"One township has 2170 inhabitants living in 51 square miles of territory, worth one and one-eighth million dollars. Its supervisor is paid $352.95 a year for a few days' work; its officers are paid $612.95. It costs $274.79 each year to elect these officers, and I understand each township is to spend about $5000 for good roads. The health officer that cares for these 2000 people over 51 miles of territory gets $42.53 a year, and the poor physician $34; while the sick-poor get helped to the munificent sum of $59.36, or two and one-half cents from each citizen. The health officers get almost exactly two cents a head for caring for the inhabitants over 51 square miles of land. The supervisor gets out of each inhabitant seventeen cents a year, the officers get thirty cents, while the sick-poor take from each citizen almost three cents. The discrepancy is too glaring to need comment. A community assessed a million dollars and probably worth two millions spends $40 a year on public health, and $60 a year on one-sixteenth of its population for sickness."
The physician proposes a county commission to take the place of the board of supervisors. He declares that the members of the board have outgrown their usefulness. "They should be junked along with other stagecoaches and a nice, new 60 h. p. county commission put in their place. The fact is that the system is wrong. Our 'government' is a survival of early times, and our science is up to date. They do not fit. You cannot expect supervisors who were useful in the time of Adam, when there were no cities, no problems, no roads, to serve in the twentieth century with its surgical treatment of degenerates, its germs and prophylactics, its preventive medicine and its scientific spirit. Supervisors could look after noxious plants and animals in the old days, and they could paper the court-house and eat fat dinners at the poor-house. They did fairly well at settling line fences, drinking sweet cider, and blarneying with insurgents. But they are out of place when it is a question of constructing roads of macadam, of building a tuberculosis hospital for an $18,000,000 county, and especially they are out of place when it is a question of dozens of defectives in the jails and thousands outside who ought to be in hospitals."
7. A community program for health[4] is much needed. The farmer lives by himself in his own house, on his own place. If a disease arises in his neighbor's family, it is not likely to spread to his family. Therefore, disease has seemed to him to be a personal rather than a neighborhood matter. There is the greatest need that the farmer possess a community sense in respect to disease and sanitary conditions. If the city is the center of enlightenment, it should help the country to get hold of this problem.
We should have a thoroughgoing system of health supervision and inspection for the open country as well as in the city. Health inspection should run out from the cities and towns into all the adjoining regions, maintaining proper connections with state departments of health. It should be continuous. It should include inspection of animals as well as of human beings. In other words, the whole region is a unit, one part depending on the other. The remarks of the physician, just quoted, indicate how great is the need of an organized health supervision for country communities.
We need meat inspection laws for meat killed and sold within the states, to supplement the inter-state law. We need community slaughter-houses in which all slaughtering of animals shall be under proper inspection. We need state milk inspection programs. It is not right that any large city should be compelled to inspect the milk throughout the state in order to protect itself. It is not right to the farming districts that such inspection should center in the city.
We must not assume that the farmer is specially guilty of sanitary faults. There are many such shortcomings in the open country, and I accept them without apology; but I can match them every one in city conditions. The fact is that the whole people has not yet risen to an appreciation of thoroughly sanitary conditions, and we cannot say that this deficiency is the special mark of any one class of our population. Persons ride along the country roads and see repulsive barn-yards, glaring manure piles, untidy back-yards, and at once make remarks about them. All these things are relegated to the rear in towns and cities and are not so visible, but they exist there.
I know that there are very filthy stables in the country districts, but I have never known worse stable conditions than I have seen in cities and towns. All progress in these directions must come slowly, and we must remember that it is expensive to rebuild and reorganize a stable. No doubt one of the reasons for the high cost of living is the demand of the people that pure-food laws shall be enacted and enforced, for this all adds to the cost of food supplies; similarly, we must expect a betterment in conditions of stabling to result in increased price of dairy products. In the cost of living we must figure the expense of having clean and pure food.
The farmer is much criticized for polluting streams; but when the farmer pollutes one stream occasionally, a city will pollute a whole system of streams continually. One of the greatest sins of society is the wholesale befoulment of streams, lakes, and water-courses. I do not see how we can expect to be called a civilized people until we have taken care of our refuse without using it to fill up ponds and lakes, and to corrupt the free water supplies of the earth.
If the countryman has been ignorant of sanitary conditions, we must remember that his ideas are largely such as he has derived from teachers, physicians, and others.
We cannot expect a man to develop within himself enough community pride and altruism to compel him to go to great expense for the benefit of the public; but he will gladly contribute his part to a public program.