USA > Massachusetts > Bristol County > Attleboro > Reports of town officers of the town of Attleborough 1924 > Part 5
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The preventorium affording a continuous healthy out door life, under proper supervision, with attention to the diet, education, and training of the infected child, is more than its name implies. If such a system is finally instituted, maintained, and endorsed by the medical profession, it will prevent tuberculosis by attacking the disease where it can best be prevented, by removing to a place safe from harm, its intended victims. More than this, it will cure tuberculosis by appropriate treatment of the infection at that period when treatment offers the most reasonable hope for cure, in its incipiency.
TEN MILE RIVER
Early in the Spring of 1923, the Health Department began a thorough survey of sanitary conditions along the Ten Mile River. This investiga- tion was preliminary to the carrying out of a definite plan, having as its object the prevention of the pollution of this stream with sewage and other waste.
The efforts of this department were directed toward the transforming of this river into a thing of beauty, and to make of it a civic asset instead of allowing it to continue to function as a common sewer, to remain a disgrace to the community, and to present evidence of local neglect and violation of the rules of sanitation, as it has in the past.
70
ANNUAL REPORT
Our survey disclosed two main sources of pollution; one,-by the direct emptying of sewage into the river from factories and other buildings located along its banks; the other,-indirect pollution through the waste connections of certain premises with drains, which emptied finally into the river. The former source of pollution was fairly easy to correct. The latter or indirect pollution, however, presented a problem which has de- manded considerable time and effort on our part for correction, and which has not as yet been completely solved.
A study of the plan of the old drain which was used as a sewer prior to the installation of our present municipal sewerage system, and which in former days carried sewage into the Ten Mile River, furnished evidence that it was still an active source of pollution of the river, in spite of the fact that it was intended and should have been employed only for the drainage or surface water. Such an undesirable condition was caused by the fail- ure of several property owners along the line of the municipal sewer to change their waste connections from the old drain to the new sewer, when the latter was installed.
In addition to the indirect pollution caused by this old drain, there was also a certain amount of pollution contributed by the Thacher Brook Drain which, in its course to the Ten Mile River, collected considerable sewage from cesspools and small drains adjacent to it.
The department has carried on a campaign to remedy conditions along the river and while the work has not been entirely completed, the results already obtained, indicate that nearly all of the former sources of pollution of the stream with sewage have now been permanently diverted into the municipal sewer. The sewage from five large factories which for years has been discharged into the Ten Mile River, now empties into the sewer so that no factory now discharges sewage into the river. The sew- age from other buildings along its course has been removed from the river. A large number of property owners along the course of the old drain on Park, Pine, Union, East, School. Pearl, Beacon, South Main and Olive Streets, thirty-four in all, have recently connected with the sewer at the request of this department, one of these buildings having twenty-five toilets under one roof. In the vicinity of Holman, Emory, Falmouth, Pearl, School and Hazel streets bordering on the Thacher Brook Drain, there have been eight recent connections made with the sewer and two of these latter are factories. All of this sewage formerly entered the river indirectly through drains which seem to permeate that portion of the city, in many instances defying detection. As soon as practicable in the Spring, it is planned to complete this work, and to remove every remain- ing cause of the trouble, including those few sources higher up the river.
CLINICS
The advantage which accrues to a city from properly supervised clinics can hardly be overestimated. We believe that all public clinics should eventually be under municipal supervision. The tuberculosis and diphtheria prevention clinics have shown a healthy growth during the past year, and may be regarded as a most important branch of local public health work. It is through the agency of the tuberculosis clinic, that proper care and follow up of all suspicious and contact cases is ob- served, and it is through this means, also, that necessary supervision and control is afforded for cases being admitted and discharged from sanatoria. The examination and follow up of cases admitted and discharged from the Health Camp is also served by this clinic. A complete revision of the record system employed in this clinic has been attempted. The diphtheria prevention clinic, conducted in the same quarters, has added to the de- partment's labors, but the community advantage of such work will un- doubtedly repay the city many times in value for the extra effort and
71
ANNUAL REPORT
slight additional expense involved. A complete card system has been installed to keep a proper record of all immunized children.
The department maintains a regular system of visits on all patients under quarantine with scarlet fever and diphtheria through the Health Department nurse, who gives proper instruction to householders with the idea of preventing the spread of these communicable diseases. A system- atic visitation is also made on cases of tuberculosis throughout the city, and contact cases of this disease are brought to the clinic for examination. The automobile provided for the nurse's use in this connection is indis- pensable as the work is now performed.
Advice has been given the District Nursing Association relative to the conducting of the Child Welfare Clinic, which, we believe, is one of the most important and necessary clinics in the city. We are interested in the work of the District Nursing Association, and call attention to the valuable asset to the public health afforded by its child welfare and baby hygiene conferences.
A dental clinic, with adequate supervision, is planned for the coming year if the appropriation is forthcoming. The establishment of such a clinic with a dental hygienist at work in the schools is now a real need, and is another necessary link in the important chain of disease prevention in childhood.
THE CITY DUMP
The dumping of refuse material in different sections of the city by persons who consider it proper procedure to dump a load of rubbish in any convenient spot, has caused the department much trouble and annoy- ance. The placing of signs on some of these places has stopped the prac- tice for a time, until someone removes the sign, and the dumping is re- sumed. Warning is given that action will be taken against violators of the law who are careless in this respect.
The City Dump has again been moved. It is now located on Bishop Street, where it is apparently sufficiently removed so as to cause little trouble to nearby residents. The department keeps an employee at work here to care for the dump and to prevent damage to nearby property. We request of all merchants and others who have refuse from stores, factories, and dwellings to dispose of, that they use the city dump only for the disposal of such material, and thus assist us in our attempt to have city present a more orderly appearance. Papers, and other inflammable material, decaying vegetables and fruit should not be deposited in this or any other dump in the city limits, and such violation of the city ordinances will be properly dealt with if called to our attention.
We are still of the opinion that a large incinerator should be installed, in the near future, to take care of this material in a more satisfactory manner.
HEALTH CAMP
The Attleboro Health Camp first inaugurated in 1923, when it began its work with a day camp for ten boys, is now one of the city's permanent institutions. Its demonstration this year of what can be done with a carefully worked out and definite plan to build up the resistance of under- nourished children during the summer months, has received favorable comment; the assurance of future community support to the idea provides encouragement for similar work on a larger scale next season. The day and night camp in 1924 took care of thirty boys, for a period of six weeks. The management was undertaken by the Health Department and the Attleboro Tuberculosis Society. Financial assistance, including the erection of permanent buildings, and the provision of most of the cost of maintenance for the year, was furnished by the Attleboro Lions Club.'
Most of the details of how the Health Camp was conducted are familiar to all and will not be dwelt on in this report.
72
ANNUAL REPORT
A complete physical examination of each applicant was made before the camp opened, which, with individual photographs of each boy made on admission, and at discharge, furnish, together with the weight charts, true and permanent records of great comparative value. No child was admitted who was not free to gain, which means that all remediable defects interfering with normal growth, were corrected before admission.
The management is quite certain that its provision of not admitting cases who were known to come from tuberculous families was entirely reasonable and consistent with local needs. Other arrangements were made for the latter group of children needing treatment, at the Bristol County Hospital.
The applicants for the camp were carefully selected and formed a group of the city's most poorly developed and undernourished children. The results obtained were striking and compare favorably with those of any other camp in the state. An aggregate gain of 21514 pounds was made by the boys during the six weeks of camp life with an individual average gain of 712 pounds. Follow up work is now being done on these children in the Health Department Clinic, the boys reporting in small groups at intervals for examination.
DIPHTHERIA PREVENTION
The activities of the department in diphtheria prevention are now approaching the close of the second year, and it is estimated that nearly fifteen hundred ehildren will have been protected from this disease, since the work of immunization was started.
Diphtheria is prevalent, for the most part, in the fall and early winter, and it is at that season that we plan to do most of our intensive work in prevention. The parents of the young children, who may become future victims of this dread disease, will not be able to present the excuse that the necessity of prevention has not been repeatedly called to their atten- tion or that opportunity has been lacking to have their children protected. As we mentioned in our report last year, the responsibility of future occur- rence of diphtheria in children has now been put squarely up to the parents. Each fall the clinic will be open on Saturday mornings at the Sturdy Hospi- tal, and diphtheria prevention will receive as much publicity as we can give it while the work is in progress. It is our fond hope and expectation that, in a few years, a noticeable reduction in the death rate from diphther- ia will be shown, locally, as a result of our efforts. The department notes a steadily increasing demand, on the part of parents, to have their children immunized, which fact makes it evident that here, as in other localities, parents are giving some forethought to the prevention of this terrible disease. If the prevailing death rate from diphtheria is allowed to con- tinue, in view of the existing knowledge of the disease and its prevention, one can only infer that this knowledge is not being put to use. In diph- theria prevention, parents must bear constantly in mind the greater fatality of diphtheria in children of pre-school age as compared with the school age group. The disease is nearly twice as fatal under school age, as it is after that period. Children between one and two are practi- cally all susceptible, and the disease is then very fatal if contracted. Be- tween the ages of two and six, practically all children are still susceptible, and the occurrence of diphtheria in this age group is a very serious affair indeed.
A special effort will be made by the department from now on, to advocate the general immunization of children at the age of one year with toxin-antitoxin, and of those other children of pre-school age. who have not already received protection.
We have had no difficulties thus far in our immunization work, and none are anticipated. The immunization of hundreds of thousands of children all over the country has demonstrated sufficiently the practical
....
--
H
Opening Attleboro Health Camp 1924
73
ANNUAL REPORT
value of this work, as well as the harmlessness of its application. It is planned to continue this work next fall with a full educational campaign.
HEALTH SHOW
The first Health Show was held under the auspices of this department in April at the Y. M. C. A., the use of the whole building having been kindly donated for the purpose, by the directors of that organization. During the two days of the exhibit, there was an estimated attendance of about five thousand persons, and a marked interest was manifested by the public in the lectures, and demonstrations.
As an educational, attractive, and entertaining exposition on public health, the event was entirely successful, and the favorable result of the affair in greater part, was due to the combined efforts of the members of a very energetic committee of public spirited citizens who had charge of the details. All the official and volunteer health agencies of the city were represented, and each took full advantage of the opportunity thus offered to explain in detail, to the large gathering of interested spectators, its mission in public health work.
Included at the show were attractive exhibits on health; the different clinics were shown in actual operation, and a fine educational program of interesting talks by authorities on public health was carried out.
Moving pictures on health subjects were shown, and a large amount of literature on health topics of every description was distributed. The State Department of Public Health furnished complete exhibits, assisted materially in arranging the program and sent several of its representatives each day, many of whom took part in the show; all seemed interested in this rather novel idea of presenting the subject of health to the community. The Attleboro Doctors' Club rendered valuable assistance, and took charge of the entertainment of out of town guests. It is planned to duplicate this event on a somewhat larger scale in 1926.
CONCLUSION
If a fair advance has been made during the year in common welfare, in public health, and in improved sanitation, such progress has not been made entirely by this department. Real progress in public health work is never made by any health department alone and unassisted. The best results in such work are attained only by the cooperation and by some expression of real interest on the part of the citizenship as a whole. Our work has been made easier by the support given to our efforts by the local unofficial health agencies, by the physicians, as evidenced by their prompt- ness in reporting cases of communicable diseases, and also by the interest- ed attitude of the Doctors' Club toward preventive medicine. The citizens as a whole, here as in other places, have accepted the idea that public health is a community affair, that the health of each is the concern of all.
We desire to acknowledge the valuable aid and assistance that has been rendered the department by the press, on which we depend to such a great extent for publicity, by the Chamber of Commerce, by many of the nurses and public school teachers, as well as by the other city depart- ments.
In conclusion, we may say that new hopes as well as new plans may be entertained for the future. Nothing is more interesting in romance or fiction, or more encouraging than the true story of what has been ac- complished by preventive medicine in saving as well as in prolonging human life. Since 1910, four years have been added to the expectancy of life; while these accomplishments are due largely to the work that has been done in conserving the lives of infants and young children, recent reports would tend to indicate that results are coming from the attention
74
ANNUAL REPORT
shown in the last few years to the early discovery of disease in those of middle age or older.
In this connection and at this time, we wish to make a further appeal to the citizens concerning the advisability of periodic physical examina- tions of adults. One needs to take occasional account of one's physical condition as well as one's financial and business status. To this end, we urge that each citizen, especially those of forty or over, form the habit of consulting his family physician on his birthday, or at least once annually, for the purpose of having a health examination made and an inventory taken of his physical condition. Once this becomes a custom and each individual in the community practices personal disease prevention, the matter of personal health becomes what it should be in the last anaylsis,- the foundation of public health.
Respectfully submitted, WILLIAM O. HEWITT,
Health Officer.
EXPENDITURES 1924
Health Officer
$900.00
Nurse
1,500.00
Milk Inspector.
750.00
School Dentist-3 months.
150.00
Inspector of Slaughtering.
600.00
Inspector of Animals.
300.00
Attending Physician at Tb. Clinic
75.00
Garbage Collector.
1,500.00
Caretaker of Dump
728.00
Clerk.
468.00
Total
$6,971.00
General Expenses
Incidentals
Printing
$43.25
Stationery and postage. 31.50
316.51
$391.26
Automobile.
548.23
Supplies for Dump.
73.19
Plumbing Inspection.
192.00
Physicians' Fees
50.00
Laboratory
Rent .
$150.00
Light.
12.47
Supplies
107.22 $269.69
Tuberculosis and Diphtheria Prevention Clinics
Printing
31.00
Advertising
34.75
Supplies.
151.14
216.89
Fees Other Cities and Towns
Malden. ..
78.00
Fall River
316.00
Providence
186.50
Waltham.
106.50
687.00
State Sanatoria
Westfield.
130.28
Lakeville.
90.86
Bristol County Hospital.
9,162.40 9,383.54
General expenses.
Expended for salaries
75
ANNUAL REPORT
Care at Home
Scarlet Fever
$100.00
Diphtheria.
70.00
Supplies.
22.64 192.64 12,004.44
Total.
$18,975.44
INCOME OF HEALTH DEPARTMENT
Subsidy from the State
Cases at Bristol County Hospital December 1, 1923
November 30, 1924.
$3,688.59
Reimbursement from the State
Cases at Bristol County Hospital, having state settlement.
January 1, 1924-December 31, 1924. 894.40
Reimbursement from other cities and towns
Cases at Bristol County Hospital, having no settlement here.
January 1, 1924-December 31, 1924
214.50
Plymouth, Mass. North Attleboro, Mass
16.90
License fees paid the Health Department.
130.50
Total
$4,944.89
HEALTH AND SANITATION Estimated Appropriations for 1925
Health Officer's Salary
Laboratory Maintenance
$125.00
Dental Clinic.
1,500.00
Clerk
468.00
Inspector of Milk.
750.00
Care of Dump.
750.00
Garbage Removal.
1,500.00
Inspector of Slaughtering.
600.00
Inspector of Animals
300.00
Inspector of Plumbing
300.00
Nursing, Care at Home.
300.00
State Sanatoria.
8,500.00
Fees to Other Cities and Towns.
500.00
Physicians' Fees
50.00
Rent and Light .
180.00
Incidentals.
300.00
Health Department Nurse.
1,500.00
Automobile.
800.00
Tb. and Diphtheria Prevention Clinics
300.00
Totals
$18,723.00
WILLIAM O. HEWITT, Health Officer.
RECOMMENDATIONS
1. A full time milk and sanitary inspector.
2. An appropriation for a properly supervised dental clinic.
3. Chlorination of our municipal water supply.
4. A general municipal health survey.
WILLIAM O. HEWITT,
Health Officer.
76
ANNUAL REPORT
MORTUARY REPORT BY MONTHS
Month
Number of Deaths
Still Births
January
27
4
February
19
4
March
25
0
April
22
2
May
25
2
June
24
1
July
15
1
August
19
1
September
18
1
October
19
1
November
17
1
December
24
3
Totals
254
21
DEATH-RATE
Year
Population
No. of Deaths
Death Rate
1914
16215
236
14.5
1915
18480
181
9.8
1916
18730
249
13.3
1917
18980
244
12.9
1918
19230
303
15.8
1919
19480
256
13.1
1920
19731
258
13.1
1921
20553
205
9.9
1922
21375
209
9.8
1923
22197
263
11.8
1924
23019
254
11.0
ANNUAL REPORT
CAUSES OF DEATH
Cause of Death
January
February
March
April
May
June
July
August
September
October
November
December
Totals
Accidental poisoning, Ill- uminatng gas.
1
1
Accidental burns.
2
1
3
Accidental drowning
1
1
Accidental, Electricity .
1
1
Alcoholism.
1
Angina Pectoris
1
1
1
3
Appendicitis
1
1
2
Arterio sclerosis
1
2
1
4
Arthritis, acute
1
1
Automobile accident.
1
1
1
3
Bronchitis, acute.
1
1
2
Cancer.
1
1
2 5 22
3
2 2
1 1
22
Carbuncle.
1
1
1
2
Cerebral embolism .
1
1
2
Cerebral hemorrhage
1
3
2
4 1
1
1
1
1
1
16
Cholera Infantum.
1
1
Cirrhosis of liver.
1
1
1
3
Congenital defect.
1
1
1
3
Convulsions.
2
1
3
Cystitis, chronic
1
1
Diabetes.
1
1
Diphtheria.
1
1
1
Endocarditis, chronic.
2
1
1
2
1
7
Epilepsy
1
1
Erysipelas.
1
1
Fracture, hip.
1
1
Fracture, skull
1
1
1 1 1
1
2
General Paralysis
1
2
3
Heart disease
4
5 3
1
1231
3
2
25
Hepatitis. chronic.
1
1
Hypertrophy of Prostate. Influenza.
1
2
1
1
5
Inguinal hernia.
1
1
Intestinal Obstruction.
1
1
Lesion Central Nervous System
1
1
Meningitis
1
1
Myocarditis, acute.
1
1
Myocarditis, chronic.
3
2 21 1
2
1
1
13
Nephritis, chronic.
2
4 1
2
1
1
1
12
1
1
Hemorrhage of new born.
1
1
2
4
Gastro-enteritis, acute.
1
Embolism femoral artery
1
Cardio-renal disease
1
77
78
ANNUAL REPORT
CAUSES OF DEATH, (Continued)
Month
January
February
March
April
May
June
July
August
September
October
November
December
Totals
Parkinson's disease.
1
1
Peritonitis
1
1
1 3
Pericarditis.
1
1
Pernicious Anemia
1
1
1
3
Pertussis.
1
1
1
3
Pleurisy with effusion.
1 3
1
2
7
Pneumonia, lobar.
1
1
1
1
2
Premature birth.
1
1
1
1
1
1
1
1
1
9
Pulmonary embolism.
1
1
Pulmonary oedema.
1
1
Pyemia. .
1
1
2
Septicaemia.
2
1
1
4
Shock received at birth
1
1
Suicide.
2
2
4
Tabes Dorsalis
1
1
Tuberculosis, General
1
1
Tubercular Meningitis.
1
1
2
Tuberculosis, Miliary.
1
1
** Tuberculosis, Pulmonary Tuberculosis of Spine.
3
4
3 3 4312 54
2
34
Unknown
1
1
Uraemia. 1
1
2
Totals. 27 19 25 22 25 24 15 19 18 19 17 24 254
3 21 Still births 44022111111
** Non-resident deaths from Th. (Patients at Bristol County Hospital) 24
1
2
Pneumonia, broncho
1
Toxaemia.
1
1
1
1
79
ANNUAL REPORT
MORBIDITY BY AGES AND MONTHS
No. of Deaths
Female
Male
Under 1 yr.
1 to 2 yrs.
4 to 5 yrs. 3 to 4 yrs. 2 to 3 yrs.
15 to 20 yrs. 10 to 15 yrs. 5 to 10 yrs.
20 to 30 yrs.
30 to 40 yrs.
40 to 50 yrs.
50 to 60 yrs. 60 to 70 yrs.
70 to 80 yrs.
Over 80 yrs.
January February March April
27 19
11
16 10
4 0 3
000
0000
00000
021
000
1
3
2
2
5 5
3
2
3
4 0
July
August
19
10 12
9
1
-
C
0 0
20 10 0
0 0 0
1 1 1 3
0 3
3 2 2
2 4
3 4 1 0
22
0
November
17
00
December
24
10
14
2
1
1
3
1
0
0
20
000
2 0 0
1 2
2 1
3 2 0
2 3 0
3
1
5
1 3 1
October
19
6
10 9
20 30 31 1
0 0 0 1 0 1 50100
0 1
2
1 3
1 2
001
232
3
4
5
1 4
May
25 24 15
4
11
31
0
0
September
18
6
3
HHHO
10
0
0 0 C
1
00 C
0
1 2
1 2
4
3 2
June
22
12
10
12
13
11
13
10
001 0 3 1 1
0 0 00
1
4 3 3
1
1
3 5
1
0
Totals
254 124 130 33 7 3 0 2 11 2 8 20 24 20 31 34 40 19 Still births excluded.
AHO
02 5
25
16
9
9
1
1
1
80
ANNUAL REPORT
INFANT MORTALITY Classification of Deaths Under One Year
Totals
Male
Female
Under 1 day
1 day
1 to 2 days
2 to 3 days
3 days to 1 wk.
1 to 2 weeks
2 to 3 weeks
3 wks. to 1 mo.
1 to 2 mos.
2 to 3 mos.
3 to 6 mos.
6 to 9 mos.
9 to 12 mos.
January
4
4
1
1
1
1
February
3
2
1
1
1
1
March
3
1
2
1
1
1
April
2
2
1
1
May
1
1
1
June
3
3
1 1 1
1
1
August
1
1
1
September
2
2
1
1
October
3
1
2
1
1
1
1
1
December
5
2
3
2
1
1
1
Totals
33 16 17 11
3 2
1 3
1
1722
Premature Birth
9
27 6 2
1
Pneumonia, Broncho3
3
1 1
1
Bronchitis, acute
2
2
1
1
Influenza
1
1
1
Cholera Infantum
1
1
1
Haemorrhage of new born
3
3
2 1
Tubercular menin- gitis
1
1
1
Cerebral haemorr.
1
1
1
Convulsions
1
1
1
Congenital Defect
1
1
1
Whooping Cough Meningitis
2
2
1
1
1
1
1
Pneumonia, lobar
2
1
1
2
Shock rec. at birth
1
1
1
Gastro Enteritis
1
1
1
Unknown
1
1
1
Patulous Foramen Ovale
1
1
1
Toxaemia
1
1
1
Totals
33 16 17 9 2
321211822
July
3
2
1
1
November
3
2
1
1
DEATHS FROM CONTAGIOUS DISEASES REPORTED BY MONTHS FOR 1924.
Cerebro-Spinal Meningitis
Trachoma
Encephalitis
Lethargica
Poliomylitis
Other Forms of
Tuberculosis
Pulmonary
Tuberculosis
Diphtheria
Scarlet Fever
Typhoid Fever
Chicken Pox
Whooping Cough
Measles
Mumps
Ophthalmia
Influenza
Lobar
Pneumonia
Cases
Deaths
Deaths
Deaths
Deaths
Deaths
Deaths
Deaths
Deaths 0 0
Cases 1 1
Cases 0 40 0 10 -
Deaths 0 0 16
0 4
0
1
0
20 0
1
0
1
0
2
2
0
1
- 0 0
0) 0 0
0 0 0
2 0
0) 1 0
June .. July. . . August
0)
0) 0
1 0
0 0
0 0
0
0
0
2
0
6
4
0
3
0
0
2
0
0
0
2
0
0 0 0
C 0
4
0
0
0
0
0 0
1 0
0 0 0
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