Euthenics, the science of controllable environment / A plea for better living conditions as a first step toward higher human efficiency

by Ellen H. Richards

“New York City will spend in 1910 $6,500 for making over twenty rooms in regular buildings, a first step in an entirely new plan of ventilation, which will eventually give outdoor air to all children, sick or well.”[8]

Speaking generally, America is one of the last of the civilized nations to deal with the subject of the medical inspection of school children upon a comprehensive and national scheme. But once aroused to the needs, it is safe to say that the nation will speedily educate parents to correct such home conditions as reduce the child’s ability to profit from schooling, and to persuade governments to see that safe homes are provided. It will be easy to convince the taxpayer that it is cheaper to provide such care than to neglect the future parent and citizen, for it is easy to prove that medical inspection in our schools returns large dividends on small investments. Dr. Luther Gulick says that it seems probable, though only a guess, that the total annual expenditure for medical inspection of schools in the United States at the present time is perhaps $500,000. The money saved by enabling thousands of children to do one year’s work in one year, instead of in two or three years, would greatly exceed the total expense of examining all children in all boroughs.[9]

The health of all our school children should be conserved by a system of competent medical inspection which should secure the correction of defects of eyes, ears, teeth, as well as defects due to infection or malnutrition.

The statistics of medical inspection in public schools tell a pitiful tale wherever it has been tried: thirty or forty per cent of the children are found with defective or diseased eyes, ten to twenty per cent with distorted spines, fifteen per cent with throat and nose troubles, all of which directly affect their intellectual proficiency.

When these deficiencies are discovered and reported to the parents, such is the apathy of disbelief that seventy-five per cent of the cases usually go unattended; therefore the school nurse, who follows the case home and explains the needs and sets forth the penalties, has become a necessity.

The parent who permits his child to go to school physically unfitted to profit from school opportunity is not only injuring his own child, but is injuring his neighbor’s child, and is taxing that neighbor without the latter’s consent.

It would seem as if such parents had forfeited their right to the sole care of the children, and that government would be obliged, for its own protection, to step in and do the work while it is needed. The author has termed this temporary paternalism. The providing of penny lunches during the morning recess, the service of the school nurse and the home visitor to teach those parents who are willing to learn all these schemes for the saving of the child, may be carried out in a spirit of helpfulness with a support which may be withdrawn when no longer needed.

Although all America has not become aroused to the undoubted fact of tendencies toward physical deterioration, it is on the verge of an awakening. The public school is the natural medium for the spread of better ideals, and if the teachers of cooking and of hygiene would coöperate and use all the material which sanitary science is heaping on the table before them, we should soon see a betterment of the physical status. Combined with medical inspection and sanitary construction of schoolhouses, this would raise the general health of the community thirty or forty per cent in five years and fifty to seventy per cent in ten years.

There has been in some quarters much objection to public effort towards remedying evils which would not have existed if each family had lived up to its duties. The community is a larger family, with greater resources, and can employ investigators to find the means for greater security. That individual is very foolish who does not recognize this interaction between community and individual, and who objects to taking the benefits of the larger knowledge.

To take one of the latest examples of social problems: In every thousand children in the public schools of any city, probably of the town also, there are perhaps fifty who are ill-nourished (not necessarily underfed), ill-clothed, unwashed, and deprived of good air for sleeping. What is the duty of the public? This is one of the burning questions of the moment. Send missionary teachers to the homes, some say, but that is costly; the selection of the suitable missionary is difficult, and the result may be slight. Others say, give one good luncheon at the school, for which the children pay in part or in whole, and make that an education which, by the aid of the school nurse, will in time affect a change in habit. In short, the problem is this: Shall the children suffer in childhood and become a burden on society in adult years, or shall society protect itself from future expense by community care now? “Because finding diseases and defects does not protect children unless discovery is followed by treatment, fifty-eight cities take children to dispensaries or instruct at schoolhouses; fifty-eight send nurses from house to house to instruct parents and to persuade them to have their families cared for; 101 send out cards of instruction to parents either by mail or the children; while 157 cities have arranged special coöperation with dispensaries, hospitals, and relief societies for giving the children the shoes or clothing or medical and dental care which is found necessary.”[10]