Social survey of the city of Jackson, and Madison County, Tennessee

Front matter

SOCIAL SURVEY

—OF—

The City of Jackson and Madison County, Tennessee

Introduction

I. HISTORY

II. HEALTH

III. HOUSING AND SANITATION

IV. EDUCATION

V. FAMILY WELFARE

VI. CHILD WELFARE

VII. RECREATION

VIII. CHURCH LIFE

IX. INDUSTRY

X. AGRICULTURE

Page.

... 9

... 33

... 78

... 101

XI. GOVERNMENT

Introduction

America is entering upon a new era; it is an era of constructive community planning and building. We are beginning to realize that any community can be as clean, as moral, as healthy and wholesome, and as prosperous and progressive as its citizens wish to make it. But these attributes do not come as a gift; they are an achievement which is based upon forethought, mutual understanding and a spirit of co-operation upon the part of the citizens and the social and civic organizations which constitute the community.

In undertaking a study of social and living conditions, the City of Jackson and Madison County have gone on record for intelligent community planning and building. The object has been to discover the actual conditions as they exist, to secure real facts, and on the basis of these facts to build a program which will make for community welfare and progress.

“A Model City in a Model County” has been the slogan of those who have been at work. The work that has been done and the methods which have been employed, as well as the leadership in the survey, is proof sufficient that this slogan was not too ambitious. Every portion of the report of the various committees points to the fact that the City of Jackson and Madison County have been and are progressing. The possibilities for a model social program in the city and county are unlimited. While it is true that here and there very urgent needs were discovered by the committees, we must bear in mind that we have just passed through a great war and that we have not made as much improvement at home during the period of the war as would have been made in normal times; hence, in some instances the situation may be startling. In addition, it is true that the war has brought us to a better realization of the needs and possibilities in public health, wholesome recreation, better schools, a more vital religion, and the possibilities of community effort in meeting community needs.

The distinctive features which have characterized the survey are: First, that it has been a community affair. Originally, the survey was initiated by the Jackson-McClaran Red Cross Chapter, but it was endorsed by all of the leading civic and social agencies of the city and county. A Central Committee, representing 25 of the leading organizations, was then elected, and this committee directed in no small part the entire work It appointed sub-committees to investigate the various fields that were covered in the survey and these sub-committees reported back to the Central Committee, which made many helpful suggestions and which makes the final report a real community product.

The second outstanding feature in the survey has been the leadership which was provided. Nearly all of the State Departments participated in the work: Dr. Olin West and Dr. Eugene L. Bishop of the State Board of Health, and the local representative, Dr. C. B. Crittenden, gave leadership to the Health Committee. C. B. Clark of the State Department of Foods and Drugs, and Dr. C. W. Davis of Union University, directed the Sanitary Survey. Albert Williams of the State Department of Education, and a special representative, Miss Gertrude Folks, gave valuable suggestions to the School Committee. Mrs. Julia Wey, representing the State Board of Charities, directed the study of Child and Family Welfare; R. K. Atkinson, Field Secretary of the National Playground Association, in co-operation with the Rotary Club and Recreation Committee, worked out a complete playground and recreational program for the City of Jackson, which was submitted to the City Commission. The Agricultural Survey was directed by Judd Brooks and Miss Bertha Corbitt, and the Survey of Church Life was directed by the pastors, particularly

Dr. A. C. Bell and Rev. G. M. Oakley. This leadership gives to all of the reports real quality.

The third and perhaps most important characteristic of the work was that it aimed at community action. Each committee gathered the available data regarding needs and resources in its field and on the basis of this data made recommendations and built a practical program which will make for improvement and progress.

Community action has already come as a result of the work. A Parent-Teacher Association has been organized in connection with Junior and High School and a Presidents’ Club is being organized. This club will be a clearing-house of all the social agencies in the future, creating mutual understanding, preventing waste and duplication in financial campaigns, and planning a unified program of welfare and progress for the city and county.

Fourth — The work done by the colored people deserves special mention because of its thoroughness, and because of the sincere and intelligent desire that was manifested among them in the interest of improvement. Special committees carried on the work parallel with the remainder of the work.

It is impossible to express an appreciation to all of those who have contributed so greatly in making the survey a success. Acknowledgment is due the City Commission, Rotary and Lions’ Clubs, the Association of Commerce and the Woman’s Club. Special acknowledgment is due all of the representatives of the State Departments, particularly Mrs. Julia Wey, who assisted in editing reports, and to Dr. C. B. Crittenden and Mrs. Crittenden, who gave a great deal of time to the completion of the Health Survey. Acknowledgment is also due to Miss Annette McClaran, Red Cross Secretary, and Miss Emily Walker, Field Representative A. R. C., and Miss Sarah R. Woodall, for their splendid assistance throughout the survey. Special mention is further due the Southern Division of the American Red Cross and the Jackson McClaran Chapter for financing the work and for publishing the reports.

The reports which are presented in the following chapters give the findings and recommendations of the various committees. We bespeak for this publication a very careful and extensive reading, and ask that the citizens of Jackson and Madison County not merely give it their sympathetic interest, but that they use it in making “A Model City in a Model County.”

A. F. KUHLMAN,

CHAPTER I. History of Jackson and Madison County

Madison County, named after our fifth President, lies in the west-central part of Tennessee. It has an elevation of 400 feet above sea level, and an area of about 530 square miles. The surface in general is level.

Before the pioneers settled Madison County, it was a hunting ground for the Indians. The Indian mounds at Pinson and west of Jackson stand as monuments of this period.

The first settlers of the county came from Middle Tennessee, in 1819-20, over Indian trails and by keel boats which ran the Forked Deer river, and later this river became a shipping route of much produce to Memphis, Cincinnati and New Orleans* The early settlers came because there was much fertile land, fresh water, and some for the sake of adventure.

The first settlement in the county was at Cotton Grove. This was followed by settlements on the McClanahan farm, two miles west of Jackson. It was in this neighborhood that the small settlement of Alexandria sprang up, and when the important question arose as to where the county seat should be located, Alexandria, Golden Station, and the present site of Jackson, which was then farm land owned by Dr. W. E. Butler and Mr. Shannon, were the places that entered the race.

When the vote was taken, Jackson was chosen, and Dr. Butler’s farm became the county seat. The first court house was ready for occupancy in 1822. It was erected by John Houston at a cost of $135.00, and stood on the northeast corner of the present Court Square. It was a log building one story high, and was covered with clap-boards. This building stood until 1825, when the rapidly increasing population demanded a new courthouse. The second^ %as a brick building, two stories high. This was not a substantial building, and it was necessary to rebuild in a few years. The new house contained rooms for all the county officers and for the various courts, as well as a Supreme Court room. This building was remodeled in 1890, and still serves as the county courthouse-

The importance of having good communication between the different parts of the county was recognized at an early date, and the main roads leading out of Jackson were opened at once. Spring Creek, which stands at the crossing of the Trenton-Lexington road with the Jackson-Huntingdon road, was one of the first towns settled in the county. This town became quite a school center. Madison College was established there and was patronized by all of West Tennessee. Denmark, which lies about 12 miles southeast of Jackson, is in the midst of a good farming community. Some fine estates lie near Pinson, 12 miles south of Jackson on the Mobile & Ohio Railroad. Bemis, which is two miles south of Jackson, is the home of one of the largest cotton mills in the South. It is a most progressive mill town.

The county seat is named after Andrew Jackson. There is a tradition that the General and his brave men passed down College Street, or Main Street, on their way to fight the Indians in the War of 1812, and this path was then called the “Notched Traced Road.”

Jackson was created a town by an Act of the General Assembly in 1821. Not one of the early settlers is now living, nor is a single house standing today that was built at that early date. Jackson was governed by a town board until its incorporation in December, 1845.

The first bank in Jackson was simply an agency of the old States Bank, which had its branches in various towns and cities. After the Civil War, there was a Savings Bank, and later the National Banks were established here, and today the town boasts of five good banks.

The Methodists established the first church in Jackson in 1826 Ten years later the Baptists organized, and later the different churches as we know them today developed.

The educational interests began with a boys’ school in the lot where Green Gate Cottage now stands, and some time later a girls’ school on North Royal Street. This was known as the

Biglow School. The Methodist Woman’s College was founded and chartered in 1873 and during the 77 years of its existence it has been of great value to Jackson. The Methodist Conference in 1919 formed plans to rebuild this institution on another site.

The public schools were organized under an amended act of 1873. At the beginning they consisted of three departments, primary, intermediate and grammar. This school system has enlarged until it has made our city and Madison County important as an educational center.

In April, 1874, a convention was called in Murfreesboro to consider the question of establishing a Baptist college for the State. Jackson was selected and it was first called the Southwestern Baptist University. After the fire of five years ago, the name was changed to Union University.

So much for the past. In the following chapters are outlined the major interests of the city and county at the present time. These, as is clearly indicated, are all in the making, pointing toward “A Greater Jackson and a Better Madison County.”

Note — The Survey History Committee launched a History Essay Contest among the school children. In this contest Union University offered a scholarship to Seniors in High School and the Parent-Teacher Association offered $25.00 in prizes. Seventy-five pupils took part in the contest- The data contributed in the contest is to be compiled into a permanent history and historical pageant.

MRS. J. SILVERSTEIN,

MISS ALLIE DRAKE,

CHAPTER II. The Health Problems of Jackson and Itladison Countq

Health and life are primary possessions, whose real value we do not appreciate until we are in danger of losing them. In gathering together data for a report on health and life, one has to take into consideration the fact that as yet no adequate bookkeeping is done in man’s most important business undertaking— LIVING. This fact will help account for the incompleteness of this report. In the survey of health the committee has found it convenient to divide its work into three sections. Part 1 presents the health problems in the City of Jackson and in Madison County; Part 2 outlines the facilities and resources provided to solve these problems; and Part 3 is a statement of what is needed to make these facilities and resources adequate and effective.

Part 1. Citq of Jackson

The most definite index to a city’s health is her death record- The most striking fact in this record of the City of Jackson for 1919, as is indicated in the diagram below, is that the leading causes of death were among preventable diseases.

Leading Causes of Deaths in Jackson, 1919.

Infants under one (Multiplicity of causes)

Tuberculosis 31

Influenza 35*

Influenza Pneumonia 22i

Pneumonia II

Diarrhea and Enteritis Children under two Years 1!

Prematurity I3i

Typhoid 7ihh

The highest death rate was among infants under one. A study of this death rate shows that it was distributed quite equally throughout the year. It is reasonable, therefore, to believe that the factors causing it were more or less regular and not influenced greatly by complications incident to certain seasons of the year. The outstanding factors in infant mortality are inadequate pre-natal and post-natal care of the mother and improper feeding, clothing and care of the child. That these are the chief causes of deaths of infants under one, is also corroborated by the fact that there were 13 premature deaths.

Diarrhea and enteritis, causing in 1919 the death of 15 children under two years of age, are also largely due to improper feeding and lack of proper sanitation.

A comparative study of still-births in Jackson as shown in Table 1, indicates that the average annual number for the past three years was 14.3. This figure is entirely too high. It shows the need of pre-natal education and nursing work among mothers.

Next to infants under one, perhaps no other disease deserves more serious consideration than tuberculosis. It was responsible for the deaths of 39 persons in 1919. A comparative study for the years of 1917, 1918 and 1919 (See Table 1) indicates that the rate for 1919 was not unusual, but that it represents a fair annual average. The graveness of this disease is indicated only in part by the death rate. We must bear in mind that for every death there were ten cases of illness, plus many incipient cases, which were not fatal during the year 1919, but many of which will be fatal in 1920, and nearly all of which will prove fatal sooner or later unless remedial treatment is provided.

Table 1 — Deaths in Jackson.

Tuberculosis (all forms)

Pneumonia

Cancer

Typhoid

Malaria

Pellagra

Measles

Whooping Cough

Diphtheria and Croup

Influenza

Cerebro-Spinal Meningitis

Infants under 1 year

Diarrhea and Enteritis (under 2 yrs)

Tetanus

Diarrhea and Enteritis (over 2 yrs.)

Puerperal conditions

Homicide

Accidents

Prematurity

Still-births

The high death rate from pneumonia in 1918 was due chiefly to influenza. In 1919 its death rate was lower, due in part to better control; but due primarily to the fact that individuals whose vitality was low succumbed in 1918. This explanation is corroborated by the lower death rate from tuberculosis, malaria, and pellagra in 1919. Many who would in normal times have succumbed from tuberculosis, malaria and pellagra in 1919 were caught by the epidemic in 1918.

These diseases are, to a considerable degree, preventable if proper precautions are taken in due time and if there is adequate public supervision of health.

Medical authorities agree that the death rate from typhoid is an index to the civilization of a city. The average annual death rate from typhoid in Jackson is eight. Typhoid is one of the best understood and most preventable of all communicable diseases. Vaccination and proper care of typhoid patients and sanitary disposal of human excreta would eliminate deaths from typhoid entirely.

Malaria and pellagra cause too many deaths in Jackson. Malaria could be reduced to a negligible amount by the eradication of mosquito breeding places, and pellagra can be controlled through proper diet.

Experience shows that a control of from 80 to 90 per cent of malaria is possible. In Hamburg, Arkansas, the number of cases attended by physicians fell from 2,312 in 1916, to 259 in 1917, and to 59 in 1918, a reduction of 97.4 per cent, as a result of effective treatment of mosquito breeding places.

DEFECTS AND DISEASES OF SCHOOL CHILDREN.

The death rate from various diseases outlined above for Jackson gives one aspect of the public health problem. Another aspect of this problem is given in the examination of school children. Table 2 shows defects which, though not often fatal, cause much suffering and are a serious handicap to the children of Jackson.

These figures show that among the 853 children examined 825 defects and diseases were found; 54.27% of the children had defective teeth; 27.08% had defects of the throat, tonsils, adenoids, enlarged cervical glands, and 12.39% of the children had defective eyes.

Table 2 — Physical Examination of School Children of Jackson in 1917.

C £

5 a j= a

o o o

a

rf *

O

tn

‘5 eg

CJ

V

o

o ®

t-

o

d>

*5' 2

Is

£ w

O w

0/ o Giz;

Ch

o

College St. ...

Whitehall

W. Jackson

Percent

12.39

1.75

1.64

27.08

54.27

69.16

Another fact that deserves notice is that 69.16% of the school children were not vaccinated at the time of the examination.

FOOD SUPPLY.

A most serious aspect of Jackson’s public health problem is given in the inspection of her food handling places.

During a period of 16 months, under the State Department of Food and Drugs, a total of 741 inspections of places producing, selling or preparing food for eating purposes was made in Jackson by G. B. Clark, Inspector for West Tennessee. The number of instances and grounds on which orders were issued and the number of cases approved are indicated in Table 3.

A careful study of the total number of inspections shows that orders had to be issued in 501 out of 741 cases. This means that in 67.3% of the places, conditions or methods were pronounced a menace to public health.

A careful study of the summary shows that not a single bakery in Jackson in fifteen inspections was in sanitary condition; that not one drug store in eighteen inspections, no bottling plant in nine inspections, no slaughter house in seven inspections, no fish market in six inspections, no vegetable market in sixteen inspections, no candy factory or creamery in three inspections of each place, and no ice cream factory in ten inspections was ever found in sanitary condition. Orders to clean up or close up had to be issued.

Table 3 — Result of Inspection of Various Food Handling Places in Jackson.

(Period, December 1, 1918-April 1, 1920.)

Places Inspected

Orders Issued

Percent

No. O. K.

Percent

Floors

Cellars

Side Walls

and Ceilings

Toilets

Living

Quarters

Food Not

Protected

e

o o

c

X

K

General Bad

Condition

Groceries

. 245

Restaurants

. 120

Soft Drink Stands

. 167

Meat Markets

. 67

Bakeries

,. 15

Confectionaries

,. 38

Drug Stores

. 18

Bottling Plants

. 9

Slaughter Houses

. 7

Fish Markets

. 6

Fruit Stands

. 17

Vegetable Market

. 16

Ice Cream Factories...

. 10

Candy Factories

. 3

Creameries

. 3

Totals

. 741

The gravity of this whole problem becomes at once apparent if we consider upon what conditions orders are issued. These are as follows:

Floors that are not impermeable, and that have dirt and grease accumulated on them.

Cellars with trash, rubbish, etc., not removed, not free from water, with damp and foul odors, and not well ventilated.

Sidewalls and ceilings with plastering or papering not in good condition, with an accumulation of dust, dirt and grease, in restaurants especially.

Toilets which are not separate and apart from rooms where food is prepared, stored, served and sold. For instance, not separate and apart by having no self-closing doors, no solid top to booth, no outside ventilation. In some instances no booth was provided, and only a cloth curtain was used as a door.

Living quarters which are not separate and apart from rooms where food is stored, prepared, served and sold. For instance, with door between living quarters not self-closing or with transom over door opened, or partition not reaching to ceiling-

Food not protected — Groceries, cooked meat, also fruits and vegetables inside or outside of, stores, not properly protected from dogs and all other foreign contamination.

Expectoration — Where suitable cuspidors are not provided and spitting is on floors, stoves, sidewalks, behind kegs, boxes, barrels or in dark places, or in corners or in open floor.

A detailed study of Table 3 raises some serious problems: 17.3% of orders that were issued because toilets were unsanitary. Eighteen out of 64 orders against restaurants were issued because of the condition of toilets. Again, the condition of fruit stands deserves notice. The seriousness of orders to clean up in 58.8% of the inspections is obvious when we bear in mind that a great deal of fruit is eaten just as it is sold from the stand without being washed. Further, when we consider that milk is an excellent culture media for many bacteria that are a menace to health, noticeably those producing typhoid and diarrhea, the condition of Jackson’s creameries and ice cream factories becomes a serious matter.

The above chart presents a problem with which the State Department of Food and Drugs has been grappling during the past sixteen months.

Much has been accomplished by virtue of the fact that the law enables said department to prosecute cases in which sanitary conditions are not improved.

Public sentiment must be created which will make it necessary for persons handling food to go even beyond the requirements of the law, says the inspector, if Jackson is to be a safe or fit place in which to live. During the past sixteen months 28% of the confectionaries, 52% of the restaurants, 60% of the fruit stands and groceries, 71% of the meat markets, 77% of the soft drink stands, 100% of all of the creameries, the ice cream and candy factories, the fish and vegetable markets, and 100% of all of our bottling plants, slaughter houses and bakeries have not been up to the standards set by the State Department of Food and Drugs, and these are minimum standards in public health. It is possible to keep food handling places sanitary. The inspector reports that since the State Board has been at work in the city there has been a decided improvement in conditions everywhere. The State Board deserves the co-operation of all of the citizens of Jackson. With this co-operation it will be only a question of time when food handling places will be sanitary-

HEALTH PBOBLEMS IN THE COUNTY.

To count the tally of Madison County’s disease and death record should be of positive value and should lay the foundation for constructive action. Our task, therefore, in general terms is to examine sanitary conditions; to study sickness and death records and to determine what losses the county is suffering and in what ways these losses may be prevented.

This diagram indicates that influenza reaped the greatest toll of deaths in Madison County in 1919.

Influenza must be considered as an epidemic disease. We will compare it with the next highest toll, that of infants under one year, these deaths being in a large measure preventable.

Leading Causes of Death in Madison County, 1919.

Influenza

Infants under 1 year

(Multiplicity of causes)

Pneumonia

Tuberculosis

Typhoid

Puerperal condition other than Septicemia

Accidents, Inc. Bailroad

Malaria

Table 4 — Deaths in Madison County.

Tuberculosis (all forms)

Pneumonia

Cancer

Typhoid

Malaria

Pellagra

Measles

Whooping Cough

Scarlet Fever

Diphtheria and Croup

Influenza

Cerebro-Spinal Meningitis

Diarrhea & Enteritis (under 2 yrs.)

Tetanus

Diarrhea & Enteritis (over 2 yrs.)

Infants under 1 year

Puerperal conditions

Homicide

Suicide

Accidents

Prematurity

Still-births

Influenza is an epidemic which sweeps over the country as a tire across a grassy plain, fearful and spectacular as it passes, an occurrence that may not repeat itself for a number of years. In Madison County in 1919 influenza as a cause of death represented 21.3% of the deaths from all causes. Yet year after year there is a loss of life among infants under one year which parallels and often surpasses the high death rate from influenza of last year. In 1917, sixty-seven infants under one year died in Madison County; this number exceeds the influenza death rate for 1919 by nine. The average annual death rate for infants under one year for Madison County was 54.3.

The causes of infant mortality (as indicated above) often have their inception before birth and are closely related to the care given the infant in its first weeks and months of life. Pre-natal education and nursing among mothers as well as better attendance to mothers at child-birth cannot be too strongly emphasized.

It is these same causes which are responsible very largely for an annual average of 22.2 still-births in Madison County during the past three years.

Untrained midwives constitute a serious factor in infant mortality. No midwife should be allowed to practice unless registered, trained and supervised.

Tuberculosis, or the Great White Plague, was responsible for 15% of the deaths of Madison County in 1919. The number of deaths in 1919 being even lower than the average death rate from tuberculosis for the past three years, which was 42.1. Moreover, the best medical authorities state that in every community there are ten cases of illness from tuberculosis to every case which is fatal, which means that in Madison County there were constantly over 400 persons suffering with tuberculosis during the past three years.

Typhoid, the most controllable of all diseases, had a toll of 12 deaths and 168 other cases not fatal. Its occurrence depends wholly upon infection from man to man and from infection carried by flies. Universal screening and sanitation of homes and places of handling food, coupled with typhoid vaccination, would eradicate this disease in one year, and this at a reasonable cost.

Another disease which can be controlled is malaria. It causes an annual death rate of 8.1 persons in the county.

DEFECTS AND DISEASES AMONG CHILDREN OF MADISON COUNTY.

The only index which is available to diseases and defects among the children of Madison County is that which is given in the findings made by the Field Unit of the Bureau of Rural Sanitation of the State Board of Health.

During the past six months white school children of five neighborhoods have been examined. These are representative neighborhoods and the findings may be considered as representing conditions among school children in the county. A total of 270 children were examined, and the following defects found:

Table 5 — Defects of School Children of Madison

Ear — Minor deafness 37

Major deafness 22

Foreign bodies 16 75

Nose — Minor nasal deformities 15

Major nasal deformities 14 29

Throat — Diseased tonsils 80

Grossly diseased tonsils 93

Adenoids 44 217

Teeth — Defective 125

Grossly defective 36

Pyorrhea 12 173

Eyes — Minor errors 60

Major errors 42 102

Undernourished 28

Enlarged cervical glands 25

Trachoma 2

Hypertrophed Turbinate 10

Deviated Septem 10

Goitre 3

Tuberculosis of Spine 4

Tinea Tonsurans 3

Follicular Conjunctivitis 1

Otterrhea 1

Infectigo Contagiosa 4

This study shows that in Madison County 10% of the school children are undernourished, 10.7% have nasal defects, 27% have defects of the ear, 37.8% have defects of the eyes, 41.47% have defective teeth and 80.4% suffer because of defects of the throat.

Table 6 gives the distribution of the chief defects of the examinations tabulated in Table 5 by grades. A careful study of this table shows that the greatest number of defects per child occur among the children of the lower grades. It is the opinion of the examiner that the children with physical handicaps drop out of school and that this is the explanation of the lowering of the number of defects per child in the upper grades.

Table 6 — Defects of School Children by Grades.

. P

No. of Pupils

. 18

No. Examined

. 18

Minor deafness

. 4

Major deafness

. 0

Foreign bodies

in ear

. 2

Minor nasal de-

formities

. 1

Major nasal de-

formities

. 0

Diseased tonsils...

. 6

Grossly diseased

tonsils

. 4

Adenoids

. 5

Defective teeth

. 7

Grossly defective

teeth

. 2

Minor errors of

vision

. 0

Major errors of

vision

. 2

Undernourished ....

. 4

. 37

Number defects

per child

.2

3.2

2.4

2.8

2.2

2.5

.2

1.6

1.6

.8 :

2.7

1.4

1.3

SANITARY SURVEY OF MADISON COUNTY.

The acuteness of the health problem, particularly from a sanitary point of view is indicated by the findings in a survey of an area of 36 square miles. This survey was conducted by the Field Unit of the Bureau of Rural Sanitation under the direction of Dr. C. B. Crittenden during the past eight months. A total of 278 homes — 188 colored and 90 white — was surveyed.

One hundred and sixty-one out of the 188 colored homes and 57 out of the 90 white homes had no toilet facilities whatever. Add to this situation the fact that 98% of the colored homes and 41% of the white homes had no screening and you have an explanation for 168 cases of illness and twelve deaths from typhoid each year in Madison County.