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| Letter of transmittal | |
| 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 health facilities and... | |
| Bureau of sanitary engineering | |
| Bureau of mental health | |
| Bureau of narcotics | |
| Bureau of entomology | |
| Bureau of dental health | |
| Bureau of finance and accounts | |
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Cover Title Page Page i Letter of transmittal Page ii Page iii Members of the Florida state board of health Page iv Official staff Florida state board of health Page v Directors of county health departments Page vi Table of Contents Page vii General administration Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Plate Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Bureau of local health services Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Bureau of vital statistics Page 64 Page 65 Page 66 Page 67 Page 68 Page 69 Page 70 Page 71 Page 72 Page 73 Page 74 Page 75 Page 76 Page 77 Page 78 Page 79 Bureau of maternal and child health Page 80 Page 81 Page 82 Page 83 Page 84 Page 85 Page 86 Page 87 Page 88 Page 89 Page 90 Bureau of preventable diseases Page 91 Page 92 Page 93 Page 94 Page 95 Page 96 Page 97 Page 98 Page 99 Page 100 Page 101 Page 102 Page 103 Page 104 Page 105 Page 106 Page 107 Page 108 Page 109 Page 110 Page 111 Page 112 Page 113 Page 114 Page 115 Page 116 Page 117 Page 118 Page 119 Page 120 Page 121 Page 122 Page 123 Bureau of laboratories Page 124 Page 125 Page 126 Page 127 Page 128 Page 129 Page 130 Page 131 Page 132 Page 133 Page 134 Page 135 Page 136 Page 137 Page 138 Page 139 Page 140 Page 141 Bureau of health facilities and services Page 142 Page 143 Page 144 Page 145 Page 146 Page 147 Page 148 Page 149 Page 150 Page 151 Page 152 Page 153 Page 154 Page 155 Page 156 Page 157 Page 158 Page 159 Page 160 Page 161 Page 162 Page 163 Page 164 Page 165 Page 166 Page 167 Page 168 Bureau of sanitary engineering Page 169 Page 170 Page 171 Page 172 Page 173 Page 174 Page 175 Page 176 Page 177 Page 178 Page 179 Page 180 Page 181 Page 182 Page 183 Page 184 Page 185 Page 186 Page 187 Page 188 Page 189 Page 190 Page 191 Page 192 Page 193 Page 194 Page 195 Page 196 Page 197 Page 198 Page 199 Page 200 Page 201 Bureau of mental health Page 202 Page 203 Page 204 Page 205 Page 206 Page 207 Page 208 Page 209 Page 210 Page 211 Page 212 Page 213 Page 214 Bureau of narcotics Page 215 Page 216 Page 217 Page 218 Bureau of entomology Page 219 Page 220 Page 221 Page 222 Page 223 Page 224 Page 225 Page 226 Page 227 Page 228 Page 229 Page 230 Page 231 Page 232 Bureau of dental health Page 233 Page 234 Page 235 Page 236 Page 237 Bureau of finance and accounts Page 238 Page 239 Page 240 Page 241 Page 242 Page 243 Page 244 Page 245 Page 246 Page 247 Page 248 Page 249 Articles by staff members Page 250 Page 251 Page 252 |
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FLORIDA STATE BOARD OF HEALTH 1962 I^TTB Annual Report State Board of Health State of f~Larda 1962 The following reports will be published separately: SUPPLEMENT I-FLORIDA VITAL STATISTICS, 1962 SUPPLEMENT II-FLORIDA MORBIDITY STATISTICS, 1962 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, 1962. Sincerely yours, ALBERT V. HARDY, M.D., DR.P.H. Acting State Health Officer (October 16, 1961 through December 31, 1962) May 1, 1963 Jacksonville, Florida Respectfully forwarded, WILSON T. SOWDER, M.D., M.P.H. State Health Officer (Returned from leave of absence on January 1, 1963) 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, 1962, to December 31, 1962, inclusive. Respectfully submitted, EUGENE G. PEEK, M.D. President May 1, 1963 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, 1962 DIRECTORS State Health Officer (on leave)...................Wilson T. Sowder, M.D., M.P.H. Acting State Health Officer............-..........Albert V. Hardy, M.D., Dr. P.H. (Assistant 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..................Elizabeth 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....................ames O. Bond, M.D., M.P.H. (Acting Coordinator of Research and Training) Division of Tuberculosis Control................Dwight W. Wharton, M.D. Division of Radiological and Occupational Health..............................Edwin G. Williams, M.D. Division of Epidemiology (Acting)............C. M. Waters, M.D. Division of Veterinary Public Health (Acting) .................. ....William G. Winkler, D.V.M. 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. Bureau of Mental Health............................. Wayne Yeager, M.D., M.P.H. Bureau of Dental Health...........................Floyd H. DeCamp, D.D.S. Bureau of Entomology ..............................John A. Mulrennan, Sr., B.S.A. Entomological Research Center............. Maurice W. Provost, Ph.D. Bureau of Sanitary Engineering.....................David B. Lee, M.S. Eng. Assistant Director.......................................Sidney A. Berkowitz, M.S. Eng. Division of Water Supply.......................John B. Miller, M.P.H. Division of Waste Water....................... Ralph H. Baker, Jr., M.S. San. Eng. Division of Special Services...................... Charles E. Cook, C.E. Division of Industrial Waste...................... Vincent D. Patton, M.S.S.E. Bureau of Narcotics.......................Frank S. Castor, Ph.G. DIRECTORS OF COUNTY HEALTH DEPARTMENTS December 31, 1962 Alachua ......................................................... Edward G. Byrne, M.D., M.P.H. Bay................................................................A. F. Ullman, M .D. Brevard......................................................T. Paul Haney, M.D., Dr. P.H. Broward.........................................................Paul W. Hughes, M.D., M.P.H. Collier...........................................................Clyde L. Brothers, M.D. Dade.............................................................T. E. Cato, M.D., M.P.H. Duval ............................................................ Thomas E. Morgan, M.D., M.P.H. Escambia....................................................... J. C. McSween, M.D. Hillsborough..................................................John S. Neill, M.D., M.P.H. Lake..............................................................J. Basil Hall, M .D., M .P.H. Lee................................................................ Joseph W. Lawrence, M.D. Leon..............................................................Joseph M. Bistowish, M.D., M.P.H. Manatee.........................................................Frederick K. Allen, M.D. Marion...........................................................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. St. Johns..................................................James C. Loranger, M.D. Santa Rosa....................................................A. E. Harbeson, M.D. Sarasota......................... ... ....R. H. Veldhouse, M.D. Seminole...................................................Frank Leone, M.D. 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. Jefferson-Wakulla..........................................Karl L. Van Horn, M.D. Madison-Taylor..............................................Charles L. Mattes, Jr., M.D. Osceola-Indian River...................................C. C. Flood, M.D., M.P.H. (Acting Director) Pasco-Sumter.................................................William L. Wright, 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-Hamilton-Gilchrist.................... George M. Dame, M.D. Franklin-Gulf.............. ..................Willa Dean Lowery, M.D. (On Educational Leave) Glades-Hendry-Highlands ...............................William F. Hill, Jr., M.D., M.P.H. Holmes-Walton-Washington...........................Robert V. Schultz, M.D., M.P.H. (Acting Director) 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; Divisions of Per- sonnel and Health Education; and General Data Processing) ........................................................................ 1 Bureau of Local Health Services (including Divisions of Public Health Nursing, Sanitation and Nutrition; and Accident Prevention Program) .......................................... 24 Bureau of Vital Statistics (including Statistical Section) ............ 64 Bureau of Maternal and Child Health ...................................... 80 Bureau of Preventable Diseases (including Divisions of Epidemiology [Venereal Disease Control Program], Radiological and Occupational Health, Tuberculosis Control; and Veterinary Public Health) .......................... 91 Bureau of Laboratories ............................................................ 124 Bureau of Special Health Services (including Divisions of Chronic Diseases and Hospitals and Nursing Homes; and the Hospital Service for the Indigent Program) ............ 142 Bureau of Sanitary Engineering (including Divisions of Water Supply, Waste Water, Special Services; and In- dustrial W aste) ............................................................... 169 Bureau of Mental Health (including Florida Council on Training and Research in Mental Health) .......................... 202 Bureau of N arcotics ................................................................ 215 Bureau of Entomology (including Entomological Research Center) .............................................................................. 219 Bureau of Dental Health .......................................................... 233 Bureau of Finance and Accounts (including Purchasing and Property) ........................................................................ 238 Articles by Staff Members ...................................................... 250 GENERAL ADMINISTRATION 1 WILSON T. SOWDER, M.D., M.P.H., State Health Officer (On leave entire calendar year) ALBERT V. HARDY, M.D., Dr.P.H., Acting 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 year under review will be remembered by many as an ex- ceptional one in public health in Florida. This was the full year during which Florida's health officer of 16 years was on leave. It was the year of the encephalitis outbreak, hopefully to be recalled as the one major outbreak in the state of this serious disease. These and other matters which came forcefully to administrative attention are reviewed here. The provision of leadership on an interim basis involves prob- lems. A static hold-the-line policy was considered not in the best in- terest of public health. Rather the attempt was to move forward through the broadest practicable cooperative action of senior staff. Generous and congenial participation and assistance is acknowledged with appreciation. Accomplishments are to be credited to staff; the weaknesses may be charged to the interim leadership. The interesting and stimulating experiences, rather than the problems and frustrations, are prominent in memory. The dominant event of the year was the encephalitis epidemic which is considered in adequate detail elsewhere in this report. Per- sonnel of four county health departments (CHDs) and three bureaus were involved in study and control. These were joined by the mosquito control districts and by the laboratory and epidemiology divisions of the Communicable Disease Center (CDC), U. S. Public Health Serv- ice. In-state and out-of-state consultants aided. The prompt establish- ment of a field virological laboratory in space provided by the Tampa Tuberculosis Hospital was a remarkable accomplishment. Staff and equipment were made available through the cooperation of CDC. The resources of the mosquito control districts were used in the broad and intensive control activities. There were outstandingly effective activi- ties but problems also are worthy of note. There were problems in working relationships in the county with the earliest cases which pointed to a need for a clearer definition and understanding of the inter-related responsibilities of state and county personnel in epidemic control. The urgent need for expert aid in the handling of the news in a dramatic epidemic situation became evident also. This was provided when weaknesses were obvious. It solved problems but in retrospect it is apparent that assistance of this type may be needed from the earliest threat of an epidemic. With vigorous efforts, and probably because of them, the epidemic subsided quite promptly. Its occurrence together REPORT, 1962 with the two small outbreaks in 1959 and 1961 demanded the de- velopment of ongoing encephalitis study and control programs. A re- quest for a National Institutes of Health research grant was given special and prompt consideration. A five-year study program was ap- proved and began on December 1. The initial grant of funds in the broad fields of "Chronic Illness and Aging" was received in late 1961; funds were substantially in- creased in 1962. The planning and initiation of this new program de- manded much attention in 1962. Major emphasis was given to the development of home nursing services. Due in part to weaknesses in communication, this program was not always acceptable to medical societies. However, many counties, as described elsewhere, adopted the combined home nursing program. Separate divisions of adult health were organized to develop appropriate programs to serve the health needs of the large populations of aged in Dade and Pinellas Counties. In obtaining official approval of these and other programs par- tially supported by federal grants, it became increasingly evident there was hesitancy in accepting such funds by the Budget Director's office and the Budget Commission. In part this appeared due to past experi- ence that when federal funds terminated state funds were requested to continue the programs. Hence in approval of federally supported activities, there was the specific stipulation that this did not imply any obligation to replace federal with state funds should the former no longer be available. It became evident also there was a further reserva- tion due to the practice of paying from state funds the agency's con- tribution to social security and retirement for persons deriving salary from federal funds. This situation led to a full exploration of what had heretofore been a not clearly stated problem. A program to gradually provide from federal funds for these contributions was evolved and initiated. Medical service to the Cubans is predominantly a Dade County problem and program. However, budgeting for this involved adminis- trative participation of state personnel. During the year an activity which had been assured of support only on a month-to-month basis, attained an appropriate annual budget. This provided for the medical care needs but there was limited success in seeking supplementary sup- port for the community health services required by the more than 100,000 political refugees with very limited economic resources. The denial or withdrawal of license for hospital or nursing home involved time-consuming and disturbing administrative problems. Complaints of damage by air pollution were highly vocal in Polk Coun- ty, and this complex matter was a constant source of concern. The Board met jointly with the Merit System Council in August and with the Air Pollution Control Commission in December. These 2 ANNUAL GENERAL ADMINISTRATION resulted in a better understanding of problems in which there is joint interest and responsibility. In mid-December word was received that the State Health Offi- cer would return from leave on January 1, an announcement which was received with great relief by the Acting State Health Officer, and with great pleasure and satisfaction by him and the entire staff. STAFF ASSISTANCE Assistance to the State Health Officer is available from all staff members, but attention is directed here to that provided by staff spe- cialists reporting directly to him. A health program analyst has served longest in this capacity. His major responsibility is to make available those factual data required for decision making. He is on call to aid in the study of a variety of problems. He functions also in a liaison capacity and maintains par- ticularly close contact with the Interim Legislative Committee on Health and Welfare and other legislative bodies. He serves also as the Board of Health representative on the Florida Milk Commission. The internal auditor is available for the study of fiscal problems. His major responsibility is to assure that fiscal matters are handled in a business-like manner wholly acceptable to the state and federal audi- tors. During the latter half of the year he had an assistant who devoted major attention to the CHDs. Audits were completed on 43 CHDs in the six months since this added assistance has been available. Defects have been chiefly in procedure. Some quite unacceptable practices were revealed and have been corrected. Attention was directed also to developing a basic bookkeeping system which is proving both acceptable and effective (see Bureau of Local Health Services elsewhere in this Report). The staff attorney during the year had as his major task the re- drafting of the Sanitary Code and all official rules and regulations which according to the newly enacted Florida administrative code must be deposited with and published by the Secretary of State. This was a very time consuming and exacting responsibility. A variety of other legal problems demanded attention, but of even more importance consultation was provided to foster the most favorable handling of problems with potential legal implications. Late in the year a Coordinator of Training was added. It has been long recognized that such a position was needed. The full-time news director prepared and distributed 125 news items and other releases to the press, radio, television and magazines. 4 ANNUAL REPORT, 1962 This contributed substantially to the dissemination of information to the public. ACTIVITIES OF THE BOARD Ashbel Williams, M.D., member of the Board of Health, sub- mitted his resignation in 1962. A replacement for Dr. Williams was not appointed by the Governor during the year. February 13-Jacksonville 1. Approved three short term projects to be supported out of Maternal and Child Health (MCH) Funds (Children's Bu- reau): assistance in polio immunization program in Hills- borough County; contract for movie on health problems of the migrant laborers; determination of possible use of well-trained Cuban physicians in the MCH program throughout the state. 2. Authorized Albert Hardy, M.D., to discuss the Civil Defense Program with the Governor in order to determine how much was expected of the State Board of Health in this program. 3. Approved public health applicants for postgraduate training for September 1962-63. 4. Discussed proposed legislative recommendations to present to Interim Legislative Committee on Health and Welfare. 5. Approved of a Merit System study and certain recommenda- tions with regard to it. 6. Approved a revision of Chapter XXIV, School Sanitation, of the Sanitary Code. 7. Appointed a Committee on Demographic Studies. 8. Elected officers-retaining the present incumbents: E. G. Peek, M.D., President, and T. M. Cumbie, Ph.G., Vice President. April 8-Washington, D. C. 1. Approved a revision of Chapter VI, Privies, of the Sanitary Code. 2. Approved a revision of Chapter VII, Section 6, of the Sani- tary Code. 3. Approved a study of Iodination of Water to be conducted by the University of Florida, the Bureau of Sanitary Engineering and the Bureau of Laboratories. 4. The Board discussed "sabbatical leaves" for study and ob- servation and adopted a plan whereby individual cases for study leave would be considered by them and approved only if a worthwhile plan for study and observation of public health programs is presented. GENERAL ADMINISTRATION 5. Approved changes in the Hospital Service for the Indigent rules and regulations. 6. Authorized Dr. Hardy to continue working with the State Hotel and Restaurant Commission on an agreement. 7. Authorized Dr. Hardy to set up a meeting with the Merit System Council and the Board of Health. 8. Approved of a vacation for Dr. Hardy the latter part of Au- gust and early September for a period of three weeks. 9. Approved the recommendations of the Ad Hoc Polio Advisory Committee. May 10-Miami Beach 1. Held a hearing regarding sanitary facilities in subdivisions in Monroe County. 2. Approved revisions in regulations and standards for licensing of hospitals. 3. Approved of Miss Elizabeth Reed accepting a Travel Fellow- ship from the World Health Organization for the period Oc- tober 1 to December 15, 1962, and allowed her to remain on salary status during this period. 4. Approved of Carlton P. Maddox, Attorney for the Board, taking appropriate legal procedures in the case of the Arling- ton Medical Center. 5. Approved 18 applicants for medical scholarships. June 24-Jacksonville 1. Approved certain rules, regulations and standards of the State Board of Health to be filed in the Office of the Secretary of State in line with new Administrative Procedures Act passed in the last session of the Legislature. 2. Approved the establishment of two additional divisions in the Bureau of Sanitary Engineering. 3. Approved an applicant for Osteopathic Scholarship. 4. Approved nine applicants for Dental Scholarships. 5. Approved the rules of the State Board of Beauty Culture as revised. 6. Approved the appointment of Dr. Peek as Advisory Director to the Board of Directors of the Florida Tuberculosis and Health Association. 7. Discussed with Mr. Maddox the Ft. Lauderdale situation with regard to the site of a garbage dump in that area. The Board authorized the Broward CHD to represent the State Board of Health in this matter and stated that Paul Hughes, M.D., and Richard Almeida specifically are agents of the State Board of Health for this problem. 6 ANNUAL REPORT, August 11 -Jacksonville 1. The Board of Health and the Florida Merit System Council held a joint meeting and discussed the problems of concern with regard to the Merit System and the State Board of Health. August 11 -Jacksonville 1. Approved certain rules, regulations and standards of the State Board of Health for filing in the Secretary of State's Office under the Administrative Procedures Act. 2. Approved the Budget for the biennium 1963-65 for the State Board of Health and County Health Units. 3. Approved the legislative program of the State Board of Health. 4. Approved a State Natural Disaster Plan. 5. Approved of a plan whereby deduction of 10 per cent of matching funds be made from CHD budgets that have a sur- plus. 6. Approved the designation of C. M. Waters, M.D., as Acting Director, Division of Epidemiology. 7. Designated W. G. Winkler, D.V.M., as Acting Director, Di- vision of Veterinary Public Health. 8. Discussed the licensure of Lakeside Hospital, DeFuniak Springs, and agreed to approve a provisional license providing certain criteria could be met by those owning the hospital. 9. Approved in principle an agreement between the State Hotel and Restaurant Commission and the State Board of Health. 10. Appointed William L. Wright, M.D., as Acting State Health Officer during Dr. Hardy's absence from the continental lim- its of the United States. October 18-Miami Beach 1. Discussed a proposed meeting with the Air Pollution Control Commission, citizens group and the Board of Health to be held in either Lakeland or Tampa; the purpose of which would be to hear the problems of all concerned regarding air pollution in the area. 2. Approved the amount of $25,000 to be used for a study of mental health in Florida to be conducted by arrangements through the Governor's Office. 3. Approved revisions to the recommendations of the Ad Hoc Polio Advisory Committee. 4. Discussed and directed that certain procedures in the Person- nel Office be investigated by A. P. Ashby, Internal Auditor, and a report given to the Board on this investigation. 1962 ADMINISTRATION 5. Welcomed Hans Tanzler back to his position as attorney after a year's leave of absence for military duty. 6. Appointed Walter Weiss' replacement, Don Evans, as a mem- ber of Advisory Committee for Hospital Service for the In- digent. 7. Approved a resolution to the Surgeon General seeking return of Wilson T. Sowder, M.D., to his position of State Health Officer by January 3, 1963. 8. Authorized a year's leave of absence for James O. Bond, M.D., director of the Bureau of Preventable Diseases, be- ginning some time in December 1962, in order that he be the director of the Encephalitis Project in the Tampa Bay Laboratory; and at the end of the year this leave would be reviewed. 9. Approved an additional request of $75,000 in state funds in the legislative budget for the next biennium for the purpose of constructing a virus laboratory in the proposed new Tampa Laboratory building. 10. Authorized the securing of a clear title to land opposite the Tampa Tuberculosis Hospital for construction of the Tampa Laboratory building. 11. Approved the amount of $20,000 be included in the budget for the next biennium for a building in Vero Beach. COORDINATION OF RESEARCH JAMES O. BOND, M.D. Acting Coordinator of Research The director of the Bureau of Preventable Diseases continued to serve as Acting Coordinator of Research and Training in 1962. His personal interest led to special emphasis on research in the communi- cable diseases. Early in the year there was an evaluation of a trivalent oral polio vaccine. This was a cooperative project conducted by the Hillsborough County Health Department (CHD), the Hillsborough County Medical Association and the State Board of Health (SBH). The purpose of this project was to evaluate the effectiveness of a trivalent oral polio vaccine with the hope that it would meet the standards for licensure and be made available for general use. A total of 190,000 persons were fed one or more doses of vaccine in a period from February to May. This was approximately 74 per cent of the county population under 40 years of age. The best community responses were obtained in the low socio- GENERAL 8 ANNUAL REPORT, 1962 economic groups. The reasons for this were the subject of careful in- vestigations by a team of social scientists. Serological responses to the vaccine were measured on a group of 1500 children and it was found that after feeding of two doses of the trivalent vaccine there was greater than 90 per cent conversion against each of the three types. The effect of the vaccine on the enterovirus prevalence in the community was measured by taking weekly sewage specimens in selected areas in the county and monthly collections of rectal swabs from healthy preschool nursery children. Clinical surveillance for paralytic disease and non- paralytic infections of the central nervous system was established in October 1961 and continued at a high level of intensity throughout 1962. No cases of paralytic polio were detected during or after the feeding program. The usual incidence of aseptic meningitis and other viral infections of central nervous system were observed during this period. An outgrowth of this Hillsborough County program was the establishment on an experimental basis of a continuing plan for the immunization of all newborn infants brought into the community after the mass vaccination program. A pilot study was initiated in this county and later in Orange and Palm Beach Counties to evaluate procedures for attaining effective ongoing immunization programs. This study, which bears the title "An Evaluation of the Use of Birth Certificates as a Means for Achieving Mass Saturation of Immunization of One-Year- Old Infants in the Community," was supported by a one-year contract with the Communicable Disease Center, U. S. Public Health Service (USPHS). The basic plan in all three counties was to identify each infant of three months by the use of birth certificates filed with the CHD. The parents of these infants are contacted at this time to see if immunization had been initiated and again at the age of 12-18 months to see if they have been completed and boosters administered. In each of the three counties the parents of the child were first contacted by mail, then by telephone or by public health nurse visit, if no response was received by any of the preceding steps. In Orange and Hillsborough Counties the clerical and mailing procedures were facilitated by use of data processing equipment from the SBH. In Palm Beach County all administrative procedures were handled locally. The purpose of the project is to measure the cost of carrying out the program in the three different areas, and to determine the effectiveness in achieving immuni- zation of all infants under age of one year. These studies will determine whether such a program should be extended on a statewide basis. During the latter half of the year the Coordinator gave his time virtually exclusively to the encephalitis epidemic (See Bureau of Pre- ventable Diseases, Epidemiology, elsewhere in this report). Research training was an important responsibility of the Co- ordinator. He maintained temporary direction of the research training grant through which a limited number of promising physicians and scientists are provided opportunity for training in community-based Organizational Chart of t- - GOVEI -- -BOARD OF Medical Scholarship Dental Scholarship Council on Training Advisory Committee Advisory Committee and Research in STA- EALTH I (on Ih CITING ASSISTANT HEALTH t STATE HEALTH OFFICER 'Research, Program DIVISION OF PERSONNEL UInalariii BUREAU OF BUREAU OF BUREAU OF VITAL MENTAL LABORATORIES BUREAU OF Demographic STATISTICS HEALTH (Regional FINANCE |Advisory Committee (Clinics) Laboratories) AND ACCOUNTS Deogah t BUREAU OF SPECIAL HEALTH SERVICES DIVISION OF OF INDUSTRIAL SPECIAL NWSTE SERVICES (Air Pollution) DIVISION OF DIVISION OF HOSPITALS AND CHRONIC NURSING HOMES DISEASES (Licensure and (Heart, Cancer, Indigent Pgms.) Diabetes, etc.) I BUREAU OF SANITARY ENGINEERING ASSISTANT DIVISION OF DIVISION OF BBUREA WASTE WATER LOCAL' HEALTH WATER SUPPLY (c DIVISION OF SANITATION 0 67 County Healt -orida State Board of Health ,NOR ] HEALTH RS Hospital Licensure Advisory Committee Air Pollution Advisory Council for Hospital Sevice Control Conmission for the Indigent ,:E w ---- --- II II OFFICER ave) STATE FFICERASSISTANT STATE HEALTH OFFICER DIVISION OF HEALTH EDUCATION (Library) mKImmm BUREAU OF BUREAU OF BUREAU OF RENTOOLOGY BUREAU O BUREAU O DISEASES MATERNAL (Research Center, DENTAL B A O AND osqui to Control HEALTH HEALTH Districts) OFFICER DIVISION OF DIVISION OF IIIn DIVISI I OF DIVISION OF F RADIOLOGICAL AND VETERINARY EPIDEHI SERVICES OCCUPATIONAL PUBLIC HEALTH TUBERCULOSIS (Includi fe on) HEALTH (Mi'lk Sanitation) CONTROL ont E IN DIVSISION OF PUBLIC HEALTH NUTRITION NURSING IN OF OLOGY ng V.D. rol) h Departments I ! I GENERAL ADMINISTRATION 9 research. This involves individual consultation and guidance. For broader participation the Coordinator arranged a three-day visit to USPHS research activities in Washington and Bethesda in which 12 staff members participated. Also there was held in Jacksonville a re- search conference planned and sponsored by Region IV, USPHS. This provided a ready opportunity for many staff members to become better informed as to the availability of research grant funds for a wide variety of differing studies. Another important training and education activity carried out during the year was assistance in the preparation of an issue of Health Notes on the research programs carried on by the SBH and its various CHDs. This was a concise summary of the many projects being carried out by the SBH in the areas of research, demonstration and program development. A part-time consultant on research in mental health was employed during the year (See Bureau of Mental Health elsewhere in this report). A number of project applications for mental health re- search were submitted to the Council on Training and Research in Mental Health and received preliminary review and evaluation by this special consultant and by the Coordinator. The summer student training program continued to develop and is rapidly becoming one of the most effective mechanisms for recruiting young people into the field of public health. A total of 135 applica- tions were received for 42 positions which were available during the summer of 1962. The accepted students saw widely diversified pro- grams in various bureaus, divisions and CHDs. Some carried out creditable research projects of their own during the summer months and submitted formal reports. During the year the initiation of a neurological and sensory dis- ease service program by the USPHS added a new source of study funds. The University of Miami School of Medicine and the SBH were spe- cifically invited to consider undertaking studies supported by these funds. Under pressure of a very early deadline for submitting pro- posals, a joint project was submitted for studies predominantly by the research division of the Dade County Department of Public Health and the University of Miami School of Medicine. Initially this calls for fact finding. Later program development will demand consideration. The Bureau of Special Health Services was involved in planning these studies and it is anticipated that it will have an even greater role in evaluating findings as to service needs. The Community Studies Unit consists of a physician, a health program analyst and a secretary, financed by a research grant from the Kellogg Foundation. During 1962 principal emphasis was on the de- velopment and testing of a system for the evaluation of public health programs and on the compilation of a description of the school health program as seen by participants at the county level. A number of REPORT, 1962 studies were conducted regarding the efficacy of methods of presenta- tion of public health programs, the factors influencing their acceptance or rejection, and child spacing. Consultation was offered to program directors, health officers and others in the revision of long range plans, in the development of data collection instruments and in the improve- ment of administrative procedures. The need for a publication medium for reporting selected re- search and investigative activities in public health in Florida was rec- ognized two years ago by the establishment of a SBH monograph series. This was intended primarily for the publication of studies which were either too long and comprehensive for publication as short reports in professional journals or were of a multi-disciplinary nature so that the publication in a single journal would not adequately reach the pub- lic health audience which would be interested in the findings. The first three such monographs have been published and have received com- mendable response but also indicated a need for establishment of over- all policies and an editorial committee. Such a committee was appointed in 1962 by the Coordinator and was formally designated by the State Health Officer as an editorial board for the monograph series. The fourth monograph was accepted for publication during the year and plans were formally approved for the fifth. SCHOLARSHIPS FOR PROFESSIONAL EDUCATION The scholarship programs created by the 1955 Legislature for the study of medicine, dentistry and the several disciplines concerned with mental health, were continued with only one significant change. Stipends for residencies in psychiatry were terminated as required by the Legislature of 1961. Scholarships for the study of medicine were awarded upon the recommendation of a seven-man advisory committee authorized by statute. The seven members were: George T. Harrell, M.D., Dean of the School of Medicine, University of Florida; John C. Finerty, Ph.D., Assistant Dean of the School of Medicine, University of Miami; Richard C. Clay, M.D., Miami; James T. Cook, Jr., M.D., Marianna; David W. Goddard, M.D., Daytona Beach; Homer L. Pearson, Jr., M.D., Miami; and Melvin M. Simmons, M.D., Chairman, Sarasota. As authorized by the Legislature in 1959, one scholarship was awarded for the study of osteopathic medicine. The recipient was rec- ommended by the State Board of Osteopathic Medical Examiners. Scholarships for the study of dentistry were awarded by the Board upon the recommendations of the State Board of Dental Examiners. Scholarships in the several disciplines of mental health were 10 ANNUAL GENERAL ADMINISTRATION awarded by the Board upon the recommendations of the Florida Coun- cil on Training and Research in Mental Health. 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 CHDs for specialized 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 1962 were: MEDICAL Scholarships Awarded in 1962: Richard Julian Bagby............Miami Leonard Channing Bass......Live Oak Joseph William Haddock......Hilliard Donald Gammon Hall....Blountstown Gordon David Onstad..................Miami Springs Laurie Miles Pardee..............Irvine Howard Todd Willson..........Orlando Lloyd Dale Gauvin*....Walton Beach Richard Thomas Roby, Jr......................acksonville Richard Allison Pollock..Jacksonville Continuing Scholarships Awarded Prior to 1962: Awarded 1959: Gordon Thames Couch Francis Thomas Greene Everett Norwood McCormick Wilbur Williams, Jr. Awarded 1960: Sylvester Barrington Mirion Perry Bowers Rodney Lee Brimhall John Agustine Moore Cupid R. Poe Frederick Oliver Smith Paul Vincent Sullivan Tommie Lynn Thomas* Robert Whelchel Miles *Studying osteopathic medicine Awarded 1961: Thomas John Calhoun George Duncan Finlay Buford Gibson, Jr. Betty Lou Bottoms Jack Denby Bergstresser* Oliver Hunt Harper Betty Jo Johnson James Cranford Phillips Thomas Joseph Philpot Joseph Thomas Rabban David Oliver Westmark Prince Benjamin Oliver, Jr. Hubert Warren Wingate Ronald Loyde Haney Braxton William Price DENTAL Scholarships Awarded in 1962: George Wallace Boring, Jr.....Arcadia Robert Renne Burch................West Palm Beach James V. Ferdinand................Miami Ronald Emil Molinari....Lake Worth William Walker Motley, Jr.....Miami Henry Cephas Nichols....Laurel Hill Alvan Carlton Smith............Orlando Gordan Dennis Wiebe......Tallahassee John Paroy Youngman................St. Petersburg Emory Turner Cain............Pensacola 12 ANNUAL REPORT, 1962 Continuing Scholarships Awarded Prior to 1962: Awarded 1959: George W. Alexander Robert A. Brown Gene Watkins Eng Robert G. Fountain Paul Vonbose Ladd Daniel Gordon Noland Thomas Melvin Scott Awarded 1960: Teddy Wallace Brown Edward Martin Clayton Harold Glenwood Gregg Emmett Alfred Kirksey Lorenza Laws Charles H. Bitter Earl Thomas Sherman Alien R. Treadwell Awarded 1961: Clement W. Barfield George B. Dorris Guy Ronald Estes John T. Griffin, Jr. Charles A. Harrell Arthur R. Higgs Clarence L. McNair Edward L. Peters Ivan Beryl Roberts David M. Strimer William R. Warrender MENTAL HEALTH CLINICAL PSYCHOLOGY Charles E. Buchanan........Gainesville Donald B. Clark............Coral Gables Benjamin F. Gillis..........Tallahassee Mack R. Hicks................Gainesville Stephen G. Irving............Gainesville Patsy Ann Livingston......Jacksonville Nathan W. Perry, Jr.......Tallahassee Richard Toister..............Coral Gables Eve Lyn Weeks............Coral Gables John F. White................Tallahassee PSYCHIATRIC NURSING Betty Land.........................Branford Gretchen LaGodna...................Ocala PSYCHIATRIC First Year Dorothy C. Baker...................Dover George A. Brown..............Homestead Helen C. Ervin......................Dania Cleo G. Griffin............St. Petersburg Phyllis R. Keith..............Opa Locka Lilli Ann Kresge........Ormond Beach William H. Mathis............Indian Lake Estates Imogene C. Peel................Lake City Jo Ann Suco.....................Tampa Allie Mae Truxal........Chattahoochee Herbert W. Uppitt.................Miami Ruth E. W. Wilson............Pensacola Sally Reynalds...............Clearwater Cynthia Strazis......................Orlando SOCIAL WORK Second Year Aza Lee Baxter................Tallahassee Asa O. Flake .................Tallahassee John E. Killiany...................... Miami Mina Jo Powell...............Williston PUBLIC HEALTH PERSONNEL E. R. Broussard.............Health Officer III....................Escambia E. Charlton Prather....... Health Officer II...............State Board of Health Willa Dean Lowery.......Health Officer III..................Franklin-Gulf Marilyn Ferwerda..........Public Health Nurse II..........Broward Genevieve Larsen ..........Public Health Nurse II..........Dade Dorothy Cantall.............Public Health Nurse II..........Broward Irma Taylor...................Public Health Nurse II..........Hillsborough H. Grady Callison.. .... Sanitary Engineer V................State Board of Health GENERAL ADMINISTRATION 13 Frank L. Cross..............Sanitary Engineer II............. State Board of Health Donald W. Rogers.........Sanitary Engineer I...............Hillsborough A. L. Johnson..............Resident Analyst......................Dade Leon Stanley..................Psychiatric Social Worker III.Duval Homer Thompson..........Administrative Assistant...........Broward Robert A. Graves...........Bioanalyst IV...........................Tallahassee Regional Laboratory DIVISION OF PERSONNEL MILES T. DEAN, M.A. Director Under the general direction of the State Health Officer, this di- vision is responsible for the administration of the personnel program of the State Board of Health. This includes advising administrative of- ficers concerning personnel practices and development; putting into effect procedures for carrying out approved personnel policies; partici- pating in the preparation and administration of the approved Classifi- cation and Compensation Plan; administering the leave regulations; maintaining 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, demo- tions, transfers, dismissals, lay-offs and resignations; providing and administering a service rating system; and the preparing of necessary reports both state and federal. Payroll operation, also a responsibility of this division, includes the administration of leave accounting, the employee insurance program, retirement and Social Security, as well as the preparation of the administrative payroll and distribution of war- rants. Preparation of the salary portion of the Legislative Requesting and the Operational Budgets is also a responsibility of the Division of Personnel. During 1962 the number of new employment increased signifi- cantly from 624 employment in 1961 to 821 in 1962. Employment procedure was complicated additionally with the fingerprinting of all new employees. All employees were fingerprinted in accordance with an order from the Governor. Considerable time was spent during the year in debate with the Merit System concerning proposed rule changes. Certain changes were made, most of which were of a procedure nature. These have been somewhat helpful. A proposal was made after consultative study to establish a tripartite approach to SBH personnel operation as a strengthening of Merit System action. An increase in recruitment activities was begun. Training work- 14 ANNUAL REPORT, shops were completed throughout the state on personnel practices and procedures. Distribution was made of office supervisors' training pro- gram material on an experimental basis. Turnover continues to be a problem. There were 526 total ter- minations during the year. Postgraduate training was completed by 13 persons and 14 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, 1953-1962 Year State County Health Total (As of Dec. 31) Office Departments Employees 1962. 692 1821 2513 1961. 626 1593 2219 1960-.. 604 1534 2138 1959 586 1396 1982 1958 558 1321 1879 1957 ..-- 528 1234 1762 1956 481 1127 1608 1955. .-........ 442 1057 1499 1954 421 980 1401 1953-.-- 439 928 1367 1962 GENERAL ADMINISTRATION TABLE 2 DISTRIBUTION OF PERSONNEL-STATE BOARD OF HEALTH (OTHER THAN COUNTY HEALTH UNITS) DECEMBER 31, 1962 r I ADMINISTRATIVE UNIT | .I - .0 fC 4 P0 E-t ~ ~ l' P4Z W M CS -^ 0 Grand Total_.....-_. ___. Administration: SHO ........... Personnel-................................. Data Processing .... ....- ..... Encephalitis (Tampa Bay Regional) ........... Total .....-- --- .... Dental Health................- ........... Entomology.......... ........ Finance and Accounts: Fiscal .......... ........ .. .. Purchasing and Property ..... Total... Health Education: Laboratories Central (Jacksonville)__ Miami .................. Orlando..... ... ....... Pensacola..................................... Tallahassee-..--................................ Tampa................-- .....-... ....-- West Palm Beach...........,..... Total ...............- Local Health Services: Bureau and Inservice Training...... Nursing......- ...-.....-- ........ Sanitation ..................... ... Nutrition ............. ......--..... . Civil Defense..........-............ Accident Prevention -............ Total................... ... .. Maternal and Child Health: Mental Health: Narcotics: Preventable Diseases: Bureau-.................................... Radiological and Occupational Health ........ Tuberculosis Control ....- ...- Epidemiology and Venereal Diseases Control .....-.... Veterinary Public Health ..... Total--------... _-. Sanitary Engineering and Air Pollution Control: Special Health Services: Bureau and Hospitals and Nursing Homes...... .... Chronic Diseases ......-.............. Total ............ ............. ... Vital Statistics .......... ....-....--...... 7 -_ *------- 3 ...... -- ---- ...----.... ... 2 1 .......... ................... ...... 236 9 4 2 2 17 10 29 6 33 39 8 17 4 3 3 2 7 1 39 2 1 .5 1 9 9 7 13 1 3 10 14 1 29 10 9 1 10 9 I I I I r I I .--.-.-... 16 ANNUAL REPORT, 1962 TABLE 3 DISTRIBUTION OF PERSONNEL IN COUNTY HEALTH UNITS-DECEMBER 31, 1962 COUNTY 3 3 ' .i I] I S GRAND TOTAL.__.. 1821 106 308 12 644 35 380 336 1. Alachua --.... 40 2 5 13 2 8 10 2. Baker-...--..... 4 ._ 1 1 __.. 1 1 3. Bay......-.- ... 17 1 2 ;- 6 1 3 4 4. Bradford-____. 6 1 1 --- 2 1 1 5. Brevard__r .. 31 1 6 11 9 4 6. Broward.... ..... 82 3 16 3 244 19 17 7. Calhoun.-- .-- 5 1 2 .. 1 1 8. Charlotte ---_ 11 1 2 -- 6 2 9. Citrus ....._ 6 1 1 1 2 .....- 1 1 10. Clay ............ 8 1 __- 4 2 1 11. Collier....... 11 1 1 ___ 3 1 3 2 12. Columbia.............. 10 1 3 .... 4 .......... 1 1 13. Dade_..... ..... 343 33 54 3 138 9 70 36 14. DeSoto ............. 6 -..... 1 2....... 1 2 15. Dixie.._.. 3 1 .... .... 1 1 16. Duval__.... 48 2 9 .. .. 12 2 10 13 17. Escambia....--.... 68 3 11 ...-- 19 4 21 10 18. Flagler...----..-- 4 .___ 2... .. 1 1 19. Franklin_..___-. 5 1 1 -- 1 2 20. Gadsden ----. 13 1 3 .- 6 2 1 21. Gilchrist___....... 2 __..---- 1-. .. 1_ 22. Glades---....---- 1 ..I ___. ____. 1 . 23. Gulf --_.. .... 7 __.... 1 .. 2 ....-- 3 1 24. Hamilton _....... 6 .._... 1 ......- 3 -...... 1 1 25. Hardee-......-...-- 7 1 ..... 3 ..- 2 1 26. Hendry ...... 10 ... 1 .. 4 ..-.... 3 2 27. Hernando.......... 2 ........ ........ 1 ... 1 28. Highlands- _..._ 10 1 2 4 ........ 2 1 29. Hillsborough ..... 191 8 39 1 68 1 35 39 30. Holmes------ 5 .......-.. 12 ...... 1 1 31. Indian River_.... 12 1 2 ..5 ... .... 2 2 32. Jackson --.-..... 14 1 2 .-... 5 ........ 2 4 33. Jeferson ....... 9 1 1 .... 2 1. 1 3 34. Lafayette ._.. 4._ 1 .. 1 .... 1 1 35. Lakei__ .... .. 18 1 3 ...-... 7 ...-... 3 4 36. Lee___..... ... 14 1 3 ....... 5 ..... 2 3 37. Leon -...-.......... 41 4 5 ... 12 1 9 10 38. Levy..._ ..... 6 ...... .... 2 .. 1 2 39. Liberty.......... 3 ....... ...... .......... I ... 1 1 40. Madison .......... 7 1 1 2 .. 2 1 41. Manatee .......... 30 1 5 ..... 11 2 7 4 42. Marion.__.. 17 1 3 .... 7 ...... 2 4 43. Martin____.... 5 .___ 2 2 ..... 1 44. Monroe__.... 19 1 3 6 5 4 45. Nassau___ _..... 12 1 2 .3....... 3 3 46. Okaloosa...._... 15 1 2 ..._... 5 ........ 1 6 47. Okeechobee_...... 4 1 1 ..... 1 1 48. Orange-....... .... 75 3 12 1 1 22 1 19 17 49. Osceola-__...._...... 5 __.... 1 2 2....... 2 . 50. Palm Beach...... 88 5 14 1 29 2 16 21 51. Pasco- .4... 4 ... 1 ..... 2 ... I 1........ 52. Pinellas ............. 166 9 29 2 67 4 33 22 53. Polk .___..... 90 2 14 1 33 2 17 21 54. Putnam .........-..... 14 1 "1 5 ....... 3 4 55. St. Johns .............. 12 1 3 ..... 4 ........ 3 1 56. St. Lucie......... 18 1 5 .. 3 1 3 5 57. Santa Rosa....__. 10 1 1 ...-.. 4 ........- 1 3 58. Sarasota .............. 44 1 8 14 .-...... 13 8 59. Seminole _...._......... 14 1 3 4 ...--.. 3 3 60. Sumter_.... .- 4 1 1 .... 1 1 61. Suwannee -___.... 9 1 1 3 2 2 62. Taylor---__..... 5 ..._.. 1 2 .. 1 1 63. Union___..._......3.. 3 1 I 1 _ 64. Volusia 54 4 8 -...... 19 1 7 15 65. Wakulla...... 2 1 .... ..... 1 66. Walton__...._.. 7 1 1 :...'. 2 ...... .. 3 67. Washington ....... 5 1 .. 2 ........ 1 1 GENERAL ADMINISTRATION TABLE 4 TURNOVER BY CLASSIFICATION OF THE FLORIDA STATE BOARD OF HEALTH-STATE AND COUNTY CALENDAR YEAR 1962 TERMINATIONS TURNOVER RATE Physicians__.......-. 10 9.2 Sanitarians........ .. ........ 35 11.0 Sanitary Engineers-- ....... 6 14.0 Public Health Nurses... .. ............. 87 12.4 Laboratory Workers (Prof. and Tech.)........ 21 13.5 Clerical .. 156 27.9 All Others-__........................................ 116 21.1 Total_ 431 18.2 Not including persons employed on a temporary or for a specific duration. There were 95 such terminations. TABLE 5 TERMINATION OF FLORIDA STATE BOARD OF HEALTH EMPLOYEES-STATE AND COUNTY BY SALARY RECEIVED AT TIME OF TERMINATION MONTHLY SALARY Up to 200- 300- 400- 500- 600- 700 800 900 CLASSIFICATION Total 199 299 399 499 599 699 799 899 999 1,000 Total ..... ................... 431 54 179 118 37 13 19 4 2 5 ........ Physicians- -.................... 10 ........ ...... ........ .... 1 2 1 5 ..... Sanitarians ................ ....... 35 ..... ......... 20 13 2 ..... ... ----.. Sanitary Engineers ......................... 6 ... ................. 3 ......... ........ Public Health Nurses..................... 87 2 26 52 7 ... ....... ... ........ Lab. Workers (Prof. and Tech.)...... 21 ...... 5 9 6 1 ............. Clerical ......... .. ... ..... 156 17 119 18 2 .. ........ ....----- All Others.-................... 116 35 29 18 6 10 15 2 1 -...... 18 ANNUAL REPORT, 1962 DIVISION OF HEALTH EDUCATION ELIZABETH REED, R.N., B.S. Director This division can report numerous activities during 1962 in line with its assigned duties. As a service unit to bureaus and divisions and county health departments (CHD), it provides the materials for informing a wide diversity of persons both professional and lay about the preventive aspects of health maintenance as well as current public health problems in Florida. It cooperates with all voluntary and official agencies, including schools, that are interested in any aspect of health. It serves as a resource to the general public. The contributions of health education and the social sciences are employed to understand and mo- tivate individuals and communities to take responsibility for their own health through a variety of projects. In 1962, 1052 books were added to the State Board of Health (SBH) Medical Library. Most of these were bound volumes of journals. The collection now numbers 18,465. Circulation statistics: books on regular loan, 1937; books on indefinite loan, 394; periodicals, 13,601; pamphlets, 66. Photocopies made from the library's bound journals totaled 1694; 86 photocopies were ordered from the National Library of Medicine; and 19 interlibrary loans were sent to other li- braries. Reference questions in the number of 2420 were answered and 38 bibliographies were prepared. SBH personnel (2594) were again at the top of the list of bor- rowers. Ranking second were CHD personnel with 47 coming in per- son, and 1453 items mailed out on request. Two hundred seventy-four students from local colleges, nursing schools and high schools came for service. Eighty-two non-medical persons also requested assistance. The library continued to serve in the capacity of an auxiliary agency to the Jacksonville Hospitals' Educational Program (JHEP) libraries. Interns and residents no longer have to come to the library in person. If the item is not available in one of the JHEP libraries, then their librarian requests it from this facility. However, 201 doctors ar- ranged their own loans directly this past year. A list of duplicate journals was offered to other libraries through the Medical Library Association Exchange. A total of 162 requests were received. To date, 1442 journals have been sent to 139 different li- braries; 19 of these are in foreign countries. Exhibits, posters, reproductions, illustrations, slides, signs, field trips, etc., with over 500 recorded projects kept the exhibits section ADMINISTRATION busy throughout the year. Florida was given three honorable mentions for scientific exhibits out of a total of eight awarded at the 1962 APHA meeting in Miami. One of these was designed and carried to completion by the exhibits consultant. Pamphlets distributed last year reached a quarter of a million in spite of limitations imposed on quantities distributed to organiza- tions and schools. Leading in popularity were those on communicable diseases, nutrition and maternal and child health. There is an increas- ing demand for pamphlets giving information on health careers in de- tail. One interesting trend is the increasing number of employees who browse in the pamphlet room. One lamented trend is the steady reduc- tion of well prepared pamphlets offered free of charge by commercial companies. Florida Health Notes monthly mailing list grew to 17,000 by the end of the year. Extra copies are kept on hand to answer numerous requests that continue to come months and even years after publica- tion. This bulletin is designed for a lay audience. Subjects covered dur- ing the year were: intestinal parasites, community nursing service, civil defense, eyesight, toxic pesticides, school health, encephalitis, alco- holism, research in public health and a simplified annual report. Ap- proximately 75,000 extra copies of the issue on encephalitis were or- dered following the epidemic in Pinellas County. Other writing responsibilities included assistance with the editing of SBH Mono- graph No. 3 and the Annual Report. A public service spot campaign was inaugurated on Florida radio stations, with a packet of 42 spots on various subjects, of which 15 were deleted during the year with an equal number added. Plans are being made to serve TV stations in the same manner. A "Guide to Eating and Lodging Places" was prepared for traveling SBH personnel. The "Florida Health Intelligencer," a compilation of news notes about persons in health work in Florida, appeared four times. There is a constant stream of pamphlets and bul- letins being developed. Responsibility for all photography except that concerned with publicity resulted in much activity in this area. An effort was made to streamline the activities of the Audio- Visual library since requests continued to increase, though in many instances could not be met. The use of a tape recorder for booking and a new daily reminder system for posting, shipping and checking on re- turned films was employed. Aids totaling 39 were removed as obsolete or damaged and 96 were added. Equipment placed in the library included: a motion picture projector, new type of overhead projector, tape recorder and an automatic slide projector. There is a constant in- crease (11 per cent in 1962) in the use of equipment by SBH person- nel. A new catalog was printed and distributed. Motion pictures still lead the field with 92 per cent of all aids booked. Circulation showed a slight decrease principally because aids requested are often not avail- able. The total booking orders processed were 4984 in 1962 as com- pared to 5047 in 1961. GENERAL REPORT, 1962 Other activities Staff consultation time was spent with directors of bureaus and divisions and their technical personnel and the three health educators employed by them, the five employed by CHDs, the one with the Com- munity Cervical Cytology Project (see Division of Chronic Diseases elsewhere in this report), with individual mental health workers, as well as CHDs which do not have a health educator on their staff .... Talks to university classes, CHD staffs, civic, educational and professional or- ganizations, consume many hours. Helping people plan meetings, seminars, workshops (and sometimes acting as leader or moderator), serving on interbureau committees, or as officers of voluntary health and professional organizations, attending innumerable meetings, keep the staff occupied. Four regular orientation programs (and one for summer students) were held with 220 persons attending. These seem to grow more pop- ular each year and include invited persons from the education field, PTAs, voluntary and official agencies, universities, as well as SBH and CHD. .. .There was cooperation with Glades and Hendry Counties in setting up a health education program (snake bite problems) for the Seminole Indians. Personnel assisted with the annual Teachers Project (see Bureau of Maternal and Child Health elsewhere in this report) The director was given a 10-week leave of absence to ac- cept a World Health Organization travel fellowship in Latin America so as to better serve foreign visitors (six in 1962) for which this division has the major responsibility. .There was continued work in many ways with schools, faculty groups and PTAs. This division is constantly torn between its time-honored func- tions as a service unit and its desire to embark on community projects that would demonstrate the desirability of more involvement of people within their own groups in improving their health. Two such projects were undertaken in 1962: Promotion of oral polio vaccine in Hills- borough County and chest X-rays in Hardee County. Both of these were aimed at low socioeconomic groups and the discovery and involve- ment of health opinion molders. Until such time as more personnel are assigned, there will regretfully have to be only limited assistance given to projects of this type. Some major problems are the constant struggle to demonstrate to directors of CHDs the desirability of adding a health educator to their staff An adequate budget, sufficient space and a better floor plan for the Medical library are still unsolved. The need for a librarian's office remains acute. Although categorical funds have made possible the updating of books in certain subject areas, other sections are un- balanced and contain much obsolete material Plans for the future include reorganizing and simplifying methods of disposing of duplicate journals; compilation of a staff manual; inauguration of a continuous inventory and encouragement of use of available materials. Also, the librarian plans to work toward accreditation as a Certified Medical Li- 20 ANNUAL GENERAL ADMINISTRATION 21 brarian. Last minute requests and increased activities remained a source of concern to the exhibits section while the problem of storage space for the many valuable materials accumulated grows year by year. Categorical funds which limit the subjects which can be purchased with certain monies make the Audio-Visual library unbalanced in its coverage. Some lacks are accidents, civil defense, arthritis and rheu- matism, vision, etc. Further discussion is needed concerning an additional health educator on the staff, more assistance to CHDs with a significant Spanish-speaking population, acceleration of health career recruitment, stimulation of the 30 community colleges to identify public health problems and locate teaching resources, and a year's study of one or more representative CHDs expenditures on health education. As a contrast to the above, it should be noted that in the long range plan for the division first written in June of 1961, and revised in July 1962, tangible results were noted. Needed equipment for the Medical library and the Audio-Visual library had been purchased, radio spot announcements had been inaugurated and money for a high school student had been budgeted for assistance in the libraries. At the year's end in cooperation with the Bureau of Maternal and Child Health, a television educational program on health designed for fifth and sixth grade children in Duval County was becoming a reality. 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 function consists of the analysis of present methods and systems of office performance, with the objective to simplify, improve, mechanize, or in some cases, eliminate a system. The principal aim is to afford a saving to the agency or in- crease the efficiency of a particular operation, especially in the areas of records handling and storage, forms design, and mechanization of hand operated procedures. IBM DATA PROCESSING: The varied and expanded health programs within the State Board of Health (SBH), as well as the rapid growth of Florida, have led to an equally large production and accumu- lation of paper work. This has required a continuing increase in the mechanization of many of the manual record keeping procedures. This unit now processes approximately 100 programs in the IBM section. These include one or more programs for almost every bureau or division of the SBH. With this expansion of activities it has become necessary 22 ANNUAL REPORT, 1962 during the year to borrow IBM computer time from other state agencies as well as outside industry. Six computer programs have been written and are currently being processed on the IBM 1401 Computer at the Florida State Department of Public Welfare. More procedures are now being programmed for computer use during the coming year. INACTIVE FILE RECORDS DEPARTMENT: Four years ago it was deemed necessary to establish this department. The rapid accu- mulation of records presented a serious and costly problem. Additional costly filing equipment was continually requested; costly prime floor space; and each of these active files needed clerical maintenance. In- ventory of records is now in progress and those found to be inactive are placed in transfer file boxes and removed to the Inactive File De- partment. In addition much microfilming was done, further reducing the size of the records accumulated. The year end inventory of the In- active Records Department showed that the four years of accumulated records now in storage, afforded this agency a savings of over 80 thou- sand dollars. This savings plus the savings involved in records micro- filmed and destroyed in the last three years will show a savings of over 100 thousand dollars. SERVICES RENDERED Personnel Division-A major conversion of records processing continued. All payroll calculations and tabulations as well as leave ac- counting 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 10,444 prac- titioners 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 reports on Workmen's Compensation, salary budget projections, tabulations on expenditures, travel and county receipts and property inventory. 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 9000 discharges were processed in 1962.... Local Health Services- 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 activi- ties reporting of the various disciplines in the county health depart- ments. Maternal and Child Health-A monthly maternal death listing as well as an annual listing is prepared for this bureau. ... Dental Health, Health Education, Entomology-There are numerous small studies and IBM machine tabulations 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 through- GENERAL ADMINISTRATION 23 out the year. Vital Statistics-The processing of all the vital records included in 1962 approximately 120,000 births, deaths, mar- riages, 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 Report, Supplement No. 1, and the Monthly Vital Statistics Report. Preventable Diseases-This bureau received during 1962 over 90,000 communicable disease reports. These were processed by this unit and the data developed were published in the following major reports: Morbidity Report, Supplement No. 2.... Special Health Serv- ices and Indigent Hospitalization Program-During the 1961-62 fiscal year, 34,039 approved applications for indigent hospitalization were processed. From this fiscal information many statistical tables were re- quested, such as age of patients, length of hospitalization, average cost per admission, etc. .Also tabulated were monthly listings of cancer deaths, rheumatic fever deaths, reportable diseases and the semi- annual poison control register. 24 ANNUAL REPORT, 1962 BUREAU OF LOCAL HEALTH SERVICES WILLIAM L. WRIGHT, M.D., M.P.H. Director HUBERT U. KING, M.D. Assistant Director This bureau has as its major responsibilities the supervision of the 67 county health departments (CHD) and the coordination of public health programs throughout the state. The bureau is administered by a director and an assistant director with a small clerical staff. Within the bureau are the Divisions of Pub- lic Health Nursing, Sanitation and Nutrition. Each division has its own director and staff. Additionally, the bureau is responsible for clerical consultation services, the Accident Prevention Program and the Health Mobilization Program (civil defense medical and health ser- vices). For the greater part of the year the bureau had the services of an additional health officer, who was used as a field consultant throughout the state in working with directors of the CHDs. Health programs and activities have continued to grow and ex- pand in the CHDs with particular attention being given to new health services for the chronically ill and aged. Almost all the counties are presently participating to some extent in these new health services. Recruitment of suitable, experienced and trained personnel con- tinues to be a matter of concern in all the professional categories. A number of positions are vacant in the CHDs due to this lack of ade- quately trained and suitable professional applicants. The problem is most acute in the rural areas. Adequate financing of CHDs continues to be a problem, especi- ally with the smaller health units. Many departments have gradually depleted their financial reserve over the past several years and at the same time have either reached or are very near the maximum of the allowable millage for their operations. On January 1, 1962, the Health Mobilization Program was trans- ferred from the Bureau of Special Health Services to this bureau. CLERICAL SECTION In 1962 the duties and responsibilities of the clerical consultants were expanded to include more phases of the work being done by the clerical personnel in the CHDs. These consultants now assist the CHD staffs in all matters of personnel papers, finances, payrolls, bookkeep- ing, record keeping, filing, vital statistics, recording and the comple- tion of medically indigent applications. Additionally, the clerical consultants spent considerable time and effort in the central office assist- ing in the preparation of budgets, making budget changes, recording SERVICES 25 changes of personnel in the counties and compiling information and data which are of value and assistance to the CHDs. Clerical consultations and/or instructions were given to 49 CHD staffs during the year. About two-thirds of these consultations were made by requests coming from the counties with the remainder result- ing from observations made in the bureau office. Such consultation services will usually average three to four days each. Assistance was given to eight CHDs where new clerical personnel had been employed without previous public health experience. In these instances follow-up visits were routinely made after a short interval so that additional in- struction could be given. In cooperation with the Internal Auditor of the State Board of Health (SBH) a simple basic bookkeeping system was established in 65 counties and also for one Mental Health Guidance Center. The other two counties, Dade and Pinellas, because of the size and com- plexity of their financial requirements, continued to use their present more detailed bookkeeping systems. Indications are that the simplified bookkeeping system has been well accepted and is proving of value to the county health officers and staffs. The clerical consultants devoted considerable time during the year to assisting the CHDs in setting up and completing the change-over to the new nursing record system. As of the end of 1962 there were 13 counties using the complete new nursing record system, with an addi- tional 38 counties having made some start towards this change-over. The clerical consultants compiled the monthly report of activities from similar reports submitted by the 67 counties. Much of the sta- tistical information contained in the tables in this annual report come from these monthly reports of activities. Each activity report submitted by a CHD is checked for completeness and accuracy. Only two of the 67 counties, Sumter and Volusia, submitted reports for the entire year without a single error. Continued assistance was given by the clerical consultants to both the state and local records committees. HEALTH MOBILIZATION Under executive order of the Governor, the SBH is responsible for the organization and provision of the following emergency services: medical care, public health, potable water supplies and mortuary serv- ices. This responsibility involves this agency with all of the medical, paramedical and public health personnel in the state. Also involved are many other groups not usually considered as being medical personnel. These responsibilities include the management of medical personnel, supplies and facilities and the actual provision of services during a disaster. LOCAL HEALTH REPORT, 1962 About the first of March the SBH received 98 kits with which to carry out a pilot study of a medical self-help program. These kits were distributed to the respective counties. The ultimate objective of this program is to train one person in each family so that they might take care of the sick or injured in case the services of a physician were not immediately available during a disaster. The initiation of this pro- gram involved a personal visit to each county by the health mobiliza- tion coordinator, the establishment of a county planning committee and the preparation for conducting the 16 hours of instruction. A total of 26 counties participated in this pilot demonstration which met with varying degrees of success. During the late summer the 34 civil defense emergency hospitals, now prepositioned throughout the state, were inspected by the Federal General Services Administration. Most of these hospitals were in fairly good shape but almost all of them had some minor items which needed correction. Two additional emergency hospitals for training purposes are located in the state, one in Miami and the other in St. Petersburg. The latter has been set up in a building at the county-owned airport and is being used for training purposes. The one in Miami has not been fully utilized. These 36 hospitals and their medical stockpiles have a value of $833,000. The Cuban crisis late in the year provided a sudden spur to all the state's civil defense activities and steps were taken to organize a Task Force for Health Resources Management. Represented on the Task Force Committee are some 26 agencies and/ or organizations. At the close of the year emergency medical and health plans and activities presented a very spotty picture. Some counties had developed satisfactory local plans and were prepared to take effective steps to cope with emergencies while some others had only begun to work on their plans. Health mobilization responsibilities include not only civil defense emergencies but natural disasters as well. In September such a natural disaster developed in the Sarasota area due to excessive rains and con- siderable flooding. A mobile laboratory from the SBH was dispatched immediately to assist the CHDs on the lower west coast with the prob- lems of potable water supplies, both public and private. ACCIDENT PREVENTION The purpose of the accident prevention program is to give guid- ance to the CHDs in expanding their accident prevention activities in the fields of home, school and recreational safety. While an active interest in traffic and industrial safety is maintained, it is felt that these are adequately covered by other state agencies. Efforts were made during the year to interest CHD personnel in giving additional atten- tion to accident prevention by incorporating this consideration into their other daily responsibilities. 26 ANNUAL LOCAL HEALTH SERVICES 27 A special detailed study of accidents to residents and employees of nursing homes in the state was completed early in the year. This study was carried out with the cooperation of the Florida Nursing Home Association. Not all of the nursing homes in the state were involved in this project. Those which were involved gained a good bit of useful information concerning their own accident hazards. This report was circulated to all nursing homes in hopes that others would survey their own facilities and remove such accident hazards. In cooperation with the National Safety Council and the Sliding Glass Door Institute, the Dade County Department of Public Health undertook a survey of accidents involving sliding glass doors in homes. The study was later expanded to three other counties in the state and is presently continuing. A total of 141 accidents with 21 injuries were investigated. It is expected that this study will result in recommenda- tions concerning the manufacture, installation and use of these glass doors. Florida's 20 poison control centers were inspected and inven- toried during the year and recommendations were made for improve- ments where these were indicated. These inspections resulted in a renewed interest in poison prevention and the SBH received inquiries from a number of communities desiring to establish such centers. A total of 3880 poisonings were reported to the SBH during the year. Since the coverage of the state by poison control centers is not com- plete, the number of poisonings being reported is estimated to be not more than 50 per cent of the total which actually occurs. The public health nurses made 3147 follow-up visits on reported poisonings. It is during such visits that the nurses have the opportunity to give parents and family members information concerning the prevention of poison- ings. Tabulation of the reports indicates that 60 per cent of the total poisonings occur in children under five years of age with the highest frequency being in the two- and three-year-old children. Substances most frequently reported include: aspirin, other internal medications, cleaning and polishing agents, insecticides and kerosene. The SBH, in cooperation with the University of Florida Medical School and the Florida Medical Association, set up a reporting system for all snake bites occurring within the state. At the close of the year information had been collected on 280 snake bites which had resulted in three fatalities. About one-half of the bites occur in children 15 years of age or younger with two-thirds of the total occurring in people 20 years of age or younger. About half of the bites occurred on the arms and the other half on the legs. During 1962 the personnel of the Palm Beach CHD undertook to make a survey of accidents occurring to members of their immedi- ate families. Some 200 individuals of 75 families were involved in the study with 70 accidents of various kinds and degrees of severity being reported. Slightly over half of these accidents took place in or about the home with the kitchen and yard areas being the most frequent sites of occurrences. 28 ANNUAL REPORT, 1962 COUNTY HEALTH DEPARTMENTS The organizational pattern for county health units remained essen- tially the same during 1962. The Jefferson-Wakulla Unit and Frank- lin-Gulf Unit were officially made permanent bi-county units. With the appointment of a health officer for the former, the Leon CHD was relieved of responsibility for supervision of this unit. Thus there were 25 single county departments; nine bi-county units; and eight tri- county units-for a total of 42 county health units. Some 77 physicians were employed full-time in county health units in 1962. During the year three local directors resigned, three transferred to other positions, and there were five new appointments. At the end of the year, there were four vacancies for local directors in the state-with definite prospects for filling two of these positions. Four public health residents received approved training during the year. And one health officer received postgraduate training leading to the Masters of Public Health degree. Staffing and Financing: (See Bureau of Finance and Accounts and Division of Personnel elsewhere in this report.) As of Decem- ber 31, 1962, there were 1821 employees on the staffs of CHDs. CHD budgets totaled $9,968,436 for the calendar year 1962. Of this total $6,752,114 came from local contributions; $2,515,362 from state and federal funds; and $700,960 came from the budgeted re- serve. Health Center Construction: New headquarters centers were completed at Naples in Collier County and Ft. Myers in Lee County; new auxiliary centers in Ft. Walton Beach in Okaloosa County, Ha- vana in Gadsden County, Frostproof and Auburndale in Polk County and Ft. Lauderdale in Broward County. Other quarters were secured in the City of Okeechobee in Okeechobee County, and quarters were remodeled at Reddick (Marion County). Construction began on new headquarters centers in Ocala in Marion County, and Ft. Pierce in St. Lucie County. HIGHLIGHTS OF LOCAL PROGRAMS The statistical report of CHD activities (Table 7) indicates the number and types of various services rendered by local health depart- ments. The following is a summary in abstract form of some of the more exceptional or outstanding developments in local programs: Baker-The combination nursing program continued during the year demonstrates the value of a program of this type in a rural area. Added emphasis was placed on rabies and hookworm control as well as school sanitation and accident prevention. Brevard-Under the new medical director a comprehensive study LOCAL HEALTH and evaluation of the nursing and environmental sanitation programs were undertaken. These studies indicate that the continuing population growth resulting from National Aeronautics and Space Administration and other space activities require substantial expansion of services through the addition of more adequate staff and facilities. Steps are being taken to meet these needs. Plans were formulated for the renewal of a mental health program in the county. Specific attention was given to psychiatric emergencies with the result that commitment of such patients to jails has been eliminated. In cooperation with the U. S. Public Health Service (USPHS) and Winthrop Laboratories Research Department, the CHD began a Measles Vaccine Field Trial. Some 897 children under seven years of age are participating in the program. Follow-up on these children will continue during the next few years. A mass tuberculin testing X-ray program was successfully completed in September. The CHD cooperated in establishment of a program for hospitalization of medically indigent maternity patients; began a com- bination nursing service in the county on a limited basis; cooperated with the SBH in the atypical acid-fast study, and completed plans for a pollution survey of the Indian River. Broward-Reported a serious outbreak of some 200 cases of in- fectious syphilis which was brought under control through the team- work of the CHD staff, VD investigators and private physicians. Con- ducted studies in cooperation with local psychiatrists in an effort to expand outpatient and home care services for psychiatric patients. Made fluoride drops available to children under care of the dental clinic to determine the effectiveness of this procedure in reducing the decayed-missing-filled rate. Assisted the county commissioners in a pro- gram in which the county plans to take over operation of water and sewage utilities in unincorporated areas. Conducted an extensive sur- vey of garbage disposal as a result of which the county commission laid plans to build three incinerators and assume responsibility for garbage disposal. Established 20 air pollution stations in a study to provide baseline information which will be of great value as the county becomes more industrialized. Published an extensive 25-year history on public health in Broward County. Charlotte-Increased school health activities. Expanded psychologi- cal testing in the schools. The Gray Lady program was also expanded to include all but one school. Volunteers were secured to serve as health room attendants and were given instruction in general duties, first aid, etc. In cooperation with school officials prepared and distrib- uted a school health manual. Regular meetings were held with PTA officials. Formation of PTA Health Committees was stimulated. Indi- vidual conferences with teachers, especially those newly employed, were held to discuss school health problems. Discussed services of health department with lunchroom managers. Gave numerous lectures in the schools on health subjects. Established a home nursing service in the county. Conducted the first glaucoma screening program in the county with over 800 individuals tested. Seventy-three suspects were SERVICES 29 REPORT, 1962 detected. Pollution sewage of tidal water was a major program during the year. Collier-Moved headquarters from Everglades City to Naples as result of the referendum moving the county seat. In November moved into a new modern health center in east Naples adjacent to other county government buildings. Dade-The Cuban Refugee Medical Dispensary was moved to larger quarters. With expanded facilities and increased staff, as many as 16,000 patients were served during a single month. At the end of the year the staff assisted in processing and rendering care to the Bay of Pigs Cuban prisoners. In another new development a Division of Adult Health and Aging was established, and will have as its goal the coordination and expansion of activities in the control of chronic illness and problems relating to aging. The nursing home and hospital inspec- tion programs are also included in this division. Through increased state and federal support intensified casefinding and treatment activi- ties in both tuberculosis and VD control. Began a new air pollution control program under the Engineering Division. A countywide survey was initiated, local legislation was drafted and monitoring techniques established. The Divisions of Research and Epidemiology were com- bined and jointly engaged in 20 research projects during the year. Established a psychiatric unit within the CHD to assist the Juvenile Court. Conducted a program for the prevention of recurrent congestive heart failure. Also began planning for a project to tape record heart sounds of children in public schools. One of the highlights of the year was the 90th annual meeting of the American Public Health Associa- tion at Miami Beach in October. The Florida Public Health Association met concurrently and awarded T. E. Cato, M.D., Director of the Dade County Department of Public Health a Meritorious Service Award. Escambia-One hundred and sixty-three children participated in a study of the effectiveness of inactivated measles virus vaccine sup- plied by Pfizer Laboratories and conducted by the CHD. During the summer, a student training program in environmental sanitation was inaugurated. Gadsden-Highlight was construction of a new auxiliary health center at Havana. Glades-Hendry Began a unique program that of teaching first aid to the Seminole Indians. This in cooperation with the Ross Allen Institute, Ocala, and local Red Cross. Included were courses on snake bite, firearms safety and general first aid. Hardee-Continued expansion of staff and program. Physical examinations were given to all students taking physical education, and to football and basketball players. With assistance of the Gray Ladies conducted audio-visual tests in the schools. Completed a tuberculin skin testing program on all students in the first, second, third, ninth, 30 ANNUAL LOCAL HEALTH SERVICES 31 tenth and eleventh grades with careful follow-up of all positive reactors and their families. Helped expand the Gray Lady program to cover all elementary schools. Purchased a complete dental unit and made plans for a dental health program. Initiated a home nursing program in the county. Conducted a study utilizing community resources in a mobile X-ray program to demonstrate the importance of community resources in the success of mass surveys. Hillsborough-Approximately 388,000 doses of Sabin Trivalent Oral Polio Vaccine (Lederle) were fed to citizens of Hillsborough County in a mass immunization program in the spring. No polio-like illnesses occurred after the vaccine was given. Sewage specimens and fecal specimens from nursery school children will be taken routinely for two years to determine the extent of natural virus which may remain in the county. A "vaccine acceptance" sociological sampling survey and an immunization level sampling survey were also con- ducted-with some 1200 children tested for antibody response. In- tensified the general immunization program by using a new immuni- zation reminder system. Conducted a sampling survey for streptococcal infections among school children using throat swabs. The SBH pro- vided funds with which the CHD began a survey count of acute rheumatic fever and acute glomerulonephritis cases in the county. Continued the occupational health program sponsored by USPHS grant and begun in 1961. A project was begun to study air pollution in three areas of the county. Information on industries in the area was collected. A special study was done in an area adjacent to a large asphalt plant using a non-industrial area as the control area to correlate the incidence of respiratory symptoms with air pollution. In coopera- tion with the USPHS carried out a cancer demonstration project in which some 57 per cent of all female Aid to Dependent Children (ADC) recipients were examined for uterine cancer. The community nursing program was expanded during the year. Cooperated with the SBH and the USPHS in radiological sampling of food and drink. Con- ducted an intensive communitywide educational program on fluorida- tion of public water supplies. Holmes-Devoted much time to the formulation of civil defense plans. Put a mosquito control program into operation at Bonifay. Com- pleted plans for a sanitary landfill program to begin early in 1963. Developed an outstanding school health program in one of the schools which it is hoped will serve as a model for other schools in the county. This program will be under direction of the school health coordinator in cooperation with the CHD staff. Projected as a five-year study, cor- relation of student health and scholastic achievement will be one goal of the program. Lake-Expanded the sanitary landfill program in the county and in cooperation with three townships purchased 140 acres of land and a new bulldozer for this program. It is felt that the development of a countywide garbage disposal program has contributed materially to 32 ANNUAL REPORT, 1962 the elimination of rabies in dogs by removal of "feeding areas" formerly provided by open dumps. The CHD has concentrated efforts on the civil defense program and has done much to stimulate private construc- tion of fallout shelters. Some 50-plus shelters have been built with the largest ones accommodating more than 100 people. Conducted a school survey on smoking habits of 500 high school students. Conclusions are that more education needs to be done with those under 15 years of age. Parents' smoking habits are closely correlated with those of their children-if neither parent smokes there is one chance in 11 that the child will smoke by the senior year; if one parent smokes the chances appear to be one in four; but if both parents smoke the chances increase to one in three. No definite correlation could be established as to cause and effect of smoking and poor grades. Every school in the county received at least one lecture on the harm of "Fiddling with the Filthy Fags." Lee-Moved into new quarters in the Courthouse Annex. Ex- panded tuberculosis casefinding program with the addition of an X- ray machine. In cooperation with the Lee-Hendry County Medical Society administered Types I and II Sabin Polio Vaccine in the com- munity. Conducted an extensive survey of the waters of the county so that with few exceptions all waters are now approved for shellfish and other controlled fishing. Madison-Inaugurated a combination nursing service during the year. Conducted a small community screening survey for diabetes, anemia and hypertension. Manatee-Began a community home nursing program in coopera- tion with the Manatee County Medical Society in March. Since that time the program has shown rapid growth and progress. Additional staff nurses and a director of nursing service have been added to the staff. Marion-A team from USPHS assisted the staff in making tests on ADC recipients for uterine cancer. Of 467 patients tested, 69 had abnormal findings. The nursing staff spent much time on this project with a number of discussion meetings being held to prepare patients for the tests. A number of home visits were required to insure proper medical follow-up for those with abnormal tests. A dental clinic was begun with the appointment of a dental preceptor. Over 1000 indi- gent children have received dental inspections with 121 completed treatments. Late in the year services of a physical therapist for one day a week were secured. Much time was spent in laying plans for the home nursing program expected to begin in 1963. The town of Reddick pro- vided new health clinic quarters and Dunnellon began remodeling a building for a clinic there. The sanitation staff was busy with sub- division inspections with installation of two new community water systems and extension of city lines to three new subdivisions. Belleview and Dunnellon expanded their water systems and began work on sew- LOCAL HEALTH SERVICES 33 age treatment plants. The county commission appropriated funds to begin an arthropod control program. Additional equipment was ob- tained to expand and improve landfill operations. Under supervision of the CHD the county's first animal pound was constructed and began operation. The number of cases of rabies in wildlife increased and a study in cooperation with the USPHS and SBH was conducted. A number of "growth study committees" were organized to study the problems of community growth in suburban areas. Construction was begun on the new health department headquarters in Ocala. Monroe-A large amount of time and attention was devoted to sewage disposal which constitutes a significant and unique problem in the Keys due to the geology of this area. The SBH is cooperating in conducting a survey in the Keys to determine the amount of pollu- tion of contiguous waters. Much interest has been shown by citizens and community leaders so that progress should be made in this program in the near future. The Hansen's Disease (leprosy) register still shows some 17 known cases of this disease in the county. All are under treat- ment. The tuberculosis casefinding program has been stepped up by substituting tuberculin skin tests for routine chest X-rays. Nassau-A community committee with representatives from the county medical society, local hospital trustees, welfare department, county commission and health department was organized to study the problem of providing adequate funds for hospitalization of the indigent and to establish criteria for "medical indigency." As a result patients are being more carefully screened and the limited funds available are being used to better advantage. Land was secured and plans made for an auxiliary health center at Yulee. A countywide X-ray program was conducted in August. A survey of local waters for oyster gathering was conducted. Palm Beach-A new rehabilitation program was organized under a plan developed by Dr. Howard Rusk. This program has as its goal the rehabilitation of disabled persons in the county home and hospital, those in private nursing homes, and patients seen through the bedside nursing program. In addition to a well-trained physician, the staff consists of a physical therapist and an occupational therapist. A reha- bilitation center has been established at the county hospital. The pro- gram is being used to train interns, nurses and other students. A countywide committee representing over 25 agencies interested in re- habilitation is being organized to coordinate services. The coordinated administration of health, welfare and indigent medical care services in this county continues to provide an opportunity for program devel- opment which would not be possible without this coordination. Ex- amples are the rehabilitation program, improvement in mental health services and reorganization of the total indigent medical care program in the county. A psychiatric clinic for adults was organized in 1962. The entire mental health program is being reviewed and reorganized to meet changing needs for services. A medical plan for the county 34 ANNUAL REPORT, 1962 home and hospital was submitted to the Board of County Commission- ers projected to the year 1980. Based on this, a construction program and plans for a 500-bed facility have been prepared. The first phase of construction will begin in 1963. In cooperation with local physi- cians, a newborn immunization program was begun. Parents of new- born infants are contacted and follow-up is made to get these infants under medical care and immunized. The Migrant Project continued with expansion of medical care carried out through mobile clinics taken to the farms. The CHD in cooperation with the SBH has developed a new record system to improve the evaluation of services. Conducted a study of accidents among health department personnel. Participated in evaluation of the Pfizer Trivalent Oral Polio Vaccine among 100 pre- viously unimmunized children with studies to determine antibody levels and rectal swabs for viral studies. Cooperated with a local hospital in organizing an outpatient department serving patients admitted under the Hospital Service for the Indigent program. Daily clinics are held and patients are followed for three months after discharge from the hospital. A public health nurse coordinates inpatient and outpatient services, including use of home nursing and ancillary services. Pinellas-Experienced a serious outbreak of viral encephalitis during the Fall. An extensive mosquito control program was planned for the Spring of 1963 for the purpose of lessening the probability of another outbreak. In October began a Psychiatric Emergency Service to prevent jailing of mentally disturbed patients. Cooperated with the USPHS in establishing a study of accidents among the aged. Con- ducted a series of nine symposia to interpret the findings of the Gerontology Research Project. The symposia covered the health prob- lems of the chronically ill and aged and utilized the services of state and national speakers-focusing on solutions to problems of the aged through community health programming. Began a study in July on the extra-hospital needs in a retirement area. Six public health nurse inter- viewers were trained and some 850 of an anticipated 2850 interviews were completed. Early findings indicate that greatest needs are in nutrition, dental care and preventive health services. A great deal of chronic illness has been discovered-most of which is being handled adequately by the family. A Health Careers Futurama was held in January for 3500 students, teachers, guidance counselors and parents. The largest water supply expansion program in the history of the county was completed in 1962. The sanitary sewerage program con- tinued with much success-with some 75 per cent of the population being served by sanitary sewers. Putnam-Assisted the county medical society and local chapter of the National Foundation in a Sabin Polio Vaccine feeding program. All three types were used. Public response was excellent for the first two feedings but lagged on the third one. A unique feature was use of voting polls as feeding stations. Plans for a new headquarters build- ing are almost complete. Approval for a community home nursing pro- LOCAL HEALTH SERVICES 35 gram was secured from the county commissioners and medical society -which program began in April. This program is showing satisfactory progress to date. Supervision of landfill operations was delegated to the health department as part of its arthropod control program. Additional equipment has been secured and by the end of the year nine landfills were in operation. St. Lucie-Construction was begun on the new $150,000 health center. Completion is expected early in 1963. Santa Rosa-Initiated a dental health program with appointment of a dental preceptor. During 1962 some 744 school children received dental inspections and 649 patients received dental care. Programs on nutrition and dental care were conducted in the schools. Six classes in medical self-help were conducted. Numerous meetings were held to stimulate completion of a nursing home for the county. The staff gave lectures in the high schools on preparation for marriage. A tuberculin testing program was begun using the Sterneedle technique. Over 4700 tests were completed last school year. All positive tests were rechecked with the Mantoux test. A report of the two-year study will be published upon its completion. The CHD took over operation of the arthropod control program in the county. Sarasota-Cooperated with the county medical society in con- ducting a Sabin Polio Program. Types I and II were given in 1962 with Type III scheduled for March 1963. Some 108,260 doses of Type I and II vaccine were given. The Tumor Clinic was moved into the hospital to coordinate activities with the maternity clinic. This has greatly facilitated clinic operation. The mental health program con- tinued to grow and provided social, economic and environmental in- formation to the courts, state hospitals, local doctors and CHD staff. As a specialized aspect of this program 129 alcoholic patients were referred to the staff. Forty-one of these patients were treated at the Florida Alcoholic Rehabilitation Center and 88 in the community. Visiting Nurse Association-Public Health Nursing Program continued its growth during 1962. A nurse was employed to coordinate hospital activities with those of the health department in this field. Better referrals and a closer working relationship with the hospital have resulted. The CHD served as a training center to give public health nurses training in home nursing care techniques. The CHD also con- tinued to provide "observation" experience to nursing students from the Manatee Junior College and Sarasota Vocational (Practical Nurses) School. In the field of sanitation the following progress was noted: The city of Sarasota passed a local ordinance requiring Department of Agriculture inspection of all meat sold in the city. Local bay areas were surveyed and approved for commercial shellfishing. A countywide ordinance was passed requiring licensing and bonding of all county well-diggers and provides for control and conservation of underground water supplies. Conducted a "management institute" for restaurant managers and owners. 36 ANNUAL REPORT, 1962 Seminole-Established a new well-child clinic in cooperation with local pediatricians. Conducted an extensive intestinal parasite screening of colored school children. Distributed 549 Dreypacks for detection of diabetes during Diabetes Detection Week. Nine previously unknown cases of diabetes were discovered and confirmed by blood sugars. Sanford began construction of new sewage treatment plant. County entered into an arthropod control program in cooperation with the SBH. Three sanitary landfills are being operated giving the county a good garbage disposal program. Surveys and maps were begun look- ing toward an extensive drainage and larvaciding program for mosquito control in 1963-64. Considerable progress was made in control and expansion of water and sewage facilities. A franchise agreement be- tween the county government and utility companies has been under study this year. As a result improvement in services provided by these companies has resulted. Volusia-Conducted a comprehensive foodhandlers school with some 275 foodhandlers from schools, nursing homes, hospitals and restaurants attending. Carried out a water pollution survey with ap- proval of shellfish gathering in certain areas. Participated in cancer detection program for ADC recipients. Of 592 patients examined, 24 had some type of pathology requiring follow-up which is now in prog- ress. Conducted a survey among all retarded children in public schools to detect phenylketonuria. Trained six public health nurses from other counties in the home nursing care program. Supplied information about this program to a number of university students. Home nursing services increased significantly during the year. Two nurses were added to the staff. Walton-Washington-Particular attention was given to the de- velopment of a definitive civil defense program-with assignment of duties and responsibilities to all staff members. LOCAL HEALTH SERVICES 37 DIVISION OF PUBLIC HEALTH NURSING RUTH METTINGER, R.N. Director The administrative structure of this division remains unchanged, consisting of a director, five generalized consultants, one nurse-mid- wife consultant and two clerical assistants. One of the consultants acts as assistant director and guides the nursing in-service education pro- gram. The nurse-midwife is responsible for the training and super- vision of midwives. The purpose of the division is to insure that a high quality of public health nursing service is offered by each county health depart- ment (CHD). In attempting to achieve this purpose, the consultants' duties are: to participate in planning conferences with bureau and di- vision directors; to interpret to local personnel the policies of the State Board of Health and new trends in nursing programs; to offer consulta- tion in specific and general technical aspects of public health nursing, including interpersonal relations; to participate in the planning and implementation of local, district and statewide in-service training pro- grams, community health activities and workshops; and to promote continuing education and in-service training for nurses. All aspects of the public health nursing program received atten- tion during 1962, but certain activities received particular emphasis. NURSING CARE OF THE SICK AT HOME An increase in federal funds for the improvement of programs for the chronically ill and aged made possible an acceleration of the plan for extending to rural areas nursing care of the sick at home. At the beginning of 1962 there were 12 areas in which this service was combined with other public health nursing activities; as the year ended there were 29 areas with expanded services, an increase of almost 150 per cent. A major portion of the consultants' time was spent in interpreting this program to CHDs and in helping to organize citizens' advisory committees to help promote and implement the programs. ORIENTATION AND TRAINING ACTIVITIES As the expansion of the home nursing care program accelerated, there was a need for refresher courses in bedside nursing techniques for public health nurses, and for advanced and special courses in re- habilitation nursing. Thirty-two public health nurses from health units where the combined service was in operation or in the planning stage spent two weeks in Clay, Sarasota or Volusia County for orientation in nursing care of the sick at home. Fifteen participated in a two-weeks' short course on home care of the sick and aged offered by the University of Florida. Thirty-one 38 ANNUAL REPORT, 1962 public health nurses were sent to Rusk Institute, Sister Kenny Insti- tute, New York Medical Center and/or the University of Miami for short courses in rehabilitation. Six nurses went to the University of North Carolina for short courses in special fields, such as supervision, chronic diseases, etc. A national conference on home care of the sick and aged was attended by 12 public health nurses from Florida, including one of the nurse consultants who presented a paper. In-service study groups continue to meet regularly as in the past. Junior colleges were encouraged to establish programs leading to the associate degree in nursing. Six such programs were in operation during 1962, and four more will be initiated next year. REVISION OF NURSING RECORDS AND FILING SYSTEMS In cooperation with the clerical consultants, the nursing consult- ants helped CHD personnel to install the recently approved central filing system and revise nursing records. WORKSHOPS AND CONFERENCES The division continued to conduct workshops and conferences on human relations and mental health in public health nursing, in coop- eration with the Bureau of Mental Health. A committee of nurses from CHDs and the Division of Public Health Nursing prepared a "Guide for Public Health Nurses Working With Families Who Have Emotional Problems," which was distributed and reviewed with public health nurses throughout the state. TRAINING, LICENSING AND SUPERVISION OF MIDWIVES The nurse-midwife consultant made 46 visits to counties to con- duct or assist in the planning of educational programs for midwives. About 150 midwives attended. Two hundred and three midwives were licensed in 1962, a decrease of 14 from the preceding year. Midwives in rural areas are being eliminated where local physicians and hospitals are able to care for indigent prenatals. OTHER ACTIVITIES Aid was given to the Division of Hospitals and Nursing Homes in the grading of nursing homes, and consultation was offered to CHD nurses and sanitarians regarding local nursing home problems. One of the consultants participated on a committee with members of the Florida League for Nursing and Florida Tuberculosis and Health Association in the organization and activities of a committee on nurs- ing in tuberculosis and other respiratory diseases and helped plan future conferences on this subject. LOCAL HEALTH SERVICES 39 In carrying out their assignments the consultants made a total of 262 visits to counties during the year, emphasizing the listed activi- ties and continuing to give attention to all phases of public health nursing. DIVISION OF SANITATION A. W. MORRISON, JR., R.S. Director The activities of this division continue to focus on the broad objectives of development and improvement of local environmental health programs designed to effectively serve the needs of each com- munity in the state. To this end, the staff consisting of: the director, four sanitation consultants and two clerical personnel plus the half- time services of a training consultant, directed major emphasis toward providing high quality consultation services and other supporting as- sistance for the county health departments (CHDs). Sanitarian train- ing and recruitment activities were expanded and specific sanitation program functions continued to show a steady upward rise during the year. Considerable time was devoted to preparation of recommended revisions of 11 chapters of the State Sanitary Code in accordance with provisions of the 1961 Administrative Procedure Act. These chapters along with other revised regulations were adopted by the State Board of Health on June 24, 1962. Extensive revision of sanitation forms was completed by the end of the year and a number of new forms will be available for distribution to the CHDs in early 1963. CONSULTANT SERVICE Consultation services were provided for all of the CHDs through- out the year. Staff members made 349 field visits to assist county health officers and sanitarians in all areas of environmental health. Each county was visited at least once with most counties receiving multiple visits for periods ranging from a few hours to several days. Studies of the complete environmental sanitation programs were conducted in four counties during the year. In each case, detailed analysis of activities and accomplishments led to specific recommenda- tions for increasing program effectiveness. A number of changes were initiated prior to completion of the respective final survey reports and the counties involved have continued to improve their environmental sanitation programs by systematic implementation of recommended methods and procedures. Staff consultants provided a wide range of assistance to CHDs in such diversified functions as: investigation of food-borne illnesses, preparation of local ordinances, setting-up pollution surveys, planning 40 ANNUAL REPORT, 1962 local training programs, providing sanitation services for Seminole In- dians and formulating procedures for submission of specimens for viral studies during an encephalitis outbreak. Consultants also conducted essential county sanitation activities on several occasions during the year in cases where local sanitarians were ill or positions otherwise unmanned for extended periods. TRAINING Sanitarian in-service training activities were expanded to include two basic 12-week general sanitation courses and three topical short courses, one of which was offered at two locations. The 12-week four weeks of internship in selected CHDs. Thirteen sanitarians, one each from Alachua, Columbia, Dade, Duval, Escambia, Hills- borough, Monroe, Orange, Pinellas and four from Broward, success- fully completed this program in 1962. The topical courses were presented as follows: a five-day course in Jacksonville on adminis- tration of local sanitation programs which was attended by 25 sanitarians from 22 counties, a five-day course in St. Petersburg on food processing sanitation which was attended by 24 sanitarians from 15 counties and a two-day course held in both Winter Haven and Tallahassee on swimming pool sanitation which was attended by 38 sanitarians from 19 counties. An analysis of topical training activi- ties for the eight-month period extending from October 1961 through May 1962 revealed that 136 sanitarians completed the short courses. Although several attended two or more courses during this period, 48 counties (72 per cent) were represented at least once. Future in- service training plans include continuation of the basic 12-week gen- eral courses and short courses on timely topics as needed. Division personnel conducted a three-day sanitation course for members and inspectors of the Florida Barbers' Sanitary Commission, a 12-lesson medical self-help course for SBH employees, a two-day food sanitation and epidemiology course for nurses at Florida State University and assisted other bureaus and divisions, CHDs, sanitarian associations and other groups in planning and conducting a variety of educational activities throughout the year. Twelve CHDs: Alachua, Dade, Escambia, Hillsborough, Manatee, Orange, Pasco, Pinellas, Polk, St. Lucie, Sarasota, Volusia, often as- sisted by staff consultants, reported foodhandler training activities in 1962. The combined total of 3596 foodhandlers trained represented a modest increase of 437 over last year's figure. RECRUITMENT Recruitment activities were again directed toward obtaining quali- fied personnel with sufficient science background and other necessary aptitudes to effectively cope with the ever increasing complexity of environmental health problems in the counties of the state. In coopera- SERVICES 41 tion with the Florida Merit System, several major recruitment drives were conducted in critical areas and oral board examinations were instituted to better screen applicants for entry-level sanitarian posi- tions. Recruitment efforts continue to become less productive, how- ever, as salary schedules are set too low to attract a sufficient number of badly needed young college graduates into this field. A study of the problem by the division has led to a recommendation for changes in minimum training requirements and salary levels. PROGRAM ACTIVITIES This division is responsible in whole or in part for some 16 specific sanitation programs; issues required SBH licenses or permits for trailer parks, food processing plants, camps, bottled water plants and rendering plants. Another program involves recommendations from the division to U. S. Public Health Service (USPHS) for required federal certification. Field activities associated with each of these pro- grams are carried out by CHD sanitarians. Staff consultants provide technical assistance to the counties in all program areas. TRAILER PARKS Florida's 2137 permitted trailer parks (excluding 622 tourist courts formerly reported in this program) provided 89,882 trailer coach spaces at the close of 1962. This represents a net increase of 115 parks and 4069 additional spaces for the year. The division processed 331 permit transactions involving new parks, expansions, changes of ownership and park closures in 1962. County sanitarians made 7582 visits to trailer parks in the interest of environmental health during the year. FOOD PROCESSING PLANTS The number and variety of food processing plants continues to show a significant rise each year. Operating permits were issued to 570 plants in 38 counties in 1962. This represents an increase of 133 plants (30 per cent) over last year's figure. County sanitarians made 4170 visits to insure that food processing plants were operated under sanitary conditions throughout the year. CAMPS A total of 300 camps consisting of 260 migrant labor camps with space available for 34,770 occupants and 40 recreational camps providing facilities for 4706 persons were licensed in 1962. This represents an increase of 65 camps (28 per cent) over the 1961 figure. County sanitarians continued to exercise close surveillance over all camps during periods of occupancy in order to maintain high-level environmental conditions. This activity necessitated 5366 fields visits in 1962. LOCAL HEALTH 42 ANNUAL REPORT, 1962 BOTTLED WATER PLANTS The number of bottled water plants remained static with 29 plants in 17 counties and four out-of-state shippers being permitted in 1962. One new plant was constructed (replacing an older one) and improvements were effected in other plants. Routine observations and continuous sampling of bottled waters for laboratory analysis were maintained to insure a high quality product. County sanitarians made 318 visits to accomplish this purpose. RENDERING PLANTS This minor activity covers only 14 plants, including a single new one, which were permitted in 1962. County sanitarians exercise careful control over these operations in order to minimize odor, waste and other nuisance problems. COMMON CARRIER FACILITIES The division cooperates with USPHS in the Interstate Carrier Certification Program which covers water and food placed aboard common carriers and the handling of liquid and solid wastes from such carriers. Complete evaluations of these facilities are made at least twice each year by the CHDs and reports are submitted to the division. These reports serve as a basis for semi-annual recommendations to USPHS. The 112 facilities recommended for approved status in 1962 included: 27 airline catering and watering points, 10 airline servicing areas, seven railroad commissaries and catering points, 20 railroad watering points and 48 vessel watering points. FOOD ESTABLISHMENTS All counties continued major food sanitation activity directed toward the prevention of food-borne diseases with increasing emphasis being given to proper handling, preparation and storage of potentially hazardous foods. The counties recorded a total of 30,391 food estab- lishments of all types (an increase of 3334 over the previous year) and sanitarians made 156,113 visits to these establishments in 1962. LOCAL HEALTH SERVICES 43 TABLE 6 'PERMITTED ESTABLISHMENTS AND FACILITIES-1962 Food Bottled County Trailer Processing Water Rendering Parks Plants Camps Plants Plants Alachua- 34 Bakery _.. 3 Bay---,-- 58 Bra ... .. 5... Bradford. Brevard ........... ... 89 Broward.- 119 Calhoun ......... 1 Charlotte.__..... 16 Citrus__ ............... .. Clay ......... 12 Coler ........... 22 Columbia.-.. ............ ...... 3 Dade ___.......... 95 DeSoto ....... ........... ..... .. Dixi e--..-..--- 5 DuvaL--. - 47 Escambia -------- 9494 Flagler -.. .... .. 3 Franklin ....... ... 4 Gadsden .. ..............-... 7 Gilchrisths.. L.... _ Glades. ........ 1.. .. . Gulf_ ..._.............. Hamilton-__.... ___.. Hardeed--- . Hendry__.......... Herando___._-..... Highlands..-------............_- Hillsborough................... Holmes .............. Indian River............ ackson-- ......... efferson.----- fayette ........ Lake_-_...... _ Lee-- .. ........... Leon__ .-.-...-..... Levy .....--....-......... .. Liberty_...... Madison.............--.. Manatee_.......... Marion_ ---...----- Martin----- . Monroe_........... Nassau-.- ........- Okaloosa-...--..-...._.... Okeechobee......-............- Orange-----............. Osceola---.............. Palm Beach_-...-. . Pasco-- __ Pinellas_ Polk_ ...... Putnam --.._a.. St. Johns-...--........ St. Lucie ..._......... --......... Santa Rosa_.._.... .. Sarasota_ ............. Seminole_---l.. . Sumter---..... _.. . Suwannee_ ..--_--__ Taylor-.__........ Union_..__..____.. Volusia-_-..........-.. Wakulla............. Walton.__.______.- Washington_ . Out-of-State.___.__ 5 5 3 1 5 2 8 173 17 6 1 29 68 . 32 7 1 76 32 28 60 8 43 15 117 12 104 48 269 96 16 10 22 19 77 4 7 3 6 19 3 25 3 ..............--- --- . 1 1 88 5 9 31 1 1 55 4 -- ---------- 2 10 3 2 29 2 4 1 2 19 4 75 42 1 3 9 45 10 4---- I-~i~ 1 1 5 2 1 2 1 _- -- -- -- - --- --- - --- - 2 1 53 1 1 4 5 2 5 2 20 2 7 2 10 1 1 7 51 12 6 21 4 3 2 2 1 9 3 1 -_____ ____ ----- 4 ..- --- 4 Totals. 2137* 570 300 33 14 *622 tourist courts without trailer coach spaces deleted from list * 1 1 4 1 1 1 1 2 1 1 1 3 1 4 I1 - --- - - - - - - - 3- -- . 4. --- - -- - I ____________ 44 ANNUAL REPORT, 1962 OTHER PROGRAMS The CHDs functioned in a variety of additional environmental health activities involving: housing, school health, water, liquid and solid waste disposal, nuisance control, swimming pools, rabies control, hospitals and nursing homes, child-care centers, recreational areas and other facilities. It is evident that such activity will increase as Florida's population continues to spiral upward. DIVISION OF NUTRITION MARY BRICE DEAVER, M.S. Director It is the primary responsibility of this division to work toward the continued improvement of the nutritional status of the people of Florida. Since good nutrition is basic to good health and to the control and prevention of many diseases, it is important to include a sound nutrition program in the overall health program of each county. During the year there were several staff changes: one regional nutritionist resigned in the late spring and was replaced in September; one county health department (CHD) nutritionist resigned and that position has not been filled as yet; one CHD created a new position for a nutrition consultant; a special demonstration project was estab- lished to explore the value of a "shared nutritionist" for several rural counties but it has been impossible to fill the position; one CHD nutri- tionist returned to her position from a year's educational leave to obtain a master's in public health. The pattern of work established previously was continued and expanded so that many counties in each region are now receiving regularly scheduled nutrition services. The program areas may be divided as follows: health department services; community activities; work with other organizations and agencies; services to institutions; training and research responsibilities. Increased work in the area of research which it had been hoped could start this year had to be postponed because of lack of qualified personnel. In services to county health departments, priority was placed on in-service education. During the year 113 group conferences and 260 individual conferences were held. The nutritionists had major respon- sibility for these and participated in 95 additional meetings with CHD personnel. Because of increased interest in home care programs and in the use of nutrition in a curative as well as preventive role, numerous requests have been received this year for the latest nutrition informa- tion in relation to rehabilitation, cardiac conditions, weight control, metabolic disturbances, diabetes and other chronic illnesses. There SERVICES 45 have been many classes and meetings held on these topics with a total attendance of over 1500. In maternal and child health, there has been considerable interest in developing materials which may be used at a very low educational level. Some simple, very short demonstrations have been used quite effectively with small groups, along with a single illustrated sheet for the patient to take home. Work has been done cooperatively with the Bureau of Maternal and Child Health in following up phenylketonuria (PKU) patients. This involves instruction for parents of the children with PKU as well as working with professional personnel. In cooper- ation with the Crippled Children's Commission, diet referrals from the regional clinics are followed by the nutrition consultant in the area. Sixty-three group conferences as well as numerous individual ones were held in other services to prenatals and children. During the first year of the revised migrant project in Palm Beach County, the nutrition consultant has placed priority on plan- ning and preparing for the nutrition component of the project. Special attention has been focused on the growth patterns of the migrant chil- dren in relation to diet. Follow-up has been done on the previous work with families and schools in the Belle Glade area as well as extending the nutrition services available to other migrant groups. In providing services to the community, many talks, demonstra- tions and classes have been held for community organizations and clubs. A variety of topics have been covered including food budgeting, weight control, food additives, food fads, foods for civil defense and family food planning. Groups requesting such meetings were civic clubs, home demonstration groups, PTA groups and other local organi- zations. In regard to services to other organizations and agencies, much work has been done cooperatively with such agencies as agricultural extension, school food service and the schools themselves working to- ward the improvement of teenage nutrition. Participation by some counties in the National Youth Power Conference projects has spurred considerable interest among the high school students and has led to increased cooperative planning among the county agencies concerned. In several counties such efforts have led to the formation of county nutrition councils or committees and offer an excellent beginning for cooperative efforts on other nutrition problems. In other counties em- phasis has been placed on practical nutrition teaching in the elemen- tary grades in an effort to improve food habits of the children. Since many CHDs devote a high percentage of time to school health, service to schools continues to be one of the most frequent requests for nutri- tion consultation. During the year, 103 group conferences and 142 in- dividual conferences were held with school personnel. Sixteen dietary surveys in schools were completed, the information being used largely for program planning in nutrition education. Nutrition consultants also took an active part in county land regional school lunch workshops. LOCAL HEALTH REPORT, 1962 The Florida Heart Association and many local affiliates have re- quested and received assistance in planning and conducting classes for heart patients and their families. Individual diet counseling has also been given at the request of the CHDs and private physicians. Two nutritionists were speakers at the state meetings of the Florida Heart Association. Work was completed on cost recommendations for low-income diets and for therapeutic diets in cooperation with state welfare per- sonnel. An annual state price index for food was also revised as a reference for state and county personnel in computing diet costs. Assistance has been provided in several counties in cooperation with county and state welfare personnel in regard to the expanded family surplus commodity program. Demonstrations in the use of the commodity foods, menu plans, recipes and some direct family con- sultation have resulted in better acceptance and use of the foods. As yet, there are only a limited number of counties in the state participat- ing in this program. Considerable time was spent in cooperation with other agencies in program planning and assisting with the local arrangements for the Home Economics Section of the Southern Agricultural Workers' Asso- ciation which met in Florida in 1962. The nutrition staff has actively participated in many national meetings in Florida this year. These included the American Dietetic Association, the American Home Eco- nomics Association, the Institute of Food Technologists and the Ameri- can Public Health Association. In service to institutions, the dietary consultation program for nursing homes has progressed considerably. Several different methods of dietary consultation were used in working with nursing home per- sonnel. Visits were made by the dietary consultant to 40 nursing homes for periods varying from one-half to several days. A nutrition workshop was conducted in one county for six half-day sessions. A pilot food cost study was conducted to provide pertinent information on food purchas- ing as related to menu planning, size of home, proportion of personnel to patients and physical facilities. A "Diet Guide and Menu Planner" was prepared and distributed to many homes to assist in preplanning of menus to provide an adequate diet. Consultation was also given to several small hospitals and to the state institutions for the mentally retarded. Work has been started on a revision of the "Food Service Manual for Nursing Homes" which was first prepared by the Division of Nutrition in 1958. In the area of training, field experience was provided to two graduate nutrition students from the University of California School of Public Health and one graduate student from the University of Michigan School of Public Health. A short period of field observation was also provided for a student from Thailand at the request of the Food and Agriculture Organization of the United Nations. 46 ANNUAL SERVICES 47 Classes haire been taught and consultation provided to schools of nursing, to practical nursing programs, to health education students and to undergraduates in food and nutrition courses. Considerable attention has been focused on methods and pro- cedures of program evaluation this year. A trial evaluation procedure involving a new method of reporting information in regard to services performed has been worked out and will be tested during the coming year. Recruitment has been a major problem and little success has been achieved in filling existing vacancies or new positions. It is felt that definite action in regard to salary ranges and job specifications is necessary to alleviate this situation. Because of such difficul- ties, it has been necessary to curtail some activities and postpone plans in regard to a rural nutrition demonstration program. In planning for the future, it is becoming more apparent that efforts must be increased to provide basic nutrition information in the student training of future doctors, nurses and other allied professional personnel. More attention will be paid to the older population group. However, the preventive aspects of nutrition will be emphasized as well, beginning with the early years of life and with special attention to the teen years. LOCAL HEALTH 48 ANNUAL REPORT, 1962 TABLE 7 MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 A. COMMUNICABLE DISEASE CONTROL IMMUNIZATIONS COMPLETED a a a * COUNTY No S _1 2-3 4 5 6 7 8 9 10 11 12 Total 1962-.. 5409 11082 39219 90704 147646 91942 230474 312104 77444 51 53321 Alachua__ Bakery . Bay._---- Bradford...-- Brevard... Broward-... Calhoun- Charlotte-... Citrus- Claye y Collier...... Columbia---. Dade---- DeSoto._--- Dixie.__ __ Duval..--- Escambia- Flagler-- Franklin... Gadsden...... Gilchrist--- Glades- Gulf --- Hamilton..- Hardee--.... Hendryg Hernando- Highlands- Hillsborough. Holmes - Indian River- Lackson..--..... efferson_... ayette-- Lake__.__.. Leon Levy -- Liberty.... Madison.... Manatee-.-- Marion--- Martin-__ Monroe-- Nassau Okaloosa- Okeechobee-. Orange- Osceola--- Palm Beach. Pasco Pinellas-a Polk..--- Putnam----. St. Johns- St. Lucie- Santa Rosa-. Sarasota- Seminole... Sumter--..... Suwannee.-. Taylor..-- Union- Volusia...... Wakulla..- Walton.--- Washington-. 45' 20 29 18 107 224 9 951 1 23 48 0 59 13 26 15 10 3 37 37 33 28 0 0 4 27 11 3 1222 13 11 80 2 4 20 0 200 9 11 3 174 37 3 40 44 202 3 267 4 239 7 417 213 99 25 1 1 67 48 47 2 8 9 80 11 5 0 61 22 54 21 235 372 9 2335 1 33 277 0 1015 29 47 23 22 3 46 37 41 34 0 0 9 56 18 6 1872 27 23 101 3 4 53 0 241 14 12 5 211 111 3 57 53 224 4 575 15 838 24 681 429 107 31 4 2 97 132 86 5 11 30 164 20 7' 0 1926 997 167 112 559 375 165 239 43 95 501 1384 349 238 163 263 1354 395 199 5756 422 44 619 1002 217 167 144 111 1708 984 209 399 323 84 155 317 416 438 354 495 235 1006 434 9 756 294 39 534 174 458 967 275 1213 707 267 10 517 88 3748 1122 533 320 158 216 194 442 615 2004 436 "1645 216 1386 3182 306 333 136 238 290 619 23245 292 102 1294 6854 149 520 1816 311 81 546 118 182 447 154 130 5551 503 409 1319 861 136 223 1643 3127 410 258 872 349 2002 601 973 1206 1425 80 3343 205 4034 347 2159 3696 1044 1406 98 752 357 1180 726 242 241 107 475 70 495 747 2605 580 1581 627 3038 6420 393 802 443 369 2107 5499 19070 484 476 4123 14333 339 381 2980 303 400 909 413 528 935 443 547 9444 943 789 1833 652 78 765 1952 1598 1124 346 1147 585 2773 944 1448 1449 3130 221 8068 841 9296 869 4953 7203 1348 2792 260 1381 1096 1474 655 721 956 227 690 213 920 1334 2114 337 1574 310 1657 3631 258 315 189 248 738 4274 16705 308 301 3030 10790 148 381 975 208 74 687 278 298 295 120 319 5855 457 379 1071 517 54 402 840 1217 279 145 401 264 1482 335 505 737 2146 97 3238 576 4116 754 3903 4093 365 447 227 1067 676 1158 485 447 503 131 600 210 589 612 3956 120 3898 747 3286 7120 720 857 494 535 2184 6069 50720 553 577 5754 32412 442 1193 5058 733 420 1261 486 661 941 783 579 10254 1143 1133 3836 1156 150 775 3375 2509 1215 828 1781 979 3901 1083 1625 2460 4323 255 9344 841 10510 890 5530 8887 1660 2853 492 1807 1205 2271 666 1367 1196 272 723 610 1084 1842 5376 1526 4690 1396 3698 8401 1505 588 1016 828 1796 5003 42942 1150 824 8954 32749 688 1485 7811 685 497 1373 653 919 905 1242 811 5830 1626 1101 5183 1693 145 1010 5018 3911 2086 790 1933 48947 4420 674 1984 4682 4651 347 13636 1528 12978 3154 8257 12869 1112 4813 339 2141 1293 3650 921 1781 2174 380 1808 396 1403 1929 982 859 7699 42 500 224 1298 122 160 6 264 3318 829 38 481 637 14055 14 424 3142 424 381 937 214 80 561 2 37 492 626 670 1716 1255 52 .12 1695 1822 755 439 578 96 3215 944 860 3475 2893 110 7134 497 1232 25 260 685 19 1112 51 1299 38 2071 377 724 344 312 59 479 540 751 0 99 0 172 0 0 0 0 0 346 0 0 0 0 0 0 5628 0 0 0 0 62 0 181 0 85 0 0 33474 0 0 0 423 0 0 0 0 0 0 126 3005 0 0 0 315 0 0 1890 0 0 0 38 7231 0 0 0 0 0 0 0 0 156 0 0 0 0 90 LOCAL HEALTH SERVICES 49 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 B. VENEREAL DISEASE CONTROL S .9 COUNTY i 1 2 3 4 5 6 TOTAL 1962 43201 14398 6943 13275 35547 80515 Alachua_- ...... ... 102 46 63 8 29 155 Baker- ........5... 5 2 2 1 12 14 Bay- a. ........ 170 99 61 80 278 208 Bradford-- -------51 30 30 23 .27 79 Brevard----------- ---. 49 7 37 6 68 76 Broward- 889 573 623 1002 1797 1920 Calhoun-- 18 13 9 7 4 25 Charlotte......---. 4 0 1 0 0 9 Citrus --. .... ..... 22 4 11 11 34 22 Clay....----------.----- 26 7 8 7 24 45 Collier ............ .128 65 75 143 254 173 Columbia-...---- -----..---. .._ .... 162 101 101 60 125 141 Dade------. --------- ... 14931 3248 1642 3539 13517 38137 DeSoto .. ------- -4 0 4 0 0 8 Dixie--.... ---. 12 6 17 3 10 15 DuvaL ---_- 11979 1661 577 1880 4862 14939 Escambia-_ ___ 2720' 2648 183 947 2120 2989 Flagler ...... .. 9 6 11 5 8 34 Franklin__. .. ..4 2 4 0 0 8 Gadsden ............ .99 99 90 37 90 137 Gilchrist..-----.. 2 2 2 3 2 5 Glades ..... 11 7 7 6 6 13 Gulf ...... 8 1 "1 3 8 22 Hamilton ......8 7 0 0 4 9 Hardee-_- 9 1 2 6 9 8 Hendry ------ --74 11 20 25 71 79 Hernando ...-...... 9 7 6 10 16 13 Highlands --- ---..... 52 42 73 104 165 93 HiUsborough--- ---.---.-...- 3477 1284 626 1170 3250 8439 Holmes .---1--- -- 10 1 7 8 1 20 Indian Biver-.. 124 95 102 101 20 142 Jackson -- ...- ..................... 24 22 19 6 9 30 Jefferson -- .............. ... 31 24 10 7 7 46 Lafayette ........... ... 4 3 1 1 3 8 Lake.............. ... 17 10 3 3 16 15 Lee.---------.-.- -. 65 41 54 27 82 66 Leon953 782 12 60 14 1330 Levy 48 18 22 40 23 91 Liberty. ----- -2 2 2 1 0 4 Madison .............27 26 27 9 8 29 Manatee ............ ... .--... .. 259 138 154 120 260 325 Marion ..-...---- ....--------- 1026 359 223 460 1263 1769 Martin-....-.... ....------.. .....--... 91 42 75 90 147 34 Monroe -... -----.. -..........-- ...-....... 124 98 91 82 236 281 Nassau ................................ 23 14 7 1 11 57 Okaloosa ..... .... .. ... 42 4 38 39 35 3 47 Okeechobee--- ...........- 6 1 4 7 22 15 Orange ----------------- ------ 1066 572 292 944 2034 2034 Osceola.---------. .. 29 28 20 57 26 134 Palm Beach -..------ 1098 683 405 747 2137 1665 Pasco ------------------------ 19 16 17 10 4 22 Pinellas----------- ..---------- ..1472 521 238 481 1197 1864 Polk.--- ...---. .------- ---------507 255 115 261 421 658 Putnam ...........-..-- .........------ 115 65 98 43 34 151 St. Johns ...............-............ 213 96 111 82 10 375 St. Lucie-....--.............-.. ........ 69 69 99 94 267 96 Santa Rosa-----.------------.......- 10 5 7 4 4 19 Sarasota-------------.. 135 46 54 174 207 257 Seminole---------------... .... ... 171 104 127 59 147 311 Sumter..----.---------...... --------. 40 40 40 20 16 59 Suwannee ....-----.---------- .... 28 22 12 5 11 32 Taylor ..........-------------- ...... 41 30 29 15 19 44 Union -------------.--------3 1 1 1 0 12 Volusia.......--- .......----- -... 236 120 118 110 83 615 Wakulla ...-...... ...... ........... 8 5 5 11 1 9 Walton ..-- .---.. -- -..23 18 10 11 14 26 Washington_. ------ 8 4 7 2 0 8 50 ANNUAL REPORT, 1962 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 C. TUBERCULOSIS CONTROL ADMISSIONS TO SERVICE PERSON D COUNTY 3 -.4u -- J l 1 2 3 4 5 6 7 8 9 10 TOTAL 1962 2270 718 6236 19809 482053 40804 73573 37183 49403 1850 Alachua .......... 14 10 42 106 9430 377 472 480 175 13 Iaker----- --- 3 0 3 20 944 38 67 43 23 2 ay........ 16 4 95 185 0 482 104 128 314 14 Bradford -. 3 2 29 44 2442 88 48 207 60 3 Brevard .- 24 14 105 588 2 2852 5136 1140 1282 27 Bro ward- 130 39 372 916 47808 190 5268 3649 1361 74 Calhou7 6 20 13 0 58 29 17 124 3 Charlotte -- 7 1 22 90 2768 1202 368 280 207 7 Citru .. 2 2 6 15 0 10 9 23 23 3 Clay ---.. 6 26 12 43 3331 61 65 135 41 2 Colier 12 7 41 113 5532 154 1145 220 227 9 Columbia .--..... 6 5 13 30 683 77 56 84 38 3 Dade ..----- 376 85 967 6826 75155 7648 3533 4498 18796 460 DeSoto .. 2 0 16 28 4545 413 2 147 126 0 Dixie 2 3 4 24 0 23 29 77 45 2 DuaL -.. 135 83 547 401 4773 2469 526 778 1970 238 Escambia -.----. 161 20 314 696 11359 1038 674 3732 337 76 Flagler -----.. 2 0 6 39 1020 81 404 40 201 2 Frankin--... 2 1 13 46 1684 70 33 41 114 6 Gadsden ._-_ 19 1 46 177 9610 85 155 622 172 17 Gilchrist. ----------- 4 3 1 30 366 24 77 57 43 1 Glades- .. 1 0 3 14 860 244 21 19 17 1 Gulf .---- ..._ 8 1 19 91 2456 461 73 111 140 8 Hamilton .............. 3 3 7 24 1065 39 27 19 76 6 ardee....... .. 8 12 10 37 0 485 1913 89 81 3 Hendry.-----.---.- 5 0 13 41 2158 161 247 115 96 1 Hernando-____. 4 0 15 4 0 25 13 40 29 4 Highlands- .- 9 11 24 102 5219 255 222 191 174 8 Hisborough.-.- .- 415 77 881 3940 77431 1569 7765 3977 5196 192 Holmes ----- 4 0 11 138 3 93 400 110 236 2 Indian River 8 2 8 19 0 148 199 106 71 6 ackson --.-. 23 4 41 214 0 351 649 468 423 10 efferson-____.__ 5 0 7 14 0 0 33 45 19 2 afayette .._ 2 1 6 0 0 5 0 14 10 1 Lake .------------ 24 6 137 245 13044 423 58 922 189 29 Lee.... ... 29 10 50 52 17286 379 4136 206 237 16 Leon_ ----- 46 10 112 360 12392 329 2636 1280 956 22 Levy_ 7 5 28 39 639 41 35 102 33 9 Liberty -..... 5 3 1 28 663 14 35 42 34 4 Madison --- _-._. 8 0 42 95 353 43 133 52 218 10 Manatee ---_ -_- 23 4 91 146 9726 65 130 525 431 14 Marion .-------. 25 2 54 93 0 591 1312 386 63 19 Martin- ....... 14 6 41 93 3752 186 1878 164 121 10 Monroe ................ 11 18 35 85 3595 579 1193 415 310 8 Nassau ........... 1 6 19 49 4279 103 0 163 99 2 Okaloosa ..--- -.-. 3 4 30 47 0 2480 1131 235 150 3 Okeechobee__ 4 1 15 13 1188 36 16 33 43 1 Orange__... 104 36 178 388 15743 1050 436 1317 1906 62 Osceola------- 11 1 27 18 2517 100 59 52 242 4 Palm Beach___ 158 79 240 326 26960 1247 1512 2045 870 150 Pasco... .. 13 6 32 129 1547 156 86 162 306 7 Pinellas- ...... 95 4 423 600 30346 1993 1719 1804 4849 79 Polk.-- --.---- 88 37 488 1036 28971 1247 15755 2587 3155 52 Putnam-__. .-. 20 3 20 74 2289 1013 2768 136 109 19 St. Johns-...-_ 5 6 22 20 0 203 1566 66 56 5 St. Lucie-.--__--- 21 2 55 59 0 201 88 384 296 21 Santa Rosa.----_. 8 1 22 17 0 350 2430 76 91 6 Sarasota -__.. 22 6 63 100 6320 335 134 639 477 12 Seminole..___ 22 6 29 146 0 414 1521 370 680 23 Sumter_ ..._ 10 0 7 50 0 131 559 123 132 8 Suwannee.---- 6 2 33 47 914 117 160 46 139 3 Taylor-. ... 6 1 11 17 3292 15 75 48 21 10 Union- 0 1 5 0 61 28 3 3 32 0 Volusia_._____ ... 34 19 166 241 23929 5495 582 933 628 28 Wakulla--------- 8 1 1 23 920 14 10 49 28 4 Walton 8 2 20 63 683 92 1619 96 136 1 Washington_ .. 3 7 20 42 0 58 36 20 119 3 LOCAL HEALTH SERVICES TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 D. MATERNITY SERVICE E. CHILD HEALTH ---SERVICES S 8 Admissions To Well S8 a b a Child Medical Service cr u It I I in 4 a 1-2 3 6 7 8 9 10 11 12 1A,2A IB,2B 1C,2C TOTAL 1962 14957 44970 23015 47043 60665 1049 1050 23 465 14558 13376 6852 Alachua-.... Baker .......... Bay ..... Bradford ...... Brevard.__. Broward--- Calhoun..... Charlotte..--- Citrus-_-.--. Clay .... Columbia-....- Dade .......... DeSoto----- Dixie...---.- Duva..---- Escambia...... Flagler....... Franklin... Gadsde_..... Gilchrist---. Glades......- Gulf.....-...... Hamilton-... Hardee.-..... Hendry...----. Hernando_. Highlands..... Hillsborough- Holmes ........ Indian River.. ackson...... efferson-........ afayette......- Lake .........-.. Lee ............ Leon__ ......... Levy_---- Liberty--........ Madison..... Manate........ 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- 265 25 142 70 248 343 3 0 3 88 122 198 2998 0 25 44 794 72 9 761 20 27 18 25 34 36 9 21 2432 1 0 125 40 10 118 219 228 79 14 63 83 0 0 65 4 35 2 991 132 572 2 862 1209 238 52 211 0 106 165 15 33 51 54 297 22 6 21 558 34 142 163 825 389 4 0 .3 246 383 193 9497 0 42 147 2101 237 22 1374 34 78 40 40 128 98 17 31 8547 1 0 163 87 12 273 252 738 200 17 204 377 0 0 106 4 38 2 3124 316 1976 2 4034 3574 687 109 755 0 435 469 16 61 91 150 1238 59 6 21 629 74 183 78 390 588 27 8 3 135 156 236 5229 0 46 219 1082 91 24 1106 19 30 38 189 35 83 10 11 3071 67 47 331 78 16 219 419 435 36 18 163 217 62 0 112 29 114 2 1134 137 916 71 935 1575 296 89 252 2 179 360 117 47 59 83 472 26 17 93 1812 115 448 287 1177 1522 4 15 9 399 134 491 13833 0 62 336 2202 79 38 1013 50 43 126 529 29 254 9 8 5047 7 86 367 145 44 311 542 1323 31 9 389 566 166 0 236 40 97 1 878 122 3008 117 1697 3627 259 131 206 5 540 450 148 43 64 59 1120 37 37 64 1493 42 213 32 1663 1102 87 0 2 281 755 453 9160 0 115 289 2828 243 59 1806 27 62 99 272 158 308 18 13 10817 77 84 876 123 50 320 973 858 20 27 291 641 5 0 215 11 117 5 3239 312 2741 81 5279 6546 726 206 990 3 516 675 135 133 176 151 1482 17 25 142 21 3 18 50 26 16 0 2 0 18 10 95 7008 0 2 104 89 7 5 178 3 0 16 0 2 32 0 4 3044 7 0 27 37 0 1 1 141 0 20 9 103 0 0 18 18 1 0 188 48 130 0 1240 41 13 17 5 4 0 11 1 4 5 29 495 8 0 1 58 4 5 3 16 15 1 3 0 110 16 74 2316 0 1 167 35 11 0 75 6 0 4 0 0 14 0 6 2089 0 0 13 14 0 0 1 78 1 9 10 194 0 0 8 17 0 0 194 0 97 0 496 190 77 20 2 32 0 20 0 5 13 32 296 2 0 2 I I F I I """' 52 ANNUAL REPORT, 1962 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 E. CHILD HEALTH SERVICES (Continued) VISITS MEDICAL ADMISSIONS TO FIELD NURSING OFFICE NURSING CONFERENCES NURSING SERVICE VISITS VISITS COUNTy I , S 4t .9 4 4 9 3A 3B 3C 5A 5B 5C 6A 6B 6C 7A 7B 7C TOTAL 1962 29292 24927 9603 27363 33711 63459 55064 61936 64450 37432 36525 138070 Alachua ..-.- Baker ..... Bay Bradford ..... Brevard ...--- Browardn....-.. 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.. ackson ...... efferson.... afayette.... Lake.... . Lee ........ Leon ...... Levy........ Liberty ...... Madison_ . Manatee-.... Marion ...... Martin ...... Monroe .- . Nassau ........ Okaloosa..... Okeechobee.--- Orange...... Osceola ...... Palm Beach_.. Pascon.... Pinellas--- Polk____ Putnam ----. St. Johns-- St. Lucie-_ Santa Rosa- Sarasota- Seminole--- Sumter-- Suwannee- Taylor-- Union-- Volusia_........... Wakulla-...... Walton--_ Washington..- 158 2 389 53 133 820 0 0 0 38 84 116 11895 0 4 919 2146 55 4 368 7 20 16 0 9 56 0 12 4665 3 0 101 91 0 28 120 106 22 9 19 144 0 0 23 11 15 0 695 149 1881 0 1821 740 133 27 46 1 0 75 6 9 27 143 857 16 0 5 34 3 45 52 29 64 0 2 0 22 16 95 11213 0 2 217 344 16 6 199 4 0 17 0 2 61 0 6 8456 7 0 39 44 0 1 5 197 0 20 10 134 0 0 23 21 1 0 428 103 252 0 1618 69 13 20 16 4 0 11 1 5 5 74 892 8 0 1 679 71 188 147 385 1001 11 473 13 126 112 258 6426 3 57 850 1187 72 45 872 21 14 57 90 35 71 8 11 4186 11 58 270 218 84 295 335 436 30 9 152 425 116 29 167 37 118 3 929 96 1231 83 1175 1624 229 81 150 7 147 257 136 92 50 135 558 26 27 68 600 249 97 419 669 583 19 175 35 234 60 587 8857 12 72 235 460 154 68 1745 65 13 56 34 33 94 41 8 .6297 45 19 234 471 76 541 363 1291 25 18 113 797 85 123 467 81 104 2 1114 78 445 146 1846 1311 134 36 231 47 113 72 75 230 30 125 690 42 27 93 1218 260 281 406 1012 1294 77 1780 46 715 146 235 9831 250 82 812 964 165 48 706 166 24 64 20 80 167 69 84 6713 297 491 151 228 112 592 306 1828 68 49 483 *2199 603 . 179 586 299 360 84 1675 98 3464 62 9975 5309 184 122 28 1195 642 199 50 163 28 105 2157 212 1137 24 1849 157 623 418 1076 2506 7 614 19 413 111 443 15564 1 95 829 2637 84 81 1211 66 16 86 274 48 162 10 12 4430 7 230 321 391 157 426 488 1558 27 13 381 .453 314 31 277 54 104 3 1013 95 5303 156 2800 3658 275 149 238 12 464 431 145 142 91 110 780 33 39 53 1567 541 320 1263 2107 1682 28 84 56 482 80 711 21220 0 130 245 1308 132 114 2684 154 25 142 283 34 221 68 14 4417 27 73 383 539 203 799 443 4716 24 19 214 272 226 95 850 79 265 10 957 106 2259 319 3502 2325 182 44 635 64 305 184 85 362 34 171 887 40 42 84 1408 550 576 728 2863 3015 97 883 121 682 212 314 10741 234 134 518 1316 66 97 630 257 32 119 296 74 306 86 82 5508 113 249 251 195 190 695 363 3396 66 49 320 759 759 226 752 273 764 92 1627 105 6242 96 7359 3149 136 138 35 366 1141 616 60 200 56 168 1161 94 231 13 526 23 418 11 220 695 11 395 2 63 201 135 10950 3 46 1682 1510 80 15 431 44 17 66 72 9 92 3 6 7159 18 26 286 221 68 171 170 249 16 2 51 707 5 15 185 11 103 0 1210 212 2166 69 2314 2266 159 42 55 15 1 239 106 95 55 159 983 9 25 63 1097 36 302 224 616 236 55 2895 2 727 50 115 67406 64 17 602 2659 174 35 446 363 16 54 74 32 155 1 50 6687 480 515 152 127 128 334 74 1493 19 6 421 2400 261 53 862 526 212 37 1745 259 6736 28 21869 6311 157 98 37 1312 323 672 111 107 47 146 3077 127 1598 20 LOCAL HEALTH SERVICES 53 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 F. SCHOOL HEALTH Pupils Examined By Physician Screening By Other Health Dept. Personnel Parent Present Parent Not Present Visual Audiometer COUNTY " IA 1B IC 2A 2B 2C 3A 3B 3C 4A 4B 4C 7 TOTAL 1962 29416 3439 2536 37003 3023 755 391290 32252 11667 187438 5779 1335 105044 Alachua........ Baker-.-- Bakery....... Bradford.... Brevard..-.. Broward_..-. Calhoun.. Charlotte...... Citrus ........... Clay Collier.....--... Columbia..... Dade..._._.._ DeSoto ..... Dixie_....... Duval.. Escambia._ Flagler......... Franklin....... Gadsden....... Gilchrist..... .Glades---.... Gulf ..........- Hamilton-_._ Hardee ........ Hendry........ Hemando...... Highlands.. Hillsborough.. Holmes-....... Indian River.. ackson..... efferson-.- afayette........ Lake......_ Lee__..... Lcon_.__.. Levy....___ Liberty....... Madison--_ Manatee...... Marion_...._.. Martin-.--... Monroe....--.. Nassau........... Okaloosa.....- Okeechobee-.. Orange ....... Osceola--... Palm Beach.. Pasco. ..- - Pinellas....-- Polk ........ Putnamn-..-... St. Johns-..... St. Luie-..... Santa Rosa... Sarasota-_... Seminole-.__ Sumter ... Suwannee--e Taylor ..... Union.... Volusia. .. Wakulla....... Walton-...- Washington- 85 46 60 262 1 290 0 31 59 166 39 129 2367 89 95 4 13 94 4 256 58 194 10 221 47 218 215 226 2555 621 0 56 288 12 844 0 384 138 64 23 107 0 96 74 111 616 56 194 139 389 0 15652 325 56 22 0 414 4 390 235 49 16 87 355 89 172 4 6155 624 10314 288 1 10990 159 2027 49 1661 2341 59 65855 2772 112 9198 15632 706 386 2517 53 76 1592 2 635 3386 62 26 55649 558 2305 268 2804 1 4549 1663 7171 961 87 238 1378 1691 2045 7025 178 2937 528 23924 2857 23861 0 58404 17778 752 64 469 557 9513 8195 1498 913 2 75 11135 585 753 241 600 72 1021 8 1 2075 84 164 15 86 328 12 5930 355 0 1104 1670 169 29 166 16 29 131 0 51 198 8 10 3802 125 100 131 245 0 432 204 702 27 3 48 254 152 188 454 26 298 57 1458 700 2686 0 2464 1054 60 23 36 28 261 642 90 64 0 9 980 23 85 9 2748 17 697 0 0 8 29 688 20 1 1050 14 39475 2411 72 10 4171 2 390 673 33 0 271 663 652 399 0 2 25768 13 2012 262 149 0 266 25 3812 837 194 0 1302 560 96 5885 7 281 63 10128 14 9506 0 46115 3908 0 1 0 100 5952 4817 5 317 250 0 '9179 663 440 15 1704 214 2626 89 923 6336 263 608 257 631 1059 31 26968 482 96 1543 3139 33 40 1203 242 142 302 244 463 566 4 104 10392 211 294 563 139 31 722 406 1649 21 27 160 746 971 147 1734 464 438 55 3538 302 6863 0 12436 7481 228 178 0 420 1812 1430 130 278 29 46 120 75 139 57 __ 54 ANNUAL REPORT, 1962 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 G. DENTAL HEALTH (Dentist Only) NUMBER REQUIRING DENTAL INSPECTIONS TREATMENT COUNTY 1 -4 O 4d E 1 1A 1B IC ID 2A 2B 2C 2D 3 4 5 6 7 TOTAL 1962 119 100259 100 84 39 56674 140 180 7598 24673 65892 19463 1006 Alachua--. Baker--.-- Bay____ Bradford-L._ Brevard__- Broward__ Calhoun_ Charlotte- Citrus__ Clay Collier__-. Columbia__ Dade------ DeSoto--- Dixie__ Duval Escambia--.. Flagler __. Franklin. Gadsden__- Gilchrist-- Glades..-- Gulf-_ ...--. Hamilton--- Hardee .. Hendry--- Hernando-__ Highlands-_. HiMlsborough- Holmes-.-. Indian River.- fayette.-_ Lake__- Lee__....- Leon- Levy Liberty- Madison_.-- Manatee... Marion--_ Martin____-. Monroe-.-.. Nassau__-. Okaloosa___ Okeechobee- Orange--- Osceola ..--. Palm Beach- Pasco---- Pinellas-.._ Polk...___ Putnam..-_ t: t St. Johns__ St. Lucie__ Santa Rosa_ Sarasota_ Seminole_._ Sumter.. Suwannee... Taylor____ Union .. Volusia..... Wakulla_. Walton._- Washington... 12944 432 0 0 0 603 0 0 0 24 0 0 0 81 0 700 208 911 0 0 0 70 0 0 0 662 0 5070 13497 0 0 0 165 0 3771 0 0 0 0 0 1553 1020 0 174 0 0 0 36039 0 4115 S0 9212 6238 1022 0 0 0 1034 113 0 0 0 0 601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1147 0 0 0 0 522 0 0 0 0 0 0 8410 0 0 1351 725 310 0 0 0 0 0 0 0 48 0 194 1917 0 0 0 95 0 737 0 0 0 0 0 89 764 0 117 0 0 0 1262 0 3816 0 602 433 737 0 0 673 77 42 0 0 0 0 605 0 0 0 4627 43 0 0 0 3363 0 0 0 0 0 0 27380 0 0 2419 772 594 0 0 0 29 0 0 0 108 0 547 5391 0 0 0 161 0 4130 0 0 0 0 0 139 1035 0 83 0 0 0 1785 0 4903 0 2617 1141 973 0 0 980 70 13 0 0 0 0 2589 0 0 0 149 0 0 0 0 1 0 0 0 0 0 0 8 0 0 221 0 176 0 0 0 0 0 0 0 0 0 42 9 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 38 0 0 0 0 0 0 0 0 0 198 0 0 0 LOCAL HEALTH SERVICES 55 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 H. CHRONIC DISEASES Cancer Service Diabetes Service Heart Disease Control COUNTY . r > 1 2 3 4 5 6 7 8 9 10 11 12 TOTAL 1962 5520 13611 14284 9250 3072 12561 15224 498 3627 5342 22915 9902 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.... ackson............ efferson-........... afayette ......... 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..... 289 12 9 53 68 206 22 30 2 47 70 19 220 25 14 14 534 3 29 51 11 4 32 8 25 6 6 31 778 36 16 50 12 3 52 20 107 5 11 28 48 76 25 89 14 35 14 229 20 378 23 560 681 11 12 16 39 66 7 25 22 35 6 67 14 29 21 195 13 5 11 179 465 5 38 1 28 128 18 75 35 11 7 1502 3 48 28 13 5 57 12 17 14 0 23 3615 43 22 22 1 2 39 170 3 10 28 14 2 13 75 6 12 8 2709 31 893 96 1499 1766 10 11 4 35 0 1 35 40 73 12 0 2 18 26 127 0 0 0 29 224 0 0 0 0 151 0 5989 0 0 1992 74 0 0 0 0 0 0 0 0 0 0 1 33 2 0 1 0 0 0 0 7 0 0 0 17 0 0 0 0 2 0 221 26 16 0 303 6 0 0 0 0 10 0 19 0 0 0 0 0 0 0 360 3 87 24 142 151 12 165 27 133 120 18 83 16 15 21 1349 21 18 46 13 23 59 23 2 96 2 45 1865 11 187 53 43 8 112 8 220 15 5 23 338 71 20 99 32 24 10 62 13 354 198 164 640 7 121 1 49 124 16 13 87 35 4 4372 15 62 8 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 1 0 0 0 0 1 0 0 498 55 0 0 0 0 0 0 4 0 0 48 77 4 0 2860 1 0 0 6 0 0 37 6 0 0 1 0 0 0 20 0 0 0 1 0 0 2 0 96 55 37 44 220 45 6 45 14 75 49 7 179 0 44 26 469 33 29 220 97 15 62 59 22 40 4 14 870 26 16 69 21 19 46 13 124 82 228 33 100 26 2 76 18 29 6 93 18 156 34 533 193 20 7 18 51 77 33 11 58 23 14 132 19 35 7 495 34 220 348 494 110 3 177 3 568 90 9 2594 0 139 46 1836 150 8 1002 117 13 78 78 63 98 2 26 2408 42 48 60 44 18 89 14 813 54 589 22 368 112 0 167 34 63 10 274 17 599 74 4159 302 21 15 157 114 991 47 12 99 .70 0 2097 29 70 12 159 124 15 72 263 12 5 12 73 66 91 6 17 0 114 5 771 62 105 761 579 27 272 179 15 121 2 6 1034 92, 10 279 7 13 39 29 87 255 997 38 128 9 6 45 9 32 13 49 92 172 38 1403 304 38 2 2 87 0 64 20 227 25 52 98 34 122 11 56 ANNUAL REPORT, 1962 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 H. CHRONIC DISEASE J. MENTAL HEALTH. (Continued) Other Chronic Diseases Admissions To Service Field Visits Office Visits COUNTY g I I 13 14 15 1 2 3 4 5 6 7 8 TOTAL 1962 9383 28057 9425 6383 4775 3999 12882 18407 23236 27038 10652 Alachua----- Baker_.... Bay __ Bradfordc- 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..- ayette___ 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- 103 11 221 91 286 223 32 97 3 194 80 43 51 102 102 27 508 2 31 147 100 8 21 173 38 12 16 49 805 72 62 139 12 11 109 95 64 20 14 58 27 102 18 200 34 65 36 343 22 319 108 2738 402 17 1 31 17 166 23 56 73 30 11 216 28 59 9 - -. I-- -I 412 2 821 222 967 660 61 176 2 623 350 59 330 134 170 29 3774 19 4 492 189 7 107 16 98 29 28 99 1860 47 196 89 13 46 184 106 623 34 20 137 114 318 33 441 76 187 51 468 21 1716 181 6202 977 77 1 85 20 853 57 72 214 143 0 2383 31 62 39 128 15 207 206 364 23 43 53 16 175 95 43 17 130 512 10 31 0 29 122 474 6 80 628 10 17 0 25 229 90 25 166 5 0 69 232 21 19 2 .43 8 13 6 93 30 37 18 52 23 198 147 3546 359 9 0 69 21 5 32 71 186 21 16 30 7 50 18 469 2 3 3 71 224 26 74 18 107 261 0 1598 43 6 10 9 3 23 21 1 30 27 0 38 44 15 9 829 24 29 53 4 1 25 44 275 6 2 1 25 40 56 38 22 89 37 671 6 60 7 45 378. 44 4 166 13 35 60 10 16 1 2 100 22 8 0 157 13 74 24 100 19 34 3 34 24 28 36 410 5 5 156 184 4 35 53 2 0 13 5 5 5 21 9 637 11 19 44 19 0 30 77 120 32 3 14 143 314 9 38 10 22 5 173 0 630 27 298 288 22 20 30 36 43 21 16 14 10 3 99 * 10 27 3 179 5 10 9 66 238 12 9 9 36 103 6 314 4 3 36 188 0 8 21 1 0 2 1 13 15 0 60 278 7 32 25 3 4 11 58 414 2 0 6 71 122 19 71 26 14 3 68 12 252 9 332 150 27 S 126 18 351 33 0 22 2 2 59 14 3 0 1068 11 338 69 381 102 44 82 55 218 119 49 1335 11 39 265 856 10 74 128 4 3 86 4 15 29 16 69 895 16 148 182 13 12 60 112 272 55 4 53 295 279 13 143 108 155 1 434 25 952 73 1187 600 89 34 9 70 626 87 13 61 8 6 223 43 40 6 3990 13 133 37 644 57 122 149 123 243 190 11 2013 38 24 270 830 2 175 151 1 27 163 3 26 68 73 154 831 17 163 458 19 1 64 189 217 91 5 38 517 293 36 293 155 297 0 390 20 1020 79 1085 792 109 19 43 91 464 342 45 42 6 9 295 113 26 2 1268 28 20 17 84 2443 25 25 34 61 869 33 5200 48 5 28 34 20 17 80 4 25 13 8 92 55 4 35 1906 47 88 63 16 0 25 102 2731 8 1 24 110 94 69 68 20 75 34 738 26 1565 19 139 1444 92 41 1040 54 953 77 54 47 31 6 779 22 48 5 1806 7 26 9 -377 1585 49 134 105 162 849 1 5211 51 9 24 24 3 17 55 2 18 8 3 56 83 30 87 3141 28 50 85 9 0 41 432 1042 49 1 32 181 386 251 48 39 111 128 1991 19 952 37 807 1822 49 24 1235 50 2101 420 61 26 6 0 543 21 26 3 430 1 3 0 5 2585 172 42 149 30 459 0 858 46 8 2 1 0 185 60 2 8 203 1 30 37 66 27 499 5 146 462 73 0 0 147 135 21 0 2 127 281 22 18 74 216 10 63 19 337 0 239 400 38 "12 227 9 573 92 0 0 0 0 840 155 0 0 LOCAL HEALTH SERVICES 57 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 K. MISCELLANEOUS M. NUSNG 1 2 3 4 5 6 7 8 1 2 TOTAL 1962 9460 20876 14112 173060 215078 2295 1438 2824 401 4679 Alachua-..........-........ 419 443 390 319 3622 5 9 139 2 31 Baker-.. .-... 62 170 199 28 88 0 7 0 0 0 Bayke......36 95 7 0 2262 60 6 41 2 12 Bradford ............ 75 180 112 44 234 109 17 0 1 4 Brevard----............ 450 686 262 20 3092 78 58 0 10 36 Broward....- ..... 221 503 29 734 21476 30 1 114 19 255 Calhoun .... .. 99 16 191 25 204 11 9 0 0 0 Charlotte.... ....... .... 47 403 356 0 886 8 4 1 1 1 Citrus.........----.... 23 33 87 54 566 5 4 0 0 0 Clay .............. 138 259 61 36 384 90 16 1 1 1 Coer-... .... 123 289 138 67 900 9 8 3 0 0 Columbia------- 243 295 300 60 313 13 19 0 0 0 Dade .....--------............ 59 247 412 164224 21635 42 23 -475 46 741 DeSoto .................- 19 55 5 4 453 21 0 0 0 0 Dixie...... ........ 58 43 58 7 301 69 10 2 0 0 Duval-.... -...- 34 30 33 4 5685 2 0 636 40 563 Escambia............ 187 647 243 1193 11523 13 143 189 8 61 Flagler ...... ........ .... 65 244 327 124 196 34 3 0 0 0 Franklin.............. 47 43 22 16 794 7 0 0 0 0 Gadsden .................. 133 455 423 33 852 671 2 0 .0 0 Gilchrist.....----... 263 232 855 36 103 1 0 1 0 0 Glades...................... 116 158 348 33 62 1 0 0 0 0 Gulf ............................. 37 40 66 3 326 215 20 2 0 0 Hamilton....: ........-.... 126 2 177 70 349 1 5 0 3 4 Hardee ............. .... 23 33 13 0 430 11 8 0 1 7 Hendry....................... 138 291 .539 12 457 27 0 0 0 0 Hernando............ ....... 6 12 3 242 511 0 1 0 3 13 Highlands-.................... 31 22 19 72 555 10 8 0 4 14 Hillsborough.................. 644 3282 129 664 42227 4 7 319 37 947 Holmes ........................ 3 35 6 32 44 327 4 27 0 2 23 Indian River .............. 27 141 20 54 944 2 0 1 3 23 ackson-.......... ........... 87 69 65 42 695 63 48 0 0 0 efferson........................ 47 111 23 34 253 15 0 0 1 2 afayette ...........-....... 39 154 65 1 17 13 0 0 0 0 Lake ......................... 30 43 12 15 947 17 0 0 6 14 Lee..........-- ......... 82 71 107 199 3584 3 1 23 4 18 Leon... ......... 283 600 282 100 3118 10 1 0 2 8 Levy ..................... 28 26 146 163 627 3 -31 3 2 10 Liberty..................... 64 177 198 59 110 1 0 0 0 0 Madison .................. 39 67 40 11 166 16 32 0 0 0 Manatee---... ............ 165 612 393 210 3639 4 3 61 10 79 Marion ..........-- 3 18 3 99 2248 198 13 11 2 28 Martin .................... 11 42 20 0 0 12 3 0 1 3 Monroe .................. 300 353 224 50 1369 24 38 0 2 7 Nassau................. 119 151 69 19 621 48 11 4 0 0 Okaloosa................... 151 1001 1070 167 1829 25 0 0 1 2 Okeechobee........---... 4 8 1 0 198 0 3 0 1 8 Orange----..-.............. 130 224 63 602 3808 18 42 221 25 210 Osceola---............ .. 8 18 16 69 774 1 9 0 8 47 Palm Beach..---....... 304 1082 366 338 14533 39 46 350 18 78 Pasco----.......--. 86 117 53 12 2133 5 4 0 10 110 Pinellas---..---.. 916 1848 704 406 30575 1 550 65 41 382 Polk ................... 1117 699 1637 29 7430 85 44 63 25 198 Putnam.... ....... 395 318 727 262 1035 2 3 0 6 21 St. ohns------ ... 54 25 46 7 1066 0 1 1 7 17 St Lucie ----.. 0 0 0 0 1006 6 17 0 4 25 Santa Rosa.............. 112 52 284 238 493 1 34 2 0 0 Sarasota....... ... --..... 159 966 2 0 2382 4 20 84 10 97 Seminole.-----............... 25 59 20 0 632 31 2 0 8 91 Sumter...--- ..----- 46 47 56 3 432 0 9 0 1 8 Suwannee ......... 139 263 925 33 422 0 3 0 1 14 Taylor--------- 115 63 149 44 458 7 14 0 0 0 Union--.....---..... 120 32 176 55 111 14 0 2 0 0 Volusia -......-- 186 2143 213 1443 5682 51 0 10 21 451 Wakulla..........----.. 19 15 6 6 302 12 0 0 0 0 -Walton--.----. .. 82 10 85 81 379 5 26 0 0 0 Washington............. 11 37 10 41 247 8 15 0 1 15 58 ANNUAL REPORT, 1962 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 P. SANITATION WATER SEWAGE Private New Specifica- Public Water Private Water Bottled Water Public Sewerage Sewerage tion Septic Systems Plants Plants Systems Systems Tanks Installed COUNTY 2 3 4 5 6 TOTAL 1962 6896 17697 7720 13223 56 318 1219 8274 543 2742 25650 38352 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... ackson ...... Jefferson ...-... Lafayette ..... Lakes.. .= Leon__........_ Levya ........ Liberty--__..... Madison ....... Manatee-- .. Marion ....... Martin.-- ..... Monroe--.. .. Nassau__ .. Okaloosa....... Osceola ....---.... Palm Beach_-- Pasco__..... Pinellas---- Polk...---.. Putnam ---- St. Johns___- St. Lucie_..... Santa Rosa- ... Sarasota--... Seminole__ Sumter---__ Suwannee___ Taylor._-.. Union_-__ Volusia_. . Wakulla.---.. Walton ... Washington--- 373 60 349 10 334 738 52 50 74 146 241 26 1301 117 63 4057 589 0 95 94 0 45 86 21 72 104 20 44 527 3 3 68 33 13 35 50 177 57 352 46 632 111 231 14 4 193 85 1838 56 678 18 1179 549 42 12 46 31 466 219 188 3 112 0 318 55 34 58 192 8 171 0 120 319 2 34 107 5 34 3 628 37 9 390 531 2 5 38 1 1 47 51 61 1 19 70 780 6 2 5 28 1 53 6 25 30 5 21 868 160 93 10 6 31 20 4 1 699 12 83 270 22 19 68 11 1323 78 16 3 70 0 35 14 1 I 358 9 282 0 265 550 3 628 122 22 111 5 1252 44 11 493 592 3 53 46 1 19 91 20 134 12 21 82 1361 11 2 10 34 1 94 6 33 44 8 38 975 240 152 29 17 104 35 112 7 838 26 188 395 28 60 151 34 2642 96 37 4 95 0 65 20 1 1 37 2 31 1 58 51 0 6 8 6 8 3 49 1 5 98 40 2 6 3 1 5 0 1 1 9 5 42 1 7 4 2 0 1 17 1 1 4 Io 1 50 3 7 11 1 8 2 351 1 9 12 115 46 1 9 4 10 21 23 1 1 1 1 6 3 1 2 106 8 162 11 454 783 0 16 27 23 91 14 454 6 11 553 569 2 73 21 1 4 9 0 17 48 10 13 773 2 24 40 7 0 S2 158 4 2 5 8 194 4 124 36 4 95 34 1001 32 172 18 1168 247 2 89 26 42 261 178 4 2 6 2 13 5 2 2 365 33 264 106 3076 2405 51 203 10 49 103 178 1 4 1 459 1284 46 2 80 19 9 49 19 62 81 6 473 1199 25 44 33 2 7 703 475 279 75 4 15 647 293 445 109 64 227 116 1600 104 2943 101 1747 1465 194 34 285 68 1165 461 41 18 44 110 1039 2 27 22 487 97 553 109 4076 3225 103 229 22 106 276 474 1 4 1 677 1472 75 9 132 134 14 67 52 140 113 8 596 1461 57 67 143 4 7 1057 480 417 111 39 1223 426 694 262 185 328 166 2150 137 3580 194 2596 2246 298 103 669 127 3088 475 70 30 48 185 1882 4 47 39 - - LOCAL HEALTH SERVICES 59 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 P. SANITATION (Continued) SEWAGE MISCELLANEOUS Percola- New Specifica- Garbage Subdi- tion and Public tion Privies Disposal vision Soil Log Pollution Bathing Areas Swimming COUNTY Installed Systems Analysis Test Survey Surveyed Pools 7 8 9 10 11 12 13 -I S Si 1 Z J Si 'r Si I- Si l TOTAL 1962 222 487 448 4386: 438 14426 288 2962 209 1000 2383 16732 Alachua_... 0 0 2 48 64 833 15 20 8 9 15 127 Baker....... 0 5 1 1 0 0 0 0 0 0 1 4 Bay ....... 0. 0 0 7 7 11 272 2 10 0 0 40 390 Bradford 0 0 6 63 0 18 0 0 3 3 3 13 Brevard.. 2 2 8 114 9 1849 5 35 11 25 21 125 Broward_... 0 0 15 25 22 26 32 163 5 5 554 2974 Calhoun .. 0 0 1 5 0 0 0 0 0 0 1 1 Charlotte .... 0 0 1 13 0 10 4 150 2 4 4 52 Citru ....... 0 0 5 15 0 2 2 5 2 2 2 6 Clay.............. 1 1 4 54 0 147 1 1 1 1 5 13 Cor....... 17 51 2 27 0 33 2 29 0 0 21 214 Columbia.... 3 4 1 234 3 39 1 1 1 1 4 10 Dade 0 0 1 1 1 2 64 127 27 265 691 5929 DeSoto....- 0 0 5 9 0 14 0 0 0 0 0 0 Dixie____ 0 0 1 6 0 15 0 0 0 0 0 0 Duval_.. 2 4 41 482 13 1881 1 21 1 6 4 11 Escambia... 8 85 5 1222 8 80 12 106 6 60 30 112 Flagler .. 0 0 0 0 2 69 5 6 2 3 1 5 Franklin--...... 3 3 5 85 0 7 0 0 0 0 2 13 Gadsden ..... 90 126 8 138 1 0 1 21 2 10 4 37 Gilchrist........ 2 4 1 26 0 10 0 0 0 0 0 0 Glades. ...... 1 1 1 14 1 0 0 0 0 0 0 0 Gulf...... 0 0 0 0 0 1 0 0 0 0 0 .0 Hamilton......... 19 23 1- 1 0 2 0 0 0 0 1 3 Hardee...... 0 0 2 16 0 1 1 2 0 0 1 2 Hendry -.. 0 0 0 0 0 2 0 0 0 0 2 23 Hernando 0 0 2 7 0 25 3 9 0 0 2 2 Highlands .... 0 0 4' 10 9 0 2 3 0 0 19 28 Hi2sborough .. 2 27 75 248 27 209 5 981 3 56 60 771 Holes...... 0 0 1 2 0 36 0 0 0 0 0 0 Indian River-... 2 2 1. 6 3 56 1 1 3 3 15 119 Jackson. ....... 0 4 1 1 1 116 2 10 2 7 1 15 efferson....... 2 2 1 1 0 1 2 2 0 0 0 0 afayette........ 1 1 1 8 0 29 0 0 0 0 0 0 Lake....-... 0 0 0 0 31 159 3 4 0 0 4 6 Lee... 2 3 4 17 0 1 3 25 0 0 12 31 Leon 1 2 6 13 0 18 12 12 10 206 20 121 Levy-__ 0 0 5 23 2 17 0 0 0 0 0 0 Liberty_ 0 0 0 1 0 0 0 0 0 0 0 Madison__ 1 1 1 1 0 2 0 0 0 0 2 6 Manatee ..... 4 8 2 4 12 163 3 41 9 30 19 161 Marion .._ 7 9 89 223 16 369 0 0 1 3 15 67 Martin............ 1 1 4 19 0 363 6 48 1 1 12 52 Monroe ........... 0 8 66 2 0 20 526 8 39 38 78 Nassau..... 2 9 7 23 0 7 1 1 1 5 9 54 Okaloosa ........ 1 1 1 28 2 267 3 8 1 1 2 10 Okeechobee..... 0 0 1 2 0 62 0 0 0 0 1 4 Orange ....... 1 4 4 352 45. 2214 4 123 2 34 69 518 Osceola.... 0 0 1 51 6 21 1 1 1 1 1 4 Palm Beach.... 0 0 5 41 11 32 3 37 3 4 203 2053 Pasco ._ ... 1 1 4' 4 1 38 1 5 0 0 3 14 Pinellas ..-. 16 21 12 266 5 2850 7 140 7 72 220 1255 Polk.-... 1 5 10 50 22 637 23 78 37 72 48 172 Putnam .------ 0 0 12 89 2 56 0 0 3 4 5 18 St. ohs....... 9 41 17 33 11 43 3 14 1 3 24 72 St. lucie_ 0 0 0 5 27 1 194 2 22 1 11 11 81 Santa Rosa..- 0 0 0 0 0 3 4 6 6 1 1 Sarasota_...._. 7 17 4 12 74 527 10 100 8 12 28 166 Seminole.... 0 0 8 57 12 377 4 21 24 27 7 19 Sumter...... 2 4 2 2 0 40 1 6 1 4 2 25 Suwannee.... 4 4 0 0 0 33 0 0 0 0 4 18 Taylor .... 1 1 5 30 0 2 4 11 0 0 13 26 Union- -. 1 1 0 0 1 0 0 0 0 0 0 0 Volusia- 5 9 16 41 5 90 7 31 4 4 99 693 Wakulla... 0 0 1 1 0 3 0 0 0 0 5 5 Walton --- 0 0 3 4 1 56 1 1 1 1 0 0 Washington.. 0 0 1 28 0 0 0 0 0 0 2 3 60 ANNUAL REPORT, 1962 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 P. SANITATION (Continued) MISCELLANEOUS Tourist Schools Mobile Camps Courts or Child Care Complaints Home Parks Motels Centers Investigated COUNTY 14 15 16 17 18 19 TOTAL 1962 1611 4536 1634 7583 560 5366 557 1533 1553 5190 32635 68889 Alachua .-.. 9 53 31 79 26 74 98 119 12 86 .303 728 Baker__. .. 5 34 4 4 0 0 1 1 0 0 28 50 Bay -.... 30 31 53 109 1 1 21 51 0 0 122 173 Bradford... 7 8 2 4 7 14 3 4 1 1 29 56 Brevard ------ 17 54 85 443 2 10 5 14 15 56 973 1616 Broward.-----. 128 239 102 338 20 173 6 23 173 719 2429 4443 Calhoun__- 5 53 1 1 0 0 0 0 0 0 8 12 Charlotte-__ 3 37 1 53 1 7 2 30 0 0 13 148 Citrus ---- 4 11 5 7 0 0 7 10 0 0 31 36 Clay 12 80 12 120 7 60 7 47 1 7 23 40 Collier ... 4 5 9 22 50 239 5 11 3 4 73 163 Columbia------ 14 21 2 4 2 8 2 2 1 3 27 80 Dade --- 260 426 139 385 68 3178 0 0 210 332 7791 18712 DeSoto.- -----. 7 56 1 2 0 0 9 9 0 0 42 45 Dixe 1- 16 0 0 1 2 2 2 0 0 10 25 Duval ..- 91 122 27 90 5 9 34 109 240 344 1545 3942 Escambia__ __ 92 95 78 199 0 0 11 29 30 87 3219 5386 Flagler_____ 1 2 1 1 5 24 0 0 0 0 8 14 Franklin .. 4 27 7 28 4 10 0 0 0 0 25 97 Gadsden----. 15 105 4 18 3 19 9 49 1 1 52 83 Gilchrist-__. 0 0 0 0 0 00 0 1 1 1 4 Glades----.--. 4 10 1 6 9 21 0 0 1 2 13 20 Gulf-.... ..- 7 51 7 13 0 0 9 17 0 0 24 56 Hamilton------ 0 0 1 4 0 0 0 0 0 0 19 44 Hardee---......-- 2 17 4 10 10 32 2 2 0 0 14 55 Hendry--...----- 5 17 3 30 9 58 5 36 2 2 19 74 Hernando .... 2 2 4 5 3 5 1 1 0 0 50 72 Highlands-..-- 6 10 40 90 27 40 22 35 0 0 75 111 Hillsborough---. 24 422 116 868 13 234 3 26 184 1964 1933 5750 Holmes- 9 58 0 0 0 0 0 0 0 0 11 15 Indian River- 1 34 9 27 3 11 2 7 1 2 118 249 Jackson___ 3 24 3 37 1 2 1 3 0 0 12 42 Jefferson __ 8 19 2 2 0 0 0 0 1 1 24 45 Lafayette___ I1 1 0 0 0 0 3 3 0 0 7 7 Lake ..--.. 21 32 11 17 8 25 7 11 1 1 78 118 Lee ..... 30 88 27 41 1 3 1 3 2 2 102 198 Leon ... 29 43 35 94 23 55 42 46 42 119 268 527 Levy.. .. 9 26 4 5 5 8 9 9 0 0 25 26 Liberty-- .... 6 22 0 0 2 6 0 0 0 0 0 0 Madison-... 8 10 0 0 2 3 2 2 0 0 15 20 Manatee ... 3 4 51 101 11 46 12 22 23 44 376 578 Marion ..-. 44 109 28 86 14 47 44 121 13 40 387 838 Martin. ...- 1 13 14 67 1 2 4 10 0 0 91 246 Monroe. ---..-. 12 37 58 132 6 9 8 18 6 11 158 261 Nassau.-----..... 9 44 5 17 1 6 3 14 0 0 54 98 Okaloosa ----.---- 9 61 2 12 1 10 5 12 4 9 125 155 Okeechobee...... 4 8 16 83 0 0 0 0 1 2 17 26 Orange- -..--.. 168 564 88 452 4 55 42 347 218 416 1546 4046 Osceola---....- 5 41 9 63 1 2 13 24 0 0 58 83 Palm Beach.-.... 101 211 51 142 98 309 3 16 157 548 2328 3793 Pasco .....- 2 2 28 60 11 87 6 12 0 0 54 95 Pinellas .. 147 530 234 2531 8 165 3 4 96 132 5332 10550 Polk--.. 78 146 38 181 32 172 7 38 14 24 862 1466 Putnam ____. 1 1 2 3 10 19 10 12 1 1 81 138 St. Johns_____ 20 86 10 16 12 12 4 6 9 10 42 84 St. Lucie ........ 8 8 28 177 6 35 0 0 11 11 134 253 Santa Rosa__.. 5 16 4 5 0 0 0 0 0 0 46 69 Sarasota .---. 22 55 63 122 2 10 13 23 34 125 633 1179 Seminole.... 18 81 4 15 7 16 3 4 21 32 248 447 Sumter --- 8 28 4 9 2 4 8 32 0 0 24 34 Suwannee.------ 11 11 4 13 4 4 10 26 2 13 13 29 Taylor--------..-.. 5 28 7 10 0 0 15 57 0 0 20 28 Union .-..-... 2 10 0 0 0 0 0 0 0 0 1 3 Volusia ........-... 18 30 52 127 9 20 5 6 17 29 396 1023 Wakulla.-....-.. 6 12 0 0 0 0 3 3 0 0 17 36 Walton.---_. 14 16 3 3 2 5 3 3 4 9 13 22 Washington __.. 6 23 0 0 0 0 2 2 0 0 20 27 LOCAL HEALTH SERVICES 61 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 P. SANITATION (Continued) MISCELLANEOUS (Continued) PROTECTION OF FOOD AND MILK Nui- sances Rabies- Eating and Food Pro- Shellfish and Cor- Plumbing Animal Bites Drinking cessing Abattoirs Crustacea COUNTY reacted Establishments Plants 20 21 22 23 24 25 26 TOTAL 1962 23394 2179 6482 17902 54438 20817 105685 1066 4170 130 781 194 1535 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- ackson-..------ efferson-....- fayette-..... 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.. 438 10 32 38 850 1662 10 36 18 35 51 15 3941 11 8 1333 2867 15 31 170 5 7 18 14 13 47 37 28 2210 14 45 5 10 4 38 72 383 19 0 6 304 417 55 171 20 66 3 1108 16 884 43 3940 453 31 51 140 62 739 110 9 8 10 4 179 3 6 16 6 1 0 1 2 168 0 1 4 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 2 2 0 0 0 0 2 2 0 1 6 0 0 4 0 1 0 2 4 1 2 0 2 0 0 0 0 1 0 0 0 0 0 1 0 0 0 972 78 132 116 1226 3552 2 56 10 178 109 245 15998 42 6 1128 3080 31 33 43 8 16 38 30 55 40 2 104 14026 23 100 49 34 1 55 129 843 82 4 33 280 371 43 258 47 254 51 2679 81 321 64 1522 2178 47 44 319 134 1582 306 102 15 93 12 832 16 37 41 344 12 230 42 428 1640 34 14 41 82 94 120 4818 42 29 685 685 64 47 93 6 52 59 37 27 49 17 184 1963 55 113 118 35 10 197 308 292 74 16 37 295 237 112 180 56 100 60 460 56 1109 240 1848 687 117 99 181 81 393 166 52 78 63 7 718 77 97 56 1177 77 849 355 1986 4164 271 257 65 621 233 594 25085 182 98 1585 3621 203 159 526 121 135 445 97 82 231 26 306 20332 295 670 672 68 33 455 803 1882 84 94 90 620 786 569 423 446 366 387 2409 216 2907 705 12032 4771 280 378 1560 153 1353 615 134 661 158 15 4137 102 217 256 81 0 3 0 32 135 0 21 1 3 15 6 730 13 0 42 133 0 27 8 0 0 11 0 13 0 6 1 505 0 15 9 2 0 8 52 15 4 0 0 216 36 26 4 1 4 4 248 11 79 28 836 269 4 12 64 0 162 77 41 0 0 0 149 3 5 0 2 0 160 0 51 2 0 84 6 0 0 "0 7 0 38 196 113 1 7 33 0 0 26 0 0 0 0 0 93 0 22 0 0 0 0 75 6 67 0 0 8 0 2 5 -29 0 0 4 0 4 2 177 2 2 76 2 10 96 0 0 0 13 0 13 89 9 3 I I I I I I I 62 ANNUAL REPORT, 1962 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 P. SANITATION (Continued) PROTECTION OF FOOD AND MILK (Continued) Dairy Cows Farms Other Food Food- Milk and Milk Cows Tuber- under Grocery and Establish- Handlers Products Bangs culin Mastitis COUNTY Meat Markets ments Trained Dairy Farms Plants Tested Tested Control Program 27 28 29 30 31 32 33 34 1 1I I I I | | | S S Z < > > Z Z TOTAL 1962 6325 33089 2043 10853 3596 791 10404 822 7807 19491 93262 374 Alachua------ 137 412 4 9 4 21 66 3 13 0 0 5 Baker-----... --- 15 40 16 31 0 4 26 0 0 0 0 0 Bay ------- 63 159 4 32 0 3 33 2 18 0 283 0 Bradford----- 33 255 2 3 0 3 35 3 35 0 44 0 Brevard- .----- 54 404 11 .26 0 5 32 7 65 0 0 0 Broward..------. 376 1100 20 47 0 3 25 11 89 122 156 0 Calhoun-- .._. -- 11 16 0 0 0 11 212 0 0 0 717 0 Charlotte---..---- 8 67 1 5 0 0 0 1 12 0 0 0 Citrus------ 2 2 0 0 0 0 0 0 0 0 0 0 Clay----.. 36 454 0 0 0 7 82 2 18 0 0 Collier -- 17 33 1 2 0 0 0 0 0 0 0 0 Columbia .-- 59 169 0 0 0 1 3 2 23 0 0 0 Dade 1498 6868 924 5328 1693 97 943 352 3144 0 1335 0 DeSoto ..... 22 104 10 16 0 2 49 0 0 0 0 0 Diie--- 3 4 0 0 0 0 0 0 0 0 0 0 Duval----- 364 868 52 92 0 1 9 1 8 0 0 0 Escambia-- 263 1191 49 184 387 70 985 10 55 0 3831 0 Flagler--- 8 26 0 0 0 1 5 0 0 0 0 0 Franklin 5 5 0 0 0 0 3 3 0 0 0 0 0 Gadsden-- 32 41 I 1 0 3 79 1 14 20 289 0 Gilchrist-__ 2 2 2 0 0 0 0 0 0 0 0 0 Glades.------ 14 32 0 0 0 5 92 0 0 0 0 0 Gulf-. 61 403 7 21 0 1 15 0 0 0 78 0 Harmilton_ 8 8 0 0 0 0 0 0 0 0 0 0 Hardee------ 2 3 1 1 0 3 40 0 0 0 187 0 Hendry.. 10 52 0 0 0 7 51 0 0 0 0 0 Hermando.___ 1 1 0 0 0 1 1 0 0 0 0 0 Highlands .. ..- 30 55 1 2 0 8 40 6 10 0 3386 0 Hillsborough_-. 857 8946 464 3757 51 88 2293 15 1053 1306 15819 88 Holmes ----- 23 149 0 0 0 16 223 0 0 0 761 0 Indian River____ 6 93 0 0 0 5 48 1 29 0 1 0 0ackson-- .. O 0 0 0 0 24 358 3 27 144 0 0 efferson.-- 26 42 0 0 0 9 96 2 13 134 126 0 afayette--- 4 5 1 1 0 20 385 0 0 0 1503 3 Lake-- 8 10 0 0 0 4 7 0 0 0 0 0 Lee---63 109 28 31 0 8 65 1 55 0 0 0 Leon--- 174 826 25 28 0 13 170 7 163 0 2099 0 Levy ------ 14 14 1 1 0 1 1 12 0 9 0 Liberty --... .0 0 0 0 0 0 0 0 0 0 0 0 0 Madison 0 0 0 0 0 7 31 3 6 0 490 0 Manatee- .. 61 118 4 5 0 26 347 6 13 0 7277 0 Marion--------- 59 128 8 18 3 13 327 5 46 0 1160 0 Martin-------- 36 163 3 4 0 9 100 5 21 0 3683 0 Monroe--- --- 22 48 1 6 0 0 0 6 11 0 0 0 Nassau.....---- 23 69 0 0 0 1 1 0 0 0 0 0 Okaloosa -.. 1 1 0 0 0 2 16 1 1 25 73 0 Okeechobee -. 29 181 0 0 0 24 309 2 22 0 18000 5 Orange ---. 23 501 253 521 278 25 215 37 391 0 0 0 Osceola---- 9 10 0 0 0 8 96 0 0 0 0 0 Palm Beach 243 639 37 67 0 23 167 31 884 17629 15287 199 Pasco- 3 4 1 1 1 21 232 1 2 0 4677 0 Pinellas------- 614 3357 34 312 109 12 216 234 1137 82 3568 12 Polk_ --. 317 2264 33 214 99 46 602 2 28 0 4524 47 Putnam-n 37 79 0 0 0 7 31 0 0 0 0 0 St. Johns-.-- 5 12 1 '3 0 10 21 2 13 0 0 0 St. Lucie. ---- 65 629 3 3 26 7 46 4 14 0 1767 0 Santa Rosa__.. 0 0 1 1 0 10 116 0 0 0 0 0 Sarasota--- .. 99 204 16 42 25 5 68 3 21 1 98 4 Seminole---- -. 59 228 1 2 0 8 79 1 1 0 224 0 Sumter------ 15 57 1 5 0 9 110 0 0 0 162 0 Suwannee- ..- 0 0 0 0 0 6 71 1 5 22 148 0 Taylor-----. 10 17 I 1 0 0 0 0 0 0 0 0 Union----..... 10 15 0 0 0 0 2 8 0 0 0 0 0 Volusia---- .. 214 1142 17 24 920 41 414 42 337 0 0 0 Wakulla. 2 3 0 0 0 0 0 0 0 0 0 0 0 Walton--- 32 65 4 5 0 11 45 5 8 6 660 11 Washington_ .... 28 187 I 1 0 10 264 0 0 0 840 0 VITAL STATISTICS 63 TABLE 7 (Continued) MAJOR ACTIVITIES OF LOCAL HEALTH UNITS, 1962 P. SANITATION (Continued) V. HEALTH EDUCATION X. LAB. Private Public . Premises Premises 35 36 COUNTY 0 . Sa I Il S0 1 2 3 1 4 5 6 7 8 1 "22 TOTAL 1962 30730 92689 12714 37879 10096 8771 7626 34083 2939 311 1954 681 66996 1040 2 10 11 Alachua._ ...- Baker ... Bay........ Bradford_...... Brevard ...... Broward- -....-.. Calhoun . Charlotte ....... Citrus_ HendrClay....... Colier...-.. Columbia ... Dade-- -...... ... DeSoto ---....... - Dixie .. . DuvaL..._.. Escambia---.. Flagler.... Franklin_ .... Glades .-.... Gul.f- .. HamiltoL-_..-- Hardee........ Hendry------ Hernando........ Highlands- ... Hillsborough__ olmes......... Indian Iliver- Jackson .... iefferson --... Lafayette..... Lake........ Leeon__-...... 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-. 90 87 259 3 20 1448 4 18 102 14 6 27 7646 65 18 6380 3315 2 42 450 17 48 127 2 81 83 65 73 1114 7 86 9 28 23 628 45 52 119 3 5 247 648 610 161 44 39 33 240 43 490 52 2474 446 4 7 483 39 924 400 136 40 191 203 140 11 11 3 456 110 419 3 94 2426 12 87 157 139 19 263 14864 122 25 11572 4836 169 131 559 23 800 188 50 161 841 144 132 15898 12 670 58 68 31 779 95 281 244 3 5 312 1010 791 247 182 106 46 1137 87 817 147 24824 707 18 62 648 96 1882 1116 335 73 315 453 268 42 19 3 104 6 16 0 26 237 3 5 6 18 27 64 8003 95 7 256 457 2 24 21 3 5 41 1 20 32 1 26 297 3 26 5 5 14 .187 113 58 50 6 6 41 189 36 62 14 49 32 209 38 276 3 502 57 1 20 135 38 449 68 12 8 30 11 136 8 10 4 1040 19 27 0 293 758 18 235 6 103 73 286 16628 252 17 1174 1207 .9 96 57 3 48 103 1 85 261 1 134 2812 5 159 38 16 17 263 231 143 156 8 8 74 375 178 122 88 518 162 1821 385 620 20 4121 138 17 187 370 71 829 369 24 10 45 19 481 15 21 9 226 24 84 111 162 228 34 117 38 84 158 102 1310 17 11 211 323 7 34 86 26 50 38 35 95 88 16 57 916 27 221 112 22 30 51 273 201 16 4 67 273 217 30 135 46 31 8 339 49 910 15 927 444 56 46 54 159 248 59 22 21 35 10 191 5 52 2 180 23 61 56 111 308 29 210 40 120 125 30 1346 15 16 132 222 1 27 101 27 21 48 74 34 59 4 22 909 33 173 101 19 13 31 112 103 40 4 26 121 122 69 117 104 50 27 386 59 471 S9 574 382 30 31 106 169 329 153 39 56 25 5 296 19 11 5 779 18 296 51 4349 3299 29 1580 67 503 117 1163 1029 143 198 77 289 6 66 785 759 26 363 50 233 85 46 100 823 55 149 143 63 20 588 56 499 35 4 134 230 156 113 723 250 17 158 2543 11 3034 43 1463 672 14 248 59 780 3312 641 134 42 87 2 203 47 25 1 1133 9865 1315 10521 36362 1612 4401 1254 1901 5207 3657 82136 1728 1657 18488 36878 1222 2432 6095 1541 755 1960 2168 12374 2316 919 3131 125939 4584 4053 6722 2342 470 3574 7001 23644 2164 1740 2168 11835 7326 1510 4328 2546 4962 1098 27948 2567 30654 3648 59031 27399 4233 3252 3356 3910 5619 2934 2225 2262 1538 1009 7895 2284 2933 1912 I I I . 64 ANNUAL REPORT, 1962 BUREAU OF VITAL STATISTICS EVERETT H. WILLIAMS, JR., M.S., Hyg. Director This bureau is responsible for the collection and preservation of the following records: birth, stillbirth, death, marriage, annulment of marriage, divorce, adoption and legal change of name. It is responsible for the issuance of certified copies of most of these vital records and for processing of various types of amendments to the records. The records have legal value in that they are accepted by courts as legal proof of the facts stated thereon. In addition to their legal value, these records have statistical value for public health agencies and others in- terested in demographic studies. COLLECTION Collection of records is one of the primary functions of the vital statistics system. The value of these records for both legal and statistical purposes is completely dependent upon the effectiveness of the collec- tion system. The county health officers are registrars for their areas and are responsible for the collection of birth, stillbirth and death cer- tificates. Particular emphasis has been placed upon promptness of filing birth and death records. Last year, 98.9 per cent of all births and 97.7 per cent of all deaths were registered at this bureau by the fifth of the following month. In each case this represents an improvement of one- tenth of one per cent over the preceding year. A total of 21 counties submitted 98 per cent or more of their birth records and 26 counties submitted 98 per cent of their death records within the prescribed time limit. Unfortunately, there are still a sizable number of counties which need considerable improvement in the timeliness of filing birth and death records. One measure of the relative efficiency between counties with regard to birth and death registration is the "Vital Sta- tistics Scoreboard," which is published annually (Table 15). The top 10 units are to be congratulated on their superior performance. They are: Jacksonville-Duval, Dade, Citrus, Hillsborough, Martin, Volusia, Hernando, Seminole, Orange and Polk. Last year, a total of 231,997 current certificates were registered with the bureau, an increase of 1.5 per cent over the preceding year. CERTIFICATIONS The issuance of certified photocopies and other certifications is one of the large volume jobs performed by the bureau. Last year, 122,149 requests for certifications were received and processed. This figure represents an increase of 1.9 per cent over the previous year. Birth and death certificates are confidential records and certified copies are not issued to persons who cannot demonstrate the proper interest in the record. For those persons who are not entitled to receive certi- VITAL STATISTICS fled photocopies of birth records, a birth registration card can be issued showing the name, date of birth and place of birth. Last year, a total of 23,665 birth registration cards were issued. Table 8 shows com- parative data for other types of certifications issued during the past two years. AMENDMENTS One of the most complex and troublesome functions of the bureau is the amendment of records. Many requests are received to have rec- ords corrected. In each case, the applicant must submit evidence to substantiate his request and bureau personnel must determine whether sufficient proof has been submitted to justify the correction. Every effort is made to correct minor errors as easily as possible while making sure that sufficient evidence is obtained for major corrections to main- tain the legal validity of the record. A set of administrative regulations governing requirements for correction of records was passed by the State Board of Health (SBH) during the year. DELAYED REGISTRATION OF BIRTHS A "Delayed Birth Certificate" is one which is filed after the per- son's first birthday. An application for filing a delayed birth certificate must be accompanied by documents which verify the date of birth, place of birth and parentage. Requirements for documentary evidence must be sufficient to minimize the filing of fraudulent records and to make the record of sufficient value that it will be acceptable to other agencies and offices using these records as proof of birth. During 1962, administrative regulations governing evidentiary requirements for filing a delayed birth certificate were enacted by the SBH. Bureau personnel must explain these requirements for evidence in writing and orally, and must determine when sufficient proof has been submitted. Last year, a total of 3254 delayed birth certificates were filed. This is a decrease of 7.5 per cent under the total for the preceding year. ADOPTIONS In 1962 there were 4225 adoption decrees received from the courts for children who were born in Florida. This represents an 8.3 per cent increase over 1961. When an adoption decree is received for a person born in Florida a new birth certificate is substituted for the original certificate. The new certificate shows the new parents' names and does not disclose the fact of adoption. The original certificate is sealed and is only available upon receipt of a court order or upon receipt of a request from the registrant if he or she is of legal age. Adoption decrees received for persons born in other states are for- warded to the vital statistics office of the state of birth for similar 66 ANNUAL REPORT, 1962 processing. A total of 1210 adoption reports were forwarded by this office to other states during the year 1962. This is an increase of 15.8 per cent over the preceding year. COMMITTEE FOR DEMOGRAPHIC STUDIES A State Committee for Demographic Studies sponsored by the SBH was organized in January. This was later officially approved as an Advisory Committee to the SBH. Two meetings were held during the year. The following func- tions were approved: a clearing house for information on studies, re- ports and activities of members and their organizations in the broad area of Florida demography to include vital statistics, population char- acteristics, population estimates and projections, and the following areas as they relate to the preceding subjects: health, employment, labor force, economic development, public welfare, medical care, eau- cation, gerontology, urban and rural growth; a source of encourage- ment for research studies and the publication of reports on demo, graphic topics; a forum for exchange of views by the members of the committee; a source of technical advice to public agencies on matters within the committee's competence; and an agency for cooperation with the Bureau of the Census (and other federal agencies) in the development of improved statistics for Florida's population. Two subcommittees were appointed during the year by the chair- man. First, a Subcommittee on Census Tracts to act as liaison between the Census Bureau and several untracted metropolitan areas in the state. The first areas to be considered were West Palm Beach, Ft. Lau- derdale-Hollywood and Pensacola. The second subcommittee appointed was the Subcommittee on Population Estimates and Projections. This committee was to study methodology for current population estimates and population projections. As of the end of the year, members of the Demographic Com- mittee were as follows: John N. Webb, Ph.D., College of Business Administration, University of Florida, Chairman; T. Stanton Dietrich, Ph.D., Department of Sociology, Florida State University (FSU), Vice Chairman; Everett H. Williams, Jr., SBH, Secretary; Robert B. Beas- ley, Management Director, Florida Industrial Commission; James O. Bond, M.D., SBH; Oliver Boorde, Statistician, SBH; John O. Boynton, Research Director, Florida Development Commission; Ralph A. Brad- ley, Ph.D., Head of Department of Statistics, FSU; Richard G. Cornell, Ph.D., Associate Professor, Department of Statistics, FSU; Howard Croom, Assistant Director for Administration, State Department of Public Welfare; John K. Folger, Ph.D., Dean, Graduate School, FSU; Charles M. Grigg, Ph.D., Director, Institute for Social Research, FSU; Albert V. Hardy, M.D., Assistant State Health Officer, SBH; Robert G. Hoffmann, Ph.D., University of Florida Medical School; George B. VITAL STATISTICS Hurff, Ph.D., Bureau of Economic and Business Research, University of Florida; Miss Iris Kiem, Biostatistician, University of Miami School of Medicine; George Macesich, Ph.D., Director, Council on Economic Development; Edward A. Mueller, Assistant Engineer for Traffic and Planning, State Road Department; Travis J. Northcutt, Ph.D., Social Scientist, SBH; Carter Osterbind, Ph.D., Director, Bureau of Economic and Business Research, University of Florida; James A. Paisley, Chief, Research Division, Metropolitan Dade County; Earl R. Rich, Ph.D., Department of Zoology, University of Miami; T. Lynn Smith, Ph.D., Head, Department of Sociology, University of Florida; Miss Dena Snodgrass, Research Analyst, State Chamber of Commerce; Mit- chell Wade, Ph.D., specialist in Research and Statistics, State Depart- ment of Education; Irving L. Webber, Ph.D., Research Social Scien- tist, Pinellas County Health Department. STATISTICAL SECTION OLIVER H. BOORDE, B.S., B.A. Director This section of the Bureau of Vital Statistics is responsible for summarizing and analyzing data obtained from vital records and from 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 publishes a monthly vital statistics bulletin which reveals the latest available data on births, deaths, marriages and divorces. Accompanying this bulletin is a monthly article concerning various subjects of public health inter- est. It is widely distributed to 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 publishes 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) is published in cooperation with the Bureau of Preventable Diseases. This report reviews the number of cases of reportable diseases and analyzes any apparent trends. During 1962, 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. Con- sultation was also provided to insure that study procedures were adapt- able to IBM processing. Among the major projects completed in 1962 was a sociological and immunization survey accomplished in connection with the Hills- borough County oral vaccine field trial. In this survey the section was 68 ANNUAL REPORT, 1962 responsible for the sample design, sample selection, technical aspect of data collection and statistical interpretation of the data. Objectives were to determine the most effective means of persuading persons to take the vaccine and to determine the pre- and post-vaccination im- munization level of the area. A special survey was also conducted in the Bradenton-Sarasota area as to the result of the encephalitis outbreak in the area. The sec- tion's responsibilities were the same as in the Hillsborough County survey. The objectives in this study were to obtain data on living con- ditions of persons selected in the survey. There was also a serological aspect to this survey, wherein a blood sample was taken, when possible, and an encephalitis titer was determined. During 1962, tabulations were completed and analyses begun on a detailed study of neonatal mortality in the state. The following report presents a brief summary of preliminary vital statistics for 1962. A more detailed analysis of these statistics can be found in Supplement No. 1 of this report, entitled Florida Vital Statistics, 1962. Preliminary 1962 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 1962 data covering marriages, divorces and annulments are contained in Table 14, and Tables 11A and 12A pre- sent final 1961 natality and mortality figures. Population The Bureau of Economic and Business Research, University of Florida, provisionally estimated the 1962 midyear population of Flor- ida at 5,349,900. This represents a gain of 3.7 per cent over their 1961 estimate of 5,158,100. On the basis of these figures, the state is adding an average of almost 16,000 persons to its population each month. Births Preliminary figures indicate a total of 115,520 births in 1962. This is a one per cent drop since 1961 and it resulted in a further decline of the birth rate per 1000 population from 22.6 in 1961 to 21.1 in 1962. The resident birth rate in Florida rose from 17.6 in 1940 to a peak of 25.0 per 1000 population in 1956. However, since 1956, the rate has gradually declined to its present level (21.6). The number of white births totaled 84,721 in 1962. This is a 1.3 per cent decrease from the preceding year and yielded a rate per 1000 white population of 19.3 in 1962 as compared with the 20.3 rate for 1961. The 30,799 nonwhite births in 1962 are approximately the same as the 1961 figure (30,803). However, the rate fell from 33.4 births per 1000 nonwhite population to 32.2 in 1962. The nonwhite birth rate remains about 50 per cent higher than the white birth rate. One VITAL STATISTICS of the principal reasons for the declining birth rate, especially among the white, is that a large portion of Florida's in-migration has been by persons beyond the child-bearing ages. Deaths The preliminary mortality data for 1962 indicate a rise of 7.7 per cent in resident deaths (48,690 to 52,443) yielding a rate of 9.8 per 1000 population as compared with the 1961 rate of 9.4. Deaths among white residents rose from 39,703 and a rate per 1000 popula- tion of 9.4 in 1961 to 43,110 and a rate of 9.8 in 1962. Nonwhite deaths rose from 8987 and a rate of 9.7 in 1961 to 9333 deaths in 1962 with a rate of 9.8. Once again, increases in the state's aged population was probably the main cause of the higher rates. The 10 leading causes of death with rates per 100,000 popula- tion for 1962, and with the comparative position of these causes in 1952 are represented in Table 10. The first six of these causes have remained in the same position throughout the period. It is interesting to note that the top three of these diseases-heart disease, cancer and cerebral vascular disease-are diseases associated with aging and all three experienced a rise in rates during the 1952-1962 period. This rise in death rates is probably due to the increasing average age of Florida citizens. Although the next two causes-all accidents and dis- eases of early infancy-retained their positions throughout this period, both experienced a drop in death rates. Influenza and pneumonia's position also remained static, although it shows a slight increase in rate during the period. Three of the remaining leading causes of death (general arteri- osclerosis, other circulatory diseases and diabetes mellitus) are also of a chronic nature and are more prevalent among the aged. Since 1952, general arteriosclerosis has moved from eighth place to seventh, and the death rate per 100,000 population rose slightly (15.4 to 16.4). Deaths from other circulatory diseases rose dramatically during this 10-year period as this cause went from a ranking of sixteenth place in 1952 to eighth in 1962 with a rate twice that of 1952 (7.7 to 15.4). Diabetes mellitus experienced a slight drop in death rate (14.0 to 13.9) during the 1952-1962 period, but retained its ranking of the ninth leading cause of death. Ranking tenth in 1962 were suicide deaths, with a rate of 13.1 per 100,000 population compared with 11.6 and a rank of twelfth in 1952. Although suicide is not generally thought of as a cause of death directly associated with aging, the death rate increases markedly among older people. Tuberculosis and chronic ne- phritis, ranking seventh and tenth in 1952, dropped to rankings of nineteenth and fifteenth, respectively, in 1962. 70 ANNUAL REPORT, Marriages, Divorces and Annulments There were 41,540 marriages in Florida in 1962, giving an increase of 54.3 per cent over 1952 when 26,924 marriages were recorded. However, the rate per 1000 population has dropped from 8.9 in 1952 to 7.8 in 1962 (12.4 per cent). Divorces and annulments totaled 22,180 in 1962; an increase of 8.4 per cent over the 20,468 granted in 1952. The rate per 1000 population has dropped from 6.7 in 1952 to 4.1 in 1962 (38.8 per cent). Infant Mortality There were 3259 infant deaths in 1962. The rate per 10,000 live births has declined from 34.0 in 1952 to 28.2 (17.1 per cent) in 1962. The white rate declined from 25.8 to 22.2 between 1952 and 1962, and the nonwhite rate fell from 55.3 in 1952 to 44.8 in 1962. TABLE 8 ACTIVITIES OF THE BUREAU OF VITAL STATISTICS DURING THE YEARS 1961 AND 1962. Activity 1961 1962 Per Cent Change Current certificates fled 228,457 231,997 + 1.5 Delayed birth certificates filed_.......... .. ... 3,519 3,254 7.5 Amended certificates filed for adoptions ..... 3,900 4,225 + 8.3 Adoption reports forwarded to other states .... 1,045 1,210 +15.8 Legitimations processed-..... ... 466 526 +12.9 Legal changes of name received .......... 935 976 + 4.4 Requests for certifications: Total.. .... .. 119,822 122,149 + 1.9 Fee paid ....... 96,000 98,800 + 2.9 Free .- .-. 23,822 23,349 2.0 Photostats made --------- ... 127,843 134,254 + 5.0 Birth registration cards made ... ...... 22,924 23,665 + 3.2 Fees collected and transmitted to State Treasurer.. $151,990.78 $157,194.42 + 3.4 1962 VITAL STATISTICS 71 TABLE 9 RESIDENT 'BIRTHS AND DEATHS WITH RATES 'PER 1000 POPULATION, :FLORIDA, 1940, 1950, AND. 1952-1962 Midyear Year Population Births Birth Deaths Death Estimate Rate Rate 1962 ..... ....... 5,349,900 115,520 21.6 52,443 9.8. 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 ..- .... 3,223,000 80,087 24.8 30,529 9.5 1952 .. ............. 3,033,100 74,219 24.5 29,136 .9.6 1950 ....... .. ... 2,797,100 64,370 23.0 26,525 9.5 1940 .......- .. ....... .......... 1,915,155 33,696 17.6 21,458 11.2 *Provisional estimate. -.. TABLE 10 TEN LEADING CAUSES OF DEATH WITH RATES PER 100,000 POPULATION, FLORIDA, 1952 AND 1962 NUMBER OF DEATHS RATE*" CAUSE OF DEATH 1962** 1952 1962 1952 c Non- Now- Non- Non- ' Total White white Total White white Total White white Total White white Total Deaths 52,443 43,110 9,333 29,136 21,615 7,521 9.8 9.8* 9.8* 9.6* 9.0' 11.9' 1 Diseases of the heart (400-443)- 18,900 16,599 2,301 9,577 7,787 1,790 353.3 377.8 240.6 315.7 324.3 283.3 1 2 Malignant neoplasms (140-205) 8,765 7,692 1,073 4,195 3,523 672 163.8 175.1 112.2 138.3 146.7 106.4 2 3 Cerebral vascular disease (330-334)- 6,197 5,032 1,165 3,301 2,383 918 115.8 114.5 121.8 108.8 99.2 145.3 3 O 4 All accidents (800-962) 3,129 2,351 778 2,015 1,454 561 58.5 53.5 81.3 66.4 60.6 88.8 4 5 Diseases of early infancy (760-776)- 1,947 1,192 755 1,510 886 624 36.4 27.1 78.9 49.8 36.9 98.8 5 I ,6 Influenza'and pneumonia (480-493)- 1,679 1,176 503 901 452 449 31.4 26.8 52.6 29.7 18.8 71.1 6 7 General arteriosclerosis (450)- 880 775 105 469 396 73 16.4 17.6 11.0 15.4 16.5 11.6 8 8 Other circulatory disease (451-468)- 822 706 116 233 179 54 15.4 16.1 12.1 7.7 7.5 8.5 16 9 Diabetes mellitus (260) 745 591 154 424 328 96 13.9 13..5 16.1 14.0 13.7 15.2 9 0\ 10 Suicide (963, 970-979) 700 670 30 353 331 22 13.1 15.3 3.1 11.6 13.8 3.5 12 19 Tuberculosis-all forms (001-019).. 215 136 79 501 250 251 4.0 3.1 8.3 16.5 10.4 39.7 7 15 Chronic nephritis (592-594) 326 219 107 423 246 177 6.1 5.0 11.2 13.9 10.2 28.0 10 *Rate per 1000 population. *Based on midyear population estimates. *""Provisional data. TABLE 11 RESIDENT DEATHS AND DEATH RATES BY CAUSE, BY RACE, FLORIDA, 1962 (PRELIMINARY) CAUSE OF DEATH DEATHS Bate per 100,000 Population (Numbers in parentheses refer to the International List of Causes of Death) Total White Nonwhite Total White Nonwhite ALL CAUSES 52,443 43,110 9,333 9.8* 9.8* 9.8* Tuberculosis of respiratory system (001-008) 202 130 72 3.8 3.0 7.5 Tuberculosis, other forms (010-019) --13 6 7 0.2 0.1 0.7 Syphilis and its sequelae (020-029) ...106 57 49 2.0 1.3 5.1 Typhoid fever (040) 0 0 0 0.0 0.0 0.0 Dysentery, all forms (045-048) 10 5 5 0.2 0.1 0.5 Diphtheria (055) .-1 0 1 0.0 0.1 Meningococcal infections (057) 219 16 3 0.4 0.4 0.3 Acute poliomyelitis (080) 1 0 1 0.0 0.1 Acute infectious encephalitis (082) 41 37 4 0.8 0.8 0.4 Measles (085) 10 5 5 0.2 0.1 0.5 Typhus and other rickettsial diseases (100-108) _- 0 0 0 0.0 0.0 0.0 All other diseases classified as infective and parasitic (030 to 138 with exception of above causes) -- 189 124 65 3.5 2.8 6.8 Malignant neoplasms, including neoplasms of lymphatic and haematopoietic tissues (140-205) 8,765 7,692 1,073 163.8 175.1 112.2 Diabetes mellitus (260) 745 591 154 13.9 13.5 16.1 Anemias (290-293) 117 81 36 2.2 1.8 3.8 Major cardiovascular-renal disease -27,525 23,608 3,917 514.5 537.4 409.5 Cerebral vascular disease (330-334) 6,197 5,032 1,165 115.8 114.5 121.8 Diseases of the heart 18,900 16,599 2,301 353.3 377.8 240.6 Rheumatic fever (400-402) -- 15I 10 5 0.3 0.2 0.5 Chronic rheumatic heart disease (410-416) 461 414 47 8.6 9.4 4.9 Arteriosclerotic heart disease, coronary disease (420) 14,708 13,456 1,252 274.9 306.3 130.9 Nonrheumatic chronic endocarditis and myocardial degeneration (421, 422) 1,170 943 221 21.9 21.6 23.1 Hypertension with heart disease (440-443) 1,552 974 578 29.0 22.2 60.4 Other diseases of heart (430-434) 9..94 796 198 18.6 18.1 20.7 Hypertension without heart disease (444-447) 400 277 123 7.5 6.3 12.9 General arteriosclerosis (450) --. 880 775 105 16.4 17.6 11.0 Other circulatory disease (451-468) 822 706 116 15.4 16.1 12.1 Chronic and unspecified nephritis (592-594) 326 219 107 6.1 5.0 11.2 Influenza (480-483) 89 56 33 1.7 1.3 3.5 Pneumonia (490-493) -1,590 1,120 470 29.7 25.5 49.1 Ulcer of stomach and duodenum (540-541) ...325 286 39 6.1 6.5 4.1 Intestinal obstruction and hernia (560, 561, 570) -_.. ah o272 225 47 5.1 5.1 4.9 Gastritis, duodenitis, enteritis and colitis, except diarrhea of the newborn (543, 571, 572) -. 302 163 139 5.6 3.7 14.5 Cirrhosis of liver (581) -618 557 61 11.6 12.7 6.4 Acute nephritis and nephrosis (590, 591) .- 62 34 28 1.2 0.8 2.9 Complications of pregnancy, childbirth and the puerperium (640-652, 660, 670-689) d the puerp m 49 21 28 4.2* 2.5* 9.2* Congenital malformations (750-759) ___598 460 138 11.2 10.5 14.4 Birth injuries, postnatal asphyxia and atelectasis (706-762) 834 555 279 15.6 12.6 29.2 Infection of the newborn (763.768) ...... .... .. 164 64 100 3.1 1.5 10.5 Other diseases peculiar to early infancy, and immaturity unqualified (769-776) 949 573 376 17.7 13.0 39.3 Symptoms, senility, and il-defined causes (780-795) __757 436 321 14.1 9.9 33.6 All other diseases (residual) .. 3,786 3,021 765 70.8 68.8 80.0 Motor vehicle accidents (810-835) 1,351 1,078 273 25.3 24.5 28.5 All other accidents (800-802, 840-962) ____ 1,778 1,27 50 33.2 29.0 52.8 Suicide and self-inflicted injury (963. 970-979) 700 670 30 13.1 15.3 3.1 Homicide and operations of war (964, 965, 980-999) 475 166. 309 8.9 3.8 32.3 Infant mortality (deaths under one year of age) _3,259 1,880 1,379 28.2"* 22.1**. 45.18 * *Bate per 1000 population. **Rate per 10,000 live births, ***Rate per 1000 live births. -Less than 0.05 pet 100,000 population. TABLE 11A RESIDENT DEATHS AND DEATH RATES BY CAUSE, BY RACE, FLORIDA, 1961 (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 ALL CAUSES 48,690 39,703 8,987 9.4- 9.4- 9.7- Tuberculosis of respiratory system (001-008) 200 132 68 39 3.1 7.4 Tuberculosis, other forms (010-019) 17 9 8 0.3 0.2 0.9 Syphilis and its sequelae (020-029) 97 35 62 19 0.8 6.7 Typhoid fever (040) __ 0 0 0 0.0 0.0 0.0 Dystery, all form (045-048) 6 4 2 0.1 0.1 0.2 Scarlet fever and trep sore throat (050, 051) .... 5 5 0 0.1 0.1 0.0 Diphtheria (055) -1 0 1 0.0 0.1 UWooping cough (056) -- 4 2 2 0.1 0.2 Meningococcal infections (057) 17 11 6 0.3 0.3 0.7 (030 to 138 with exception of above causes) __ 170 114 56 3.3 2.7 6.1 Malignant neoplasms, including neoplasms of lymphatic and haematopoietic tissues (140-205) -- 8,233 7,175 1,058 159.6 169.4 114.7 Benign and unspecified neoplasms (210-239) 123 93 30 2.4 2.2 3.3 Diabetes mellits (260) 753 576 177 14.6 13.6 19.2 Anemias (290-293) e 103 67 36 2.0 1.6 3.9 lMajor cardiovascular-renal disease ...-25,500 21,747 3,753 494.4 513.4 407.0 Cerebral vascular disease (330-334) -..... -5,660 4,559 1,101 109.7 107.6 119.4 Diseases of the heart 17,586 15,410 2,176 340.9 363.8 236.0 Rheumatic fever (400-402) 9 4 5 0.2 0.1 0.5 Chronic rheumatic heart disease (410-416) .___ 461 421 40 8.9 9,9 4.3 Arteriosclerotic heart disease, coronary disease (420) .... 13,647 12,403 1,244 264.6 292.8 134.9 Nonrheumatic chronic endocarditis and myocardial degeneration (421, 422) 1,136 938 198 22.0 22.1 21.5 Hypertension with heart disease (440-443) -- 1,493 966 527 28.9 22.8 57.1 Other diseases of heart (430-434) .....840 678 162 16.3 16.0 17.6 Hypertension without heart disease (444-447) ..371 227 144 7.2 5.4 15.6 General arterioscleross (450) -- 8,2. 843 738 105 16.3 17.4 11.4 Other circulatory disease (451-468) 720 608 112 14.0 14.4 12.1 Chronic and unspecified nephritis (592-594) __ 320 205 115 6.2 4.8 12.5 Influenza (480-483) 50 24 26 1.0 0.6 2.8 Pneumonia (490-493) 1 1,192 817 375 23.1 19.3 40.7 Bronchitis (500-502) .101 86 15 2.0 2.0 1.6 Ulcer of stomach and duodenum (540-541) 315 271 44 6.1 6.4 4.8 Appendictiis (550-553) ......... __es (451 38 13 1.0 0.9 1.4 Intestinal obstruction and hernia (560, 561, 570) 257 202 55 5.0 4.8 6.0 Gastritis, duodenitis, enteritis and colitis, except diarrhea of the newborn (543, 571, 572) h 337 175 162 6.5 4.1 17.6 Cirrhosis of liver (581) 1591 531 60 11.5 12.5 6.5 Acute nephriti an nenhrosis (590, -51) 48 22 26 0.9 0.5 2.8 Hyperplasia of prostate (610) 50 ... ... 133 103 30 2.6 2.4 3.3 Complications of pregnancy, childbirth and the puerperium (640-652, 660, 670-689) .1.... .. 58 19 39 5.0'*1 2.2 12.7 Congenital malformations (750-759) __.5 612 465 147 11.9 11.0 15.9 Birth injuries, postnatal asphyxia and atelectasis (760-762) 54-1. 1 906 578 328 17.6 13.6 35.6 Infection of the newborn (763-768) 162 66 96 3.1 1.6 10.4 Other diseases peculiar to early infancy, and immaturity unqualified (769-776) 988 663 325 19.2 15.7 35.2 Symptoms, senility, and ill-defined causes (780-795). 777 457 320 15.1 10.8 34.7 All other diseases (residual) 2,867 2,288 579 55.6 54.0 62.8 Motor vehicle accidents (810835) 1,241 979 262 24.1 23.1 28.4 All other accidents (800-802, 840-962) 1,598 ,139 459 31.0 26.9 49.8 Suicide and sef-inflcted injury 963, 970-979) --664 630 34 12.9 14.9 3.7 Homicide and operations of war (964,965, 980-999) 477 152 325 9.2 3.6 35.2 Infant mortality (deaths under one year of age) 03,390 1,994 1,396 29.1"'* 23.21 45.3"* **Rate per 10,000 live births. **Rate per 1000 live births. -Less than 0.05 per 100,000 population. *Rate per 1000 population VITAL STATISTICS 75 TABLE 12 ESTIMATED POPULATION AND RESIDENT BIRTHS, DEATHS, AND INFANT DEATHS, BY RACE, BY COUNTY, FLORIDA, 1962 (Preliminary) Population BIRTHS DEATHS INFANT DEATHS COUNTY 1962 - Prov. Est. Non- Non- Non- Total White white Total White white Total White white STATE....... 5,349,900 115,520 84,921 30,599 52,443 43,110 9,333 3,259 1,880 1,379 Alachua........ Baker..--... Bay.......... Bradford--- Brevard...-- Broward..... Calhoun..-- Charlotte... Citrus- - Clas-- co&=r........ Coler __._ Columbia--.- Dade-___ DeSoto___. Dixie.__.. Duval.--... Escambia... Flagler--- FrankUln...- Gadsden.__ Gilchrist-... Glades. .... Gulf---..__ Hamilton_..-.. Hardee...... Hendry-_ Hernando.-__ Highlands.-- Hillsborough- Holmes.... Indian River- Jackson--._ efferson---_ _ ayette- Lake-.---- Lee--__ Leo----.. 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. 82,800 7,700 66,600 12,900 134,700 377,000 7,500 16,700 10,300 19,000 19,300 21,200 1,024,100 12,700 4,600 482,600 183,100 4,100 7,100 43,100 2,700 2,600 9,400 7,700 12,900 9,600 12,000 23,600 413,000 11,100 28,400 34,900 9,200 3,200 61,700 65,300 76,200 11,300 3,100 14,900 75,200 56,600 19,400 53,900 18,300 63,600 7,700 285,400 19,500 252,900 38,600 401,300 206,300 33,000 30,500 43,500 32,700 84,500 62,800 12,400 16,200 13,600 6,400 133,100 5,500 15,600 11,500 2,205 179 1,870 284 3,858 7,433 178 237 175 477 460 527 19,686 269 130 12,599 5,039 98 159 1,134 53 47 259 209 297 264 289 574 9,281 193 643 716 249 57 1,176 1,308 1,905 257 69 377 1,176 1,280 397 1,379 437 2,047 214 6,682 340 5,287 617 5,660 4,479 793 674 976 1,057 1,363 1,537 276 367 349 103 2,200 106 287 217 1,487 121 1,540 200 3,252 5,132 138 211 131 393 364 327 14,567 190 111 9,181 3,717 44 122 272 43 27 187 105 258 146 186 385 7,421 180 449 442 71 43 812 992 1,211 134 54 158 835 705 274 1,242 305 1,839 166 5,323 264 3,516 521 4,539 3,305 480 438 499 963 1,102 1,119 146 237 247 65 1,544 63 239 141 718 58 330 84 606 2,301 40 26 44 84 96 200 5,119 79 19 3,418 1,322 54 37 862 10 20 72 104 39 118 103 189 1,860 13 194 274 178 14 364 316 694 123 15 219 341 575 123 137 132 208 48 1,359 76 1,771 96 1,121 1,174 313 236 477 94 261 418 130 130 102 38 656 43 48 76 600 55 452 123 830 3,546 83 233 126 151 154 234 9,334 121 51 3,953 1,203 70 96 358 37 24 64 87 126 80 123 304 4,109 122 326 323 110 38 763 657 519 111 18 140 1,051 584 232 364 143 288 57 2,438 329 2,669 495 6,249 1,907 330 333 427 214 1,100 510 152 158 119 55 2,045 44 151 145 330 42 371 93 708 3,022 70 221 109 125 114 152 8,186 97 41 2,692 853 42 74 115 33 15 45 47 117 52 109 232 3,435 118 260 225 37 34 653 540 284 80 15 68 928 354 173 310 96 260 41 2,080 294 2,112 467 5,923 1,537 219 235 294 176 1,017 347 119 112 73 43 1,776 26 134 108 270 13 81 30 122 524 13 12 17 26 40 82 1,148 24 10 1,261 350 28 22 243 4 9 19 40 9 28 14 72 674 4 66 98 73 4 110 117 235 31 3 72 123 230 59 54 47 28 16 358 35 557 S28 326 370 111 98 133 38 83 163 33 46 46 12 269 18 17 37 68 7 55 9 91 214 6 4 8 15 14 19 478 8 3 360 143 8 4 71 4 3 4 8 4. 7 8 21 277 8 23 18 11 3 44 38 46 7 1 14 35 34 16 28 11 48 6 194 16 149 13 135 132 23 23 36 23 40 41 13 8 7 5 68 3 10 8 76 ANNUAL REPORT, 1962 TABLE 12A ESTIMATED POPULATION, RESIDENT BIRTH AND DEATH RATES PER 1000 POPULATION AND RESIDENT INFANT DEATH RATES PER 1000 LIVE BIRTHS, BY RACE AND COUNTY, 1961 (FINAL FIGURES) Midyear BIRTH RATE DEATH RATE INFANT DEATH RATE COUNTY Population COUNTY Estimate Non- Non- Non- 1961 Total White white Total White white Total White white STATE 5,158,100 22.6 20.3 33.4 9.4 9.4 9.7 29.1 23.2 45.8 Alachuat-..-.. Baker ._ Bay--........ Bradford..- Brevard ......... Broward .__ Calhoun.__.. Charlotte ..--- Citrus .-_.... Cla y__ 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 ._. Okalossa ..- 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..- 79,700 7,200 66,000 12,800 119,600 367,500 7,000 16,400 11,000 21,400 18,700 19,600 968,700 13,800 4,700 460,900 180,400 4,600 7,000 41,300 2,700 3,000 11,000 7,900 12,500 9,100 12,400 22,600 402,100 10,700 26,100 35,400 9,600 3,100 57,500 63,000 74,400 11,200 3,100 15,600 74,500 53,200 19,100 47,300 18,000 67,600 8,100 275,400 19,500 236,300 37,400 392,000 201,500 32,300 30,900 43,900 28,900 82,300 61,100 11,500 14,900 12,900 6,200 129,900 5,800 14,700 11,600 32.6 29.2 30.1 24.5 29.2 21.0 21.7 14.3 17.3 23.6 22.8 26.1 20.2 25.0 24.0 27.9 29.2 23.5 24.3 32.9 23.3 19.3 26.1 28.4 23.8 27.7 26.2 23.9 23.4 14.6 24.5 20.4 26.6 15.2 20.1 20.8 30.0 21.0 27.7 22.4 17.1 23.2 21.3 27.5 26.0 30.4 26.4 25.2 18.0 21.3 18.3 14.7 22.8 27.1 21.9 21.7 35.6 16.2 25.2 22.0 23.2 26.9 27.0 18.5 19.5 20.6 19.9 31.1 27.0 29.4 23.2 28.0 17.3 21.4 14.2 14.6 22.8 21.7 23.5 17.6 23.5 22.5 26.5 27.4 11.8 23.1 20.5 19.2 20.0 22.7 22.7 21.8 24.1 22.4 19.5 22.1 13.9 20.7 17.6 16.7 10.4 17.3 18.3 28.9 14.1 26.2 17.2 14.3 20.1 15.7 27.8 24.6 29.6 25.4 23.8 16.3 18.3 17.7 12.9 21.1 23.4 19.2 17.9 35.6 14.3 23.9 18.1 19.5 25.2 22.6 16.1 18.3 19.1 16.1 36.2 36.9 34.2 29.0 39.2 39.2 23.6 16.0 29.5 28.3 28.2 32.0 35.3 29.7 32.9 32.8 36.3 41.7 28.7 40.3 56.7 18.3 36.9 35.4 42.5 37.2 40.4 40.2 32.0 32.5 38.4 26.5 33.3 47.5 31.3 34.2 32.2 36.8 36.0 28.1 32.6 28.8 42.8 25.5 30.2 41.1 31.5 33.3 32.4 31.3 22.6 33.9 30.5 35.4 28.9 29.7 35.7 34.0 28.9 33.0 32.7 32.2 44.4 30.4 22.4 30.5 35.2 7.5 8.2 6.2 10.0 5.6 8.7 10.8 13.7 11.1 7.6 7.7 10.1 .9.2 8.9 9.2 7.5 6.3 6.4 13.3 9.2 10.4 10.0 5.6 10.2 9.3 6.2 11.4 10.8 9.3 10.8 10.5 8.2 10.3 11.1 12.8 9.0 7.0 10.4 11.2 10.5 12.7 10.0 10.3 6.9 7.9 4.2 7.4 7.9 15.6 10.3 13.6 14.8 8.5 9.3 11.3 10.6 5.6 11.0 7.0 10.2 10.5 9.0 13.7 14.4 7.1 9.8 11.0 12.4 13.1 7.2 11.3 7.5 8.0 11.8 12.0 9.0 12.3 9.4 12.9 7.6 11.3 11.4 10.7 9.2 13.3 10.7 11.0 26.7 4.2 11.2 10.9 8.3 15.2 10.4 13.3 12.2 27.5 8.2 8.5 9.5 12.5 12.1 12.2 11.9 12.6 14.0 8.5 9.4 12.4 10.5 9.2 12.0 7.7 16.9 9.0 13.3 9.0 9.0 8.3 8.7 15.2 12.0 9.4 16.2 10.9 10.3 13.3 16.1 13.1 10.0 10.1 12.4 11.0 11.7 *Based on less than 100 live births, which limits the significance of the rate. tRates based on population excluding large institutional segments. 23.5 38.1 23.1 31.8 28.9 30.0 39.5 38.5 21.1 25.8 35.1 45.0 24.4 33.0 35.4 26.2 24.8 46.3 23.5 60.9 31.7* 17.2* 34.8 31.3 23.6 55.6 33.8 51.9 32.2 32.1 21.9 36.1 39.2 42.6* 43.4 31.3 32.4 51.1 23.3* 48.7 38.6 28.4 46.8 26.9 42.7 27.8 28.0 25.5 31.3 37.7 36.5 27.2 28.3 33.1 25.1 55.6 23.3 24.7 24.7 39.5 34.8 11.5 0 25.8 17.7 23.1 30.3 13.3 39.7 20.0 26.4 26.6 21.1 39.7 36.7 22.9 28.6 35.9 43.5 21.3 28.0 11.1* 20.7 18.9 30.3* 23.6 33.6 0* 27.8* 20.9 40.0 20.3 31.4 27.3 37.5 26.2 28.0 18.9 32.6 15.4* 35.7* 31.1 27.8 20.2 45.5 29.4* 42.6 34.3 21.5 29.3 24.6 45.2 25.3 28.9 22.1 31.8 27.2 32.3 24.2 22.8 13.4 16.2 37.7 18.9 19.7 14.5 19.5 19.0 16.4 0* 24.8 13.3* 16.5 26.7 45.1 33.9* 38.3 46.0* 41.9 49.7 38.5* 62.5* 16.9* 11.8* 32.3* 47.6 33.2 44.9* 130.4* 40.7 41.6 53.3* 23.3* 69.2 117.6* 0* 62.5* 24.2 39.2* 96.8* 47.6 77.7 57.7 76.9* 27.9 41.2 47.4 52.6* 71.4 41.3 53.6 56.0 0* 52.9 '48.9 37.3 71.9 48.0 36.8 51.8 24.4* 39.3 29.4* 58.5 63.2* 38.9 44.9 62.1 40.7 77.8 80.0* 44.1 50.5 70.7* 59.7 0 0* 28.4 26.3* 49.2* 37.0 VITAL STATISTICS 77 TABLE 13 PRELIMINARY TOTALS OF RESIDENT DEATHS FROM CERTAIN CAUSES BY COUNTIES, FLORIDA, 1962 Cardio-Vascular-Renal Diseases 4 COUNTIES | | * ,0 .4 S w Q STATE.................. 49 215 106 10 1 8,765 745 117 1,679 6,197 18,900 326 2,102 1,351 1,778 Alachua........---------- 0 1 1 0 0 98 2 1 18 85 165 5 30 18 19 Baker .........----------- 0 0 0 0 0 7 0 0 6 8 14 0 4 0 2 Bay ......-..........------ 0 3 2 0 0 60 8 3 14 45 132 0 19 13 24 Bradford .............. 1 1 0 0 0 20 1 0 6 16 31 3 3 5 6 Brevard ------------....... 0 2 0 0 0 114 16 0 21 78 279 4 29 38 35 Broward ....---....... 4 7 7 0 0 638 60 13 122 324 1,322 27 154 70 119 Calhoun .-.......... 0 0 0 0 0 11 0 0 2 10 39 0 2 1 3 Charlotte ..---...-------- 0 0 0 0 0 42 4 0 2 23 115 0 9 2 5 Citrus --- ..... 0 0 0 0 0 25 0 0 3 18 53 0 5 2 4 Clay.................-------------- 0 0 0 0 0 26 4 1 6 24 42 0 10 1 9 Collier..--..------ 0 0 0 1 0 22 2 0 6 14 47 1 7 6 5 Columbia..--.. 0 6 1 0 0 28 2 0 6 34 76 1 5 13 9 Dade......-............. 11 59 20 3 0 1,727 156 18 268 859 3,436 55 338 225 246 DeSoto............. 0 0 1 0 0 22 2 0 2 17 34 2 7 3 2 Dixie ............---........ 0 1 0 0 0 11 1 0 4 7 9 1 3" 4 1 Duval -------------........ 3 24 19 1 0 637 55 9 125 471 1,260 18 166 107 166 Escambia.............. 1 9 1 0 0 168 7 1 46 123 412 4 40 60 60 Flagler .............. 0 0 0 0 0 10 0 0 4 9 20 0 4 3 6 Franklin......--------- 0 0 0 0 0 20 1 0 2 17 40 1 4 2 5. Gadsden -...-....---------1 0 1 0 0 36 4 1 18 32 97 2 11 13 33 Gilchrist......--------..... 0 0 0 0 0 2 0 0 3 3 17 1 2 0 2 Glades ................ 0 1 0 0 0 3 0 0 0 2 8 0 0 0 2 Gulf ........----------__...... 0 1 0 0 0 9 1 0 0 8 27 0 1 1 8 Hamilton............... 0 1 0 0 0 7 2 0 3 9 44 0 2 2 1 Hardee.-..-........------ 0 1 2 0 0 23 1 0 4 22 34 0 4 7 6 Hendry ................ 0 0 0 0 0 11 0 0 3 3 24 0 6 8 3 Hernando............. 0 0 0 0 0 27 2 0 2 16 36 0 9 6 1 Highlands............. 0 1 1 0 0 56 6 2 7 38 104 4 8 11 6 Hillsborough......... 6 16 10 1 0 667 63 18 144 508 1,498 26 147 95 130 Holmes................. 0 0 0 0 0 15 0 0 4 14 54 3 5 3 2 Indian River ......... 0 0 1 0 0 53 2 0 13 35 127 2 8 13 12 Jackson .................. 0 0 1 0 0 41 5 0 10 47 120 5 22 8 6 efferson ............. 1 0 0 0 1 14 1 0 5 15 36 2 8 0 6 Lafayette ............. 0 0 0 0 0 4 1 0 0 6 13 1 1 1 4 Lake ....-................. 0 1 1 0 0 126 11 2 22 82 276 6 48 23 27 Lee ...-------------..........---........0 1 0 0 0 101 11 0 18 71 212 5 25 18 25 Leon .......-............ 0 5 1 0 0 70 5 5 23 62 164 5 16 10 21 Levy .---- .... 0 0 0 0 11 1 0 11 18 30 0 5 3 6 Liberty ............... 0 0 0 0 0 3 0 0 0 3 5 0 1 1 1 Madison---------..... 1 0 2 0 0 19 0 1 6 9 57 0 2 3 8 Manatee.....-...... 0 4 2 0 0 158 20 1 48 157 417 6 37 16 38 Marion ........... 2 2 1 0 0 88 4 0 10 97 203 5 18 17 27 Martin ............. 0 0 2 0 0 32 4 0 5 31 80 2 8 8 5 Monroe .......------ 1 0 0 0 0 57 5 0 11 42 111 4 14 21 16 Nassau .... ..... 0 0 0 0 0 30 2 1 3 15 36 2 3 8 8 Okaloosa...------......----..... 0 2 0 0 0 30 4 0 14 27 94 5 7 10 15 Okeechobee.......... 0 1 0 O 0 6 1 0 6 3 16 1 1 3 8 Orange................ 2 8 3 1 0 385 33 3 102 322 896 18 80 74 79 Osceola----..---- 0 0 2 0 0 56 1 0 11 46 106 2 12 5 15 Palm Beach.--.. 4 10 0 0 0 502 46 6 84 356 885 8 90 80 96 Pasco .................... 1 1 1 0 0 80 7 0 10 62 210 1 24 18 17 Pinellas ............... 0 13 6 1 0 1,144 63 12 158 925 2,541 25 323 89 107 Polk ...--.............. 4 8 2 0 0 313 34 4 58 233 630 19 85 72 67 Putnam ........... 1 3 2 2 0 32 6 2 16 31 129 14 6 10 19 St. Johns ...._...... 0 0 1 0 0 56 4 1 11 38 107 4 19 4 16 St. Lucie ....... 0 4 2 0 0 74 7 0 13 41 137 3 12 14 13 Santa Rosa........... 0 1 0 0 0 23 2 0 8 25 71 2 4 9 36 Sarasota .............. 1 3 1 0 0 201 14 1 31 143 420 3 57 24 38 Seminole............-------.. 1 2 2 0 0 88 8 1 20 54 169 0 20 12 23 Sumter .......... 0 0 0 0 0 20 3 0 4 18 44 3 2 7 10 Suwannee........... 0 1 1 0 0 16 2 1 8 27 51 2 5 1 12 Taylor .................... 1 0 2 0 0 20 0 1 7 17 45 0 4 4 3 Union................ 0 2 0 0 0 1 0 0 3 7 24 0 2 1 2 Volusia ........... 2 9 4 0 0 336 36 7 64 232 834 12 89 39 60 Wakulla................ 0 0 0 0 0 7 1 0 2 10 10 0 2 0 2 Walton............ 0 0 0 0 0 15 0 0 8 27 64 0 1 3 7 Washington-.......... 0 0 0 0 0 11 1 1 5 26 61 1 7 3 3 *Includes all vascular lesions affecting the central nervous system. 78 ANNUAL REPORT, 1962 TABLE 14 MARRIAGES BY RACE, DIVORCES AND ANNULMENTS BY COUNTY, FLORIDA, 1962 MARRIAGES ANNUL. COUNTY ,DIVORCES MENTS Total White Nonwhite MN STATE- ....-- 41,504 34,499 7,005 21,997 181 Alachua .. 540 391 149 187 0 Baker- 86 64 22 61 0 Bay 492 404 88 273 1 Bradford_-___ 116 104 12 61 1 Brevard--- 963 821 142 673 5 Broward_... 2,961 2,438 523 1,392 10 Calhoun--------..... 41 38 3 50 0 Charlotte- ... 113 104 9 74 0 Citrus ...-- 105 89 16 61 0 Clay .. 106 94 12 77 0 Co ler ..... -189 167 22 82 0 Columbia ......... 189 123 66 86 0 Dade....----. 8,953 7,730 1,223 4,765 64 DeSoto....-..-..- .... 136 119 17 49 1 Dixie...---- 54 45 9 30 0 Duval--- .----.- 2,991 2,363 628 2,057 10 Escambia...-......... 1,448 1,145 303 959 19 Flagler. 52 36 16 95 1 Franklin ........ 59 50 9 27 0 Gadsden----.. .... 152 78 74 77 0 Gilchrist ._ .... 48 38 10 7 0 Glades -- 36 25 11 24 0 Gulf..-. .---- 89 67 22 38 0 Hamilton .58 38 20 32 0 Hardee _178 151 27 273 2 Hendry __ 127 100 27 68 0 Hernando.___- __ 144 124 20 55 0 Highlands. ---208 158 50 85 2 Hillsboroughh 3,462 2,992 470 1,842 9 Holmes-..--. 119 112 7 64 0 Indian River-- 234 175 59 80 1 Jackson ... ..168 136 32 48 0 Jefferson 56 28 28 30 0 Lafayette 15 15 0 0 0 Lake.- 482 381 101 833 4 Lee- -- 492 409 83 234 1 Leon 480 333 147 240 3 Levy --91 68 23 33 0 Liberty-. 6 5 1 8 0 Madisnn 76 56 20 31 0 Manatee--- 579 473 106 172 0 Marion 478 312 166 122 0 Martin- 192 153 39 88 0 Monroe 443 399 44 293 3 Nassau--- 84 68 16 43 0 Okaloosa- 323 305 18 297 2 Okeechobee 87 73 14 44 0 Orange 2,140 1,806 334 523 4 Osceola..- 230 190 40 77 0 Palm Beach-- h1,946 1,535 411 853 5 Pasco. 400 365 35 112 3 Pinellas_ 2,909 2,617 292 1,337 13 Polk _1,792 1,483 309 773 4 Putnam.... 215 148 67 330 1 St. Johns 218 171 47 217 3 St. Lucie- 355 236 119 191 1 Santa Rosa-.. 205 187 18 106 1 Sarasota __700 643 57 265 1 Seminole-- ........... 366 268 98 226 0 Sumter 130 104 26 111 2 Suwannee.--...... 119 87 32 39 0 Taylor 112 82 30 38 0 Union ... 49 41 8 17 0 Volusia __915 770 145 486 4 WakullUa 36 29 7 0 0 Walton.... 87 74 13 44 0 Washington ... 79 66 13 32 0 VITAL STATISTICS 79 TABLE 15 VITAL STATISTICS SCOREBOARD BASED ON PROMPTNESS AND COMPLETENESS OF CERTIFICATES, FLORIDA, 1962 Per Cent of Per Cent of Per Cent 8: Certificates Complete of , COUNTY Filed on Time Certificates Monthly -' 5 ______Reports 'n" g Births Deaths Births Deaths on Timeed 40 STATE-_... ............ 94.9 97.7 99.7 99.5 94.3 486.1 + 1.6 Jax.-Duval .-......... -- 1 100.0 100.0 100.0 99.9 100.0 499.9 + 0.3 Dade...................... 2 98.5 100.0 99.9 99.9 100.0 498.3 + 0.5 Citrus................ 3 99.4 100.0 98.7 100.0 100.0 498.1 + 1.8 Hillsborough........ 4 98.4 99.6 100.0 99.8 100.0 497.8 + 0.5 Martin ........ 5 98.6 100.0 99.7 99.1 100.0 497.4 + 4.7 Volusia.................... 6 99.3 98.8 99.7 99.5 100.0 497.3 + 9.0 Hernando...... 7 99.7 100.0 100.0 97.2 100.0 496.9 + 9.2 Seminole ..---..... 8 99.7 99.5 98.9 98.5 100.0 496.6 + 2.7 Orange............. 8 97.7 99.2 99.9 99.8 100.0 496.6 0.7 Polk..................... 10 98.4 97.9 99.5 99.0 100.0 494.8 +15.3 Escambia............ 11 97.6 97.1 99.9 99.8 100.0 494.4 0.1 Pinellas....---------. 12 96.4 97.7 99.9 99.9 100.0 493.9 1.0 Clay......................... 13 98.2 97.4 98.8 98.0 100.0 492.4 + 2.6 Palm Beach............ 14 92.4 99.2 99.7 99.6 100.0 490.9 + 2.3 Broward............... 15 99.1 100.0 99.8 99.7 91.7 490.3 8.1 Sarasota ........-........ 16 99.4 99.8 99.9 99.3 91.7 490.1 + 8.9 Alachua ............ 17 91.4 98.7 99.8 99.9 100.0 489.8 4.6 Bay......................... 18 95.8 94.5 99.9 97.8 100.0 488.0 +10.9 Jefferson ... 19 98.3 100.0 99.2 98.7 91.7 487.9 7.3 Bradford_--...... 20 99.0 98.4 99.3 99.2 91.7 487.6 +16.4 Suwannee ... .... 21 91.5 97.1 99.7 98.6 100.0 486.9 0 Washington..........- 21 96.9 91.7 100.0 98.3 100.0 486.9 1.5 Baker ............ 23 98.2 99.1 98.8 98.2 91.7 486.0 5.2 Indian River.......... 24 99.0 97.3 98.2 99.7 91.7 485.9 + 9.9 Hardee ------...... 25 98.4 99.0 98.4 98.1 91.7 485.6 +20.7 Lee......... 25 86.5 99.7 99.6 99.8 100.0 485.6 1.7 Putnam............. 27 92.3 95.0 98.9 99.0 100.0 485.2 +14.3 St. Lucie__ ._... 28 92.5 93.5 99.6 99.5 100.0 485.1 + 7.2 Brevard__...._.... 29 96.2 98.9 99.3 98.0 91.7 484.1 +10.1 Gulf .. .... 30 93.3 94.6 99.3 96.4 100.0 483.6 + 3.1 Levy-..........-..-...._. -31 98.1 85.9 99.4 100.0 100.0 483.4 2.4 Walton.......___ 32 92.3 91.7 100.0 99.3 100.0 483.3 + 9.8 Taylor ............ 33 86.9 96.3 99.7 100.0 100.0 482.9 + 9.6 Highlands............... 34 87.9 96.2 99.2 98.6 100.0 481.9 -34.1 Franklin.................. 35 99.4 92.3 100.0 97.4 91.7 480.8 + 8.8 Lake..............-----....... 36 89.5 91.4 99.5 99.0 100.0 479.4 + 8.8 St. Johns .........._... 36 92.4 90.9 98.8 97.3 100.0 479.4 4.6 Manatee.................. 38 84.6 96.8 99.4 98.3 100.0 479.1 + 2.5 Okeechobee..--...._ 39 91.7 89.9 100.0 97.1 100.0 478.7 +38.4 Hamilton ........ 40 93.0 84.9 100.0 100.0 100.0 477.9 +17.1 Charlotte.............. 41 92.4 96.5 96.5 100.0 91.7 477.1 6.7 Hendry.__.............. 42 83.2 98.7 100.0 94.9 100.0 476.8 + 1.5 Flagler ....... 43 94.4 94.1 100.0 100.0 83.3 471.8 + 6.0 DeSoto...................44 98.5 100.0 99.4 98.6 75.0 471.5 -10.2 Collier........... ...... 45 89.3 100.0 100.0 98.8 83.3 471.4 +37.0 Wakulla.................. 46 87.5 92.0 100.0 100.0 91.7 471.2 2.9 Gilchrist......------. 47 85.7 81.3 100.0 100.0 100.0 467.0 +35.1 Holmes............-...... 48 94.1 85.8 94.9 100.0 91.7 466.5 2.0 Osceola.---..---. .... 49 67.2 99.0 99.2 98.0 100.0 463.4 + 8.7 Gadsden........... 50 74.3 90.5 99.2 99.1 100.0 463.1 + 3.7 Madison.....---.... 51 98.5 98.2 98.1 100.0 66.7 461.5 -32.3 Santa Rosa-_ ......... 52 90.8 92.2 99.6 94.4 83.3 460.3 +16.2 Monroe....---------. 53 82.2 89.2 98.8 97.8 91.7 459.7 + 4.9 Calhoun- ......... 54 74.5 85.5 99.3 98.7 100.0 458.0 + 0.8 Marion......... 55 71.2 94.6 98.9 99.2 91.7 455.6 + 8.2 Union ....----- 56 70.2 95.5 98.2 100.0 83.3 447.2 2.5 Sumter................... 57 68.2 76.4 99.2 100.0 100.0 443.8 8.6 Liberty................... 58 66.7 100.0 100.0 100.0 75.0 441.7 +48.7 Jackson.............. 59 70.4 78.3 99.8 99.6 91.7 439.8 6.4 Dixie ---........ 60 81.3 64.0 100.0 100.0 91.7 437.0 -21.5 Columbia ........ 61 63.5 83.0 99.1 98.8 91.7 436.1 +11.0 Nassau........- 62 59.3 85.7 99.3 98.0 91.7 434.0 + 2.4 Okaloosa----------.. 63 72.2 72.1 99.0 98.7 91.7 433.7 -39.2 Leon.................. 64 75.4 77.5 99.1 97.8 83.3 433.1 -13.7 Pasco...........- ....... 65 65.4 95.8 99.6 99.4 58.3 418.5 -47.9 Lafayette............ 66 50.0 81.8 92.3 100.0 91.7 415.8 -58.3 Glades................... 67 0.0 100.0 100.0 100.0 91.7 391.7 -83.3 REPORT, 1962 BUREAU OF MATERNAL AND CHILD HEALTH L. L. PARKS, M.D., M.P.H. Director The work of this bureau is aimed at promoting better care for mothers and children through the county health departments (CHDs). This is done by making certain consultative services available to the counties and by making available funds from the Children's Bureau. These are used primarily to strengthen the nursing staffs of the CHDs. Funds and consultative services are also available to the special projects that are operated through grants from the Children's Bureau. These presently are the Migrant Project, the Developmental Evaluation Clinic and the Premature Demonstration Program, and are described later in this report. The bureau has continued to make some supplies available to the CHDs, such as Lofenalac for the early phenylketonuria (PKU) cases if the patient is indigent. Planned parenthood supplies have been made available to maternity clinics when requested by the county health director, and 33 counties made at least one such request during the year. Medical textbooks on obstetrics, pediatrics, mental retardation, nutrition and school health program were made available to each director to build his CHD library. Most of them took advantage of the offer by requesting one or more books. To strengthen the Audio- Visual Library of the State Board of Health (SBH), selected new films on subjects pertaining to the health of mothers and children were pur- chased from funds available to this bureau. There are many official and non-official agencies in the state which are concerned with the health of mothers and children, and members of the staff of the bureau were frequently called upon to take part in meetings or conferences with such organizations as the Florida Children's Commission, Florida Congress of Parents and Teachers (and local PTA groups), Florida Committee on Rural Health, State Department of Public Welfare, Florida Medical Association (and local medical societies), Florida Council for the Blind, Florida Cooperating Council for Children and Youth, State Department of Education, State Tuberculosis and Health Association, various nurses organizations, Sunland Training Centers, Florida Education Association and many others. MATERNAL HEALTH The provisional maternal mortality rate of 4.2 per 10,000 live births for 1962 shows a slight decline from the 5.0 rate recorded in 1961. There were 49 maternal deaths during the year, compared with 58 the previous year. 80 ANNUAL MATERNAL AND CHILD HEALTH 81 Final maternal mortality data revealed substantial improvement for both races. In 1951 the white maternal mortality rate was 7.1 whereas it was 2.2 in 1961; the nonwhite maternal mortality rate was 25.5 in 1951 compared with 12.7 in 1961. There were 203 midwives licensed to practice during the year as compared with 217 for 1961, and there continues to be a decrease each year. In 1951 the percentage of deliveries in hospitals for white births was 93.2; whereas, it was 99.0 per cent in 1961. The percentage of nonwhite hospital deliveries was 43.5 in 1951 as compared with 81.2 per cent in 1961. Physicians delivered 98.0 per cent of white babies in 1951 and 99.2 per cent in 1961, while physicians delivered 57.1 per cent of nonwhite babies in 1951 and 82.9 per cent in 1961. Midwives delivered 1.6 per cent of white babies in 1951 and 0.6 per cent in 1961. Midwives accounted for 41.8 per cent of nonwhite babies in 1951 and 16.1 per cent in 1961. This shows the gradual trend away from midwife deliveries and toward physician-hospital births. During the period from 1951 to 1962 the number of licensed midwives has dropped from 425 to 203. The number of illegitimate births is increasing. In 1951, 8.15 per cent of births were illegitimate, and in 1961, 9.52 per cent illegit- imate births. The proportion of white illegitimate births increased from 1.8 per cent in 1951 to 3.0 in 1961; while the nonwhite per- centage rose from 24.1 to 27.6 in the same period, which means the nonwhite rate is about one in four. The CHD maternity clinics are open to all expectant mothers who do not have their own physician. Fifty-eight counties operate such clinics. More and more counties are providing planned parent- hood services through these clinics, and the interest in this service is growing. INFANT AND PRESCHOOL HEALTH In 1962 preliminary figures show there were 115,520 births, or a rate of 21.6 per 1000 population. For the same period there were 3259 infant deaths reported and the rate was 28.2 deaths per 1000 live births. Immaturity continues to be reported as the leading cause of infant death. The CHDs 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 conducted in the majority of counties. The total infant mortality rate was 33.1 per 1000 births in 1951 and it dropped to 29.1 in 1961; the white rate fell from 27.0 to 23.2 and the nonwhite rate declined from 48.4 to 45.3 during the 1951- 1961 period. 82 ANNUAL REPORT, 1962 The total number of immunizations reported by the CHDs show there were 90,704 immunizations for smallpox, 147,646 for diph- theria, 230,474 for tetanus, 91,942 for Whooping cough and 312,104 for polio during the year. There was an increase in the number of immunizations given this year for all of the above diseases. HEALTH SERVICES FOR MIGRATORY AGRICULTURAL WORKERS The estimated peak population of migrants in Florida is 51,655. Palm Beach County is reported to have 10,400, Dade 8550 and Brow- ard 5300. The number of migrants in 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 Bach County alone has 15,000 to 20,000 at the peak of the season. The health problems of the migrants vary from community to community depending upon many factors such as housing and local medical facilities. These problems do not differ materially 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 has continued to provide funds to support this project. The purpose of this grant is to extend health services to the agricultural migrants in Florida through the CHDs in counties where most of the migrants are located. Migrants coming into the state place a heavier load upon many communities, and outside assist- ance is needed. Local funds have not been sufficient to provide the necessary CHD personnel. The Children's Bureau special grant helped to provide 17 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 to cover all the public health services needed by the migrants. At the present health services are being extended from the Belle Glade area to other areas of Palm Beach County by means of mobile 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 also been made avail- able to Dade, Lee and Collier Counties. Health services to migrants include the usual services such as nursing supervision, medical and dental services, information on nutri- tion and social welfare services, and to a limited extent general health education, although the latter 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 group, although there is the usual problem of persuad- ing patients to come in early for diagnosis and treatment. There has been excellent cooperation on the part of local physicians. The CHDs license labor camps under state laws which means frequent inspections by sanitarians. MATERNAL AND CHILD HEALTH 83 Health problems are only a part of the many problems of the migrant. It has been found that all agencies concerned such as 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 working with the official agencies concerned with migrants. Efforts have been made to bring together farmers, crew leaders and persons in charge of securing migrant labor but this has not been very successful. However, much progress is being made in providing better health services to the migrants. The Florida Committee on Rural Health, which is made up of representatives of the Farm Bureau Federation, Cooperative Extension Services, Medical Association, SBH and the Veterinary Medical Asso- ciation, is very much concerned with the problems of the migrant. During its semi-annual meeting in December a tour was taken of Collier County to obtain firsthand knowledge of the problems of the migrants. It happened that the tour came on the day following the worst freeze Florida has had during this century and the members of the committee now better understand the migrants' problems. Collier County has a local migrant committee which is very active. Some of the members have been on this committee for a number of years. Dade County is in the process of forming such a committee. There is an increased interest in migrants because of the recent bill passed by Congress which may make additional funds available to improve their health. TABLE 16 1962 POSTGRADUATE OBSTETRIC-PEDIATRIC SEMINAR REGISTRATION BY STATES STATE Doctors Nurses Other Total Alabama. ........... 12 2 0 14 Georgia _. 32 1 0 33 South Carolina-.... ......25 0 0 25 MississippiP. 9 0 0 9 Other states 3 1 1 5 Florida _____120 59 2 181 TOTALS_5. ___ 201 63 3 267 84 ANNUAL REPORT, 1962 POSTGRADUATE OBSTETRIC-PEDIATRIC SEMINAR This seminar has been held annually since 1951. It is held with the cooperation of the Bureaus of Maternal and Child Health of the State Health Departments of Florida, Georgia, Alabama, South Caro- lina and Mississippi; the Maternal Health Committee of the Florida Medical Association, the Florida Academy of General Practice and the Children's Bureau. Plans have been made to return to Daytona Beach for the 1963 meeting. PREMATURE PROGRAM Physicians, nurses, hospitals and CHDs working with some of Florida's smallest citizens-premature infants-have completed a year filled with activity designed to give these babies a better chance in life. They have been working together and with this bureau to improve care given premature babies in hospitals and in their homes. Approximately nine per cent of the babies born in Florida during the year, were born before term. Because they were immature, special care through the first months of life was essential to their survival. Premature infant care is highly specialized and expensive, since special equipment operated by specially trained personnel is imperative. The training of physicians and nurses in this field had major attention during the year. Three five-day seminars were held for nurses at the Premature Demonstration Center, Jackson Memorial Hospital, Miami, and 93 nurses were enrolled in these classes. In addition seven carefully selected nurses were given three additional weeks of intensive training in premature infant nurseries at the Demonstration Center. They were chosen from large hospitals where a high percentage of the state's tiny infants were born or to which they were transferred at birth. The trainees then returned to their hospitals to teach other nurses and employees new techniques and procedures. The training program is jointly sponsored by this bureau, Jackson Memorial Hospital and the University of Miami School of Medicine, with cooperation from local medical groups and hospitals, and with funds made available by the Children's Bureau. Students from several schools of nursing in addition to those from Jackson Memorial Hos- pital, medical students, interns and residents also receive training in premature infant care. One group of physicians from a nearby air base spent a week learning how to care for the tiny infants at the Center. Numerous other visitors from this and other countries have taken ad- vantage of the training offered. One medical student from the Uni- versity of Miami, who was interested in the care of the premature, was given further training and experience in this field during the summer months. He gave some valuable assistance in the study and follow-up of the premature. A pediatrician and a well-qualified nurse MATERNAL AND CHILD HEALTH 85 have been available to hospitals for consultation on their problems or procedures. A series of 10 lectures, given as in-service training for nursery personnel at one large hospital, was judged valuable. A nurse- physician team received a scholarship to attend the Institute on Pre- mature Care at New York Hospital-Cornell Medical Center. Both are now participating in the Florida training program. To meet the need of small hospitals unable to release nurses for the five-day seminar at the Demonstration Center, regional one-day Demonstration Clinics are arranged, and during the year one was held in the Orlando-Winter Park area. More than 100 members of the nurs- ing profession came from the immediate and adjacent areas to attend. An evening session for physicians drew an audience of approximately 30 pediatricians and general practitioners. New technical textbooks have been provided for the libraries of CHDs so staff members may be kept abreast of the most modern methods of infant care. Publications likewise have had wide distribu- tion through appropriate channels. Manuals of procedure prepared at the Demonstration Center have been supplied to hospitals for use by medical and nursing personnel in premature and newborn nurseries. SCHOOL HEALTH PROGRAM Joint responsibility for the health of the school age child is legally assigned to the State Board of Health and the State Department of Education (School Law 232-20). This responsibility is then relegated to the local CHDs and boards of public instruction for implementation (School Law 232-31). The activities of this bureau in the field of promoting physical examination on children in selected grades are now further strengthened by the new accreditation requirements for Level I, which are as follows: "First Grade Health Examination-All pupils during the first grade shall be required to present the results of a physical examination for recording on the cumulative health record form MCH 304." Primary responsibility for this requirement lies with the parent. Yet this regulation indicates the need of the CHD to co- operate with the local board of public instruction and the local medical society to satisfy the demand. Recommendations for physical examination at age 11-13, junior high level, and age 15-18, senior high level, will be satisfied by the new standards for accreditation. "Grades 7-9 Health Examination- All pupils at some time during grades 7-9 shall be required to present the results of a physical examination for recording on the cumulative health record MCH 304. This may be done at the sixth grade level." "Grades 10-12 Health Examination-All pupils some time during grades 10-12 shall be required to present the results of a physical examination for recording on the cumulative health form MCH 304." The activities in the area of school health records are now sig- nificant because this is now a part of the required physical examina- 86 ANNUAL REPORT, 1962 tions. In an effort to facilitate the recording of future subsequent physi- cal examinations, this bureau is in the process of developing a single sheet physical health record which can be easily inserted into the child's cumulative folder. This effort is in part responsible for the project by the State Department of Education to record all of this data on IBM cards to facilitate processing and reporting. Screening procedures for hearing, vision and dental defects are fairly continuous over the state. Measuring of height and weight is a common practice in Florida's public schools. There is need for some uniformity in the screening practices but the greatest need is in the referral and follow-up procedure. The problem is educating the parent to do something about the defect that is detected in the child. In this respect PTAs whenever possible are advised to urge the parents to seek medical assistance for their child. The PTA groups have scheduled health workshops in an effort to encourage parents to understand and meet the responsibilities of health of their children. The School Health Coordinators plan is another effort on the part of the public schools to encourage a better health program in the schools. The coordinator should in consultation with the principal establish a school health committee and policies for retaining key people and rotating others. The coordinator should be acquainted with existing health policies of the school and the county education and public health departments. The school health coordinator presently has a full teaching load and is many times unfamiliar with the new assignment. The bureau has been engaged in the process of giving information to these individuals to enable them to do a more effective job. The information given to this important member of the health team is accepted eagerly and enthusiastically. This plan with definite guidance fills the void that is so apparent in the teaching of health. The elementary schools generally do a com- mendable job in health instruction, yet this plan can encourage more ingenuity in methods used by the teacher in presenting the subject with current and more attractive materials which will be in line with the needs and interests of the children in the community. The definite lack of health instruction in secondary schools can receive a great impetus if this plan is successful at this level. This bureau has exerted some effort to give this group of secondary level health coordinators some assistance to motivate them to improve their respective school's health program. Some progress is noted, but success is slow and much more is needed in this area before significant progress will be made. The team approach in this problem will insure the success of this program. Public health nurses, insofar as personnel and other service pro- grams permit, visit the schools regularly and routinely. Other services they perform in the school, beyond regular nursing duties, are serving as resource people to the teachers in all matters related to health. The MATERNAL AND CHILD HEALTH 87 nurse aids the health coordinator in resolving specific health problems related to each school. Where there is a need felt for more services than the public health nurses can provide, the Gray Lady Program functions effectively, especially in the care of the sick child at school. More areas are receiving encouragement to make use of this worth- while program. The Florida School Bulletin, issued December 1962, shows that the school enrollment for 1961-62 was 1,131,502, which was a 5.18 per cent increase over the previous year. This is for grades from 1 through 12 and does not include kindergarten. There were 22,453 elementary school teachers and 19,274 teachers in the secondary schools, or a total of 41,727 teachers in the public schools of Florida. TEACHERS PROJECT The Teachers Project in Health Education conducted its seventh annual session with 57 teachers enrolled from 27 counties. This was the greatest participation by CHDs since the Project was initiated in 1955. In addition to CHDs, the Health Department of the City of Jacksonville volunteered to accept and provide field experiences for teachers working in Jacksonville schools. The institutions providing the academic aspect of the project in- cluded Bethune-Cookman College, Florida State University and the University of Florida. The University of Miami did not participate in the 1962 project due to the sabbatical leave of the director of the course. The course directors expressed a feeling that the teachers en- rolled displayed sincerity, interest in discovering new resources for their school health programs and deep concern for the health of their stu- dents. The distribution of teachers to the three schools was as follows: Bethune-Cookman College, 11; Florida State University, 16; Univer- sity of Florida, 30. The project was originally designed to familiarize teachers with health and welfare resources available to them in their school health programs. This objective remains paramount in the minds of all per- sonnel involved. From a survey of schedules of activities prepared by CHDs for teachers, it would appear that a great many facilities and opportunities were presented the enrollees. Teachers were recruited from the counties in which they will teach in the next school year. Many teachers expressed amazement at the number and variety of the programs from which they could draw to improve the health and well being of the school child and his family. Teachers visited regional facilities of activities serving their county, such as tuberculosis hos- pitals, child guidance clinics, Sunland Training Centers, clinics oper- ated by the Crippled Children's Commission and others. Several teachers remarked that more helpful information had been obtained from this course than from any they had previously 88 ANNUAL REPORT, 1962 taken. Favorable comments were made as to the pertinence of the material presented and its adaptability to their needs. They also re- ported pleasure at learning more of the activities of the CHDs and how its various programs might be utilized. CHD personnel stated that having the teachers in the health department was good for them as it tended to make them sharpen their "tools." They also felt that they had learned more of the problems of the teachers and ways in which they might work more effectively in the school health program. The Teachers Project is a four-weeks course for which teachers earn three hours of credit to be applied in a variety of ways. Teachers spent four days on the campus of the university of their choice, two in the orientation and two in the evaluation phase of the project. Fol- lowing orientation to all that would follow, the teachers returned to their respective counties for 14 days spent in field experiences. Con- census of all of those participating in the Teachers Project in Health Education in 1962 was that it was a success. It is planned to continue the project in 1963. MENTAL RETARDATION This bureau is concerned with the entire field of mental retarda- tion and is active 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 SBH 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 retarda- tion 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 the communities and inform their own people of the mental retarda- tion institutions of the state from firsthand experience. Seven commu- nity programs were held with an attendance of 821 persons; 12 Orien- tation Programs at Sunland Training Centers-attendance 263. Another activity is the early detection, diagnosis and treatment of mental retardation. This is usually accomplished through the well child conference and child guidance 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, immuniza- tions and physical examinations. This gives an opportunity for the MATERNAL AND CHILD HEALTH 89 child to be seen early and any defects or abnormality that are present has a chance to be noted and proper referral made. If an indigent case is found and the parents are unable to provide the necessary diet supplement for a PKU patient, this bureau has been making some supplies available to these cases. 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. If a PKU case is found, other members of the family are urged to be tested and it is stressed to the parents the importance of having any future children born into the family tested in the first few weeks of life. The biggest gap in the knowledge and work is the complete lack of knowledge of the causes of mental retardation and how to prevent it. DEVELOPMENTAL EVALUATION CLINIC This special project in mental retardation is located in Miami and during 1962 completed a total of 276 comprehensive evaluations. Seventy-seven were new patients admitted to service and 199 were re-evaluations of children seen in the previous year. By the end of the year the clinic had 262 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, speech specialist, Fellow in Pediatrics, secretary and clerk-typist. During the past year the requests for service have increased as has the caseload. Since most of these children are in the preschool 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 representing 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. Recommendations of the clinic to the parents have to be coordinated with existing community agencies. At times it is frustrating to find that optimal treatment facilities do not exist to carry out recommenda- tions 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 pro- 90 ANNUAL REPORT, 1962 gram, 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 caseload. Fifty-four patients are being supervised in a home training program by the clinic s public health nurse. The Children's Bureau has continued to make funds available for a Fellowship in Pediatrics at this clinic. Two medical students and two psychology students were employed during the summer of 1962 and rendered some valuable service in addition to getting training in this field. The clinic has been used as a training field for the pediatric residents at the University of Miami School of Medicine as in the past. BUREAU OF PREVENTABLE DISEASES 91 CLARENCE M. SHARP, M.D. Acting Director During 1962 there was a major epidemic of St. Louis encephalitis in the Tampa Bay area resulting in a sizable research grant from the U. S. Public Health Service (USPHS) to study arthropod-borne encephalitis in this area. The Tampa Bay Regional Encephalitis Lab- oratory was established on the grounds of the Southwest Florida Tu- berculosis Hospital in Tampa. The USPHS has made a grant to this laboratory for five years. This disease outbreak had a tremendous effect upon the economic life of the St. Petersburg area. Florida is confronted with what may be the state's greatest public health problem in recent years. The Tampa Bay Regional Encephalitis Laboratory and its field study unit is attempting during the dormant season of the disease to find the weak link in the chain of host-vector-man and try to break it. Florida is in for a critical period, so far as its tourist economy is concerned, should there be addi- tional outbreaks of the disease. This outbreak is discussed at some length under the Division of Epidemiology. During the last six months of the year almost the full-time efforts of the State Board of Health's epidemiologist and the staff of the Di- vision of Veterinary Public Health have been spent on this problem. Poliomyelitis reached an all time low during the last year. There have been a significant number of both cases and virulent carriers of diphtheria, particularly among the nonwhite residents of Jackson- ville. There has been a significant increase in cases of infectious hepa- titis for the past five years. Florida is still having a few cases of typhoid fever reported, but no major threat presented itself during 1962. During 1962 no major outbreak of influenza was noted, although the Asian influenza virus has been reported. Venereal diseases, particularly infectious syphilis, continue to in- crease and during 1962 the greatest number of infectious cases (1632) occurred during any year since 1949. Fortunately the USPHS is stepping up funds for an increased program in casefinding and control during the next year. The State Board of Health was indeed saddened at the untimely death of James Scatterday, D.V.M., director of the Division of Veter- inary Public Health. There has been a slight increase in tuberculosis cases reported primarily as the result of the Cuban refugee problem in Dade County. |
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