HOW SOME COMMUNITIES SAVE MONEY.
Some prosperous American communities hold human life so cheaply that they maintain no public health service at all. Others—and there are many of them—have a mere skeleton service. The citizens imagine that if they appoint a health board consisting of doctors, all will be well with them. The suggestion that the board be provided with money to carry on its functions would be regarded as wanton extravagance.
There are scores of cities and towns which select a doctor to head the health department and expect him to earn his living by practicing his profession among the very people over whom he is supposed to exercise police authority in enforcing sanitary and other health regulations.
There are cities of from 5,000 to 100,000 population that hire a doctor on the “part time” plan as chief health officer, and pay him a trifling salary. Whether he is a competent sanitarian or in any way skilled in the prevention of disease is a matter of little concern to them. The fact that they are saving a few dollars in his salary fills them with joy and indifference as to the consequences to the community.
I know of a thriving, wealthy young city in the South of 130,000 population with a substantial preventable death rate which saves as much as $800 annually in this way.
I know of a prosperous New England city of 40,000 population with but three people in its health department—two of them are “part time” employes. It is a six cents per capita department and 50 per cent. of the annual deaths in that city are of children under five years of age.
In theory, we must all stand ready to serve the State when called upon, even at personal loss. But does it not seem the height of absurdity to expect a competent professional man to leave his practice to take charge of these under-manned and under-financed health departments at the small salaries which our States and cities offer them? If he does his duty, he is sure to make enemies during his term of service, and if he is an able man he will certainly lose money by leaving his practice.
Surely we offer our health officers every inducement to follow the line of least resistance.
A SAMPLE GROUP OF CITIES.
An investigation was recently made of forty-four Illinois cities averaging in population about 16,000; fifteen of them had over 20,000 population, and three had over 50,000.