CHARLIE MAGNE R.

MAGCALAS

BSN 3-1

Archives consist of articles that originally appeared in Collier's Year Book (for events of 1997 and earlier) or as monthly updates in Encarta Yearbook (for events of 1998 and later). Because they were published shortly after events occurred, they reflect the information available at that time. Cross references refer to Archive articles of the same year.

1950: Public Health

The Public Health Service, a constituent unit of the U.S. Federal Security Agency, was established in 1798. It is organized in four major administrative units, under its basic law, Public Law 410, passed in 1944 and amended in succeeding years. During the decade 1940-1950, a dozen new programs were added to the growing activities of the Service, and during the same period, annual appropriations increased eight-fold. Funds available for 1950 totaled more than 321 million dollars. The staff of the Public Health Service, as of July 1, 1950, included approximately 17,000 employees, 2,152 of whom were commissioned officers. Research and Aid to Research. The research function of the Public Health Service was carried out by seven National Institutes of Health. Of these seven institutes, two were newly created by act of Congress in August 1950: The National Institute of Arthritis and Metabolic Disease, and the National Institute of Neurological Disease and Blindness.The startling discovery of therapeutic action of two hormones cortisone and ACTH (adrenocorticotropic hormone) provided a clue for promising research into the basic mechanisms of many diseases. The Institute of Arthritis and Metabolic Disease was established to explore the action of these and related materials and to investigate the causative factors in diseases such as arthritis, glomerular nephritis, and diabetes; it would also absorb the functions of the former Institute of Experimental Biology and Medicine, which had been abolished. Five other institutes Cancer, Heart, Dental Research, Mental Health, and the Microbiological were to continue to inquire into specific disease problems, in addition to carrying on basic research. Further investigations outside the Federal Government were stimulated by a system of grants and fellowships administered by the Public Health Service. Research investigations of a variety of types were carried on in many parts of the Service, although most basic research was conducted by the National Institutes of Health. Each operating program required some special kind of research. A Research Planning Council with representatives from each bureau reviewed all research projects conducted in the Public Health Service and made recommendations on the entire intramural research program. The National Microbiological Institute conducted research on all types of micro-organisms that produce disease in man. It also administered the Biologics Control Law of the United States, ensuring the safety, potency, and purity of biologicals sold in interstate traffic. In 1950 a new vaccine, which is effective for at least one year in the prevention of mumps, was perfected and placed on the market. Also, during the year, investigators identified a number of chemicals having a lethal effect on certain types of snails that act as hosts to the worm-like parasite of schistosomiasis. This disease affects 115 million people in the Far East and in Africa.

Virus disease studies included research on the common cold, poliomyelitis, influenza, rabies, and encephalomyelitis. Other studies showed the effectiveness of auromycin in the treatment of whooping cough. It can be taken by mouth and will facilitate the treatment of children at home. Tropical disease research was focused on anobiasis, schistosomiasis, onchocersiasis, and African sleeping sickness. Chemotherapy of malaria continued to be an important field of study. The National Cancer Institute conducted much fundamental research; aided clinical and basic research; trained research scientists and clinicians; aided medical and dental schools in improving their undergraduate cancer-training programs; and conducted a cancer control program. Fundamental research in cancer included studies in pathology, endocrinology, biochemistry, biophysics, biology, and chemotherapy. The year 1950 saw the completion of a five-year search for specific chemicals capable of destroying cancer. Of some 2,500 chemicals tested, 125 offered promise in their damaging effects on cancer. These chemicals will now be submitted to further investigation to determine which of them may be used with safety and success on clinical patients suffering from cancer. Also, the thymus gland was found to have a significant connection with the incidence of leukemia. Using young mice of a strain that usually die of spontaneous leukemia, investigators showed that total removal of the thymus prevented leukemia in most of the animals. In 1950 grants-in-aid totaling $3,500,000 were expended for cancer control work; one third went to state and local health departments, hospitals, universities, and other institutes. Medical and dental schools also received funds to assist in professional instruction in cancer. The National Institute of Dental Research devoted much of its efforts to investigation of the causes and control of the nation's most prevalent disease dental caries. In 1950 much work was being carried on in the study of fluorides and their effect on decay. Investigators were attempting to assess the value of supplementing communal water supplies with fluorides as a caries control measure. In research efforts, however, emphasis was placed on basic problems underlying and contributing to pathologic conditions of the teeth and their supporting tissues. For example, by use of methods made possible by such advanced instruments as the electron microscope and the electron diffraction apparatus, investigators were progressing on studies of the structure and composition of the teeth and the influence thereupon of normal and experimentally produced environments. Gains were also made in three major sectors of the mental-health program during the year: research, aid to research and training, and community mental health services. The total program was being developed by the National Institute of Mental Health. While its facilities for conducting research were very limited, some expansion had been possible, and a small laboratory was established at the National Institutes of Health. Also, the mental health center at Phoenix, Ariz., was reorganized as a research project, and research at the Public Health Service Hospital at Lexington, Ky., was increased. Many important achievements were accomplished through grants-in-aid to the states for mental-health programs. In addition to approximately $3,300,000 in grants, advisory services were supplied by the Institute, its regional consultants, and by the members of the National Advisory Mental Health Council.

Steady progress was being made against America's leading cause of death: diseases of the heart and circulation. A vast research effort, buttressed by the support of many agencies, public and private, was well under way in 1950, the National Heart Institute of the Public Health Service providing leadership and co-ordination for the overall program. Direct activities of the Institute, however, were focused primarily on research and training, while control aspects of the program were administered by the Division of Chronic Diseases. Considerable expansion, in keeping with the magnitude of the problem, was made possible in research, training, and control activities. With respect to the exceedingly complex heart-disease problem embracing more than 20 diseases of the cardiovascular system, the greatest need in 1950 was for more knowledge of the causes, additional methods of diagnosis and treatment, and new curative measures. An example of one research activity was the development of a powerful new drug, procaine amide, as an effective treatment for irregular heart beat or palpitations. The drug acts quickly and, what is more important, it can be taken by mouth. Grants and Fellowships. For the year 1950, 1,556 applications were approved for Public Health Service research grants totaling $14,200,000, compared with 1,091 grants totaling $10,800,000 in 1949. In 1950 general medical, public health, and basic sciences received 713 grants, totaling $6,000,000; cancer 354, totaling $3,200,000; cardiovascular 388, totaling $4,000,000; mental health, 67 grants, totaling $805,000; and dental research, 34 grants, totaling $200,300. Medical Services. The Bureau of Medical Services of the Public Health Service includes the Division of Hospitals, Division of Hospital Facilities, Division of Foreign Quarantine, and three Resource Divisions Medical and Hospital Resources, Nursing Resources, and Dental Resources. The Division of Hospital Facilities administers the Hospital Survey and Construction Act, under which Federal grants are made to State hospital agencies for the construction of facilities included in the state's survey and plan. In 1950 the Public Health Service operated 19 general hospitals, two tuberculosis sanatoriums, two psychiatric hospitals (originally established to treat drug addicts), a leprosarium, 19 clinics, and 100 'outpatient' offices. These facilities are maintained for the care and treatment of legal beneficiaries of the Public Health Service, primarily merchant seamen, the Coast Guard, and Federal employees injured at work. During the fiscal year 1950, nearly 80,000 patients were admitted to the hospitals. The number of visits to the outpatient clinics totaled slightly more than one million. Many clinical research and training projects were carried out at these hospitals. Professional personnel of the Service also provided medical care or medical administration in many other Federal agencies. As a result of financial and planning stimulus, striking advances have been made in the past three years in the construction of hospitals and health centers. Under the National Hospital Program, the Service has stimulated local communities to construct health facilities, and it has allocated grants for this purpose. By June 30, 1950, 1,300 projects

had been approved, 300 were in operation, and 500 were under construction. When these projects are completed, the United States will have 65,000 additional hospital beds and 250 new health centers. Nearly one billion dollars had been spent on construction by the end of 1950; of this total, the Federal contribution was about 345 million dollars. The great majority of the new facilities were small hospitals, located in areas of greatest need and lowest income. The Public Health Service administers the quarantine laws and regulations of the United States, and it also acts as the medical branch of the Immigration and Naturalization Service. All persons seeking visas to the United States for immigration, travel, study, or business are examined. All persons passing through United States ports of entry and border stations, including American citizens, are inspected for the presence of quarantinable disease. Inspection of ships and aircraft arriving at ports of entry from other countries is part of the foreign quarantine procedure. Despite increased international travel, not a single case of cholera, yellow fever, or plague was brought into the United States during 1949 and the first ten months of 1950. A single case of smallpox and one of typhus fever were imported but were controlled without further outbreak. The foreign quarantine service made 1,660,000 examinations of aliens. This included examination of 137,481 displaced persons. Services to the States. Close working relationships are maintained with state and local health authorities. To assist in developing better health services for the United States, the Public Health Service administers grants to states, gives consultation on request, and demonstrates new techniques. In 1950 approximately 100 million dollars in grants was certified for payment to the States and territories. More than half this sum was expended for hospital construction. The balance, approximately $45,000,000, was allocated for general health, control of tuberculosis, heart disease and cancer, mental health activities, and industrial waste studies. The Federal sum distributed for these purposes represented an increase of $5,500,000 over 1949 but was less than 20 per cent of the total national investment for public health services. A high level of general sanitation is necessary to general health. The Public Health Service aids the states in developing standards and methods of protecting foods, milk, and water from contamination. Special attention is given to municipal and rural sanitation, to protection of shellfish and maintenance of standards of sanitation aboard interstate and international carriers. A field center has been established to serve as a focal point for all environmental research activities. The effect of housing on health, the treatment of sewage and industrial wastes, the health hazards associated with radioactive materials are but a few of the problems under investigation within the Service. Studies of the bactericidal action of high-frequency sound waves have revealed that some strains of bacteria are killed by ultrasonic exposure. The work is of great potential significance for preventing the spread of infection. Abatement of water pollution was recognized as a major national problem with passage in 1948 of Congressional legislation authorizing $22,500,000 for sewage-treatment plant

construction loans, and $1,000,000 for research. By the end of 1950 no construction loans had been made, but research was already underway. Three new interstate compacts were created, bringing the number of interstate agencies to ten, serving 29 states. Since the smog disaster in Donora, Pa., in 1948, followed by a very thorough health survey, many communities have requested studies of air pollution. In 1950 one of these studies was being conducted over the international boundary between Windsor, Ont., and Detroit, Mich. Investigations also were made of poisoning from metal fumes, gases, resins, and other industrial substances. The use of atomic energy poses a whole new set of public health and environmental problems, and measures were being developed to safeguard against radiation hazards of all kinds. The level of health among American workers was extraordinarily high in 1950, a result not only of the vigilant efforts of health agencies but also of collaboration of these agencies with management, labor organizations, the insurance industry, and other groups. In addition to research and medical care, the Public Health Service operated in 1950 many programs for the prevention and control of disease, with markedly successful results. For example, the United States moved closer toward the goal of conquering venereal disease. A steady downward trend was noted in the total number of reported cases of syphilis and gonorrhea. Admissions to rapid treatment centers dropped 19 per cent below the 1949 figure. Only congenital syphilis failed to show a substantial decrease. In co-operation with the Children's Bureau, a concerted effort was underway to combat syphilis in pregnant mothers and in infants. During the year the Service assisted 32 states in mass testing, contact investigation, and public appeal. The projects affected about 17,000 communities, with a total population of approximately 68 million. A nation-wide attack on tuberculosis, launched in 1944, is reflected in a decreased death rate. The rate for 1949 was estimated at 26.2 per 100,000 population, a decline of more than 35 per cent under the rate in 1944. Case finding by the mass survey method has expanded rapidly. During 1950 over two million X rays were taken in community-wide surveys, with equipment and personnel provided by the Public Health Service. Malaria continued to decline in the 13 southeastern states where intensive campaigns to eradicate the disease were being conducted. Continuing investigations were also being carried out for control of plague, leprosy, poliomyelitis, typhus fever, and other diseases. More than 25 million people in the United States suffer from long-term illnesses. These cause 75 per cent of the deaths in the United States. New administrative machinery has been set up to attack chronic illness on four broad fronts: prevention, early diagnosis, rehabilitation, and development of community services for the ill and aging. Pilot studies in obesity control are underway and other special projects are focused on diabetes, heart disease, cancer, and nutrition. The concept of multiple screening, which combines in one procedure a variety of tests for syphilis, anemia, diabetes, blood type, defects of vision and hearing, tuberculosis and heart disease, was receiving increased impetus at state and local levels. New projects for home care of the chronically ill were also being explored. Auxiliary services such as administration of grants-in-aid, budget and program planning, recruitment and training of personnel, vital statistics, public health nursing, and public education provided the basis for public health programs. In the field of vital statistics, for example, long-range programs of birth and death registration and

standardization of morbidity reporting were administered in addition to carrying out special statistical projects. World Health Progress. The Public Health Service continued to battle for health on world levels in 1950. In May Congress passed legislation authorizing a long-range program of technical assistance to under-developed areas; this was known as the Point IV Program. Under this program, assistance will be given in many fields, including that of health. Almost half the people of the world are prey to disease and hunger, and control of disease has become part of America's overall efforts for global peace and freedom. World health progress was substantial during 1950, and in many areas where disease had reached alarming heights after World War II, internationally-supported public-health activities began to bear fruit. The Public Health Service played an active part in the work of the World Health Organization, and Service technical personnel served in many capacities. Public Health Service missions continued to operate in Liberia, Greece, and the Philippines at the request of those governments. During 1950 special missions were sent to Indochina, Iran, Korea, and to Latin-American countries. These programs were designed to stimulate peoples to self-help by demonstration and training, and through improved health to lift their economic productivity and social vitality. Health in the United States. The general death rate has been declining for the past two decades in the United States. In 1949 it decreased to a record low of 9.7 per 1,000 population, as compared with 9.9 in 1948. Life expectancy in 1900 was 49 years; a person born in 1950 could expect to reach 67. These added years reflect gains in control of communicable disease but pose a new problem in national health the problem of the aging and of long-term illness. The era of quick death from large epidemics seems to have passed; the slow killers have become the nation's outstanding health enemies. Chronic illness has emerged as a major public-health problem of the mid-century, with heart disease and cancer topping the list of the nation's most frequent killers. Great strides have been made in conquering diseases that were once widespread. Infectious diseases such as diphtheria and smallpox have been reduced to a negligible threat. Efforts to control tuberculosis, malaria, and venereal diseases have been markedly successful. New lows were reported in 1949 and in the first ten months of 1950 for diphtheria, malaria, scarlet fever, typhoid fever, and smallpox. A flare-up of poliomyelitis, which reached a record high in 1949, subsided somewhat during the first ten months of 1950, although the disease remained more prevalent than in preceding years. During the same period, a rise was reported for influenza, whooping cough, and meningitis. Despite much progress, there remained problems in the spread of communicable disease and in the uneven distribution of health services at local levels. An adequate supply of health personnel doctors, dentists, sanitary engineers, nurses, and auxiliary staff, as well as a sufficiency of health centers and hospitals, are essential to the maintenance of national health. The quality of training and education also affects the quality of patient care. Increasing the health resources of the nation to meet both national and local needs was of paramount concern to the Public Health Service in 1950 as the nation moved into a period of mobilization when large numbers of specialists in the health field might be withdrawn from civilian occupations. To counteract the risk of disrupted services, efforts were being made to increase the number of candidates in the

health professions, to improve educational programs, to estimate minimum essential civilian requirements, and to plan for orderly distribution and most efficient use of existing personnel. Studies of experience in the United States and other countries during World War II were in process, as well as a specific study in the Pittsburgh area of minimum medical requirements of an industrial area. Other studies were undertaken to assure the nation of the adequate medical, dental, and nursing resources. Source: Microsoft Encarta 2008. 1993-2007 Microsoft Corporation. All rights reserved. REACTION:

The continuous efforts of different medical organizations and nursing associations together with the governments programs were indeed fruitfulthanks to statistics. When I first look at statistics, it may seem that it is far related to medicine especially nursing but as I dig in deeper and analyze, it is truly as helpful and important. Through statistics, many diseases that were spreading across a certain country can be monitored and given a lot of attention in order to eliminate the cases, as well as to prevent deaths.

As a nursing student, I am very glad that medicine and statistics came at par to some extent that it has been able to improve the quality of medical services and has been improving the quality of the lives of the people. As we all know, many different diseases are constantly large rate of mortalities; research and experiments have been, in my opinion, the best and most effective way to decrease the incidence and increase the survival rate.

Treatment, risk factors, and new development of preventive measures on a wide variety of diseases and conditions have been introduced to the clientele, with a guaranteed effectivity and a low risk of adverse effectsthanks to STATISTICS.

I certainly did reflect on the topic about what if statistics has not been able to incorporate with medicine. I assume that the delivery of health care to the clients would be very meager, which would cause a lot of fatalities for sure. Being able to research more about the importance of statistics in nursing, Ive been able to realize on how vital it is for us to look at the figures first.