Part 2 of the 90th Anniversary for the Health Department

This article is Part II of the 90th Anniversary of the Cattaraugus County Health Department Series. 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, 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.

(See Part I of the 90th Anniversary for the Cattaraugus County Health Dept. published in August Healthy Living edition).

In 1928, Dr. Reginald Atwater, Cattaraugus County Health Official, summarized achievements of his then 6 year old Health Department in this paraphrased report:

Prenatal – “unborn, the average Cattaraugus County individual receives attention equal to the services of one public health nurse. The child’s mother has the benefit of numerous classes on prenatal care under the auspices of the Health Department. If the unborn child’s life is in danger from the spirochete of syphilis, he may have the benefit of prenatal arsphenamine from a public clinic. His mother is likely to receive adequate hospital care at confinement because of follow-up for cases with complications. There is inadequacy in lack of sufficient beds. Unless the child’s parents can afford to pay hospital costs, he will scarcely benefit from additional safeguards in a maternity hospital. About 97% of births have a physician in attendance at the baby’s birth, 2% are attended by midwives, and 1% are without an attendant.”

The average baby born,” continues Atwater, “one of 1,500 born annually in this county, has a fair chance of arriving in a home where a set of maternity supplies are on hand and where a layette has been prepared. He shares 2,500 visits from the public health nurse with other neonatal citizens; he may even be one of the 40 annual cases where the physician is assisted at delivery by a public health nurse.”

Infant – the average baby will have one visit from the public health nurse during the post-partum period and will have access to child health conferences in his district. In 1927, 1 in 4 babies outside of the Olean area attended these conferences, and 84 children received the prophylactic toxin-antitoxin. Substantial aid is given in promotion of breast feeding, the use of cod liver oil, and in teaching new mothers how to prepare the doctor’s feeding formulas.”

Preschool – “By the time a child reaches his first birthday, he has been the recipient of considerable public health effort. The child has access to further conferences and to nursing supervision that has become well-articulated with his doctor’s advice. His defects are sought out and a persistent effort is made to secure necessary corrections. His mother is urged to make his diet conform to best standards. There is a desire that he be trained in good mental health habits, emphasized by the public health nurse visits. The child and mother prepare for entrance to school by having an examination and detection of defects.”

School – Dr. Atwater continues, “on entering school at age 5 or 6, the child comes under supervision of educational authorities who provide medical examination. This examination is attended by a public health nurse and the child’s record becomes a permanent form, following him through his school career. In addition to defects and attempts to correct those defects, weight records, nutrition and communicable disease history are recorded. School days consist of morning inspections, nutritional advice, and frequent talks by the public health nurse, all educating the child on good approaches to hygiene and prevention. Throughout his school years, the child benefits from close supervision of communicable diseases by local and county authorities. He has opportunity to take toxin-antitoxin in clinics, has privilege of vaccination against smallpox, has access to curative sera and diagnostic tests, and has medical consultations. If he is a boarding home child, he receives even more attention through sanitary inspection of his home.”

At some point,” Dr. Atwater adds, “the average child has access to a health camp, especially if he is underweight or otherwise in need of the benefits of outdoor life. If he is crippled, there is a committee of responsible citizens who obtain adequate funds, supplemented by state aid, for his rehabilitation. His tonsils may be removed by private physicians or through cooperative efforts between doctors, clinics and hospitals, or at public tonsil clinics. In short, this Cattaraugus County child has a fair chance of having a sound body.”

Among the families supervised in 1927-1928, health progress was impeded by financial situations in 15% of the population. Many families were able to make the grade until such time as the costs of illness interfered, thus demonstrating the values of health and the need for effective intervention.”

Some 85 years later, we, the Cattaraugus County Health Department staff, continue to move toward the vision Dr. Atwater shared, hopefully with that same passion and integrity, on behalf of rural America.

Part III will be shared next month.

Submitted September 13, 2013 by Debra J. Nichols, Public Health Educator