On the other hand, such results of improper personal living as do not come under legal control—diseases of the heart, kidneys, and general degeneration, matters of personal hygiene—have so enormously increased as in themselves to show the attitude of mind of the great mass of the people, “Let us eat and drink and be merry, what if we do die tomorrow!”
Probably not more than twenty-five per cent in any community are doing a full day’s work such as they would be capable of doing if they were in perfect health. This adds to the length of the school course, to the cost of production in all directions, to increased taxation, and decreases interest in daily life.
The trouble is that the public does not believe in this waste which comes from being “just poorly” or “just so as to be about.” It has no conception of the difference between working with a clear brain and a steady hand, and working with a dull and nerveless tool. It must be convinced of this in some way. General warnings have been ineffective, and now the appeal is being made to the American people on the basis of money loss. Thus it has been carefully estimated that the average economic value of an inhabitant of the United States is $2,900. The vital statistics of the United States for population give 85,500,000. Eighty-five million five hundred thousand multiplied by $2,900 equals $250,000,000,000 (minimum estimate), and this exceeds the value of all other wealth. The actual economic saving possible annually in this country by preventing needless deaths, needless illness, and needless fatigue is certainly far greater than $1,500,000,000, and may be three or four times as great.
Dr. George M. Gould estimated that sickness and death in the United States cost $3,000,000,000 annually, of which at least one-third is regarded as preventable.
From all sides comes testimony to the decrease in personal efficiency of workers of all degrees. Medical science has prolonged life, hospitals and visiting nurses have made sickness less distressful, but have also in many cases prolonged the time and increased the cost. Sanitary science aims to prevent the beginnings of sickness, and so to eliminate much of the expense.
The discovery that the mosquito is the carrying agent for the yellow fever germ has saved more lives annually than were lost in the Cuban War. In the yellow fever epidemic of 1872, the loss to the country was not less than $100,000,000 in gold.
“With our present population there are always about 3,000,000 persons in the United States on the sick list.... By means of Farr’s table, we may calculate that very close to a third, or 1,000,000 persons, are in the working period of life. Assuming that average earnings in the working period are $700, and that only three-fourths of the 1,000,000 potential workers would be occupied, we find over $500,000,000 as the minimum loss of earnings.
“The cost of medical attendance, medicine and nursing, etc., is conjectured by Dr. Biggs in New York to be from $1.50 each per day for the consumptive poor to a greater amount for other diseases and classes. Applying this to the 3,000,000 years of illness annually experienced, we have $1,500,000,000 as the minimum annual cost of this kind.
“The statistics of the Commissioner of Labor show that the expenditure for illness and death amounts to twenty-seven dollars per family per annum. This is for workingmen’s families only. But even this figure, if applied to the 17,000,000 families of the United States, would make the total bill caring for illness and death $460,000,000. The true cost may well be more than twice this sum. Certainly the estimate is more than safe, and is only one-third of the sum obtained by using Dr. Biggs’s estimate. The sum of the costs of illness, including loss of wages and cost of care, is thus $460,000,000 plus $500,000,000 equals $960,000,000.... At least three-quarters of the costs are preventable.”[3]
The cost of certain preventable diseases a year is estimated by various authorities as: