A Bureau of Child Hygiene
REVIEWS AND CRITICISM. Co-operative Studies and Experiments by the Department of Health of the City of New York and the Bureau of Municipal Research. September, 1908.
This pamphlet presents the results of two experiments conducted by the Bureau of Municipal Research in co-operation with the Department of Health of New York City. A further result, which promises to be of incalculable benefit, is one to which a pamphlet of this kind could hardly do justice, and that is, the establishment on August 19, 1908, by the Department of Health of a division of child hygiene. The first investigation had for its object, to devise “more effective methods of supervision and of follow-up” in the medical examination of school children for non-contagious defects. A study conducted in the spring of 1908 had clearly shown “that the accuracy of the examination was open to serious question, and that no adequate methods had been worked out for securing the treatment of children supposed to be defective. Inspectors examining in the same schools rendered reports differing as widely as by 100 per cent in the number of children found defective; while of the parents notified that their children required medical attention, only 8 per cent reported any action.” The experiment was limited to three schools in different parts of Manhattan, representing three distinct nationalities, Irish, Jewish, and Italian. An inspector and a nurse were assigned to each school. The returns from the three schools were very similar, and showed that from 88 to 98 per cent of the children were in need of treatment. The nurses followed up the recommendations of the inspectors, interviewed parents, and took children to clinics. By this method “81 per cent of the total number of children needing treatment were actually treated for one or more defects.” This gratifying improvement in the efficiency of medical inspection was accomplished at a cost of only sixty cents for each child treated.
The second investigation was conducted during the summer of 1908, with the view of securing better oversight of the health of babies in Manhattan. “Instead of, as previously, a large corps of inspectors and a small number of nurses engaged in a house to house visitation for sick children under two years of age, the Department of Health employed a large staff of nurses and a few inspectors, the former visiting the homes from which births were reported and instructing mothers in the care of their babies, the latter visiting sick babies referred by nurses or others, and conducting educational lectures and instructions in vacation schools, playgrounds and recreation centres.” Although full reports of the work are not yet available, the present returns show a decrease in the infantile death rate, as compared with the summer of 1907. Here, as abroad, the experiment has proved that “the problem of infant mortality is fundamentally educational and is therefore not merely a summer problem, but demands an all-the-year-round service.” The practical outcome of this experiment is that the Department of Health “is planning to incorporate, as soon as possible, in its regular program of work the instruction of mothers of new-born babies.”
The whole pamphlet is a model of clear and satisfactory arrangement. It is accompanied by tables which minutely analyze the statistics, and by copies of the various blanks used by the medical inspectors and nurses, and is illustrated by three excellent pictures of school children taken at the nose and throat dispensary. Dr Thomas Darlington, the Commissioner of Health, contributes a foreword.
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