Community health

Front matter

Class

Book_ < T 7 _

GopiglitN 0 __

Preface

This book, like the others in this series, has been produced in the classroom by presentation, adaptation, revision, re-presentation, and further modification. It presents both the social and the personal aspects of com¬ munity health. Its place is in the seventh or eighth grade, where the child begins to give considerable atten¬ tion to the subject of civics.

The historical approach — which presents the health problems of early settlers in America, the difficulties of those pioneers who undertook the western migration, the development of rural life, and finally the development of urban life — has many advantages. It provides a natural presentation of country as well as city health problems, of rural as well as municipal sanitation. It presents a perspective of the changes in the mode of living during the last few generations, and, what is per¬ haps more important, it allows the pupil to see the origin and need of town and city government in the mainte¬ nance of health.

The health-education program at this grade level re¬ gards continued training in the habits of healthful living as a primary objective. Many subjects and school ac¬ tivities should contribute to this end. It is often as diffi¬ cult for a child to maintain a specific habit at this age as it was for him to establish the habit at an earlier time. The Appendix presents suggestions for the organization iii

IV

PREFACE of both class and school activities in the furtherance of positive health and the health-training program.

The authors express appreciation of the continued cooperation of the School Board of the City of Malden and the Department of Biology and Public Health of the Massachusetts Institute of Technology. Particular thanks are due Superintendent F. G. Marshall and the principals and teachers in those junior high schools in which were developed the varied experimental methods and approaches from which, by the selection of the best, this course of study was gradually evolved.

Grateful acknowledgment is also made to Professor F. B. Dresslar of George Peabody College for Teachers, in Nashville, Tennessee, to Mrs. Florence Hobson, teacher of hygiene at the Fairmount Junior High School of Cleveland, Ohio, and to Miss Effie Knowlton, Director of Health Education in Binghamton, New York, who read the manuscript and made many constructive sug¬ gestions. We also acknowledge the courtesy of the Walker-Gordon Laboratories, in allowing us to use sev¬ eral pictures of sanitary milk production, and the kind¬ ness of the various national organizations and agencies through which desirable illustrations were secured.

People who have used the Malden Health Series have already made the acquaintance of our artist, Mrs. Hazel Ives. The authors feel that her contribution to the value of the book is a large one.

C. E. T.

G. B. C.

Contents

CHAPTER PAGE

I. Health . i

II. A Pioneer, Family .n

II A Pioneer Family

Do you know:

How the life of the pioneer differed from your own?

How the early settlers safeguarded their health?

What precautions were necessary in order to protect the family?

What problems the modern farmer has in keeping a healthful home?

You are all familiar with stories of the covered wagons by which families traveled from the towns of the East to make their new homes in the West. One may picture a family consisting of a man, his wife, and their children — perhaps a boy of sixteen, a girl of thirteen, and several younger children — all sharing this experience of travel¬ ing several hundred miles to a new settlement in a new and unknown land.

Usually they led their cows along with them in order to have milk. They might even carry two or three little pigs and some hens. Sometimes they would kill one of these animals for fresh meat, but usually the shotgun or rifle provided this part of the meal from the wild game along the way. A shepherd dog was always a good com¬ panion on the journey because he would care for the sheep and guard the camp. When the family reached the sec¬ tion where they expected to settle, the man staked out a ii claim, for the land belonged to the government and was given in certain amounts to people who would settle on it.

The building site, — The first problem was to choose the site for building a house. A prime consideration in this selection was the question of water supply, because water is a necessity for life. In some sections good springs were found, and these determined the location of the home. In some cases wells were dug. In constructing

THE PIONEER FAMILY SOUGHT A NEW HOME

A PIONEER FAMILY

!3 a well the wise settler chose a place higher than the land where the house was built, or so located that no waste could drain into it. When completed, the well was walled with stone and tightly covered so that hens, dogs, or people moving about at the top of it could not scatter dirt into it. The careful man thus had drinking water which was pure and a well that could be kept clean.

Another consideration in choosing the location of the home was the nature of the soil. The cabin would be placed on high rather than marshy land. Thus the set¬ tler’s family would be assured of a home that was dry and removed from mosquito-breeding pools. The man who built on a rise of land in gravel soil was very fortunate, because gravel drains easily and is good land in which to put the underpinning or foundation for a house. He was fortunate, too, if his house was built so that the sun shone upon the long side, making the rooms pleasant and dry and helping to warm the house in winter.

Domestic animals. — The pioneer’s next step was to build a stable for the domestic animals — a barn or leanto or shed. He used hay or straw for bedding. He built a pen for the pigs and a coop for the hens. These animals were useful to the family, not only in furnishing food, but also in using up the kitchen waste.

The wise man was careful about the cleanliness of his cows and the methods of milking. The milk was cooled quickly by hanging the milk pails in the well or setting the pans of milk in the cellar. All milk was kept in a clean place where dirt could not get into it.

The sensible man knew also the importance of using only healthy animals for food. Sick animals were killed and buried in the woods; meat from these animals was not eaten. The meat supply was supplemented by buf¬ falo, hunted on the plains, or bear and deer from the highlands. With his gun the settler shot down vigorous, healthy animals. He bled them properly, dressed each creature, and carried home a larger piece of fresh meat than we ever buy at the market.

Crops. — In the spring he planted a vegetable garden, in clean, fertile soil, at a place where there was no drain¬ age from the barn or toilet. He raised many vegetables, for they were an important part of his food supply. In the summer the garden supplied fresh lettuce, spinach, beet greens, corn, string beans, and cucumbers. In the fall it furnished potatoes, carrots, turnips, cabbage,

GRINDING CORN BY HAND

A PIONEER FAMILY onions, and other vegetables to be packed away in a dry place for use in winter.

The settler raised his own corn and wheat, too. Some¬ times he carried the whole grain to some place at a dis¬ tance, where he had it ground into coarse meal and flour; sometimes he himself ground it by hand or in some crude grinding machine. All the food supply for the family was raised by the settler himself, and he could guarantee its quality.

Wastes. — There was always the problem of disposing of wastes from the house. The food waste was fed to pigs and chickens, so that it was promptly taken care of without creating a nuisance. There was a sink spout to take the waste water away from the kitchen. If the set¬ tler was fortunate enough to be able to cut his own ice in winter and store it for summer, there was an ice k chest which had to be drained by a pipe. The water from the washtubs was carried a little way from the house and poured on the ground. There was no bathroom, of course, and the washtubs served as bathtubs once or twice a week. The waste water from the house was car¬ ried far enough away so that it would not cause odor or dampness. It was frequently poured over a pile of rocks or upon light gravel soil in a sunny place in order that the water might be dried up and purified by nature.

The pioneer was obliged to build an outdoor toilet, or privy, because he had no running water supply for a bathroom. One way of building such an outhouse was i6 COMMUNITY HEALTH

to dig a deep pit in the ground. He covered the pit tightly so that animals and flies could not get in. He kept the contents of the pit dry by using sand or dry dirt. Such an outdoor toilet was quite satisfactory. The manure from the stable was disposed of by spreading it on the land, where it would become part of the soil.

Keeping well. — Families living in the wilderness were not worried about measles or scarlet fever, or any such illnesses. The children played only among themselves, for there were no other children near enough to play with them. Unless they all went into town for a county fair or a rodeo, they were not likely to catch any communi¬ cable diseases, because there was no one from whom to catch them.

In the life of the pioneer all of these various health problems were, for the most part, under his own control. In order to raise good crops and healthy animals, and to take good care of his family, he had to meet these health problems. Of course some men were wiser than others, and consequently provided more successfully for their families. Some were more fortunate, and happened to make choices which were favorable to health. You can easily imagine that a stupid man would fail at pioneering. Only the intelligent and industrious man could bring up a family safely in the wilderness.

Select from this story of the pioneer the things which are related to health and write them down on paper. When we start to study community health we are con¬ fronted by many of these same problems. Most of us do

A PIONEER FAMILY not live on ranches or farms where the control of things is in our own hands. We live in towns or cities and must meet these problems in a different way.

1. Make a list of all the conditions related to health which are

mentioned in this chapter.

2. See which conditions are mentioned most frequently in your

classmates’ lists. Are they the most important?

3. Discuss the way these problems are met at your home or at

some farm or camp where you have been.

4. Answer the questions at the beginning of this chapter.

Ill

THE HEALTH OF A LARGE COMMUNITY

How much money is spent for health each year in your town or city?

How much is this per person each year?

For what things is this money spent?

Could the taxpayers of your town or city do these things for themselves on the same amount of money?

What health problems are found in cities but not in the country?

Have you ever read Robinson Crusoe or Swiss Family Robinson? In these stories there were no problems of government. So it was with the pioneers, for their homes were far apart. But as others came, settling nearer and nearer, communities were formed. Then common in¬ terests developed, common difficulties appeared. Local government was established.

As you study civics you learn the purpose and nature of government. You may have thought of it as a means of having things done for the people. See if your class can agree upon a definition of government.

Government. — In the Declaration of Independence of the United States there is this statement of the rights of people in government: “ We hold these truths to be self-evident: That all men are created equal; that they are endowed by their Creator with certain unalienable

THE HEALTH OF A LARGE COMMUNITY 19

rights; that among these are life, liberty, and the pursuit of happiness.” These, then, are the recognized rights of each human being: life , liberty , and the pursuit of happiness . If one lives alone, like Robinson Crusoe, no one interferes with these rights, but when people live in towns or cities it is fairly certain that some will not regard the rights of others. Some system of government must be formed.

Each person is guaranteed personal liberty, but if he goes beyond his rights and interferes with others the reg¬ ulations of government compel him to stop. What is meant by the sentence: “ Personal liberty ends where the acts of the individual interfere with the public welfare ”?

You may ask whether health is part of these “ unalien¬ able rights ” under government. Is health an important part of life? Surely we are more concerned over the loss of health than over the loss of money. Is health related to happiness? It is possible, of course, to have a large share of happiness without health, but health is a decided aid in the search for happiness.

One duty of government, then, is to protect the health of each citizen. Another function of government is serv¬ ice — that is, doing things for the people. For example, education is provided for all the children of the commu¬ nity. Would it be practicable to hire a separate teacher for the children of each family? It would be very expen¬ sive even in a family with three or four children.

The Swiss Family Robinson had to build their own roads. What a burden it would be if we had to build a road to wherever we wanted to go! It is easy to see that the best way to have good roads is for people to join to¬ gether and pay for having them built. In the city there is a Street Department. We pay money through taxes, and this department builds better roads than we ourselves could build.

Health problems. — In the country a man either keeps a cow himself or buys milk from a neighbor. He can visit his neighbor’s barn and see for himself how the milk is handled. Most of you get your milk from a milk dealer; you cannot go to the farms where the cows are. Your government accepts the responsibility of seeing that the milk is pure and clean.

How many of you get water from your own well? How do you know that the water is pure? In using a city water supply, you cannot see where the water comes from. You rely upon your government to safeguard the water supply.

Do any of you keep pigs and kill them for pork in the fall? How many of the families represented in your class raise chickens? Most of us have to buy meat which comes from a distance. We cannot see for ourselves thdt it comes from healthy animals.

How many of you buy bakery food? Perhaps you could go into the bakery kitchen and see how the food is cooked, but you are not likely to do so. Some one from the Health Department makes sure that the food is clean and wholesome.

THE HEALTH OF A LARGE COMMUNITY

It is quite clear that you and I should be in danger unless some one did these things which are necessary to safeguard our health. The branch of the government which does this work is the Board of Health or Health Department.

If you review the things which are important in main¬ taining the health of the home, you will see that there

22 '

are similar problems in keeping a city clean and well. Look over the following list of problems which have to be met in both country and city. Discuss the way these problems differ in the country and in the city.

Problems of Cleanliness

1. Securing clean and wholesome food.

2. Securing clean water.

3. Providing sewage disposal.

4. Removing ashes, rubbish, and kitchen waste.

5. Avoiding dust and smoke.

6. Preventing rat nuisance, mosquito nuisance, and fly nuisance.

7. Securing proper bathing facilities.

Problems of Disease Prevention

1. Providing immunization against smallpox, diphtheria, and

some other diseases.

2. Preventing the spread of disease.

Problems of Providing Recreation

1. Giving opportunity for games and sports.

Problems of Comfort

1. Securing comfortable housing.

2. Securing proper heating and ventilation in public buildings.

3. Securing proper lighting in public places.

Problems of Safety

1. Control of fires.

2. Control of traffic.

3. Police protection.

In addition to the health problems which exist in both the country and the city, there are certain problems which are peculiar to the city alone. There is, for ex¬ ample, the problem of city planning. A well-arranged

THE HEALTH OF A LARGE COMMUNITY

A TYPICAL GROUP OF CITY BUILDINGS city cannot grow up without a plan any more than a good house can be built without one. The streets must be laid out properly. Some cities have made a wise provision by planning for the kind of building to be done in differ¬ ent parts of the city. One section of the city is set aside for factories and large business buildings, while another part is set aside for homes. Such a plan is usually called a Zoning System.

To maintain the health of a large community is a com¬ plex problem. In meeting this problem there is a double responsibility: (1) that of the city government to render sound, scientific, faithful, and honest service; (2) that of all citizens to give loyal and intelligent support. Will you do your part?

1. Why is it worth while to spend tax money upon health?

2. What divisions in the city government do things which are

related to health?

3. What kinds of health work does your city do?

IV Is life possible without water?

How is it possible for mold spores to stay alive in dry dust?

Is there any plant or animal which can grow without water in some form?

What are the uses of water on a farm?

What are the uses of water in a city?

What would happen in the place where you live if there were no water for two weeks?

What kind of water is necessary for drinking purposes?

How much water does your city use each day?

How does a big city get a satisfactory supply of drinking water?

Importance of water. — Water is a necessity for health. Indeed, nothing can live without it. The body itself is about two-thirds water; the soft parts of the body, like muscle and brain, are three-fourths water. Every living thing contains a high percentage of water.

Spores of mold can stay alive in dry dust because a thick wall is formed around the living substance. This wall prevents the small amount of water from drying out. Mold plants cannot grow, however, until a spore gets back to a place which is warm and moist. You have noticed how grass and flowers freshen up and grow when there has been rain for a few days. Abundance of water is one of the first essentials for maintaining a healthy plant or animal.

“ Drink at least four glasses of water a day ” is one of the first health rules you learned to practice. By now you have probably increased the amount to six glasses or more each day. You have learned that the circulation of fluids in the body is one of the most important activities which go on in the human mechanism. These fluids bring food and oxygen to the tissues and carry away the waste products. You have seen the importance of water to good digestion and proper use of food by the body. It has been shown that man can live for a month or more without food, but he can live only a few days without water. Have you ever read tales of men lost in the desert, without water, or afloat in a small boat at sea without fresh water to drink?

The farmer knows that he must have a good supply of water for his animals, as well as water in the land to make the crops grow. In the city, water is used in hundreds of different ways. It is used for cleanliness about the home, to water the lawn, to wash the streets, to put out fires, to supply power for mills, and to help in many kinds of man¬ ufacturing processes. You could prepare a rather long list of the particular uses for water which you have seen in your own town or city.

Selecting a water supply. — Every pioneer in the early days made sure of a good water supply before he started to build his house. How utterly foolish it would be for a man to say that only a few quarts of water a day were needed for drinking, and that it could be brought to the house from some distant place. Unless water is close at hand and easy to secure, there is danger that people will not drink enough to maintain perfect health; and cer¬ tainly proper cleanliness is difficult to secure when the supply is scanty.

What quality of water does the pioneer try to secure? Does he wade out through the mud and grass of a swamp until he is knee-deep in water, and then put down a pipe through which he can pump? You recognize this as a silly procedure, of course, but do you know the exact reasons why such a water supply would not be good?

In the first place, swamp water is usually yellow or greenish in color; it may even be somewhat blackened if the soil of the swamp is very dark. You can easily see that water which is colored is neither attractive to drink nor practicable to use for bathing and laundering. The color of swamp water comes from plants which have been soaking in the water and from the muddy soil. This color is not injurious to health, but it makes the water undesirable.

Standing water is often green in color, not from the / large green plants which have been growing in it, but from tiny green plants which are floating there. These plants, which are called algae, are so small that they can¬ not be seen except through the microscope. They are as harmless as grass, and it probably does us no more harm to drink water in which there are algae than to eat a very thin vegetable soup. The greenish color is unattractive, however, and frequently there is an unpleasant odor. When water contains plenty of dissolved food material for these plants they grow in sunlight with great rapidity until there are thousands of them in every cupful of water. There is one variety of alga which has an odor like a rose gera¬ nium; another which has a rather grassy odor; others have odors not so pleasant. In looking for a water supply, there¬ fore, we should avoid water from a swamp, because such water is likely to have a disagreeable color, taste, and odor.

We should also avoid water which is roily. Have you ever seen roily water? Shallow water is so much dis¬ turbed by a hard rain that particles of mud are picked up by it. Such water is said to be roily, or turbid. River water often picks up mud. The Mississippi is spoken of as a turbid river.

Sometimes there are traces of iron in the soil which give the water an iron taste like that of water which has run through new iron pipes. Iron may also give a cloudy yellow color and leave rust spots on clothes when they are washed.

The pioneer, or settler, would refuse swamp water

MICROSCOPIC GREEN PLANTS IN WATER because of its temperature. In a northern climate the whole swamp would freeze in winter. In warm weather swamp water would be unsatisfactory, too, because it would be so warm that no one would like to drink it.

Water is likely to contain harmful bacteria if it is lo¬ cated where body wastes from men or animals may drain into it. The pioneer would be in little danger of finding polluted water, however, because he would be in a loca¬ tion practically uninhabited.

In selecting a water supply one would look for a spring of clear water bubbling up out of the cool ground of a hillside, or dig a well to bring up the clear, cool water which is slowly moving through the ground at some dis¬ tance below the surface. This water has soaked through from the surface, of course, but it has been purified by filtering slowly through the deep layers of the clean earth. It is cool, clear, and tasteless.

Springs and wells may not always remain safe, how¬ ever, unless properly protected. In the first place, a spring or well should be located in such a way that dirt from the toilet or stables will not run into it. A well should be properly built, so that it is protected from all kinds of surface drainage. The top should be surrounded with a layer of cement or concrete which extends into the ground for a short distance. The covering on top of the well should be tight. Wells which are not properly built are open to pollution, and frequently such wells are the means of spreading disease. Springs need to be protected, too, if their purity is to be maintained. A spring may be covered with a boxlike structure which has a pipe through which the water may run.

Water from springs or wells ought not to be too hard. In soaking through the ground, water sometimes picks up mineral substances which change it from soft water which fell upon the ground as rain to a very hard water, with which one must use a large amount of soap in washing. What experience have you had with hard and soft water?

Sometimes a farmer brings water from a spring on a hill directly into his house. He is careful to use a gal¬ vanized iron pipe to keep the water pure, for long lead pipes would poison the water.

Qualities of good water. —The questions which the pioneer or the farmer asks in regard to good water are the same ones that you need to consider if you are secur¬ ing a water supply for a camp in which you expect to spend the summer. Indeed, they are essentially the same questions that a city must ask in selecting its water supply:

1. Is the water free from color?

2. Is the water clear — that is, free from suspended matter like

sand or clay?

3. Is the water free from odor?

4. Is the water free from iron?

5. Is the water cool?

6. Is the water soft enough?

7. Is the water free from lead or other poisons?

8. Is the water free from waste material which may contain

germs of communicable diseases?

City water supplies. — It is not easy to get a satis¬ factory water supply for a big city because the city needs not only the right kind of water but also a tre¬ mendously large amount of it. Sanitary engineers who plan city water supplies provide water for American cities on the basis of a hundred gallons a day for every person in the city. We do not actually require one hundred gallons each for personal use, of course. Large amounts are used about the house, in factories, in putting out fires, and in sprinkling streets or cleaning them. How much water is needed per day for your city?

The city, like the pioneer, must choose between a surface water supply from rivers, streams, or lakes, and a ground water supply from large, deep wells. Occa¬ sionally a city may be fortunate enough to have an ideal water supply near at hand. Back in the hills somewhere, there may be lakes of clear water which are fed by springs and by drainage from hillsides where no one lives. The water falls as rain upon the hillsides and soaks into the ground, making its way through sand or gravel down to the lakes. In moving through the ground the water leaves all of its dirt behind and comes to the lakes clear and cold. From these natural reservoirs it flows downhill to the city, where it is distributed to houses and factories.

As a city grows and the country about it becomes more thickly settled, the^e is greater difficulty in securing a safe and sufficient water supply. New York brings part of its water supply from the Catskill Mountains,

WATER SUTPLY

3 1 a distance of many miles. In many places the only water available is soiled with the wastes from houses and factories. There are various ways of purifying water supplies.

Water purification. — The most dangerous substances likely to be in a water supply are those which come from the wastes of the human body, because they contain bacteria from the intestinal tract. Water which has been soiled by the entrance of body wastes is said to be polluted. It is easy to see that such water must be purified before it can be used as a drinking-water supply, If typhoid fever germs get into water, from the body wastes of a person who has typhoid, they may live in