2013 is the 90th Anniversary for the Health Department

Year 2013 marks the 90th Anniversary for the Cattaraugus County Health Department, the first organized county health department in New York State. It is our privilege to share a brief history with the public over the next few months, most of which is taken from C.E.A. Winslow’s Health on the Farm and in the Village: A Review and Evaluation of the Cattaraugus County Health Demonstration with Special Reference to Its Lessons for Other Rural Areas, 1931.

Prior to 1923, Cattaraugus County, like all New York State rural counties at that time, had no general county health organization. Each city, town and village had its part-time health officer and each school its part-time medical inspector with no coordinated health system. The only step taken by the County was the erection of the Rocky Crest Sanitorium for tuberculosis, opened in 1916, with one public health nurse assigned to the institution. The Rocky Crest Sanitorium was located on Route 16, south of Olean near what was known as Rock City Park. Treatment for tuberculosis was relativity primitive with the assumption that if diagnosed individuals could be placed where they had access to fresh air in the mountains, it would be helpful. In its day, the Sanitorium site had many buildings on the property which included a water tower and nurses quarters in addition to patient housing.

In 1922, the Milbank Memorial Fund designated funding to Cattaraugus County as a demonstration project, “to demonstrate…whether by intensive application of known health measures the extent of sickness could be further and materially diminished and mortality rates further and substantially reduced.” The project was initiated in 1923, resulting in an organized full-time Cattaraugus County Health Department.

Initially there were bureaus of communicable disease, tuberculosis, statistics, and laboratory services. In 1925, the well-developed nursing service became a separate bureau and a bureau to control venereal disease was initiated. In 1926, a full-time bureau of Maternity, Infancy and Child Hygiene was created, and in 1929, the first trained sanitary engineer was appointed. Dr. Leverett D. Bristol was appointed County Health Officer and Director of the demonstration project, based in Olean. John Walrath of Salamanca was appointed the President of the County Board of Health by the Board of Supervisors. Many of these originally created bureaus, including those that oversee communicable disease, tuberculosis, laboratory, statistical records, maternity and infant/child hygiene, and health education continue to be core activities today.

Dr. Reginald M. Atwater, Health Official for Cattaraugus County in 1928, shared the following: “…the average adult individual becomes one of our County citizens who receive benefits from all divisions of activity. He finds that the public water supply is supervised by state and local authorities through routine laboratory analyses and field studies. His milk supply is protected within the limits of existing regulations. He and his dependents receive nursing service. His children receive oral prophylaxis and benefit from well-baby conferences, nutrition programs, venereal disease clinics, mental clinics, orthopedic clinics, and the manifold benefits from an adequate public health laboratory. If his family income is insufficient, the nurse or social worker stands ready to help him. His social adjustments, particularly as they relate to health, are made easier through the Social Service Department of Cattaraugus County Tuberculosis and Public Health Association. He profits from a constructive educational campaign maintained by public as well as private organizations…”

Dr. Atwater goes on to say, “Other needs which are scarcely met at all may be listed: hospital beds available to rich and poor; provision for hospitalizing communicable diseases and for correction of defects; obstetrical care for mothers unable to afford the ordinary costs; and the care of sick people in the county whose care by doctors represents a difficult problem for physician and patient alike. Services received by the average Cattaraugus County person are intended in no way to replace a private physician. The doctor’s place is extremely important and one of expanding possibilities in the new day of better health. The relationship between the private practitioner and public health workers is characterized by cooperation in a common task, not by competition in any sense. Only by thus cooperatively using all means at hand is it possible to reduce the enormous amount of disability that comes from improper hygiene, the accumulations from neglect of medical care, uncorrected defects and chronic disease that might have been prevented by proper foresight.”

The Milbank Memorial Fund, in its centennial report, noted the following results from the Cattaraugus County demonstration project: “…deaths from tuberculosis declined more quickly in Cattaraugus County than in comparison counties, from 55 per 100,000 in 1929 to 25 per 100,000 in 1930; infant mortality rates also fell more quickly; and the project launched a successful countywide school health service.” The report goes on to note that other rural counties launched their own health departments based upon the success of this demonstration. Further, in a report commissioned by the Milbank Memorial Fund 25 years following the demonstration, Yale University researchers noted that “the entire progress made in the United States in developing health services for rural areas owes its inception to Cattaraugus County.”

We look forward to sharing Part II of our 90 year history next month.

Submitted by Debra J. Nichols, Public Health Educator, July 11, 2013 (First in a series)