Address to the American Public Health Association

Fifteen years ago, almost to the day, I had the pleasure of addressing the American Public Health Association. You were gathered here then as you are now, to exchange ideas and information in your professional work as official guardians of the public health. At that time, 15 years ago, I had just come from observing at first hand in Belgium and other war areas the acute problems of public health produced by violent dislocations in the normal economic processes of the life of nations. In my remarks upon that occasion I discussed some of these problems as I had observed them during that experience. Difficult as conditions were for the civil populations of all the nations in the war area, they would have been infinitely more difficult had it not been for the modern organization of protective health services and the scientific understanding of sanitary measures necessary to prevent and check such epidemics of communicable disease as had always, in earlier wars, swept over the nations.

My next major contact with your body was during the Mississippi River flood in 1927. In traveling over the region affected by those floods, from the lower Ohio River Valley to the mouth of the Mississippi, and organizing the measures of the Federal Government to overcome that calamity by rescue from flood and reestablishment of a million of our people in their homes, it was obvious that sanitation and health control were imperative to prevent the outbreak of devastating epidemics. In this emergency the public health agencies and the allied groups were indispensable, and I took the liberty of mobilizing the energies of your members. They rose to the situation and by their skill and promptness Prevented a very serious loss of life.

As a result of this experience in the flood area, I later called a meeting of public health officials and suggested the development of a stronger health service. Out of the conferences which were called as an outgrowth of this meeting, there evolved the idea of the most effective means of strengthening the public health service in harmony with the spirit of our American institutions. By this I mean the idea of the county health unit. That is, that every county in the United States should set up for itself, as its minimum health organization, a unit consisting of a doctor, a sanitary engineer, and a trained nurse. These units were established in 100 counties in the flood area, and the extraordinarily successful results of their work confirmed the wisdom of the plan. The public health in these counties for 18 months after the flood was so much better than it had been in the 18 months before the disaster as to prove an object lesson in what could be done by organized public health work.

By every means within my reach I have ever since promoted the idea of establishing these units in every one of our 5,000 counties in the United States. I have frequently helped the voluntary cooperating groups to raise the funds for such units by public subscription, and many times, through conferences and in other ways, have assisted in promoting legislation in the States by which State governments have supplemented these funds on the familiar basis of duplicating from the State treasury the sums raised locally by the county or municipal governments. I have gone farther than that. Although I am generally opposed to Federal subsidies to the States, yet I have regarded contagion as one interstate question and have recommended Federal contributions to such a universal service.

I am in favor, as a constructive measure of public economy, of a program to be carried out on such wise lines, to reduce contagious disease with Government encouragement. If communicable diseases could be reduced by even one-third, such a reduction would repay the country more than a thousandfold its cost, by its saving of the present losses in productive time of workers and its saving of the present losses to school funds by absences from classes. That is the sheer economics of it. But far beyond that, there would be the wealth of gain in human comfort and human happiness.

Still beyond that, there is the gain of definite community action looking to the protection of the home--the cooperation of organized society in a great work of social well-being, with all its additions of assurance to men and women of a further security to their families against the menace of contagion and ill health.

And even beyond that in importance, there is the well-being of the future generations of our children, the building up of safeguards around the home, and the health of the parents and of the growing family, which will contribute to the production of a healthier and more virile race and to the preservation not only of the treasures of childhood as a whole, but also to the preservation of those precious exceptional children, whose birth cannot be predicted of any class or moment and from whom comes the leadership of our democracy, to which they rise through the free channels of opportunity in our country.