Conclusion

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 one-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). In 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.

U. S. GOVERNMENT PRINTING OFFICE. 1931

For sale by the Superintendent of Documents, Washington, D. C.

Price 10 cents