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Twenty-one of these communities have a full-time medical inspector, 17 of whom are employed by the board of education. The remainder are employed by the county, city, or State and probably give only part of their time to the schools.

A part-time medical inspector is reported by 431 superintendents, 230 of whom (56 per cent) are employed by the board of education; 59 are county, 53 city, 45 State, and 11 district health officers. The Parent-Teacher Association employs one. Eight physicians give their services without charge.

In 299 communities (29 per cent) there is a full-time nurse. In 231 she is employed by the board of education and probably devotes all her time to the schools. In 345 (34 per cent) there is a part-time nurse (a total of 63 per cent of schools with nurses). In 106 communities these are hired by the school board, in 89 they are county nurses, in 35 they are city nurses, in 22 Red Cross nurses, etc.

Fifty-one (5 per cent) superintendents report a “special health supervisor," 49 of whom are employed by the board of education.

In 545 (54 per cent) there is a physical-education director, 481 of whom are employed by the local board of education, six by the county, 16 by the district, 28 by the city or town, etc.

Health Examinations

According to these reports from 826 superintendents their teachers are daily on the alert for signs of communicable disease and an even larger number, 903, state that pupils with such diseases are promptly isolated. This is all too good to be true.

In 900 of these communities pupils are weighed and measured. In 8 they are weighed weekly, in 348 monthly; in 178 less often but more than twice a year, in 182 twice a year; in 136 yearly, in 5 every 2 years, in 1 every 4 years. In 70 per cent therefore the children are weighed at least twice a year. In 349 this is done by the teacher, in 305 by nurses, in 138 by nurse and teacher.

A general medical examination is given yearly in 533 (53 per cent) of these communities. In about 500 it is given by a physician.

In 864 (86 per cent) the eyes of the pupils are examined. In 747 this is done yearly or oftener.

In 298 it is done by nurses, in 128 by teachers, in 221 by a physician. (It is somewhat puzzling that these figures for examinations by physicians do not equal or exceed those for general medical examinations).

In 829 the hearing of pupils is examined. The frequency and the examiners are about the same as for vision.

In 847 localities the teeth are examined, in 596 places ycarly, in 102 twice a year, in 11 monthly. The examinations are made by a dentist in 204 of these schools (20 per cent of all); by a nurse, dentist, or doc

tor in 68; and by a dentist and doctor in 13. In all a dentist is mentioned by 285 (28.5 per cent) of the superintendents answering the questionnaire.

A general clinic is available for examination or treatment of children in 282 towns. In 111 it is a traveling clinic, and 223 are free clinics. Only 34 of these are under the direction of boards of education. Fifty-two are maintained by county health departments, 49 by State departments, 24 by local hospitals, 10 by nurses, 7 by physicians, 5 by Parent-Teacher Associations, etc.

The eye clinics reported are 136, of which 98 are traveling clinics. (Probably these also diagnose or treat nose and throat conditions.) These are all free. Only 14 of these are under the jurisdiction of departments of education.

In 305 towns (35 per cent) there is a dental clinic, of which 189 are traveling and 183 are free. These are under the department of education in 69 communities; 33 are supported by private agencies (dentists?), 40 by dentists, 11 by the Red Cross, etc.

Mental Hygiene “Psychological clinics" are reported by 126 superintendents (12.5 per cent). These are traveliny clinics in 75 instances and 63 are under the direction of the State. Seven are county clinics; 6 university clinics; 3 research clinics, and 10 others are maintained by private associations. There is no charge in 104 of these clinics.

One hundred and forty-three “other” clinics are reported, 59 of which are traveling clinics. Doubtless these are mostly Dose and throat clinics, and do not wholly duplicate the clinics already men. tioned.

Health Education Health education is reported by 973 superintendents (97 per cent). In about 50 per cent of schools it is given in all grades. Some degree of correlation of hygiene with other subjects is made in 58 per cent.

Noon lunch.There is provision for a noon lunch in 1,980, or 26 per cent of these schools. In 442 of the school districts this is supervised by the teacher, in 123 by the home-economics teacher, in 18 by the Parent-Teacher Association, in 3 by a dietitian, in 2 by janitors, and in 2 by a nurse, etc.

Physical Education In 812 towns a regular time is set apart in the curriculum for “physical education.” A gymnasium is reported in 15 per cent of schools (probably mostly high schools). Nineteen per cent hare play rooms. Playgrounds are reported for 90 per cent of the schools.


In these schools 374 superintendents feel that their health work is satisfactory and 244 think it is fairly so (about 60 per cent in all). Besides lack of funds, personnel, and organization, the need of welltrained teachers is mentioned by some of the superintendents.

Rural Communities

Reports from County Superintendents

Roughly 50 per cent of 2,930 county or district superintendents responded to our questions.

In 1,500 counties which reported the number, there were 100,566 schools with an enrollment of over 6,500,000 pupils (about onefourth the total school attendance). This does not represent an exclusively rural population, however, as a number of cities are included in this enrollment). There are 65,650 ope-room schools in these counties and districts, and probably about 20 per cent of the children attend these schools.

Thirty per cent of the superintendents report that there is no one in charge of their health work, which, judging from the other reports, is equivalent to saying that no special worker in this field is employed.

In the remaining counties the “health work is in general charge" of the county health officer in 486 (about 32 per cent), a nurse in 272 (18 per cent), a physician in 126 (8 per cent), the county superintendent in 105 (7 per cent), a nurse and doctor in 26 (2 per cent), the Red Cross in 6, a physical educator in 3, State department of health in 12, and by miscellaneous agencies (including a coal company) in the remainder.

There is a full-time medical inspector employed in 170 counties (11 per cent). He is employed in 102 cases by the “county,” in 1 by the "district,” in 12 by the board of education, in 4 by the city, in 26 by the county and State, in 6 by the State, in 2 by a "private agency," in 1 by the Red Cross, etc.

A part-time medical inspector is employed in 410 counties (27 per cent). He is employed by the county or district in 162 instances, by the board of education in 116, by the State (county and State?) in 33 counties, by the board of health in 25, by the county and State in 19, and by miscellaneous agencies in the remainder.

There is a full-time nurse in 415 counties (27 per cent) (about the same number as for part-time physicians). She is employed by the “county" (agency not specified but probably health department) in 186 counties, by the board of education in 100, by the Red Cross in 26, by the “board of health” in 14, by the “State" in 7, by the "county and State" in 29, etc.

A part-time nurse is employed by 341 counties (22 per cent) which makes a total of about 50 per cent of counties having some kind of a nurse (about 40 per cent have some kind of a physician). This parttime nurse is employed by the county (board of health?) in 108 instances, by the board of education in 58 counties, by the Red Cross in 46, by a tuberculosis association in 25, by the State in 23, county and State in 14, department of health in 18.

There is a special health supervisor in 83 counties (6 per cent). Forty-nine of these are employed by the county," 9 by the board of education, 8 by the State, 3 by the county and State, 4 by the board of health.

A physical-education director is employed by 266 counties (19 per cent). He is employed by the board of education in 190 cases, in 34 by the “county,” in 22 by the State, etc.

Nine hundred and six superintendents (about 60 per cent) state that the teachers inspect the pupils daily for signs of communicable disease and 1,229 (80 per cent) report that pupils having such defects are promptly isolated and sent home.

In 925 counties (about 60 per cent) the pupils are weighed. In 262 counties this is done yearly, in 192 twice a year, in 333 monthly, in 85 over twice a year but not monthly.

In 410 counties the teacher does the weighing, in 292 the nurse, in 82 the county or school doctor, etc.

In 990 schools the children are measured. In 561 counties this is done yearly, in 50 twice a year, in 9 monthly, in 44 every 2 years, in 20 every 3 years, etc. In 390 the measuring is done by the teacher, in 316 by the nurse, in 93 by the physician, and in the remainder by 2 or more of the above officials.

A general health examination is reported by about 52 per cent of superintendents. In 50 this is given twice a year, in 561 yearly, in 44 every 2 years, in 20 every 3 years, in 11 at "entrance" (which may mean yearly), in 9 "in emergency,” etc. This examination is given by a doctor in 417 counties, by the nurse in 159, by the teacher in 25, etc.

The eyes of pupils are examined in 969 counties (63 per cent). In 670 counties it is done yearly, in 78 twice a year, in 12 more than twice a year, in 7 monthly, in the remainder it is done less often than yearly. The eyes are examined by nurses in 313 counties, in 116 by the teacher, by physician in 334, by the family doctor in 4 counties, by “specialists” in 12, etc.

In 907 counties (about 60 per cent) the cars (hearing) are examined, In about 700 this is done yearly or oftener. It is done by about the same examiners as for vision.

The teeth are examined in 1,006 counties (about 65 per cent). This is done daily in 2, every 2 weeks in 2, in 6 monthly, in 76 twice a

year, in 668 yearly, and in the remainder less often. In 132 reports a dentist is mentioned as the examiner (about 10 per cent of counties). ID 291 the nurse is the examiner, in 90 the teacher, in 230 the physician, etc.

No report regarding "follow-up” work was made (or there is no such work) in 662 counties (43 per cent) which is equivalent to saying that in all but 5 per cent of counties where there is a general medical examination something is done to secure correction of defects. The follow-up agent is the nurse in 323 counties; the teacher in 115; physician in 103; parents in 85; nurse and teacher in 67; nurse, teacher, and doctor in 135; Parent-Teacher Association in 3; etc.

A general medical clinic is available for treatment of children in 421 counties (27 per cent). In 219 counties this is a traveling clinic; in 334 it is free. One hundred and forty-two of these clinics are supported by the county, 108 by private agencies, 9 by boards of education, 17 by public health associations, etc.

There are dental clinics in 299 counties (20 per cent) 150 of which are traveling. Ninety-seven are under the supervision of the county, 100 under a private agency, 26 under the board of education, etc.

There are eye clinics in 165 (11 per cent) of counties of which 65 are traveling clinics.

Psychological clinics are reported by 128 counties (8 per cent) and 69 of these are traveling clinics. Of these psychological clinics 61 are under the supervision of the State, 27 of the county, 7 of the board of education, 7 of universities, 22 of private agencies, and 4 of hospitals.

"Other” clinics (probably for nose and throat or lungs) are reported by 218 superintendents of these 113 are traveling clinics.

A regular time is devoted to physical education in 973 counties (about 65 per cent). In 17 per cent of schools (exclusive of 1-room schools) there is a gymnasium; for 89 per cent of all schools reported there is a playground; and in 11 per cent there is a play room.

In 20 per cent of all schools there is provision for a hot noon lunch, usually supervised by the teacher; in 45 by the Parent Teacher Association and in 145 by the home-economics teacher.

Health education is reported by 1,418 superintendents (93 per cent). In 857 it is given in all grades.

In 979 counties (65 per cent) there is correlation of the hygiene work with other school subjects and some correlation is reported by 227.

Three hundred and forty-five superintendents are satisfied with their present plan of health work (23 per cent) and 235 are fairly well pleased with their program-a total of about 38 per cent.


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