I now have the pleasure of introducing Prof. Irving Fisher, of Yale University, who has given this subject many years of study and research and will now speak to you upon the “Public Health Movement.” (Applause.)
Address, “Public Health Movement”
Prof. Fisher—The Conservation movement is a movement to prevent waste. When the Conservation Commission was appointed, four years ago, emphasis was placed on the wastes of our natural resources, but by the time the Commission made its report, it had come to the conclusion that by far the most serious as well as the most preventable wastes are the wastes of human life.
A generation ago it was a common impression that the average human lifetime was fixed as by a decree of fate. When I was in college one of our reverend instructors showed us a mortality table and said with great impressiveness: “There is no law more hard and fast than the law of mortality.” I believed it, and even yet many people are under this delusion. Pasteur did much to introduce a more optimistic view. He stated his belief in these immortal words, “It is within the power of man to rid himself of every parasitic disease.” He staked this opinion on his own wonderful laboratory revelations as to germ life. Today we can confirm his words by absolute statistics. And now his successor, Metchnikoff, has surpassed even Pasteur in optimism. Metchnikoff is devoting himself to the question of the prolongation of human life and already gives us a vision of the time when centenarians will be regarded merely as in the prime of life and when the normal span of a century and a quarter will be a frequent occurrence.
The growing consciousness that human life is not a fixed allotment, which we must accept as our doom, but a variable, which is within our power to control, has recently led to extraordinary exertions all over the world to save human life. This impulse has gained strength also from the great and almost universal decline in the birth rate. Old countries like France, and new countries like Australia, are confronted with the specter of depopulation. Consequently, as human life becomes scarce, it becomes precious—like any other commodity! These two facts, the consciousness that much mortality is preventable, or at any rate postponable and the fact that increasingly fewer babies are being born in the world, are together operating to produce a great health movement throughout the world. Nothing will stop it until the whole world is convinced of the paramount importance of this problem of human Conservation.
This world-wide movement for the conservation of human life has expressed itself in many ways—in medical research; in societies for preventing tuberculosis, infant mortality, social diseases, alcoholism, and vice; in the growth of sanatoria, dispensaries, hospitals and other institutions; in an immense output of hygienic literature, not only technical books and journals, but also popular articles in the magazines and daily news papers; in the constant agitation and legislation for purer foods, milk supply, meat supply and water supply; in the movement to limit the labor of women and children and to improve factory sanitation; in the establishment of social insurance in Germany, England, Denmark and other countries; in the improvement of departments of health; in the spread of gymnastics, physical training and school hygiene; in the revival of the Olympic games and the effort to revive the old Greek ideals of physical perfection and beauty, and last, and most important, in the sudden development of the science of eugenics.
In the summer of 1911 was held in Dresden a unique world’s fair, devoted exclusively to health—the International Hygiene Exhibition. In this were shown the fruits of the whole movement in all lands—except, alas, our own; for to our shame it must be said that we, as yet, are among the backward nations in this movement for the conservation of human life. Our Congress was asked to appropriate $60,000 to erect a building and supply an exhibit to show what we have done for our part in this movement, but Congress thought it could not afford so large an expenditure for so small (!) an object, and the result was that from the millions of people who visited this exhibition one constantly heard the question asked: “Where is the United States?”
And those few Americans who did go to visit the exhibition found that other nations had far outstripped us in this movement for national sanitation and health. Some of the achievements already attained by other nations should be recorded among the wonders of the world. One is the striking decline of the death rate in the city of London. Within two decades, London’s death rate has virtually been cut in two and is now only thirteen per thousand, or less than that of most cities one-fiftieth its size.
Probably, however, the greatest achievement of any country is that of Sweden, where the duration of life is the longest, the mortality the least and the improvements the most general. There alone can it be said that the chances of life have been improved for all ages of life. Infancy, middle age and old age today show a lower mortality in Sweden than in times past, while in other countries, including the United States, although we can boast of some reduction in infant mortality, the mortality after middle age is growing worse and the innate vitality of the people is, in all probability, deteriorating. The reason why Sweden of all countries has succeeded in improving the vitality of middle age and old age, while other nations have failed, is, I believe, to be found in the fact that Sweden, of all nations, has seen the problem of human hygiene as a whole instead of partially. In most other lands, and particularly in the United States, public health has been regarded almost exclusively as a matter of protection against germs; but protection against germs, while effective in defending us from plague and other epidemics of acute diseases, is almost powerless to prevent the chronic diseases of middle and late life. These maladies—Bright’s disease, heart disease, nervous breakdowns—are due primarily to unhygienic personal habits. Medical inspection and instruction in schools, as well as Swedish gymnastics, have aided greatly in the muscular development of the citizens of Sweden. Swedish hard bread has preserved their teeth. The Gothenburg system is gradually weaning them from alcohol. There has even been a strong movement against the use of tobacco. Other countries are tardily following in the path which Sweden has trod so successfully.
The significant fact is that Sweden has not hesitated to attack the problems of personal habits. I believe we must have a revolution in the habits of living in the community if we are going really to realize the promise of Metchnikoff and others as to the prolongation of human life. Health officers in this country have not regarded it as a part of their duty either to live personally a clean, hygienic life, or to teach others to do so, or even to investigate what those conditions of well-being are which make for personal vitality.