 43. 15 2 2
Indian River......................... 14 .................... 1 ..........
Jackson ..... .............. .... .. 5 8 1 .... 1
Lake ................ .............. 9 .
Lee .......... ..................... .. 56 5 1 .
Leon.................... ....... 49 .... 1 .....
Levy .... .................... 10 .......... .......... ......... .....
M anatee............................. 77 21 7 2 .........
Marion..........................2 ... 1 ...
M artin...... .. ................ ... 27 4 .......... 1 .. ..
M onroe.................. .......... 60
Nassau..................... .... 7 ......... .......... .........
Okaloosa .............. ... ........... 42 .......... .......... .......... ......
Okeechobee.......................... 2 .......... .......... ....... .
Orange ..................... ..... .. 106 14 1 1 ........
Osceola............. ... .. ........... 11 ........... 1 ...
Palm Beach.......................... 100 17 22 8 .........
Pasco.......... ....... ....... 89 ......... 7 1
Pinellas........................... 264 52 ......... 4 ..
Polk ......................... 215 17 15 1 ...
Putnam......... ....... ........ ..13 2 4 ...... ....
St. Johns ................... ....... 10
St. Lucie..................... ........ 24 11 4 1 .....
Santa Rosa ................... ..... 2 3 ..... ........
Sarasota ................. ... 72 41 1 2 ....
Seminole.... ...... ........... 12 1 .................... 1
Sumter............ .. .......... 17 .. 1
Suwannee................. .. ...... ..
Taylor .... .... ...... ... ......... ... ... .
Volusia .. ..... .................. 69 28 8 2 .........
W alton .................. ..... ....... 4 .
Out-of-State............... ...... ........ .............. .... 4
Totals............................... 2,528 858 188 84 7








46 ANNUAL REPORT, 1960


NUTRITION SERVICES

MARY BRICE DEAVER, M.S.
Director


The purpose of Nutrition Services is to improve the nutritional status
of the people of Florida, including all ages and socio-economic levels and
to promote good nutrition throughout the state. Therefore, an attempt
has been made to extend nutrition coverage insofar as possible within the
limits of existing staff.

During 1960, there have been several changes in staff with 1 regional
nutritionist returning from educational leave to resume her duties in
September and 1 nutritionist resigning to leave the state in July-that
position being filled in September. All positions were filled at the end of
the year, making a total of 4 regional nutritionists, 1 nutritionist on the
Migrant Project staff in Palm Beach County and the director. Volusia
County has added a part-time nutritionist to the county staff and becomes
the second county in the state having a nutritionist; Hillsborough County
has had a full-time nutritionist since 1958.

During the year, 62 counties have been visited. This does not mean,
however, that each of these counties has received equal service, nor does
it give an indication of the nutrition program in the county. Actually,
8 counties received only 1 visit, an indication that planning may be
underway for the future, but so far very little use of nutrition consul-
tation has been made. Twenty-two counties received more than 5 visits
and here is where the greater concentration of service was given. Follow-
ing the plan started during the preceding year, the regional nutritionists
have attempted to provide regularly scheduled consultation service to
those counties desiring it. This has worked well in most instances and has
resulted in giving more nutrition assistance in most of these counties. The
community feels that the nutritionist is a part of the local staff when she
returns to the county regularly and uses her services in a variety of ways.
In some counties the health department prefers to use the nutritionist only
on request, and while these requests are filled whenever possible, there are
occasions when a conflict in dates arising from a prior commitment
occurs.

Although good nutrition is basic to two main objectives of public
health, the promotion of optimal health and the control of disease, the
inclusion of nutrition in the over-all health program is still a goal to be
accomplished in many instances.

In the scope of activities, they might be classified generally as: serv-
ices to health departments; services to the community; services to institu-
tions; services to other professional organizations such as education and
welfare; and training.








LOCAL HEALTH SERVICES


SERVICES TO HEALTH DEPARTMENTS
Inservice education is always a most important part of nutrition con-
sultation and during the year 91 group conferences and 47 individual
ones were held for health department personnel. In addition to these
sessions which were the primary responsibility of the nutritionist, 25
additional meetings were attended where the nutritionist participated but
did not lead the discussion.
In maternal and child health, there were 71 group conferences and
240 individual ones; 19 classes were taught with a total attendance of
505. These included services to prenatals, well children, the mentally
retarded and crippled children.
In chronic diseases, 20 group conferences and 531 individual con-
ferences were held. Services included classes for diabetics and their
families and for heart patients with 735 attending such classes. Advances
in the knowledge and treatment of debilitating diseases and greater efforts
toward the prevention of the conditions now associated with aging have
led to increased requests in this area. This is also occupying considerably
more time in many county health programs, especially where home care
is given. Programs in rehabilitation have also included nutrition in the
planning.
The nutritionist with the Migrant Project has worked with other
members of the team in continuing the investigation of the nutritional
status of the migrants as well as studying methods and techniques for
working with them. The special study which was done on dietary
patterns and food habits has been accepted for publication.

SERVICES TO THE COMMUNITY
Talks were given to PTA groups, civic clubs and other organizations
on normal nutrition and food habits and customs. Group meetings were
requested and held on the following topics: weight control, new foods
on the market, low cost foods, popular food fads and food preparation.

SERVICES TO INSTITUTIONS
There have been numerous requests for dietary consultation to
institutions. It was not possible, because of limited time and personnel,
to provide any more service in this area than had been given in the
previous year. A manual on food service for nursery schools was com-
pleted and made available. There were numerous requests for this
manual throughout the state and also from other states. Dietary con-
sultation to nursing homes has been given on a limited basis but it has
not been possible to fill all requests.

SERVICES TO OTHER AGENCIES AND ORGANIZATIONS
In working with the schools, 43 group conferences and 115 individ-
ual conferences were held. An attendance of 4350 was present for 171








48 ANNUAL REPORT, 1960

classes which were held for school personnel, including teachers, super-
visors and other administrative personnel and school lunch personnel.
Several requests have been received for assistance in planning for the
inclusion of more nutrition education in classroom teaching where nu-
trition is one of the major health problems. This has involved working
with school health coordinators and other faculty members and should
prove valuable for other counties as well. Ten dietary surveys were con-
ducted in schools, providing information on food habits to aid in planning
for nutrition education programs.
Work is being done jointly with the Crippled Children's Commission
in preparing diet instruction sheets which may be used in their clinics.
Preliminary planning has been done for a dietary study with the Chil-
dren's Commission. In cooperation with the State School Lunch Program,
revisions were made in the nutrition course outlines for school lunch
workshops. All of the nutritionists participated in school lunch work-
shops held in their districts.
In cooperation with the Florida Heart Association and local heart
associations, classes have been planned and taught for heart patients and
their families in regard to normal diet and modifications as indicated in
certain heart conditions.
Consultation has been given to county and state welfare personnel in
regard to food budgeting problems and special diet problems.

TRAINING
Field experience was offered for a graduate student from the Uni-
versity of Tennessee, another from the University of North Carolina
and 1 undergraduate student from Florida State University. Classes have
also been taught and consultation given to schools of nursing, to practical
nursing programs and to health education courses.
It is obvious that the nutrition services offered are limited by the
small number of nutritionists on the staff and the great amount of travel
necessary for each consultant to cover 16 to 18 counties. In planning
for additional staff, priority should be given to the need for a position
for a dietary consultant for state and county institutions and small hospit-
als. This is an area of service that has hardly been touched and is
urgently needed. Increased dietary consultation to nursing homes is also
a need that is increasing rapidly as the number of nursing homes in the
state increases. If the food service is to be brought up to and maintained
at a desirable level in these homes, there is definite need for training
of the food service supervisors and workers. Most of them have had no
training and yet are expected to prepare good food, serve it attractively
and keep food costs down.








TABLE 6

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960
Cs



d d



A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service...................... 9 81 17 365 71 254 5 65 85 106 20 0 123 7 47 34 0
2. Field and Office Visits.................. 21 105 28 584 102 338 7 96 85 117 29 0 662 25 104 145 0
3. Hookworm Treatment Given............... 191 107 72 112 40 59 161 78 129 53 24 1,323 10 61 111 13 0
TYPE OF IMMUNIZATION
4. Smallpox .............................. 1,789 248 708 411 1,228 2,859 273 1,071 99 119 253 647 10,418 258 129 1,428 0
5. Diphtheria.............................. 2,877 915 1,411 578 2,717 4,580 361 1,173 526 236 802 3,247 10,417 1,081 436 3,710 0
6. Whooping Cough .......................... 2,062 715 1,411 390 1,408 2,186 353 1,144 272 170 407 3,247 10,268 364 329 2,292 0
7. Tetanus................................. 4,301 2,057 2,666 792 3,083 5,234 948 1,638 971 311 1,326 3,984 14,158 1,094 458 5,113 0
8. Poliomyelitis........................... 7,404 1,733 1,294 1,567 12,093 5,870 962 2,363 1,514 543 1,145 3,866 276,380 1,486 665 8,589 0
9. Typhoid ..................1,795 1,137 5,717 187 950 5,483 873 497 1,429 4 2,722 2,193 6,767 2,942 401 717 0
10. Rabies-Human .............. 0 0 0 15 0 0 0 0 0 0 0 1 1 0 5 0
11. Rabies-Animals ....................... 0 71 0 65 0 0 0 0 197 287 0 0 0 0 0 0 0
B. VENEREAL DISEASE CONTROL
1. Admissions to Service................................ 203 0 221 69 35 506 7 3 1 33 90 83 8,962 4 3 10,240 0
2. NotInfected ........................... 7 0 121 19 6 133 1 2 0 15 9 0 5,812 1 1 7,924 0
3. Treated in Clinic......................... 145 0 100 45 1 320 5 1 1 11 20 44 2,086 0 2 2,317 0
4. Treated by Private Physician .............. 0 0 0 0 11 55 0 0 0 7 0 0 2 0 14 0
5. Returned to Treatment in this Clinic........ 49 0 0 2 2 47 0 0 0 1 0 0 363 0 0 42 0
6. Epidemiological Treatment of Contacts..... 2 0 0 0 2 3 0 0 0 4 11 39 703 0 0 894 0
7. Dropped or Transferred......................... 2 0 0 3 0 6 0 0 0 2 3 0 0 0 0 16 0
8. Patients Interviewed............................. 32 0 43 69 25 145 1 4 1 12 22 83 1,366 3 4 1,159 0
9. Contacts Obtained ....................... 20 0 67 57 8 182 1 1 0 13 23 29 2,972 2 4 2,025 0
10-11. Field & Office Visits.................... 261 0 344 131 89 3,414 16 5 1 67 223 147 38,974 6 10 22,433 0
C. TUBERCULOSIS CONTROL
1. Admission to Service-Case Active.......... 38 6 14 1 37 154 5 12 17 13 240 4 156 0
2. Admission to Service-Case Inactive........ 75 3 69 43 92 280 13 7 7 21 31 201,310 8 6 732 0
3. Admission to Service-Contacts & Suspects.. 218 22 82 131 262 801 30 42 26 98 217 48 4,186 20 20 281 0












TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960









1.AdmissionstoService .. 40 1 0 28 22 8 1 0 143 0 0 651,714 31 6 423 52
-P 0

0 0


A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service ..................... 40 1 0 28 22 8 1 0 143 0 0 65 1,714 31 6 423 52
2. Field and Office Visits .................... 104 1 0 38 22 9 4 0 191 0 0 93 2,368 45 10 517 84
3. Hookworm Treatment Given .............. 244 3 128 70 213 32 561 321 131 44 86 22 245 916 115 304 95
TYPE OF IMMUNIZATION
4. Smallpox............................... 4,748 100 291 2,952 112 22 422 338 383 62 264 128 5,537 477 251 1,802 570
5. Diphtheria................... ......... 8,444 266 275 3,970 129 164 1,107 459 1,173 497 370 595 10,784 947 684 2,782 719
6. Whooping Cough ......................... 5,226 145 279 961 98 66 925 459 506 254 236 310 6,639 429 344 1,291 397
7. Tetanus................................. 13,173 318 676 5,991 172 169 1,662 763 1,414 514 616 606 4,197 1,261 947 5,176 963
8. Poliomyelitis............................. 18,319 594 1,396 8,856 265 287 1,942 1,030 2,154 807 1,881 1,511 20,946 1,763 1,700 5,807 890
9. Typhoid................................. 5,171 24 688 3,647 40 9 1,451 311 1,912 28 249 26 790 452 761 3,319 203
10. Rabies_Human.......................... 0 0 1 0 0 0 0 0 0 0 0 10 0 0 1 0
11. Rabies-Animals ......................... 0 0 0 0 0 69 120 211 0 85 0 0 29,017 0 0 0 481
B. VENEREAL DISEASE CONTROL
1. Admissions to Service..................... 2,289 23 7 121 5 19 7 20 8 8 6 47 3,972 5 48 53 23
2. NotInfected............................ 916 5 0 10 0 8 0 0 1 7 1 6 793 1 0 4 3
3. Treated in Clinic .............. ...... 1,358 9 3 83 4 7 5 15 0 1 5 20 1,618 1 33 40 10
4. Treated by Private Physician .............. 0 0 2 7 0 1 1 0 5 0 0 3 11 0 3 2 0
5. Returned to Treatment in this Clinic........ 8 6 0 0 1 0 0 6 2 0 0 14 7 0 1 3 0
6. Epidemiological Treatment of Contacts...... 0 0 2 21 0 0 0 0 0 0 0 4 244 0 13 7 4
7. Dropped or Transferred ................... 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 2
8. Patients Interviewed....................... 544 13 6 10 1 8 0 7 6 1 0 3 865 5 33 42 12
9. Contacts Obtained ........................ 958 9 2 26 2 9 0 7 4 0 0 20 1,404 2 24 37 6
10-11. Field & Office Visits .................... 3,942 59 19 314 39 29 43 2 17 14 6 91 13,137 15 63 74 45
C. TUBERCULOSIS CONTROL
1. Admission to Service-Case Active.......... 156 1 6 20 2 0 5 4 4 4 6 03 4 7 19 2
2. Admission to Service-Case Inactive........ 257 8 8 33 0 17 6 8 14 7 36 1,029 10 21 57 15
3. Admission to Service-Contacts & Suspects.. 644 44 3 279 5 11 56 39 9 44 27 59 4,372 69 29 90 43








TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960




0 C c
Is ililI __ I a i

A. COMMUNICABLE DISEASE
CONTROL
Admissions to Service ............... 17 33 148 175 51 0 0 40 131 7 137 40 207 1 266 2 78 39
2. Field and Office Visits ............. 17 141 258 190 51 0 0 65 251 9 168 55 245 1 769 12 137 107
3. Hookworm Treatment Given......... 27 94 102 143 56 172 114 13 281 7 0 124 372 19 134 91 16 303
TYPE OF IMMUNIZATION 370
4. Smallpox ........................... 55 143 1,655 2,181 212 157 712 279 939 735 1,086 1,298 1,520 108 ,244 178 4,305 370
5. Diphtheria ......................... 111 746 1,943 1,656 528 317 897 798 1,250 963 1,064 1,546 3,060 331 5,829 850 7,609 1,831
6. hoping Cough ................ 72 403 835 1,543 208 259 493 392 813 460 350 576 1,968 124 3,319 637 3,278 461
7. Tetanus ......................... 212 844 3,948 3,678 688 48 1,559 1,014 2,304 1,307 1,962 2,581 4,204 342 8,677 850 9,655 1,840
8. Poliomyelitis ...................... 364 1,273 4,02 5,879 1,403 932 2,136 1,28 3,325 1,69 1,290 2,422 6,255 61 14,363 1,36814,581 2,555
9. Typhoid............ ....... 87 160 1,838 2,452 494 253 1,940 75 2,536 908 4,339 3,060 2,859 182 6,441 500 1,415 241
10. RabiesHuman ............... ..... 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. Rabies-Animals............. 0 0 0 0 259 2,469 0 1 0 62 0 0 0 0 0 0
B. VENEREAL DISEASE CONTROL
Admission to Service .............. 1 19 100 1,048 19 2 24 532 529 51 105 12 72 35 523 65 964 17
2. Not Infected ........................ 0 2 20 130 1 0 9 202 126 14 14 5 2 0 30 0 236 13
3. Treated in Clinic ................... 1 0 45 660 2 13 197 08 22 52 2 58 20 392 54 559 4
4. Treated by Private Physician........ 0 9 0 16 0 0 0 21 8 3 9 0 2 0 3 2 11 0
5. Returned to Treatment in this Clinic.. 0 0 6 77 5 0 0 52 10 2 1 3 14 0 51 0 45 0
6. Epidemiological Treatment of Contacts 0 0 21 155 7 0 7 47 78 5 30 0 15 11 89 12 102 1
7. Dropped or Transferred ............. 0 0 0 0 0 0 0 25 4 3 0 0 2 0 0 0 1 1
8. Patients Interviewed .............. 0 64 239 4 0 19 162 170 25 37 1 6 19 165 50 398 5
9. Contacts Obtained .................. 0 2 59 426 4 0 7 344 233 11 33 1 43 19 596 132 516 3
10-11. Field & Office Visits .............. 3 23 118 1,925 25 2 57 1,069 1,424 61 339 62 89 60 2,898 252 2,560 27
C. TUBERCULOSIS CONTROL
1. Admission to Service-Case Active.... 6 40 27 55 6 1 3 1 2 9 9 4 11 7 64 15 165 17
2. Admission to Service-Case Inactive.. 126 64 36 14 2 28 9 89 14 42 47 1 17 114 2 330 30
3. Adm. to Service-Contacts & Suspects 7 296 127 147 81 7 88 51 7 28 113 71 52 23 327 21 333 62












TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960

0
F4D



Sm I I I | I
0 0

Wi43 4; g s g | | & a4

A. COMMUNICABLE DISEASE
CONTROL
1. Admissions to Service ..................... 269 366 35 13 6 93 175 25 2 2 4 75 1 1 0 6,264
2. Field and Office Visits..................... 420 542 59 14 5 7 99 292 25 2 2 4 169 2 1 0 10,053
3. Hookworm Treatment Given............... 87 250 25 0 8 162 16 137 79 89 47 155 55 249 1,138 380 11,027
TYPE OF IMMUNIZATION
4. Smallpox................................ 1,68 3,613 719 304 72 558 578 441 474 269 329 117 458 66 473 181 69,911
5. Dihtheria............................. 4,995 8,213 1,466 1,111 226 1,085 1,322 1,397 1,082 807 812 285 462 352 1,390 1,650126,416
6. Whooping Cough... .................. 4,108 5,038 410 14 149 800 1,034 1,124 564 530 420 115 437 346 671 729 78,263
7. Tetanus................................ 5,418 10,160 1,891 805 609 1,837 1,417 2,179 1,104 1,259 1,581 332 487 923 1,666 2,061176,694
8. Poliomyelitis...................7,849 15,770 2,001 290 689 2,885 2,168 3,65 2,263 1,901 1,408 73 1,645 850 1,467 2,085 510,901
9. Typhoid .................... .......... 62 692 34 358 69 1,023 60 1,953 392 484 331 221 31 699 1,402 247 91,033
10. Rabies--Human .......................... 0 4 0 0 0 0 0 109 0 0 0 3 0 0 0 0 150
11. Rabies-Animals ........................ 32 0 0 0 0 0 0 1 0 0 383 0 0 0 0 0 33,810
B. VENEREAL DISEASE CONTROL
1. Admissions to Service................. 829 510 178 57 67 12 269 13 35 16 31 8 111 8 7 20 33,550
2. Not Infected........... 104 12 66 17 4 3 137 2 1 4 10 3 10 13 4 0 0 17,098
3. Treated in Clinic. ................................. 352 272 78 18 64 4 130 63 24 10 20 8 59 2 6 19 11,833
4. Treated by Private Physician.............. 107 6 5 2 0 0 2 0 0 1 1 0 6 2 0 1 341
5. Returned to Treatment in this Clinic........ 21 36 27 5 0 0 1 11 6 0 0 0 17 0 0 0 944
6. Epidemiological Treatment of Contacts...... 61 35 5 18 1 0 0 17 4 1 6 0 10 0 1 0 2,710
7. Dropped or Transferred ................... 0 227 0 4 0 5 0 2 0 0 0 0 2 0 0 0 320
8. Patients Interviewed...................... 226 114 84 27 63 4 209 29 34 4 22 7 87 2 5 20 6,924
9. Contacts Obtained ....................... 250 158 88 16 10 1 261 45 14 2 20 7 45 2 2 8 11,272
10-11. Field & Office Visits.................... 2,872 1,143 337 93 128 20 622 392 66 26 44 23 385 9 14 30 96,251
C. TUBERCULOSIS CONTROL
1. Admission to Service-Case Active.......... 111 71 9 2 20 13 22 36 5 8 10 0 57 2 16 2,151
2. Admission to Service-Case Inactive....... 452 388 7 9 63 24 9 70 14 26 23 3 231 36 36 6,770
3. Admission to Service-Contacts & Suspects.. 709 658 60 32 59 84 68 208 39 59 29 1 386 52 109 97 16,895







TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960





O

Tuberculosis Control Cont'd.
--- --- ; ----- -- -- --- o

4. No of Person X-rayed-Minature Films.... 10,220 0 0 2,242 0 30,505 1,452 0 0 3,213 3,954 0 23,206 0 0 0 0
5. No. of Persons X-rayed-Large Film....... 863 28 488 210 2,959 1,154 72 614 32 163 290 63 6,501 378 55 2,531 0
6. Tuberculin Test ............ ............ 312 5 122 117 207 6,993 37 841 19 53 1,905 33 1,414 13 57 165 0
7. Field Visits ............................ 742 43 166 416 483 3,93 42 217 29 262 338 115 4,423 59 91 897
8. Office Visits.............................. 241 18 185 107 731 940 71 82 49 153 549 70 19,523 111 132 2,336 0
9. Cases Hospitalized ....................... 29 6 16 6 23 78 5 0 3 7 13 13 429 4 0 25 0
D. MATERNITY SERVICE
1-2. Patients Admitted to
Maternity Medical Service.............. 139 22 103 95 146 290 9 1 3 86 111 3 2,780 0 24 1 0
3. Visits by Antepartum Cases to
Medical Conferences.................... 359 21 104 209 295 675 9 1 3 210 446 3 9,071 0 59 2 0
4. Patients given Postpartum =
MedicalExaminations................. 34 1 0 5 46 82 0 0 0 8 25 0 895 0 1 7 0
5. Patients Admitted to Maternity
Nursing Service ....................... 923 58 118 126 262 461 34 5 19 144 151 154 3,229 0 56 274 0
6. Field Nursing Visits.................. 1,44 87 15 429 626 1,066 34 10 19 385 167 226 10,519 0 53 347 0
7. Office Nursing Visits..................... 1,149 9 119 73 763 821 58 0 4 266 1,035 347 8,988 0 179 165 0
8. Number of Midwife Meetings ............. 1 1 0 0 27 12 0 0 0 0 12 9 0 0 0 0
9. Visits for Midwife Supervision ............ 27 8 18 27 79 83 3 0 0 8 33 56 69 0 35 0 0
10. No. of Midwife Deliveries Superivised
by Health Dept. Personnel. ............. 0 0 0 2 1 1 0 0 0 0 0 0 0 0
11. No. of Individuals Enrolled in Classes
for Expectant Mothers.................. 169 10 0 0 0 0 0 0 0 0 0 0 1,153 0 0 16 0
E. CHILD HEALTH SERVICES
1-2-a. Adm. to Well Child Medical Service- 0
Infants .......................... .. 325 4 57 56 78 459 0 0 0 40 39 36 4,414 0 3 273 0
1-2-b. Adm. to Well Child Medical Service-1-4 90 3 12 116 51 18 0 0 0 40 25 25 5,651 0 2 152 0
1-2-c. Adm. to Well Child Medical Service---
5 over ................................ 65 5 3 105 67 11 1 49 0 63 23 35 2,530 0 8 108 0
3. Visits to Well Child Medical Conference:-
Infants................................ 409 7 178 122 81 795 0 0 0 45 55 36 10,157 0 3 527 0
1-4................................ 120 5 17 209 52 82 0 0 0 53 40 25 11,067 0 2 259 0
5-over............................... 88 8 6 188 84 148 49 0 83 8 354,104 0 8 127 0
(A










TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960



0 0

S. 3 j I 1 0 1 4
1-2. Parties A d to M y M l O I I
Tuberculosis Control Cont'd. --.
4. No. of Persons X-rayed-Minature Films 9139 0 0 9,634 0 0 0 6 0 831 0 0 7132 1858 3886 0 1
5. No of Persons X-rayed-Large Films....... 1,443 163 211 129 7 69 392 34 37 267 29 239 1,340 63 256 340 49
6. Tuberculin Test......................... 523 338 13 1,086 22 33 42 5 172 16 98 9,499 202 34 71 33
7. Field Visits.............................. 3,672 58 35 1,049 11 1 74 11 34 117 68 112 4793 77 121 203 106
8. Office Viits. ............................ 424 340 66 243 1 32 90 82 41 87 8 128 5,545 127 34 325 38 M
9. Cases Hospitalized........................ 74 0 6 2 0 6 4 2 3 159 1 8 15 1
D. MATERNITY SERVICE
1-2. Patients Admitted to Maternity Medical 0
3. Visits by Antepartum Casesto Medical 766 60 12 495 4 23 66 12 16 2316 13 0 196 43
SConferences ..........................1,359 205 16 1,213 6 27 33 0 27 165 15 26 8,593 27 0 242 90 H
4. Patients given Postpartum Medical
Examinations.......................... 203 22 1 272 0 1 17 0 2 0 0 0 1006 5 0 74 1
5. Patients Admitted to Maternity Nursing 74
Service.............................. 850 80 13 873 30 21 32 134 39 30 10 8 2,934 25 85 442 122
6. Field Nursing Visits....................... 2,088 114 5 1,057 46 21 56 365 49 22 11 12 5,244 33 173 746 338
7. Office Nursing Visits..................... 2,078 264 20 1,534 24 19 60 248 57 49 12 0 10,783 60 92 1,045 154
8. Number of Midwife Meetings.............. 2 2 0 9 1 0 0 2 0 0 0 0 0 0 0 6 0
9. Visits for Midwife Supervision.............. 22 0 0 191 0 0 6 2 1 0 7 4 8 8 4 133 10 O
10. No. of Midwife Deliveries Supervised
by Health Dept. Personnel .............. 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0
11. No. of Individuals Enrolled in Classes
for Expectant Mothers.................. 139 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0
E. CHILD HEALTH SERVICES
1-2-a. Admission to Well Child Medical
Service-Infants .......... .......... 357 39 0 318 1 0 1 6 21 0 9 2,951 14 0 58 41
1-2-b. Admission to Well Child Medical
Service--4.......................... 72 9 0 276 0 1 1 0 0 17 0 9 4,231 30 0 24 11
1-2-c. Admission to Well Child Medical
Service-5-over................. ...... 13 28 0 79 0 50 0 0 0 21 0 1 3,780 5 0 15 3
3. Visits to Well Child Medical Conference:
Infants .............................. 976 69 0 344 0 7 1 0 6 41 0 10 5,594 17 0 68 47
1-4.................................. 204 22 0 293 0 1 1 0 0 30 0 9 7,170 35 0 25 11
5-over................................ 16 51 0 84 0 50 0 0 0 34 0 1 5,198 5 0 21 4





TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960




a 0 ,g N
4 0 W I I
'S iS a a 5S M cc
Si H- a a 4 a

Tuberculosis Control Cont'd. -
4. No. of Persons X-rayed-
Miniature Films .................. 0 12,05 13,755 12,508 7 555 2,370 11,402 0 494 0 0 0 712 20,586 2,067 40,600 386
5. No. of Persons X-rayed-
Large Films .... 6 527 664 740 96 9 64 617 683 183 1,354 165 1,326 87 834 116 1,548 246
6. Tuberculin Test................... 0 3,200 2,253 1,801 66 3 51 217 1,118 860 165 88 1,287 406 649 14 8,332 417
7. Field Visits................... .... 21 903 257 707 251 12 88 169 520 124 389 30 378 116 1,516 86 1,902 120
8. Office Visits ........................ 15 354 338 266 72 9 171 196 73 40 203 150 231 61 1,225 125 816 268 -4
9. Cases Hospitalized................... 0 31 24 42 3 0 1 31 15 4 5 9 4 2 57 5 114 5
D. MATERNITY SERVICE
1-2. Patients Admitted to Maternity
Medical Service.................. 1 110 198 219 82 9 60 111 0 0 61 2 18 0 769 103 495 23
3. Visits by Antepartum Cases to
Medical Conferences.............. 2 238 241 716 220 16 122 366 0 0 158 1 14 0 2,851 382 1,600 30
4. Patients given Postpartum Medical t -
Examinations .................... 1 33 74 48 10 19 10 68 0 0 12 1 9 0 312 35 123 3
5. Patients Admitted to Maternity
Nursing Service ................. 21 246 382 304 97 10 145 130 104 7 148 41 101 0 881 123 806 53
6. Field Nursing Visits ................ 26 396 435 1,220 26 10 293 183 274 7 220 69 159 0 1,129 229 1,801 71
7. Office Nursing Visits................ 44 307 872 2 246 23 193 443 4 7 251 22 113 0 3,070 456 1,386 106
8. Number of Midewife Meetings...... 0 0 6 12 0 0 3 1 9 0 8 3 0 0 38 1 6 4 c
9. Visits for Midwife Supervision........ 6 20 1 41 13 0 20 2 28 0 2 37 11 0 4 12 11 6
10. No. of Midwife Deliveries Supervised
by Health Dept. Personnel........ 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0
11. No. of Individuals Enrolled in Classes
for Expectant Mothers............ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0
E. CHILD HEALTH SERVICES
1-2-a. Admission to Well Child Medical
Service-Infants ................ 0 20 86 103 26 6 14 154 0 1 16 3 9 0 147 78 240
1-2-b. Admission to Well Child Medical M
Service-1-4 .................... 0 4 3 121 11 10 7 260 0 9 7 4 2 0 37 52 39 9
1-2-c. Admission to Well Child Medical
Service-5-over. ................. 0 0 4 7 4 7 12 231 0 0 0 4 0 0 125 0 32 0
3. Visits to Well Child Medical
Conference:-Infants............. 0. 20 92 115 29 6 16 182 0 1 16 3 10 0 247 143 679 5
1-4.................. 0 4 8 124 12 10 7 321 0 9 7 4 2 0 55 109 53 11 ur
5-over.............. 0 4 12 4 7 13 280 0 0 0 6 0 0 153 0 39 0 U1









TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960


0
sl I I I I I

d ~s 2 S .8. a ^ i
I ha i j S I I|
.a y,, gg l l % ^ al^
JAS113 9 0 mI
0 ca
-P, E404,~~B


Tuberculosis Control Cont'd.
4. No. of Person X-rayed-Miniature Films.... 27,776 27,564 0 33 0 3,911 15,699 0 0 0 2,498 68724,530 0 2,387 0394,711
5. No. of Person X-rayed-Large Films........ 4,078 1,900 1,302 4 201 136 697 270 143 217 37 17 6,126 38 197 52 46,485
6. Tuberculin Test .......................... 3,250 7,130 1,541 215 46 121 91 54 48 54 75 0 769 25 567 91 59,486
7. Field Visits ............................ 1,913 2,564 163 17 336 381 715 502 96 85 34 8 1,621 98 39 61 38,994
8. Office Visits.............................. 8,084 2,905 96 47 372 140 560 512 110 141 67 43 663 29 266 212 51,799
9. Cases Hospitalized ....................... 85 56 6 3 16 5 15 15 3 3 9 0 34 5 1 15 1,586
D. MATERNITY SERVICE
1-2. Patients Admitted to Maternity Medical
Service............................... 674 1,161 234 0 254 1 99 122 21 6 47 61 246 29 10 31 13,116
3. Visits by Antepartum Cases to Medical
Conferences.......................... 3,100 3,297 628 0 927 1 325 323 26 6 73 129 924 95 11 33 40,366
4. Patients given Postpartum Medical
Examinations.......................... 433 157 61 0 0 2 46 30 0 0 13 2 142 11 1 22 4,398
5. Patients Admitted to Maternity Nursing
Service................................ 803 1,564 303 7 316 2 102 397 103 25 50 80 433 37 26 111 19,700
6. Field Nursing Visits....................... 1,434 3,337 287 6 405 4 342 677 101 38 19 68 944 135 24 124 40,443
7. Office Nursing Visits ................. 3,899 6,116 738 3 1,142 2 374 557 107 55 156 135 1,224 36 62 134 52,760
8. Number of Midewife Meetings.............. 1 10 6 0 0 0 0 7 2 0 10 0 2 3 0 3 223
9. Visits for Midewife Supervision.............. 31 29 21 1 1 0 0 87 43 4 8 0 51 19 11 5 1,367
10. No. of Midewife Deliveries Supervised
by Health Dept. Personnel ............. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13
11. No. of Individuals Enrolled in Classes for
Expectant Mothers ..................... 0 16 0 0 0 0 80 0 0 0 4 0 0 0 0 0 1,652
E. CHILD HEALTH SERVICES
1-2-a. Admission to Well Child Medical
Service-Infants ............ 771 700 112 2 77 4 0 34 0 4 29 59 335 13 1 14 12,667
1-2-b. Admission to Well Child Medical
Service-1-4........................... 931 105 16 0 0 1 0 6 0 1 0 68 425 3 1 16 13,014
1-2-c. Admission to Well Child Medical
Service-5-over........................ 528 151 19 5 0 0 0 2 0 1 6 65 351 1 1 10 8,634
3. Visits to Well Child Medical Conference:
Infants. ............................... 1,518 1,191 123 2 145 4 0 35 0 5 38 89 695 13 1 18 25,086
1-4................................... 1,370 139 20 0 0 1 0 6 0 1 0 122 849 3 1 2123,001
5-over................................ 683 211 19 5 0 0 0 2 0 1 8 156 576 1 1 14 12,600


z
s;
20
a


bri
Fi
0


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0
,q


",
o,
o








TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960





.c g a

4l M M B n 3B

Child Health Services Cont'd.
5. Admission to Nursing Service
Infants.................... 674 98 108 168 376 1,198 19 331 27 155 111 226 4,088 18 60 713 0
1-4 ....................... 637 293 143 630 603 398 29 31 46 293 173 286 5,096 26 82 509 0
5-over..................... 1,005 271 285 334 727 445 29 1,536 37 1,137 191 184 7,760 184 205 759 0
6. Field Nursing Visits-Infants .............. 1,391 149 445 62 854 1,925 41 121 39 468 124 166 9,979 12 79 777 0
1-4.................. 1,395 472 382 1,706 1,402 825 48 86 79 640 114 243 11,680 5 97 510 0
5-over............... 1,494 466 544 744 1,518 732 55 1,024 46 653 182 137 8,342 52 222 742 0
7. Office Nursing Visits-Infants.............. 796 32 203 34 175 514 6 286 10 75 210 139 7,868 16 30 1,059 0
1-4. ................... 753 66 17 48 257 70 14 113 2 100 309 122 8,929 27 39 618 0
5-over................ 1,000 116 469 172 486 516 15 2,086 9 1,274 239 111 67,745 187 49 564 0
F. SCHOOL HEALTH
1. Pupils Examined by Physician with
Parent Present......................... 73 34 3 308 31 1,575 2 331 118 157 14 83 3,055 0 126 86 0
(b) Referred for Further Diagnosis ......... 30 21 2 76 1 219 0 0 8 19 12 9 0 0 23 0 0
(c) Completed Referrals ................... 20 7 0 58 2 7 0 0 0 0 12 6 0 0 1 0 0
2. Pupils Examined by Physician with
parent not present...................... 212 128 5 18 32 3,031 0 5 912 5 10 20 14,965 8 235 5 0
(b) Referred for Further Diagnosis ......... 5 24 0 50 1 1,035 0 0 47 1 1 7 0 0 44 279 0
(c) Completed Referrals .................. 2 9 0 34 0 1 0 0 4 1 2 7 0 0 0 13 0
3. Screening by other health department
personnel-Visual. ..................... 4,538 285 9,830 98 6,179 764 68 2,230 12 2,692 844 149 65,157 1,361 918 3,181 0
(b) Referred for Further Diagnosis ......... 552 95 664 22 98 326 9 110 2 253 167 19 6,693 206 92 1,297 0
(c) Completed Referrals .................. 89 3 36 26 6 6 10 87 5 89 15 17 1,635 25 0 298 0
4. Screening by other health department
Personnel-Audiometer Testing .......... 4,814 1 541 0 0 42 0 1,977 1 1 169 0 42,001 47 20 110 0
(b) Referred for Further Diagnosis......... 225 0 63 0 0 28 0 16 1 1 31 0 1,117 6 0 290 0
(c) Completed Referrals.................. 99 0 0 0 0 0 0 11 1 1 2 0 502 0 0 6 0
7. Nurse-Teacher Conference.................. 2,409 112 1,289 462 758 473 114 774 193 502 684 0 26,148 266 232 3,198 0
G. DENTAL HEALTH
1. Number of Dental Inspections ............. 5,017 298 0 0 0 2,620 0 257 373 53 219 0 0 49 28 28,628 0
2. Number Requiring Treatment............. 3,115 237 0 0 0 1,613 0 257 336 30 219 0 0 1 28 18,595 0










TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960








Child Health Services Cont'd. -4
5. Admissions to Nursing Service-
Infants.............. 61 274 383 440 43 4 137 325 132 18 166 25 97 0 941 120 903 49
1-4................. 124 427 506 673 28 15 166 737 106 79 331 68 107 2 1,316 138 346 92
5-over............... 85 551 802 1,287 105 14 355 1,764 534 80 520 212 329 84 2,723 139 3,532 910
6. Field Nursing Visits-Infants. ....... 102 416 455 1,442 18 9 319 185 343 24 05 54 266 0 1,127 104 2,604 74
1-4............ 224 560 569 2,246 29 15 244 228 254 119 633 93 237 2 1,291 158 1,007 98 'd
5-over......... 210 742 737 3,065 105 16 352 416 812 167 449 261 735 46 1,865 148 3,908 143
7. Office Nursing Visits-Infants......... 42 117 161 1 35 15 19 461 7 2 171 24 103 0 2,578 187 624 29 O
1-4............ 93 154 152 1 17 11 14 1,692 1 4 450 29 111 0 3,385 159 259 83
5-over......... 108 233 552 2 69 8 163 2,493 391 8 1,004 339 232 77 7,922 257 6,755 1,240
F. SCHOOL HEALTH
1. Pupils Examined by Physician with
parent present................... 43 899 0 509 147 56 23 187 0 83 92 4 544 44 6 82 31 38
() Referred for Further Diagnosis... 2 179 0 0 19 0 2 1 0 0 41 0 16 18 0 4 20 1 3.
(c) Completed Referrals ............ 0 29 0 0 0 0 0 0 0 0 2 0 6 1 0 2 19 1 O
2. Pupils Examined by Physician with
parent not present ............... 45 205 83 0 736 23 244 56 1,095 38 245 21 377 3 5 182 97 1 0O
(b) Referred for Further Diagnosis... 4 28 0 0 76 1 9 1 0 0 31 0 1 1 78 0 4 1 O
(c) Completed Referrals ............. 0 5 2 0 1 1 1 0 0 0 1 0 1 0 2 0 16 0
3. Screening by other health dept.
Personnel-Visual................ 7 2,360 1,489 5,973 1,268 107 110 2,270 1,093 2,808 2,660 198 3,486 736 23,897 126 21,219 1,216
(b) Referred for Further Diagnosis... 7 309 166 976 114 0 25 333 154 291 157 20 304 4 2,751 22 3,476 38
(c) Completed Referrals ............ 4 152 55 300 23 0 2 55 42 39 186 14 35 6 1,056 6 1,057 15
4. Screening by other health dept.
Personnel-Audiometer testing..... 0 583 109 4,697 522 33 40 76 445 321 3,041 431 401 195 1,035 7 5,805 21
(b) Referred for Further Diagnosis... 0 67 0 637 12 0 7 5 30 31 47 40 27 16 62 2 563 0
(c) Completed Referrals ............. 0 9 0 90 0 0 0 4 4 9 7 3 0 3 4 1 138 0
7. Nurse-Teacher Conference............ 69 620 507 384 40 26 208 1,102 1,338 199 584 865 590 96 2,998 247 5,915 427
G. DENTAL HEALTH
1. Number of Dental Inspections ........ 0 470 0 0 162 0 0 13 991 93 0 0 0 0 32,537 0 4,399 1,881
2. Number Requiring Treatment........ 0 451 0 0 152 0 0 17 926 88 0 0 0 0 13,075 0 3,902 1,610







TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960




I .- *| a
____________ Is b o

Child Health Services Cont'd. -
5. Admissions to Nursing Service--
Infants.......... ...... 872 95 20 975 45 11 42 108 35 35 9 10 4,308 22 95 402 283
1-4.................. 274 200 42 1,971 121 9 40 51 25 7 59 8 6,848 38 35 482 628
5-over..................... 603 180 29 586 14 11 53 11 59 71 90 75 10,459 182 557 197 353
6. Field Nursing Visits-Infants.............. 2,276 160 38 1,532 82 27 69 311 79 76 18 22 4,078 236 744 616
1-4.................. 889 232 63 3,539 236 17 44 266 42 1 89 17 3,445 20 123 1,132 1,283
5-over .............. 1,316 124 33 816 44 13 52 51 283 45 158 102 6,535 79 408 582 339
7. Office Nursing Visits-Infants............. 1495 80 2 379 3 31 1 7372 2 36 91
1-4 ................. 23 151 0 498 6 4 34 17 2 63 18 111,111 59 27 346 774
5-over............... 2,058 173 1 371 2 6 56 10 21 111 15 15 12,043 534 653 132 373
F. SCHOOL HEALTH
1. Pupils Examined by Physician with
parent present ......................... 119 4 0 275 15 5 57 122 40 167 166 314 2,07 232 1 15 144
(b) Referred for Further Diagnosis.......... 1 0 0 24 2 1 8 8 7 14 9 131 1,805 71 0 0 2
(c) Completed Referrals.................... 1 0 0 5 1 0 8 8 7 6 0 7 1,143 0 0 0 0
2. Pupils Examined by Physician with
parent not present ......... ..... 33 83 44 337 46 59 106 108 132 188 81 72 4,4 1 0 41 4
(b) ReferredforFurther Diagnosis......... 72 5 0 58 1 0 0 4 3 9 90 195 679 0 0 1 0
(c) Completed Referrals ................... 1 0 0 0 1 0 0 0 3 1 25 26 178 0 0 0 0
3. Screening by other health dept.
Personnel-Visual.....................15,714 507 41 1,986 212 57 867 1 131 268 12 8 55,11 163 8,319 719 1,194
(b) Referred for Further Diagnosis......... 2,0 104 14 168 8 5 17 1 24 23 2 202,429 829 49 54
(e) Completed Referrals .................. 77 11 5 58 2 0 17 0 23 9 0 1 1,620 9 156 5 25
4. Screening by other health dept. .2
Personnel-Audiometer testing.......... 2,05 14 6 989 0 13 5 0 5 8 0 10 30,603 2 2,799 234 7
(b) Referred for Further Diagnosis......... 128 0 1 75 0 1 3 0 5 0 0 5 2,15 1 261 16 2
(c) Completed Referrals.......................... 2 0 1 16 0 0 3 0 2 0 0 01,150 0 0 2 0
7. Nurse-Teacher Conference. ................ 2,568 54 27 1,786 106 207 525 141 19 51 46 9045 191 507 528 276
G. DENTAL HEALTH
1. Number of Dental Inspections ............. 568 0 214 0 0 0 0 0 0 0 0 1,606 14,890 0 0 1186 552
2. Number requiring Treatment.................. 565 0 2 0 0 0 0 0 0 0 0 578 8,963 0 0 10 265
--- --_ ___ UI
>0










TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960
C
0
0 k
Sa c c0
N

it i s s

Child Health Services Cont'd.
5. Admissions to Nursing Service- 03
Infants .................. 1,170 2,095 251 3 232 58 97 320 126 85 58 90 546 57 40 103 25,181
1-4 .................. 2,021 2,512 281 4 206 77 101 494 81 176 48 132 772 98 66 188 32,561
5-over .................... 8,454 6,089 314 57 9 1,282 572 1,368 63 173 48 87 2,458 284 1,261 36 65,200
6. Field Nursing Visits-nfants ..............2,055 ,764 319 4 428 25 30 882 121 92 97 7 31 108 44,734
1-4..................2,725 4,569 317 5 615 114 405 754 64 276 53 181 1,287 232 49 216 51,021
5-over *............ 7,277 2,970 375 22 18 520 1,395 1,461 25 227 55 102 2,266 227 526 23 59,599
7. Office Nursing Vistis-nfants .............2,28 ,811 214 0 164 55 1 100 87 89 6 96 45 28 43 6633,944
1-4. ............... 2,710 2,858 225 0 1 35 11 376 84 90 14 139 707 13 78 98 38,972
5-over............... 15,950 7,886 340 54 0 1,826 112 2,085 86 87 27 167 2,718 212 1,300 34146,349
F. SCHOOL HEALTH
1. Pupils Examined by Physician with
parent present ...................... 15,487 64 57 5 0 152 20 525 115 112 3 82 650 59 23 134 31,585
(b) Referred for Further Diagnosis......... 2,760 88 4 0 0 53 11 110 43 0 7 0 6 19 0 5,402
(c) Completed Referrals ................... 60 0 1 54 6 6 0 0 3 0 2 1 0 ,594
2. Pupils Examined by Physician with 0 1 3,4
parent not present .................... 1,930 268 68 12 0 2,967 104 186 48 55 159 124 128 84 541 84 37,345
(b) Referred for Further Diagnosis ......... 768 5 0 2 0 44 18 2 0 3 4 8 0 1 11 0 3,712
(c) Completed Referrals................... 540 4 0 10 0 42 4 1 0 0 1 5 1 2 2 959
3. Screening by other health dept.
personnel-Visual ................... 9,485 13,798 245 4 2,475 1,00 3,534 2,695 3,107 595 127 26 8,933 706 769 242 352,463
(b) Referred for Further Diagnosis......... 2,890 1,075 131 5 193 212 487 238 166 57 3 5 732 41 17 1 31,950
() Completed Referrals................... 2,797 143 42 1 0 120 153 48 35 9 3 2 237 41 29 1411,086
4. Screening by other health dept.
personnel-Audiometer testing........... 7,51 321 0 0 0 57 7,067 11 26 551 334 0 5,465 5 18 0393,608
(b) Referred for Further Diagnosis......... 538 47 0 0 0 0 94 3 0 22 16 0 85 2 3 6,789
(c) Completed Referrals................... 404 7 0 0 0 0 33 0 0 1 0 0 7 2 0 02,524
7. Nurse-Teacher Conference............... 12,411 7,014 376 36 0 729 1,601 1,021 137 225 2 65 425 71 95 58 94,504
G. DENTAL HEALTH
1. Number of Dental Inspections ..... .. 6,692 0 224 0 0 0 524 0 0 0 03,63 0 108147
2. Number requiring Treatment .............. 3,139 0 0 0 0 0 267 0 0 0 0 0 2,822 0 0 0 61,63









TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960







____________M_____ M m o oM M is
Dental Health Cont'd.
3. Number completing treatment ............. 376 41 0 0 0 221 0 8 24 0 13 0 227 1 28 474 0
4. Number admitted to clinic for treatment..... 1,222 119 0 0 0 504 0 83 57 0 156 0 1,177 0 79 1,183 0
5. Total fillings. .......................... 2,223 163 0 0 0 2,342 0 124 86 0 179 0 3,970 0 83 2,963 0
6. Total extractions........................ 278 120 0 0 0 554 0 51 19 0 99 0 1,359 0 30 969 0
7. Topical applications of fluoride ............ 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0
H. CHRONIC DISEASES
1. Admission to Cancer Service............... 99 10 26 49 49 194 8 6 5 33 63 19 77 19 2 2 0
2. Field Visits-Cancer...................... 60 84 128 187 198 346 16 13 4 156 199 9 850 59 4 7 0
3. Office Visits-Cancer................................. 156 7 2 81 112 388 2 2 1 11 84 19 79 43 5 0 0
4. Admission to Orthopedic Service......... 96 9 154 71 187 132 14 1 14 55 29 15 13 81 30 12 0
5. Field Visits-Orthopedic Service............ 171 10 499 287 613 450 47 57 19 208 109 14 57 82 56 25 0
6. Office Visits-Orthopedic Service........... 107 2 87 43 490 29 9 78 23 241 49 3 4 112 6 7 0
7. Admission to Diabetes Service ............. 23 5 10 26 36 54 5 18 10 19 17 0 20 7 4 3 0
8. Field Visits-Diabetes .................... 144 5 43 51 125 252 80 1 166 80 0 64 3 4 3 0
9. Office Visits-Diabetes .................... 32 9 1 35 152 250 36 40 13 14 61 0 13 21 43 0 0
10. Admission to Cardiovascular Renal Disease. 12 6 17 75 196 24 2 3 31 72 22 0 90 1 2 3 360
11. Field Visits-Cardiovascular Renal Disease. 2 71 75 327 372 49 0 5 1 470 50 0 1,437 1 5 4 6,372
12. Office Visits-Cardiovascular Renal Disease.. 9 113 0 162 243 4 13 1 120 16 24 0 9 0 49 1 0
J. MENTAL HEALTH
1. Admission to Service-Children............. 396 0 5 3 163 233 16 42 23 45 176 0 994 42 10 38 0
2. Admission to Service-St. Hospital Pts...... 125 2 46 27 61 27 11 5 27 22 8 6 238 1 4 106 0
3. Admission to Service-Other Adults......... 134 0 12 7 101 478 7 9 13 43 67 2 180 3 7 36 0
4. Field Visits-With Patients ................ 678 3 162 70 221 194 42 54 39 12 190 7 769 29 13 152 0
5. Field Visits-About Patients............... 650 0 102 46 374 529 71 173 170 126 272 4 1,178 56 12 199 0
6. Office Visits-With Patients............... 780 1 15 31 626 1,359 16 8 27 702 5 5,129 22 6 27 0
7. Office Visits-About Patients............... 3,832 0 5 12 891 659 21 90 36 91 496 3 4,732 41 8 67 0
8. Mental Health Conferences ................ 737 149 0 4 983 2,529 131 46 187 34 285 0 893 92 9 160 0











TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960





B a I g A 5


Dental Health Cont'd.
3. Number completing treatment .............. 146 0 2 0 0 0 0 0 0 0 0 10 1,925 0 0 0 81
4. Number Admitted to Clinic for Treatment... 240 0 0 0 0 0 0 0 0 0 0 0 1,828 0 0 0 160 Mt
5. Total Fillings ............... 600 0 16 0 0 0 0 0 0 0 0 0 4,359 0 0 130
6. Total Extractions...............78 0 0 0 0 0 0 0 0 0 0 2,458 0 0 0 207
7. Topical Applications of Fluoride ............ 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 O
H. CHRONIC DISEASESw
1. Admission to Cancer Service .............. 413 1 18 34 8 12 27 5 23 8 18 20 437 86 14 46 21
2. Field Visits-Cancer ............... 1,860 1 26 149 9 4 42 2 89 10 28 72 706 29 6 19 76
3. Office Visits-Cancer.................... 1,181 0 17 12 2 26 30 4 20 21 10 13 2,268 47 6 38 7
4. Admission to Orthopedic Service............ 28 1 52 107 5 1 82 2 21 16 17 27 835 60 45 140 31
5. Field Visits-Orthopedic Service............ 912 4 29 383 6 0 112 7 77 40 27 70 1,37 71 156 235 83
6. Office Visits-Orthopedic Service........... 64 0 78 102 0 1 79 0 6 10 1 12 281 114 30 232 7
7. Admission to Diabetes Service ............. 188 5 15 31 2 6 10 3 32 16 3 22 719 49 33 30 35 0
8. Field Visits-Diabetes.................... 878 13 19 103 9 8 33 0 26 64 5 7 1,615 4 147 109 45 0Q
9. Office Visits-Diabetes................... 548 16 84 70 1 16 21 5 44 87 2 28 6,950 316 15 149 114
10. Admission to Cardiovascular Renal Disease. 313 4 26 154 13 20 62 8 2 46 2 5 978 81 6 59 25 O
11. Field Visits-Cardiovascular Renal Disease... 2,369 10 1 754 14 34 70 0 2 101 1 23 2,835 61 31 155 76
12. Office Visits-Cardiovascular Renal Disease.. 614 7 73 496 79 24 238 14 0 129 7 8 1,080 34 4 286 10
J. MENTAL HEALTH
1. Admission to Service-Children............. 365 1 28 26 0 24 16 0 22 59 8 28 918 6 23 31 1
2. Admission to Service--St. Hospital Pts...... 204 1 19 35 0 0 7 0 4 4 5 10 235 9 16 18 17
3. Admission to Service-Other Adults......... 247 0 11 76 0 5 12 0 6 5 0 37 407 9 25 13 2
4. Field Visits-With Patients ............... 448 3 50 265 0 9 36 0 24 28 11 98 1,420 11 16 118 21
5. Field Visits-About Patients............... 594 0 168 220 0 24 8 0 69 61 78 187 767 5 260 269 8
6. Office Visits-With Patients................ 2,602 2 8 28 0 18 18 0 34 59 2 41 2,072 11 41 19 11
7. Office Visits-About Patients............... 2,646 0 16 72 0 30 22 0 78 104 1 71 2,678 24 34 9 5
8. Mental Health Conferences ............... 1 0 289 249 0 14 209 0 77 1112 41 233 10 49 250 0









TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960



i .c




Dental Health Cont'd.
3. Number completing treatment........ 0 91 0 0 19 0 0 14 53 34 0 0 0 0 1,320 0 1,586 31
4. Number Admitted to Clinic for
treatment ....................... 0 1,035 0 0 39 0 0 91 0 93 0 0 0 0 1,380 0 3,624 88
5. Total fillings ....................... O0 1,689 0 0 67 0 0 124 0 113 0 0 0 0 1,039 0 2,988 113
6. Total extractions.................... 0 497 0 0 3 0 0 44 0 23 0 0 0 0 1,752 0 1,470 31
7. Topical Applications of Fluoride...... 0 5 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0
H. CHRONIC DISEASES
1. Admission to Cancer Service.......... 14 50 23 97 3 20 21 31 3 13 87 17 18 11 87 17 307 30
2. Field Visits-Cancer ................ 40 115 28 13 3 18 29 56 6 20 268 33 48 22 16 7 355 16
3. Office Visits-Cancer ............... 4 17 36 264 1 15 17 13 0 11 55 2 10 3 1,437 24 1,025 38
4. Admission to Orthopedic Service...... 19 78 79 80 16 30 25 20 107 16 91 25 75 21 169 18 125 67
5. Field Visits-Orthopedic Service...... 71 129 105 263 50 38 103 34 400 42 207 64 246 37 322 44 894 73
6. Office Visits-Orthopedic Service..... 8 36 140 904 6 8 7 7 24 4 73 10 74 11 101 30 73 136
7. Admission to Diabetes Service........ 5 23 12 16 15 5 9 56 14 9 47 12 38 6 27 8 29 28
8 Field Visits-Diabetes .............. 17 41 11 8 6 2 9 133 60 86 102 24 57 16 51 14 216 19
9. Office Visits-Diabetes............... 46 17 8 176 27 56 77 16 10 12 131 46 51 13 126 115 107 90
10. Adm. to Cardiovascular Renal Disease 35 27 2 2 71 106 7 128 9 5 109 14 39 0 43 15 67 24
11. Field Visits-Cardiovascular Renal
Disease ......................... 153 51 2 4 52 385 13 79 55 6 230 38 39 0 90 12 491 8
12. Office Visits-Cardiovascular Renal
Disease ......................... 118 15 0 0 314 490 5 97 4 0 78 2 110 0 41 140 191 53
J. MENTAL HEALTH
1. Admission to Service-Children ....... 1 20 49 254 15 3 4 76 112 55 53 82 123 37 692 7 36 10
2. Adm. to Service-State Hospital Pts.. 2 28 74 38 26 5 5 56 229 1 20 2 49 0 82 0 334 30
3. Admission to Service-Other Adults... 3 5 30 333 9 14 4 54 123 13 71 8 22 2 58 6 77 6
4. Field Visits-With Patients.......... 10 29 124 183 64 10 18 107 247 30 165 22 129 6 221 21 320 31
5. Field Visits-About Patients......... 1 54 226 221 111 13 7 285 241 73 270 109 619 70 299 26 613 48
6. Office Visits-With Patients.......... 0 9 55 1,917 30 68 13 86 99 43 42 16 11 52 836 13 77 25
7. Office Visits-About Patients......... 0 22 408 932 21 12 16 194 288 130 61 43 106 67 2,262 21 553 36
8. Mental Health Conferences .......... 0 0 120 80 26 28 4 216 281 42 128 475 142 22 60 10 155 0












TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960


a
g a 0 |a


Dental Health Cont'd.
3. Number completing treatment............. 916 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 7,771
4. Number Admitted to Clinic for Treatment... 1,031 0 0 0 0 0 0 0 0 342 0 0 0 14,531
5. Total fillings ......................... ..4,769 0 0 0 0 0 0 0 0 0 0 0 1,338 0 0 0 29,478
6. Total extractions ........................ 786 0 0 0 0 0 0 0 0 0 0 0 501 0 0 0 11,632
7. Topical applications of fluoride ............ 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 106
H. CHRONIC DISEASES
1. Admission to Cancer Service ............... 517 401 17 0 17 62 47 15 21 10 36 10 80 7 50 24 3,955
2. FieldVisits-Cancer..................... 1,849 210 3 0 23 62 421 22 25 42 34 4 765 19 41 4710,349
3. Office Visits-Cancer ...................... 1,306 1,18 25 5 127 28 8 45 3 8 29 26 3 61 39 10,594
4. Admission to Orthopedic Service ............ 101 158 35 0 41 8 53 51 60 68 44 12 118 21 69 42 4,593
5. Field Visits-Orthopedic Service............ 775 462 10 0 126 140 208 172 84 138 11 5 595 55 113 87 12,482
6. Office Visits-Orthopedic Service............ 30 130 8 0 70 27 11 73 58 123 82 13 9 6 91 74 4,989
7. Admission to Diabetes Service ............. 83 242 4 9 3 24 16 12 22 30 13 7 70 12 36 17 2,415
8. Field Visits ............................ 245 788 11 11 15 62 107 27 9 48 0 3 2,074 50 131 11 8,527
9. Office Visits-Diabetes .................... 656 297 6 9 0 110 17 39 58 116 46 81 305 32 238 156 12,476
10. Admission to Cardiovascular Renal Disease. 382 186 18 0 2 24 64 17 11 29 2 7 56 1 38 11 4,230
11. Field Visits-Cardiovascular Renal Disease.. 4,310 380 26 0 4 36 848 47 15 21 2 2 1,030 0 56 7 24,293
12. Office Visits-Cardiovascular Renal Disease.. 547 301 18 0 0 118 3 15 11 49 0 39 1 2 100 49 6,778
J. MENTAL HEALTH
1. Admission to Service-Children................ 35 297 28 0 172 56 64 108 17 14 9 0 164 22 8 0 6,315
2. Admission to Service-St. Hospital Pts...... 28 194 4 0 0 19 94 20 10 6 7 2 123 7 11 5 3,118
3. Admission to Service-Other Adults......... 140 126 2 1 85 10 243 47 5 10 2 0 85 4 0 0 3,582
4. Field Visits-With Patients................ 542 448 109 1 14 51 619 217 11 12 7 4 294 26 26 4 9,543
5. Field Visits-About Patients............... 708 50 141 0 78 69 1,060 999 21 31 8 1 41 83 17 4 14,135
6. Office Visits-With Patients..................... 176 1,867 29 0 1,271 34 264 56 37 5 27 0 709 8 13 0 21,846
7. Office Visits-About Patients............... 497 1,578 9 0 1,016 51 662 588 41 5 7 1 1,325 15 16 0 27,757
8. Mental Health Conferences ............... 234 439 2 0 166 38 569 229 0 2 0 0 1,190 79 0 0 12,525


0






t-4
M

0





-0

0








TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960




-----------------_____- ____ --__-__-__-__-__--__- __-0



K. MISCELLANEOUS C
1. Admission Morbidity Service .............. 361 91 56 325 399 91 18 81 15 226 134 82 34 24 44 51 0
2. Field and Office Visits-Morbidity.......... 771 180 114 669 602 241 70 400 41 658 386 115 279 61 200 96 0
3. General Medical Examinations ............. 144 0 0 156 326 1,491 42 0 37 20 18 11 3,117 13 3 0 0
4. Health Cards Issued ..................... 3,354 99 2,256 251 2,133 15,771 82 90 294 259 462 246 18,091 340 205 5,145 0
5. Visits in the Interest of Vital Statistics ..... 20 1 13 41 80 115 16 10 6 177 4 0 65 27 108 0 0
6. Conferences or Visits in the Interest of
Civil Defense ......................... 7 0 2 14 9 10 0 0 0 3 1 0 12 0 5 0 0
7. Visits in the Interest of Reported Accidents, 9M
including Poisoning .................... 50 0 3 5 7 113 0 0 0 0 0 0 363 0 4 122 0
M. NURSING HOMES
1. Number of Nursing Homes Admitted n
to Service ............................. 3 0 3 1 4 24 0 0 0 3 0 1 82 0 0 64 0
2. Visits to Nursing Homes. .................. 158 0 19 7 61 89 0 0 0 9 0 6 1,033 0 0 194 0
P. SANITATION
1. Approved Water Supplies Installed,
Private & Semi-Public.................. 333 0 93 0 28 974 0 1 0 2 0 0 19 0 1 4,979 0
2. Approved Water Supplies Installed, M
New Public Water Connections.......... 5 0 0 0 7 0 23 1 3 1 0 59 0 0 241 0
3. New Specification Privies Installed.......... 0 0 0 0 0 0 0 0 1 0 0 0 0 0 6 0
4. Percolation Water Table or
Soil Log Test ........................ 1,116 0 260 36 2,894 66 8 26 4 181 18 5 0 26 9 1,704 0
5. SubdivisionAnalysis..................... 35 0 6 1 118 82 6 2 0 1 2 1 259 1 0 10 0
6. Pollution Survey......................... 20 0 0 5 266 194 0 28 0 0 1 0 83 3 0 3 0
7. New Specification Septic Tanks
Installed.............................. 838 28 300 118 2,134 4,751 60 439 41 50 142 311 2 85 13 628 0
8. Rabies-Number of Animal Bites
Investigated .......................... 32 7 74 28 296 1,488 4 106 3 87 55 22 3,253 20 3 953 0
9. Field Visits for Rabies Investigation......... 708 10 126 42 643 3,198 4 77 7 319 77 32 11,849 48 2 953 0
10. Complaints Investigated................... 680 17 213 64 972 1,909 14 79 36 67 97 22 7,408 45 13 2,692 0
11. Nuisances Corrected ..................... 327 6 89 9 334 1,027 50 9 13 86 20 4,329 10 6 894
12-21. Field Visits........................ 6,68 55 2,552 145 13,644 13,980 218 2,639 567 768 1,020 1,356 61,301 642 157 9,175 0
~~I_____ __-- -- -- uL










TABLE 6 (Continued) o,
o0
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960





Id .02 ;3 S 5 a
I I -
________ _JAJi 3 I w N I I I ig
K. MISCELLANEOUS
1. Admission Morbidity Service .............. 324 90 9 98 45 71 28 300 18 143 9 44 814 62 29 52 34
2. Field and Office Visits-Morbidity..........2,876 308 32 704 153 240 133 488 120 492 40 77 4,769 77 96 146 98
3. General Medical Examinations............. 493 75 62 44 2 42 32 4 7 42 134 42 654 60 40 62 26
4. Health Cards Issued .................... 10,425 2 364 892 7 91 278 302 342 3 238 54 40, 30 607 577 142
5. Visits in the Interest of Vital Statistics ...... 64 39 11 366 2 0 132 4 5 12 1 41 11 6 4 71 26
6. Conferences or Visits in the Interest of I'
Civil Defense ......................... 9 0 0 0 1 1 0 1 1 0 13 1 0 2 0 0
7. Visits in the Interest of Reported Accidents, 0 0 0 0 0 0
including Poisoning .................... 173 0 0 0 4 0 0 0 0 0 0 0 207 0 0 0 0
M. NURSING HOMES
1. Number of Nursing Homes Admitted
to Service............................. 16 0 0 0 0 0 0 0 2 0 4 2 34 2 2 0 1
2. Visits to NursingHomes .................. 9 0 0 0 0 0 0 0 11 0 12 5 999 15 25 0 17
P. SANITATION
1. Approved Water Supplies Installed,
Private & Semi-Public.................. 532 0 0 50 0 0 2 0 3 1 0 74 917 8 0 1 10
2. Approved Water Supplies Installed, 0
New Public Water Connections.......... 806 0 0 465 0 1 68 0 1 3 0 4 1,187 4 0 0
3. New Specification Privies Installed.......... 27 0 0 108 0 0 0 9 0 0 0 0 4 1 0 3 0
4. Percolation Water Table or
Soil Log Test .......................... 53 60 30 17 0 0 9 0 0 5 41 10 558 42 122 6 1
5. Subdivision Analysis....................... 8 4 0 2 0 1 0 0 0 7 1 80 66 0 12 1 0
6. Pollution Survey ......................... 9 0 0 62 0 0 2 0 2 5 0 2 55 0 0 0
7. New Specification Septic Tanks
8. RInstalled ....er o ia it. ........... 1,405 56 9 152 80 20 54 18 82 192 37 654 2,476 17 126 40 16
8. Rabies--Number of Animal Bites
Investigated ........................ 1,11 6 12 16 5 11 11 1 12 3 0 45 2631 10 15 17 9
9. Field Visits for Rabies Investigation......... 3612 11 45 21 5 29 8 14 0 102 16927 17 40 38 6
10. Complaints Investigated................... ,34 11 7 63 4 18 8 11 49 88 58 139 3,059 32 208 1 13
11. NuisanesCorrected........................ 2,48 10 31 193 4 46 2 5 12 52 18 57 ,752 24 59 6 7
12-21. Field Visits ............................ 26,615 207 447 1,015 554 486 650 328 909 1,480 496 2,664 56,445 155 1'283 464 385








TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960





S0 a 0 N
ri IH ri Ni Ni ri N 0 0 0 P4 P4f


K. MISCELLANEOUS
1. Admission Morbidity Service......... 29 33 148 70 72 31 15 85 4 4 256 73 182 8 34 17 481
2. Field and Office Visits-Morbidity... 80 59 246 126 270 335 36 234 56 28 504 156 1,435 13 231 42 1,782
3. General Medical Examinations..... 0 18 80 46 163 4 35 355 44 0 6 29 144 0 0 19 316
4. Health Cards Issued ............... 16 1,114 2,925 2,527 543 57 243 3,517 2,012 0 1,323 619 1,394 163 2,448 563 7,492
5. Visits in the Interest of Vital
Statistics....................... 11 18 1 10 5 8 7 2 140 12 21 222 34 1 29 0 12
6. Conferences or Visits in the Interest
of Civil Defense ................. 0 6 0 1 0 1 14 1 2 33 13 1 0 0 0 3
7. Visits in the Interest of Reported
Accidents, including Poisoning..... 0 1 12 1 0 0 34 20 0 5 1 4 1 133 0 82
M. NURSING HOMES
1. Number of Nursing Homes
Admitted to Service.............. 0 6 4 2 1 0 0 9 3 1 1 1 0 1 24 10 33
2. Visits to Nursing Homes............. 0 26 17 5 7 0 0 47 31 4 1 1 0 6 146 78 127
P. SANITATION
1. Approved Water Supplies Installed,
Private and Semi-Public .......... 1 0 0 0 0 0 1 21 196 45 5 0 6 1 0 1
2. Approved Water Supplies Installed,
New Public Water Connections.... 0 0 0 1 0 4 0 8 14 0 18 2 2 0 3
3. New Specification Privies Installed.... 0 0 0 4 0 0 0 3 2 0 0 1 3 0 2 0 11
4. Percolation Water Table or
Soil Log Test ................... 12 136 0 69 2 0 4 231 205 170 0 80 70 41 4,840 49 138
5. Subdivision Analysis................ 0 32 0 5 4 0 0 10 52 0 0 14 1 0 215 46 12
6. Pollution Survey ................... 0 7 306 380 2 0 0 6 46 3 2 8 3 0 415 0 4
7. New Specification Septic Tanks
Installed........................ 6 944 330 343 107 2 17 435 475 157 229 211 242 58 3,343 121 1,718
8. Rabies-Number of Animal Bites
Investigated .................... 3 24 101 177 17 2 10 169 124 19 154 2 132 21 1,078 132 272
9. Field Visits for Rabies Investigation.. 9 51 179 927 40 2 21 342 101 44 183 31 132 66 1,298 210 14
10. Complaints Investigated............ 6 207 55 376 9 3 17 358 757 56 185 61 170 9 5,773 118 1,608
11. Nuisances Corrected........ 3 35 15 88 8 0 8 251 301 30 161 16 52 4 1,617 20 569
12-21. Field Visits ..................... 42 2,320 1,232 3,428 901 241 292 3,199 3,584 1,026 4,302 731 3,099 329 55,950 956 10,620


80
98
1
1,383 t"

1
o m

o >
0 ti



0



8
1
0<
28 -
1

112
17
31
95
18
251 0
N


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TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960



d1 0 I

W a B ro

____________ Sg S 5 cc
0 4S ; cc


K. MISCELLANEOUS
1. Admission Morbidity Service ..............
2. Field and Office Visits-Morbidity.........
3. General Medical Examinations.............
4. Health Cards Issued .....................
5. Visits in the Interest of Vital
Statistics. ...........................
6. Conferences or Visits in the Interest of
Civil Defense ..........................
7. Visits in the Interest of Reported Accidents,
including Poisoning. ....................
M. NURSING HOMES
1. Number of Nursing Homes Admitted to
Service ...............................
2. Visits to Nursing Homes...................
P. SANITATION
1. Approved Water Supplies Installed,
Private and Semi-Public ................
2. Approved Water Supplies Installed,
New Public Water Connections ..........
8. 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 Investigated ........
10. Complaints Investigated ..................
11. Nuisances Corrected. .....................
12-21 Field Visits. .........................


35 22 7
408 125 41


Z


0 4
01 4


0 6 12
0 83 33


1 1
8 1C


0 22
0 453


8,772
36,964
11,899
181,614 Mt
2,428 'd
234 O
1,470


462
4,495
'0
0%
8,499 O
3,069
345
22,792
1,254
1,997
34,470
15,137
46,890
37,299
20,127
371,942


0 1
0 9
3 0
49 10
1 1
0 3
27 27
9 15
11 35
11 28
8 22
226 466


0 2
0 45
0 0
19 14
2 5
0 0
3 99
6 19
11 19
11 91
1 35
112 729












TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960


W

5 0 s 0



R. PROTECTION OF FOOD AND MILK
1. Food-handling Establishments
Admitted to Service .................... 452 47 218 67 365 1,533 19 68 25 109 69 20 6,337 26 16 845 0
2. Field Visits to Food-handling
Establishments......................... 2,482 173 1,458 711 2,032 4,246 314 564 70 871 241 187 41,224 93 136 2,673 0
3. Number of Food-handlers Trained .......... 198 254 124 0 139 0 0 0 0 0 0 0 0 0 0 3 0
4. Dairy Farms Admitted to Service ........... 15 4 5 3 3 0 12 1 1 9 0 2 112 3 0 0 0
5. Field Visits to Dairy Farms ................ 177 8 97 29 73 0 219 5 1 69 0 20 980 47 0 0 0
6. Milk & Milk Products Plants
Admitted to Service .................... 6 0 3 2 2 5 0 1 0 2 0 1 183 0 0 0 0
7. Field Visits to Milk & Milk
Products Plants ....................... 55 0 19 30 2 54 0 4 0 15 0 16 3,610 0 0 0 0
8. Cows Tuberculin Tested ................... 0 0 0 875 0 138 0 0 0 0 0 0 4,426 0 0 0 0
9. Cows Bangs Tested ....................... 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
10. Dairy Farms under Mastitis Control
Program .. .......................... 0 0 5 0 0 0 0 0 0 0 0 0 0 0
V. HEALTH INFORMATION
1. Meetings Attended...................... 1,455 64 62 69 552 352 76 150 115 216 220 14 1,667 38 26 106 0
2. Lectures and Motion Picture Showings ...... 661 4 117 14 310 212 69 236 88 91 56 2 1,265 8 12 46 0
4. Radio & Television Programs .............. 56 0 0 1 12 5 11 1 11 0 41 11 0i 1 0
5. News Articles Published ................... 10 15 0 19 13 0 3 40 9 29 9 2 74 20 131 1 0
6. Exhibits Displayed........................ 13 4 0 0 6 0 0 37 4 14 2 0 38 11 4 0 0
X. LABORATORY
1-22. Specimens Examined. .................. 9,89 1,664 6,878 1,706 12,622 29,623 1,308 3,906 1,840 1,695 3,908 2,184 79,413 1,848 2,668 21,006 0













TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960


R. PROTECTION OF FOOD AND MILK
1. Food-handling Establishments
Admitted to Service.................... 686 74 39 92 7 30 113 13 24 45 14 142 2,840 104 73 117 24
2. Field Visits to Food-handling
Establishments....................... 4,983 517 278 368 115 53 1,042 46 507 266 31 424 35,193 674 743 1,252 175
3. Number of Food-handlers Trained.......... 360 0 0 0 0 0 0 0 0 0 0 0 14 32 0 0 0
4. Dairy Farms Admitted to Service........... 52 1 0 7 0 3 1 0 4 5 1 3 99 16 4 26 8
5. Field Visits to Dairy Farms ... ...... 1,010 3 0 172 0 28 17 0 50 18 1 32 2,767 222 45 286 52
6. Milk & Milk Products Plants
Admitted to Service ................... 5 0 0 2 0 0 0 0 0 1 0 2 44 0 3 1 1
7. Field Visits to Milk & Milk
Products Plants....................... 505 0 0 30 0 0 0 0 0 8 0 2 1,271 0 10 24 4
8. Cows Tuberculin Tested................... 3,197 0 0 72 0 0 45 0 0 0 0 0 21,327 964 1 0 970
9. Cows Bangs Tested.................... 88 0 0 0 0 0 0 0 0 0 0 0 477 0 1 0 972
10. Dairy Farms under Mastitis Control..
Program............................... 0 0 0 0 0 0 0 0 0 0 0 0 99 32 0 0 0
V. HEALTH INFORMATION
1. Meetings Attended....................... 442 14 40 207 4 62 30 61 91 77 32 66 1,798 35 380 94 68
2. Lectures and Motion Picture Showings...... 388 1 34 118 4 15 38 6 60 13 18 19 785 86 72 128 90
4. Radio & Television Programs .............. 0 0 0 0 0 23 5 0 30 1 0 0 34 23 0 1 0
5. News Articles Published .................. 30 4 5 29 0 19 11 12 5 47 0 7 51 9 0 1 18
6. Exhibits Displayed ........................ 0 0 11 0 0 1 5 0 0 6 0 0 9 3 0 3 1
X. LABORATORY
1-22. Specimens Examined................... 31,704 1,268 1,277 5,488 309 703 1,761 1,213 2,446 139 805 2,426 118,437 3,346 2,539 6,099 1,032


z




1--





0





0%

0
0










TABLE 6 (Continued)
SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960








R. PROTECTION OF FOOD AND MILK
1. Food-handling Establishments
Admitted toService .............. 9 124 323 438 54 7 31 318 78 232 146 46 100 56 1,017 36 930 243
2. Field Visits to Food-handling
Establishments .................. 29 319 581 2,582 90 41 109 1,251 600 395 514 343 324 194 3,121 281 2,315 663
3. Number of Food-handlers Trained... 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,148 0 0 0
4. Dairy Farms Admitted to Service..... 21 10 4 14 1 0 9 28 18 8 0 0 3 21 79 9 33 24
5. Field Visits to Dairy Farms.......... 345 25 52 95 5 0 148 269 326 113 0 0 62 150 182 114 171 214
6. Milk & Milk Products Plants
Admitted to Service .............. 0 3 7 7 1 0 1 2 8 2 4 0 1 1 24 0 28 0
7. Field Visits to Milk & Milk
Products Plants .................. 0 3 40 44 5 0 16 14 35 3 14 0 22 4 261 0 1,091 0
8. Cows Tuberculin Tested............. 349 0 0 264 0 0 800 4,958 1,128 2,385 0 0 0 12,041 0 0 30,184 0
9. Cows Bangs Tested.................. 0 0 159 0 0 0 0 0 0 0 1 0 1,120 0 0 19,370 0
10. Dairy Farms Under Mastitis
Control Program ................. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 196 0
V. HEALTH INFORMATION
1. Meetings Attended .................. 6 44 271 74 38 11 37 62 213 86 202 230 83 17 497 31 1,017 79
2. Lectures and Motion Picture Showings 3 30 126 128 71 1 49 454 67 31 127 137 125 20 1,434 29 642 58
4. Radio & Television Programs......... 0 0 35 2 0 0 3 3 9 0 5 2 14 0 26 0 0 0
5. News Articles Published............. 0 0 19 96 1 1 11 15 32 0 4 31 17 0 76 0 3 2
6. Exhibits Displayed.................. 0 0 6 0 0 0 2 2 2 0 1 14 3 0 5 0 21 0
X. LABORATORY
1-22. Specimens Examined............. 593 3,730 7,480 19,632 2,339 1,088 2,130 11,326 7,400 1,375 6,652 2,830 4,192 1,177 21,006 2,661 21,998 3,453


0



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M




n
tn
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TABLE 6 (Continued)

SOME MAJOR ACTIVITIES OF LOCAL HEALTH UNITS DURING 1960


0

0 |
3 4 a 4 S
g 4 0 0 0 -
S S S | 4M

R. PROTECTION OF FOOD AND MILK
1. Food-handling Establishments Admitted to
Service ................... ....... 2,445 1,130 198 17 287 74 439 70 38 66 75 14 949 37 107 63 24,850
2. Field Visits to Food-handling
Establishments ........................ 11,974 6,869 900 41 3,649 265 1,478 462 197 675 227 47 4,415 124 261 324149,797
3. Number of Food-handlers Trained.......... 204 222 0 0 0 0 0 0 0 0 25 0 0 0 0 0 2,723
4. Dairy Farms Admitted to Service.......... 17 63 4 1 6 20 7 7 9 6 0 3 23 0 15 11 864
5. Field Visits to Dairy Farms ............. .. 313 552 34 4 44 149 39 39 111 76 0 53 525 0 189 294 11,121
6. Milk & Milk Products Plants Admitted to
Service ... ............................ 44 2 0 1 4 0 4 8 0 0 2 0 13 0 4 1 426
7. Field Visits to Milk & Milk
Products Plants........................ 924 27 0 1 31 0 22 3 0 0 2 0 260 0 26 1 8,508
8. Cows Tuberculin Tested .................. 4,507 6,999 0 0 1,986 0 215 0 682 138 0 0 0 0 1,043 594100,238
9. Cows Bangs Tested ....................... 2,867 0 0 0 807 0 207 0 264 11 0 0 0 0 2 23 26,370
10. Dairy Farms under Mastitis
Control Program....................... 18 49 0 0 0 0 4 0 8 0 0 0 0 0 15 0 427
V. HEALTH INFORMATION
1. Meetings Attended..................... 973 178 113 25 71 202 231 204 43 40 84 24 324 10 50 10 14,823
2. Lectures and Motion Picture Showings...... 1,468 596 21 1 50 46 166 137 29 20 89 17 79 75 80 6 11,519
4. Radio & Television Programs ............. 42 9 6 0 0 0 3 0 0 0 0 0 0 3 0 428
5. News Articles Published ................... 115 45 0 16 15 71 24 26 10 8 11 14 2 10 0 1,183
6. Exhibits Displayed........................ 24 2 6 0 0 0 10 0 0 0 2 0 0 2 19 2 295
X. LABORATORY
1-22. Specimens Examined ................... 53,480 27,292 4,345 342 3,655 3,304 10,016 2,908 2,778 1,649 1,262 1,405 8,481 1,903 4,378 1,799 612,215


C:







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0




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VITAL STATISTICS


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

Vital records in Florida consist of records of the following events:
birth, stillbirth, death, marriage, annulment of marriage, divorce, legal
change of name and adoption. These events are recorded by legal re-
quirement at the time of occurrence through an established registration
system and the records have documentary value in a court of law.
In addition to the legal value the records have a statistical value and
public health agencies are the principal users of statistics derived from
vital records.

COLLECTION
Collection of records is one of the primary functions of a vital
statistics system. At the present time particular emphasis is being placed
upon promptness of filing birth and death records. Last year 94.2 per
cent of all births and 97.5 per cent of all deaths were registered at this
Bureau by the fifth of the following month. The gradual improvement in
promptness of filing records is gratifying. However, there are still a
number of counties showing less than 80 per cent of certificates filed on
time.
One measurement of the relative efficiency of birth and death
registration is the "Vital Statistics Scoreboard" which is published
annually (Table 13). The top 10 counties are to be congratulated on
their superior performance. They are Wakulla, Duval, Dade, Hills-
borough, Orange, Citrus, Jefferson, Sarasota, Broward and Martin.
Last year a total of 222,759 current certificates were registered
with the bureau, an increase of 3.3 per cent over the preceding year.

INDEXING
As reported last year the re-indexing project for old records which
was started several years ago is still progressing slowly. No personnel are
available for full-time work on the project, so it is being carried on as
a spare-time job whenever current work is completed.

CERTIFICATIONS
The issuance of certified photocopies and other certifications is one
of the large-volume jobs performed by the bureau. Last year 114,324
requests for certifications were received and processed. This figure
represents an increase of 6.6 per cent over the previous year and is a
good index of the increase in work load in the bureau.








74 ANNUAL REPORT, 1960


AMENDMENTS
The amendment of records is one of the most complex and trouble-
some functions of the bureau. Numerous requests are received to have
records corrected. In each case the applicant must submit evidence to
substantiate his request and bureau personnel must determine whether
sufficient proof has been submitted. Every effort is made to correct
minor errors as easily as possible while making sure that sufficient evi-
dence is obtained for major corrections to maintain the validity of the
record. During the year considerable time was spent in drafting revised
administrative procedures for amendments. It is hoped these procedures
can be effected early in 1961.

DELAYED REGISTRATION OF BIRTH
A "Delayed Birth Certificate" is one which is filed after the person's
fourth birthday. It must be accompanied by documents which verify the
date of birth, place of birth and parentage. Requirements for documen-
tary evidence must be sufficient to minimize the filing of fraudulent certif-
icates. Bureau personnel must explain requirements for evidence in
writing and orally, and must determine when sufficient proof has been
submitted. In 1960 a total of 3241 delayed birth certificates were filed.
This is approximately the same as for the preceding year.

ADOPTIONS
Legal adoptions have increased rapidly in this state. In 1960 a total
of 4384 adoption decrees were received from the courts. This represents
a 12.3 per cent increase over 1959. When an adoption decree is received
for a person born in Florida a new birth certificate is substituted for the
original certificate. The new certificate shows the new parents and does
not disclose the fact of adoption. The original certificate is sealed and
is only available upon court order or request of the registrant if of legal
age. Adoption decrees received for persons born in other states are for-
warded to the vital statistics office of the state of birth for similar
processing.

POPULATION
The official U. S. Census population count of the state as of April
1, 1960 was 4,951,560. This is a gain of 78.7 per cent over the population
count for 1950. The population count by color or race has not yet been
released by the Census Bureau. It should be made available during the
first 6 months of 1961. The census count for Florida indicates that our
previous estimates were slightly low. When final census figures by race
are received, revised estimates will be made for the period 1951-1959.

STATISTICS
This report contains a brief summary of vital statistics for 1960. A
more detailed analysis of these statistics can be found in Supplement







VITAL STATISTICS


No. I of this report entitled FLORIDA VITAL STATISTICS, 1960. Pre-
liminary 1960 figures have been used in this report because of the time
lag in receipt of records, but the supplement mentioned above will contain
final figures. Final data for 1959 are contained in Tables 9a and 10a.

BIRTHS
The preliminary birth figure for 1960 is 115,610, which gives an
increase of about 80 per cent over the 64,370 births in 1950. During this
same period white births rose 85 per cent, from 45,699 to 84,377, and the
nonwhite went from 18,671 to 31,233 (67 per cent). However, it should
be noted that the birth rate per 1000 population changed only from 23.2
in 1950 to 23.3 in 1960 (up 0.4 per cent). The white birth rate dropped
from 21.1 in 1950 to 21.0 in 1960 (0.5 per cent) and the nonwhite rate
increased from 30.8 to 33.4 (8.4 per cent). Therefore, the large increase
in the number of births resulted almost entirely from the expansion in
population.

DEATHS
Preliminary figures show 47,719 deaths to Florida residents during
1960, of which 38,664 were white and 9055 were nonwhite, compared
with a death total of 26,525 in 1950 with 19,443 white and 7082 non-
white. This reveals a percentage increase of 98.9 for the white and 27.9
among the nonwhite, with total deaths rising 79.9 per cent. However,
this gain in the number of deaths does not reflect the whole picture, as
the death rate per 100,000 population remained the same with a rate of
9.6 in both 1950 and 1960. The white death rate rose from 9.0 in 1950
to 9.6 in 1960 (6.7 per cent) and the nonwhite rate declined from 11.7
in 1950 to 9.7 in 1960 (17.1 per cent).
Listed in Table 9 are the 10 leading causes of death with rates per
100,000 population for 1960 with the comparative position of these causes
in 1950. It is of interest to note that the first 6 of these causes have
remained the same throughout the past decade. Of the top 6 causes,
only 2 have experienced a decline in the rate per 100,000 population; the
rate for all accidents declined from 68.6 in 1950 to 58.6 in 1960, and
diseases of early infancy went from 47.7 to 41.6. The remaining 4 of
the 10 leading causes changed as diabetes mellitus moved into seventh
place from tenth with a 1960 rate of 14.9 per 100,000 population com-
pared with 13.4 in 1950. General arteriosclerosis moved from ninth
place in 1950 with a rate of 16.5 to eighth place and a rate of 14.8 in
1960. Suicides ranking twelfth in 1950 with a rate of 11.4, moved up to
ninth place in 1960 with a rate of 13.5. The most dramatic change
occurred in the rise of other diseases of the circulatory system from
sixteenth place in 1950 with a rate per 100,000 population of 7.0 to
tenth place in 1960 with a rate of 13.2. Nephritis and nephrosis,
seventh place in 1950, and tuberculosis (all forms) eighth, dropped to
rankings of 14 and 18 respectively.









76 ANNUAL REPORT, 1960

MARRIAGES, DIVORCES AND ANNULMENTS

There were 39,315 marriages recorded in Florida during 1960, giving
an increase of 42.5 per cent over 1950 when 27,588 marriages were
recorded. However, the rate per 1000 population declined from 10.0 in
1950 to 7.9 in 1960 (21.0 per cent). Divorces and annulments increased
from 18,033 in 1950 to 19,511 in 1960 (8.2 per cent); while the rate
per 1000 population dropped from 6.5 in 1950 to 3.9 in 1960 (40.0
per cent).


TABLE 7
ACTIVITIES OF THE BUREAU OF VITAL


STATISTICS


DURING THE YEARS 1959 AND 1960

Activity 1959 1960 Per Cent
Change
Current certificates filed ....................... 215,624 222,759 + 3.3
Delayed birth certificates filed .................. 8,264 3,241 0.7
Adoption decrees received ...................... 3,904 4,384 +12.3
Amended certificates filed for adoptions.......... 3,404 3,601 + 5.8
Legal changes of name received ................. 839 976 +16.3
Requests for certifications:
Total .................. ................ 107,252 114,324 + 6.6
Fee paid................................. 86,700 90,700 + 4.6
Free .... ... .... .. 20,572 23,624 +14.8
Photostats made .............................. 133,140 189,709 + 4.9
Birth registration cards made.................... 22,036 23,133 + 5.0
Fees collected and transmitted to State Treasurer. $137,636.33 $142,917.91 + 3.8







TABLE 8
RESIDENT BIRTHS AND DEATHS WITH RATES PER 1,000
POPULATION, FLORIDA, 1940, 1950-1960

Year Population Births Birth Rate Deaths Death Rate
1960*.................. 4,951,560 115,610 23.3 47,719 9.6
1959.................... 4,730,300 112,733 23.8 44,179 9.3
1958................... 4,448,000 108,014 24.3 43,353 9.7
1957................... 4,250,400 103,806 24.4 39,937 9.4
1956................... 3,897,400 97,320 25.0 36,705 9.4
1955................. 3,643,562 89,112 24.5 33,295 9.1
1954.................. 3,481,528 84,831 24.4 81,503 9.0
1953................... 3,111,100 80,087 25.7 30,529 9.8
1952................... 3,006,400 74,219 29.7 29,136 9.7
1951.................... 2,901,800 70,431 24.3 27,857 9.6
1950................... 2,797,100 64,370 23.0 26,525 9.5
1940................... 1,915,155 33,696 17.6 21,458 11.2

*1960 data based upon preliminary totals.









VITAL STATISTICS 77


TABLE 9
TEN LEADING CAUSES OF DEATH WITH RATES PER 100,000

POPULATION, FLORIDA, 1950 AND 1960

1960 1950
1960 __ _1950
Rank CAUSE OF DEATH Rank
Deaths Rate Deaths Rate
1 Diseases of the heart (410-443)..... 16,995 343.2 8,666 812.7 1
2 Malignant neoplasms (140-205) ..... 7,719 155.9 3,661 182.1 2
8 Cerebral vascular disease (330-334).. 5,491 110.9 8,021 109.0 3
4 All accidents (800-962) ............. 2,903 58.6 1,902 68.6 4
5 Diseases of early infancy (760-776).. 2,059 41.6 1,323 47.7 5
6 Influenza and pneumonia (480493).. 1,640 33.1 791 26.4 6
7 Diabetes mellitus (260)............. 739 14.9 370 18.4 10
8 General arteriosclerosis (450)........ 733 14.8 458 16.5 9
9 Suicide (963, 970-979).............. 667 13.5 315 11.4 12
10 Other diseases of circulatory system
(451-468)....................... 652 13.2 195 7.0 16
14 Nephritis and nephrosis (490-494)... 890 7.9 593 21.4 7
18 Tuberculosis--all forms (001-019)... 206 4.2 522 18.8 8





TABLE 10

RESIDENT DEATHS AND DEATH RATES BY CAUSE, BY RACE, FLORIDA, 1960 (PRELIMINARY)


CAUSE OF DEATH
(Numbers in parentheses refer to the International List of Causes of Death)


DEATHS


White


Nonwhite Total


Rate per 100,000 Population N
00


White Nonwhite


TOTAL DEATHS ............................................................ 47,719 38,664 9,055 9.6* 9.6


Tuberculosis of respiratory system (001-008) ............................................
Tuberculosis, other forms (010-019) .................. .....................................
Syphilis and its sequelae (020-029)..........................................................
Typhoid fever (040) ................. ...............................................
Dysentery, all forms (045-048) .......... ....................................... ..
Diphtheria (055) ........ .......................................................
Meningococcal infections (057)................ .................................
Acute poliomyelitis (080).................. ......... ... ..... .......... .............
Acute infectious encephalitis (082)................... ......................................
M easles (085) ......................................................... ..................
Typhus and other rickettsial diseases (100-108) .............................................
All other diseases classified as infective and parasitic (030 to 138 with exception of above causes)...
Malignant neoplasms, including neoplasms of lymphatic and haematopoietic tissues (140-205)......
Diabetes mellitus (260).............................................................
Anemias (290-293)...................... ................ ... ...................
Major cardiovascular-renal disease .........................................................
Cerebral vascular disease (330-334)...................................................
Rheumatic fever (400-402) ............... ........... ...........................
Diseases of the heart (410-443)................................
Chronic rheumatic heart disease (410-416) ...........................................
Arteriosclerotic heart disease, coronary disease (420) ................... ..............
Nonrheumatic chronic endocarditis and myocardial degeneration (421, 422)..................
Hypertension with heart disease (440-443)................ ...........................
Other diseases of heart (430-434) .............. ................. ...............
Hypertension without heart disease (444-447). ...........................................
General arteriosclerosis (450)......... .........................................
Other circulatory diseases (451-468) ......................................................
Chronic and unspecified nephritis (592-594).............................................
Influenza (480-483). ......................
Pneumonia (490-493). ....................... .....................................
Ulcer of stomach and duodenum (540-541) ...........................................
Intestinal obstruction and hernia (560, 561, 570) .............................................
Gastritis, duodenitis, enteritis and colitis, except diarrhea of the newborn (543, 571, 72) ..........
Cirrhosis of liver (581) ................... .. ...................................
Acute nephritis and nephrosis (590, 591) .................................................
Complications of pregnancy, childbirth and the puerperium (640-652, 660, 670-689)...............
Congenital malformations (750-759) ...........
Birth injuries, postnatal asphyxia and atelectasis (760-762) ...................................
Infection of the newborn (763-768) .........................................................
Other diseases peculiar to early infancy, and immaturity unqualified (769-776) ...................
Symptoms, senility, and ill-defined causes (780-795)........................................
All other diseases (residual)... ........................................ ............
Motor vehicle accidents (810-835)............ ....... .......................
All other accidents (800-802, 840-962) ............................... .................
Suicide and self-inflicted injury (963, 970-979) ............ ..............................
Homicide and operations of war (964, 965, 980-999) ................... .....................


191
15
111
1
6
3
18
4
15
3
0
176
7,719
739
107
24,562
5,491
11
16,995
495
12,861
1,231
1,569
839
353
733
652
327
180
1,460
304
246
316
568
63
53
561
931
155
973
974
3,246
1,211
1,692
667
449


121
7
63
0
2
1
11
2
12
3
0
111
6,710
560
57
20,880
4,426
6
14,794
441
11,682
1,033
980
658
245
640
562
207
106
980
275
210
158
503
44
15
428
590
72
625
574
2,566
960
1,240
632
146


70
8
48
1
4
2
7
2
3
0
0
65
1,009
179
50
3,682
1,065
5
2,201
54
1,179
198
589
181
108
93
90
120
74
480
29
36
158
65
19
38
133
341
83
348
400
680
251
452
35
303


3.9
0.3
2.2
0.0
0.1
0.1
0.4
0.1
0.3
0.1
3.6
155.9
14.9
2.2
496.0
110.9
0.2
343.2
10.0
259.7
24.9
31.7
16.9
7.1
14.8
13.2
6.6
3.6
29.5
6.1
5.0
6.4
11.5
1.3
4.6**
11.3
18.8
3.1
19.7
19.7
65.6
24.5
34.2
13.5
9.1


3.0
0.2
1.6
0.1
0.0
0.3
0.1
0.3
0.1
2.8
167.1
13.9
1.4
520.0
110.2
0.1
368.4
11.0
290.9
25.7
24.4
16.4
6.1
15.9
14.0
5.2
2.6
24.4
6.8
5.2
3.9
12.5
1.1
1.8**
10.7
14.7
1.8
15.6
14.3
63.9
23.9
30.9
15.7
3.6


I 1 1 055 1


Infant mortality (deaths under one year of age)............. .............................. 3,432 2,004 1,428 29.7*** 23.8***
*Rate ~~~~- per0 1,0 popuatio **at per*** 10,000* liebrh1* e ,0 iebrh


9.7*
7.5
0.9
5.1
0.1
0.4 Z
0.2
0.7
0.2
0.3

6.9
107.8 W
19.1
5.3
393.5 .
113.8
0.5 0
235.2
5.8
126.0
21.2
62.9
19.3
11.5
9.9 10
9.6
12.8
7.9 0
51.3
3.1
3.8
16.9
6.9
2.0
12.2**
14.2
36.4
8.9
37.2
42.7
72.7
26.8
48.3
3.7
32.4
45.7***


***Rate per 1,000 live births


*Rate per 1,000 population


**Rate per 10,000 live births




RESIDENT DEATHS AND DEATH RATES BY CAUSE, BY RACE, FLORIDA, 1959 (FINAL FIGURES)

CAUSE OF DEATH DEATHS Rate per 100,000 Population
(Numbers in parentheses refer to the International Lise of Causes of Death) Total White Nonwhite Total -White Nonwhite
TOTAL DEATHS ................. ........ ............. ............... 44,179 35,550 8,629 9.3* 9.3* 9.6*
Tuberculosis of respiratory system (001-008)................ ............................. 210 153 57 4.4 4.0 6.4
Tuberculosis, other forms (010-019)..... ....... .......... ...... 17 9 8 0.4 0.2 0.9
Syphilis and its sequelae (020-029) ........................................ .... ....... 91 42 49 1.9 1.1 5.5
Typhoid fever (040) ................. ................... ................................. 0 0
Dysentery, all forms (045-048)................. .......................................... 9 1 8 0.2 0.0 0.9
Scarlet fever and strep. sore throat (050,051) ............................................. 1 1 0 0.0 0.0 ....
Diphtheria (055)................... ........................5 1 4 0.1 0.0 0.4
Whooping cough (056) .................. ...............................................9 1 8 0.2 0.0 0.9
Meningococcal infections (057)................... ................................. .... 15 9 6 0.3 0.2 0.7
Acute poliomyelitis (080) ................... ......................................... ... 14 14 0 0.3 0.4 ....
Acute infectious encephalitis (082)................ ...................................... 23 13 10 0.5 0.3 1.1
M easles (085)..... ........ .......................................................... 11 3 8 0.2 0.1 0.9
Typhus and other rickettsial diseases (100-108)................... ................... 0 0 0 ..... ..... ..........
All other diseases classified as infective and parasitic (030-138) with exception of above causes..... 198 119 79 4.2 3.1 8.8
Malignant neoplasms, including neoplasms of lymphatic and haematopoietic tissues (140-205)...... 7,271 6,359 912 153.7 165.8 101.8
Benign and unspecified neoplasms (210-239) ............................................... 116 84 32 2.5 2.2 3.6
Diabetes mellitus (260) ............... ...... .. ........ .. ............................ 598 469 129 12.6 12.2 14.4
Anemias (290-293).................... ....... ..... ............................... 115 71 44 2.4 1.9 4.9
Major cardiovascular-renal disease....................................................... 22,481 19,014 3,467 475.2 495.0 387.0
Cerebral vascular disease (330-334) ................................................... 5,097 3,977 1,120 107.8 103.7 125.0
Rheumatic fever (400-402) ........................................................... 28 15 13 0.6 0.4 1.5
Diseases of the heart (410-443).......................................................... 14,513 12,750 1,763 306.8 332.5 196.8
Chronic rheumatic heart disease (410-416)............................................. 448 406 42 9.5 10.6 4.7
Arteriosclerotic heart disease, coronary disease (420)................................... 11,592 10,595 997 245.1 276.3 111.3
Nonrheumatic chronic endocarditis and myocardial degeneration (421-422) ................... 1,039 836 203 22.0 21.8 22.7
Hypertension with heart disease (440-443) ........................................... 1,434 913 521 30.3 23.8 58.1
Other diseases of heart (430-434).......................................... ......... 844 676 168 17.8 17.6 18.7
Hypertension without heart disease (444447)............................................ 351 232 119 7.4 6.1 13.3
General arteriosclerosis (450)....................................................... ... 693 621 72 14.7 16.2 8.0
Other circulatory diseases (451-468) ................................................... 617 530 87 13.0 13.8 9.7
Chronic and unspecified nephritis (592-594) ................. ............ ...... ... .. 338 213 125 7.1 5.6 14.0
Influenza (480-483)........................................... .................. 67 29 38 1.4 0.8 4.2
Pneumonia (490-493) ... ...................... .. .............. ........ ........ 1,156 774 382 24.4 20.2 42.6
Bronchitis (500-502) ..... ...... ................................................ 92 72 20 1.9 1.9 2.2
Ulcer of stomach and duodenum (540, 541)........................ ................... ... 278 236 42 5.9 6.2 4.7
Appendicitis (550-553) ................... ................... ................... 2 34 18 1.1 0.9 2.0
Intestinal obstruction and hernia (560, 561, 570) .................. ... ............ .. 241 192 49 5.1 5.0 5.5
Gastritis, duodenitis, enteritis and colitis except diarrhea of the newborn (543, 571, 572)........... 335 175 160 7.1 4.6 17.9
Cirrhosis of liver (581) .. .. ............................................................ 534 470 64 11.3 12.3 7.1
Acute nephritis (590-591) .................. ...................... ................... 6 37 28 1.4 1.0 3.1
Hyperlasia of prostate (610) ............................................................. 148 122 26 2.1 3.2 2.9
Complications of pregnancy, childbirth and the puerperium (640-652, 660, 670-689)............... 57 19 38 5.1** 2.3** 12.3**
Congenital malformations (750-759) ..................................................... 606 459 147 12.8 12.0 16.4
Birth injuries, postnatal asphyxia and atelectasis (760-762) ................................... 923 609 314 19.5 15.9 35.0
Infection of the newborn (763-768) ......................................................... 187 88 99 4.0 2.3 11.0
Other diseases peculiar to early infancy and immaturity unqualified (769-776) ................... 1,001 597 404 21.2 15.6 45.1
Symptoms, senility, and ill-defined causes (780-795)......................................... 897 554 343 19.0 14.4 38.3
All other diseases (residual)....... ................................................. 2,562 1,990 572 54.2 51.9 63.8
Motor vehicle accidents (810-835) ....................................................... 1,112 894 218 23.5 23.3 24.3
All other accidents (800-802, 840-962) ...................... .......... ........... 1,599 1,134 465 33.8 29.6 51.9
Suicide and self-inflicted injury (963, 970-979)............................................. 572 552 20 12.1 14.4 2.2
Homicide, and operations of war (964, 965, 980-999)........................................ 511 150 361 10.8 3.9 40.3
Infant mortality (deaths under one year of age) .. .................... .............. ... .. 3,558 2,058 1,500 31.0*** 25.1***1 48.7***


***Rate per 1,000 live births


*Rate per 1,000 population


**Rate per 10,000 live births






80 ANNUAL REPORT, 1960


TABLE 11

CENSUS POPULATION, 1960, AND PRELIMINARY TOTALS OF
BIRTHS, DEATHS, AND INFANT DEATHS, BY RACE,
BY COUNTY, FLORIDA, 1960


Census BIRTHS DEATHS INFANT DEATHS
COUNTY Population
1960 Non- Non- Non-
Total White white Total White white Total White white
STATE....... 4,951,560 115,610 84,377 31,233 47,719 38,664 9,055 3,432 2,004 1,428
Alachua...... 74,074 2,102 1,368 784 572 350 222 50 24 26
Baker......... 7,363 198 132 66 72 62 10 6 4 2
Bay.......... 67,131 2,113 1,718 395 466 876 90 64 43 21
Bradford...... 12,446 298 210 88 123 90 33 13 5 8
Brevard ....... 111,435 3,428 2,893 535 670 556 114 93 66 27
Broward....... 333,946 7,489 5,132 2,357 2,947 2,467 480 251 139 112
Calhoun...... 7,422 164 136 28 66 51 15 6 4 2
Charlotte ...... 12,594 211 195 16 155 148 7 6 6 0
Citrus......... 9,268 144 95 49 137 109 28 7 1 6
Clay.......... 19,535 486 414 72 143 116 27 15 11 4
Collier......... 15,753 379 291 88 122 91 81 13 6 7
Columbia...... 20,077 475 287 188 214 139 75 19 10 9
Dade.......... 935,047 19,685 14,350 5,335 8,297 7,227 1,070 541 328 213
DeSoto........ 11,683 235 158 77 107 75 32 10 5 5
Dixie.......... 4,479 144 120 24 52 36 16 11 5 6
Duval......... 455,411- 12,538. 9,057. 3481- 3,910. 2,635 1,275 391 226 165
Escambia...... 173,829 5,423 8,987 1,436 1,234 887 347 162 99 63
Flagler....... 4,566 125 57 68 45 26 19 5 2 3
Franklin....... 6,576 171 136 35 78 48 80 1 1 0
Gadsden...... 41,989 1,175 272 903 350 111 239 78 9 69
Gilchrist....... 2,868 68 56 12 33 25 8 2 1 1
Glades......... 2,950 68 45 23 22 11 11 4 2 2
Gulf........... 9,937 273 191 82 81 58 23 8 6 2
Hamilton...... 7,705 197 76 121 80 48 32 7 4 3
Hardee........ 12,370 272 223 49 139 123 16 13 8 5
Hendry........ 8,119 191 116 75 72 44 28 6 2 4
Hernando...... 11,205 304 203 101 134 106 28 14 6 8
Highlands...... 21,338 560 376 184 259 202 57 26 14 12
Hillsborough... 397,788 9,491 7,663 1,828 3,951 3,248 703 275 184 91
Holmes........ 10,844 197 186 11 118 113 5 5 5 0
Indian River... 25,309 628 406 222 262 223 89 15 8 7
Jackson........ 36,208 814 487 327 315 195 120 25 11 14
Jefferson....... 9,543 266 74 192 117 35 82 12 2 10
Lafayette...... 2,889 51 39 12 37 31 6 4 3 1
Lake.......... 57,383 1,303 917 386 687 577 110 47 26 21
Lee ........... 54,539 1,147 843 304 582 489 93 45 29 16
Leon.......... 74,225 1,932 1,134 798 511 269 242 55 21 34
Levy.......... 10,364 235 106 129 121 73 48 9 8 6
Liberty........ 3,138 74 56 18 47 39 8 3 1 2
Madison....... 14,154 326 132 194 142 74 68 7 3 4
Manatee....... 69,168 1,154 827 327 949 842 107 26 16 10
Marion........ 51,616 1,164 593 571 527 327 200 28 15 13
Martin........ 16,932 392 252 140 181 146 85 11 7 4
Monroe........ 47,921 1,294 1,151 143 847 288 59 89 33 6
Nassau........ 17,189 437 812 125 164 113 51 14 8 6
Okaloosa....... 61,175 2,185 1,991 194 272 238 34 48 40 8
Okeechobee.... 6,424 172 141 31 54 39 15 6 4 2
Orange........ 263,540 6,995 5,586 1,409 2,153 1,812 841 159 106 53
Osceola........ 19,029 868 300 68 349 327 22 15 10 5
Palm Beach.... 228,106 4,813 3,162 1,651 2,305 1,770 535 149 68 81
Pasco......... 36,785 641 530 111 497 453 44 20 11 9
Pinellas........ 374,665 5,775 4,565 1,210 5,693 5,847 346 161 96 65
Polk........... 195,139 4,543 3,340 1,203 1,752 1,421 331 130 84 46
Putnam ....... 32,212 888 533 355 333 223 110 21 7 14
St. Johns ..... 30,034 656 426 230 347 235 112 25 9 16
St. Lucie....... 39,294 926 501 425 357 256 101 25 12 13
Santa Rosa..... 29,547 976 894 82 214 184 30 26 20 6
Sarasota....... 76,895 1,376 1,090 286 870 783 87 30 18 12
Seminole....... 54,947 1,478 1,055 423 454 308 146 45 27 18
Sumter........ 11,869 267 154 113 129 92 37 7 4 3
Suwannee...... 14,961 329 220 109 173 126 47 11 6 5
Taylor......... 13,168 298 221 77 134 79 55 15 9 6
Union......... 6,043 98 66 32 53 34 19 2 1 1
Volusia........ 125,319 2,347 1,660 687 1,609 1,377 232 68 42 26
Wakulla....... 5,257 114 65 49 43 30 13 2 0 2
Walton........ 15,576 296 243 53 170 132 38 15 12 3
Washington.... 11,249 248 162 86 120 99 21 10 6 4







VITAL STATISTICS 81


TABLE 11A

ESTIMATED POPULATION WITH RESIDENT BIRTH AND
DEATH RATES PER 1,000 POPULATION AND RESIDENT
INFANT DEATH RATES PER 1,000 LIVE BIRTHS, BY RACE,
BY COUNTY, 1959 (FINAL FIGURES)


Population BIRTH RATE DEATH RATE INFANT DEATH RATE
COUNTY Estimate
1959 Non- Non- Non-
Total White white Total White white Total White white
STATE........ 4,730,800 23.8 21.4 34.4 9.3 9.3 9.6 31.6 25.1 48.7
Alachua ....... 72,200 28.2 24.8 38.8 7.5 6.2 11.5 33.0 27.2 44.6
Baker......... 7,300 26.3 25.3 29.4 7.5 6.7 10.0 20.8 14.4 37.7*
Bay........... 64,500 34.7 33.4 41.6 6.4 6.1 7.6 27.9 22.7 51.9
Bradford....... 12,200 17.1 15.5 21.9 10.5 10.9 9.4 36.8 35.0 40.4*
Brevard....... 97,600 31.9 30.2 44.6 6.1 5.7 9.2 25.7 22.6 42.0
Broward...... 811,400 22.1 18.2 38.8 8.2 8.3 8.1 31.2 19.9 53.4
Calhoun...... 7,400 23.8 21.7 35.5 10.4 10.3 10.9 39.8 29.2 76.9*
Charlotte...... 10,500 17.7 17.6 18.9 11.6 12.2 5.6 32.3 29.6 58.8*
Citrus......... 9,000 17.3 15.0 26.7 11.0 11.4 9.4 32.1 27.8 41.7*
Clay .......... 19,100 30.6 29.6 37.2 7.1 6.6 10.4 30.8 32.6 21.5*
Collier......... 14,700 23.7 25.2 19.1 8.7 8.2 10.3 43.0 31.9 89.6*
Columbia...... 19,500 26.7 24.7 30.8 11.4 11.3 11.7 38.5 49.5 20.3
Dade.......... 902,700 21.3 18.5 36.8 8.9 9.1 7.5 28.8 24.1 42.0
DeSoto........ 9,600 24.9 21.6 32.9 11.8 11.2 13.2 46.0 13.6 97.8*
Dixie.......... 4,500 30.0 26.1 70.0 7.1 6.3 15.0 22.2 18.7 35.7*
-Duval......... 442,200 28.1. 26.2 34.3- 8.3 7.2 12.0 33.4. 26.2 51.4
Escambia...... 170,700 31.5 29.8 37.4 6.9 6.0 9.8 33.5 25.6 55.2
Flagler........ 4,500 30.4 22.3 46.7 10.9 11.0 10.7 29.2* 29.9* 28.6*
Franklin....... 6,300 27.8 27.8 27.7 13.0 11.6 18.5 17.1 21.6 0.0
Gadsden....... 82,800 33.9 23.6 39.9 10.7 9.8 11.2 60.2 24.7 72.3
Gilchrist....... 8,000 21.3 18.6 40.0 5.0 5.0 5.0 0.0 0.0 0.0
Glades......... 2,800 21.4 26.0 16.2 10.4 9.3 11.5 50.0* 0.0 142.9*
Gulf........... 9,500 27.8 26.3 32.1 6.7 5.2 11.2 26.5 21.4 38.0*
Hamilton...... 7,900 28.4 23.9 33.2 12.3 13.2 11.3 40.2 40.8* 39.7
Hardee........ 12,600 22.6 21.1 42.2 8.4 8.7 4.4 17.5 16.2 26.3*
Hendry........ 7,700 28.8 25.3 36.7 9.9 8.5 12.9 54.1 37.3 79.5*
Hernando...... 10,300 28.3 23.2 45.7 10.2 9.2 13.5 30.9 21.5 47.6
Highlands...... 20,400 26.2 23.6 33.0 11.3 12.4 8.4 71.2 63.0 86.5
Hillsborough... 885,100 24.3 23.1 31.0 9.7 9.5 10.6 29.8 26.5 43.3
Holmes........ 10,800 19.7 19.3 28.0 10.4 10.2 14.0 14.1 15.1 0.0
Indian River... 23,400 24.8 20.1 41.3 11.2 11.3 10.8 46.5 30.1 74.4
Jackson........ 35,900 22.8 20.2 28.6 9.2 8.2 11.5 28.2 20.0 41.0
Jefferson....... 9,600 28.9 21.3 33.8 11.4 11.8 11.0 54.2 12.8* 71.4
Lafayette...... 2,900 17.6 14.8 55.0 7.9 7.4 15.0 19.6* 25.0* 0.0
Lake.......... 54,700 21.6 18.6 34.3 11.6 11.9 10.4 37.2 38.9 33.3
Lee ........... 50,000 23.6 20.9 36.2 9.1 8.8 10.4 30.5 19.9 58.3
Leon.......... 72,300 26.3 24.4 30.0 6.7 5.4 9.1 25.2 18.2 36.0
Levy.......... 10,300 20.3 15.3 30.9 10.6 10.1 11.5 47.8 37.4 58.8
Liberty........ 3,100 24.5 21.5 40.0 11.9 11.2 16.0 18.2* 0.0 50.0*
Madison....... 14,100 27.7 23.0 33.2 8.9 8.7 9.2 40.9 45.7 37.0
Manatee....... 65,200 17.0 14.2 29.3 13.0 13.6 10.3 45.2 39.8 56.8
Marion........ 60,200 24.9 20.1 34.1 10.4 9.9 11.5 28.8 25.6 32.4
Martin........ 15,100 24.7 19.3 42.6 11.8 11.6 12.6 48.8 49.1 47.0
Monroe ....... 44,600 31.4 31.4 31.1 6.8 6.1 12.1 26.4 29.5 0.0
Nassau........ 16,600 28.3 27.3 30.9 8.3 6.7 12.7 42.6 39.4 50.4
Okaloosa....... 59,400 31.9 31.2 40.2 4.4 4.2 7.4 31.7 29.6 53.3
Okeechobee.... 5,900 26.4 27.1 23.6 8.8 8.3 10.9 44.9 38.5 76.9*
Orange........ 248,900 26.3 24.7 35.3 8.0 8.0 7.6 24.3 21.5 35.0
Osceola......... 17,500 21.4 19.6 37.6 15.3 15.8 10.0 32.1 25.8 62.5*
Palm Beach.... 216,500 22.1 19.5 29.7 9.6 10.2 8.0 34.9 23.3 56.7
Pasco.......... 34,900 18.2 16.6 31.6 11.5 11.8 8.9 33.0 30.8 42.7
Pinellas........ 347,900 16.2 14.1 34.0 14.7 15.4 8.4 28.6 23.4 47.7
Polk........... 189,900 22.7 20.5 32.1 8.6 8.5 8.9 34.3 28.6 49.6
Putnam ....... 31,000 28.0 25.2 34.0 10.4 9.8 11.6 32.2 20.7 50.4
St. Johns ..... 28,700 22.1 19.1 28.6 11.9 12.3 11.0 42.7 13.3 85.6
St. Lucie...... 36,900 26.5 18.0 48.0 9.6 8.7 11.8 46.0 25.3 65.5
Santa Rosa. .... 28,000 33.5 32.8 43.2 5.6 5.2 11.1 19.2 18.7 24.4*
Sarasota....... 72,200 17.3 16.0 27.0 11.3 11.6 9.2 32.1 25.7 59.6
Seminole....... 50,300 27.6 25.4 33.9 8.5 7.4 11.9 31.0 26.6 40.2
Sumter........ 11,700 24.3 18.4 40.6 10.9 10.8 11.3 42.3 25.3 63.5
Suwannee...... 15,100 21.6 18.7 28.8 11.1 10.2 13.3 46.0 14.9 96.8
Taylor........ 12,800 28.1 26.6 33.7 10.3 8.8 15.9 36.1 29.7 54.9*
Union......... 4,100 22.7 27.6 15.0 11.0 12.0 9.4 10.8* 0.0 41.7*
Volusia........ 118,900 20.0 17.1 31.6 12.7 13.3 10.3 29.5 21.3 47.7
Wakulla....... 5,300 19.6 15.4 29.4 7.7 7.3 8.8 19.2 0.0 42.6*
Walton........ 15,400 20.5 20.2 21.8 9.9 9.6 11.8 34.9 41.2 0.0
Washington.... 11,300 19.2 16.3 32.5 9.4 9.5 9.0 32.3 26.3 46.2*

*Based on less than 100 live births, which limits the significance of the rate.







82 ANNUAL REPORT, 1960


TABLE 12

PRELIMINARY TOTALS OF RESIDENT DEATHS FROM
CERTAIN CAUSES, BY COUNTY, FLORIDA, 1960


Cardio-Vascular-Renal
6 o Diseases w
z

P9 .3 '2________


STATE.............. 53 206 111 6 4 7,719 739 107 1,640 5,491 16,995 327 1,749 1,211 1,692
Alachua .............. 1 2 1 0 0 90 7 2 35 86 151 3 24 20 24
Baker .............. 1 0 0 0 0 14 0 0 3 13 20 0 2 2 2
Bay ................ 0 3 0 1 0 67 3 0 14 40 132 2 13 23 27
Bradford ............ 0 0 0 0 0 7 2 0 7 22 42 0 4 6 8
Brevard ............. 1 1 0 0 1 127 7 4 23 74 191 4 33 16 26
Broward ............ 13 7 0 0 534 41 3 93 293 1,055 14 87 67 115
Calhoun............ 0 1 0 0 0 4 1 0 2 14 22 1 0 1 8
Charlotte............ 0 0 0 0 0 22 5 1 3 24 60 0 5 2 8
Citrus............... 0 0 0 0 0 21 0 0 6 22 59 0 9 1 4
Clay..... ........... 0 0 0 22 2 0 6 22 37 1 6 4 3
Collier............... 0 0 0 0 16 5 2 4 10 39 0 2 4 6
Columbia ........... 1 0 1 0 0 18 4 0 13 40 65 1 12 4 5
Dade................ 9 43 21 2 1 1,495 140 18 239 747 3,017 43 279 182 270
DeSoto............. 0 0 1 0 0 15 0 0 5 14 33 7 4 3 3
Dixie................ 1 0 0 0 5 0 0 2 8 12 2 0 7 1
Duval............... 2 30 16 1 0 594 64 12 167 443 1,222 32 121 123 159
Escambia ............ 0 6 3 0 0 151 12 2 59 131 453 4 27 38 59
Flagler............... 0 0 0 0 4 3 0 1 4 9 3 2 3 4
Franklin............. 0 0 0 0 16 3 0 1 10 21 0 4 0 4
Gadsden ............. 2 1 1 0 0 27 5 1 17 44 110 3 11 8 25
Gilchrist............. 0 0 0 0 0 3 1 0 2 4 12 1 0 1 3
Glades .............. 0 0 0 0 0 2 0 0 1 3 1 0 0 1 2
Gulf................. 0 0 0 0 0 13 0 0 2 5 32 2 1 3 5
Hamilton............. 0 0 0 0 0 8 0 0 5 8 31 0 3 5 1
Hardee.............. 2 1 0 0 0 21 2 1 6 14 48 0 7 4 5
Hendry.............. 0 0 0 0 6 3 0 5 5 23 0 3 9 2
Hernando............ 1 0 0 0 0 21 0 0 6 18 37 2 1 6 4
Highlands............ 1 1 0 0 0 37 5 2 15 21 92 3 14 11 8
Hillsborough .......... 23 8 0 0 636 73 7 103 470 1,223 30 169 99 107
Holmes .............. 2 0 1 0 0 19 2 0 5 21 38 1 7 2 5
IndianRiver.......... 0 1 0 0 0 41 3 0 7 24 109 1 7 11 7
Jackson.............. 1 1 0 0 0 33 4 2 17 51 105 5 17 8 17
Jefferson ............. 1 1 0 0 0 10 3 1 10 17 38 1 3 1 4
Lafayette ............ 0 0 0 0 0 6 1 0 2 3 13 0 5 0 1
Lake ................ 1 2 4 0 0 104 17 1 25 63 270 7 32 17 22
Lee ................. 0 1 0 0 0 85 12 2 18 57 175 5 32 15 33
Leon ................ 3 0 0 1 64 6 1 23 67 142 8 12 18 28
Levy ............... 0 0 0 0 18 1 0 8 14 42 0 7 2 9
Liberty .............. 1 0 0 0 0 6 1 0 2 3 19 0 1 6 2
Madison............. 1 1 0 0 0 18 4 0 4 15 58 1 6 0 3
Manatee............. 5 3 0 0 142 13 1 48 117 396 11 33 20 12
Marion............... 2 1 0 0 79 7 2 14 82 188 4 26 19 12
Martin.............. 0 0 0 0 0 32 2 2 5 22 56 0 6 5 10
Monroe .............. 3 0 0 0 56 8 1 9 36 104 1 12 17 13
Nassau.............. 2 0 0 0 0 15 2 0 4 25 57 3 3 6 11
Okaloosa.............. 0 2 0 0 0 41 2 0 12 26 74 2 10 14 15
Okeechobee .......... 0 0 0 0 0 8 1 0 3 13 14 0 0 1 4
Orange ............. 2 8 2 0 0 334 22 4 83 247 808 15 71 50 90
Osceola............ 0 0 3 0 0 46 1 12 54 117 2 19 10 17
Palm Beach.......... 2 10 7 0 0 399 48 4 90 280 828 9 80 74 83
Pasco................ 1 0 3 0 0 82 10 2 14 61 200 4 16 12 20
Pinellas........... 2 12 8 0 0 1,050 77 11 131 785 2,400 16 242 86 105
Polk................. 2 8 4 1 1 270 22 3 63 212 631 22 61 47 67
Putnam.............. 0 4 1 0 0 49 3 0 14 29 125 19 13 7 17
St. Johns............ 2 0 1 0 37 7 1 16 47 122 3 14 6 14
St. Lucie............ 1 1 2 0 0 53 5 0 13 55 118 2 15 9 10
Santa Rosa........... 0 0 0 0 0 20 6 0 10 32 71 1 8 10 13
Sarasota ............ 1 1 2 0 0 175 10 5 15 84 360 4 38 12 22
Seminole ............. 1 4 0 0 63 6 4 25 33 167 2 8 20 26
Sumter.............. 1 0 0 0 14 0 0 1 11 46 3 3 6 3
Suwannee............ 0 1 1 0 0 22 0 0 9 34 58 1 9 3 10
Taylor............... 1 4 0 0 0 24 4 0 9 22 34 1 5 5 4
Union ............... 0 0 0 0 0 4 2 0 0 9 23 0 1 1 4
Volusia ............. 1 5 0 0 271 31 4 53 172 633 12 73 35 56
Wakulla............. 0 1 0 3 0 0 2 10 10 0 1 0 6
Walton............. 0 0 0 0 0 16 3 0 16 24 56 2 7 0 14
Washington.............0 0 0 0 14 1 0 3 25 41 1 3 3 5
*Includes all vascular lesions affecting the central nervous system.











VITAL STATISTICS 83

TABLE 13

MARRIAGES BY RACE, DIVORCES, AND ANNULMENTS

FOR FLORIDA, AND EACH COUNTY, 1960


MARRIAGES
COUNTY DIVORCES ANNUL-
MENTS
Total White Nonwhite
STATE.................... 39,315 32,479 6,836 19,326 185
Alachua .................. 458 318 140 168 0
Baker..................... 75 60 15 94 1
Bay....................... 477 390 87 269 3
Bradford .................. 83 66 17 65 1
Brevard.................... 791 682 109 909 8
Broward................... 2,611 2,126 485 1,032 9
Calhoun ................... 37 34 3 61 0
Charlotte.................. 131 118 13 66 0
Citrus...................... 103 89 14 75 0
Clay...................... 146 139 7 88 1
Collier ..................... 208 181 27 37 0
Columbia .................. 154 107 47 70 0
Dade...................... .. 8,160 7,049 1,111 4,275 71
DeSoto ................... 146 121 25 40 0
Dixie................... .. 40 33 7 8 0
"Duval... ............. ... 3 nnl -, ? 1 677 1,694. 6
Escambia ................... 1, 1 "l,1 1 "03 804 14
Flagler................... 58 40 18 172 3
Franklin ............ ...... 61 48 13 23 0
Gadsden .................. 191 88 103 66 0
Gilchrist .................. 55 44 11 5 0
Glades .................... 47 33 14 10 0
Gulf .................. .... 72 60 12 44 0
Hamilton ................... 49 30 19 23 0
Hardee.................... 161 146 15 246 2
Hendry.................... 125 98 27 55 0
Hernando................ 156 133 23 39 0
Highlands.................. 200 164 36 99 0
Hillsborough................ 3,466 2,951 515 1,623 10
Holmes................ 114 107 7 38 0
Indian River. ............... 216 173 43 53 1
Jackson ................... 168 135 33 83 1
Jefferson .................. 53 21 32 13 0
Lafayette. ................. 26 24 2 3 0
Lake ..... ............. .. 479 359 120 453 1
Lee....................... 450 384 66 169 2
Leon...................... 472 321 151 223 0
Levy.................... .. 96 67 29 31 0
Liberty. .................... 12 11 1 5 0
Madison .................. 98 70 28 28 0
Manatee.................... 566 464 102 133 0
Marion.................... 451 307 144 119 1
Martin... .................. 148 118 30 49 0
Monroe.................... 428 380 48 235 1
Nassau ................... 79 69 10 35 0
Okaloosa.................... 340 322 18 250 2
Okeechobee ................. 99 88 11 26 0
Orange. .................... 2,025 1,701 324 325 5
Osceola.................... 230 190 40 30 0
Palm Beach................ 1,575 1,214 361 753 6
Pasco......... ............. 382 348 34 144 2
Pinellas.................... 2,766 2,465 301 1,154 6
Polk....................... 1,761 1,454 307 703 11
Putnam.................... 236 170 66 389 3
St. Johns ................... 231 189 42 239 1
St. Lucie................... 314 227 87 150 2
Santa Rosa ................ 237 226 11 79 1
Sarasota.................... 661 579 82 275 3
Seminole................... 373 248 125 210 1
Sumter..................... 149 119 30 104 2
Suwannee.................. 129 93 36 57 1
Taylor..................... 114 93 21 27 0
Union ..................... 34 28 6 24 0
Volusia. .................... 918 761 157 483 3
Wakulla.................... 40 30 10 0 0
Walton ................... 91 72 19 51 0
Washington ................ 65 56 9 23 0







84 ANNUAL REPORT, 1960

TABLE 14

FLORIDA STATE BOARD OF HEALTH VITAL STATISTICS
SCOREBOARD BASED ON PROMPTNESS AND
COMPLETENESS OF CERTIFICATES FILED IN 1960


Percent of Percent of Percent of
Certificates Complete Monthly Total Score Change
COUNTY Rank Filed on Time Certificates Reports (Maximum from 1959
-Submitted = 500) Total Score
Births Deaths Births Deaths on Time
STATE.......... ...... 94.2 97.5 99.6 99.4 93.0 483.7 0.9
Wakulla.......... 1 100.0 100.0 100.0 100.0 100.0 500.0 + 7.7
Duval........... 2 99.9 99.9 99.9 99.7 100.0 499.4 0.0
Dade............ 3 99.1 100.0 99.9 99.8 100.0 498.8 + 1.7
Hillsborough...... 4 98.8 99.8 99.9 99.8 100.0 498.3 + 0.6
Orange........... 5 99.2 99.3 99.9 99.7 100.0 498.1 + 1.5
Citrus........... 6 100.0 100.0 98.4 99.2 100.0 497.6 + 1.1
Jefferson......... 7 100.0 100.0 98.7 98.9 100.0 497.6 0.8
Sarasota......... 8 99.5 100.0 99.2 98.7 100.0 497.4 + 0.9
Broward ......... 9 98.1 99.9 99.6 99.6 100.0 497.2 + 1.1
Martin........... 10 99.1 98.1 100.0 98.8 100.0 496.0 + 1.5
Suwannee ........ 11 99.0 97.1 99.7 100.0 100.0 495.8 + 1.3
Polk............. 12 98.0 98.5 99.7 99.3 100.0 495.5 + 5.2
Volusia.......... 13 98.2 98.5 99.3 99.5 100.0 495.5 0.5
St. Lucie.......... 14 99.1 98.1 99.3 98.6 100.0 495.1 + 1.6
Indian River...... 15 95.2 98.4 99.5 99.6 100.0 492.7 +16.0
Escambia........ 16 93.3 99.0 99.9 99.8 100.0 492.0 + 0.4
Seminole......... 17 98.1 96.8 98.8 98.1 100.0 491.8 2.2
Franklin......... 18 96.0 96.0 99.4 100.0 100.0 491.4 + 0.3
Hernando........ 19 97.3 99.3 99.2 94.2 100.0 490.0 8.9
Palm Beach...... 20 91.5 98.2 99.7 99.6 100.0 489.0 + 9.1
Baker............ 21 99.4 100.0 98.9 98.6 91.7 488.6 9.5
Washington...... 22 97.2 89.6 100.0 99.1 100.0 485.9 2.8
Taylor........... 23 91.9 97.5 99.3 96.7 100.0 485.4 + 7.9
Gulf............. 24 96.1 93.0 97.7 98.6 100.0 485.4 + 0.9
Alachua ......... 25 91.2 94.6 99.8 98.7 100.0 484.3 1.4
Pinellas.......... 26 85.0 99.2 99.7 99.8 100.0 483.7 4.4
Holmes........... 27 98.8 96.7 96.3 98.9 91.7 482.4 2.9
Putnam.......... 28 93.5 89.9 99.4 98.6 100.0 481.4 0.2
Levy............ 29 94.7 89.7 99.2 97.4 100.0 481.0 + 0.1
Manatee......... 30 93.9 98.4 97.6 99.2 91.7 480.8 3.1
Leon............. 31 85.3 93.3 99.5 97.8 100.0 475.9 +21.6
Glades........... 32 100.0 100.0 100.0 100.0 75.0 475.0 -25.0
Gadsden......... 33 81.2 94.3 98.9 98.7 100.0 473.1 3.0
Highlands........ 34 83.0 90.9 99.7 98.9 100.0 472.5 1.0
Monroe.......... 35 83.0 89.9 98.7 99.1 100.0 470.7 5.3
Lee.............. 36 79.9 92.7 99.1 98.6 100.0 470.3 +46.6
Madison......... 37 95.5 98.3 99.2 99.1 75.0 467.1 -13.5
Gilchrist.......... 8 84.6 82.4 100.0 100.0 100.0 467.0 +32.9
Hendry ......... 39 84.5 93.9 99.3 97.6 91.7 467.0 +20.5
DeSoto ......... 40 95.3 97.2 99.6 99.6 75.0 466.7 -11.3
Columbia........ 41 81.6 93.3 99.6 99.6 91.7 465.8 +49.5
Clay............. 42 84.4 93.8 98.2 97.5 91.7 465.6 4.1
Flagler........... 43 97.9 97.4 100.0 94.7 75.0 465.0 -13.5
Osceola.......... 44 86.1 98.2 98.3 98.2 83.3 464.1 -12.8
Charlotte......... 45 79.5 96.6 99.4 96.6 91.7 463.8 + 7.5
Marion.......... 46 74.4 98.3 98.7 99.2 91.7 462.3 +35.3
Dixie............ 47 81.4 80.0 100.0 100.0 100.0 461.4 +17.4
St. Johns......... 48 99.5 97.4 99.5 98.3 66.7 461.4 -24.9
Lake............ 49 84.5 78.2 99.3 98.3 100.0 460.3 4.3
Okaloosa......... 50 85.1 76.6 99.1 97.0 100.0 457.8 7.9
Santa Rosa....... 51 84.7 82.6 99.5 97.9 91.7 456.4 -12.3
Hamilton........ 52 85.6 77.0 98.3 94.6 100.0 455.5 -21.1
Hardee.......... 53 94.4 100.0 95.3 99.1 66.7 455.5 -34.3
Walton .......... 54 90.6 80.3 100.0 100.0 83.3 454.2 -25.9
Bay............. 55 77.8 77.9 99.5 98.3 100.0 453.5 1.9
Pasco............ 56 86.6 86.4 97.6 98.8 83.3 452.7 +18.0
Brevard.......... 57 89.5 96.8 99.3 98.4 66.7 450.7 -27.8
Calhoun......... 58 75.3 86.3 97.8 98.0 91.7 449.1 -36.3
Jackson.......... 69 82.7 75.3 99.3 99.2 91.7 448.2 3.0
Okeechobee....... 60 70.9 81.4 100.0 94.9 100.0 447.2 -21.7
Union........... 61 75.4 90.9 94.7 100.0 83.3 444.3 -17.6
Sumter ......... 62 71.3 77.0 95.9 97.7 100.0 441.9 + 1.3
Nassau.......... 63 51.1 87.1 99.7 94.4 100.0 436.3 -18.1
Liberty.......... 64 100.0 61.9 71.4 100.0 100.0 433.3 +48.3
Lafayette.... .. 65 71.4 89.5 78.6 100.0 91.7 431.2 -18.2
Bradford......... 66 98.3 96.3 97.7 100.0 33.3 425.6 -89.8
Collier ........... 67 31.1 85.3 99.4 96.9 66.7 379.4 -62.0








MATERNAL AND CHILD HEALTH


BUREAU OF MATERNAL AND CHILD HEALTH

L. L. PARKS, M.D., M.P.H., Director
E. L. FLEMMING, Ed.D., Assistant Director

STAFF
On July 1 the director of the Bureau of Maternal and Child Health
exchanged positions with the director of the Bureau of Special Health
Services. There were no other staff changes during the year except that
the pediatric consultant went on educational leave in September. He is
expected to return at the end of the school year in June 1961.
The staff of the bureau remains small; however, its responsibilities
are of a general consultant nature to those programs concerned with the
health of mothers and children. It also provides an indirect type of serv-
ice through the county health departments by the allocation of funds pro-
vided by the U. S. Children's Bureau for this program.
In developing its long range plan, the staff had an opportunity to
review the programs of the bureau with outside consultants, to inventory
and evaluate the services and programs in operation and make plans for
future programs to meet the current and anticipated problems. It was
thought that the bureau has 4 major areas which need special promotion,
namely: further reduction of infant and maternal mortality rates, es-
pecially the premature problem; improvement of school health services;
development of the program on the problem of mental retardation, and
the reduction of infant and maternal mortality through family planning.
The many other programs of an educational nature and services should
not be de-emphasized, and are being carried on in a reasonably satisfac-
tory manner.
The former director of the bureau and the assistant director had the
opportunity of participating in and contributing to the 1960 White House
Conference on Children and Youth. Recommendations from this Con-
ference may be helpful in developing our program. The present director
of the bureau had the opportunity of attending the National Conference
on Day Care for Children. Statewide regulations for day care centers
are being prepared and will be presented to the next State Legislature
by the agencies concerned with this problem. Many of the day care
centers long have been overcrowded and are in need of some supervision
for health and safety reasons.

MATERNAL HEALTH
The provisional maternal mortality rate of 4.6 per 10,000 live births
for 1960 shows that our program in this field is still making progress.
Table 15 gives the resident maternal death rates since 1935 at 5 year
intervals.








86 ANNUAL REPORT, 1960

TABLE 15
RESIDENT MATERNAL DEATH RATE
(PER 10,000 LIVE BIRTHS)
BY RACE, FLORIDA 1935-1960: 5-YEAR INTERVALS

Total White Nonwhite

Year Deaths Rate Deaths Rate Deaths Rate
1935.......... 242 86 143 73 99 117
1940.......... 215 64 118 50 97 98
1945.......... 142 29 66 18 76 60
1950.......... 83 13 34 7 49 26
1955.......... 57 6.4 24 4 93 13
1960*......... 53 4.6 15 2 38 12
*Provisional
Efforts to reduce this rate seem to depend upon the development of
more knowledge of the causes of maternal mortality or greater emphasis
on the application of our present knowledge. In some states attention
has been called to the fact that expectant mothers are not seeking medical
care as readily during their pregnancy as they once did. Perhaps a
thorough study of this should be made to determine if this is true in
Florida for the data available suggest some discrepancies. Of the patients
admitted to medical services through the county health department
prenatal clinics, the number of visits per case has averaged from 2.8 to
2.9 visits for the past 7 years. It is noted that of all births in Florida,
the percentage of expectant mothers attending the health department
prenatal clinics has moved from 7.3 per cent in 1954 to 9.1 per cent in
1959 and 11.3 per cent in 1960. The remaining expectant mothers are
presumed to be under the care of private physicians. Midwives have been
required for some years to accompany their patients to the health depart-
ment clinics if they attend the case at delivery. The health department
maternity clinics are directed by private physicians or the county health
director who is a physician.
A survey of the number of maternal and child health clinics in
operation in the state was made this fall and it was found that 218
maternity clinics are operating in 56 counties. These clinics are primarily
for the indigent. This means that it is possible for almost every mother
in Florida to secure adequate prenatal care. If she does not have a
private physician, she may then attend a health department clinic which
is held in most counties of the state. Delivery is attended by a private
physician or midwife. Hospitalization under the Hospital Services for the
Indigent Program is available in some counties, or by special arrange-
ment at a low cost payment with local hospitals, but hospitalization plans
are not readily available in many counties.
It is noted that the number of mothers securing a postpartum exami-
nation continues to be low. More emphasis is needed in this service.
During 1959 there were 3870 mothers, or only 31 per cent of these








MATERNAL AND CHILD HEALTH


mothers attending the health department prenatal clinics, who returned
for a postpartum visit. In 1960 there were 4398 postpartum visits, or 33.5
per cent. This examination is important to the mother's health and
especially important in the early diagnosis of cancer, as well as for in-
struction in future family planning.
In 1959 physicians attended 99.2 per cent of white deliveries and
81.6 per cent of nonwhite deliveries. Deliveries were in hospitals in
98.8 per cent of white births and 79.7 per cent of nonwhite births. There
were 53 maternal deaths for the year as compared with 57 for the previous
year; however, the figures for 1960 are provisional.
The Maternal Welfare Committee of the Florida Medical Associa-
tion has continued to study ways and means of lowering the maternal
mortality rate. Some maternal deaths could be classified as preventable
if proper care had been more readily available.
There were 228 midwives licensed in Florida in 1960 by the State
Board of Health. Midwives delivered 6010 babies during the year. They
received supervision and training by the county health departments. The
number of midwives is decreasing annually; in 1950 there were 422
licensed midwives and 336 in 1955. There is less need for midwives as
more physicians are now practicing in rural areas and there are more
hospitals in all parts of the state. Young girls seem to be less interested
in going into this type of service; however, there is still a need for the
midwife in some areas of the state.
On the question as to what the health departments should do in
the field of planned parenthood, there has been some favorable reaction
and at the same time some are not interested in promoting such a pro-
gram. In view of the medical problems arising from poor family planning,
it is believed that some attention should be given to this type of service by
the county health departments. It has been the general policy to leave
it to the discretion of the respective county health officer as to whether
or not he wishes to promote such a program in his county. Some of the
county health departments are already carrying on this service when it
is requested, and it is believed this is the way that it should be done.

INFANT HEALTH
In 1960 there were 115,610 births, or a rate of 23.3 per thousand
population. In the same period 3432 infant deaths were recorded and
the rate was 29.7 per thousand live births.
Prematurity is one of the major causes of death in infants. How-
ever, much attention and effort is being devoted to this part of the pro-
gram. Improved prenatal care will help the mother to carry her baby to
full term; but if the baby is premature, efforts are being made to give
the baby every possible chance to survive.
A survey made in the fall showed that more than 500 incubators
are available to help care for premature infants in 53 counties. These








88 ANNUAL REPORT, 1960


incubators have been provided by the hospital or are on loan to them
by the health departments and are readily accessible. The August 1960
issue of the American Hospital Association Guide lists 90 hospitals or
about half of the hospitals in the state, that operate premature nurseries,
or provide services for the premature. The number of births for the year
in these hospitals with premature nurseries varies from 75 to 6065.
County health department nurses are available to help provide super-
vision of the premature baby upon its discharge from the hospital, and
better still to investigate the home situation before the baby arrives from
the hospital. Efforts are being made to promote better premature centers
in the state and to provide further for the training of personnel working
in the centers (See special report on the Premature Demonstration
Center).
Well-baby clinics are in operation in many centers in the state, (a
total of 237 clinics in 54 counties). These clinics are staffed by county
health department personnel and in many instances by private physicians.
Services are provided to encourage proper care of the baby, such as in
nutrition, immunizations and the proper growth and development of the
child so he will be normal mentally and physically. These clinics are in-
tended for those persons unable to secure such services through private
means.
There has been a gradual decline in the infant mortality rate as
noted in Table 16 in both the white and nonwhite population.

TABLE 16
RESIDENT INFANT DEATHS (PER 1000 LIVE BIRTHS)
BY RACE, FLORIDA 1935-1960: 5-YEAR INTERVALS

Total White Nonwhite

Year Deaths Rate Deaths Rate Deaths Rate
1935.......... 1728 61.6 983 50.2 745 88.0
1940.......... 1812 53.8 1052 44.2 760 76.8
1945.......... 2092 42.8 1315 36.3 777 61.6
1950.......... 2078 32.3 1225 26.8 853 45.7
1955......... 2649 29.7 1476 23.0 1173 46.8
1960*......... 3432 29.7 2004 23.8 1428 45.7

*Provisional

PRESCHOOL HEALTH
The preschool, or 1-5 age group, has not yet developed immunity
to the contagious diseases and has its share of the other causes of death
that face all ages, such as accidents, chronic diseases, as well as con-
genital malformations. Immunizations are available through the health
departments to the indigent population for smallpox, tetanus, diptheria,
typhoid, polio and whooping cough. There were 69,911 immunizations
for smallpox, 126,416 for diphtheria, 176,694 for tetanus, 78,263 for








MATERNAL AND CHILD HEALTH


whooping cough and 510,901 for polio given during the year. Continued
efforts must be made to keep up the immunity level of this age group in
order to prevent these diseases. Samples of local population have been
made to determine the immunity level and these reports show that a large
percentage of preschool children are still not protected against the diseases
for which prevention is available.
Services of the Developmental Evaluation Clinic of Miami for this
age group are described elsewhere.

SCHOOL HEALTH
At the present time the school health services may be summarized
as follows: schools and county health departments encourage the parents
of preschool children to secure the necessary immunizations and physi-
cal examinations from their family physician before entering school. If
these services are not obtained before entering school, then the health
department with the aid of teachers, or volunteer workers such as the
Gray Ladies, do certain screening tests. These tests are for vision, hearing,
tuberculosis and intestinal parasites. Some funds have been available to
help the county health departments in the provision of equipment for
these tests. Teacher observations are made for illness. Physical examina-
tions are not done on every child routinely by a physician but usually
only on those children referred by a nurse and/or teacher. Immuniza-
tions are not usually offered routinely in the schools, as was done pre-
viously, but efforts are being made to promote these services in the physi-
cian's office and at the health department clinics at regularly scheduled
times.
The health department staff assists schools with sanitation problems,
in their school lunch services, with special classes and in instruction in
health. Movies, demonstrations and talks are among the methods of
instruction.
In schools seeking accreditation, the principal is required by the State
Department of Education to designate a teacher to serve as School Health
Coordinator. The title indicates the duties and responsibilities. Health
department staff members working with the Coordinator assist in bringing
local persons and resources into focus for the school health program.
These include physicians, dentists, churches, hospitals, PTAs and other
groups interested in the health of the school child.
"We learn best by doing" is one of the tenets of educators. Based on
this belief, the State Board of Health and the State Department of Edu-
cation some years ago developed a plan for assisting teachers in learning
about community resources available to them for the school health pro-
gram. At the same time, the plan provided that the teachers could earn
3 hours of credit at the university of their choice. During 1960 the fifth
Teachers Project in Health Education was conducted with 76 teachers
enrolled from 22 counties.







90 ANNUAL REPORT, 1960


Academic work was given at the University of Florida, Florida State
University, University of Miami and Bethune-Cookman College. During
the time allocated for field experiences teachers worked in the county
health departments in their home counties for 13 days, thus seeing first-
hand the program of the county health department and those of other
official and voluntary health agencies.
In the 5 years in which the project has been conducted, 257 teachers
have availed themselves of the opportunity and have urged that the plan
be continued. The plan originally was designed for school health coor-
dinators, many of whom have enrolled, but later it was opened to quali-
fied teachers interested in the health of the school child.
An analysis of the data collected in a special study of a junior-senior
high school late in 1959 reveals the need for a series of planned investi-
gations of other such schools in the state to determine, more adequately,
the school health needs of the adolescent.
In addition to the above, the school health program is being ad-
vanced by interested agencies through conferences and training programs
on the state level.

PREMATURE PROGRAM
With the close of 1960, the Premature Demonstration Center, Jack-
son Memorial Hospital, Miami completed 10 years of service to thousands
of babies born prematurely. In this period the Center likewise provided
training and experience for several hundred physicians and nurses in the
care of the tiny infants.
Through a grant from the Children's Bureau, hospitalization has
been provided for 2004 infants during the 10-year period. In addition
many other babies received care which was financed privately or under
other programs. Infants hospitalized at the center were drawn from
Dade and adjacent counties where facilities either were not adequate or
available.
During the year, 2 five-day Seminars on Premature Infant Care were
held. One was given for physicians and nurses, the other for nurses only.
A 2-day Short Course for Physicians was held with 13 physicians in
attendance. Seventy-two hospital nurses were enrolled in the 2 seminars
and several public health nurses attended as observers. This brings to 216
nurses and 34 physicians the number enrolled for these special training
courses given at the center since 1958.
In addition, students from the School of Nursing, Jackson Memorial
Hospital, and students affiliated with the hospital from Schools of Nurs-
ing at Florida State University and Barry College were assigned to the
center for periods of training. Interns and resident physicians from Jack-
son Memorial Hospital also are routed through the Center for practical
experience in premature infant care.








MATERNAL AND CHILD HEALTH


The training programs have included practical experience in the
nurseries and lectures supplemented by visual aids and the presentation
of illustrative clinical material. During the year the training opportunities
at the Center were opened to physicians and nurses from Georgia, Ala-
bama and South Carolina.
A 1-day Demonstration Clinic on premature infant care was held
at Pensacola to serve Escambia and 6 other northwest Florida counties.
Approximately 125 persons in nursing categories attended, 70 of whom
came from the 21 hospitals in the area. At the session for physicians, 18
were in attendance. The programs were presented by a team of physicians
and nurses who were members of the staff of the Demonstration Center
and the Dade County Department of Public Health.
A Manual of Procedure on care of premature infants was prepared
by the Premature Demonstration Center and has been distributed to
Florida hospitals and county health departments. A manual prepared
by another State Health Department entitled "Standards and Recom-
mendations for Public Prenatal Care" has also been distributed to each
county health department.
A qualified nurse-educator has been added to the staff of the Pre-
mature Demonstration Center to assume responsibility for developing
a longer term training program for nurses. Plans for the extended train-
ing course will enable nurses enrolled to have considerable time in
nurseries where they will be caring for premature infants daily. Other
practical experiences, lectures and conference groups are envisioned.
A slide series and accompanying texts, developed with cooperation
from staffs of the Center, the Department of Pediatrics, University of
Miami School of Medicine and the Dade County Department of Public
Health, were used enthusiastically during the year. The slides show
5 important phases of premature infant care and were booked 66 times.
Viewing audiences were medical students, nurses, hospital staffs, hospital
trustees and similar groups. Eleven complete sets and 1 partial set were
sold to Schools of Public Health, medical schools and State Departments
of Public Health in other states.
Revision of a pamphlet "Preemie Problems" was completed and
published by the Division of Health Information during the year. It
will be used by this bureau for distribution to a general audience interested
in the problems of premature infants and their families.

HEALTH SERVICES FOR MIGRATORY
AGRICULTURAL WORKERS
This special project to develop health services for migrants is now
in its fifth year of operation. Personnel engaged in the project include
6 public health nurses, a social work supervisor, health educator, nutri-
tionist, sanitarian, 2 clerks and 4 part-time physicians who offer health
services to migrant workers, especially women and children.








92 ANNUAL REPORT, 1960


This program is not a sporadic emergency health service but rather
a planned health program organized to fit the health needs, the cultural
background and the living and working conditions of the specific migrant
population served.
The program has demonstrated effective ways to provide service
through multipurpose family clinics held at night, nursing visits to camps
on a regular schedule, a liaison worker as intermediary between health
workers and families, and intergroup cooperation to provide curative
as well as preventive care with local physicians, hospital administrators
and public health and public welfare workers involved.
The physicians and nurses have continued the family clinics, giving
special attention to prenatal and postnatal factors which influence the
health of the mother and child.
The social worker continues in the development of community
health resources and the utilization of these resources by the migrant
workers.
The nutritionist has established mothers' classes demonstrating ways
in which available foods can be utilized to provide a maximum diet with
minimum waste, and has been instrumental in the development of sewing
and homemaking classes for younger migrants.
The health educator and liaison worker have conducted studies to
determine communication levels in an attempt to develop a health
vocabulary which could be understood by all migrants. They have also
investigated differences in the utilization of health services when migrants
find themselves part of a minority group within the migrant community.
An example is the study of Negro migrants in Immokalee where the
majority of migrants are from Texas or Mexico.
The sanitarian has established schools for the landlords of various
rental units. In these classes he has tried to help prevent the abuse of
property by training the landlords how to instruct the migrant renters in
the proper use of living facilities.
During the past 6 months the entire staff has been processing the
data which they have accumulated while carrying out the service aspects
of the project during the past 4 years. This data will be compiled and a
final report of the project will be ready for publication in the spring
of 1961.

TENTH ANNUAL POSTGRADUATE
OBSTETRIC-PEDIATRIC SEMINAR
The tenth annual seminar was held at Ormond Beach under the
sponsorship of the Bureaus of Maternal and Child Health of the State
Health Departments of Florida, Georgia, Alabama and South Carolina,
the Maternal Welfare Committee of the Florida Medical Association and
the Florida Academy of General Practice. Physician interest in this 3-day