Observe condition of sidewalks and other public places with respect to expectoration. Is there a law on the subject in your community'? Is it observed or enforced? Who is responsible? Dangers from expectoration.
Medical inspection in the schools of your county, town, and state. If any, its results. Kinds of defects most commonly found. How is it conducted? Who sends the inspectors? To what extent the homes of the community cooperate with the schools in getting results from medical inspection.
BETTER CONDITIONS IN CITIES DUE TO ORGANIZED TEAM WORK
We may well ask why ill health and physical defects seem to be more prevalent in rural communities than in cities. The answer probably is, simply, that in cities they are PREVENTED more effectively. The chart on page 313 shows that while the death rate in New York City was 20.6 per thousand in 1900, it had declined to 14 per thousand in 1914; while that in the rural districts of New York State remained practically the same during these years (15.5 per thousand in 1900, 15.3 in 1914).
This indicates that health conditions in the city were originally much worse than in the country. They were rapidly improved by organization for health protection. There is not the occasion, in rural communities, for the elaborate health-protecting organization that is now found in all large cities, because the people in rural communities are not so completely dependent upon one another nor at the mercy of conditions over which, as individuals, they have no control. And yet even in rural communities physical well-being depends largely upon organized team work.
SCHOOLS AS AN AGENCY FOR HEALTH CONSERVATION
Cities have used their school organization to combat physical defects and weaknesses of pupils, and that is why they make a better showing than rural communities in such matters as those shown in the table on page 312. Removing such defects from young people means a stronger and more efficient adult population ten or twenty years from now; for these defects are often the causes of more serious illness in later years. The table on page 299, Chapter XIX, shows how much behind cities rural communities have been in the use of their school organization for this purpose. The encouraging thing is, however, that rural communities are beginning to find the means to use their schools in this way. The way has been opened by school consolidation (p. 295), by the grouping of all the small and isolated schools of a county under a central county administration (p. 294), by aid from the state, both in money and in supervision, and by cooperation from the national government.
HEALTH EDUCATION FOR ADULTS IN CITIES
Cities have extended their health-educational work to the adult population. This takes place in part through the schools also. Instruction given to children is of course taken home by them. Visiting nurses employed by the schools visit the homes. Classes for mothers are conducted at the school in the afternoon or evening. But more than this, city boards of health, often in cooperation with the school authorities, conduct educational campaigns by means of literature distributed to the homes through school children, by means of evening lectures and moving pictures, and through the newspapers.