Annual report - State Board of Health, State of Florida

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FLORIDA

STATE BOARD
OF
HEALTH

1961

ANNUAL REPOR

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State Board of Health

State of 7loecda

1961

The following reports will be published separately:
SUPPLEMENT I FLORIDA VITAL STATISTICS, 1961
SUPPLEMENT II FLORIDA MORBIDITY STATISTICS, 1961

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

JACKSONVILLE, FLORIDA

The Honorable Eugene G. Peek, M.D., President
Florida State Board of Health
Ocala, Florida

Dear Dr. Peek:

I herewith submit the annual report of the Florida
State Board of Health for the year ending December 31,
1961.

Sincerely yours,
ALBERT V. HARDY, M.D., Da.P.H.
Acting State Health Officer

May 1, 1962
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, 1961, to
December 31, 1961, inclusive.

Respectfully submitted,
EUGENE G. PEEK, M.D.
President

May 1, 1962
Ocala, Florida

Members of the
FLORIDA STATE BOARD OF HEALTH

EUGENE G. PEEK, M.D., President
Ocala

T. M. CUMBIE, Ph.G., Vice President
Quincy

ASHBEL C. WILLIAMS, M.D.
Jacksonville

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

W. S. HORN, D.O.
Palmetto

OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH

December 31, 1961

DIRECTORS

State Health Officer (on leave)....................Wilson T. Sowder, M.D., M.P.H.
Assistant State Health Officer..................Albert V. Hardy, M.D., Dr.P.H.
(Acting State Health Officer)
Assistant State Health Officer...................Clarence M. Sharp. M.D.
(Acting Director of Bureau of
Preventable Diseases)
Assistant State Health Officer...................William L. Wright, M.D., M.P.H.
Division of Personnel.................................Miles T. Dean, M.A.
Division of Health Education....................lizabeth Reed, R.N., B.S.
Librarian ...................................................Tomma Pastorett, B.S., M.A.
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...................William L. Wright, 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., R.S.
Division of Nutrition................................Mary B. Deaver, M.S.
Bureau of Preventable Diseases
(Acting Coordinator of Research
and Training)....................... James Bond, M.D., M.P.H.
Division of Tuberculosis Control..............Dwight W. Wharton, M.D.
Division of Radiological and
Occupational Health............................Edwin G. Williams, M.D.
Division of Epidemiology.........................
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 (Acting) ....................................George W. Hoover, M.D.
Division of Chronic Diseases......................James E. Fulghum, M.D.
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.
Assistant to Director..................................Charles E. Cook, C.E.
Division of Water Supply..........................John B. Miller, M.P.H.
Division of Waste Water......................Ralph H. Baker, Jr., M.S., San. Eng.
Bureau of Narcotics......... ..........Frank S. Castor, Ph.G.

OFFICIAL STAFF FLORIDA STATE BOARD OF HEALTH

December 31, 1961

DIRECTORS

State Health Officer (on leave)....................Wilson T. Sowder, M.D., M.P.H.
Assistant State Health Officer..................Albert V. Hardy, M.D., Dr.P.H.
(Acting State Health Officer)
Assistant State Health Officer...................Clarence M. Sharp. M.D.
(Acting Director of Bureau of
Preventable Diseases)
Assistant State Health Officer...................William L. Wright, M.D., M.P.H.
Division of Personnel.................................Miles T. Dean, M.A.
Division of Health Education....................lizabeth Reed, R.N., B.S.
Librarian ...................................................Tomma Pastorett, B.S., M.A.
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...................William L. Wright, 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., R.S.
Division of Nutrition................................Mary B. Deaver, M.S.
Bureau of Preventable Diseases
(Acting Coordinator of Research
and Training)....................... James Bond, M.D., M.P.H.
Division of Tuberculosis Control..............Dwight W. Wharton, M.D.
Division of Radiological and
Occupational Health............................Edwin G. Williams, M.D.
Division of Epidemiology.........................
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 (Acting) ....................................George W. Hoover, M.D.
Division of Chronic Diseases......................James E. Fulghum, M.D.
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.
Assistant to Director..................................Charles E. Cook, C.E.
Division of Water Supply..........................John B. Miller, M.P.H.
Division of Waste Water......................Ralph H. Baker, Jr., M.S., San. Eng.
Bureau of Narcotics......... ..........Frank S. Castor, Ph.G.

DIRECTORS OF COUNTY HEALTH DEPARTMENTS

(As of December 31, 1961)

Alachua..............................................................Edward G. Byrne, M.D., M.P.H.
Bay.........................................................A. F. Ullman, M.D.
Brevard...........................................................William L. Wright, M.D., M.P.H.
(Acting Director)
Broward ............. ..........................................Paul W. Hughes, M.D., M.P.H.
Collier.......................................................... Joseph W. Lawrence, M.D. (Acting
Director)
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.
Jefferson............................................................ Joseph M. Bistowish, M.D., M.P.H.
(Acting Director)
Lake........... ................................................J. Basil Hall, M.D., M.P.H.
Lee........... .................................................. Joseph M. Lawrence, M.D.
Leon.............................................................Joseph M. Bistowish, M.D., M.P.H.
Manatee.... ...................................................Frederick K. Allen, M.D.
Marion...............................................................P. H. Smith, M.D.
Monroe ........................................................John L. Ingham, M.D.
Okaloosa.........................................................B. R. Provost, M.D.
Orange................................. ........................... W. N. Sisk, M.D., M.P.H.
Palm Beach.....................................................C. L. Brumback, M.D., M.P.H.
Pinellas.......................................................... William C. Ballard, M.D., M.P.H.
Polk ............................................................. James F. Cason, M.D., (Acting
Director)
St. Johns..........................-...............................William L. Wright, M.D., M.P.H.
(Acting Director)
Santa Rosa.................................................. A. E. Harbeson, M.D.
Sarasota....................................... .................. William L. Wright, M.D., M.P.H.
(Acting Director)
Seminole...........................................................W. N. Sisk, M.D., M.P.H.
(Acting Director)
Volusia..............................................................D. V. Galloway, M.D., M.P.H.
Baker-Nassau.....................................................B. F. Woolsey, M.D.
Calhoun-Jackson.............................................. Terry Bird, M.D., M.P.H.
Flagler-Putnam.... .......................................James F. 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. 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...........................George M. Dame, M.D.
Franklin-Gulf-Wakulla..................................... William L. Wright, M.D., M.P.H.
(Acting Director)
Glades-Hendry-Highlands-..............................William F. Hill, Jr., M.D., M.P.H.
Holmes-Walton-Washington... ........................Leo R. Evans, M.D., M.P.H.
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; and Divisions of Per-
sonnel and Health Education) ......................................... ...... 1

Bureau of Local Health Services (including Divisions of Public
Health Nursing, Sanitation and Nutrition) .................................. 21

Bureau of Vital Statistics ........................................................................ 52

Bureau of Maternal and Child Health ........................................... 65

Bureau of Preventable Diseases (including Divisions of Epide-
miology, Venereal Disease Control, Radiological and Occu-
pational Health, Tuberculosis Control and Veterinary
Public H health) ............................................................... ................... 74

Bureau of Laboratories ............................................................................ 111

Bureau of Special Health Services (including Accident Preven-
tion Program, Divisions of Chronic Diseases and Hospitals
and Nursing Homes, and the Hospital Services for the
Indigent Program) ........................................................................... 128

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) ...................................... 151

Bureau of Mental Health (including Florida Council on
Training and Research in Mental Health) .................................... 180

Bureau of Narcotics ................................................................................ 192

Bureau of Entomology (including Entomological Research
C enter) ................................................................................................ 196

Bureau of Dental Health ........................................................................ 215

Bureau of Finance and Accounts (including Purchasing and
Property) ......--..........................................-----------........--.... .... 220

Articles by Staff Members ...................................................................... 231

GENERAL ADMINISTRATION 1

WILSON T. SOWDER, M.D., M.P.H., State Health Officer (on leave)
ALBERT V. HARDY, M.D., Dr.P.H., Assistant State Health Officer
C. M. SHARP, M.D., Assistant State Health Officer
WILLIAM L. WRIGHT, M.D., M.P.H., Assistant State Health Officer

A statement by the Acting State Health Officer, Albert V. Hardy,
M.D., Dr.P.H.:
"The problems in public health are manifold, but if there is one single
issue which eternally confronts us it is the effort to improve constantly the
public health program for Florida. And it is worthy of special note here
that programs are in progress looking toward critical revaluation of cur-
rent programs and exacting ones for the future.
It is difficult to capsule public health problems or solutions because
both are constantly overlapping. But I believe the most significant matters
facing us for the next decade will be the realms of chronic illness and aged
persons. Hospital care for our aged and indigent is assuming increasing
importance. Eighteen and a half million dollars has been allotted for the
1961-63 biennium for the county-state and state-federal programs. These
matters involve many facets such as public health nursing, home nursing,
rehabilitation and auxiliary services.
Of equal importance must be new emphasis on mosquito control and
environmental sanitation-air and water. These will continue to present
complex difficulties in suburban areas. They will continue to increase as
the state maintains its rapid growth. And along with air pollution is the
matter of radiological health. In this regard, the Governor has designated
the State Board of Health "the state agency for nuclear licensing and
control."
Then, there are imperative requirements concerning mental health.
Essentially, these center around the necessity of developing community
responsibilities in handling more adequately those persons who have early
signs of mental problems; of developing community means of preventing
serious mental disease, and in follow-up of persons returning home from
mental hospitals. There are many things involved in this, but it is chiefly
a matter of evolving within each community the means of doing a better
job.
We must not forget the ever-present hazard of epidemic-nor forget
that public health workers are in the first line of attack and defense for
the protection of Florida's residents and her visitors. There were two
potentially dangerous situations last year: typhoid in Franklin County and
encephalitis in the Tampa Bay area. These threatened outbreaks might
have gone out of hand had not prompt control measures been taken.
Just as we have one major overall concern-the constant improve-
ment of our public health program-so we have one principal problem
in dealing with it. This plague is the perennial one of money and men.
Florida faces with critical acuteness the demanding and far-reaching
needs of a constantly expanding population and industry. These needs

2 ANNUAL REPORT, 1961

are growing much more rapidly than our resources: enough qualified per-
sonnel and enough money. We must be forever forward-looking but when
we have found what we are looking for, we must be given-we must, in
fact, already have in hand-the means of promptly approaching and
firmly securing that goal."

ACTIVITIES OF THE BOARD
During the year two changes occurred in the membership of the
Board. Eugene G. Peek, Jr., M.D., of Ocala was appointed by the Gover-
nor, effective June 28, 1961, to replace John D. Milton, M.D., who had
been a member of the Board for four years and its President during most
of that period. Ashbel C. Williams, M.D., of Jacksonville, was appointed
by the Governor effective June 19, 1961, to succeed Sullivan G. Bedell,
M.D., of Jacksonville who served four years on the Board. Eight meet-
ings were held during the year; there was one telephone conference meet-
ing. The date, place and business transacted were as follows:
January 15-Jacksonville
1. Mr. Hans Tanzler, attorney at law, was appointed as attorney
(General Counsel) to the State Board of Health.
2. Discussed in detail the proposed Pilot Cancer Cytology Program
in Dade County and approved an additional $5900 of federal
cancer funds to be spent in connection with this over a period of
one year at the end of which this program would be evaluated.
3. Approved the appointment of Dr. James Fulghum as Director of
the Division of Chronic Diseases.
4. Created a Division of Personnel with Mr. Miles Dean as Director.
5. Adopted recommendations of the Hospital Advisory Committee
on Hospital Services for the Indigent utilizing the benefits of the
Mills-Kerr Bill.
6. Heard report by Dr. Milton regarding the Cuban refugee prob-
lem in Dade County and authorized the expenditure of $25,000
federal funds received from the Public Health Service specifically
for this purpose.
7. Authorized the State Health Officer to act as their representative
in discussions with various groups regarding the Mills-Kerr Bill.
February 14-Jacksonville
1. Discussed proposed chapter of the Sanitary Code on air pollution
and postponed action pending further study.
2. Created a Division of Nutrition in the Bureau of Local Health
Services with Miss Mary Brice Deaver, Chief Nutritionist, as its
Director.
3. Discussed proposed regulations for the control of radiation
hazards and postponed their adoption to permit further study.

GENERAL ADMINISTRATION

4. Discussed a situation with regard to a chicken cannery in Braden-
ton in which there were certain required sewage facilities needed
that had not been met. The Board authorized legal assistance to
Dr. Allen in serving an injunction in this instance.
5. Discussed proposed budget for the enforcement of the Drug, De-
vices and Cosmetic Law. Decided that this matter should be
referred to the Legislative Council for study and recommendation
since funds collected under the law were not adequate for its
proper enforcement.
6. Authorized the disposal of the wooden laboratory building in
Orlando.
7. Approved certain persons for postgraduate training in public
health during the academic year 1961-62.
8. Adopted a policy regarding the employment of summer students
by the State Board of Health.
9. Discussed salary of State Health Officer with committee of Flor-
ida Association of County Health Officers and approved that a
recommendation be made to the Governor for a minimum salary
of $20,000 and preferably $25,000 for the State Health Officer.
March 11-Jacksonville
1. Adopted a new chapter of the Sanitary Code on air pollution.
2. Adopted regulations for the control of radiation hazards.
3. Discussed and approved proposed bills to be presented to the
Legislature.
4. Discussed with a Committee of the Florida Association of County
Health Officers the restoration of County Health Unit funds to
the legislative budget.
5. Discussed with Chairman of the Legislative Committee of the
Florida Anti-Mosquito Association support of the group for ad-
ditional funds for the mosquito control program of the State
Board of Health and another research laboratory on dogflies.
May 8-Telephone Conference Meeting
1. In a telephone Conference meeting discussed and approved an
agreement regarding the duplication of duties between the Flor-
ida State Board of Health and the State Hotel and Restaurant
Commission.
May 27-Miami Beach
1. Discussed Grand Jury Report regarding air pollution in Polk
County.
2. Discussed request made by Jackson Memorial Hospital, Miami,
for cancer funds for personnel in the amount of $7548 per year
but it took no action.

4 ANNUAL REPORT, 1961

3. Approved policy regarding surplus reserve funds in county health
departments.
4. Approved change in the name of the Division of Health Infor-
mation to Health Education.
5. Discussed the legal case on fluoridation in Ft. Pierce and au-
thorized the State Health Officer to take whatever action he
deemed necessary in the case.
6. Approved changing the position of Director of Local Health
Services from a Health Officer IV to a Health Officer V position.
7. Approved the recommendations of the Medical Scholarship Com-
mittee for medical scholarships for certain persons (listed else-
where).
8. Discussed a resolution regarding patient services through health
departments introduced to the House of Delegates of the Florida
Medical Association and decided on course of action.
9. Heard a report by Mr. Carter on legislation and outcome to date.
July 23-Jacksonville
1. Elected Dr. Peek as President succeeding Dr. Milton (no longer
a member of the Board) and reelected Mr. Cumbie as Vice
President.
2. Appointed Dr. William Wright as Assistant State Health Officer
and Director of the Bureau of Local Health Services.
3. Authorized a study by an outside accounting firm to make a
thorough study of distribution of funds to county health depart-
ments.
4. Authorized a proposal for one year only a formula for the dis-
tribution of funds to county health departments.
5. Heard a progress report on the building at Winter Haven.
6. Adopted revisions of Chapter XII of the Sanitary Code on
Abattoirs.
7. Approved intervention in the court case regarding fluoridation in
Ft. Pierce.
8. Authorized attorney of Board to assist Board of Pharmacy and
Attorney General's Office in injunction proceedings against
Webb's City Drug Store in St. Petersburg.
9. Authorized the State Health Officer to advise the City of Sanford
of contemplated legal action regarding requirements set forth by
State Board of Health regarding sewage system.
10. Approved recommended osteopathic scholarship.
11. Approved postgraduate training for Mr. Charles Haney for 1961-
62.
12. Approved new positions in the cancer control program.

GENERAL ADMINISTRATION 5

13. Approved appointment of members on the Hospital Advisory
Committee on Hospital Services for the Indigent.
14. Discussed the plan to close the training school for Negro nurses at
Brewster Hospital.
15. Approved plan to seek additional funds from the Budget Com-
mission for the employment of four additional narcotic inspectors
and two chemists for the enforcement of the Drug, Devices and
Cosmetic Law.
September 8-Tallahassee
1. General discussion regarding State Board of Health matters by
the Board members with the Governor and Mr. Harry Smith,
Budget Director.
September 17-Jacksonville
1. Approved seeking approval of Budget Director for use of lapsed
funds from State Board of Health monies for the employment of
personnel for the Drug, Devices and Cosmetic Law.
2. Discussed salary problems existing among professional categories
within the State Board of Health.
3. Heard a status report regarding litigation of the State Board of
Health.
4. Approved a year's leave of absence for military duty for Mr.
Tanzler; and approved the appointment of Mr. Carlton Maddox
as General Counsel during his absence.
5. Discussed proposed regulations on toxic pesticides and authorized
Mr. Mulrennan to submit them to the Toxic Pesticides Advisory
Council.
6. Adopted a statement on oral polio vaccine.
7. Approved the appointment of Dr. John Milton as a member of
the State Advisory Committee for Practical Nursing Education.
8. Approved a leave of absence for Dr. Wilson T. Sowder, State
Health Officer.
9. Designated Dr. Albert V. Hardy as Acting State Health Officer,
when the Governor approved the Board's recommendation for
the leave of Dr. Sowder.
10. Approved payment of secretarial services for the President of the
Board.
November 19-Jacksonville
1. Approved payment of membership for one year for the American
National Council for Health Education of the Public.
2. Approved the establishment of a position of Coordinator of Civil
Defense with secretarial assistance.

6 ANNUAL REPORT, 1961

3. Approved the transfer of civil defense activities and the accident
control program from the Bureau of Special Health Services to
the Bureau of Local Health Services.
4. Approved a plan for budgeting of additional federal funds.
5. Met and heard from groups regarding the proposed regulations
on toxic pesticides.
6. Discussed the proposed regulations on toxic pesticides and legal
complications and postponed their adoption.
7. Discussed the use of 12 inch plastic pipe by municipalities for
sewer mains.

A full-time news director was added to the administrative staff to
aid press, radio, television and magazines in obtaining health information
for public dissemination. The office distributed 111 stories to the above
media.

RESEARCH COORDINATION
ALBERT V. HARDY, M.D., Dr.P.H.
Assistant State Health Officer
Coordinator, Research and Training
Detailed reports on research in progress during 1961 are included as
a part of the record of the bureau or division engaged in these studies.
This is a summary report.
In 1961 approximately three-fourths of a million dollars was budg-
eted by the State Board of Health in 26 different research or demonstra-
tion projects. As in the past, the major support was for the Entomological
Research Center in Vero Beach. Three other projects were supported by
state funds from the Council on Training and Research in Mental Health.
There were 19 projects supported by federal funds, 15 by grants from the
National Institutes of Health (NIH) and four by direct grants or con-
tracts from other program activities of the U.S. Public Health Service.
One each was supported by the Kellogg Foundation, Armed Forces
Epidemiological Board and a private pharmaceutical company.
In the year under review, new project grants from the National
Institutes of Health were awarded to the Bureau of Entomology for a
study of Wildlife Usage of Salt Marshes on the East Coast of Florida;
to the Bureau of Sanitary Engineering for a study of the Chironomidae
of Florida; and to the Bureau of Laboratories for a study of Arthropod-
borne Viruses in Florida. The latter grant, although approved, could not
be funded due to a restriction in NIH monies. Also, the Coordinator of
Research was instrumental in obtaining a small grant from a pharma-
ceutical company for a study of Chemotherapeutic drugs during an out-
break of bacillary dysentery in the Sunland Training Center in Ft. Myers.

GENERAL ADMINISTRATION 7

Substantial assistance was provided to Florida State University in obtain-
ing a biometry training grant in which graduate students would obtain a
portion of their field experience with the State Board of Health. This
training grant was approved for the Department of Biostatistics at the
university.
This office was active in obtaining a project for the evaluation of oral
polio vaccine in Hillsborough County. This program was initiated in the
late fall with a study of 15 lots of monovalent vaccine prepared from
Sabin strains. This pilot project provided data on effectiveness of the
vaccines which is required in applying for licensure. This proved to be the
first phase of a larger project involving the entire community using a
trivalent vaccine. During the earlier study the Hillsborough County Health
Department and the Florida State Board of Health research team be-
came familiar with the procedures required for community administration
of oral vaccines and developed the necessary surveillance utilizing both
epidemiological and virological procedures. A special grant was obtained
from the Lederle Laboratory to support these studies.
A new contract was awarded to the Division of Radiological and
Occupational Health for study of methods to evaluate and reduce the ex-
posure levels from ionizing radiation administered through medical and
dental offices. This contract is a part of a broader proposal designed to
evaluate the total population dose in two or more areas of Florida as a part
of a long range study to measure the biological effects of chronic exposure of
populations to low doses of ionizing radiation.
Two ongoing research projects were renewed. The major one was in
Pinellas County where for the past three years a project has been carried
out to determine the needs for a public health program to meet the
special health problems of the aged. The project was approved to be
continued another three years to initiate and evaluate special programs
as indicated by the previous three years' study. Also, the project entitled
"The Epidemiology of Unclassified Mycobacteria" which has been in
progress for the past three years was renewed for another three-year
period. This program has been studying the special epidemiological and
laboratory aspects of this infection which so closely simulates tuberculosis.
A report of the first five years of this investigation was made to the
American Public Health Association in Detroit and indicated substantial
progress in defining the reservoir and mode of transmission of these
infections.
A special study of administration in public health, financed by the
Kellogg Foundation, is being continued. This year the emphasis has been
on developing evaluation indices for school health programs and continu-
ing the establishment of careful long range plans for each of the various
program activities in the state and county health departments. A system
for continuous evaluation of a program against its objectives was devised,
and is being used experimentally in the migrant project in Palm Beach
County. It appears to be capable of adaptation to any program, and may
prove to be a valuable tool in public health administration. A con-
siderable amount of time of the director of this project has been taken

8 ANNUAL REPORT, 1961

up with the preparation of administrative plans for a combined program
of nursing services in 26 rural northern Florida counties.
During the year the office assisted in the preparation of two new NIH
applications and three special project applications. The latter were pre-
pared following the passage by the Congress in July of the Community
Health and Facilities Act providing for support of special projects to
develop and demonstrate better methods of providing community health
services for the chronically ill and aged. In Dade County a project was
prepared to coordinate the services of the welfare and health departments
in providing a continuity of comprehensive medical care for welfare
clients particularly those assigned to nursing homes. In Pinellas County
a project was designed to make a comprehensive study of extra-hospital
community nursing needs. This was prepared with the assistance of con-
sultants from the University of Pittsburgh School of Public Health and
it is hoped it will provide objective evidence required for the organization
of adequate home nursing services. Assistance was also given to the
faculty of the School of Nursing, University of Florida, in the preparation
of a project to test a procedure for referral and follow-up by county
health department personnel of patients discharged from the teaching
hospital or attending its outpatient clinics. The major objective of this
project was to encourage continuing home nursing care, to evaluate spe-
cial needs and problems and to provide information which could be
utilized in the training of public health nurses who are embarking on this
new program.
New NIH grant requests which have been submitted include a pro-
posal to develop standards for sanitary quality of salad-type foods. If
authorized this would be carried out by the Bureau of Laboratories,
Division of Sanitation and the Orange and Duval County Health De-
partments. Also a request was submitted for a combined study by the
Divisions of Radiological and Occupational Health and Veterinary Public
Health of those factors related to the apparent high levels of cesium 137
in milk produced in the peninsular area of Florida.
There was special concern with research training authorized and
financed through a research training grant. In this program a social
scientist is receiving training in a school of public health and a physician
is receiving special clinical training related to public health in the De-
partment of Medicine at Jackson Memorial Hospital in Miami. During
the summer months the Coordinator of Research administered the pro-
gram of special training for 46 summer students. Approximately 26 of
these were in 10 bureaus and divisions of the State Board of Health and
20 were assigned to various county health departments.
A beginning was made on coordinating various inservice training
programs carried out by bureaus and divisions in the central office. A
catalog was prepared of the activities carried out during the first six
months of 1961 and the proposed activities of the first six months of 1962.
This will be the basis for a calendar distributed to all bureaus, divisions
and health departments and also the basis for an evaluation of the spe-
cial needs in coordination and extension of inservice training.

GENERAL ADMINISTRATION

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 seven-man advisory committee
authorized by statute. George T. Harrell, M.D., Dean of the School of
Medicine, University of Florida, and John C. Finerty, M.D., Assistant
Dean of the School of Medicine, University of Miami, are ex officio
members. The president of the Florida Medical Association designates the
remaining five members. They were: Richard C. Clay, Miami; James
T. Cook, Jr., Marianna; Homer L. Pearson, Jr., Miami; Melvin M. Sim-
mons, Chairman, Sarasota; and Richard F. Sinnott, Ft. Pierce. Sixteen
new scholarships for the study of medicine were awarded in 1961 and 24
previously awarded scholarships were continued.
The 1959 session of the Legislature authorized the State Board of
Health to award one of the 10 medical scholarships each year to a student
for the study of osteopathic medicine. The State Board of Osteopathic
Medical Examiners recommends the student for this award.
Forty thousand dollars is appropriated annually for the award of
scholarships for the study of dentistry. As provided by statute, the State
Board of Dental Examiners consults with the State Board of Health in
awarding dental scholarships. Thirteen new scholarships for the study
of dentistry were awarded in 1961 and 23 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 interns in clinical
psychology, psychiatric nursing and psychiatric social work. Since 1955
stipends for the training of residents in psychiatry had been awarded;
however, these awards were terminated by the 1961 Legislature.
Through the Federal Social Security Act of 1935, the State Board of
Health receives federal funds which are used to provide stipends to its
employees and those in affiliated county health departments for special-
ized professional training. These stipends are awarded to career employees
who evidence potential for growth and service in specialized areas of
public health.
Persons receiving scholarships in 1961 were:
MEDICAL
Scholarships Awarded in 1961:
Thomas John Calhoun......Jacksonville Betty Lou Bottoms..................Westville
George Duncan Finlay....Blountstown Jack Denby
Buford Gibson, Jr..............Sarasota Bergstresser*..................Vero Beach

10 ANNUAL REPORT, 1961

Oliver Hunt Harper........Wewahitchka
Betty Jo Johnson...............Dade City
Webb Buckley Olliphant....Jacksonville
James Cranford Phillips..St. Petersburg
Thomas Joseph Philpot........Suwannee
Joseph Thomas Rabban....Jacksonville

David Oliver Westmark........Pensacola
Prince Benjamin
Oliver, Jr. .............Daytona Beach
Hubert Warren Wingate...Gainesville
Ronald Loyde Haney................Miami
Braxton William Price..Ft. Lauderdale

Continuing Scholarships Awarded Prior to 1961:

Awarded 1958: Awe
Jarrett Charles Black Robe
Robert Elliott Blakey Gord
William Edwin Braun Fran
Edward Richard Laur
McDonough Ever
Lawrence Donald Porter M
Raymond Charles Walker Wilb
Robert Paul Whittier
George Allen Williams

*Studying Osteopathic Medicine

irded 1959:
:rt Allen Boudet
ion Thames Couch
cis Thomas Greene
ence DeLano Kelley
ett Norwood
cCormick
ur Williams, Jr.

Awarded 1960:
Sylvester Barrington
Mirion Perry Bowers
Rodney Lee Brimhall
John Agustine Moore
Cupid R. Poe
Frederick Oliver Smith
Paul Vincent Sullivan
Shirley Rose Simpson
Tommie Lynn Thomas*
Robert Whelchel Miles

DENTAL 3'<, L"7

Scholarships Awarded in 1961:
Clement W. Barfield ............Pensacola Arthur R. Higg
Larue E. Curenton ............Crestview Clarence L. M
George B. Dorris ........................Miami Edward L. Pete
Guy Ronald Estes ........Winter Haven Ivan Beryl Rob
John T. Griffin, Jr...............Pensacola James A. Rober
Charles A. Harrell............Auburndale David M. Stri
William R. Wai

s........................Miami
cNair........Port St. Joe
rs.............Port St. Joe
erts...................Tampa
tson....................Miami
mer........St. Petersburg
rrender..Winter Haven

Continuing Scholarships Awarded Prior to 1961:

Awarded 1958:
Alvin Bayer, III
Raymond W. Gage, II
James Emmett Mongoven
Oran Lloyd Turner, Jr.

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

Awarded 1960:
Teddy Wallace Brown
Edward Martin Clayton
Harold Glenwood Gregg
Emmett Alfred Kirksey
Lorenza Laws
Charles H. Ritter
Earl Thomas Sherman
Allen R. Treadwell
Theodore C. Wilson

MENTAL HEALTH
RESIDENTS IN PSYCHIATRY
(Stipends for Residents in Psychiatry terminated in June by Legislative Act)
Herbert C. Anderson, M.D.......Miami Ralph O. Maercks, M.D...Coral Gables
William H. Geiger, M.D...........Miami William L. Gustafson, M.D......Miami
Ronald A. Shellow, M.D..........Miami Theodore M. Wolff, M.D.........Miami
Paul B. Hamilton, M.D.............Miami

CLINICAL PSYCHOLOGY
Alan W. Rusnak............Miami Beach Eve Lyn Weeks ..............Coral Gables
Everette E. Hall, Jr...........Gainesville Donald B. Clark..........Ft. Lauderdale
Nathan W. Perry, Jr.........Tallahassee Mack R. Hicks..................Gainesville
Charles G. Wood, Jr...............Tampa Stephen G. Irving............Coral Gables
Benjamin F. Gillis............Tallahassee

GENERAL ADMINISTRATION

PSYCHIATRIC NURSING

Elma E. Dykes..........................Miami
Joan M. O'Brien ..............Tallahassee
Helen G. Kocik.......................Miami

JoAnn H. Patray..........Gainesville
Lenora J. Hayes............Chattahoochee

PSYCHIATRIC SOCIAL WORK

First Year
Ronnie Fisher .........................Tampa
Harry L. Gaskins................Tallahassee
John E. Killiany ....................Miami
Mary L. Pittman........................Dania
Mina Jo Powell......................Williston
Aza Lee Baxter...................Lakeland
Doris M. Cameron............Jacksonville
Asa O. Flake........................Oklawaha
Marjorie H. Hall.....................Tampa
Margaret R.
Schaedel ..........Clearwater Beach
Diane Wilhite...................... Lake City

Second Year
Eldred R. Bratsen....................Miami
Barbara E. Holland....................Miami
Veda N. Jaeger......................Lakeland
Elizabeth M. Pickel............Ft. Myers
James W. Strayer................Lakeland

PUBLIC HEALTH PERSONNEL
E. R. Broussard, M.D................Health Officer III....... .............Escambia
Elbert Charles Hartwig, Jr.........Biologist III.....................................Laboratory
Thomas D. Haupt........................Clinical Psychologist III.................Dade
Edward L. Flemming, Ed.D........Clinical Psychologist IV..................Maternal and
Child Health
Valerie Anne Rains.......................Health Educator I........................Sarasota
Katherine M. Baker....................Mental Health Worker II..............Dade
Alice B. Bessenger.........................Public Health Nurse II................... Pinellas
Barbara Lewis........................... Public Health Nurse II...................Okaloosa
Jane Moultrop ........................ Psychiatric Social Worker III.......Dade
W. C. Galbreath....................Sanitary Engineer III.....................Broward
Charles P. Haney..........................Sanitary Engineer II.......................Sanitary Eng.
A. L. Johnson............................ Research Trainee ........................... Dade

DIVISION OF PERSONNEL
MILES T. DEAN, M.A.
Personnel Director

Under the general direction of the State Health Officer, this division
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; participating 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 administer-
ing a service rating system; and the preparation of necessary reports, both
state and federal. Payroll operation, also a responsibility of the Division

12 ANNUAL REPORT, 1961

of Personnel, includes the administration of leave accounting, the em-
ployee 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 Requesting and the
Operational Budgets is also a responsibility of this division.
Effective January 1, certain changes were made in payroll pro-
cedures which involved placing a considerable amount of calculations
on IBM, including the accounting of annual and sick leave.
Pay ranges for 98 classes involved in the State Board of Health
Classification and Pay Plan were revised upward. Supplemental rules to
the Pay Plan, passed by the Merit System Council and approved by the
State Personnel Board, did not allow the salary advancements, as well as
salary adjustments, that would have been granted iri accordance with the
rules for administration of the Pay Plan. A Meritorious Longevity Pay
Plan was adopted effective July 1, 1961. Several State Board of Health
employees received salary advancements under this plan.
A bill relating to retirement of Merit System employees was passed
into law by the 1961 Legislature (Chapter 61-289). This law grants au-
thority to agencies to retire or transfer employees with tenure rights after
age 65 and further provides that persons who have reached age 70 will
automatically be retired unless they request continuation of employment,
which must be approved by the agency concerned.
Turnover continued to be a problem with a significant increase in
rates in the sanitary engineering classes.. Terminations during the year
increased to 458; employment papers for 624 new employment were
processed .... Postgraduate training was completed by 18 employees and
14 additional 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, 1952 1961

Year State County Health Total
(As of Dec. 31) Office Departments Employees
1961 ............................... 626 1,593 2,219
1960.................................... 604 1,34 2,138
1959 .................................... 586 1,396 1,982
1958..... ...........................58 1,321 1,879
1957................................... 528 1,234 1,762
1956.................................... 481 1,127 1608
1955.................................... 442 1,057 1,499
1954.. ........ ....................... 421 980 1,401
1953.... ........... ............... 439 928 1,367
1952............... .................... 458 895 1,353

GENERAL ADMINISTRATION 13

TABLE 2

DISTRIBUTION OF PERSONNEL-STATE BOARD OF HEALTH

(OTHER THAN COUNTY HEALTH UNITS)

DECEMBER 31, 1961

ADMINISTRATIVE UNIT 1j : a
o S g -6
i- I 1 u 1 1 0 U

Grand Total .........................
Administration:
SHO............................
Personnel ...................
Data Processing ...................
Total ........................
Dental Health.....................
Finance and Accounts:
Fiscal ..........................
Purchasing and Property ...........
Total.........................
Health Education
Laboratories:
Central (Jacksonville) .............
M iami................... ......
Orlando........................
Pensacola .......................
Tallahassee ....................
Tampa........ ...................
West Palm Beach .................
Total......................
Local Health Services:
Bureau. ......................
Civil Defense ...................
Nutrition .....................
Nursing........................
Sanitation .......................
Total.....................
Maternal and Child Health...........
Mental Health....................
Narcotics .......................
Preventable Diseases:
Bureau ...........................
Radiological and Occupational Health.
Tuberculosis Control...............
Epidemiology and Venereal Disease
Control......................
Veterinary Public Health...........
Total .........................
Sanitary Engineering.................
Special Health Services:
Bureau and Hospitals and Nursing
Homes.......................
Chronic Diseases................
Total.......................
Entoology......................
VtlSaistcs...........

2..... ...........
2 ...

5 2 1 ......
..... 2 27 .....

14 ANNUAL REPORT, 1961

TABLE 3

DISTRIBUTION OF PERSONNEL IN COUNTY

HEALTH UNITS-DECEMBER 31, 1961

COUNTY B |
r o
? n 4| 1 .

GRAND TOTAL.... 1593 79 808 12 553 6 336 299
1. Alachua......... 32 2 4 ....... 12 ........ 7 7
2. Baker........... 4 ...... 1 ... 1 ........ 2 ....
3. Bay.......... 16 3 .... 6 ....... 4
4. Bradford........ 5 ........ 1 .. .. 2 ...... 1 1
5. Brevard......... 24 ........ 6 ........ 9 ........ 8 1
6. Broward......... 79 2 15 2 24 ........ 20 16
7. Calhoun......... 4 ........ 1 ........ 1 ..... 1
8. Charlotte ....... 5 ...... 1 ...3 ...... 1 .
9. Citrus.......... 7 1 1 .... 2 ... 1 2
10. Clay............ 8 1 2 .. .3 ........ 1 1
11. Collier.......... 11 ........ 2 .. 4 ...... 8 2
12. Columbia....... 7 1 2 ........ 2 ........ 1 1
13. Dade......... 253 15 53 3 107 ........ 6 29
14. DeSoto.......... 5 1 1 ........ 1 ....... 1 1
15. Dixie............ 3 ........ ....... ........ 1 ........ 1 1
16. Duval........... 4 2 7 ........ 14 1 8 10
17. Escambia........ 61 3 11 ........ 18 ........ 17 12
18. Flagler.......... ....... 1 .. 1 ...... 2
19. Franklin......... ........ 1 .. .. 1 ...... 1 1
20. Gadsden......... 12 1 2 ....... 6 ........ 2 1
21. Gilchrist.......... 2 ........ ....... .................. 1 1
22. Glades........... 1 .......................... ... ........ 1 ...
23. Gulf........... .... 1 .. 2 ........ 1 1
24. Hamilton....... 4 ........ 1 ........ 1 ........ 1 1
25. Hardee.......... 5 ........ 1 ........ 2 ........ 2 .
26. Hendry......... 8 ........ 2 ........ 3 ........ 2 1
27. Hernando....... 2 ........ ........ .. ...... 1 ........ 1 .
28. Highlands....... 8 1 2 ...... 2 ........ 1 2
29. Hillsborough..... 182 8 89 2 62 1 4 36
30. Holmes........... 5 ....... 1 ........ 2 ........ 1 1
31. Indian River..... 11 1 2 ........ 6 ........ 1 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 3 ........ .......... 4 3
36. Lee............ 12 1 3 ........ 4 ........ 2 2
37. Leon........... 37 3 6 ........ 10 ........ 9 9
38. Levy........... 6 ........ 1 ........ 2 ........ 1 2
39. Liberty.......... 3 ..... ...... .. ... 1 ....... 1 1
40. Madison....... 7 1 1 ........ 2 ........ 2 1
41. Manatee......... 24 1 5 ........ 6 ........ 6
42. Marion......... 14 1 3 ........ 5 ........ 2 3
43. Martin.......... 5 ....... 2 ...... 2 .. 1 ....
44. Monroe......... 19 1 3 ........ 6 ....... 4
45. Nassau.......... 1 1 2 ........ 3 ....... 4
46. Okaloosa....... 16 1 2 ........ 5 ........ 5
47. Okeechobee.... 4 ....... 1 ........ 1 ....... 1
48. Orange......... 70 2 12 1 22 ........ 19 14
49. Osceola.......... 5 .. .. 1 .... 2 .. 2 .
50. Palm Beach...... 79 6 13 1 23 ........ 16 20
1. Pasco........... 5 1 1 ........ 2 ... .... 1 .
52. Pinellas......... 148 8 29 2 57 1 30 21
53. Polk............ 78 2 15 1 30 ........ 14 16
54. Putnam......... 10 1 1 ........ 4 ........ 3 1
55. St. Johns........ 10 1 3 ........ 3 ........ 2 1
56. St.Lucie........ 14 1 4 ........ 3 ........ 3 3
57. Santa Rosa...... 10 1 2 ........ 3 ........ 1 3
58. Sarasota...... 89 ........ 9 ....... 13 ....... 10 7
59. Seminole........ 12 ........ 3 ........ 4 2 3
60. Sumter.......... 4 ........ 1 ....... 1 1.. 1
61. Suwannee... 8 1 1 ........... 3 ........ 2 1
62. Taylor........ 4 ....... 1 ........ 1 ........ 1 1
63. Union........... 3 ........ 1 ........ 1 ........ 1 .
64. Volusia.......... 57 3 9 ........ 17 1 9 18
65. Wakulla......... 2 ........ .............. 1 ........ 1
66. Walton.......... 7 ........ 1 .. 2 ........ 1 3
67. Washington ..... 5 ........ 1 ........ 2 ........ 1 1

GENERAL ADMINISTRATION

TABLE 4
TURNOVER BY CLASSIFICATION OF THE FLORIDA STATE
BOARD OF HEALTH-STATE & COUNTY
CALENDAR YEAR 1961
TERMINATION TURNOVER RATE
Physicians .................. ............. 23 22.5%
Sanitary engineers ................................ 10 24.4%
Sanitarians ..................................... 22 6.9%
Public health nurses ............................ ... 102 17.9%
Laboratory workers (Prof. & Tech.)............... 16 12.8%
Clerical .......................................... 121 22.7%
All others (Including Laborers) ................... 164 31.1%
Total ............................................ 458 21.0%

TABLE 5
EMPLOYEES BY AGE, RACE AND SEX
STATE AND COUNTY-DECEMBER 31, 1961

White White Nonwhite Nonwhite
Age Total Male Female Male Female
Under 20............ 18 2 16 0 0
20-24............... 100 8 87 3 2
25-29............... 162 49 99 6 8
30-34............... 223 90 101 12 20
35-39............... 318 134 161 3 20
40-44............... 339 104 201 8 26
45-49............... 329 108 199 4 18
50-54.............. 321 99 196 5 21
55-59.............. 214 67 130 7 10
60-64............... 118 47 61 3 7
65-69................ 53 26 27 0 0
70-74............... 18 8 9 1 0
75-79............... 6 2 3 1 0
TOTALS........... 2219 744 1290 53 132

16 ANNUAL REPORT, 1961

GENERAL DATA PROCESSING UNIT
ARNOLD KANNWISCHER, B.S.
Procedures Director

This unit performs three major functions: system and procedure
analysis, IBM data processing and inactive records storage.
SYSTEMS AND PROCEDURES: This is the analysis of present
methods and systems of office performance, with the objective to simplify,
improve, mechanize or (in some cases) to eliminate a system to afford a
saving to the agency or to increase the efficiency of a particular operation,
especially in the areas of records handling and storage, forms design and
the mechanization of hand operated procedures.
IBM DATA PROCESSING: 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 proc-
esses approximately 100 programs in the IBM Section. These include one
or more programs for almost every bureau or division of the State Board
of Health.
INACTIVE FILE RECORDS DEPARTMENT: Three years
ago it was deemed necessary to establish this department. The rapid ac-
cumulation of records presented a serious and costly problem. Additional
costly filing equipment was continually requested; worn out file cabinets
needed replacing. All of these file cabinets occupied costly prime floor
space, and each of these active files needed clerical maintenance. Inven-
tory of records is now in progress and those found to be inactive are
placed in transfer file boxes and removed to the Inactive File Depart-
ment. In addition much microfilming was done, further reducing the
size of the records accumulated.
During 1961 the Inactive Records Department received for storage:
187 transfer file boxes, representing 47 file cabinets, 368 boxes IBM cards,
252 microfilm rolls, 143 volumes of Vital Statistics Indexes, 5764 sets of
Engineering blueprints for microfilming. It was estimated that the above
transfer of records in 1961 afforded the agency a savings of well over
twenty-two thousand dollars.
The following were some of the major activities rendered to the
bureaus and divisions in 1961:
Personnel Division-A major conversion of records processing con-
tinued. All payroll calculations and tabulations as well as leave accounting
and personnel statistics were programmed for IBM machine handling.
. Narcotics-The work for this bureau consisted mainly of one large
registration procedure: the registration of 10,158 practitioners of the
healing arts which consists of the mailing and processing of applications
for licensing-and the subsequent tabulation of related statistics. .
Finance and Accounts-The work processed for this bureau included re-

GENERAL ADMINISTRATION 17

ports on Workman's Compensation, salary budget projections, tabulations
on expenditures, travel and county receipts. Property inventory was suc-
cessfully converted to punch card methods during this year Mental
Health-The reports submitted by the community mental health clinics
on discharged patients are processed on a monthly basis by this unit.
From these reports, calendar year as well as fiscal year statistical data are
prepared. Data on more than 8000 discharges were processed in 1961.
. Local Health Service-Numerous requests for statistical information
for specific counties and communities were tabulated during the year.
A major undertaking of this unit was the study of the feasibility of
automating the daily activities reporting of the various disciplines in the
county health departments Maternal and Child Health-A monthly
maternal death listing as well as an annual listing is prepared for this
bureau .... Dental Health, Health Education, Entomology-There were
numerous small studies and IBM machine tabulation performed for these
bureaus. Sanitary Engineering-The major undertaking for this
bureau was the consolidation of their filming and records system. Micro-
filming of the blueprints and engineering drawings continued throughout
the year. .. Vital Statistics-The processing of all the vital records in-
cluded in 1961, 116,886 births, 49,110 deaths, 40,934 marriages and
21,682 divorces and annulments. Information from these records were
coded and transferred into punch card format, from which are derived
the statistics compiled and published in the Annual Report, the Vital
Statistics Annual Report, Supplement No. 1, and the Monthly Vital
Statistics Report. ... .Bureau of Preventable Diseases-This bureau re-
ceived during 1961, 90,000 communicable disease reports. All these re-
ports 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. 2. Special Health Services and Indigent Hospital-
ization Program-During the fiscal year 1960-61, 30,016 approved ap-
plications for indigent hospitalization 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 listings of cancer deaths, rheumatic
fever deaths, reportable diseases and the semi-annual poison control
register.

DIVISION OF HEALTH EDUCATION
ELIZABETH REED, R.N., B.S.
Director
The division's name was changed in 1961 from Health Information
to Health Education as more indicative of its functions. It serves in
both a staff and a line capacity to other bureaus and divisions; that is, it
acts as an advisory and service unit on matters relating to health educa-
tion and information. It also serves, to the limit of its available staff
time, the county health departments. It acts in many instances as a liaison

18 ANNUAL REPORT, 1961

with voluntary and official health agencies, and schools and universities.
Contacts with the general public are also enjoyed.
During 1961, the following specific activities were noted:
Besides working on displays and exhibits (83) much of the exhibit
consultant's time was spent doing signs (124) and illustrations (105).
Many layouts, charts and maps (145) were for reproduction (61) or
slides (15) while miscellaneous duties and conferences (66) kept him
busy in Jacksonville. Eight field trips were made to various parts of the
state for planning and assisting with exhibits at meetings and fairs.
Sufficient planning time and work-storage space remain problems.
Florida Health Notes carries its messages about health problems to
more people every year. Following the clearing of the mailing list late in
1960 the county health departments were requested to send in names of
those they wished to add to the list. As a result, in 1961 the number of
copies distributed each month hit a new high of 15,000. The majority of
the readers are lay persons.
Subjects included in the 1961 series were: arthropods, the story of
the growth of Florida's county health departments, water pollution, hurri-
cane Donna, diseases of animals transmissible to man, a simplified annual
report, the Cuban refugee problem, infectious hepatitis, some of the
smaller public health programs and the follow-up program on patients
returning from state mental institutions.
Pamphlets continue to enjoy wide circulation, though an effort was
made to cut down the number of titles offered and to increase those that
would be suitable for persons with less than a sixth grade education.
Approximately 235,000 were distributed, with the most popular ones in
the field of communicable diseases, nutrition, and maternal and child
health. The rise in interest in health careers was reflected in the larger
number of pamphlets distributed on that subject.
Packets on "Pure Water and You," (a joint project with the Division
of Water Supply) comprising a dozen selected pamphlets, were mailed
to representative junior high school teachers. Public libraries were asked
if they would like to receive public health pamphlets at regular intervals.
Over 60 per cent of the larger libraries replied.
"Who uses the State Board of Health Library?" is a question that is
frequently asked. In 1961 State Board of Health personnel led the list
with a total of 2265. Next were 571 local (Jacksonville) physicians. The
third largest group were 267 students from high schools, colleges and
nursing schools. The library was asked for service by 235 employees of
county health departments, 147 physicians other than those in Jackson-
ville and 136 lay people. It is probable that those from county health
departments rank third instead of fourth since many requests come in by
mail, and these were not tabulated.
Circulation statistics were: books on regular loan, 1886; books on
indefinite loan, 550; periodicals, 12,419; pamphlets and reprints, 96.
There were 64 items borrowed on interlibrary loan and 11 books sent to

GENERAL ADMINISTRATION

other libraries. During the year 2255 reference questions were answered
(a very popular service) and 33 bibliographies prepared.
Periodical loans increased by almost 2000 even though a restriction
was placed on lending bound journals. Since the purchase of a photo-
copier in July, reprints are furnished instead of the actual journal. There
were 534 photocopies requested.
Added to the library in 1961 were 922 volumes, of which 202 were
bound journals. The library received some extra funds in June and was
able to obtain new editions of basic textbooks. There were 1848 worn, or
out-of-date items, withdrawn. The number of volumes now in the library
totals 17,580.
The information consultant for the first part of the year served as a
press secretary, issuing many news releases. During the latter part of the
year this function was taken over by the State Health Officer's staff. The
information consultant is now concentrating on writing, inter-mural
reporting and preparation and circulation of radio spots.
In the Audio-Visual Library increased activity was reflected in the
11.4 per cent increase in the number of booking orders processed, (5047),
and the 9.2 per cent increase in the number of aids circulated, (6716).
There was a marked increase in the number of times aids were used
(19.4 per cent). The audience total was 685,365 (a 43 per cent increase).
Motion pictures still led with 92 per cent of the total circulation.
There were 55 aids removed and 104 were placed in the A-V Li-
brary; 45 of these are on loan from commercial companies, professional
organizations and voluntary health agencies.
Three pieces of equipment were purchased with an electronic film
cleaning machine being the most noteworthy. Two catalog supplements
were printed and distributed. Streamlining of all procedures was em-
phasized in an endeavor to keep up to some degree with the ever-
increasing number of requests received. Major changes in booking and
filing procedures to further streamline activities will be studied in 1962.
The many and diverse activities of the staff will not be gone into in
detail. However, they include many talks given before civic clubs, PTAs,
church groups, school and university classes. Assistance was given to a
workshop for nursing home administrators, one for clerical personnel, one
on health education (auspices of Health Education Section, Florida
Public Health Association) and another for mental health workers. The
director was a member of the Interbureau Committee on Accident Pre-
vention which met frequently. Two successful community organization
projects were spearheaded in Jefferson and Baker Counties. Three regular
orientation programs were held plus one for summer student employees.
The staff assisted with the annual Teachers Project (see report of the
Bureau of Maternal and Child Health). Five foreign visitors were as-
sisted with planned experiences. Innumerable professional and lay meet-
ings were attended and the staff served on planning committees in PTAs,
educational organizations and voluntary health agencies.

20 ANNUAL REPORT, 1961

The long range plan for the division was completed during the year.
That there is much interest in such a plan was demonstrated when it was
offered to the directors of health education in other states, for 46 request-
ed a copy. In the 1960 Report, there were noted outstanding needs in the
division. Those which were satisfied during the past year were: some
acceleration of health career recruitment, and streamlining of procedure
in the Audio-Visual Library. There remains the need for a field con-
sultant, regional health educators, an exhibits trailer, scheduled TV
programs, regional workshops on cultural factors affecting health educa-
tion, and increased contact with the state's 24 community colleges.
Others are an evaluation of the problems concerned in the editing and
publication of State Board of Health monographs; an increased em-
phasis on service to other bureaus and divisions, and health educators for
vacant positions in the counties. There are presently only five functioning
on the local level.

BUREAU OF LOCAL HEALTH SERVICES 21

WILLIAM L. WRIGHT, M.D., M.P.H.
Director
HUBERT U. KING, M.D.
Assistant Director
The organization and supervision of county health departments
continues to be a major responsibility of this bureau. The bureau fur-
nishes consultation to the staffs of county health departments and assists
them with recruitment and staffing, budget planning and review, training
programs, program planning and evaluation, and coordination of local
programs with activities of the State Board of Health. The bureau is
the immediate representative of county health departments within the
State Board of Health.
This bureau is administered by a director and an assistant director.
During the year two physicians served on the standby staff of the bureau
providing additional assistance to the director. A resident with the U.S.
Public Health Service also served on the staff for part of the year. In-
cluded within the bureau are the Division of Public Health Nursing,
Division of Sanitation, Division of Nutrition, and Clerical Section (for-
merly Records Consultants). In December two new programs were added
-the Accident Prevention Program and the Health Mobilization Serv-
ices Program to coordinate health and medical services for civil defense.
Not only has the bureau been actively engaged with older respon-
sibilities, but it has devoted attention to newer responsibilities. In the
area of older responsibilities much time has been given to the review of
merit system and personnel procedures in an attempt to simplify these
procedures. Numerous meetings have been held to study budget and
accounting procedures. Additional time has been devoted to coordination
of local programs and bureau activities with those of other bureaus, state
and local relations, program evaluation, training programs and activities,
recruitment and salaries. Plans have been developed for expansion of the
combination public health-home nursing care program made possible
with additional federal funds through the Chronically Ill and Aged Pro-
gram and a USPHS grant. Plans are also under consideration for expan-
sion of the Accident Prevention and Health Mobilization Services Pro-
grams.
STAFF CHANGES
With the resignation of Wilfred N. Sisk, M.D., as director of the
bureau in December 1960, C. M. Sharp, M.D., Assistant State Health
Officer, was appointed acting director and served in this capacity until
August 1961 at which time William L. Wright, M.D., director of the
Sarasota County Health Department, was appointed Assistant State
Health Officer and director of the Bureau of Local Health Services.
Hubert U. King, M.D., continued as assistant director during the year.
James C. Loranger, M.D., was appointed to the standby staff in April and
served until December when he became director of the St. Johns County
Health Department. Chester L. Nayfield, M.D., transferred as director

22 ANNUAL REPORT, 1961

of the Polk County Health Department to the standby staff in August
as health officer consultant. E. A. Leopardi, M.D., USPHS resident,
completed his residency with the bureau in July. George A. Dame, M.D.,
former director of the Bureau of Local Health Services, was appointed
special consultant to the bureau in January.
TRAINING ACTIVITIES
During the year the bureau continued its orientation and training
programs for health officers, sanitarians and nurses. The orientation pro-
gram for new health officers was revised and four recently employed
health officers received this orientation. The Florida Association of
County Health Officers in cooperation with staff members of the State
Board of Health sponsored a three-day seminar on public health laws and
legislation at Miami Beach in September.
Study of training programs and activities within the bureau con-
tinued and was broadened to include a review of all such training ac-
tivities conducted by the State Board of Health. It is hoped that this
study will result in more interesting and better planned training programs
for our staffs.
During the year two local health officers enrolled for postgraduate
training in schools of public health. In addition ample opportunity was
provided for local health officers to participate in various meetings and
courses within and outside the state.

CLERICAL SECTION
During 1961 the records consultants continued to offer consultation
and assistance to local health officers and their clerical staffs. A major
activity was continued assistance in converting medical and nursing
records to the new central filing system with revision of certain medical
and nursing records. The consultants visited some 16 counties to assist
with this undertaking.
Other activities included visits to assist with the reorganization of
files, to assist with orientation of new clerical personnel, and to discuss
and help with special clerical problems. In addition to these activities,
these consultants also worked closely with the Bureau of Vital Statistics
in the follow-up of vital statistics problems, checked all Monthly Ac-
tivities Reports from the counties and helped clear up errors, participated
in the state orientation program for new personnel, and worked with the
State and Local Records Committees in reviewing and revising records.
At the end of the year, it was decided to broaden the services of these
consultants to include more consultation on personnel procedures, budg-
ets and accounting procedures.
COUNTY HEALTH DEPARTMENTS
During the year there were 42 well-organized county health units
in the state. Of this number 26 were single county units, seven were bi-
county units, and nine were tri-county units. The services of 78 full-time

LOCAL HEALTH SERVICES

physicians were required, including 42 directors and 36 assistant health
officers. In addition a number of part-time physicians were employed in
clinical activities and six public health residents received training. During
this period six directors resigned, three transferred to other positions, and
there were five new appointments. There were also two deaths among our
health officers.
There were no major changes in the organizational pattern of county
health units during 1961. Following the resignation of the director of the
Jefferson County Health Department, this department has been tem-
porarily aligned with the Leon County Health Department, whose di-
rector will supervise this program. Working under him will be a part-
time physician who will serve as assistant health officer for several months.
Also, due to the resignation of the director of the Franklin-Gulf-Wakulla
County Health Unit, the same physician serving Jefferson County will
serve as acting health officer for Wakulla County during the coming
months. Franklin and Gulf Counties will temporarily be served by
another health officer until the fall of 1962 and until a permanent health
officer can be secured for these counties.
Staffing and Financing: As of December 30, 1961, there were
1549 employees on county health department staffs. This is an increase
of 15 employees over 1960. County health department budgets totalled
$9,159,352 or $1.78 per capital. Of this amount $6,663,206 ($1.29 per
capital) came from local contributions and $2,496,146 ($0.49 per capital)
from state and federal funds.
Health Center Construction: During the year a new headquarters
building was completed in Hardee County. In addition, new auxiliary
centers were completed at Bartow in Polk County, Pinellas Park in
Pinellas County, Delray Beach in Palm Beach County, and in the new
courthouse annex at New Port Richey in Pasco County. Lake County
secured new auxiliary quarters at Clermont. In the planning stage are
new headquarters centers for Marion, St. Lucie and Highlands Counties.
Additional auxiliary centers are planned for Polk and Okaloosa Counties.

Trends in Local Public Health Practice
The Florida Association of County Health Officers came into being
in 1960 as a result of reorganization of the Health Officers' Conference
and continued to be an active and effective organization during 1961. In
1960 this group stimulated the publication of a quarterly Bulletin for
County Health Officers which is still published by the State Board of
Health under direction of this bureau. It is believed that the reorganiza-
tion of the Health Officers' Association and publication of the Bulletin
will improve communication among local health officers and between the
State Board of Health and local health officers. In addition during the
year, an Association of Sanitarian Directors was organized. Close co-
operation between the associations for health officers, nursing directors
and directors of sanitation should contribute materially to Florida's public
health program.

24 ANNUAL REPORT, 1961

One of the most significant trends in Florida's public health program
is the anticipated expansion of its combination nursing service. This pro-
gram which provides bedside nursing care in addition to the traditional
public health nursing services has been in existence for a number of years
in Florida. In 1960 there were seven counties with the combination
service and three counties with coordinated services where the county
health department provides administrative leadership and works closely
with the local VNA group. During 1961 Alachua and Volusia Counties
expanded the combination service and Manatee County began a new
program. With the receipt of additional federal funds from the Chron-
ically Ill and Aged Program and a USPHS grant, added impetus was
given to this program. Plans were laid in 1961 for the expansion of this
program throughout the state, and it is expected that in a few years a
majority of the state will be covered. The Clay, Volusia and Sarasota
County Health Departments have agreed to serve as training centers for
public health nurses. The University of Florida is cooperating with the
State Board of Health in establishing refresher courses in bedside care
for this program. In addition, staff members are investigating the pos-
sibility of setting up other training centers in the state especially in the
area of rehabilitation training. Scholarships will be provided for public
health nurses to receive training at New York University's Institute of
Physical Medicine and Rehabilitation and at the Kenny Rehabilitation
Institute. Other methods of enhancing this program are under investi-
gation; e.g., the use of homemakers in the program and the value of
"coordinating nurses" who will work in local hospitals to serve as liaison
people between the patient, family, attending physician, hospital staff
and the county health department.
With the added attention given to Health Mobilization Services
and Accident Prevention Programs at state level, it is expected that these
programs will be expanded during the coming year with more definitive
local programs and greater local participation.
The review and rewriting of Florida's public health laws and regu-
lations in conformity with the provisions of the Florida Administrative
Procedure Act enacted at the last session of the State Legislature should
result in clarification and better understanding of these legal provisions
with more effective and uniform application throughout the state.
HIGHLIGHTS OF LOCAL PROGRAMS
The statistical report of county health department activities (Table
7) indicates the number and types of various services rendered by county
health departments. The following is a summary of some of the more
exceptional or outstanding developments in local programs: Alachua
County Health Department-Expension of the combination nursing
service with plans for a "coordinating" nurse in the local hospital to
serve in a liaison capacity between patients, doctors, hospital staff and
the county health department.... Brevard County Health Department-
Continues to demonstrate effectively the rapid implementation of public
health services in an "impact area", resulting in this county from over-

LOCAL HEALTH SERVICES

whelming population increase due to development of aero-space activities
at Cape Canaveral. Although the program was slowed temporarily due
to resignation of the health officer, it should now expand rapidly under
direction of the newly appointed director. Broward County Health
Department-Cooperated with the local medical society, lay diabetes
society and newspaper in conducting a county "Health Fair" attended by
more than 6000 persons. As a result of this fair 10 suspected cases of
diabetes and 69 suspected cases of glaucoma were detected. Screening
procedures included urine tests for sugar, blood sugar tests for those with
glycosuria, eye tests for glaucoma, chest X rays and blood pressures. In
addition a large segment of the population received an excellent health
education program. .. .Clay County Health Department-Was desig-
nated early in 1961 as the training center for the public health nurses'
orientation program. As plans for expansion of the combination nursing
program developed, plans were made to expand the training activities
of this unit to provide additional short courses in home nursing care for
public health nurses in the state Collier County Health Department
-Began a cervical cytology program in connection with maternity clinic
program during the year using the Papanicolaou smear. Out of the initial
57 patients tested, two cases of cervical cancer were detected and con-
firmed by biopsy. In addition five other cases of chronic inflammatory
disease, probably precancerous, were found. This proves the value of this
program in a small county when coordinated with the regular maternity
care program .... Dade County Health Department-Received a USPHS
grant to demonstrate that continuity of medical care and rehabilitative
needs of persons with chronic disease can more adequately be met by
existing community resources through planning and well developed co-
ordinated efforts. Escambia County Health Department-Made a
five-year evaluation of its subdivision sanitation program which is an in-
dex not only of the progress this county has made but also reflects the rapid
progress being made throughout Florida in this program. This county
reports 75 per cent of subdivisions now served by public water supply
versus 54 per cent in 1956; 32 per cent served by central sewerage sys-
tems versus eight per cent in 1956; 63 per cent with paved streets versus
37 per cent five years ago; 34 per cent with storm sewers versus five per
cent; and 37 per cent with curbs and gutters versus 11 per cent. Began
a study of school health services with organization of a school health
council. A special team will interview school principals and health co-
ordinators and will present its findings to the council. The objectives of
this program are to improve all school health services by adding needed
services and deleting outmoded ones. Hillsborough County Health
Department-Laid plans in 1961 for a countywide program using the
Lederle Sabin Trivalent Oral Polio Vaccine to begin early in 1962. The
program has as its goals demonstration of use of a proven clinically
effective oral polio vaccine, ability to reach segments of a community
population heretofore unreached by previous polio immunization pro-
grams, maintaining community immunization by continuing infant im-
munization, demonstration of the vaccine in eliminating "wild polio
virus" from the community by long-term virological studies, and carrying

26 ANNUAL REPORT, 1961

out selected behavioral science studies to demonstrate those factors
influencing both individual and community acceptance of the vaccine.
Began community occupational health program with assistance from the
USPHS. Jefferson County Health Department-Plans were made
during 1961 to begin a continuing multiphasic screening program in this
county to determine the value of such a program in a rural area. Details
of the program are being worked out and it should begin early in 1962.
S. Lake County Health Department-Is conducting a "controlled tooth
brushing program" in the schools with some 1400 children participating.
. Manatee County Health Department-Plans were made to begin a
community combination nursing service. Held a "Diabetes Detection
Week" at the health department in cooperation with the medical society
and diabetes association. As a result 36 persons were found to have
positive urine tests and were referred to the family doctor for follow-up.
Began using membrane filter method for rapid testing of water for coli-
form organisms. Monroe County Health Department-New health
officer began intensive program to study all phases of sanitation on the
Keys. Numerous discussions have been held with officials, industry repre-
sentatives and State Board of Health consultants. This should result in a
significant improvement in all phases of the sanitation program in the
county. Orange County Health Department-In cooperation with the
medical society, welfare department and state mental hospitals, has de-
veloped an effective follow-up program for indigent patients returning
from mental hospitals to the community. Visits to the mental health
clinic and drugs for home treatment are arranged by the health depart-
ment. Public health nurses consult with the staff of the mental health
clinic and visit patients in the home. Palm Beach County Health
Department-Continued one of the state's outstanding migrant labor
programs. Early in the year conducted a combined chest X-ray and blood
test survey among 3900 migrants. The "Rapid Plasma Reagin" (RPR)
test was used for syphilis. Some 546 out of 3786 tests were reactive.
Of this number 173 were ultimately given treatment for syphilis .
Pasco County Health Department-With assistance from the Bureau of
Special Health Services, conducted a multiphasic screening program in
three retirement villages in the county. Over 800 people (eight per cent
of total population) were tested in four days. Testing was limited to
those over age 30 with more than 50 per cent being over 65 years of age.
The survey was carried out on street corners, in shopping centers and
public buildings. Tests offered were height and weight measurement,
hemogloblin determination, blood sugar, cholesterol studies and blood
pressures. As a result 11 per cent were found to be more than 20 per
cent overweight; 24 per cent had elevated blood pressures and 17 persons
(two per cent) had abnormal glucose tolerance tests on retesting and
were referred for follow-up by their family doctor. Cholesterol levels
were higher than expected-the average for males over 60 was 304
milligrams per cent and females over 60 was 330 milligrams per cent.
More comparative studies are being done and will be reported later ...
Pinellas County Health Department-Formation of a "Staphylococcus
Team" deemed necessary as a result of the increase in such infections

LOCAL HEALTH SERVICES

in schools, nursing homes, etc. The director of the Communicable Disease
Section heads the program assisted by a physician, sanitarian and public
health nurse. This team will investigate all reported cases of staphylococ-
cus infections, make bacterial studies and recommend control measures.
Developed a program to evaluate Sterneedle technique in mass screening
for tuberculosis with comparison with the Mantoux test and follow-up
X-rays as indicated. Cooperated with the Board of Education, Com-
munity Welfare Council, and newspapers in sponsoring the second annual
"Health Futurama" designed to give information to students, parents,
teachers and guidance counsellors about careers in the health and allied
professions. Purchased a Medical Disaster Trailer for use in the com-
munity. Polk County Health Department-Conducted selective 70
mm chest X-ray survey in areas where previous tuberculin testing of
school children indicated higher incidence areas. As a result, additional
data on contact rates was compiled and two new active cases of tuber-
culosis were discovered and hospitalized. Putnam-Flager County
Health Unit-Began dental preceptor program in both counties. The
beginning of this program is an index of the continued interest in smaller
counties in providing better dental care for the community. As additional
funds become available even more counties should begin similar programs.
. Sarasota County Health Department-Received a USPHS grant to
demonstrate a public health approach to reduce the incidence and
prevalence of alcoholism by incorporating this program into the general
public health program of a county health department. A psychiatric
social worker has been employed and the staff has begun a great deal of
basic community work on the program. Progress has been somewhat de-
layed, however, due to transfer of the health officer .... Plans were made
for a "coordinating nurse" in the combination nursing program. Desig-
nated as a training center for public health nurses in this program....
Volusia County Health Department-Continued expansion of the com-
munity combination nursing program. Began participation in State Board
of Health residency program with the first resident being employed in
November .... Designated as a training center for public health nurses
in connection with expansion of the home nursing program Indian
Health Services- Glades-Hendry County Health Unit continued to pro-
vide public health services as well as assisting in medical care programs
for the Seminole Indians on the Brighton and Big Cypress Reservations
in cooperation with the USPHS. The Broward County Health Depart-
ment provided similar services for the Seminoles in that county.

DIVISION OF PUBLIC HEALTH NURSING
RUTH METTINGER, R.N.
Director
This division has been for many years a part of the Bureau of Local
Health Services. Its administrative structure remains unchanged, con-
sisting of a director, an assistant director, five public health nurse con-
sultants, one nurse-midwife consultant and two clerical personnel. It is the

28 ANNUAL REPORT, 1961

responsibility of the division to offer guidance and technical assistance
to public health nurses at the local level and to coordinate the efforts
of all departments of the State Board of Health as they concern nursing
services.
The nurse consultants offer technical assistance to county supervising
nurses in planning clinic schedules, assignments and districts. In small
counties without supervisors they assist individual nurses to plan daily
activities and review family folders and caseloads.
In the field of consultation, aid in the definition and solution of
problems is offered to county health department nurses, and an attempt
is made to show the relationship of each problem to larger public health
concepts.
Education is an important facet of the consultants' duties. They keep
abreast of new developments in public health, such as civil defense,
geriatrics, homemaker services, home nursing care, mental health and
accident prevention, and through the stimulation of inservice training
attempt to pass on information to nurses at the local level. Workshops in
human relations, cancer, heart disease and other fields have been con-
ducted. Aid is offered in the planning of county and district inservice
training programs, the orientation of new personnel and in the making
of time studies and evaluation of nursing services.
At the county level, the nurses' role is to give direct service to the
community, to interpret and teach health principles to public and pro-
fessional groups and individuals and to introduce new programs in such
a way that they will be accepted by the community. This division,
through its consultants, offers support and knowledge of resources in
every phase of the nursing program.
A survey of the educational background of the public health nurses
revealed that 30 (4.6 per cent) had earned masters' degrees; 156 (23.8
per cent) bachelors' degrees, 72 (11 per cent) had completed a one year
public health nursing program, and 398 (60.7 per cent) had less than
one year of preparation.
The nurse-midwife consultant offers help to county health depart-
ment nurses in the supervision and teaching of midwives. Two significant
events in this area were the completion of a training replacement pro-
gram in two rural communities, supported by the local medical society.
The facets in the preparation of two younger women to replace old
midwives included: recruitment of suitable students, instructional ma-
terial, use of audio-visual aids in teaching, resource lecturers from various
agencies, field trips to antepartum and postpartum patients, observation
of hospital and home deliveries, and apprenticeship under licensed mid-
wives. The need for better trained midwives to become qualified to meet
the demand for such service is recognized by county health officers.
Health department staffs gave valuable assistance to the midwife
consultant in planning, scheduling and securing much needed teaching
aids in the above areas, and one-day meetings held throughout the state.
More than half the midwives were reached in these meetings. A supple-

LOCAL HEALTH SERVICES

ment on the care of the premature infant was made to the standard mid-
wife manual and distributed to the counties throughout the state.
As the number of physicians and hospitals in the state increases, the
need for midwives becomes less. Their number decreased from 228 in
1960 to 217 in 1961, a decrease of 4.8 per cent.
In the past few years, a number of new programs have come into
existence, and in some traditional activities changes in emphasis have
been necessary. The most important and comprehensive of these has been
the promotion of bedside nursing in the home by county health depart-
ment nurses. By the end of 1961 nine counties or parts of counties were
giving bedside nursing services.
In the last months of 1961, additional federal funds have been made
possible for extension of home nursing services throughout the state as
quickly as the county health departments can organize them and employ
additional nurses. It is hoped that in the immediate future the program
will become statewide. A manual has been prepared and distributed
which outlines a pattern for the development and administration of the
service. This is the first attempt that has been made to provide such
services on a statewide basis, and the entire country will be watching Flor-
ida's progress.

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

This division's responsibilities and activities in 1961 continued to be
rather diverse in the particular while remaining broadly concentrated on
the one goal of assisting the county health departments in providing effec-
tive environmental health programs. In order to function properly within
this framework the division, through the services of five consultants, the
director and two clerical personnel, carried on activities in three general
categories: consultation, training and the permitting program as well as
in a number of special programs.
CONSULTANT SERVICE
Consultation services were of primary importance in 1961. Staff
consultants made 316 visits to county health departments in order to pro-
vide information and assistance concerning various local environmental
health matters. Each county was visited a minimum of once during the
year. Most received consultation services on at least a quarterly basis.
Special assistance was requested by a number of counties, and where-
ever possible, such was provided. Worthy of note in this regard were the
complete evaluation of the environmental health program in one county
and the aid provided another county in surveying and evaluating its
nursing home facilities. Epidemiological assistance was provided in the
investigation of a food-borne disease outbreak in one county. Similar

30 ANNUAL REPORT, 1961

service was supplied by two staff members, for an extended period of
time, during an investigation of a potentially serious communicable
disease episode associated with Florida's shellfish industry.
Other activities of interest were: the major effort extended in
assisting a county health department in the survey, analysis and prepara-
tion of a detailed report to the county commission concerning the county's
vast garbage problem; the aid provided to the State Department of
Education and a county health department in a complete school plant
operation and maintenance survey; and in the special guidance and
assistance given to yet another county in establishing a housing and
premise survey and corrective program in a problem area.
TRAINING
Eight county sanitarians, one each from Dade, Hillsborough, Pinel-
las, Seminole, Palm Beach, Escambia and two from Broward completed
the division's 12-week inservice training program during 1961. Each of
the staff consultants participated in this training effort.
A significant addition to the division's training program was made
this year with the planning and presentation of topical short courses for
sanitarians. A two-day course on shellfish and crustacea sanitation was
presented in Jacksonville during October. This program was attended by
33 sanitarians representing 21 counties. In December a three-day training
session on common carrier sanitation was presented in Miami. Sixteen
sanitarians were in attendance. Valuable assistance in preparation and
presentation of both programs was provided by the U.S. Public Health
Service. Considerable planning for additional courses in the fields of pro-
gram administration, food processing and swimming pool sanitation has
been undertaken, and it is expected that such courses will be presented
early in 1962.
Twenty-two county health departments, often assisted by the divi-
sion's consultants, reported foodhandler training programs presented in
1961. A total of 3159 persons received the benefit of this training. These
figures represent a significant increase in this training activity throughout
the state as 11 counties reporting foodhandler training for 1961 recorded
no such activity during the previous year.
Staff members again participated in a wide variety of specialized
training activities. All consultants worked with representatives of the
State Department of Education in the school custodian clinics presented
throughout the state during the summer. One consultant took part in the
three-day School Plant Management Conference held in Orlando and
another staff member served as program chairman of the annual three-
day short course presented by the Florida Association of Sanitarians.
PERMITTING PROGRAM
This division is responsible for issuing State Board of Health licenses
or permits required for the operation of five types of establishments:
trailer parks, food processing plants, labor and recreational camps, bottled
water plants and rendering plants.

LOCAL HEALTH SERVICES 31

All field activities associated with these establishments are carried
on by county health department sanitarians who provide routine survey
services to determine the adequacy of environmental conditions and make
recommendations to this division concerning the issuance of permits. Di-
vision consultants continued to provide technical assistance to the coun-
ties in these programs during 1961, with considerable effort being devoted
to labor camp and food processing plant activities.
Food processing plants routinely visited by county health department
sanitarians and operating under State Board of Health permits continued
to increase in number during the year. Four hundred thirty-seven plants
were issued operational permits in 1961, resulting in an increase of 79
plants over the total permitted last year. An additional seven counties
assumed responsibility in the field during the year, raising the total num-
ber of counties involved to 26. Current planning in this program is based
on the expectation that even greater activity will occur in the coming
year.
Trailer park permit transactions accounted for a sizable share of
the permitting activities. A total of 373 permits were issued or re-issued,
involving new parks, park expansion and changes of ownership. Four
parks were reported as closing during the year and 120 new trailer parks
opened.
Camps, both recreational and labor, continued to occupy a promi-
nent place in this division's overall responsibilities. Field activities under-
taken by the local sanitarians continued to increase in order that en-
vironmental conditions in the camps could be brought to and maintained
on a high level. Two hundred and one migrant labor camps and 34
recreational camps were issued 1961 licenses, thereby increasing the
number of licensed facilities over the previous year by 47.
Bottled water plants, 33 in number and located in 18 counties and
four out-of-state areas, were permitted by this division during 1961.
Routine sampling and laboratory analysis of each product continued as an
integral part of the program. A new development of interest was that
associated with several requests for review of proposed canned water
operations. Only one such proposal, requiring appreciable consultation
and technical assistance from the county health department and this
division, actually resulted in formal approvals being issued and the com-
mercial processing of canned water.
Rendering plant permit activities showed a moderate increase over
that reported last year as a total of 13 plants had been permitted or had
permit applications pending by the end of 1961.

COMMON CARRIER CERTIFICATION
Submission of semi-annual reports and recommendations to the
USPHS regarding environmental conditions of interstate carriers and
their servicing facilities required a large amount of time and effort again
this year.

32 ANNUAL REPORT, 1961

Complete evaluations of 108 facilities and establishments were pro-
vided at least twice during the year by the county health departments and
many other routine or follow-up contacts made. Reports concerning these
activities were processed by this division and forwarded to the USPHS
for publication in their certification lists. Common carrier facilities now
include: 21 railroad watering points, five railroad catering facilities, 27
airline catering establishments, 13 airline servicing areas and 55 vessel
watering points.
OTHER PROGRAMS
Food sanitation activities were of major importance in local en-
vironmental programs. There were 27,057 food establishments, repre-
senting an increase of over 2000 from the previous year, admitted to
service. There were 169,283 visits made to these establishments in 1960.
Activities related to housing, school health, child care centers, public
and private premise sanitation, public health nuisance control, private
water and sewerage, and a myriad of other establishments and facilities
continued to increase as the state's population expanded. Such expansion
placed severe demands on many already heavily burdened local sanita-
tion staffs and markedly increased the workload of this division.
SPECIAL ACTIVITIES
Recruitment activities of the division continued at a high level,
resulting in a large number of job applicants being processed and inter-
viewed, and numerous telephone conversations and considerable cor-
respondence.
Review of several chapters of the State Sanitary Code was under-
taken in 1961 for purposes of revision and updating. Chapter XII,
Abattoirs, was revised in cooperation with other interested bureaus and
divisions, as well as the county health departments, industry representa-
tives and the Florida Department of Agriculture. The revision became
effective September 1961.
The first edition of the Sanitarians' Manual, as prepared by the staff
consultants, was completed and published in 1961. This 115 page manual
outlining responsibilities, procedures, activities and providing reference
sources for Florida's environmental health program is considered to be
one of the foremost accomplishments of the division this year.

LOCAL HEALTH SERVICES

TABLE 6

PERMITTED ESTABLISHMENTS AND FACILITIES-1961

Food Bottled
County Trailer Processing Camps Water Rendering
Parks Plants Plants Plants

Alachua ..................
Baker .....................
B ay .......................
Bradford...................
Brevard ................
Broward .................
Calhoun .................
Charlotte .................
Citrus.....................
Clay ...................
Collier.................
Columbia ..................
Dade. ...................
DeSoto....................
Dixie.......................
D uval.................. .
Escambia................
Flagler ...................
Franklin ..................
Gadsden....................
Gilchrist ...................
Glades................. .
Gulf....................
Hamilton ................
Hardee .................
Hendry..................
Hernando...............
Highlands.................
Hillsborough ...............
Holmes....................
Indian River.............
Jackson..................
Jefferson .................
Lafayette ............... .
Lake.. ................
L ee............... .......
Leon ......................
Levy ......................
Liberty....................
Madison ...................
Manatee...................
Marion ..................
Martin .................
M onroe................. .
Nassau ....................
Okaloosa....................
Okeechobee ................
Orange. ...................
Osceola....................
Palm Beach...............
Pasco...................
Pinellas ..................
Polk.......................
Putnam ................ .
St. Johns............... .
St. Lucie ................. .
Santa Rosa ................
Sarasota..................
Seminole...................
Sumter....................
Suwannee.... .............
Taylor....................
Union .................. .
Volusia................
Wakulla.................
Walton..................
Washington ..............
Out-of-State.........

80
2
69
............ ....8
81
111
2
15
18...
18
18
3
97

5
171
155
3

8

4
4
10
3
6
1
8
224

7

....... i ....

27

2

1

65
5

8
1

2
............
... .

7
............
1

4
41
1
41

...........

5

6
. .. . .

i6 ... : ..... .................. ....... .... I .....* : ......
16 4..... ... ........... .
5 4 2 i............ 1

. .. .. . .
41
70
52
10

1
79
33
29
60
7
42
15
114
11
106
96
270
220
17
10
24
27
73
12
17
3
5
. .. . .. .
77
4

. . . .

31
3
4

1

69

37
1
21

39
1

27
i. . . ..

2

.. ...........
3

12

........32 ....
10

12
3
19
6

2

11
. . ..
..... .2 ...

. .. . .

1

1.. .

. .. .. . .

i

2

1

1

3
1
4

2

3

4

1

1

2

1

2

Total............... 2644 437 235 33 13

... ........

...........
............
............
............
............
............
............
............

............
............
............
............
............
............
............

.. .........
............
............

..... .... .

.. .. ......

... .......

.. .........
............
............

34 ANNUAL REPORT, 1961

DIVISION OF NUTRITION
MARY BRICE DEAVER, M.S.
Director
This division is responsible for the organization, planning and de-
velopment of a nutrition program which will promote and work toward
optimal nutritional status for the people of Florida. Inasmuch as good
nutrition is basic to good health and to the control of many diseases, it is
the function of the division to work toward the inclusion of a sound
nutrition program in the overall health program of every county.
In February 1961, Nutrition Services was changed to the Division
of Nutrition by the State Board of Health. This action was indeed gratify-
ing and gave recognition to the growth and development of the im-
portance of nutrition in the field of public health in Florida.
During the year the staff members remained the same with two
exceptions: one regional nutritionist retired and was replaced, and a new
position, a dietary consultant for nursing homes, was added. This position
was filled in June when the first step forward in setting up a statewide
dietary consultation program for institutions was taken.
The general pattern of working, started in the previous two years,
was followed and considerable expansion noted in the development of
regularly scheduled service for the counties. The four regional consul-
tants have reported that this type of service is being accepted and used in
an increasing number of counties. Such regularly scheduled consultation
has proved to be effective in most instances in the development of a sound
public health nutrition program for the county.
Activities have continued in the general areas: services to health de-
partments; services to the community; services to other organizations and
agencies; services to institutions.
In consultation and other services to health departments, staff in-
service education holds priority in most instances. This year 122 group
conferences and 246 individual conferences were held. The nutritionist
had the major responsibility for these and in addition, attended 79 meet-
ings with health department personnel as a participant but not as the
discussion leader.
It is interesting to note the change in emphasis in the requests for
consultation. During 1961 there has been considerable concentration on
modified diets and their relationship to the chronic diseases. Requests in
this area have included many classes or meetings with community groups;
for example, 32 meetings were held in one county alone for heart patients
and others concerned with low sodium, low fat and weight control diets.
The attendance for these was 400. In other areas of chronic diseases, 54
group conferences and 237 individual conferences were held. With the
increased interest in home care programs and in rehabilitation, there has
also been increased emphasis on the place of diet in the prevention and
care of many chronic diseases. There are also constant advances in our

LOCAL HEALTH SERVICES

knowledge of nutrition in this area, and this means time must be pro-
vided for the nutrition staff to keep abreast of the wealth of new ma-
terial and research being presented.
In maternal and child health, many new developments contributed
to heightened interest on the part of county health departments. With
more consideration being given to problems of the mentally retarded,
there were numerous requests for information on diet in phenylketonuria,
galactosemia and other diseases related to mental retardation. Consul-
tation to parents of children diagnosed as having phenylketonuria has
been provided on an individual basis since acceptance and understanding
of the diet and the problems involved is essential for control of the con-
dition. In other services to prenatals, well children and crippled children,
51 group conferences and 203 individual ones were held. Twenty-four
classes were taught and demonstrations given for 487 persons.
The nutritionist with the migrant project, along with other members
of the team, completed the five-year project in the Belle Glade area of
Palm Beach County. Reports on this project have been compiled and
made available in summary form from the entire team. The special study
on dietary patterns of selected families was published in the April issue of
Public Health Reports. A further interpretation of general dietary findings
concerning migrants was presented at the annual meeting of the Ameri-
can Public Health Association to the Food and Nutrition Section. Plans
are now underway for the new migrant project which will enlarge the
area previously covered by the project team.
Working with community groups and organizations, a number of
talks and demonstrations were given on normal nutrition, dietary prac-
tices as shown by surveys in the community, low cost foods, foods for
civil defense, weight control and food fads and fallacies. Such presenta-
tions were given for PTA groups, civic clubs, scout groups, home demon-
stration groups and other local organizations.
In considering services to other agencies and organizations, school
services head the list. Increased interest was noted on the part of school
administrators in developing a nutrition program for all grades. Assis-
tance has been given in planning nutrition education to meet the needs
and capabilities of each grade, one through 12, with the overall purpose
of developing good food habits which will be lasting for each individual.
Much time and effort has been spent in fitting plans to local conditions
so that the program will be practical rather than merely theory. Eighty-
eight group conferences and 121 individual conferences were held with
school personnel. Fifteen dietary surveys were conducted in schools, pro-
viding valuable information on food habits and activities to assist in
planning nutrition education programs.
In working with school lunch personnel, more emphasis is now being
placed on working with local resource people who are qualified to offer
courses in nutrition rather than the nutritionist actually teaching. How-
ever, there are some areas where no qualified local people are available
and the nutritionists are still providing class instruction when necessary.

36 ANNUAL REPORT, 1961

Work was completed on a joint project with the Crippled Children's
Commission to provide diet instruction guides for use in their clinics
throughout the state. When the annual meeting of the Commission's
personnel was held, time was given for the nutrition director to introduce
and explain the guides.
In cooperation with local heart associations and the Florida Heart
Association, classes have been taught and counseling provided for heart
patients and their families.
Working with county and state welfare personnel, consultation has
been provided on normal nutrition, special diet problems and low cost
food budgets. Work was completed on an average state price index for
food, providing an easy reference to the amount and kind of food needed
by each age group and the average cost of such food. This index will be
revised annually to keep prices up-to-date.
In the service to institutions, this year saw the organization of a
dietary consultation program for nursing homes. This much needed
service is still in the introductory stages. However, the reception has been
excellent and plans are underway for broadening the scope of the pro-
gram as much as possible in the coming year. It will take some time to
actually investigate the existing dietary practices and procedures and to
develop a workable answer to the problems that exist. It is anticipated
that general aids for menu planning, purchasing, food cost control, etc.,
can be developed and made available statewide. Group or district meet-
ings can be utilized for instruction and help in the use of such materials
as well as individual consultation. Serving good food that is nutritionally
adequate and reasonable in cost and acceptable to the residents in the
nursing homes is the goal of this service. This is, indeed, a long-range
objective and one that will entail considerable wear and tear on all con-
cerned. However, with the number of nursing homes in the state now and
with this number constantly growing, the number of persons who eat
all their meals in such an institution is extremely large. It is particularly
important that we do everything possible to see that these people have
good food available and are as well nourished as possible since they
seldom have a choice of food except that provided by the institution. The
dietary consultant is also providing consultation to the regional nutri-
tionists on institutional food service problems so that the service can be
extended as much as possible. Plans are also underway for the revision
of the diet manual for nursing homes.
In the area of training, field experience was offered to one graduate
nutrition student from the University of Michigan School of Public
Health and one undergraduate from Florida State University School of
Home Economics.
In addition, classes have been taught and consultation given to
schools of nursing, to practical nursing programs, to undergraduates in
food and nutrition courses and to health education students.
In reviewing the program, it is obvious there are many facets that
are, of necessity, being curtailed. There is much that is being left undone

LOCAL HEALTH SERVICES

because of the limited number of nutritionists. A great deal is needed
in the realm of information regarding nutritional status in the various
age and population groups in Florida. Data that is available at present are
extremely sparse. While it serves as a general basis for community plan-
ning, it provides little in the way of accurate data for other uses. To help
meet the need for concentrated service, a new demonstration project has
been planned and approved and will begin in the coming year. This will
help to demonstrate what can be done in a rural area (two or three
counties) with a full-time nutrition staff member. Another problem is
the lack of clerical help. Much professional time is being spent in the
performance of necessary clerical duties because sufficient clerical assis-
tance is not provided. When one considers the small number of trained
nutritionists to cover the state, it is hard to justify any portion of that time
spent on duties that could be performed by clerical personnel, thus
leaving all available time for professional duties. Another serious gap is
the lack of dietary consultation for publicly supported institutions and
small hospitals where there is no trained dietition on the staff. There is a
need for a position for a general dietary consultant whose services would
be available statewide. There is also a need for someone to work more
closely with the training institutions in providing basic nutrition informa-
tion for those who will be our doctors, nurses and other allied profes-
sional personnel.
In our plans for the immediate future, it is anticipated that more
time will be spent on inservice training, particularly with new health
department personnel. Plans are also underway for preparing a series
which will be ready reference material for use in diet problems on the
expanded home care services. Some thought is also being given to making
each nutrition consultant responsible for a special portion of the program
in addition to her district. During the coming year it is our aim to make
nutrition as meaningful as possible in the overall health program of the
state.

38 ANNUAL REPORT, 1961

TABLE 7

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

A. COMMUNICABLE DISEASE CONTROL

IMMUNIZATIONS COMPLETED

COUNTY

I I! I I I I
1 2 3 4 5 6 7 8 9 10 11
Total 1961............ 7237 123521 11245 85970 142455 88040 204590 276848 78751 54 38223
Alachua .................... 87 118 125 1669 2099 1595 2746 5674 1055 0 0
Baker...................... 7 7 100 629 669 451 1761 2233 1348 0 113
Bay ........................ 56 99 116 885 1908 1908 4177 7314 7118 0 0
Bradford.................... 114 187 38 258 560 332 782 1428 130 0 27
Brevard .................... 53 90 53 1499 4298 1898 4836 6123 891 12 0
Broward ................... 275 896 2 1827 4698 2900 5628 5779 216 0 0
Calhoun.................... 1 1 51 239 318 264 756 1389 840 0 0
Charlotte................... 140 604 63 668 1688 481 1972 2160 46 0 0
Citrus...................... 19 19 55 114 522 190 671 1198 411 2 0
Clay ......... :............ 63 102 76 194 526 285 652 816 12 1 404
Collier...................... 84 151 57 289 989 504 1403 3699 325 0 0
Columbia................... 0 0 1638 836 4688 4688 5791 4293 4221 0 0
Dade ...................... 172 885 1 19869 12727 12626 23370 19513 1154 1 0
DeSoto..................... 25 52 26 289 653 340 691 1386 13 0 0
Dixie....................... 50 94 141 90 646 426 774 957 895 0 0
Duval...................... 22 34 10 1603 4467 2826 5895 9179 338 6 0
Escambia ................... 35 78 255 4644 11729 6382 15850 15368 7282 0 0
Flagler ..................... 71 71 4 74 258 158 362 638 11 0 0
Franklin .................... 8 14 52 133 222 222 322 566 2165 0 0
Gadsden .................... 75 146 69 4190 4952 1514 8091 13818 5135 1 0
Gilchrist .................... 38 49 221 24 136 91 237 538 24 0 0
Glades....................... 16 24 43 36 253 87 261 339 97 0 124
Gulf ....................... 18 38 791 617 1371 1184 1910 2717 2049 0 0
Hamilton ................... 0 0 435 95 489 433 682 1027 291 0 167
Hardee..................... 237 253 242 300 744 378 885 1446 348 0 0
Hendry ..................... 14 23 41 105 698 240 725 945 497 0 94
Hernando ................... 0 0 142 280 563 186 1062 1239 2 0 0
Highlands ................... 74 117 24 180 750 347 763 1258 53 0 0
Hillsborough................ 1957 2166 199 8188 11897 7735 17079 26854 557 12 26807
Holmes ..................... 60 89 745 410 931 468 1196 1686 770 0 0
Indian River ............... 2 9 19 337 760 452 1043 1427 660 0 0
Jackson..................... 116 138 383 1632 2257 1334 4318 5403 2215 0 0
Jefferson .................... 61 134 59 1114 1078 654 2158 2748 1195 3 495
Lafayette .................. 109 109 19 38 85 64 146 194 32 0 0
Lake ...................... 39 109 44 144 676 376 711 1174 1 0 0
Lee ....................... 92 189 80 1497 1872 826 3530 4917 1484 0 0
Leon ...................... 257 480 722 2016 1776 1745 3339 5353 2029 0 0
Levy....................... 33 86 84 382 901 251 1191 1781 686 0 0
Liberty................... 5 12 190 104 360 180 731 755 429 0 0
Madison................... 81 94 109 1066 1065 403 1702 2375 682 0 312
Manatee .................... 94 107 13 502 659 324 1029 3742 145 2 2456
Marion .................... 145 294 312 2001 3796 1461 7312 9457 8002 0 0
Martin ..................... 9 9 4 699 1117 458 1542 2343 912 0 0
Monroe .................... 127 178 0 991 940 276 1818 2045 686 0 0
Nassau..................... 289 378 845 1220 1423 730 2270 3854 3014 4 291
Okaloosa.................... 181 181 251 1796 3445 2129 4550 6845 2750 0 0
Okeechobee ................. 8 15 2 124 351 164 390 1022 183 0 0
Orange ..................... 359 811 185 4091 6800 3523 9149 11439 2775 0 0
Osceola...................... 5 47 152 149 774 525 774 2010 519 0 0
Palm Beach ................ 254 745 49 2977 8220 3970 9868 13356 1829 0 0
Pasco...................... 21 24 146 291 1004 977 1081 1528 29 0 0
Pinellas..................... 399 1127 110 2278 5151 8927 5610 8511 300 1 49
Polk....................... 419 630 217 3569 6896 4130 8469 14943 380 0 6487
Putnam .................... 95 127 12 764 1807 528 2330 2980 46 0 0
St. Johns ................... 6 13 27 1356 2121 341 2354 2569 1486 1 0
St. Lucie ................... 1 6 12 62 386 316 745 1029 41 0 0
Santa Rosa ................. 2 18 592 450 1516 1073 2762 3218 1887 0 0
Sarasota ................... 82 101 6 466 1324 929 1463 1737 71 0 0
Seminole .................... 37 117 142 1460 1615 1151 2909 4193 3075 8 0
Sumter...................... 21 24 24 401 791 599 832 1243 319 0 0
Suwannee ................... 14 14 105 270 792 451 1414 1649 537 0 0
Taylor ..................... 1 2 63 471 1219 509 1831 2446 458 0 897
Union.. .................... 6 6 93 52 253 143 266 493 105 0 0
Volusia..................... 83 146 48 346 496 450 542 1602 24 0 0
Wakulla................... 11 11 149 49 265 264 725 1327 590 0 0
Walton .................... 2 4 263 329 1046 707 1252 1998 341 0 0
Washington ................. 0 0 899 242 969 561 1104 1562 540 0 0

LOCAL HEALTH SERVICES 39

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

B. VENEREAL DISEASE CONTROL

4 -H a U CU0
COUNTY B o *
".' o p
~B .- el OV C1 = 0

1 2 3 4 5 6 7 8 9 10 11
Total 1961................. 40950 22302 11937 347 1047 8044 166 6883 11063 27556 82591
Alachua.................... 266 16 215 0 24 10 0 49 12 65 266
Baker...................... 6 1 3 1 0 0 0 3 2 8 9
Bay........................ 254 105 136 0 0 13 0 75 101 226 278
Bradford.................... 65 13 43 3 1 2 1 47 48 50 91
Brevard ................... 88 10 2 33 3 8 10 47 12 156 116
Broward.................... 795 170 333 23 66 37 36 409 485 1173 1438
Calhoun.................... 9 1 7 0 0 0 0 6 5 1 11
Charlotte .................. 4 0 2 3 0 0 0 1 3 24 4
Citrus ..................... 0 0 0 0 0 0 0 0 0 0 0
Clay ....................... 21 10 5 1 1 0 0 4 2 14 24
Collier.................................. 144 20 44 2 9 44 4 37 49 116 226
Columbia ................... 98 0 54 0 0 40 0 57 42 84 89
Dade..................... 10515 7048 2363 0 840 764 0 1366 3372 9137 36950
DeSoto .................... 3 0 0 2 0 0 0 1 2 2 4
Dixie....................... 5 0 5 0 1 0 0 4 4 2 6
Duval..................... 14223 11003 2070 0 52 1096 0 628 1671 3431 18396
Escambia................... 2316 1057 1205 0 13 41 0 95 480 1162 2461
Flagler .................... 16 6 5 0 0 0 0 10 6 12 27
Franklin................... 14 5 5 0 1 0 8 1 6 27
Gadsden.................... 123 6 106 0 0 11 0 40 43 86 184
Gilchrist.................... 2 0 2 0 0 0 0 2 1 1 3
Glades...................... 7 3 4 0 0 0 0 3 3 3 11
Gulf...................... 14 8 2 4 0 0 0 2 10 12 26
Hamilton ........ ......... 18 1 11 0 3 3 0 2 8 1 21
Hardee..................... 17 16 1 0 0 0 0 13 0 12 10
Hendry.................... 37 19 12 5 0 0 1 8 8 3 49
Hernando.... ..... 7 2 5 0 0 0 0 1 1 2 18
Highlands ................... 81 0 11 2 18 1 0 18 5 8 42
Hillsborough ............... 4370 959 1542 8 3 174 1 763 1412 3679 10136
Holmes ..................... 7 0 5 0 1 0 0 6 5 1 17
Indian River ............... 38 0 29 0 1 3 0 28 20 6 39
Jackson ..................... 30 1 27 0 1 2 0 22 14 12 33
Jefferson .................... 33 5 16 1 2 7 0 9 13 16 56
Lafayette............. 0 0 0 0 0 0 0 0 0 0 0
Lake.......... ....... 28 0 18 1 0 1 2 1 21 33
Lee....................... 86 10 52 0 9 9 0 64 22 7 113
Leon....................... 1059 176 661 7 89 116 13 72 139 386 1342
Levy................... ... 15 8 4 0 2 5 0 4 3 7 18
Liberty..................... 5 0 4 1 2 0 0 4 1 4 7
Madison.................. 19 0 16 0 0 9 0 19 13 8 37
Manatee.................... 372 102 159 7 41 45 26 140 236 179 465
Marion..................... 724 202 254 8 14 79 7 183 325 871 1330
Martin ..................... 78 20 28 9 0 13 2 38 34 47 35
Monroe.................... 121 18 60 2 2 89 0 46 35 120 211
Nassau ..................... 19 15 14 3 8 6 2 8 8 17 77
Okaloosa.................... 100 2 70 0 17 9 2 72 62 4 108
Okeechobee................. 17 0 10 0 0 1 0 6 4 12 24
Orange .................... 985 144 579 3 75 183 1 275 1010 2185 2443
Osceola....... .... 40 0 29 0 0 16 0 28 72 32 169
Palm Beach................ 1412 651 530 3 117 111 0 227 348 1582 1638
Pasco. ..................... 13 1 9 1 2 0 0 6 3 3 16
Pinellas..................... 737 126 876 150 21 61 17 252 357 1806 1092
Polk ...................... 472 138 221 16 2 4 11 29 28 120 584
Putnam .................... 196 51 100 2 24 19 0 125 75 53 248
St.Johns ................... 211 17 96 9 30 30 25 117 81 23 271
St. Lucie................... 46 1 40 0 2 3 0 87 15 36 54
Santa Rosa................. 9 1 6 0 1 0 0 0 3 0 18
Sarasota .................... 181 90 96 0 4 2 0 96 209 212 350
Seminole .................... 128 6 59 7 24 5 0 48 36 124 218
Sumter ..................... 31 2 23 0 6 0 0 29 9 12 65
Suwannee................... 26 7 12 0 0 0 0 10 7 14 40
Taylor...................... 73 14 47 3 0 12 0 46 28 29 78
Union ...................... 4 1 3 0 0 0 0 1 1 2 11
Volusia..................... 114 8 79 2 10 4 6 91 89 116 357
Wakulla .................... 14 0 8 0 4 2 0 10 8 1 14
Walton ..................... 20 2 11 2 1 4 0 10 8 10 31
Washington................ 1 24 6 18 0 0 0 0 24 13 0 26

40 ANNUAL REPORT, 1961

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

C. TUBERCULOSIS CONTROL
Persons
Admitted to Service X-rayed

COUNTY U e

U Bradford

1 2 3 4 6 6 7 8 9

Total 1961................................ 2426 6541 17823448362 45289 59063 39657 47090 1641
Alachua ................................. 23 66 335 8526 439 551 975 581 17
Bakerl.................................. 3 1 4 18 0 37 6 23 15 2
Bay..C ................................... 5 69 92 0 378 17 94 214 15
Bradford................................. 11 34 66 0 187 7 31 90 1
Brevard................................. 3 70 299 0 315 607 688 937 20
Broward ............................. 138 19 87243460 1017 6004 886 1173 82
Calhoun ...... ............ .............. 411 9 26 0 315 47 26 133 13
Charlotte ................................ 3 12 33 0 735 240 230 87 2
Citrus..................................... 5 6 24 0 1540 15 27 62 1
Clay ................................... 151 20 50 231 95 73 132 141 4
Collier ................................ 106 33 169 4684 95 1458 510 408 11
Columbia................................ 5 13 39 0 64 7 73 53 6
Dade................................... 44 1133 297 6100 664 1717 5002 15884 477
DeSoto d ................................. 1 41 14 20 0 613 11 91 98 0
Dixie ................................... 0 4 3 1234 16 11 38 45 1
Duvas ................................... 157 802 455 3958 2546 544 790 2121 16
Esumbif ................................. 04 247 589 8715 1052 498 3481 306 51
Flailer ................................ 4 6 8 0 18 487 32 167 1
Franklin .................................. 14 8 14 0 73 15 25 38 1
Gadsden................................ 1 39 167 1863 49 615 453 176 14
Gilchrist ................................. 2 2 16 0 8 10 29 11 1
Hlades ................................ 10 3 3 752 33 1 8 6 0
Gulf..................................... 0 16 37 0 498 20 79 40 2
Hamilton .................................. 4 7 1 0 11 8 15 50 1
Hardee .i............................... 14 11 27 0 580 1099 92 66 10
Hendry .................. ................ 7 10 29 2008 127 82 72 61 4
eernando ............................... 6 3 9 1732 22 15 53 14 5
Hihlands................................ 111 0 44 729 111 210 7
Hillborough ............................. 3 99 4200 81987 107 9179 417 582 154
Holmes .................................. 6 7 91 0 70 222 40 216
Indian River............................. 9 8 82 0 129 169 115 28
Jackson .................................. 19 54 96 0 398 1402 31 08 14
Jefferson. ............................... .. 9 17 1778 18 149 41 10 7
Lafayette ............................... 2 1 1 370 0 0 12 6 0
Lake .................................. 138 3 19 11005 454 671 1086 335 28
Lee..................................... 281 61 39 15393 452 3294 143 238 9
Lein .................. ................ 59 83 386 14637 530 1943 1593 871 34
Levy M .................................. 1 2 3 55 2092 51 38 114 56 1
Liberty................................... 0 0 3 0 0 0 3 2 0
Madisn .................................. 8 30 34 0 50 4 102 8
Manatee.................................. 36 42 8 6147 215 160 238 201 18
MOrion.b................................. 721 61 68 11487 526 1408 419 50 10
Martin................................. 1 2 65 0 100 114 160 40 11
Monroeo.................................. 18 37 82 0 1241 176 278 125 4
Nassau .................................. 126 25 95 0 108 108 343 139 11
Okaloosa ................................... 1 20 0 1971 1512 160 150 4
Okeechobee............................... 79 13 17 0 30 263 72 41 4
Orange .................................. 108 213 48 72662 1083 2652 1788 2709 133
Osceola.................................. 71 11 12 0 66 70 99 152 7
Palm Beach................................ 168 17 432 33126 1713 813 2069 767 103
Pasco .................................... 20 62 116 373 131 62 130 367 12
Pinellas .................................. 92 422 633 29507 2569 1197 2139 5693 82
Polk .... ............................. 100 435 840 23997 1605 7347 2499 2714 84
Putnami ................................. 10 43 72 0 1135 2083 220 60 7
St. Johns................................ 13 16 15 0 289 1375 177 192 15
St. Lucie................................. 26 57 38 0 176 70 448 184 23
Santa Ros................................ 8 23 56 1 400 5708 129 105 3
Sarasota ................................ .. 19 70 67 4859 64 85 642 46 9
Seminole................................. 17 42 159 0 418 408 337 715 11
Sumter.s.................................. 95 18 44 1994 105 132 130 182 5
Suwannee. ................................ 8 26 26 0 49 23 91 103 4
Taylor................................... 0 10 22 0 42 66 52 66 2
Union.................................... 2 3 5 0 22 0 8 46 2
Volusia .. ................................ 53 188 240 0 6809 622 1311 625 37
W akulla ................................. 5 5 28 0 17 37 94 11 6
Walton .................................. 2 28 32 322 69 508 71 113 1
Washington .............................. 3 16 11 0 19 15 28 74 4

LOCAL HEALTH SERVICES 41

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

D. MATERNITY SERVICE E. CHILD HEALTH
SERVICES
Admissions to Well
Child Med. Service

COUNTY e 'u n

1-2 8 5 6 7 8 9 10 11 la, 2a lb, 2b lc, 2c
Total 1961............ 14719 43515 21881 44858 58420 212 1324 11 440 14684 14698 9816
Alachua ............. 162 891 822 1170 1275 0 58 0 80 260 86 161
Baker .............. 15 25 66 100 25 0 4 0 0 0 5 1
Bay ................ 146 145 158 298 208 0 14 0 0 117 11 4
Bradford............. 79 157 78 860 84 0 19 0 0 66 114 59
Brevard.............. 175 02 84 685 98 81 48 8 1 84 21 47
Broward........... 28 748 452 1421 886 26 28 1 0 545 44 12
Calhoun............. 8 7 29 7 64 0 6 0 0 8 1 0
Charlotte............ 0 0 18 26 5 0 0 0 0 7 8 33
Citru .............. 5 7 8 8 0 0 0 0 1 1 0
Cla ............... 96 264 181 482 289 1 6 0 0 26 11 68
Colier ............... 119 891 156 155 974 0 27 0 0 72 27 85
Columbia............ 188 188 176 62 886 12 55 0 0 91 104 105
Dade............... 2851 7748 4068 12075 7568 10 50 0 65 5452 7170 8116
DeSoto.............. 0 0 0 0 0 0 0 0 0 0 0 0
Dixie................ 17 25 54 85 0 81 1 0 1 1 40
Duval............. 1 1 158 180 99 0 0 0 17 88 104 172
Escambia........... 924 187 1140 2174 2612 0 26 0 1 426 114 1
Flagler......82 270 87 108 819 0 0 0 0 65 7 2
Franklin............. 16 81 18 80 4 0 5 0 0 8 0 0
Gadsden ............. 682 1855 987 929 1889 10 200 0 0 817 206 57
Gilchrt............. 12 27 22 48 14 1 0 0 0 0 0 0
Glades............... 19 48 82 47 60 0 1 0 0 6 1 4
Gulf................ 26 47 42 76 99 0 10 0 0 0 0 0
Hamilton........... 48 80 128 449 846 2 4 0 0 0 0 0
Hardee........... 87 145 68 74 198 0 0 0 0 14 2 2
Hendry..... ..... 54 175 17 108 47 0 0 0 0 68 80 41
Hernando...... ..... 7 7 6 0 2 0 0 0 0 0
Highlands............ 16 81 1 2 0 0 0 0 0 18 18 1
Hillsborough......... 2569 9155 8187 5198 11425 0 9 0 0 8149 4365 8811
Holmes............. 6 15 21 9 85 0 8 0 0 4 22 9
Indian River......... 0 0 92 151 118 0 8 0 0 0 0 0
Jackson.............. 151 21 858 592 988 9 146 2 0 88 85 29
Jefferson............... 48 114 99 818 184 0 0 0 0 67 44 4
Laayette. ........... 12 12 27 7 84 0 11 0 0 0 0 1
Lake................ 18 29 219 858 847 0 82 0 0 50 4 0
Lee ........ .205 289 880 892 968 6 8 0 0 107 0 1
Leon............. 20 754 842 1897 82 14 48 0 0 127 265 177
Levy................ 80 224 79 52 209 12 0 0 12 8
Liberty..... .. 18 26 22 14 82 0 0 0 0 10 10 9
Madison............. 61 172 186 840 228 4 15 0 0 14 10 87
Manatee............. 189 598 199 428 663 1 4 0 8 141 182 171
Marion ............. 0 0 74 198 6 8 28 0 0 0 0
Martin ............ 0 0 1 2 0 0 0 0 0 0 0 0
Monroe.............. 61 142 186 215 22 8 9 1 6 14 1
Nassau ............. 6 6 85 58 20 11 54 0 0 1 0 11
Okaloosa.......... 25 27 88 102 102 0 6 0 0 8 5 18
Okeechobee............ 0 0 0 0 0 0 0 0 0 0 0 0
Orange ............. 1461 2776 176 867 272 17 6 0 0 247 68 84
Osceola............. 96 418 101 191 470 6 2 0 0 81 60 0
Palm Beach......... 560 2102 1028 028 270 4 1 0 84 417 77 50
Pasco .............. 87 44 62 188 95 1 17 0 6 0 2 1
Pinellas.............. 785 8761 958 1450 5020 2 10 0 0 875 944 477
Polk................. 1281 867 1618 476 6682 11 30 2 0 608 75 186
Putnam ............. 255 765 814 854 857 5 21 0 10 18 11
St. Johns ............ 22 41 88 11 106 1 2 1 0 8 1 1
St. Lucie ........ 228 787 246 801 999 0 7 0 0 44 2 4
Santa Rosa........... 0 1 11 2 0 0 0 0 8 8 1
Sarasota .......... 188 52 169 754 522 0 0 0 77 0 1 0
Seminole........... 176 487 420 711 748 5 109 0 0 110 7 4
Sumter........... 5 86 126 102 6 47 0 0 0
Suwannee............ 26 48 44 49 112 0 8 0 0 4 2 2
Taylor .............. 52 112 54 107 176 0 17 0 0 28 6 6
Union ............... 52 128 68 80 127 0 0 0 0 69 49 68
Volusia ............. 289 114 47 1054 1883 0 59 0 0 276 882 240
Wakulla... .... 2 77 45 120 70 2 12 0 0 7 0
Walton ........... 12 28 8 5 71 1 18 0 0 4 0 0
Washington .......... 49 51 10 119 222 2 1 0 0 25 15 8

42 ANNUAL REPORT, 1961

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

E. CHILD HEALTH SERVICES (Continued)
Visits Med. Admissions to Field Nursing Office Nursing
Conferences Nursing Service Visits Visits

COUNTY t

8a Sb Se 5a 5b 5c 6a 6b 6c 7a 7b 7c
Total 1961 .......... 29455 25526 12964 27241 88597 67708 51025 57620 68108 87782 39292 148578
Alachua ............. 805 118 188 667 740 1462 1828 1854 1481 798 808 1554
Baker............. 0 5 1 80 288 226 145 447 3884 18 50 91
Bay ................. 896 84 6 169 72 280 572 281 407 40 31 76
Bradford...... .. 81 182 67 174 846 410 489 1297 868 6 26 189
Brevard............. 115 26 55 404 881 1266 929 1628 2454 289 418 688
Broward............. 1028 106 78 1260 658 1591 2882 1569 2515 446 151 771
Calhoun ...:........ 8 1 0 12 18 45 9 14 41 18 12 27
Charlotte ........... 87 3 88 89 54 938 41 72 924 188 418 2889
Citrus............... 1 2 0 28 75 40 49 127 121 1 0 0
Clay................ 42 28 57 175 801 1006 599 658 741 78 94 1155
Collier............... 208 60 54 124 207 250 146 167 232 472 316 310
Columbia ........... 91 104 105 186 249 148 186 188 104 117 147 84
Dade............... 12255 18196 4609 5248 7456 9625 18617 18427 105671067 10275 1140 67550
DeSoto .......... 0 0 0 80 64 619 0 7 158 80 67 543
Dixie ............... 1 1 48 50 71 169 79 104 219 15 18 27
Duval............... 825 207 225 896 286 785 728 805 592 1872 411 480
Escambia............ 1240 341 1 1826 442 908 2404 943 1042 1567 886 1961
Flagler ............. 105 11 4 109 204 244 182 801 168 104 154 197
Franklin ............ 8 0 0 52 78 59 89 127 79 6 8 80
Gadsden ............. 844 210 62 872 1910 876 1289 8808 714 386 828 1141
Gilchrist ............. 0 0 0 24 72 14 64 108 22 11 19 4
Glades ............... 7 1 4 20 25 59 46 62 51 8 0 28
Gulf ................. 0 0 0 46 89 44 78 62 50 82 28 32
Hamilton ............ 0 0 0 96 29 10 295 237 46 54 9 5
Hardee............... 14 2 2 55 26 91 65 48 274 25 8 66
Hendry.............. 98 77 102 66 37 77 125 120 137 101 67 161
Hernando............ 0 0 0 6 74 96 12 100 118 7 8 7
Highlands............ 20 14 1 16 10 88 58 14 74 9 1 62
Hillsborough......... 6176 7492 5250 4717 6781 11230 4048 8023 6088 8501 11551 14179
Holmes.............. 4 28 9 15 28 132 7 18 64 16 28 245
Indian River ......... 0 0 0 87 27 428 208 104 371 79 18 374
Jackson.............. 116 57 38 372 876 150 451 540 399 367 191 107
Jefferson.............. 92 50 4 228 539 226 567 1046 885 249 606 161
Lafayette............ 0 0 1 66 112 78 191 208 200 89 109 130
Lake ............... 51 4 0 277 484 624 427 665 748 162 209 329
Lee ................ 107 0 2 827 206 438 385 281 269 146 66 297
Leon ................ 178 868 217 518 1264 1498 1720 4054 2488 342 1140 1885
Lnv. .............. 18 6 8 48 49 105 43 45 188 24 26 46
Liberry.............. 10 14 11 14 84 45 15 30 46 8 14 12
Madison............ 20 11 48 161 158 884 405 229 364 35 38 211
Manatee.............. 186 158 179 451 740 1972 225 202 432 542 1214 2179
Marion .............. 0 0 0 117 69 341 234 204 609 10 1 146
Martin.............. 0 0 0 20 81 16, 27 93 181 2 18 14
M..nror. ........... 71 14 1 1 280 557 288 467 368 151 878 982
Nasaiu ........... 1 0 11 88 72 272 65 182 849 9 38 331
Okaloosa.............. 9 5 22 89 109 527 194 262 600 58 89 352
Okeechobee ......... 0 0 0 1 1 49 8 2 25 0 0 39
Orange ............. 369 105 100 759 486 815 1215 1123 1949 1212 541 8297
Oseeola.............. 191 127 0 180 145 109 157 254 131 208 208 876
Palm Beach.......... 905 181 64 984 464 8248 8446 1590 5874 1266 224 7028
Pasco................. 0 2 1 108 166 99 215 840 127 57 77 .63
Pinellas.............. 1746 1269 531 1251 1878 9998 2828 8157 7570 2500 2894 20297
Polk ............... 1022 99 169 1857 2179 5971 8690 3660 8597 8087 2289 6827
Putnam.............. 180 15 11 299 205 824 866 892 437 215 197 288
St. Johns............ 3 1 2 68 26 112 122 56 108 86 40 102
St. Lucie............. 77 2 4 208 200 15 354 512 18 188 58 0
Santa Rosa........... 38 8 1 46 88 1123 48 86 403 15 10 1618
Sarasota ............. 0 1 0 161 121 569 557 371 1148 3 6 98
Seminole ............ 115 7 4 826 288 688 682 442 1015 120 140 1423
Sumter............... 0 0 0 128 98 132 154 95 55 70 52 151
Suwannee ............ 4 3 2 112 805 227 220 466 858 194 31.) 286
Taylor............... 26 6 7 47 71 48 75 88 65 45 52 40
Union .............. 111 85 121 95 108 188 56 123 128 116 112 125
Volusta.............. 577 767 457 565 750 2818 848 1048 1718 790 880 2888
Wakulla ............. 7 0 0 48 40 240 94 184 153 22 13 157
Walton.............. 6 0 0 88 70 936 49 52 181 41 60 1817
Washington.......... 80 22 12 76 117 41 65 111 36 91 74 L16

LOCAL HEALTH SERVICES 43

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

F. SCHOOL HEALTH
Pupils Examined by Physician Screening by Other Health Dept. Personnel
Parent Present Parent Not Present Visual Audiometer

COUNTY r r r0 g3

la lb Ic 2a 2b 2c 3a 3b 3c 4a 4b 4c 7
Total 1961..... 1795 4501 2831 35550 3014 674357041 3 2422 11321 146960 5856 1690105515

Alachua.......
Baker.........
Bay...........
Bradford.......
Brevard. ......
Broward.......
Calhoun .......
Charlotte ......
Citrus .........
Clay..........
Collier. . ..
Columbia ......
Dade...... .
DeSoto.......
Dixie .........
Duval .......
Escambia......
Flagler .......
Franklin.......
Gadsden.......
Gilchrist ......
Glades........
Gulf ..........
Hamilton......
Hardee........
Hendry........
Hernando......
Highlands......
Hillsborough ..
Holmes .......
Indian River...
Jackson........
Jefferson.......
Lafayette .....
Lake..........
Lee...........
Leon .........
Levy.........
Liberty.........
Madison.......
Manatee.......
Marion.......
Martin .......
Monroe........
Nassau. .......
Okaloosa......
Okeechobee. ..
Orange. .......
Osceola. .......
Palm Beach....
Pasco..........
Pinellas .......
Polk..........
Putnam.......
St. Johns.....
St. Lucie.......
Santa Rosa.....
Sarasota. ......
Seminole.......
Sumter .......
Suwannee.....
Taylor........
Union ........
Volusia .......
Wakulla ......
Walton........
Washington....

1539
3
112
0
0
2
26
768
0
3
829
0
27460
125
12
4
5380
73
2
508
0
9
239
0
196
36
37
38774
67
494
31
153
0:
555
22
4606
1191
39
16
1825
81
1
5305
1
3
685
8712
0
6941
0
24388
4348
0
1
0
0
5866
2479
3
627
0
0
464
1592
198
229

1947
126
2376
337
1070
4738
104
992
371
668
814
2
24793
247
98
2068
3153
28
46
1679
12
187
285
556
252
430
0
57
11550
126
242
705
196
66
710
370
1145
25
12
211
988
1123
208
467
467
888
59
4266
329
6656
2
13183
8566
426
156
0
445
1649
1644
197
363
60
34
309
94
77
65

44 ANNUAL REPORT, 1961

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

G. DENTAL HEALTH (Dentist only)

Number Requiring
Dental Inspections Treatment
______ ______ o 0

la lb le Id 2a 2b 2c 2d 3 4 6 6 7

Total 1961..... 67 79910 2 537 21 42116 3 22 9562 19915 50853 17428 306

Alachua.......
Baker.........
Bay ..........
Bradford...
Brevard.......
Broward .......
Calhoun.......
Charlotte .....
Citrus.........
Clay........
Collier.........
Columbia ......
Dade.........
DeSoto........
Dixie..........
Duval.........
Eseambia....
Flagler .. ...
Franklin....
Gadsden.......
GUlchrist......
Glades........
Gulf....... ..
Hamilton .....
Hardee........
Hendry.......
Hernando.....
Highlands.....
Hillsborough...
Holmes........
Indian River...
Jackson........
Jefferson......
Lafayette .....
Lake.........
Lee...........
Leon.........
Levy.......
Liberty......
Madison......
Manatee .......
Marion........
Martin........
Monroe........
Nassau ........
Okaloosa.......
Okeechobee. ...
Orange .......
Osceola .......
Palm Beach....
Pasco .........
Pinellas........
Polk...........
Putnam........
St. Johns......
St. Lucie.......
Santa Rosa.....
Sarasota.......
Seminole......
Sumter.......
Suwannee......
Taylor........
Union ........
Volusia........
Wakulla.......
Walton .......
Washington....

3039
0
0
0
0
2340
0
0
0
0
0
0
19669
0
0
2143
606
0
0
0
0
0
0
0
0
0
0
0
4590
128
0
0
143
305
2441
0
0

116
O
O
0
0
0
0
2386
0
2725
0
4091
2628
42
0
0
0
0
0
201
0
0
0
3260
0
0
0

38
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
2
0
66
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
191
0
0
0
O

LOCAL HEALTH SERVICES 45

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

H. CHRONIC DISEASES

Cancer Service Orthopedic Service Diabetes Service Cardiovascular Renal

COUNTY a .s s a
5 n a :
>a > > > s >

*; 0 < L 0 < O < iS O

1 2 3 4 5 6 7 8 9 10 11 12
Total 1961........... 4741 12789 13326 4382 12998 8853 2900 10727 14481 4939 20067 9348
Alachua. ............ 153 10 99 78 218 111 62 350 81 59 256 83
Baker............. 10 89 19 4 2 4 3 4 44 37 182
Bay................ 23 100 3 169 593 32 12 58 4 14 66 0
Bradford...... 68 206 55 62 265 124 12 13 18 52 345 84
Brevard. ........... 49 218 155 247 893 422 44 148 212 206 434 ?88
Broward ............ 362 644 610 206 632 38 80 348 303 30 62 7
Calhoun............. 5 17 0 19 21 28 6 3 42 2 0 6
Charlotte........... 31 103 15 32 82 81 20 85 97 12 25 7
Citrus.............. 3 1 3 8 7 2 8 30 1 10 0 69
Clay................ 48 186 26 51 232 217 24 131 12 102 477 45
Collier................. 64 261 163 30 93 37 18 6 74 27 67
Columbia ............ 20 6 20 8 8 3 5 0 5 0 0 0
Dade................ 268 1368 168 39 128 29 31 80 9 199 2472 429
DeSoto. ........... 20 189 48 71 98 132 9 5 73 6 8 4
Diie ................ 7 11 7 27 45 14 11 9 49 22 26 59
Duval............ 1 1 0 8 1 4 6 17 0 9 1
Escambia.......... ... 406 1480 979 279 853 15 274 985 76 453 2310 63
Flagler ........... 1 1 1 2 4 1 6 19 10 4 29 3
Franklin............ 2 62 17 41 28 67 1 27 52 37 6 86
Gadsden ........... 45 94 5 148 410 111 40 32 86 198 941 683
Gilchrist. ........... 6 3 3 2 2 0 2 7 1 17 8 41
Glades............... 7 11 22 5 11 6 7 25 67 18 48 82
Gulf................. 25 71 42 33 172 63 10 29 27 62 68 175
Hamilton ... ...... 5 1 4 0 0 0 6 1 23 28 0 103
Hardee............. 13 46 18 19 45 46 11 11 22 7 31 1
Hendry.............. 18 25 18 18 87 16 17 166 142 37 93 138
Hernando............ 9 22 0 4 10 0 3 2 2 0 3
Highlands........... 27 71 19 20 25 14 18 6 24 8 15 8
Hillsborough ......... 452 838 3009 661 919 274 84 170 7709 969 2548 1346
Holmes ............. 36 43 57 16 29 60 69 16 419 39 74 97
Indian River......... 17 56 7 42 179 12 28 131 23 7 32 19
Jackson............. 50 189 26 93 149 279 29 60 175 56 90 262
Jefferson ............ 14 240 1 10 19 2 33 96 85 18 53 6
Lafayette............ 6 1 5 9 42 11 7 16 22 89 36 86
Lake............... 47 96 26 88 137 63 3 70 21 42 76 33
Lee ................ 10 20 2 52 100 102 9 6 8 4 11 14
Leon............... 116 30 262 126 118 116 71 144 229 53 94 33
Levy .............. 5 3 4 19 33 4 8 8 12 89 19 260
Liberty............. 21 55 10 22 24 8 7 8 6 201 408 828
Madison............ 31 61 28 36 205 33 12 19 99 0 0 0
Manatee............. 19 40 6 21 52 16 40 112 34 417 107 624
Marion ............. 2 4 0 85 269 21 26 6 1 17 71 3
Martin............... 16 26 5 28 58 12 17 38 28 4 7 1
Monroe ............. 101 255 45 126 249 57 32 53 59 70 174 55
Nassau.............. 6 46 3 29 78 9 15 36 9 16 54 26
Okaloosa............. 31 51 20 60 215 64 19 22 53 62 78 99
Okeechobee .......... 14 27 11 17 64 11 7 7 6 0 0 0
Orange.............. 118 18 2099 93 200 55 35 54 109 77 173 73
Osceola............... 16 15 23 21 84 32 10 20 89 22 173
Palm Beach.......... 472 626 1255 149 941 46 52 227 172 65 425 135
Pasco .............. 21 43 13 61 126 49 62 95 195 20 80 48
Pinellas.............. 522 2652 1812 146 1051 63 86 191 839 444 4518 629
Polk .............. 522 186 1608 201 465 146 240 650 288 220 382 448
Putnam............. 15 24 6 20 98 16 10 20 1 16 4
St. Johns............ 6 5 12 0 0 0 88 110 92 4 2 2
St. Lucie............. 15 61 6 36 96 31 4 7 0 6 7 13
Santa Rosa.......... 40 69 57 50 126 149 37 9 245 50 22 132
Sarasota............. 50 377 12 45 275 17 25 125 8 63 809 88
Seminole ............ 8 21 1 39 162 73 9 28 101 25 67 44
Sumter.............. 16 25 31 66 91 51 22 13 66 9 16 22
Suwannee........... 24 95 42 72 163 154 34 79 155 81 140 327
Taylor............ .... 35 39 77 16 1 19 9 3 40 3 1
Union............... 12 8 15 4 6 1 1 42 7 22
Volusia ............. 61 960 9 109 107 33 84 3659 27 9 1559 25

Wakulla ............ 6 19 2 14 18 1 0 0 20 8 23 19
Walton .............. 42 86 49 44 78 66 30 129 248 23 111 80
Washington........... 33 41 51 31 37 77 24 10 201 10 3 28

46 ANNUAL REPORT, 1961

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

J. MENTAL HEALTH
Admission Field Office
To Service Visits Visits .

COUNTY ,
r -

1 2 8 4 5 6 7 8
Total 1961....................................... 6518 3712 3838 10831 14467 22327 25362 12862

Alachua ........................................ 312 130 129 849 446 1606
Baker ..................... ............... 3 1 4 24 48 4
Ba ...... ....... .. .................... 0 42 5 213 87 2
Bradord .................................. 26 6 86 54 18
Brevard ................................. ....... 283 89 178 352 702 1606
Broward ........................................ 406 22 459 200 125 1755
Calhoun.............................. ... 21 28 9 30 126 19
Charlotte ....................................... 66 7 2 83 133 16
Citrus.......................................... 1 41 5 84 212 34
lay .......................................... 63 16 64 188 164 59
Colier ......................................... 240 6 62 88 116 765
Columbia ....................................... 0 0 20 13 0 3
Dade ......................................... 1433 319 290 1090 1665 5368
DeSoto ......................................... 40 11 9 10 31 22
D ixie ........................................... 10 3 4 42 28 4
Duval ........................... .............. 246 134 57 176 248 20
Escambia....................................... 24 279 166 637 781 215
Flagi er ......................................... 0 4 1 7 1 5
Franklin..................................... 3 21 7 42 190 5
Gadsden............................ ........ 21 72 64 218 192 181
Gilchrist........................................ 0 0 0 0 0
Glades ........................................ 13 1 3 1 10 6
Gulf ........................................... 40 11 10 55 147 18
Ham ilton....................................... 1 0 0 0
Hardee........................................ 58 10 6 7 28 43
Hendry ......................................... 35 2 8 25 71 34
Hernando...................................... 15 24 0 16 89 2
Highlands ...................................... 11 11 54 58 186 27
Hillaborough.................................... 971 265 341 1240 802 2429
Holmes ........................................ 28 16 7 18 33 50
Indian River.................................... 55 23 30 80 142 100
Jackson........................................ 36 61 15 119 271 21
Jefferson ........................................ 2 11 0 21 25 7
Lafayette ....................................... 0 0 2 12 1 0
Lake ........................................... 24 37 5 39 75 10
Lee ........................................... 54 66 33 88 171 97
Leon ........................................... 262 81 369 288 215 2538
Levy ........................................... 8 26 15 45 86 27
Liberty ......................................... 2 7 15 24 41 28
Madison ............ 0 14 5 40 28 15
Manatee ..................... ... ......... 34 42 139 201 642 68
M arion ........................ .............. 91 266 117 272 289 89
Martin ........................................ 44 6 20 12 54 49
M onroe ........................................ 72 21 98 235 548 100
Nassau ........................................ 14 13 16 45 122 19
Okaloosa ....................................... 103 25 15 214 427 17
Okeechobee ..................................... 20 5 1 3 9 65
Orange ......................................... 671 142 97 422 331 774
Osceola......................................... 16 2 5 18 39 26
Palm Beach ..................................... 37 414 137 582 937 209
Pasco .......................................... 10 25 10 68 97 45
Pinellas........................................ 33 333 177 638 868 134
Polk .......................... ................ 295 226 162 507 723 1387
Putnam ........................................ 5 18 13 47 59 34
St. Johns .................................... 1 14 5 32 10 18
St. Lucie ................................ .... 192 11 119 4 37 1252
Santa Rosa..................................... 20 8 12 28 79 35
Sarasota ........................................ 32 40 131 357 241 321
Seminole....................................... 89 11 17 115 766 106
Sum ter ......................................... 19 14 1 13 48 47
Suwannee....................................... 10 14 22 46 38 29
Taylor ......................................... 19 13 19
Taylor 4 13 1 19 13 19
Union ............................ .... ...... 0 1 3 4 3 1
Volusia........................................ 119 91 52 252 246 248
Wakulla....................................... 31 8 7 5 76 13
Walton........................................ 9 31 0 53 44 59
W ashington..................................... 2 0 2 1 1 3

3083 298
9 36
9 0
2 2
1314 1774
609 2157
23 198
74 67
47 160
78 7
814 309
4 0
3513 608
51 108
8 0
282 160
167 0
0 1
14 315
48 67
0 0
18 8
17 231
0 0
84 86
60 18
6 171
113 39
3013 419
56 11
50 209
77 312
2 0
0 0
29 0
403 123
1030 261
27 33
10 4
17 1
212 203
351 367
201 40
205 391
36 140
64 197
116 14
2107 52
15 24
733 354
34 1
427 245
1684 525
11 1
12 13
1134 191
60 17
980 542
594 403
68 0
21 1
5 2
0 0
1052 816
12 130
46 0
1 0

LOCAL HEALTH SERVICES 47

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

M. NURSING
K. MISCELLANEOUS M. ESI

COUNTY o "

1 2 3 4 5 6 7 1 2
Total 1961 ................................... 10707 45772 90077200079 2460 1564 1582 418 5515
Alachua ................................. 377 723 358 3728 8 7 105 1 56
Baker ................................... 52 194 0 118 15 15 0 0 0
Bay ..................................... 40 116 0 2171 97 10 20 2 49
Bradford ............. ... ................. 187 590 100 248 53 7 1 1 3
Brevard .............. ................... 469 746 75 2878 63 21 1 8 28
Broward ................................. 235 640 864 18884 144 136 68 21 165
Calhoun ................................. 41 102 71 91 17 3 0 0 0
Charlotte ................................ 37 424 33 438 9 34 0 0 0
Citrus ................................... 20 123 40 341 5 0 0 0 0
Clay .................................... 249 427 38 273 141 40 1 2 4
Collier ................................... 183 678 100 725 7 9 0 0 0
Columbia ................................ 309 506 50 275 4 0 0 1 1
Dade. **.*. ......................... 70 526 80213 20292 49 18 392 50 1084
DeSoto .................................. 22 101 16 452 21 21 0 0 0
Dixie .................................... 38 217 39 268 123 3 1 0 0
Duval ................................... 41 75 0 5615 0 3 170 37 584
Escambia................................ 316 3506 652 11129 12 34 96 8 55
Flagler .................................. 80 386 88 277 42 0 0 0 0
Franklin ................................. 19 48 5 550 7 0 0 0 0
Gadden................................. 122 853 251 1144 628 48 0 0 0
Gilchbrist ................................. 107 362 103 85 2 0 0 0 0
Glades ................................... 94 651 43 60 0 0 0 0 0
Gulf ............................. ... 35 96 13 339 210 4 0 0 0
Hamilton................................ 329 675 17 339 2 0 0 0 0
Hardee .................................. 1 110 6 437 2 21 0 1 7
Hendry.................................. 178 903 2 362 11 5 0 0 0
Hernando ............................... 9 24 161 308 1 0 0 3 14
Highlands ............................ 38 49 21 496 16 6 0 3 3
Hillsborough ............................. 1014 4632 709 41907 2 105 293 36 1385
Holmes ................................. 76 109 97 203 2 0 0 2 8
Indian River ................... ........ 51 167 11 539 0 1 0 2 25
Jackson ................................. 24 62 0 528 54 0 0 0 0
Jefferson................................. 38 1 9 44 243 5 1 0 1 17
Lafayette ............................... 28 65 2 15 4 0 0 0 0
Lake ................................... 48 108 21 1217 12 0 0 7 31
Lee ..................................... 119 219 116 3667 2 7 0 6 24
Leon.................... ............... 257 577 43 2849 14 0 0 2 6
Levy .................................. 73 313 212 613 6 1 8 3 8
Liberty................................. 69 422 35 74 5 0 0 0 0
Madison ................... ............ 78 235 47 156 14 1 0 0 0
Manatee................................. 90 404 225 4489 7 1 49 13 53
Marion ................................. 3 22 1183 2151 201 54 10 3 32
Martin ................................. 12 21 0 0 27 45 0 1 5
Monroe.................................. 268 565 16 1558 27 59 0 3 7
Nassau.................................. 99 231 6 559 106 48 1 0 0
Okaloosa ................................. 158 1783 43 1602 2 2 0 0 0
Okeechobee. ............................ 13 33 0 244 0 19 1 8
Orange................................. 95 263 47 3000 21 12 107 43 180
Osceola .................................. 21 107 22 818 0 0 0 8 55
Palm Beach ............................. 523 1749 300 9791 10 0 86 17 63
Paco.................................... 83 231 0 1373 1 4 10 118
Pinellas ................................. 1280 10274 345 28924 0 256 41 427
Polk..................................... 1117 2432 144 7358 62 166 51 22 268
Putnam ................................ 198 1012 244 941 4 2 4 12
St.Johns.. ...................... ... 28 79 0 777 3 0 3 6
St. Lucie ................................ 1 1 0 919 9 28 0 4 43
Santa Rosa................................. 90 279 137 494 0 54 2 0 0
Sarasota................................ 15 1365 113 2541 3 13 9 14 113
Seminole ................................ 47 161 2 723 15 4 2 9 54
Sumter................................. 44 103 7 393 3 13 0 1 7
Suwannee .................. ........... 153 1088 211 8 15 0 1 14
Taylor ............................... .. 107 155 11 510 17 3 0 0 0
Union................................... 105 250 35 59 8 0 0 0 0
Volusia ................................. 288 2067 2164 5222 49 152 27 22 478
W akulla ................................. 24 55 12 33 8 0 0 0
W alton .................................. 86 99 81 52 1 0 0 0
Washington .............................. 19 44 216 230 6 6 0 1 15

48 ANNUAL REPORT, 1961

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

P. SANITATION
App. Water
Supplies a
Installed s &
COUNTY g |

1' i '- o 11

1 2 3 4 5 6 7 8 9 10 11
Total 1961.................. 3364 7646 539 18242 566 1646 27938 15465 48501 37450 20041
Alachu. ................... 12 20 0 918 10 61 408 351 603 433 258
Baker...................... 0 0 0 0 0 0 23 15 21 39 26
Bay....................... 27 2 0 205 4 192 54 96 162 87
Bradford................... 0 0 0 33 2 0 103 36 83 60 39
Brevard .................. 0 17 1 2998 51 556 2368 411 884 1059 357
Broward.................... 129 12 2 64 39 250 3264 1265 3149 1982 1236
Calhoun.................... 0 0 0 0 0 42 7 8 11 9
Charlotte .................. 1 3 2 17 5 55 296 47 66 191 16
Citrus .................... 0 0 0 19 0 8 16 4 11 57 13
Clay .................... 8 4 3 258 1 0 58 64 262 52 26
Collier..................... 4 3 0 20 1 0 199 41 79 91 37
Columbia ................... 8 2 2 13 0 0 408 56 94 29 23
Dade...................... 2 18 0 5 49 5 2 3500 12205 7114 4647
DeSoto..................... 0 1 2 42 3 2 32 48 57 64 10
Dixie....................... 0 0 0 24 1 1 12 9 6 18 8
Duval..................... 906 4180 285 1090 4 2 473 1030 1030 3139 1039
Escambia ................. 390 794 83 7 14 1234 1160 3945 3476 2191
Flagler .................. 0 0 0 71 2 0 44 14 25 3 3
Franklin .................. 0 8 0 30 0 0 6 9 27 116 37
Gadsden ............... 40 327 96 17 0 42 117 19 26 63 161
Gilchrist .................. 0 0 3 0 0 0 90 8 8 1 1
Glades...................... 1 3 8 0 0 1 16 23 43 15 14
Gulf....................... 485 0 40 0 0 48 5 7 7 2
Hamilton ................... 0 0 23 14 0 0 30 6 13 16 14
Hardee .............. .... 1 0 0 2 0 0 88 25 48 34 4
Hendry ................... 48 161 3 26 11 1 106 17 39 104 36
Hernando................... 0 0 1 12 0 0 22 3 5 93 15
Highlands.................. 53 2 0 2 24 0 601 63 124 98 55
Hillsborough ............... 758 940 32 509 75 12 1948 2340 15747 2587 2908
Holmes.................... 1 0 1 31 0 0 24 14 17 20 7
Indian River................ 4 17 2 133 3 1 103 15 51 274 52
Jackson..................... 0 1 0 9 0 0 22 11 22 14 1
Jefferson .................... 2 2 5 1 0 6 10 9 12 44 23
Lafayette .................. 0 1 0 14 0 0 7 1 2 3 2
Lake................... 1 0 0 161 28 3 897 19 41 112 37
Lee .................... 0 0 0 0 0 16 567 79 116 92 53
Leon ...................... 2 0 0 39 0 160 366 222 845 335 142
Levy................... 0 0 0 27 7 9 79 16 28 18 11
Liberty.................. 0 0 0 3 2 2 11 0 0 2 0
Madison.................. 0 0 0 8 0 0 8 6 20 9 4
Manatee................... 8 1 0 117 11 3 101 169 308 503 343
Marion .................... 226 6 0 18 40 3 437 126 234 990 570
Martin ..................... 2 2 0 867 4 4 352 13 19 46 23
Monroe ................... 0 0 0 0 0 83 362 120 186 216 178
Nassau..................... 1 4 0 21 0 16 119 26 40 88 16
Okaloosa .................... 5 0 0 177 4 2 186 14 134 191 69
Okeechobee................. 13 0 1 92 0 0 106 28 65 35 23
Orange .................. 4 86 0 930 48 278 2322 922 1349 5185 1409
Osceola .................. .. 3 0 40 43 0 164 78 169 117 22
Palm Beach ................ 1 5 0 61 9 4 2263 361 54 1383 717
Pasco ..................... 8 4 1 46 1 1 53 8 53 98 39
Pinellas ................... 59 39 6 3664 11 19 2019 585 1582 3718 1485
Polk ...................... 8 8 7 1289 8 0 1499 725 1143 668 341
Putnam ................... 14 7 3 78 5 8 198 86 66 84 35
St.Johns ................... 1 0 1 28 0 3 85 14 9 127 34
St. Lueie ................... 1 3 3 227 1 2 389 112 309 133 132
Santa Rosa ................ 0 0 0 14 0 1 47 93 187 68 12
Sarasota ................... 573 457 5 502 28 36 1093 374 1602 682 547
Seminole.................. 38 1 0 219 17 19 408 164 193 481 106
Sumter .................... 0 0 0 13 0 0 4 20 58 24 18
Suwannee .................. 0 0 3 12 0 1 26 5 7 4 2
Taylor .................... 2 11 0 13 0 0 31 13 36 25 20
Union ..................... 0 0 10 0 0 1 3 7 3 2
Volusia .................... 6 2 8 198 11 1 1138 257 759 35 198
Wakulla................... 0 0 0 9 0 0 2 11 15 45 1
Walton ................... 13 0 1 0 10 79 18 22 108 68
Washington.................... 8 0 0 1 0 0 14 28 30 36 27

LOCAL HEALTH SERVICES 49

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

P. SANITATION-FIELD VISITS

COUNTY

43| ..I r5 0I
540 5. I 2 5 I .l l I I' O|
12 18 14 15 16 17 18 19 20 21
Total 1961........................ 200849 89522 6262 5469 15793 280 10935 6776 9484 5023
Alachua........................... 1502 1750 44 77 75 4 51 52 127 89
Baker............................. 440 66 0 24 0 0 82 2 6 0
Bay............................. 1233 153 0 27 227 0 158 78 164 0
Bradford.......................... 8 71 14 1 26 0 13 14 0 0
Brevard...................... .. 5747 4131 85 41 83 11 155 411 120 3
Broward......................... 8170 8072 276 236 2364 68 545 897 520 416
Calhoun........................... 78 40 0 47 0 0 50 0 0 0
Charlotte......................... 744 553 1 50 14 0 33 24 48 2
Citrus............................. 370 21 23 37 9 0 102 19 0 0
Clay................ ........ 240 351 50 86 9 0 82 21 138 0
Collier .......................... 119 598 439 21 50 0 11 6 69 0
Columbia........................ 1708 99 3 8 7 0 9 12 1 2
Dade ............................ 26806 25703 3307 612 6289 58 135 201 727 614
DeSoto............................ 278 448 3 86 0 0 88 7 6 0
Dixie ............................. 14 39 1 8 0 0 25 4 0 0
Duval............................. 10259 2238 16 127 26 2 21 268 190 294
Escambia......................... 14031 10303 24 224 410 0 273 329 384 257
Flagler............................ 119 41 43 9 0 0 32 0 4 0
Franklin ......................... 618 142 17 27 0 0 70 79 3 0
Gadsden.......................... 682 78 81 115 20 0 186 35 28 1
Gilchrist ......................... 642 0 0 0 0 0 0 0 0 1
Glades............................ 845 112 42 15 0 0 30 2 14 0
Gulf.............................. 410 189 9 73 0 0 63 2 22 0
Hamilton.......................... 225 27 0 0 0 0 56 4 0 0
Hardee............................ 430 138 55 26 7 0 19 18 0 0
Hendry........................... 707 877 51 24 11 0 185 40 54 0
Hernando......................... 320 20 26 4 0 0 14 2 0 0
Highlands......................... 915 1191 86 29 28 2 61 42 131 0
Hillsborough..................... 45964 446 262 600 95 8 276 350 1078 2045
Holmes ........................... 70 29 0 56 0 0 1 2 5 1
Indian River....................... 773 244 16 23 124 11 2 1 8 2
Jackson........................... 163 139 42 16 10 0 89 45 1 0
Jefferson .......................... 131 179 11 78 29 0 14 10 10 8
Lafayette......................... 12 21 0 1 0 0 8 0 0 0
Lake............................ 1428 493 20 24 1 1 0 0 18 6
Lee............................... 811 430 8 89 73 4 9 7 106 0
Leon........................... 863 364 42 44 125 0 1803 15 357 129
Levy............................. 476 145 10 13 6 0 11 2 6 0
Liberty.......................... 130 11 17 26 0 0 265 9 7 0
Madison .......................... 85 18 6 27 6 0 25 7 0 0
Manatee.......................... 2119 284 84 49 95 8 65 90 108 60
Marion............................ 1729 859 39 67 85 1 93 17 82 29
Martin............................ 689 1112 0 0 11 5 41 16 69 6
Monroe........................... 2287 241 18 43 112 0 3 22 200 14
Nassau............................ 384 157 9 71 57 1 21 4 34 0
Okaloosa.......................... 835 1319 5 23 13 0 208 101 20 10
Okeechobee........................ 267 402 0 8 4 0 22 88 74 3
Orange........................... 20636 17346 190 812 422 6 2058 1465 566 333
Osceola........................... 245 419 52 32 15 8 49 7 86 1
Palm Beach ....................... 4303 3074 94 144 2073 2 422 99 108 195
Pasco............................. 46 101 188 0 11 0 25 2 74 0
Pinellas........................... 19999 3048 203 432 986 17 1853 1171 2497 201
Polk ............................. 5511 584 151 195 109 1 89 160 219 33
Putnam .......................... 811 764 70 48 56 0 18 7 74 0
St.Johns......................... 177 375 12 43 2 0 6 18 10 1
St. Lucie.......................... 1952 1816 50 19 274 10 20 20 33 45
Santa Rosa ........................ 754 809 1 46 5 0 78 53 20 1
Sarasota........................... 3937 451 14 44 236 6 68 95 108 123
Seminole .......................... 769 1087 9 101 67 0 269 238 45 35
Sumter............................ 387 80 2 49 7 0 187 4 55 0
Suwannee ......................... 97 18 14 10 24 0 11 5 40 10
Taylor............................ 348 59 0 42 49 0 5 3 61 1
Union............................. 785 46 0 0 0 3 4 0 0
Volusia .......................... 3717 890 41 94 983 46 107 77 221 37
Wakulla........................... 32 29 1 17 0 0 17 0 0 0
Walton........................... 108 205 40 84 18 0 155 42 20 12
Washington........................ 14 27 0 10 6 0 40 1 8 3

50 ANNUAL REPORT, 1961

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

R. PROTECTION OF FOOD AND MILK

.| E
COUNTY c a.g .

B ..... 222 1507 4 14 0 0 0
c8S s s s 'o s s

1 2 3 4 5 6 7 8 9 10

Total 1961......................... 27057 169283 3159 757 11170 386 8457 95727 40282 559
Alachua............................ 445 2081 128 20 102 6 22 0 0 0
Baker ........................... 54 201 248 4 18 0 0 0 0 1
Bay .l.................. .......... 222 1507 0 9 8 2 14 0 0 0
Bradord .................. ......... 52 690 0 6 36 38 135 156 0
Brevard........................... 303 1544 49 9 74 0 0 0 0 0
Broward ......................... 2192 6564 32 2 2 8 33 179 0 0
Calhoun ......................... 22 294 0 11 218 0 0 0 0 0
Charlotte........................... 66 374 0 5 14 0 0 0 0 0
Citrus.............................. 1 113 0 0 0 0 0 0 0 0
Clay .... .......... ............... 122 958 0 7 76 2 13 0 0 0
Collier. ....................... 7129 206 0 0 0 0 0 0 0 0
Columbia ................ .... .. 109 832 0 1 13 1 12 0 0 0
Dade .......................... 648742985 590 45 1217 145 3434 6539 0 0
DeSoto........................... 87 482 0 3 85 0 0 0 0 0
Dixie .......................... 32 107 0 0 0 0 0 0 0 0
Duval............................ 859 2916 3 0 0 0 0 0 0
Escambia ............ ............ 725 4586 411 52 955 5 76 4050 177 0
Flagler ............................. 184 483 0 1 10 0 0 0 0 0
Franklin .......................... 45 227 0 0 0 0 0 0 0 0
Gadsden........................... 85 644 0 7 116 2 26 99 0 0
GilHerist ................... ....... 13 136 0 0 0 0 0 0 0 0
Glades ........................... 24 73 0 8 57 0 0 0 0 2
Gulf.............................. 102 931 0 1 19 0 0 0 0 0
Hamilton............................ 41 82 0 0 0 0 0 0 01 0
Hardee............................ 28 135 0 10 51 0 0 0 0 0
Hendry i......................... 63 381 0 4 27 0 0 0 0 8
Hernando.......................... 37 67 0 2 0 0 0 0 0
Highlands ......................... 123 421 0 7 39 4 5 0 0 0
Hillborough ....................... 3187 41703 79 100 2374 25 1263 0067 122 100
Holes ............................ 77 632 0 16 220 00 411 0
Indian River........................ ..... 8 813 1 7 84 1 156 0 0 0
Jackson........................... 94 1032 149 2 371 4 34 0 0 0
Jefferson ......................... 84 349 0 8 128 1 14 981 905 9
Lafayette......................... 310 32 0 20 415 0 0 0 0 0
Lake ... ......................... 174 459 0 13 31 2 2 0 0 0
Lee............................... 418 3 1034 0 5 65 7 78 0 1 0
Leon ............................. 420 2749 0 11 240 4 151 625 0 0
Levy .............................. 837 69 0 1 1 1 1 9 0 0
Liberty .......................... 11 12 0 0 0 0 0 0 0 0
Madison.b........................ 38 106 0 8 130 3 16 846 0 0
Manatee. ........................ 363 1671 0 37 233 1 45 550 396 0
Marion ........................... 173 838 27 9 293 1 29 1889 0 0
Martin ............................ 1046 613 10 8 105 2 10 960 0 0
Monroe ............................ 202 638 0 0 0 8 37 0 0 0
Nassau ........................... 266 89 454 31 0 0 0 0 9 05 0
Okaloosa.......................... 128 244 0 4 27 0 0 0 0 0
Okeechobee ...................... 77 562 67 22 266 2 23 13031 1040 2
Orange ......................... 969 4303 682 31 231 18 547 0 0 0
Osceola. .......................... 299 307 0 7 102 0 0 0 0 0
Palm Beach...................... 1051 2323 0 34 145 30 1149 16423 32548 360
Paasco .......................... 65 567 0 16 151 0 0 4854 171 0
Pinellas........................... 2656 17036 107 12 228 49 949 2350 512 12
Polk S ............................ 1119 7555 248 49 607 2 29 633 3964 49
Putnam ......................... 136 759 0 1 30 0 0 0 0 0
St. Johns......................... 63 492 0 3 41 2 10 0 0 0
St. Lucie ......................... 212 3086 19 6 47 4 27 2271 0 0
Santa Roa ........................ 70 183 3 19 142 0 0 0 0 0
Sarasota. ..................... ... 568 2240 0 6 72 56 22 0 0 3
Seminole ......................... 1089 698 0 9 66 11 11 290 0 0
Sumter........................... 32 219 0 8 107 0 0 734 198 0
Suwannee ................... ...... 68 761 23 5 71 0 0 23 16 0
Taylor .................... ......... 77 191 32 0 0 11 0 0 0
Union ............................. 16 31 0 4 17 0 0 0 0 0
Volusia ........................... 1074 4005 320 15 506 18 290 431 0 0
Wakulla.... ........................ 22 107 0 0 0 0 0 0 0 0
Walton ............................ 112 336 0 13 156 3 29 1114 76 13
Washington........................ 72 311 0 11 249 1 1 522 0 0

LOCAL HEALTH SERVICES 51

TABLE 7 (Continued)

MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1961

V. HEALTH INFORMATION X. LABORATORY

COUNTY

1 2 4 5 6 1 thru 22

Total 1961. ................................... 17152 12820 348 1250 380 642051

Alachua........................................ 999 627 5 6 2 9860
Baker......................................... 37 21 0 27 0 1021
Bay.......................................... 85 169 2 1 5 7611
Bradford...................................... 110 20 1 10 0 1523
Brevard....................................... 437 285 2 43 0 14017
Broward....................................... 471 398 3 4 0 33837
Calhoun.................. ........ ....... ... 49 37 0 1 0 1180
Charlotte..................................... 344 162 0 45 11 4450
Citrus .................................. ...... 95 45 0 3 0 1023
Clay............... ........... 208 65 0 41 8 1902
Collier ..... .69 3 15 4 3917
Columbia ........... ....... .................. 27 8 0 5 0 2408
Dade ......................................... 1594 1381 24 43 61 80182
D eSoto ....................................... 9 12 1 9 4 2118
Dixie............................. ............ .. 22 19 0 14 7 2466
Duval...................................... .. 122 43 0 0 0 19212
Escambia...................................... 422 340 3 28 8 35191
Flagler........................................ 7 4 0 7 0 1488
Franklin ................ ....................... 82 58 0 7 25 2636
Gadsden ................. .......... ......... 218 89 0 40 0 6688
Gilchrit. ...................................... 8 0 0 0 0 587
Glades........................................ 59 9 12 4 0 598
Gulf................... ....................... 47 83 12 20 8 1727
Hamilton ................... ..... ............. 88 16 0 26 55 2101
Hardee. ..................................... 80 8 1 1 1 2511
Hendry........... ......................... 79 8 36 21 0 2308
Hernando....... ............................. 21 18 0 0 0 820
Highlands................... ............... 66 15 1 0 0 2311
Hillsborough. .......................... 1749 820 7 62 9 121305
Holmes........................................ 36 32 17 7 13 3441
Indian River ................................ 353 79 1 0 0 2933
Jackson ....................................... 81 127 0 0 0 6465
Jefferson...................................... 43 69 0 0 0 1553
Lafayette. ................................ 7 2 0 0 0 501
Lake ................ ........................ 57 38 0 0 1 3537
Lee ........................................... 300 105 14 10 3 8727
Leon ......................................... 169 189 1 88 0 21168
Levy. ................. .................... 45 78 1 5 0 2685
Liberty... .......... .......................... 6 1 0 0 0 1256
Madison................... ............... 66 52 2 11 0 2409
M anatee........... ................ ..... 490 331 8 19 3 12001
Marion .......................... ........... 285 60 36 63 11 7422
Martin ..................................... 122 64 0 0 0 1359
Monroe....................................... 219 256 16 37 2 3360
Nassau............................ ............ 148 119 0 14 5 2947
Okaloosa ....................................... 96 85 6 6 50 4186
Okeechobee........................ ............. 43 19 0 0 0 1261
Orange......................................... 1130 1464 29 43 24 27168
Osceola. ....................................... 32 21 0 0 0 3029
Palm Beach................................... 1757 924 9 12 10 27161
Pasco.................................. ......... 51 11 2 23 1 2516
Pinellas ....................................... 1023 1551 19 147 15 55474
Polk........................................... 456 618 23 58 1 27827
Putnam ....................................... 95 26 2 1 1 4796
St. Johns....................................... 148 4 0 5 0 1696
St. Lucie....................................... 106 28 0 14 0 3250
Santa Rosa .................................... 74 667 2 29 10 5873
Sarasota....................................... 422 240 11 53 6 4231
Seminole ...................................... 193 437 0 14 1 3261
Sumter........................................ 44 43 0 31 0 1709
Suwannee...................................... 87 42 0 13 2 1852
Taylor........................................ .. 75 27 1 6 0 1522
Union......................................... 12 4 0 4 0 845
Volusia ....................................... 534 91 9 35 0 8405
W akulla ...................................... 34 32 0 0 4 1798
W alton ....................................... 54 53 24 17 10 3568
W ashington ................................... .. 14 3 2 2 0 1861

52 ANNUAL REPORT, 1961

BUREAU OF VITAL STATISTICS
EVERETT H. WILLIAMS, JR., M.S., Hyg.
Director
This bureau has a dual function. First, it is responsible for the
collection, preservation and issuance of certified copies of vital records.
Second it provides public health statistical data and consultation on
these matters to the State Board of Health.
Vital records in Florida consist of reports of the following
events: birth, stillbirth, death, marriage, annulment of marriage, di-
vorce, adoption and legal change of name. By legal requirement these
events are each recorded at the time of occurrence of the event through
an established registration system and the record has documentary value
in a court of law. In addition to their legal value these records have
statistical value for public health agencies and others interested in
demographic studies.
COLLECTION
It is axiomatic that the value of statistical tabulations are dependent
upon the quality of the basic data. For this reason, collection of records
is one of the primary functions of a vital statistics system. The local
health officers are the registrars and are responsible for the collection
of birth, stillbirth and death certificates for their areas. Particular
emphasis has been placed upon promptness of filing birth and death
records. Last year 94.8 per cent of all births and 97.6 per cent of all
deaths were registered at this bureau by the fifth of the following month.
A total of 16 counties submitted 98 per cent or more of their birth
records, and 24 counties submitted 98 per cent of their death records
within this time limit. Unfortunately, there is still a sizable number of
counties which submit less than 90 per cent of their records on time.
One measurement of the relative efficiency between counties of birth
and death registration is the "Vital Statistics Scoreboard" which is pub-
lished annually (Table 15). The top 10 units are to be congratulated
on their superior performance: Jacksonville-Duval, Broward, Dade,
Orange, Hillsborough, Citrus, Jefferson, Pinellas, Escambia and
Alachua.
Last year a total of 228,457 current certificates were registered with
the bureau, an increase of 2.6 per cent over the preceding year.
INDEXING
The bureau is responsible for the preparation of a comprehensive
index of the records on file so that they can be promptly located when
needed. Annual indexes were prepared and in addition a consolidated
five-year birth index for the period 1956-1960 was made by the Data
Processing Unit.
A project for re-indexing all records prior to 1940 was started in
1958. Since no personnel have been available for full-time work on the

VITAL STATISTICS 53

project, it has been carried on as a spare-time job whenever the cur-
rent work was completed. All deaths, marriages and divorces prior to
1940 have been re-indexed by manual methods and this has resulted in
more efficient searching procedures. A more comprehensive project by
machine methods was started for births. This has proceeded rather
slowly because of the great difficulty in deciphering hand-written names.

CERTIFICATIONS
The issuance of certified photocopies and other certifications is one of
the large-volume jobs performed by the bureau. Last year 119,822 re-
quests for certifications were received and processed. This figure repre-
sents an increase of 4.8 per cent over the previous year and is a good
index of the increase in the workload in the bureau.

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 evidence is
obtained for major corrections to maintain the validity of the record. A
revised set of administrative procedures for amendments was 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 cer-
tificates. Bureau personnel must explain requirements for evidence in
writing and orally and must determine when sufficient proof has been
submitted. In 1961 a total of 3519 delayed birth certificates were filed.
This is an increase of 8.6 per cent over the preceding year.
ADOPTIONS
Legal adoptions have increased rapidly in this state. In 1961 a total
of 3900 adoption decrees were received from the courts for children born
in Florida. This represents an 8.3 per cent increase over 1960. When an
adoption decree is received for a person born in Florida a new birth cer-
tificate 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 forwarded to the vital statistics office of the state of
birth for similar processing. A total of 1045 adoption reports were for-
warded to other states.

54 ANNUAL REPORT, 1961

STATISTICAL SECTION

OLIVER H. BOORDE, B.S., B.A.
Director
This section of the Bureau of Vital Statistics is responsible for sum-
marizing and analyzing data obtained from vital records and special
studies. It also provides statistical support and consultation to all bureaus
and divisions of the State Board of Health.
During the year, the statistical section published a monthly vital
statistics bulletin which revealed the latest available data on births,
deaths, marriages and divorces. Accompanying this bulletin was a
monthly article concerning various subjects of public health interest. The
bulletin is widely distributed to the county health departments, hospitals,
libraries, schools, and to persons expressing a desire to receive this type
of information.
At the end of each year, the section published Supplement No. 1 to
the State Board of Health Annual Report-a complete summary and
analysis of vital statistics for the year. Supplement No. 2 to the Annual
Report (Florida Morbidity Statistics) was published in cooperation with
the Bureau of Preventable Diseases. This report reviews the number of
cases of reportable diseases and analyzes any apparent trends.
In 1961, assistance was requested of the statistical section for a wide
range of studies and surveys. Assistance primarily consisted of sample
design and statistical interpretation of resulting data. Consultation was
also provided to insure that study procedures were adaptable to IBM
processing. During the year, special projects included an immunization
survey of the Bradenton-Palmetto area and an immunization and
serology survey of Glades, Hendry and Highlands counties.
Project planning and much of the ground work was completed on an
immunization survey to be conducted in conjunction with the Hills-
borough County oral vaccine field trial, which is scheduled for the early
part of 1962. Basic objectives and plans were completed for a detailed
study of Florida neonatal mortality to be published in 1962.
The following report presents a brief summary of preliminary vital
statistics for 1961. A more detailed analysis of these statistics can be
found in Supplement No. 1 of this report, entitled Florida Vital Statistics,
1961. Preliminary 1961 birth and death figures have been used in this
report because of a time lag in receipt of records from the counties and
the extensive process required to summarize the data in final form.
Final 1961 data covering 1961 marriages, divorces and annulments are
contained in Table 14, and Tables 11A and 12A present final 1960
natality and mortality figures.
Population
The Bureau of Economic and Business Research, University of Flor-
ida, provisionally estimated the 1961 midyear population of Florida at

VITAL STATISTICS

5,158,100. This represented a 4.2 per cent gain over the final U. S.
Bureau of the Census count as of April 1, 1960. The 4.2 per cent increase
for the 15 months from April 1960 to July 1961 is significantly below the
7.9 per cent average annual increase experienced during the period 1950
to 1960. There remains the possibility that this provisional population
estimate for 1961 could be revised upward when additional data are re-
ceived, but even on this preliminary basis the indications are that the
state is adding an average of 13,800 persons a month to its population.
Births
There were 116,866 live births to Florida residents in 1961 accord-
ing to preliminary data. This was a 1.1 per cent rise over 1960 figures.
This increase in total births resulted from 1.9 per cent gain in births for
whites (84,402 to 86,033) and a 1.1 per cent loss in births among non-
whites (31,208 to 30,853). In spite of the decline in nonwhite births, the
birth rate per 1000 population among nonwhites remained significantly
above the rate for whites (33.5 to 20.3). The 1961 total birth rate at
22.7 births per 1000 population marked the fifth consecutive year that
the birth rate has declined. The principal reason for this downward trend
is probably the large number of persons beyond the childbearing age who
in recent years have selected Florida as their retirement home.
Deaths
Preliminary mortality data reveal that deaths among Florida resi-
dents increased 2.4 per cent from 1960 to 1961; totaling 49,110 this year
compared with 47,937 deaths the previous year. The death rate dipped
slightly from 9.6 in 1960 to the present 9.5 deaths per 1000 population.
Over the last 10-year period the death rate has remained fairly constant,
varying from a low of 9.1 in 1955 to a high of 9.6 in 1952, 1958 and
1960. The steadying influences on this rate have been the growth of the
aged population of Florida, offset by improved age-specific death rates
for each age group. By race, there has been a general upward trend in
the death rate for whites and a downward movement of death rate for
nonwhites. The white death rate has risen from a low of 9.0 in 1956 to
the present 9.5 level, while the rate for nonwhites has fallen from 11.4
to 9.8 deaths per 1000 population during the same period. All races ex-
perienced an improvement in their age-specific death rate. However,
in the case of the white race this improvement was more than offset by
an increased population of older persons. During the years from 1950 to
1960, the white population 65 years and older increased 149 per cent as
compared with a total population gain of 79 per cent during the same
period.
Table 10 presents the 10 leading causes of death with rates per
100,000 population for 1961 with comparative data for these causes for
1951. The top six leading causes have remained in their present position
during the last 10 years. However, it is of interest that except for heart
disease and cancer (malignant neoplasms) these six causes have all
shown at least some decline in their death rates per 100,000 population.

56 ANNUAL REPORT, 1961

Heart disease and cancer deaths have experienced a fairly steady increase
during the past decade. General arteriosclerosis, diabetes mellitus and
other diseases of the circulatory system in the 7, 8 and 9 positions,
respectively, are diseases primarily associated with the aged and their
rise in relative ranking can be directly attributed to the growth in the
older segment of the state's population. Tuberculosis, ranking seventh in
1951, has fallen to 20th place in 1961 and its death rate decreased a
substantial 76 per cent.
Marriages, Divorces and Annulments
There were 40,934 marriages recorded in Florida during 1961, and
this marked the ninth year in succession that the number of marriages in
the state has increased. Marriages among the white race (34,080) repre-
sented 82 per cent of the total and revealed an increase of five per cent
over the 32,479 marriages recorded last year. Nonwhite marriages were
less than one per cent above 1960 figures, increasing from 6836 to 6854.
Divorces in the state totaled 21,492, and annulments 190 during the year
1961. This yielded increases of 11 and three per cent, respectively, when
compared with 1960 data. The race of persons involved in divorce or
annulment action is not shown on the record. The 1961 data yields a
ratio of 1.9 marriages per each divorce and annulment in contrast to a
1.5 ratio 10 years ago.

TABLE 8
ACTIVITIES OF THE BUREAU OF VITAL STATISTICS
DURING THE YEARS 1960 AND 1961

Activity 1960 1961 Per Cent
Change
Current certificates filed ....................... 222,759 228,457 + 2.6
Delayed birth certificates filed ................... 3,241 3,519 + 8.6
Amended certificates filed for adoptions........... 3,601 3,900 + 8.3
Adoption reports forwarded to other states........ 854 1,045 +22.4
Legitimations processed......................... 534 466 -12.7
Legal changes of name received.................. 976 935 4.2
Requests for certifications:
Total .................................... 114,324 119,822 + 4.8
Fee Paid ................................. 90,700 96,000 + 5.8
Free...................................... 23,624 23,822 + 0.8
Photostats made............................... 139,709 127,843 8.5
Birth registration cards made .................... 23,123 22,924 0.9
Fees collected and transmitted to the State Treasurer $142,917.91 $151,990.78 + 6.3

VITAL STATISTICS

TABLE 9

RESIDENT BIRTHS AND DEATHS WITH RATES
PER 1000 POPULATION, FLORIDA, 1940, 1950-1961

Midyear
Year Population Births Birth Rate Deaths Death Rate
Estimate
1961**........... 5,158,100 116,886 22.7 49,110 9.5
1960*............ 5,012,100 115,610 23.1 47,937 9.6
1959*............. 4,742,900 112,733 23.8 44,179 9.3
1958*............ 4,498,100 108,014 24.0 43,353 9.6
1957* ............ 4,186,200 103,806 24.8 39,937 9.5
1956*............ 3,893,400 97,320 25.0 36,705 9.4
1955*............ 3,662,000 89,112 24.3 33,295 9.1
1954*............ 3,431,100 84,831 24.7 31,503 9.2
1953*............ 8,223,000 80,087 24.8 30,529 9.5
1952* ............ 3,033,100 74,219 24.5 29,186 9.6
1951*............ 2,926,500 70,431 24.1 27,857 9.5
1950............. 2,797,100 64,370 23.0 26,525 9.5
1940 ............ 1,915,155 33,696 17.6 21,458 11.2

**Provisional estimate.
*Population revised in light of 1960 U. S. Census data.

TABLE 10

TEN LEADING CAUSES OF DEATH WITH RATES PER
100,000 POPULATION, FLORIDA, 1951 AND 1961

1961* 1951
1961 CAUSE OF DEATH 1951
Rank Rank
Deaths Rate Deaths Rate

1 Diseases of the heart (400-443).............. 17,708 343.2 9,142 312.4 1
2 Malignant neoplasms (140-205)............. 8,274 160.4 3,751 128.2 2
3 Cerebral vascular disease (330-334).......... 5,705 110.6 3,298 112.7 3
4 All accidents (800-962)..................... 2,903 56.3 2,011 68.7 4
5 Diseases of early infancy (760-776).......... 2,067 40.1 1,406 48.0 5
6 Influenza and pneumonia (480-493).......... 1,260 24.4 927 31.7 6
7 General arteriosclerosis (450) ............... 847 16.4 487 16.6 8
8 Diabetes mellitus (260)..................... 760 14.7 374 12.8 10
9 Other diseases of the circulatory system
(451-468)................................ 717 13.9 181 6.2 18
10 Suicide (963, 970-979)...................... 668 13.0 330 11.3 11
20 Tuberculosis-all forms (001-019) ........... 221 4.3 518 17.7 7
16 Chronic and unspecified nephritis and other
renal sclerosis (592-594) ................... 324 6.3 461 15.8 9

*Based on preliminary mortality data and provisional population estimates.

TABLE 11
RESIDENT DEATHS AND DEATH RATES BY CAUSE, BY RACE, FLORIDA, 1961 (PRELIMINARY)

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

DEATHS
Total White Nonwhite

Rate per 100,000 Population UI
Total ---White Nonhite
Total White Nonwhite

TOTAL DEATHS..................................................... ............. 49,110 40,050 9,060 9.5* 9.5* 9.8*

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)................... ......... .....................
Measles (085)... .........................................................
Typhus and other rickettsial diseases (100-108)............ .........................
All other diseases classified as infective and parasitic (030-138) 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) ..................................................
Diseases of the heart (400-443)......................... ........... ..................
Rheumatic fever (400-402) ........................................................
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 (480-434) .....................................................
Hypertension without heart disease (444-447) .........................................
General arteriosclerosis (450)........ ....................... .....................
Other circulatory disease (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, 572)........
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).........................................

Infant mortality (deaths under one year of age)........................................

204
17
126
0
5
1
17
1
26
10
0
169
8,274
760
99
25,670
5,705
17,708
10
468
13,746
1,141
1,504
839
369
847
717
324
51
1,209
312
254
336
600
49
58
617
909
161
997
819
3,315
1,249
1,654
668
473

187
9
59
0
0
11
1
19
9
0
113
7,217
584
67
21,899
4,593
15,524
5
428
12,497
943
976
675
226
743
607
206
24
826
268
199
174
539
23
19
469
578
66
663
485
2,646
978
1,179
634
152

67
8
67
0
2
1
6
0
7
1
0
56
1,057
176
82
3,771
1,112
2,184
5
40
1,249
198
528
164
143
104
110
118
27
883
44
55
162
61
26
39
148
831
95
334
334
669
271
475
34
321

4.0
0.3
2.4
0.1
0.0
0.8
0.0
0.5
0.2
8.3
160.4
14.7
1.9
497.7
110.6
343.3
0.2
9.1
266.5
22.1
29.2
16.3
7.2
16.4
13.9
6.3
1.0
23.4
6.0
4.9
6.5
11.6
0.9
5.0**
12.0
17.6
3.1
19.3
15.9
64.3
24.2
32.1
13.0
9.2

3,415 2,003 1,412 29.2***

8.2
0.2
1.4
0.1
0.3
0.0
0.4
0.2
2.7
170.4
13.8
1.6
517.0
108.4
366.5
0.1
10.1
295.0
22.3
23.0
15.9
5.3
17.5
14.3
4.9
0.6
19.5
6.3
4.7
4.1
12.7
0.5
2.2**
11.1
13.6
1.6
15.7
11.4
62.5
23.1
27.8
15.0
3.6
23.3***

7.3
0.9
7.3
0.2
0.1
0.7
0.8
0.1
.....id... 0
6.1
114.6
19.1
8.5 I
408.9
120.6
236.8
0.5
4.3
135.4
21.5 -
57.3
17.8
15.5 -i
11.3
11.9 %O
12.8 o
2.9
41.5 1-
4.8
6.0
17.6
6.6
2.8
12.6**
16.0
35.9
10.3
36.2
36.2
72.5
29.4
51.5
3.7
34.8
45.8***

*Rate per 1,000 population. **Rate per 10,000 live births. ***Rate per 1,000 live births.

*Rate per 1,000 population.

***Rate per 1,000 live births.

**Rate per 10,000 live births.

I I I I I I

II I I

I

I

I

I

RESIDENT DEATHS AND DEATH RATES B S Y RACE, FLORIDA, 1960 (FINAL FIGURES)

CAUSE OF DEATH DEATHS Rate per 100,000 Population
(Numbers in parentheses refer to the International List of Causes of Death) Total White Nonwhite Total White Nonwhite
TOTALIDEATHS ............................................... .............. 47,937 38,837 9,100 9.6 94* 10.2

Tuberculosis ottrespiratory system (001-008)...............................................
Tuberculosis,'other forms (010-019).............. .................................
Syphilis andlts sequelae (020-029) .................. ................................
Typhoid fever (040).... .. ..... ...........................................
Dysentery, all forms (045-048) ........................................................
Scarlet fever and strep. sore throat (050,051) ............................................
Diphtheria (055) ................................................................
Whooping cough (056) ........................................ .......... .........
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 (030-138) with exception of above causes....
Malignant neoplasms, including neoplasms of lymphatic and haematopoietic tissues (140-205)....
Benign and unspecified neoplasms (210-239)..........................................
Diabetes mellitus (260) ......................................... ... ................
Anemias (290-293) ...................................................... ..........
Major cardiovascular-renal disease.....................................................
Cerebral vascular disease (330-334) ...................................................
Diseases of the heart ..... ..... ..... ...... ...................
Rheumatic fever (400-402)..................................................
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 disease (451-468) ................................................
Chronic and unspecified nephritis (592-594) ...........................................
Influenza (480-483) .................................. .............................
Pneumonia (490-493)...................... ........................ .............. ..
Bronchitis (500-502) ................................................
Ulcer of stomach and duodenum (540, 541)...............................................
Appendicitis (550-553) ................... ............................... ..........
Intestinal obstruction and hernia (560, 561, 570) .................................. .......
Gastritis, duodenitis, enteritis and colitis, except diarrhea of the newborn (543, 571, 572) .......
Cirrhosis of liver (581).. ............... ......................................
Acute nephritis and nephrosis (590, 591) ...... ......................................
Hyperplasia of prostate (610) ... ........... ........... .............. .. ..
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 (810-885) ......................................................
All other accidents (800-802, 840-962) .............................
Suicide and self-inflicted injury (963, 970-979) ...........................................
Homicide and operations of war (964, 965, 980-999) ......................................

Infant mortality (deaths under one year of age) ........................... ..........

187
18
88
1
5
2
3
4
18
5
16
3
0
182
7,789
144
741
107
24,733
5,535
17,106
9
502
12,986
1,289
1,584
836
359
745
669
319
185
1,454
104
313
60
250
820
579
67
130
58
571
939
163
970
936
2,685
1,235
1,640
672
452

119
8
42
0
2
2
1
0
11
3
12
8
0
119
6,769
111
562
57
21,043
4,462
14,894
6
447
11,751
1,044
990
656
251
650
583
203
109
976
88
283
45
218
160
511
44
102
17
434
592
75
620
541
2,152
962
1,204
637
149

68
10
46
1
3
0
2
4
7
2
4
0
0
63
1,020
33
179
50
8,690
1,073
2,212
8
55
1,185
195
594
180
108
95
86
116
76
478
16
30
15
37
160
68
23
28
41
137
347
88
850
395
533
273
436
85
303

8.7
0.4
1.8
0.0
0.1
0.0
0.1
0.1
0.4
0.1
0.3
0.1
8.6
155.4
2.9
14.8
2.1
493.5
110.4
341.3
0.2
10.0
258.1
24.7
81.6
16.7
7.2
14.9
18.3
6.4
8.7
29.0
2.1
6.2
1.2
5.0
6.4
11.6
1.3
2.6
5.0**
11.4
18.7
3.3
19.4
18.7
53.6
24.6
32.7
13.4
9.0

2.9
0.2
1.0
0.0.
0.0
0.0
0.0
0.0
0.3
0.1
0.3
0.1
2.9
164.4
2.7
13.7
1.4
511.2
108.4
861.8
0.1
10.9
285.5
25.4
24.1
15.9
6.1
15.8
14.2
4.9
2.6
23.7
2.1
6.9
1.1
5.2
3.9
12.4
1.1
2.5
2.0**
10.5
14.4
1.8
15.1
13.1
52.3
23.4
29.2
15.5
3.6

7.6
1.1
5.1
0.1
0.3
0.2
0.4
0.8
0.2
0.4

7.0
113.9
8.7
20.0
5.6
412.0
119.8
247.0
0.3 --
6.1
132.3
21.8
66.3
20.1 -
12.1
10.6
9.6
13.0 -3
8.5
53.4
1.8
3.3 '
1.7 4
4.1
17.9
7.6 -
2.6
3.1
13.1** 0
15.3 ri
38.7
9.8
39.1
44.1
59.5
30.5
48.7 0
8.9
33.8

1.439 29.7*** 2.R.R*** AR1***

5Rate per 1.000 population. *5Rate per 10,000 live births. 55515.ate per 1,000 live births.

*Rate per 1,000 population.

***Rate per 1,000 live births.

**Rate per 10,000 live births.

9

I

a

I

1 __^_ ( ____ I_

I

I

I

60 ANNUAL REPORT, 1961

TABLE 12

ESTIMATED POPULATION, 1961, AND PRELIMINARY

TOTALS OF BIRTHS, DEATHS, AND INFANT DEATHS,

BY RACE, BY COUNTY, FLORIDA, 1961

Population BIRTHS DEATHS INFANT DEATHS
COUNTY 1961 -
Prov. Est. Non- Non- Non-
Total White white Total White white Total White white
STATE........ 5,158,100 116,886 86,033 30,853 49,110 40,050 9,060 3,415 2,003 1,412
Alachua....... 79,700 2,239 1,521 718 606 364 242 53 21 32
Baker......... 7,200 208 149 59 67 46 21 8 6 2
Bay........... 66,00 2,065 1,708 37 425 355 70 46 3 13
Bradford..... 12,800 318 229 89 133 99 34 10 6 4
Brevard ....... 119,600 3,472 2,950 522 697 599 98 100 79 21
Broward....... 367,600 7,702 5,293 2,409 3,177 2,690 487 233 114 119
Calhoun ....... 7,000 149 121 28 79 66 18 6 5 1
Charlotte ..... 16,400 240 222 18 224 212 12 9 8 1
Citrus......... 11,000 190 131 59 121 103 18 4 3 1
Clay......... 21,400 514 425 89 175 188 37 12 11 1
Coler........ 18,700 448 354 94 157 123 34 16 12 4
Columbia.... 19,600 495 316 180 220 139 81 25 14 11
Dade ......... 968,700 19,645 14,469 5,076 8,759 7,656 1,103 482 312 170
DeSoto....... 13,800 304 215 89 116 82 34 10 6 4
Dixie.......... 4,700 113 89 24 47 38 9 4 1 3
Duval......... 460,900 12,866 9,325 3,541 3,805 2,650 1,155 336 192 144
Escambia...... 180,400 5,324 3,946 1,378 1,257 908 349 133 75 58
Flagler........ 4,600 108 33 75 43 18 25 5 1 4
Franklin....... 7,000 169 127 42 87 72 15 4 3 1
Gadsden....... 41,300 1,123 238 885 363 122 241 69 9 60
Gilchrist....... 2,700 67 0 17 2 23 9 2 0 2
Glades......... 3,000 59 35 24 24 18 6 1 1 0
Gulf........... 11,000 288 192 96 77 48 29 9 8 6
Hamilton ...... 7,900 224 97 127 85 47 38 9 5 4
Hardee ........ 12,500 294 241 53 114 104 10 7 5 2
Hendry........ 9,100 252 158 94 81 41 40 15 5 10
Hernando...... 12,400 328 223 105 140 113 27 11 6 5
Highlands ...... 22,600 40 345 195 254 190 64 28 13 15
Hillsborough... 402,100 9,460 7,651 1,809 3,940 3,252 688 304 199 105
Holmes........ 10,700 163 149 14 124 113 11 5 4 1
Indian River... 26,100 633 420 213 272 226 46 14 8 6
Jackson........ 35,400 686 407 279 301 204 97 28 15 13
Jefferson...... 9,600 265 70 195 96 41 55 10 1 9
Lafayette...... 3,100 46 28 18 35 30 5 2 1 1
Lake.......... 57,500 1,180 824 356 733 599 134 50 25 25
Lee........... 63,000 1,343 991 352 601 480 121 41 27 14
Leon.......... 74,400 1,878 1,193 685 549 292 257 64 25 39
Levy.......... 11,200 239 112 127 125 83 42 11 5 6
Liberty....... 3,100 85 67 18 36 29 7 2 2 0
Madison ...... 15,600 357 148 209 153 88 65 17 6 11
Manatee....... 74,500 1,243 885 358 917 813 104 49 31 18
Marion ........ 53,200 1,256 716 540 580 347 233 36 15 21
Martin ........ 19,100 406 241 165 202 161 41 19 7 12
Monroe........ 47,300 1,308 1,180 128 344 299 45 85 29 6
Nassau ........ 18,000 484 344 140 160 105 55 20 14 6
Okaloosa....... 67,600 2,076 1,885 191 310 271 39 60 50 10
Okeechobee .... 8,100 219 179 40 73 51 22 6 5 1
Orange........ 275,400 6,935 5,559 1,376 2,251 1,874 377 181 125 56
Osceola........ 19,500 344 275 69 800 272 28 11 9 2
Palm Beach.... 236,300 5,023 3,344 1,679 2,404 1,899 505 192 90 102
Pasco ......... 37,400 673 679 94 496 457 39 25 19 6
Pinellas........ 392,000 5,799 4,623 1,176 5,636 5,846 290 156 112 44
Polk.......... 201,500 4,588 3,452 1,136 1,737 1,409 328 130 79 51
Putnam ....... 32,300 870 519 351 366 212 154 31 7 24
St. Johns...... 30,900 681 431 250 354 252 102 17 7 10
St. Lucie....... 43,900 975 544 431 462 324 138 53 20 33
Santa Rosa.... 28,900 1,044 969 75 182 150 32 24 18 6
Sarasota....... 82,300 1,334 1,061 273 912 826 86 32 20 12
Seminole....... 61,100 1,540 1,104 436 479 321 158 39 16 23
Sumter........ 11,500 255 157 98 125 86 39 9 3 6
Suwannee...... 14,900 345 210 135 181 113 68 12 4 8
Taylor ........ 12,900 352 249 103 130 87 43 4 4 0
Union ......... 6,200 117 77 40 57 48 9 0 0 0
Volusia........ 129,900 2,407 1,735 672 1,793 1,569 224 62 43 19
Wakulla....... 5,800 112 75 37 49 29 20 2 1 1
Walton........ 14,700 292 232 60 150 126 24 8 4 4
Washington.... 11,600 229 147 82 130 102 28 7 4 3

VITAL STATISTICS 61

TABLE 12A

ESTIMATED POPULATION WITH RESIDENT BIRTH AND DEATH

RATES PER 1000 POPULATION AND RESIDENT INFANT DEATH

RATES PER 1000 LIVE BIRTHS, BY RACE, BY COUNTY, 1960

(FINAL FIGURES)

Midyear BIRTH RATE DEATH RATE INFANT DEATH RATE
COUNTY Populaton
Estimate Non- Non- Non-
1960 Total White white Total White white Total White white

STATE........ 5,012,100 23.1 20.5 84.8 9.6 9.4 10.2 29.7 23.6 46.1

Alachuat .....
Baker ........
Bay..........
Bradford.......
Brevard ......
Broward......
Calhoun......
Charlotte.....
Citrus.........
Clay. ...... .
Collier.... .....
Columbia......
Dade..........
DeSotot.......
Dixie..........
Duval. ........
Escambia......
Flagler .......
Franklin......
Gadsdent......
Gilchrist ......
Glades.........
Gulf .........
Hamilton .....
Hardee .......
Hendry .......
Hernando......
Highlands......
Hillsborough...
Holmes........
Indian River...
Jackson........
Jefferson.......
Lafayette......
Lake..........
Lee. ..........
Leont. ........
Levy..........
Liberty .......
Madison.......
Manatee ......
Marion........
Martin ........
Monroe .......
Nassau .......
Okaloosa.......
Okeechobee....
Orange........
Osceola........
Palm Beach....
Pasco ....... .
Pinellas........
Polk ........ .
Putnam .... ..
St. Johns......
St. Lucie.......
Santa Rosa....
Sarasota .......
Seminole.......
Sumter ........
Suwannee ......
Taylor ........
Uniont........
Volusia........
Wakulla .......
Walton........
Washington ...

74,500
7,400
67,800
12,500
113,600
342,700
7,400
12,800
9,300
19,700
16,000
20,100
947,900
11,700
4,500
459,200
175,400
4,600
6,600
42,100
2,800
3,000
10,000
7,700
12,400
8,200
11,300
21,500
401,500
10,800
25,600
36,200
9,500
2,900
57,900
55,300
74,900
10,400
3,100
14,200
70,000
51,900
17,200
48,400
17,300
61,800
6,500
267,300
19,200
231,700
37,200
380,000
196,900
32,400
30,200
39,800
29,800
78,100
55,600
11,900
14,900
13,200
7,100
126,600
5,300
15,600
11,200

33.0
26.9
31.2
23.9
30.2
21.8
22.4
16.8
15.5
24.7
24.8
23.5
20.7
23.5
32.7
27.2
30.9
26.7
25.5
32.7
25.4
22.7
27.4
25.1
22.0
23.2
27.0
26.4
23.7
17.9
23.9
21.9
28.3
17.9
22.7
21.6
30.0
22.8
24.5
22.7
16.7
22.5
22.9
26.2
25.9
35.1
28.0
26.2
19.2
20.8
17.3
15.2
23.0
26.7
21.8
25.2
33.4
17.6
26.7
22.1
21.9
22.3
22.3
18.2
21.9
18.8
22.7

31.6
22.8
29.8
21.8
28.6
17.9
22.1
16.3
12.3
24.4
22.6
20.4
17.8
21.1
32.1
25.6
28.7
20.0
25.8
19.9
23.6
25.9
25.1
18.1
19.8
19.0
22.9
22.4
22.3
17.8
19.7
19.2
19.2
16.0
19.9
18.9
26.6
15.1
21.1
18.0
14.0
17.8
18.5
26.0
24.8
34.4
27.8
24.5
17.4
17.6
16.1
13.2
20.7
23.0
19.5
20.1
33.1
15.4
25.3
17.5
20.0
22.0
19.4
15.7
17.4
17.9
18.4

86.0
41.9
39.1
31.0
42.6
42.0
24.2
25.7
28.8
27.4
36.4
30.7
37.6
30.8
35.7
32.5
39.2
37.2
24.3
40.4
40.0
18.5
34.6
33.8
44.5
34.5
42.1
41.6
32.7
20.0
39.8
27.9
84.6
30.0
34.5
35.9
36.7
40.0
47.5
27.8
31.9
31.2
40.0
28.2
29.1
44.4
29.1
35.4
34.5
31.6
26.8
36.0
32.9
35.1
28.1
35.5
36.4
38.1
31.1
85.2
27.3
23.4
32.0
30.9
33.3
24.8
41.4

9.0
9.7
6.9
9.8
5.9
8.6
8.6
12.3
15.1
7.2
7.8
10.9
8.8
10.9
11.6
8.5
7.1
10.0
11.8
9.8
11.8
7.7
8.0
10.3
11.3
9.1
11.9
12.1
9.9
10.8
10.6
8.9
12.4
12.8
11.8
10.5
8.0
11.5
14.8
10.2
13.7
10.2
10.8
7.2
9.4
4.3
8.2
8.1
18.1
10.1
13.4
15.1
8.9
10.3
11.5
9.3
7.2
11.2
8.2
10.8
11.7
10.2
11.8
12.8
8.1
10.7
10.6

8.0
10.7
6.6
9.3
5.6
8.6
8.1
12.4
14.5
6.7
6.8
10.0
9.0
10.3
9.5
7.5
6.4
9.3
9.2
8.2
9.6
6.5
7.5
11.2
11.0
7.3
12.0
11.9
9.4
11.0
11.5
8.0
9.2
12.4
12.3
10.5
6.3
10.3
14.1
10.0
14.3
9.7
11.1
6.7
8.6
4.0
7.0
8.0
18.9
10.0
13.7
15.5
8.9
10.0
10.8
9.9
6.7
11.2
7.4
10.3
11.5
7.8
10.0
13.2
8.2
9.7
10.7

*Based on less than 100 live births, which limits the significance of the rate.
tRates based on population excluding large institutional segments.

11.2
6.2
8.8
11.4
9.0
8.5
11.7
10.0
16.5
10.0
18.2
13.0
7.6
12.8
22.9
11.9
9.6
11.1
21.4
10.8
30.0
9.2
9.6
9.1
14.5
14.1
11.7
12.7
12.5
8.0
7.4
10.7
14.6
15.0
10.0
10.7
11.2
14.4
20.0
10.4
10.1
11.2
9.7
11.8
11.6
7.7
13.6
8.7
11.0
10.4
11.0
10.3
9.1
10.9
13.5
8.1
13.6
11.6
10.9
12.3
12.3
17.5
18.0
10.9
8.0
17.1
10.5

24.5
30.2
28.9
43.5
27.1
33.6
36.1
27.9
48.6
80.9
32.8
42.4
27.6
42.6
68.0
30.9
29.9
40.7
6.0
65.0
28.2*
58.8*
25.5
41.5
47.6
36.8
45.9
45.8
28.9
25.9
24.5
34.1
44.6
76.9*
35.0
37.8
30.1
29.5
39.5*
21.7
21.4
24.9
27.9
30.7
33.5
20.3
27.5
23.2
35.8
31.3
31.1
27.7
28.7
27.7
37.9
25.0
26.2
21.8
31.0
26.6
33.6
50.8
20.4*
29.5
17.2
54.4
39.4

18.2
30.3
23.8
23.9
22.9
27.4
29.2
30.5
10.5*
26.7
16.4
31.6
23.0
31.6
41.0
24.7
24.9
35.7*
7.5
30.0
16.9*
45.5*
26.2
64.1*
35.7
17.5
29.4
36.7
23.8
27.3
20.2
25.1
26.7*
75.0*
25.9
31.8
19.3
27.5
17.5*
22.6
18.1
25.0
27.6
29.3
24.8
18.7
20.0
19.4
26.8
21.2
20.6
21.2
25.3
15.5
21.1
22.2
21.9
16.6
25.4
26.0
27.5
40.9
15.2*
25.5
0*
49.6
35.9

36.1
29.9*
53.2
88.9*
49.9
46.9
69.0*
0*
122.4*
54.1*
87.9*
58.8
40.1
64.9*
200.0*
47.2
43.8
44.8*
0*
75.4
83.3*
83.3*
24.1*
26.1
102.0*
65.8*
79.2
64.2
50.0
0*
32.6
47.9
51.5
83.3*
57.0
54.5
45.6
31.2
105.3*
21.2
29.6
24.8
28.6
42.6
56.0
36.6
62.5*
38.2
72.5*
50.4
81.8
52.2
38.4
45.6
68.7
28.1
75.0*
42.0
44.9
27.5
45.9
80.0*
31.2*
39.5
40.0*
76.9*
46.0*

62 ANNUAL REPORT, 1961

TABLE 13

PRELIMINARY TOTALS OF RESIDENT DEATHS FROM
CERTAIN CAUSES, BY COUNTY, FLORIDA, 1961

Cardio-Vascular-Renol
Diseases
4,

COUNTIES |z

STATE.............. 58 221 126 5 1 8,274 760 99 1,260 5,705 17,708 324 1,933 1,249 1,654
Alachua. ... .. 0 3 0 0 0 85 6 3 23 65 193 4 27 14 31
Baker............ 1 1 0 0 10 1 0 4 7 15 1 4 1 2
Bay............... 2 2 0 0 84 5 0 2 44 129 6 12 22 19
Bradford ........... 1 1 0 0 17 1 1 1 16 49 0 8 6
Brevard............. 2 4 1 0 0 102 11 1 13 65 225 1 23 42 33
Broward............ 2 1 7 0 0 581 40 9 70 303 1,214 19 117 92 95
Calhoun............. 0 0 0 0 13 2 0 2 12 20 0 2 4 8
Charlotte .. .. 0 1 0 0 0 45 4 1 1 0 87 2 6 2 8
Citrus............. 1 0 0 0 27 1 0 1 13 43 0 8 1 10
Clay....... ..... 0 0 0 0 31 4 0 3 17 60 0 11 3 8
Collier................. 2 1 0 0 25 6 0 6 15 34 3 5 7 7
Columbia............ 3 2 0 0 28 5 1 9 35 66 1 6 14 6
Dade................ 9 2 23 0 0 1,62 136 20 215 853 3,270 48 30 173 243
DeSoto.............. 1 1 1 0 0 18 2 1 2 9 43 2 4 5 3
Dixie ............... 0 1 0 0 6 2 1 4 6 12 0 2 3 1
Duval............... 11 26 11 1 0 579 60 5 92 445 1,269 28 152 128 141
Escambia ... ... 6 1 0 0 0 186 11 3 37 130 463 9 46 48 58
Flagler............... 0 0 0 0 4 2 0 3 6 8 1 1 0 4
Franklin ............ 0 0 0 0 12 1 0 11 30 0 3 3 8
Gadsden............ 3 1 0 0 0 44 4 0 14 61 94 6 12 7 17
Gilchrist............ 0 0 0 0 0 3 2 0 2 6 4 0 1 0 4
Glades............ 1 0 0 0 4 1 0 1 3 7 0 1 1 1
Gulf. ............... 0 1 0 0 9 2 2 1 7 27 1 4 3 7
Hamilton ............ 0 0 0 0 10 0 0 5 8 36 1 0 1 7
Hardee...... .... 0 0 0 0 14 2 0 4 12 41 0 7 6 6
Hendry.............. 0 0 0 0 11 0 0 3 7 24 0 0 8 4
Hernando............ 0 0 0 0 0 24 2 0 6 9 42 0 11 6 5
Highlands.............. 4 1 0 0 45 5 1 6 28 77 1 6 10 17
Hillsborough ......... 5 29 11 0 1 629 78 14 98 464 1,354 23 16 66 135
Holmes .............. 1 0 0 1 0 17 0 0 21 55 0 4 3 3
Indian River ........ 0 1 0 0 48 4 0 6 24 97 1 11 10 12
Jackson ............. 0 1 0 0 0 39 8 0 5 48 97 2 11 12 17
Jefferson ............ 1 1 1 0 0 14 1 0 6 14 25 0 2 4 4
Lafayette........... 2 0 0 0 0 0 0 6 12 0 2 1 1
Lake ............... 0 4 0 0 0 110 15 2 16 85 280 4 6 16 32
Lee .................. 2 2 1 0 0 103 13 2 13 80 191 3 25 12 21
Leon................ 0 2 0 0 0 89 9 0 15 87 145 5 19 12 25
Levy ................. 0 0 0 0 17 0 0 9 12 38 1 4 4 5
Liberty.................. 0 0 0 0 4 0 0 0 3 16 0 1 1 2
Madison ............ 1 0 0 1 0 20 5 0 3 12 63 1 5 3 6
Manatee ............. 6 2 1 0 149 22 3 29 114 386 8 25 17 14
Marion.............. 3 1 1 0 0 88 8 1 16 86 185 7 26 23 15
Martin ............. 2 1 0 0 33 0 3 23 65 1 8 3 9
Monroe............. 0 3 0 0 0 58 7 0 8 41 100 2 7 9 18
Nassau ............. 1 1 0 0 0 25 2 1 3 11 49 1 4 9 16
Okaloosa............. 0 0 0 1 0 35 1 0 12 32 86 5 4 12 21
Okeechobee .......... 0 0 0 0 0 7 4 0 5 6 17 0 4 7 7
Orange............. 0 10 7 0 0 405 24 5 80 256 814 19 9 67 68
Osceola ............. 0 1 0 0 0 36 5 1 6 45 113 2 15 12 8
Palm Beach......... 10 7 0 0 415 35 2 68 313 842 14 82 68 86
Pasco ............... 0 2 1 0 0 73 11 0 7 69 190 2 20 11 13
Pinellas ............. 3 14 13 0 0 1,078 66 9 115 777 2,292 26 279 69 110
Polk................. 1 4 4 0 0 274 35 1 48 236 608 7 75 55 62
Putnam.............. 2 0 1 0 0 45 10 0 10 31 127 16 11 15 16
St.Johns............ 2 3 1 0 0 64 5 2 3 41 120 5 26 4 6
St. Lucie............. 0 3 5 0 0 64 6 0 23 54 156 18 11 17
Santa Rosa........... 0 0 1 0 0 15 5 1 5 18 69 6 10 8 9
Sarasota ............ 0 4 2 0 0 165 7 3 17 101 391 7 45 18 27
Seminole ............ 1 4 3 0 0 86 8 0 17 48 158 5 14 13 26
Sumter............. 0 0 1 0 0 17 5 0 3 14 41 0 1 7 6
Suwannee............ 0 0 1 0 0 16 4 0 8 31 66 1 2 7
Taylor.............. 0 1 1 0 0 19 0 4 18 43 3 6 4 10
Union .............. 0 2 1 0 0 4 1 0 0 9 26 0 2 3 0
Volusia .............. 0 11 5 0 0 20 24 2 51 199 714 6 95 37 46
Wakulla ........... 1 0 0 0 0 6 1 0 1 11 12 1 3 2
Walton .............. 0 1 1 0 0 17 8 0 7 19 50 2 3 5 4
Washington .......... 0 0 0 0 0 19 4 1 4 23 33 1 6 1 9

*Includes all vascular lesions affecting the central nervous system.

VITAL STATISTICS 63

TABLE 14

MARRIAGES BY RACE, DIVORCES AND ANNULMENTS
FOR FLORIDA, AND EACH COUNTY, 1961

MARRIAGES
COUNTY DIVORCES ANNUL-
MENTS
Total White Nonwhite
STATE ................... 40,934 84,080 6,854 21,492 190
Alachua................... 513 342 171 170 3
Baker..................... 74 58 16 94 0
Bay...................... 505 411 94 307 2
Bradford................... 90 74 16 46 2
Brevard .................. 857 755 102 680 4
Broward .................. 2,869 2,362 507 1,281 6
Calhoun .................. 88 36 2 52 0
Charlotte.................. 128 119 9 76 3
Citrus..................... 109 90 19 58 0
Clay...................... 144 125 19 74 1
Collier..................... 214 193 21 58 0
Columbia .................. 182 133 49 85 0
Dade................... 8,549 7,374 1,175 4,852 57
DeSoto.................... 125 101 24 42 1
Dixie ...................... 42 38 4 9 0
Duval..................... 2,909 2,304 605 1,887 18
Escambia.................. 1,530 1,209 321 847 5
Flagler.................... 60 41 19 146 3
Franklin................... 57 41 16 19 0
Gadsden................... 191 94 97 78 0
Gilchrist .................. 56 47 9 9 0
Glades..................... 83 27 6 6 0
Gulf....................... 76 57 19 34 0
Hamilton ................. 67 46 21 31 0
Hardee..................... 168 151 17 262 5
Hendry................... 147 116 31 60 0
Hernando ................. 158 139 19 47 1
Highlands ................. 203 161 42 73 2
Hillsborough ............... 3,433 2,932 501 1,824 3
Holmes .................... 113 109 4 56 0
Indian River ............... 230 178 52 73 3
Jackson.................... 181 136 45 74 2
Jefferson ................... 53 25 28 27 0
Lafayette .................. 30 25 5 3 0
Lake...................... 478 385 93 680 2
Lee ...................... 474 403 71 214 1
Leon...................... 481 327 154 215 0
Levy...................... 85 62 23 35 0
Liberty.................... 12 12 0 10 0
Madison ..... ........... 73 59 14 24 0
Manatee ................... 615 516 99 201 2
Marion.................... 430 289 141 113 2
Martin ................... 145 111 34 64 2
Monroe ................... 479 442 87 280 1
Nassau.................... 83 64 19 48 0
Okaloosa................... 326 298 28 289 2
Okeechobee................ 74 64 10 33 0
Orange .................... 2,183 1,848 335 516 8
Osceola.................... 215 178 37 74 0
Palm Beach ............... 1,889 1,525 864 790 5
Pasco...................... 884 353 31 143 0
Pinellas.................... 2,818 2,542 276 1,301 15
Polk ...................... 1,832 1,529 303 834 13
Putnam................... 228 150 78 436 2
St. Johns ................. 271 210 61 241 4
St. Lucie .................. 343 244 99 147 0
Santa Rosa ................. 206 189 17 83 1
Sarasota................... 653 596 57 295 2
Seminole ................... 380 300 80 221 2
Sumter .................... 149 113 36 107 0
Suwannee.................. 149 107 42 37 1
Taylor..................... 101 75 26 18 0
Union..................... 38 28 10 22 0
Volusia .................... 978 822 156 494 4
Wakulla.................. 49 40 9 0 0
Walton .................... 91 77 14 51 0
Washington................ 88 73 15 36 0

64 ANNUAL REPORT, 1961

TABLE 15

VITAL STATISTICS SCOREBOARD
BASED ON PROMPTNESS AND COMPLETENESS OF
CERTIFICATES FILED IN 1961

Percent of Percent of Percent of
Certificates Complete Monthly Total Score Change
COUNTY Rank Filed on Time Certificates Reports (Maximum from 1960
Submitted = 500) Total Score
Births Deaths Births Deaths on Time
STATE......... ...... 94.8 97.6 99.6 99.5 93.0 484.5 + 0.8
Jax-Duval...... 1 99.9 100.0 99.9 99.8 100.0 499.6 + 0.2
Broward........ 2 99.1 99.9 99.7 99.7 100.0 498.4 + 1.2
Dade........... 8 98.0 100.0 99.9 99.9 100.0 497.8 1.0
Orange.......... 4 98.9 98.7 99.9 99.8 100.0 497.3 0.8
Hillsborough ... 5 97.9 99.6 99.9 99.9 100.0 497.3 1.0
Citrus......... 6 98.6 100.0 98.6 99.1 100.0 496.3 1.3
Jefferson ........ 7 99.5 97.1 98.6 100.0 100.0 495.2 2.4
Pinellas........ 8 96.4 98.8 99.9 99.8 100.0 494.9 +11.2
Escambia ...... 9 96.9 97.9 99.8 99.9 100.0 494.5 + 2.5
Alachua......... 10 95.9 98.8 99.9 99.8 100.0 494.4 +10.1
Seminole........ 11 99.5 99.2 98.0 97.2 100.0 493.9 + 2.1
Madison........ 12 97.3 99.2 98.1 99.2 100.0 493.8 +26.7
Martin....... 13 96.5 99.4 100.0 96.8 100.0 492.7 3.3
Baker.......... 14 99.5 97.1 98.9 95.7 100.0 491.2 + 2.6
Clay .......... 15 94.0 97.0 99.4 94.4 100.0 489.8 +24.2
Palm Beach.... 16 91.5 98.0 99.7 99.4 100.0 488.6 0.4
Washington.... 17 98.8 91.5 100.0 98.1 100.0 488.4 + 2.5
Volusia......... 18 99.1 98.4 99.7 99.4 91.7 488.3 7.2
Hernando...... 19 91.0 99.8 99.5 97.9 100.0 487.7 2.3
Lee............ 20 89.3 99.5 99.2 99.3 100.0 487.3 +17.0
Suwannee....... 21 95.2 100.0 100.0 100.0 91.7 486.9 8.9
St. Johns........ 22 97.7 97.4 99.8 97.4 91.7 484.0 +22.6
Charlotte....... 23 94.5 96.5 97.3 95.5 100.0 483.8 + 2.0
DeSoto......... 24 98.4 93.2 99.5 98.9 91.7 481.7 +15.0
Sarasota ........ 25 99.4 99.8 99.6 99.1 83.3 481.2 -16.2
Levy .......... 26 94.4 89.2 99.4 98.0 100.0 481.0 0
Gulf............ 27 94.1 89.7 96.7 100.0 100.0 480.5 4.9
Polk........... 28 98.6 98.5 99.6 99.5 83.3 479.5 -16.0
St. Lucie........ 29 86.6 92.8 99.2 99.8 100.0 477.9 -17.2
Bay............ 30 88.8 90.1 99.6 98.6 100.0 477.1 +23.6
Manatee........ 31 87.5 99.0 99.2 99.2 91.7 476.6 4.2
Indian River... 32 98.4 97.7 98.2 98.4 83.3 476.0 -16.7
Hendry........ 33 85.4 93.5 99.0 97.4 100.0 475.3 + 8.3
Glades......... 34 100.0 100.0 100.0 100.0 75.0 475.0 0
Lafayette....... 35 82.4 100.0 100.0 100.0 91.7 474.1 +42.9
Wakulla........ 36 93.3 87.5 93.3 100.0 100.0 474.1 -25.9
Brevard......... 37 87.7 88.5 99.6 98.2 100.0 474.0 +23.3
Walton......... 38 91.4 90.8 99.6 100.0 91.7 473.5 +19.3
Taylor......... 9 87.5 97.3 98.6 98.2 91.7 473.3 -12.1
Okaloosa........ 40 88.7 85.7 99.2 99.3 100.0 472.9 +15.1
Franklin........ 41 95.9 94.0 100.0 98.8 83.3 472.0 -19.4
Bradford....... 42 98.3 98.5 99.4 100.0 75.0 471.2 +45 6
Putnam......... 43 92.3 89.7 98.7 98.5 91.7 470.9 -10.5
Lake .......... 44 86.9 87.2 98.6 97.9 100.0 470.6 +10.3
Holmes......... 45 97.8 88.5 98.9 100.0 83.3 468.5 -13.9
Pasco.......... 46 84.8 94.1 97.2 98.6 91.7 466.4 +13.7
Flagler......... 47 96.4 94.4 100.0 100.0 75.0 465.8 + 0.8
Hardee......... 48 92.8 98.9 98.2 100.0 75.0 464.9 + 9.4
Hamilton....... 49 85.6 76.7 98.5 100.0 100.0 460.8 + 5.3
Gadsden........ 50 76.9 93.2 99.2 98.4 91.7 459.4 -13.7
Dixie........... 51 70.0 88.5 100.0 100.0 100.0 458.5 2.9
Calhoun........ 52 68.8 89.1 99.3 100.0 100.0 457.2 + 8.1
Monroe......... 53 82.5 91.3 99.2 98.5 83.3 454.8 -15.9
Osceola........ 54 67.4 98.5 98.2 98.9 91.7 454.7 9.4
Sumter ........55 8.3 78.9 97.8 98.7 91.7 452.4 +10.5
Union.......... 56 70.5 82.5 96.7 100.0 100.0 449.7 + 5.4
Highlands...... 57 61.0 96.3 99.2 99.6 91.7 447.8 -24.7
Marion........ 58 70.5 95.1 99.2 99.3 83.3 447.4 -14.9
Leon .......... 59 84.7 89.5 99.2 98.4 75.0 446.8 -29.1
Jackson......... 60 81.4 75.1 99.3 98.7 91.7 446.2 2.0
Santa Rosa...... 61 74.5 81.9 98.0 98.0 91.7 444.1 -12.3
Okeechobee...... 62 64.6 81.4 99.4 94.9 100.0 440.3 6.9
Collier .......... 63 74.3 89.1 99.0 97.0 75.0 434.4 +55.0
Gilchrist........ 64 87.5 61.1 100.0 100.0 83.0 431.9 -35.1
Nassau......... 65 60.8 74.2 99.7 96.9 100.0 431.6 4.7
Columbia....... 66 74.2 86.9 98.9 98.4 66.7 425.1 -40.7
Liberty......... 67 62.5 72.2 75.0 100.0 83.3 393.0 -40.3

BUREAU OF MATERNAL AND CHILD HEALTH 65
L. L. PARKS, M.D., M.P.H.,
Director
E. L. FLEMMING, Ed.D.,
Assistant Director

The staff remained the same as for the previous year except that the
pediatric consultant, Nicholas G. Alexiou, M.D., returned in June from
a year of training in public health at Yale University. In the fall the
assistant director took leave for a year for postgraduate education. A
health educator, Mrs. Jean Young, was employed by the State Depart-
ment of Education to assist in the summer Teachers Project for a tem-
porary period of five months and worked out of the office of this bureau.
The staff is concerned with the health problems of mothers and
children; it is small and acts in a consultant capacity to the county health
departments. Funds are made available to them from the Children's
Bureau to strengthen the services in the counties. Funds are also made
available from the Children's Bureau for special projects such as the
Migrant Project, the Developmental Evaluation Clinic and the Premature
Demonstration Program, all described later in this bureau's report.
There were a number of interesting activities to which the staff gave
special attention during the year; namely, phenylketonuria surveys, evalu-
ating premature centers in a small number of hospitals, promoting work-
shops, summer courses and conferences with teachers and health depart-
ment personnel, orientation sessions on mental retardation, promoting
planned parenthood services in the maternity clinics of the state and re-
viewing films that will be of value in teaching health to school children
and mothers. Efforts were made with some degree of success to give
recognition to schools that had conducted outstanding school health pro-
grams to promote better school health services. Frequent conferences
were held with representatives of other agencies such as the State De-
partment of Education, State Department of Public Welfare, Children's
Commission, Parent-Teacher Associations, Florida Committee on Rural
Health and medical society committees on maternal and child health
problems. The promotion of postgraduate courses for nurses and phy-
sicians occupied much time of several members of the staff. Some of the
above activities will be described in more detail later in this report.
MATERNAL HEALTH
The provisional maternal mortality rate of 5.0 per 10,000 live births
for 1961 shows that the number of maternal deaths is about the same as
1960. There were 58 maternal deaths during the year. Each maternal
death is studied and a determination made wherever possible as to the
cause of death and how it might have been prevented. This study is be-
ing made in cooperation with the Maternal Health Committee of the
Florida Medical Association.
There were 217 midwives licensed to practice during the year as
compared with 228 for 1960.
Of the 115,610 infants delivered in 1960, medical doctors delivered
105,734 or 91.5 per cent of the total births; osteopathic physicians
delivered 3767, or 3.3 per cent; midwives delivered 5744, or 5.0 per cent;

66 ANNUAL REPORT, 1961

naturopaths delivered 204 or 0.2 per cent; two births were attended by
chiropractors and 159 by other attendants. There were 108,650 births
occurring in hospitals, or 94.0 per cent of the total births; the data show
99 per cent of white births occurred in hospitals, which was the same as
it was for 1959. The percentage of nonwhite deliveries in hospitals was
79.3 per cent for 1959 and it rose to 80.4 for 1960.
The problem of illegitimacy seems to be increasing as shown by the
following information taken from previous annual reports:
Nonwhite illegitimate birth percentages are ten times higher than those
for whites. Every effort is made to make sure that all mothers receive ade-
quate prenatal care. More and more of the maternity clinics are providing
planned parenthood services to patients who are in need of this service
and there is a growing interest in this field.

TABLE 16
ILLEGITIMATE BIRTHS PER 1000 LIVE BIRTHS
FLORIDA 1940, 1945, 1950, 1955 AND 1960

YEAR
RACE
1940 1945 1950 1955 1960
Total ...................... 63.2 61.5 79.8 88.7 95.5
White..................... 17.0 19.0 17.6 21.6 27.6
Nonwhite .................. 174.5 183.5 231.9 260.3 279.4

INFANT AND PRESCHOOL HEALTH
In 1961 there were 116,886 births, or a rate of 22.7 per 1000 popu-
lation. For the same period there were 3415 infant deaths reported and
the rate was 29 per 1000 live births. Immaturity continues to be reported
as the leading cause of death. The county health departments promote
care of the immature and more emphasis is being placed upon preparing
the home for their care prior to discharge from the hospital. This
is in keeping with the philosophy of the teaching at the Premature
Demonstration Center in Miami. Well baby clinics continue to be con-
ducted in the majority of counties.
The total number of immunizations reported by the health depart-
ments shows there were 85,970 immunizations for smallpox, 142,455 for
diphtheria, 204,590 for tetanus, 88,040 for whooping cough and 276,848
for polio during the year. There was an increase in the number of im-
munizations for all of the above over the previous year, except polio,
which showed a decrease.
HEALTH SERVICES FOR MIGRATORY AGRICULTURAL WORKERS
Public Health Service publication No. 540, revised 1960, lists 40
counties in Florida which have migrants, and their estimated peak popu-

MATERNAL AND CHILD HEALTH 67

lation as 51,655. Palm Beach County is reported to have 10,400, Dade
8550 and Broward 5300. The number of migrants in the other counties
varies downward to a minimum of 110. The migrants remain in Florida
from about November to May. These estimates are probably conservative
because other estimates have been made that Palm Beach County alone
has 15,000 to 20,000 at the peak of the season.
The health problems of the migrants vary from community to com-
munity depending upon many factors such as housing facilities and local
medical facilities. The health problems of migrants do not differ from
those of many other communities where there are medically indigent
persons, except that in the area where there are migrants, there are many
more medically indigent persons for whom to provide health services.
The Children's Bureau provided funds to help support a five-year
project which ended June 30, 1961. The purpose of this grant was to
extend health services to the agricultural migrants in Florida through the
health departments in counties where most of the migrants are located.
Migrants coming into the state place a heavier load upon many com-
munities, and outside assistance is needed. Local funds have not been
sufficient to provide the necessary health department personnel to take
on the needed services. The Children's Bureau special grant helped to
provide 17 health workers, some of whom are on a part-time basis, for
work in four different counties. Efforts have been made to use the team
approach so as to cover all the public health services needed by the
migrants.
A special report has been published entitled "On the Season," which
summarizes the services and problems encountered during the five-year
period. This report has been distributed to all state health departments
and other organizations and agencies concerned with migrants, with
many favorable comments. Copies of this publication as well as the one
entitled "They Follow the Sun" may be obtained upon request.
A request was made to the Children's Bureau asking that agency
to continue to provide financial help to support health services among
the migrants, and this was approved so that the services already in opera-
tion could be continued.
At the present time the health services are being extended from the
Belle Glade area to other areas of Palm Beach County by means of
mobile clinics and night clinics. This service makes it possible for the
migrants to work during the day and bring the mothers and children in
for services after working hours. Additional personnel have been made
available to other areas with a large concentration of migrants, mainly
Dade, Lee and Collier Counties.
Health services to migrants include the usual services such as nursing
supervision, medical and dental services, information on nutrition, social
welfare services, and to a limited extent general health education, al-
though the educational services are not as fully developed as they should
be at this time. In the opinion of the bureau medical care for the migrants
is being provided as well as it can be in many areas among the low income

68 ANNUAL REPORT, 1961

group, although there is the usual problem of persuading patients to come
in early for diagnosis and treatment. There has been excellent coopera-
tion on the part of the local physicians in the areas where the majority of
the migrants live. The county health departments license labor camps
under state laws which means frequent inspections by the county health
department sanitarians.
Health problems are only a part of the many problems of the mi-
grant. It has been found that all agencies concerned with the migrant,
such as the schools, welfare agencies, voluntary agencies and others are
rendering what services they can with their respective staffs. Experience
has been that most of the farmers are making an effort to work with the
official agencies concerned with migrants. Efforts have been made to
bring together the farmers, crew leaders and the persons in charge of
securing migrant labor but this has not been as successful as desired. How-
ever, much progress is being made in providing better health services to
the migrants.
POSTGRADUATE OBSTETRIC-PEDIATRIC SEMINAR
For the first time since this Seminar was established in Florida in
1951, the location was changed from the east to the west coast of Florida.
This year another state, Mississippi, joined the group. The eleventh an-
nual seminar was held in St. Petersburg Beach in August under the
sponsorship of the Bureaus of Maternal and Child Health of the State
Health Departments of Florida, Georgia, Alabama, South Carolina and
Mississippi; the Maternal Health Committee of the Florida Medical Asso-
ciation and the Florida Academy of General Practice. As was expected,
the change in location caused a shift in the number of physicians at-
tending from the northeast and central areas of Florida to those living
in the southwest section. An outstanding faculty presented a program
which included lectures and panel discussions on obstetrics, pediatrics,
psychiatry and medico-legal problems. Table 17 shows the registration
by states and professions.

TABLE 17
1961 POSTGRADUATE OBSTETRIC-PEDIATRIC SEMINAR
REGISTRATION BY STATES

STATE Doctors Nurses Other Total
Alabama............................... 82 5 0 37
Georgia................................ 40 5 1 46
South Carolina ......................... 25 0 0 25
M ississippi............................. 7 0 0 7
Other States. .................. ......... 4 0 0 4
Florida...................... .......... 112 54 4 170
TOTALS .............................. 220 64 5 289

PREMATURE PROGRAM
To lower Florida's infant death toll was one of the prime objectives
of this bureau for the year just past. While Florida's infant death rate

MATERNAL AND CHILD HEALTH 69

improved slightly, it continued to be higher than that for the nation and
placed the state in the unenviable position of 38th in the rank of 50
states in 1960.
Since deaths among premature infants influence the total infant
death rate, increased emphasis was placed during the year on the train-
ing of physicians and nurses in the care of babies born too soon. Two
five-day seminars for nurses and one short course for physicians were
held at the Premature Demonstration Center, Jackson Memorial Hospital,
Miami. The latest procedures and scientific information were presented.
Seventy-two nurses attended from 49 hospitals geographically scattered
throughout Florida. This project is sponsored jointly by Jackson Me-
morial Hospital, University of Miami School of Medicine, U. S. Chil-
dren's Bureau and the State Board of Health.
In addition to the 72 registered nurses who enrolled in the course,
numerous student nurses from the several schools of nursing affiliated
with Jackson Memorial Hospital also had experience in the premature
nurseries. This was also true of interns and medical students at the
teaching hospital.
A one-day Demonstration Clinic on this same subject was held in
Jacksonville, the first planned exclusively for hospitals in a metropolitan
area. It was attended by approximately 130 persons in nursing categories.
Public health nurses also attended. An evening session for physicians
drew an audience of approximately 35 physicians, including those in
private practice, interns, residents in pediatrics and obstetrics. A team of
physicians and nurses from the Premature Demonstration Center in
Miami provided programs for the two groups.
Plans have been made to offer a longer training program to graduate
nurses with the five-day seminar as a prerequisite. Three additional weeks
of supervised work in premature nurseries will be available early in 1962
and will follow immediately each seminar for nurses.
To strengthen the understanding of personnel dealing with prema-
ture infants and their families it was arranged that a medical social work
consultant be added to the staff of the Premature Demonstration Center
early in 1962. It was anticipated that this individual would assist in the
Center, in outpatient clinics and with training programs for personnel
in related services.
During the year the pediatric consultant of the bureau provided
services to a number of hospitals requesting assistance with problems in
premature, newborn and other nurseries.
A slide series on premature infant care made from pictures and ex-
periences at the Center was used by hospitals, schools of nursing and other
groups to illustrate various phases and problems in care of the babies
born too soon. Slide sets were made available to nine other state health
departments for use in educational programs and to Ceylon and Chile.
Manuals of procedure for use in premature nurseries were distri-
buted to hospitals not previously receiving them. The manual was pre-

70 ANNUAL REPORT, 1961

pared at the Premature Demonstration Center with the assistance of the
Department of Pediatrics, University of Miami School of Medicine and
financed by this bureau. Other pertinent materials were distributed to
individuals and groups interested in various phases of infant care. Exhibits
were prepared and displayed at several professional gatherings. Incu-
bators and other equipment were placed on permanent loan to hospitals
and nurseries.
SCHOOL HEALTH PROGRAM
The health department is given the responsibility for school health
with the State Department of Education. Maternal and child health ac-
tivities here are in the field of promoting preschool physical examinations
on all children and adequate up-to-date school health records kept in the
cumulative folder of each child in school. Screening procedures for phy-
sical defects, such as hearing, vision and dental, by local health depart-
ment staffs are continuous throughout most of the state.
Some attempts have been made to assist public health nurses and
teachers to learn the value of adequate physical and mental appraisal of
each child in school, particularly those who are not performing up to
expectation. The staff has had frequent conferences and workshops with
teachers, pupils, parents and civic groups, with emphasis on adolescent
health. It appears that there is a very definite lack of training among
teachers on how health should be taught in secondary schools. Efforts are
being made to promote the subject of health in teacher training institu-
tions. There should be a multiple-discipline approach to the child in
school as a service to him and school personnel to help them understand
the performance of the student. To do more, however, will require addi-
tional personnel, or greater use of personnel from other divisions and
bureaus.
Public health nurses visit schools regularly and routinely in most
counties; however, the time allotment of the nurse to the schools is
limited because of her many other service programs. The Gray Lady
Program is functioning well in some counties. Much is still needed to
make the school program what it could be in the health field.
TEACHERS PROJECT
Participating universities and county health departments decided
that the Teachers Project in Health Education should be repeated in
1961 for the sixth year. Teachers, participating universities and health
departments agreed that the project is one of the most valuable carried
on in the area of school health education in Florida.
Four institutions: Bethune-Cookman College, University of Florida,
University of Miami and Florida State University again took part by
supplying the academic portion of the course. Twenty-two county health
departments provided field experiences for teachers enrolled from their
counties. A total of 65 teachers completed the course.
The purpose of the course was to provide teachers an opportunity
to learn of health resources in their communities so that these might be

MATERNAL AND CHILD HEALTH 71

utilized in the school health programs and for the benefit of Florida boys
and girls. All teachers reported that their school health programs had been
greatly strengthened as a result of the work. Following the close of the
project it was decided that it should be conducted again in 1962 with cer-
tain aspects strengthened to include suggestions made by teachers during
evaluation sessions.

MENTAL RETARDATION
This bureau is concerned with the entire field of mental retardation
but is active only in certain aspects of the problem.
Ongoing activities include orientation talks and programs at the
several Sunland Training Centers. These are two-day programs held
regularly in cooperation with the personnel of the Sunland Training
Centers and the State Board of Health in addition to representatives of
the local communities interested in the problem. The coordinator of the
program is a public health nurse whose headquarters are at the Sunland
Training Center in Gainesville. Her duties are to arrange for speakers,
programs, workshops, to act as consultant and liaison with the voluntary
agencies and mental retardation associations in the state.
The main purpose of the program is to make professional persons
aware of the facilities, what they offer and how they operate, what the
limitations and strengths are and how the patients and inmates live, work
and learn. With this knowledge, these people can return to their com-
munities and inform their own people of the mental retardation institu-
tions of the state from firsthand experience.
Another activity is the early detection, diagnosis and treatment of
mental retardation. This is usually accomplished through the well child
conferences and clinics held throughout the state as an integral part of
the maternal and child health program. Children are brought to the
clinics for routine screening procedures, immunizations and physical
examinations. This gives an opportunity for the child to be seen early and
any defects or abnormality that are present has a chance to be noted and
proper referral made.
A special program of early diagnosis and treatment is noted in the
phenylketonuria (PKU) survey of the state. Through this program spe-
cial classes for retarded children are screened for PKU and in the case
of positive identification, a home and family investigation is made to de-
tect others with the disorder. Eligible patients are provided a special
dietary supplement through this bureau which helps to prevent mental
retardation. A statewide registry is kept in the bureau of all known cases
of PKU and through arrangements with the Bureau of Laboratories,
confirmatory serum tests for diagnosis are made available to the clinics
and physicians of the state. The hope is that the survey of high risk popu-
lation groups such as the special classes of public schools will offer a
higher casefinding rate and lead to the families of PKU patients where
there may be a younger sibling who would be a candidate for early pre-
ventive treatment diet.

72 ANNUAL REPORT, 1961

Private physicians and clinics throughout the state seeing well
children are encouraged to perform the test frequently in the first year of
life for this condition but the bureau gives no active support and offers
the confirmatory test only through the Bureau of Laboratories services.
Pamphlets and nutrition consultation have been made available to phy-
sicians of known PKU families.
The biggest gap in our knowledge and work is our complete lack of
knowledge of the extent of the mental retardation problem and in the
apparent disinterest in strengthening regular maternal and child health
programs to prevent mental retardation and to coordinate research ac-
tivities in the state.
DEVELOPMENTAL EVALUATION CLINIC
This special project in mental retardation is located in Miami and
during 1961 completed a total of 116 comprehensive evaluations. Seventy-
eight were new patients admitted to service and 38 were re-evaluations
of children seen in the previous year. By the end of the year the clinic had
200 active cases.
The clinic staff is composed of a part-time pediatrician who serves
as director and a clinical psychologist, two psychiatric social workers, a
public health nurse, a speech specialist, a Fellow in Pediatrics, a secretary
and a clerk-typist. During the past year the requests for service have in-
creased as has the caseload. Since most of these children are in the pre-
school age group, the needs of the patients and their families change
from year to year. In addition, the children coming to the clinic are a
very heterogeneous group presenting a wide variety of problems and
etiological causes. Because the clinic is seeing such a variety of problems,
the diagnostic and counseling services which are offered by the clinic
have to be extensive. It is estimated that approximately 50 per cent of
the children seen at the clinic have multiple handicaps. Recommenda-
tions of the clinic to the parents have to be coordinated with existing
community agencies. At times it is frustrating to find that optimal treat-
ment facilities do not exist to carry out recommendations of the cases
evaluated.
One of the original objectives of the clinic, the determination of
what services are necessary and available for the proper training and
guidance of the mentally retarded child and his family, continues to be
worked on by all staff members in a variety of ways.
The public health nurse has continued to make home visits on all
new patients admitted to the clinic for service. In addition to aiding some
of the parents in a home training and supervision program, conferences
are held with the general nursing staff of the Dade County Department
of Public Health who are carrying clinic patients as part of their case-
load. Forty-three children are being supervised in a home training pro-
gram, 18 are supervised by the clinic's public health nurse and 25 by the
county health nursing staff.
Three members of the clinic staff, the pediatrician, psychologist and
social worker, visited Fort Lauderdale, Palm Beach, Orlando, Tampa and

MATERNAL AND CHILD HEALTH 73

St. Petersburg to meet with county health department staffs and others
concerned with services for the retarded child in their communities.
These conferences developed out of one of the original intents of the
special project, which was to originate methods of casefinding and evalua-
tion which might be incorporated into existing facilities and to translate
and transmit up-to-date knowledge regarding the retarded child. A sum-
mary of findings and recommendations will be prepared for use by the
bureau in its long-range planning.
A Pediatric Fellow sponsored jointly by the clinic and the University
of Miami School of Medicine, through a special grant from the Children's
Bureau, will complete her two year training program in July 1962, at
which time a new Fellow will be appointed. The major portion of this
post-residency training has occurred within the Developmental Evalua-
tion Clinic. The Fellow has also been assigned to the Pediatric Neurology
Clinic of the School of Medicine, the Cerebral Palsy Clinic, the Dade
County Child Guidance Clinic and has been able to effect smoother
liaison between these community agencies and the Clinic. This has also
served to translate many of the concepts developed at the clinic into dif-
ferent areas of practice with the handicapped child.
In recognition of the increasing importance of training in the area of
handicapped children within pediatric practice, a rotating pediatric
resident has been assigned to the clinic and fourth year medical students
have made weekly visits to the clinic as part of the School of Medicine's
program in childhood development in mental retardation. Formal lec-
tures have been given to third year medical students and staff conferences
have been held with practicing pediatricians in Miami.
During the summer months, five student fellowships were sponsored
at the clinic, four of them by the State Board of Health. Two were
graduate psychology students and three were medical students from the
University of Miami. One of the medical students was assigned to the
Sunland Training Center at Fort Myers as a joint project by the Center
and this clinic. This is a logical expansion and there is hope for such
combined programs in the future.
Orientation conferences regarding the field of mental retardation in
general and the functioning of the Developmental Evaluation Clinic in
particular were provided social work students from Florida State Uni-
versity School of Social Welfare, and to nurses from the University of
Miami Department of Nursing. Joint conferences with representatives
from various community agencies were conducted periodically.

74 ANNUAL REPORT, 1961

BUREAU OF PREVENTABLE DISEASES
JAMES O. BOND, M.D., M.P.H.
Director
During 1961 several major changes in personnel occurred in the
Bureau of Preventable Diseases. In October the director was temporarily
assigned to the Office of the Coordinator of Research and Training. The
Assistant State Health Officer, C. M. Sharp, M.D., assumed the tem-
porary duties of acting director of the bureau, in addition to his other
responsibilities.
During the year the principal activities of the director concerned
five special studies. A program was carried out with the Hillsborough
County Health Department and the Bureau of Laboratories to evaluate
the effectiveness of purified Salk vaccine. The detailed results are des-
cribed in the Division of Epidemiology and the Bureau of Laboratories
reports.
The study of arthropodborne viruses on the Seminole Indian reser-
vations in South Florida required the coordination of personnel from the
Division of Epidemiology, the Communicable Disease Center, the Bureau
of Laboratories and the county health departments. As a part of this study
a serological and polio immunization survey was carried out in High-
lands, Glades and Hendry Counties involving over 600 families.
Special programs to evaluate tuberculin tests were carried out in
Duval County and the Sunland Training Center in Gainesville. The
activities of a medical student and physicians from the Division of
Epidemiology and Division of Tuberculosis Control were supervised and
coordinated in carrying out these studies.
In cooperation with the Hillsborough County Health Department
and the Hillsborough County Medical Society programs were initiated
to evaluate oral polio vaccines in Hillsborough County. During the
fall monovalent vaccines were tested on 30'4 children. This was also a
preliminary study for large scale field trials to be carried out in Hills-
borough County in 1962 using trivalent oral polio vaccines.
The director of the bureau assisted in the investigation of four large
outbreaks of communicable diseases in 1961. The first was an epidemic of
infectious hepatitis in Cross City. The second was a relatively small out-
break of poliomyelitis in Manatee County which involved multiple types
of poliomyelitis and extensive investigation and consultation over the de-
cision as to whether oral vaccine should be used to abort an epidemic.
The investigation of staphylococcal pyodermia in a large Tampa hospital
will be described in detail in the report of the Division of Epidemiology.
In the fall months an outbreak of encephalitis in Pinellas, Sarasota and
Manatee Counties received considerable attention from the staff of the
Division of Epidemiology, Division of Veterinary Public Health, the
Laboratories and coordinated assistance of the Communicable Disease
Center.

PREVENTABLE DISEASES

During the year some administrative attention was given to two of
the ongoing research projects within the bureau. A renewal application
for a National Institutes of Health grant to support the special study of
the Unclassified Mycobacterial Infections was prepared. This is reported
in more detail by the Division of Tuberculosis Control. In connection with
a special study of chronic illnesses in Dade County, the fourth and last
of a series of quarterly samples of all physicians in Dade County was
selected in February. The 13,713 reports of visits made to physicians in
Dade County during these four quarterly samples were processed and
tabulated on IBM. The purpose of this study is to develop a methodology
for obtaining reports of chronic, noninfectious diseases from private phy-
sicians, using a sampling system that will not be burdensome to any one
physician.
The director represented the State Health Officer on the Surgeon
General's Committee on Poliomyelitis Control. Assistance was given to
the preparation and presentation of the five-year report of the Un-
classified Mycobacterial Infections at the annual meeting of the Ameri-
can Public Health Association in Detroit.

DIVISION OF EPIDEMIOLOGY
CHARLES M. WATERS, JR., M.D.
JAMES F. MOLLOY, III, M.D.
Assistant State Epidemiologist
INFECTIOUS HEPATITIS
For the past two years a remarkable increase in the occurrence of
infectious hepatitis has taken place in Florida. Reported cases of infec-
tious hepatitis rose from 342 in 1959 to 1108 in 1960 and 1442 in 1961.
There has been a steady annual increase over the past five years reaching
the highest number of cases ever reported for Florida in 1961.
During the past year, the division conducted epidemiological in-
vestigations of infectious hepatitis outbreaks in Chipley, Cross City, Grace-
ville and Miami. Person-to-person contact was the primary method of
spread and only one common source could be found which was thought
to be responsible. This was an outbreak associated with chimpanzees.
Figure 2 illustrates the seasonal pattern of infectious hepatitis for the
current year in comparison with the pattern for the years from 1952
through 1960. The peak of reported cases occurred in May 1961, which
was one month later than in 1960.
Table 18 outlines the various attack rates for the group under con-
sideration. The attack rate for the white population is approximately
twice as high as that for the nonwhite group, which is similar to the
1960 data. Attack rates for males and females were about equal.
Infectious hepatitis occurred more frequently in the younger age
groups with the largest percentage of cases occurring between the ages

76 ANNUAL REPORT, 1961

of five and nine. The 10 to 14 and 15 to 19 age groups also had high
attack rates.
The only major change in the incidence of infectious hepatitis by
counties was the shift to the western peninsular counties.
A small supply of gamma globulin was again made available to the
State Board of Health and was distributed to county health departments.
Conflicting recommendations on the dose of gamma globulin for the
prevention of infectious hepatitis in infants and children appeared in
the literature during 1961. On the basis of 10 years of satisfactory
experience, and published reports by many workers, using the dosage of
0.01 ml. per pound of body weight, the State Board of Health continued
to recommend that dosage for the prevention of infectious hepatitis in
both children and adults.
POLIOMYEUTIS
Reported cases of poliomyelitis declined from 66 in 1960 to 41 in
1961. Thirty-seven of these were paralytic cases. This compares with 197
cases reported in 1959 and 252 reported in 1958. There were no deaths
from poliomyelitis during the year. In cooperation with the U. S. Public
Health Service, the intensive poliomyelitis surveillance program which
had been instituted in 1957 was again carried out by the division.
For the first time, the incidence among the white race was only
slightly higher than the nonwhite. In the past, the incidence among the
white race has been consistently higher than the nonwhite, despite the
strikingly opposite situation in the rest of the nation. The rates in males
have been consistently higher than rates in females. There has been no
marked change in the past three years in the age-specific attack rates
with the rates in children under age five remaining quite high. The peak
occurrence of reported poliomyelitis by month occurred in 1961 in the
month of July, which was expected based on the seasonal pattern of
recent years. It is interesting to note that nine of the 36 paralytic cases
had had three or more Salk immunizations.
Two epidemics were reported in the state and investigations were
carried out by this division. Eight cases of paralytic poliomyelitis sud-
denly occurred in Gadsden County during July, whereas none had oc-
curred during the first six months of the year. All the cases were non-
immunized preschool Negro children of the lower socio-economic group
widely scattered throughout the county. Neither person-to-person spread
nor a common source could be determined. Type I poliovirus was
isolated from four of the cases. A mass Salk immunization program was
carried out by the Gadsden County Health Department. No additional
cases occurred in the county.
Five cases of paralytic poliomyelitis occurred in Manatee County
from mid-April through June. Three of these were preschool age Negro
children, none of whom had received any prior Salk vaccine. A 12 year
old white male and a 20 year old female were the other two cases.
Epidemiologic studies conducted by this division and county public health

PREVENTABLE DISEASES

nurses indicated a geographic association of four of these cases; all of
them lived in nearby Palmetto. A Type I poliovirus was isolated from
the 12 year old child with bulbar poliomyelitis. One of the Negro
children showed a significant rise in antibodies against Type III polio-
virus, but results were inconclusive on the other three paralytic cases.
An intensive Salk vaccination program was carried out following this
outbreak.
This division cooperated in carrying out a poliomyelitis immuniza-
tion survey in Manatee County in July. In summary, the white com-
munity was well immunized, particularly in the Bradenton area where
92.6 per cent of the school age children had received three or more
Salk injections. However, the nonwhite population was very poorly
protected with as few as five per cent of the preschool children with
three or more shots, and only 32 per cent of the school age children
immunized.
This division also participated in a poliomyelitis immunization
survey carried out in Highlands, Glades and Hendry Counties. These
surveys are based on the Communicable Disease Center quota sampling
technique. The results indicated that 51 per cent of the preschool age
children, 67 per cent of the school age children and 40 per cent of the
persons aged 15 to 40 were adequately immunized against poliomyelitis.
Four hundred and seventy-eight blood specimens were obtained for
poliomyelitis antibody studies, which was 64 per cent of the population
in the households interviewed.
During 1961, two poliomyelitis vaccination programs were carried
out in Hillsborough County by the County Health Department and the
County Medical Association. One hundred and forty-two children under
six years of age participated in a Purivax study from March through
August. The serum neutralizing polio antibody response following two
injections of Purivax vaccine showed that 37.9 per cent converted against
Type I poliovirus, 61.5 per cent converted against Type II and 87.1
per cent converted against Type III. The percentages of conversion in
those receiving two injections of Salk vaccine were 29.1 per cent con-
verted against Type I poliovirus, 74.6 per cent converted against Type
II and 31.5 per cent converted against Type III.
A Sabin oral monovalent poliomyelitis vaccination program was
carried out during the fall. Three hundred and four children, age six
months to six years, not having received more than two Salk shots were
fed Sabin monovalent vaccines Types I, II and III. Pre- and post-feeding
titers of poliomyelitis neutralizing antibodies were measured. One hun-
dred and thirty-three of these children had poliomyelitis neutralizing
antibody titers of less than 1:4 prior to receiving the vaccine. Follow-
ing administration of the vaccine, 78.7 per cent converted* against Type I
poliovirus, 92.1 per cent converted against Type II and 85.4 per cent
against Type III.
"Conversion is defined as change in titer by MIT test from <1:4 to 1:16
or greater.

78 ANNUAL REPORT, 1961

DIPHTHERIA
A total of 43 diphtheria cases were reported in Florida in 1961 as
compared with 73 cases in 1960. One diphtheria death occurred during
the year in Putnam County.
The majority of cases occurred in Duval, Hillsborough, Polk and
Pinellas Counties. In this last county, a sharply localized outbreak of
eight cases occurred in August which was investigated by the Pinellas
County Health Department and this division. All of the cases came from
two adjacent Negro communities with approximately 50 households in
each community and a total population of the two communities estimated
at between 700 and 800 people. Approximately 30 per cent of the pre-
school and school age children in the communities had completed their
DPT immunizations. Three hundred and forty-seven people were cul-
tured and a total of 54 diphtheria carriers were discovered. A patient
with skin ulcers that contained diphtheria organisms was found during
the investigation. The clinical disease was mild, consisting of nothing
more than a slight elevation in temperature, a mild pharyngitis and
malaise. None of the cases were hospitalized; all were treated at home or
in the physician's office with penicillin and antitoxin. All organisms
isolated were of the mitis strain virulence positive. Due to crowded
living conditions, person-to-person spread was considered the most
probable means of transmission.
Reported diphtheria cases are about equally distributed between the
races and the sexes. Two-thirds of these occurred in children under nine
years of age, and more than half of these were four years of age or under.
This disease continues to have its highest attack rate in preschool un-
immunized Negro children.
FOOD POISONING
Three outbreaks of food poisoning were reported during 1961. Ap-
proximately 84 persons were involved. Usually the investigation of such
occurrences is carried out by the county health department, however,
this division did investigate one food outbreak. The patients were found
to have become infected with staphylococcal organisms. Epidemiologic
evidence indicated that both ham salad sandwiches and pork loaf sand-
wiches probably were contaminated. The sandwiches had been prepared
approximately six to seven hours before being served, and they were
allowed to incubate at room temperature during this period of time. Also
one of the food service employees had chronic furunculosis.
One outbreak of salmonella food poisoning occurred. The contam-
inated food was probably cheese pudding. Considering the excellent
media which the cheese pudding is for bacteria growth the high attack
rate for those having consumed the product, and the manner in which
it was prepared and handled, the investigators felt that possibly one of
the foodhandlers contaminated this product with salmonella from their
hands.
The third food poisoning outbreak investigated occurred at a church
supper. All of the food served was highly contaminated with staphylococ-

PREVENTABLE DISEASES 79

cal and the possible source was never determined. The food had been
prepared some six to eight hours prior to serving and was allowed to
incubate at room temperature.
Approximately 106 other persons were reported as having food
poisoning in 1961 and almost all of these were individual cases.
BACILLARY DYSENTERY
Reported cases of bacillary dysentery rose from 84 in 1959 and
112 in 1960 to 454 in 1961. Approximately one-half of the 67 counties
reported at least one case of bacillary dysentery with most of the cases
reported from the larger counties. Lee County was an exception to this,
as 106 cases occurred there during 1961. Over one-fourth of the re-
ported cases occurred in children less than four years of age. The re-
ported cases are about equally distributed between the races.
This division cooperated in carrying out an investigation of one
outbreak of bacillary dysentery which occurred at the Sunland Training
Center in Ft. Myers. Prior to August 1, 1961, twenty-five cases of
bacillary dysentery were reported from this institution. During the
month of August, 69 cases of bacillary dysentery, confirmed by cultures,
occurred in the school. An additional 100 cases occurred during the next
three months before the outbreak ceased. A common source could not
be found and it was felt that the mode of transmission was person-to-
person.
HOSPITAL ACQUIRED STAPHYLOCOCCAL DISEASE
During 1961, three hospitals asked for epidemiological investigation
of their outbreaks of staphylococcal disease. In 1960, the State Board of
Health organized a team of epidemiologists, bacteriologists and en-
vironmental engineers to provide complete diagnostic and investigative
facilities to those hospitals.
An outbreak of pyogenic infections in newborn infants from a hos-
pital in Tampa was investigated by a joint effort of the county health
department, State Board of Health and the Technical Development
Laboratories of the Communicable Disease Center, U. S. Public Health
Service. These infections were predominantly associated with the phage
strain 80,81 of Micrococcus pyogenes. Clinical lesions included impetigo,
conjunctivitis, mastitis, abscess, pneumonia and meningitis in the newborn
and breast abscess, or pyoderma, in the mothers. The overall rate of
infection in babies during a four-month period was 29.6 per cent and in
their mothers it was 10.6 per cent. Specific antecedent factors in the
epidemic were not identified due to the delay in investigation. However,
multiple factors were found which aided the propagation of the epidemic.
The major contributing causes were overcrowding of the infants in a
small nursery without adequate ventilation, physically situated on a
heavily traveled ward, with a few important breaks in proper nursing
and house-keeping techniques. Specific recommendations were made in
the areas where lapses in technique occurred and the establishment of
effective reporting and education programs were emphasized.

80 ANNUAL REPORT, 1961

Investigations of two hospitals in Jacksonville were carried out by
this division and the Jacksonville City Health Department. One-investi-
gation was rather brief as evidence accumulated failed to indicate an
outbreak of staphylococcal disease in the newborn nursery. A full-scale
investigation in conjunction with extensive phage typing was carried
out in the other hospital, as well as an environmental survey. In this
institution, the epidemiological information gathered indicated that the
outbreak of pyogenic infections in newborn infants was due to failure
of isolation technique and some breakdown in aseptic technique. In
addition, defects in the environmental aspects of the newborn nursery had
been observed.
VIRAL ENCEPHALITIS
After a year of unusual quiescence, arborvirus activity was again
apparent in Florida with a series of outbreaks in the fall of 1961.
Eastern Equine virus activity was confirmed in pheasants and wild
birds and St. Louis Encephalitis, or a closely related group B virus, was
demonstrated in humans, mosquitoes, domestic and wild birds.
During October a severe die-off occurred in a flock of pheasants
in Brevard County. An investigation by the State Board of Health field
and laboratory team involved the collection and examination of domestic
birds, quail, pheasants, turkeys, wild birds, mammals and mosquitoes.
Eastern Equine virus was isolated from eight pheasants and one bluejay.
A surveillance of cases in humans and large animals in the surrounding
area was carried out with negative results.
On the western side of the state in the Tampa Bay area, an un-
usual number of human encephalitis cases were noted from October
through early December. A total of 25 cases occurred with seven deaths.
Of the total cases, six were in Sarasota County, 10 in Manatee and nine
in Pinellas. (The latter county was the site of the extensive St. Louis
Encephalitis-like outbreak in 1959 involving 68 clinical cases.) All of the
cases presented fever, alterations of sensorium, and varying neurological
abnormalities indicating involvement of the central nervous system.
Studies of the human sera collected from 20 of these individuals for
complement fixation and hemagglutionation inhibition antibodies. carried
out by the State Board of Health and the Communicable Disease Center,
USPHS Virology Laboratories revealed 10 positive sera for SLE anti-
bodies. There was no serologic evidence of infection with EE, WE,
dengue, Murray Valley, Lymphocytic choriomeningitis or mumps. No
viral isolations were obtained from brain tissue collected from three of
the seven deceased patients. Four of the seven fatal cases were autopsied
and all revealed the typical histopathological findings of acute viral
encephalitis.
Certain epidemiological associations of interest were noted amongst
the cases. All were white; 15 were female and 13 over the age of 65.
The youngest was a 13 year old white male. In Pinellas and Manatee
Counties there was a rough geographic concentration of cases, in both
instances associated with fresh water mosquito breeding sites. Domestic

PREVENTABLE DISEASES

chicken flocks were found on the premises of two households and sera
from these birds indicated recent infection with SLE virus.
Extensive collections from the biologic environment of human cases
were carried out by field teams of the State Board of Health and CDC.
Despite an extensive drought, a moderate number of mosquitoes were
obtained as late as the second week in December. These were pre-
dominantly A. crucians, C. nigripalpus and C. salinarius. These pools
have been screened in wet chicks and suckling mice and to date a single
pool of mixed Culex species has yielded a viral agent identified by the
Virology Laboratory of the Florida State Board of Health as belonging
to the "B" group.
Although the annual fall migration of birds had passed before the
outbreak, several different species of wild and domestic birds were caught
and bled. To date, no viral isolation has been reported by the CDC
laboratory. However, there is considerable antibody against a Group B
agent closely related to SLE in sera collected from mammals and birds
in a zoo at the approximate geographic center of the Pinellas County
cases. There were also EE antibodies found in chickens in St. Petersburg
and Sarasota and WE in a parakeet in the above mentioned zoo. Final
reports are not yet available.
A total of 97 virus encephalitis cases were reported in Florida in
1961 which is the greatest number ever reported in one year in the
state. This compares with 73 reported in 1959 and 55 reported in
1960. Forty-six of the cases of viral encephalitis reported were of unde-
termined etiology. In 1961 there were 21 deaths in the state resulting from
clinically diagnosed viral encephalitis. A study of the seasonal variation
during 1961 showed the pattern of a long season of increased incidence
during the fall and winter months without complete regression during the
summer months.
TYPHOID
The year ended with a total of 21 reported cases of typhoid. This
compares with the 16 reported in 1960 and 25 reported in 1959. This year
reported cases are about equally distributed between the races; whereas,
in the past the attack rate for the white population has been approxi-
mately twice as high as that for the nonwhite group. The disease occurred
most frequently in the middle age groups.
During the late fall of 1961, six cases of typhoid occurred in north-
west Florida and two nearby states. An intensive investigation by the
State Board of Health and Franklin County Health Department traced
their source to one small oyster processing plant which employed an
oyster longer who was an unknown typhoid carrier. The organism
isolated from him, as well as from each of the cases, was salmonella
typhosa, Phage Type A. Until this source was located and further spread
prevented, there was a serious threat to the entire oyster industry.
The oyster processing plant was immediately closed after the initial
case was recognized and oysters in distributional channels were con-

82 ANNUAL REPORT, 1961

fiscated. All typhoid cases reported in Florida during 1961 were in-
vestigated by this division, and none were found to be related to the
specific oyster processing house involved. Intensive investigations of the
entire related oyster industry in Florida revealed no evidence of addi-
tional sources of contamination with enteric pathogens.

TABLE 18
INFECTIOUS HEPATITIS CASES AND RATES
PER 100,000 POPULATION, FLORIDA, 1961
BY RACE, SEX AND AGE

RACE AND SEX CASES RATE AGE CASES RATE

TOTAL ............................ 1,442 29.1 0-4 86 15.9
White male......................... 603 30.1 5-9 312 63.6
White female ....................... 635 30.8 10-14 218 50.1
Nonwhite male ...................... 99 22.7 15-24 315 49.7
Nonwhite female ..................... 81 17.9 25-34 189 30.2
Unknown ................ ....... 24 .......... 35-44 102 15.6
45+ 132 8.4
Unknown 881 .........

PREVENTABLE DISEASES 83

FIGURE 2

220
INFECTIOUS HEPATITIS
Number of Cases
0 Florida, 1960-61
200 -

Average Number of
Cases '52-'60
180-
1961 Cases liillsIe et
1960 Cases
160

140 -

-- .- -

t
1 .

200
N0 A JA

84 ANNUAL REPORT, 1961

VENEREAL DISEASE CONTROL
HARVEY M. BURNETTE
Administrator

During 1961 this program has continued with emphasis on preven-
tion and control of the venereal diseases. The ultimate goal of attaining
practical eradication has been maintained through the following activi-
ties: casefinding and preventive procedures, increased epidemiologic
intelligence, and education.
The program has 15 full-time interviewer-investigators who have
received special training in working with infected persons. They have
aided county health departments and private physicians in: interviewing
all infectious syphilis patients for their contacts and suspects; performing
rapid investigation on contacts and suspects; and, taking blood specimens
for serologic testing among those groups in which a high incidence was
known or suspected.
During 1961 the state reported 1118 cases of early infectious syphilis,
or 75 per cent increase over 1960 when 639 cases were reported. Total
syphilis cases reported during 1961 was 5324, or 29.4 per cent increase
over 1960 when 4119 cases were reported. The marked increase in the
incidence of early infectious syphilis cuts across all socioeconomic groups,
but has shown a particular increase over the 15-34 age group.
Many persons have thought that the incidence of syphilis and gon-
orrhea had been declining for years. Certainly, this was true during
World War II and until about 1952. Between 1953 and 1958, total syphilis
cases as well as early infectious syphilis remained about constant. How-
ever, a sudden increase in early infectious syphilis was reported in 1959.
This rise was continued through 1961 at the alarming rate reported
above.
Many and various factors are thought to be responsible for this con-
tinuing increase in early infectious syphilis: lack of education, breakdown
of morals, and general apathy of the public.
Venereal disease investigators interview all infectious cases whether
reported by the private physician or county health department. Ap-
proximately 60 per cent of the total syphilis was reported by the private
physician, as compared with 25 per cent of early infectious syphilis cases.
Every private physician in the state is urged to report all infectious
syphilis cases immediately. Contacts of private physicians' patients are
referred to the private physician of their choice, or the county health
department. Such interview and investigation is strictly confidential and
the identity of the original infected patient is never disclosed. The exposed
person (sex contact) is never told the name of the original patient. This
confidential program is receiving very good acceptance by the private
practitioner, the patient and the contact himself.
There is an increasing large number of homosexual cases and con-
tacts among all groups. The same confidential rapport must be main-

PREVENTABLE DISEASES 85

trained by the investigator in his interviewing and contact investigation
of such cases.
If control levels in the VD program are to be reached and main-
tained, there must be complete cooperation between the private physi-
cian and the county health department with reference to epidemiology,
interviewing, investigation and educational measures.
Gonorrhea is one of the venereal diseases largely reported by county
health departments. Private physicians report about 14.6 per cent of total
cases. This probably is due to the short length of time needed to diagnose
and treat these patients.
Chancroid, granuloma inguinale and lympho-granuloma venereum
have continued to be of minor importance due to the small number re-
ported. These diseases are usually found among the lower socioeconomic
group where poor personal hygiene is practiced.
A program of following all reactive reports on specimens submitted
to the Bureau of Laboratories by private physicians is continued. In ad-
dition, a program has been initiated to gain the full cooperation of pri-
vately owned and operated laboratories doing serologies.
The control of venereal disease is dependent upon continued and
expanded efforts to encourage and assist schools by providing venereal
disease instruction. To this end a Negro health educator has worked with
county health departments, school officials, schools and other interested
civic groups in the institution of a sound VD educational program in the
schools. The health educator meets with school officials and discusses
an approved format which has been endorsed by the State Board of
Health and the State Department of Education. When approval is
granted, the health educator is assisted by the county health officer and
other health department personnel, in initiating the program with selected
groups of teachers. These groups of teachers are given special instructions
and teaching aids in communicable disease control with specific emphasis
on venereal diseases. Teachers then correlate the information received
with curriculum subject areas and present it to students.
VD education is promoted by sending appropriate pamphlets to
private physicians and county health departments. This office assists
with newspaper articles and exhibits whenever possible. Many lectures
and pamphlets have also been given to the public.
This program is carried on by an administrator, PHS representa-
tive and health educator (all of whom travel throughout the state giving
assistance), a chief clerk and two central registry clerks.

86 ANNUAL REPORT, 1961

DIVISION OF RADIOLOGICAL AND
OCCUPATIONAL HEALTH
Edwin G. Williams, M.D.
Director
OCCUPATIONAL HEALTH
The recent publication of the Florida Development Commission,
Florida's New Industrial Plants, First Half, 1961, reports that in the first
six months of 1961, 283 new plants and 46 major expansions of existing
plants were announced in Florida. These new plants and expansions were
expected to add about 10,000 persons to the industrial working force.
In Hillsborough County a study program is going on which is present-
ly supported in large part by the U. S. Public Health Service and is
operated as an integral part of the county health department. It has as its
basic goal the development of an occupational health program seeking
to bring together all of the community activities and facilities, both public
and private, which have a bearing on the health status of the occupied
segment of the population. While not neglecting the disciplines of medi-
cine, industrial hygiene and nursing, emphasis is being placed on the
sociological and psychological aspects of worker health. Partly because
of tradition and largely because of availability, the industrial worker will
comprise the bulk of population served during the early phases of the
program, but in concept and as the activity develops, the services will be
extended to all people who work.
Field Activities-General
Occupational health personnel made 216 visits to 66 establishments
employing about 11,000 persons. It is interesting to compare these divi-
sion figures (ROH) with those reported in the aforementioned Florida
Development Commission publication (FDC) for the first half of 1961
and for 1960. According to this report there were 315 and 283 new
plants reported in the state during the first half of 1960 and 1961 re-
spectively, while the Division of Radiological and Occupational Health
was only able to render service to a total of 68 and 66 establishments
during these periods.
This comparison of the number of establishments given service with
the number of new plants reported gives a rough indication of the magni-
tude of the problem of providing minimal service to the occupied people
of the state. The problem is even greater than is indicated because many
of the establishments given service by the division do not come under
the definition of industrial plants. Even discounting this limitation and
the probable overoptimism of the Florida Development Commission
figures, the total number of places given service falls far short of the
number of new industries going into business in the state.
Request work more than doubled from 1960 to 1961 (21 per cent
to 49 per cent of total visits) while original work was substantially re-
duced (78 per cent to 51 per cent of visits). This development was due

PREVENTABLE DISEASES

in part to an increasing awareness of and interest in the services available
from this division. This seems especially evident in establishments not
previously in receipt of such services.
Field Activities-Phosphate Study
The similarity of 1961 Personnel Visit data to 1960 figures reflects
the continuing program emphasis on the phosphate study. Although only
12 per cent of the total number of establishments visited were involved
in the phosphate study, approximately 40 per cent of the visits made
were to these establishments. Activities in the phosphate study consumed
about 25 per cent of the total man-hours, or about one-half of those
available for field and laboratory work. Active cooperation in this study
was continued with the Bureau of Sanitary Engineering and the Division
of Sanitation.
Field Activities-Other
Requests for service do not always stem from outside sources. Fre-
quently, they originate close to home as witnessed by the following inci-
dents or conditions investigated by division personnel within the State
Board of Health building complex: an accidental carbon tetrachloride
spill, inadequate lighting, ventilation of a "stuffy" office, a gas leak and
a phenol exposure. In each case the investigations led to recommenda-
tions for action which eliminated the problem.
Investigations made at the request of the Florida Industrial Com-
mission continued to receive high priority consideration. These investi-
gations have taken such varied form as the evaluation of: solvent ex-
posures in a custom built awning shop, solvent exposures in a dry cleaning
plant, dust and explosion hazards in a fertilizer plant, chlorine hazards
in a transfer plant, carbon dioxide exposure in a banana ripening ware-
house. In most cases recommendations were made which when carried
out would reduce or eliminate the hazard.
Investigations at the request of county health departments or other
bureaus and divisions of the State Board of Health have ranged from
atmospheric studies in boat building plants or bacteriological sampling
in hospitals to surveys of peanut processing plants, automobile tire
reclaiming shops, or the air conditioning ducts of a new jail to an
investigation of a series of asthma attacks among guests of a motel on
one of Florida's beaches. The variety of problems was seemingly endless.
Miscellaneous Activities
Informational memoranda on the potential hazards of ozone gen-
erators and coin-operated dry cleaning machines were prepared jointly
with the Bureau of Sanitary Engineering and were given statewide dis-
tribution. Feature newspaper articles were published on the seasonal
hazards of carbon monoxide from faulty heating appliances and on the
variety of tasks the division undertakes.
Consultation was afforded the Division of Sanitation on several
problems. One of the most persistent of these was the recurring question

88 ANNUAL REPORT, 1961

of the degree of hazard to the homemaker in the use of plastic lined
fry-pans (for greaseless frying). Apparently a series of misunderstand-
ings of a safety memorandum issued by a federal agency heightened
everyone's concern and was responsible for the frequent inquiries. This
was an instance where a conservative "better be safe than sorry" attitude
on the part of several uninformed officials served to place a patently
innocuous product in jeopardy of being condemned as a serious hazard.
Cooperation and consultation with the Bureau of Sanitary Engi-
neering, particularly the Air Pollution Control Program, continued to
increase. Joint investigations were made in cases involving pine pollen
fallout, photographic shop odors, Jacksonville-Duval County air pollution,
an incinerator testing program, an occupational death in a sewage treat-
ment plant lift station, and the accidental gassing of a construction gang
working near a sulfuric acid plant. That Bureau also continued to furnish
laboratory space and some field assistance to the division field teams in
the phosphate study in Polk County.
Laboratory Activities
Chemical testing was on an increase for the year, there being 692
analytical tests performed together with 437 controls, standards and
reagent preparations.
Fluoride determinations headed the list, paralleling the strong
emphasis on study activities in the phosphate industries of southern and
central Florida. Although all 230 fluoride analyses were made by the
classic and reliable "Willard and Winter" distillation method, initial
investigative work was performed on a faster and more modern ion
exchange procedure.
Next were the 226 lead determinations. Biological materials con-
tinued to comprise the greater number of samples submitted for lead
analysis, but an interesting phase of this testing was carried out jointly
with the Division of Sanitation and involved a certain type of ceramic
dinnerware manufactured in another state. The USPHS reported that
two cases of lead intoxication had been attributed to ingestion of food
stored in dishes from certain lots of this manufacturer's production. Some
of the "tainted pottery" (newspaper quotes) was thought to have been
distributed in Florida. The efforts of the Division of Sanitation were
successful in turning up 67 samples of ceramic ware which were tested in
the division's industrial hygiene laboratory. All of the samples of this
manufacturer's ware showed excessive amounts of lead in the glaze. This
production has been recalled by the manufacturer. An interesting facet
of this investigation was revealed because samples of a similar ceramic
dinnerware from another manufacturer's production were also submitted.
Scientific curiosity being what it is, these samples were tested. Several of
them gave positive indication of excessive lead in the glaze. The authori-
ties of the state in which this ceramic ware was manufactured have been
notified of the findings.
The division's two chemists cooperated with the Bureau of Sanitary
Engineering in the testing of vegetation samples for sulphates and

PREVENTABLE DISEASES

chlorides, performing 120 of these tests. The division also gave assistance
to that Bureau, the USPHS, and the Jacksonville City Health Depart-
meet personnel who were conducting an air pollution survey of the Jack-
sonville area.
The laboratory participated in analyzing a series of aqueous and
biological samples, submitted by the Analytical Reference Service,
USPHS, to determine the accuracy of analytical procedures used for
lead analysis.
Dust counts, free silica determinations, tests for chromates, styrene,
aluminum and other materials completed the 692 laboratory analyses.

TABLE 19
OCCUPATIONAL HEALTH FIELD ACTIVITIES
JANUARY-DECEMBER 1961

Number of persons or establishments given service

Workers employed ................................
Personnel Visits to Plants
Self-initiated .............................. 37
Requests or complaints .............. 42
Agency referrals ....................... 63
Revisits ..................................... 74
Total .............................. 216
Services Rendered
Routine inspection .................... 25
Industrial hygiene survey .......... 35
Technical study ....................... 59
Consultation ............................. 57
Follow-up .................................... 17
Discuss report ............................ 6
Air pollution (with Bureau
of Sanitary Engineering) ...... 21
Non-occupational investigation .. 3

.......................................................10,957
Field Determination of:
Atmospheric Contaminants
Combustible gases .................. 6
Carbon monoxide .................. 5
Hydrogen sulfide .................... 5
Carbon dioxide ...................... 4
Perchlorethylene ...................... 4
Oxygen ..................................... 3
Total ........................... 27

Physical Conditions
Noise measurement ................ 101
Air velocity measurement ........ 77
Miscellaneous .......................... 15
Total .......................... 193

SAMPLES COLLECTED FOR LABORATORY ANALYSIS

Fluoride in air ..................... 107
Dust in air ............................. 72
Bacteria in air .......................... 142
Bacteria on surfaces ............... 122

Styrene in air ......................... 7
Chloride & sulfate
in vegetation ....................... 13
Miscellaneous ............................. 3
Total ............................... 466

90 ANNUAL REPORT, 1961

TABLE 19 (Continued)
OCCUPATIONAL HEALTH LABORATORY ACTIVITIES
JANUARY-DECEMBER 1961
Materials Type Sample Source Analyses
Lead .................... Human fluids ........ Doctors, hospitals & industry ........ 143
Ceramic ware ........ State & local agencies ................... 59
Miscellaneous ........ State & federal agencies ................ 24
Fluoride ................ Air ......................... Industry .......................................... 222
Miscellaneous ........ Biological material ........................ 8
Dust ......................... Air Industry ............................................ 79
Sulphates ............... Vegetation .......... Bureau of Sanitary Engineering .... 60
Urine .................... Federal agency ............................... 12
Chlorides .............. Vegetation ............ Bureau of Sanitary Engineering .... 60
Free Silica .......... Dust, slag ............ Industry ..................................... 10
Styrene ................ Air ....................... Industry ...................................... 7
Chromates, Alu-
minum, etc ........... Air and Misc....... Industry ....................................... 8
Total ................................ 692
Reagents, Blanks, Controls and Standards ........................................................ 437
Total ................................1129

TABLE 20
OCCUPATIONAL DISEASE REPORTS*
JANUARY-DECEMBER 1961
Dermatitis ....... .................................321
Citrus fruit ............................................................ 47
Cement ......................................... ........ 44
Detergents ...................................................... 41
Seafoods .............................................................. 19
Plant ............................................................... 19
Larva migrans ............................................... 17
Other .................................... .............. 134
Systemic Poisoning .. ....................... ......... 116
Parathion ........................................................... 97
Other .................................................................. 19
Conjunctivitis ........ ................................ ........ 91
Welders ............................................ .......... 84
Others ......................................................... 7
Miscellaneous Diseases ............ ......................- 26
Total .......................................................... 554
*Received through the Florida Industrial Commission.

RADIOLOGICAL HEALTH
The division has the responsibility for overall direction and co-
ordination of all activities related to radiological health carried out by
the State Board of Health. In addition, it has a specific responsibility in
the area of occupational exposure to ionizing radiation in cooperation
with the Florida Industrial Commission, and has established a strong pro-
gram in the area of radiation incident to the diagnostic use of X-rays.

PREVENTABLE DISEASES 91

Regulations
A final draft of the regulations Control of Radiation Hazards was
drawn up by the division, was adopted by the State Board of Health on
March 11, 1961 as Chapter XXXIV of the Florida State Sanitary Code
and became effective April 21, 1961.
Survey of X-ray Facilities
The program of radiation exposure control through inspections of
X-ray equipment and facilities was continued in 1961. Six-hundred and
ninety-two X-ray machines in 463 dental installations were surveyed in
Duval, Hillsborough, Lake, Leon, Manatee, Orange, Osceola and Pinellas
Counties on a countywide basis at the request of the county dental
societies and with the cooperation of the county health departments. A
small number of dental installations in other counties and a limited
number of medical X-ray installations in private offices, hospitals and
health departments around the state were surveyed. Individual reports
were issued to each owner and summary reports were issued to dental
societies and health officers concerned.
An investigation was initiated in regard to Chapter XXXIV Section
334.04 (1) which makes it unlawful to operate fluoroscopic or X-ray
devices for the purposes of fitting or selling footwear through commercial
channels. All county health departments responded, reporting 42 such
machines in the state, at least 10 of which were in use, 17 were in
storage and the status of 15 were unknown.
All machines were removed from operation on the recommendation
of the county health officer. All owners were advised that the regula-
tions prohibited putting the machines back in service.
Other Radiation Users
The division continued to cooperate with the U. S. Atomic Energy
Commission, Division of Compliance, by participating in inspections of
users of radioactive materials. There were at the end of the year 234
licenses in the state.
The division cooperated with local health, police and fire officials
by providing at their request lists of users of radioactive material in
their jurisdictions and notifications of new users. Twenty-four such lists
and notifications were issued through the various county health de-
partments.
Surveillance
A task force composed of representatives of the various State Board
of Health bureaus involved in environmental monitoring was organized
to formulate recommendations concerning monitoring needs, program
priorities and use of the laboratory services. This group met several times
during the year and drew up the 1961 program. This group has recom-
mended the preparation of a report presenting all environmental radio-
activity data collected in Florida during 1961.

	Cover
	Title Page
	Front Matter
	Members of the Florida state board...
	Official staff Florida state board...
	Directors of county health...
	Table of Contents
	General administration
	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
	Articles by staff members

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