The New York herald., 1922-11-05
Nevertheless 10000 Are
Now Engaged Publicly
in This Country.
PROGRESS IS REPORTED
Even General Idea Of Health
Itself Is Changing From
Education.


embarrassments facing the student
who otherwise is willing to enter the
public health service. And there is
the constant menace of political inter-
ference in the work of municipal,
State. and national bureaus of PUBLIC
health.
Oe these things writes Dr. George
g.. Vincent. president of the Rookie
feller Foundation, in the report OF
that institution for 1921. Since July,
1913. the International Health Board
OF the foundation has spent $7,493 :
624.65 in it's battle against malaria,
yellow fever, hookworm, tuberculosis
and the like. Long strides in winning
intelligent public cooperation by edu-
cation and in scientific research made
1921 a year of great satisfaction. al
though DR.. Vincent warns that 'it is
TOO early to feel complacent."
DR.. Vincent's review of last year notes
the changing ideals OF health. He writes:
Idea of Health Revised.
Advances in the cure and prevention
OF disease reflect shifting of emphasis
and q gradual revision of the idea OF
health ITSELF Being up and around or
1 can't complain represents far from
stimulating conception of bodily prosper
,ty, yet a vertical rather than horizon
tai position Is one criterion"
The report reveals the growing de-
mand for trained leaders in public health
work. DR.. Vincent proceeds to say "In
the United States there are at present
about 10000 persons engaged In public
health work under federal, State and
municipal or county auspices. In Great
I Britain probably an equal number are
giving all their time\ to the work of pre-
ventive medicine. The number In the
service of non-governmental agencies OF
all kinds can scarcely be estimated but
may represent nearly as many more.
The self-governing dominions employ
n considerable number of professional
sanitarians In continental Europe
health organization has not as n rule
= reached so high a degree of develop
ment as In the British Isles In many
tropical countries such as India, Java,
the Philippines, both curative and pre-
ventive medicine are administered by
corps of trained government officials.
In all parts of the world there is an in
tAtdSiHB dtIldUU LOT men ana WOIfltn
competent to do different kinds of pub
lie health work.
"A forecast of the probable number
needed during the next ten years in the
United States calls for 10000 persons.
Curative Branch Magniffed.
'It Is not TO be denied that on the
whole the best ability has been drafted
into the service of curative rather than
of preventive medicine. More than four
hundred replies to questions recently
put TO students now enrolled In lead
ing American medical schools disclose
an attitude of ignorance, indifference,
even antipathy with respect 10 career
in public health work. The reasons
these young men give either for not
considering at all or for deciding against
such a life work are: % II Is not a
socially recognized. clearly professional
lied calling; (2) there are no special
schools for adequate training: C0 tenure
and promotion depend not on merit but
political 'pull;' "a salaries are meager;
C) the private practice of curative med
ioine is mgre reputable, independent.
profitable and satisfying.
These young men are in many re-
spects Nuninformed and misinformed
Preventive medicine has already gained
the status of profession and is MAX
ing rapid progress In public favor At
least two special schools of high rank
are offering a thorough and appropriate
training. An increasing number OF i'm
portant posts are freeing themselves
from the trammels of 'spoils politics.
THE salary received by a health Of
ficer of full rank probably exceeds the
income of the average private prac-
titioner.
Private practice has many disad-
vantages; excessive overtime and night
work. poor collections. the necessity of
dunning patients, little chance TO study,
constant economic pressure, a heavy
burden OF unpaid service. competition
with quacks and charlatans. tempta ton
10 surrender scientific ideals Public
health service, on the other hand, Is
making a strong appeal TO many men
and women of Imagination. courage and
social spirit just because II does not
involve most Of these things and offers
many positive attractions.
yet Il must be admitted that the
sceptlcal undergraduates are not
wholly wrong. Public ignorance and
indifference. invidious comparisons,
lack OF sound training in many officials
prejudice against law enforcement. de-
lay the full appreciation OF what pre-
veutive medicine means TO society. The
establishment of adequate schools has
Deen recent event. n rev uiShca rteu-
ing instances of political tampering
with health departments have occurred
OF late. II Is also true that the level
Of pay Is far too low. Even the few
highest salaries suffer painfully in com
rerison with the annual incomes of
leading private consultants and sur
gecns.
Politics Must ne Kept out.
"A greater share OF popular admira-
ton, larger freedom from control close
personal relations with appreclative
individuals, deeper sense of profess
slonal pride. probably are still the por-
ton OF the practitioner of curative medi-
cine.
THE cry Is frequently heard that this
governmental service or that must be
taken out Of politics. In one sense
this is absolutely essential TO efficiency.
a public function which calls for tech
nical expertness Is hopelessly handi-
capped if 1t be treated as the spoils OF
n political boss or OF victorious party
machine. To no public service does this
apply more strikingly than TO depart