MANUAL
for
FLORIDA
STATE-WIDE PUBLIC HEALTH COMMITTEE
and county affiliates
by
JEAN HENDERSON
Public Relations Consultant
State Board of Health
and
Executive Secretary, State-
Wide Public Health Committee
Jacksonville
FLORIDA STATE BOARD OF HEALTH
Copyright 1940
by
Florida State-Wide Public Health Committee
All rights reserved
Published January 1940
State Board of Health
Jacksonville, Florida.
The Florida State-Wide Public
Health Committee is essentially
a lay organization and should con-
cern itself only with those broad
questions of public health which
may be participated in by lay per-
sons. Matters of a specific or
controversial nature should be
worked out with the County Health
Officer or, in the case of no
full-time Health Unit, with the
State Health Officer, Dr. A. B.
LcCreary, State Board of Health
headquarters, Jacksonville, Flor-
ida.
OBJECTIVES
THE FLORIDA STATE-WIDE PUBLIC HEALTH COMMITTEE
1. To Disseminate accurate public health informa-
tion to the people of Florida.
2. To assist in the organization and maintenance
of full-time Health Units in all counties in
the state.
3. To assist in securing the adoption of recom-
mendations in "The Health Situation in Flor-
ida," as approved and adopted by the State
Board of Health.
4. To cooperate with the State Board of Health
and the Florida Medical Association and af-
filiates in their public health programs.
COUNTY AFFILIATES
1. To secure a survey by the State Board of Health
of the health needs and resources of the coun-
ty, and to assist in carrying out the recommen-
dations presented in the survey.
2. To secure the formation of a full-time Health
Unit.
3. To actively assist the Health Unit in carrying
out its program under the guidance and with the
advice of the County Health Officer.
4. To cooperate with and assist the State-Wide Pub-
lic Health Committee in its work of dissemina-
ting information concerning public health prob-
lems in the state and the correction of these
problems as recommended in the American Public
Health Association state-wide survey, "The Health
Situation in Florida".
CONTENTS
Page
Origin of the Committee 1
State Organization Plan 10
Objectives of County Affiliates 17
What a County Survey Tells 20
What is a Health Unit? 23
Colored Auxiliary 31
Organizing the County Committee 35
Executive Board 43
Meetings 46
Topics for Meetings 57
"The Health Situation in Florida" 64
Sub-Committees 68
Public Relations Committee Publicity
and Health Information 70
Legislative Committee 80
Keeping the Committee Active 84
How Organization is Financed 87
Reports 90
What is Public Health 93
As Others See It 102
Appendix-
A Committee Organization Chart 113.
B Suggested County Constitution 114
C County Health Unit Law 119
D Additional Sub-Committees 125
E List of Newspapers by Counties 135
F A-B-C's of Preparing Newspaper Copy 148
G Officers and Board of State-Wide
Public Health Committee 157
H List of Chairmen & Co-chairmen by
Districts & Counties 160
I Map of Florida by Committee Districts 171
Available upon application to State-Wide
Committee headquarters, Jacksonville.
County Health Questionnaire
Quarterly & annual report forms
Telling the Community, bulletin on publi-
city channels.
ORIGIN OF THE CO1GITTEE
The Florida State-Wide Public Health Com-
mittee is essentially a lay organization whose
members include the state's leaders in civic,
industrial and educational affairs. It does,
however, have the endorsement and approval of
the state health department* And includes a-
mong its members many private physicians, den-
tists, lawyers and representatives of voluntary
health agencies.
These people are deeply and sincerely con-
cerned over the welfare of their state. They
are convinced that the grave public health prob-
lems brought to their attention by the Committee
must be overcome before permanent prosperity
The terms state department of health and State
Board of Health are used interchangeably in this
Manual. One of the major recommendations of the
American Public Health Association Florida survey
is that of changing the name of the official state
health agency from the State Board of Health to
the State Department of Health.
can be assured.
After giving careful study to the public
health problems and the means of solving them,
Committee members are convinced the only pen.ia-
nent solution is the carrying out of recommen-
dations set forth in the Florida health survey
made by the American Public Health Association
during the first six months of 1939. These re-
co~aendations, according to the unanimous opin-
ion of experts who have studied the report, re-
present the most modern, scientific and economical
method of administering public health.
Thus, the foundation upon which the Florida
State-Wide Public Health Ccamittoe rests is the
American Public Health Association survey. In its
summarized form, the survey is scae 75 pages in
length. Ten thousand copies are being distributed
by the Ccmmittee and the State Board of Health as a
bulletin entitled "The Health Situation in Florida".
The complete report is three times the
length of the summary and contains nany chapters
on departmental health administration studies
that are of interest only to staff members. It
is this report that has been adopted by the
State Board of Health as its long-time program.
Dr. A. B. lMcCreary, State Health Officer,
says he well realizes the program is so ambitious
"as to be alinost heroic. Nevertheless," he has
stated publicly, "the State Board of Health be-
lieves its adoption is to the best interests of
Florida people. Every resource of the state
health department will be utilized to put this
program into action as quickly as it is humanly
possible".
The U. S. Public Health Service and the U. S.
Children's Bureau, who allocate large sums of Fed-
eral money to the state health department, echo
their approval of Florida's decision to adopt the
survey as its official program. Newspapers of the
state have also been loud in their praise.
That the adoption of the program is no
idle gesture on the part of the State Board.
of Health is borne out by the fact that two
major recommendations have already been put
into effect as this goes to press. The first
was, of course, the establishment of the State-
Wide Public Health Committee, which was a primary
recommendation of the American Public Health As-
sociation field staff headed by Dr. Carl E. Buck
and his associate, Dr. G. F. Anyot. The second
was the discontinuance of the State Board of
Health district service.
When the American Public Health Associa-
tion field workers cane to Florida to make their
study they found the state divided into five of-
ficial health districts by the state Board of
Health. These districts encompassed the 50
counties that do not have full-time Health
Units. Each district had an average population
of 300,000 persons, To them a staff of one
5
Health Officer, one nurse and one sanitarian was
supposed to administer full-time health service.
That this was humanly impossible is easy to see.
The district health service was described in
the American Public Health Association report as
"expensive, inefficient and archaic." They
recommend that the districts be abolished and
the money thus saved devoted to strengthening
existing full-time Health Units and establish-
ing new ones. The U. S. Public Health Service
and U. S. Children's Bureau heartily concurred
and refused to permit further use of Federal
funds for support of district service.
Therefore, on October 1, 1939, health dis-
tricts in Florida were offi-clly relogated.to
the history pages. (Editor's-not&: The read-
er should differentiate between this kind of
health district, and the health districts be-
ing operated by sane states where they serve
such small populations and are so fully staffed
as to be comparable to County Health Units.
Such districts are, indeed, Health Units opera-
ting over several counties instead of one be-
cause the counties are small in both area and
population.)
Field workers of the Anerican Public
Health Association arrived in Florida on Janu-
ary 1, 1939 to begin their survey. They con-
pleted it June 30, the same year. The entire
cost was borne by the Association from a grant
given by the Conmanwealth Fund for the speci-
fic purpose of making state studies.
Florida had considerable competition in its
request for the survey. Bids from other states
were being considered by the State Heal th Stu-
dies Committee of the American Public Health As-
sociation.
Florida's invitation was accepted because
(1) it had the endorsement of the State Board of
Health, the State Congress of Parents and Teach-
7
ers, The Florida Medical Association, the State
Planning Board, the State Department of Educa-
tion, and the Florida Public Health Association.
(2)' there was a definite need for the survey (3)
Florida citizens C:ave evidence of sufficient in-
terest and leadership to do something with the
survey after it was made.
In February 1939 a handful of representa-
tive public-spirited citizens net to discuss
the plans for organizing the State-Wide Public
Health Coanittee. As the survey progressed this
group became so interested in the findings and
felt that they were of such paramount impor-
tance to the future welfare of the state that
in May it was decided the Committee should lay
plans toward permanent organization.
The original "handful of people" became
know as the State Planning Coimittee of the
State-Wide Public Health Committee. John P.
Ingle, Sr., Jacksonville, was elected chairman.
Lrs. Eialcolm McClellan, president of the Flor-
ida Congress of Parents and Teachers, was elected
co-chairman.
The State-Wide -ublic Health Committee of-
ficially took permanent form on November 2, 1939.
A constitution was adopted and permanent offi-
cers elected. Mr. In,:le became President and
Mrs. McClellan, his co-chairman, was elected
Vice-President.
At the time of his election, I;r. Ingle had
been in retirement from business and civic af-
fairs for two years. As President of the State-
Wide Public Health Camittee he re-entered the
civic life of Florida to carve an even deeper
niche than he had done during the long and ac-
tive period of service prior to retirement.
This statement is still more significant when
it is remembered that the earlier niche had in-
cluded such civic responsibilities as president
of the Community Chest, twice president of the
9
Jacksonville Chamber of Comimerce, president of
the Rotary Club, president of the Jacksonville
Motor Transit Company. Not long after accept-
ing the Committee chairmanship Mr. Ingle was ap-
pointed general manager for the Associated In-
dustries of Florida, Inc. By virtue of this ap-
pointment, public health and Florida industry be-
came closely aligned.
STATE ORGANIZATION PLAN
In formulating a practical plan of organi-
zation for the State-Wide Public Health Commit-
tee, three principles were kept in mind:
(1) Necessity for representation from every
section of the state.
(2) Securing prominent and enthusiastic lo-
cal leaders as Committee members.
(3) Representation of every important group--
civic, professional, lay, fraternal,
religious, industrial
Since the primary function of the Committee
is to give voice to the people, no officials of
the state, county or city health departments are
permitted to hold office in the Committee, or to
vote. They are, however, considered ex-officio
members and will attend meetings of the Committee
whenever possible in order that members may have
the benefit of their experience in public health.
The State Executive Board of the State-Wide
Public Health Committee is composed of the fol-
lowing representatives who serve by virtue
of their office in other civic and professional or-
ganizations are:
American Legion, State Commiander
Florida Bar Association, President
Florida Federation of Business & Pro-
fessional Women's Clubs, President
State Chamber of Commerce, President
State Dental Society, President
State Dental Society, President-elect
Florida Federatiao of Labor, President
Florida Medical Association, President
Florida Medical Association, President-
elect
State Nurses Association, President
Florida Congress of Parents & Teachers,
President
Florida Federation of Women's Clubs,
President
Florida Federation of Women's Clubs,
First Vice-President
and eight members-at-large appointed by the
State Health Officer.
Thus the charter members of the State-
Wide Public Health Committee who serve by vir-
tue of their offices in state organizations are:
W. C. Brooker Tanpa
D. H. Redfearn Miami
Miss Verdie Selman Jacksonville
Harold Colee*
E. B. Penn, D.D.S.
I. W. Shields, D.D.S.
Charles E. Silva
Leigh Robinson, M.D.
John S. Turberville, M.D.
Mrs. Martha Stetson
Mrs. Malcolm McClellan
Mrs. J. Ralston Wells
Mrs. Thurston Roberts
Jacksonville
Miami
Miami
Tampa
Ft. Lauderdale
Century
St. Petersburg
Jacksonville
Daytona Beach
Jacksonville
and the following appointees of the State Health
Officer:
John P. Ingle, Sr.
Mrs. Willis M. Ball
Luther W. Holloway, M.D.
George C. Killings
Mrs. John G. Kellum
Gilbert S. Osincup, M.D.
Charles B. Mabry, h.D.
Thomas E. Buclkman, L.D.**
Jacksonville
Jacksonville
Jacksonville
Pensacola
Tallahassee
Orlando
Jacksonville
Jacksonville
District Chairmen serving as associate mem-
bers of the State Executive Board are:
A. J. Cleary
Marion T. Gaines
0. W. King
Edward M. Newald
Clifford A. rayne
F. A. Rhodes
P. G, LeMoyne, (Acting)
Miami
Pensacola
Tampa
Orlando
Jacksonville
Tallahassee
Ft. Myers
*Succeeded by Carl D. Brorein, Tampa, Dec. 5, 1939
**Dr. Buckman's term expired December 5, 1939.
S. R. Norris, M.D. Jacksonville, now serves on
the Executive Board.
13
In order to stimulate local interest and
thus establish local responsibility, the rules
and regulations set down in the state constitu-
tion and the suggested constitution for county
affiliates have been mado as flexible as possi-
ble.
Experience has proved that organizations
with humanitarian goals should be free to "carry
on" to the best interest of the public whom they
would serve. It is anticipate! that at tines,
in order to fulfill this obligation, it may be
necessary to move in ways that should not be
shackled by iron-clad rules, nor cluttered with
red tape.
Officers of the State-Wide Public Health
Committee are elected annually and eligible for
re-election. The Executive Secretary does not
necessarily have to be a monber of the Conrmittee.
The State Executive Board, appointed by
the President, carries on the work of the Com-
14
mittee between annual meetings. It meets at the
discretion of the President, but can be called in-
to session upon written notice from one-fifth of
the membership of the Executive Board.
It is the duty of the Executive Board to or-
ganize affiliate and local committees in each of
Florida's 67 counties. It is also their duty to
decide matters of policy for the State-Wide Committee
as a whole and, upon invitation, for county commit-
tees that may desire such service.
State Districts Seven District Chairmen
and Co-chairmen are appointed by the Executive
Board to preside over the seven districts into
vaich the state has been divided to facilitate
Committee operation. These men and women are
associate members of the State Executive Board.
It is the duty of the District Chairmen to
assist in the organization of county committees
within their district, and to see that these
committees remain active, to hold district
15
meetings or conferences as frequently as deemed
necessary and to serve as a clearing house for
the state organization.
In appointing District Chairmen and Co-
chairmen, the precedent has been established of
choosing a nan for one position and a woman for
the other. In counties, the sane idea can be
carried out to advantage. It is thought that
this policy will engender a nore diversified
interest in the Comnittee's program.
As a matter of policy it is not desirable
that one person be allowed to hold more than
one office. For example, a District Chairman
or Co-chairman should not also serve as an of-
ficer on the Coimittee in his hore county. He
night, however, very profitably serve as a mem-
ber of the County Executive Board.
This same policy applies to members of the
State Executive Board. They should not serve
as District Chairmen, or officers of a county
16
affiliate. But they may prove very val-
uable as members of the County Executive
Board.
OBJECTIVES OF COUNTY AFFILIATES
In counties that do not have full-time Health
Units, the first and most important object of the
County Public Health Co~nittee should be the estab-
lishment of such a Unit* for the protection of the
health of all who live in the county.
In order to more fully appreciate the magni-
tude of the county's health problems and the size
Unit necessary to cope wvith those problems, a de-
tailed survey of actual conditions in the county
should be made.
Usually, surveys cost money and frequently are
very difficult to obtain. But such is not the case
with County Health Surveys. These are obtainable
upon request to the State Board of Health. But so
* It is the responsibility of the Committee to ac-
quaint the County Medical Society with the fact that
as a matter of policy the State Board of Health
and the U. S. Public Health Service recommend to the
staff of full-tine Health Units only those persons
having the approval of the County Medical Society.
18
numerous are the demands, and so limited the per-
sonnel of the state health department that it is ne-
cessary to handle them in the chronological order in
which applications are received.
Applications for county surveys should be drawn
up as formal resolutions or official letters of in-
vitation. These should come from the County Public
Health Committeo as well as from the County Medical
Society and the Chamber of Commerce, or any other
group sufficiently concerned with the welfare of the
county to participate in such a request. Anong the
possibilities are County Council of Parent-Teachers
Associations, County Federation of Women's Clubs,
American Legion, County Tuberculosis Association, etc.
In presenting invitations to the State Board of
Health requesting county surveys, it should be remem-
bered that the more passing of resolutions is not
sufficient. Copies must be sent to the headquarters
of the State Beard of Health in Jacksonville before
work on the survey can begin. The resolutions should
19
be addressed to the attention of the State Health
Officer, Dr. A. B. .icCreary.
When the survey is cocpleted and local health
problems set forth in a mimeographed bulletin, the
County Public Health Conm2ittee and other sponsors
will have a concrete foundation upon which to
base their clain for the necessity of a full time
Health Unit. It is the type of factual document
with which the Co -nitteo can face the County Com-
is sioners.
After the Unit is established the County
Public Health Comiittce still has work tG do. Its
merbors should then assist the Unit with its pro-
gran and keep the citizens of the county informed
as to progress being made.
In standing behind the Health Unit, the Con-
nittee makes a definite contribution toward the
maintenance of the highest standards of public
health service obtainable for the amount of money
expended.
WHAT A COUNTY SURVEY TELLS
In surveying the health conditions in a coun-
ty the State Board of Health entmerates and analyz-
es in detail the health problems of the. entire
county, making recommendations for their solution.
The result might be likened to surveys made by
civil engineers prior to starting work on a piece
of major construction.
As with the civil engineer, so with the health
officer. Each must know whore he is going and
what obstacles have to be overcome to reach that
goal. The survey naps cut the route for the Coun-
ty Health Officer.
That is why a survey is a prerequisite for the
establishment of a Health Unit. Even after the Health
Unit is organized the survey is valuable to the health
officers for he uses it to plan his initial disease
prevention and health promotion.
The survey is also used to dotormine the
minimum staff and budget required to satisfactorily
set up a full-time Health Unit that can be
enlarged and augmented as more funds are avail-
able.
The type of information contained in the sur-
vey is:
Population trends over a period of years, ac-
cording to race, sex, age groups.
Analysis of climate and soil in relation to
health conditions.
Commercial and economic background.
Analysis of birth and death statistics over
a period of years by race.
Investigation of disease which should be
reported to public health authorities but in all
probability are not being reported, since the
county has no full-time Health Unit.
Report on any existing facilities for mater-
nal and infant hygiene instruction through pri-
vately operated clinics, county nursing service,
etc.
Enrollment in schools by grades, race. Ex-
tensive sanitary survey of all school plants, with
a report of condition of water supply, lavatories,
sewage disposa-, ventilation, lighting, heating, etc.
List of physicians and doctors practicing in
county and analysis of geographic distribution. Num
ber of midwives practicing in county. Analysis of
hospital facilities.
Survey of tourist camps in regard to sanitation.
Survey of mosquito problem to determine whether it is
confined to pest mosquitoes or whether malaria or oth-
er disease carrying mosquitoes are present.
Recommendations for coping with the above prob-
lens.
Budget setting forth appropriation necessary to
establish a nininum full-tine Health Unit, stating
the amount which must be raised locally and the a-
mount that will be supplemented by the State Board of
Health, U. S. Public Health Service, and U. S. Chil-
dren's Bureau.
WHAT IS A HEALTH UNIT?
A full-time Health Unit seems to be a very
vague and bewildering object in the minds of most
people. Apparently they don't quite know what it
is, why it is, or what it does!
Just as the state health department is the
official health agency of the state, so the full-
time Health Unit is the official health agency
of the county.
In Florida, County Health Units are created
by what is known as a permissive law. Not in the
law, Lut estcalishel as a matter of policy by the
State Board of Health is the requirement that per-
sonnel of the Health Unit have the approval of the
County Medical Society.
The County Health Unit belongs to the County
and responsibility for its operation rests solely
with the county. The extent of State and Feder-
al operation in counties is confined to (1) Par-
tial financial maintenance (2) Consultation ser-
24
vice from State and Federal public health special-
ists (3) Distribution of free biologics to local
health officers and private physicians (4) Use of
State Board of Health laboratories at Miami, Pensa-
cola, Tanpa, Tallahassee and Jacksonville.
The state health department does not render
the direct service of health officers, sanita-
rians and nurses in any community or county other
than on occasions of emergency or highly technical
questions. It is no more reasonable to expect the
state health dopartnent to run county and city health
departments than it is to expect the U. S. Public
Health Service to establish offices in the state for
the purpose of operating the state health department.
This practice, if it were attempted, would not be
tolerated by democratic people.
Supervisory bureaus and divisions operated by
the State Board of Health for the purpose of as-
sisting full-tine Health Units with their pro-
26
health, engineering including environmental'sanitation,
health education, vital statistics and local health
service.
Specifically, the services to be expected frcm
the modern, fully-staffed, adequately financed Coun-
ty Health Unit are:
The investigation of communicable diseases such
as syphilis, gonorrhea, malaria, infantile paralysis,
meningitis, typhus fever, undulant fever, tuberculo-
sis, hookwvom, diphtheria, typhoid, with specific re-
gard to instituting measures for the control of these
diseases.
Detailed and periodic investigation and super-
vision of general sanitary conditions, particularly
as related to water supply and sewage disposal.
Supervision of the public health aspects of the
production, pasteurization and distribution of milk.
Inspection of industrial plants to eliminate
health hazards.
Examination and inspection of-sehool
children for the discovery of communicable dis-
eases or physical defects. Notification to
parents of the findings of these examinations
and referral to private physicians for diag-
nosis and treatment, or in the case of indi-
gents, to any available clinic or institution.
Operation of a dental program that includes
courses in balanced diets as aids in building
healthy teeth; pre-school dental clinics with
dental health education instruction for the moth-
ers. Effort should also be made to establish
clinics for the correction of defects of dental
indigents among children. Where there is some
moans of caring for dental indigents so that cor-
rections are assured, dental inspection by the
local dentists is desirable.
Nutrition should be an integral part of
every county health program.
Health conferences designed to improve in-
fant and pre-school care for essentially well
children. Also conferences, such as pre-natal
care for those who would not otherwise obtain
medical supervision.
Clinics for diagnosis of syphilis and gon-
orrhea. Treatment for those patients unable to
pay.
Protection against certain communicable dis-
eases movwn to be preventable. These include
smallpox, diphtheria and typhoid.
Clinics for the early diagnosis of tubercu-
losis and follow-up service on active cases, in-
cluding the examination of all members of the fam-
ily in which there is or has been an active case.
Public health nursing service in the home to in-
clude teaching both patient and family in the
care and prevention of the spread of tuberculosis.
Assistance in obtaining institutional care, and
service to rehabilitate the person who has returned
28
from the institution.
Public health nursing, which includes in-
numerable services, such as assisting at con-
ferences, school services, health education and
home visits where instruction is gi-ve in carry-
ing out the physician's orders or the regulations
of the health department.
Recording and analysis of births, deaths and
disease reports. These are essential for build-
ing future programs and evaluating the effective-
ness of past programs.
A continuous program of health education,
vhich means the dissemination of information on
healthful living and disease prevention to every-
one in the community, adults as well as children.
Working through newspapers, radio, clubs, schools,
movies, the Health Officer, public health nurse,
sanitarians and health educators to communicate to
the citizens the means of controlling, and in many
29
cases completely eliminating certain health prob-
lems.
Distribution of free biologics from the State
Board of Health to private physicians. These in-
clude smallpox and typhoid vaccine, diphtheria tox-
oid, tuberculin, diphtheria anti-toxin, tetrachlo-
roethylene for treating hookworm, insulin for in-
digent diabetics, silver nitrate to prevent blind-
ness in newborn babies, and anti-rabic treatment
for indigents.
Child guidance clinics should be a part of
every Health Unit activity. Although there arc
no mental hygiene programs being carried on at
present by Florida Health Units, the State Board
of Health hopes some will be established in the near
future.
To be successful a County Health Unit must:
1. Be full-time, meaning that its employ-
ces must work only for the Health Unit and should
not engage in private practice.
30
2. The staff nust be well trained as public
health specialists. A good practitioner of private
medicine does nct automatically make a good practi-
tioner of public health any more than a good practi-
tioner of public health would, by virtue of being
exceptional in that field, prove exceptional as a
private practitioner.
COLORED AUXILIARY
As soon as the State-Wide Public Health
Committee and its county affiliates beccrle fair-
ly well established they should diret.t their atten-
tian toward the organization of a Colored Aux-
iliary. Since one-third of the population of
Florida is composed of Negroes it is important
that attention also be focused on them in the
state-wide movement to improve health conditions.
The Colored Auxiliary of the State-Wiie
Public Health Cornittee can best be prcnoted
through colored ministers and school principals.
It must be borne in mind that no one denomination
should be given preference over another, but rath-
or an attnipt should be made to enlist one repre-
sentative from each denomination simultaneously.
In the order of size of membership, the leading
denominations are Baptist, African Methodist,
Episcopal, Catholic. The latter two have very
32
snall congregations.
Tho state office cf the State-Wide Public
Health Co mittee is already taking steps to enlist
colored leaders in various counties. As these are
recruited their names are being forwarded to the
chairmen of the County Public Health Cornlittee. For
this reason it would be well for any County Connittee
plnnitg a Colored Auxiliary to get in touch with the
state office of the State-Wide Public Health Conaittee
before taking definite steps.
Once the interest of the colored leaders is se-
cured, it is almost certain that enthusiastic pro-
grams will be carried on. They are eager for infor-
nation and take pride in having the opportunity to
help their people.
Too often are colored people the victims of
unscrupulous persons, nany times of their own race.
They need the assistance of honest, conscientious
people, both white and colored, who are in position
to guide then.
33
Syphilis, maternal and infant deaths and
tuberculosis take the greatest toll among color-
ed people. The cost is a heavy one, because, by
and large, colored people either do not know what
to do, are not financially able to do it, or if
financially able, are prone to fall prey to quacks,
untrained midwives or patent medicine vendors.
If white people are not interested in pro-
moting better health among Negroes from a human-
itarian standpoint then they should be interest-
ed frca a standpoint of self-protection. Negroes
perform most of the domestic duties in Floridad
They go into homes to cook food, wash clothes, tend
children, wait on tables, bringing -with them the
germ of whatever conmunicable disease they may have.
Outside the home they serve as chefs, waiters and
waitresses, maids, elevator operators, chauffeurs,
who in every instance are capable of transmitting
dangerous and infectious disease germs.
Too often is the remark heard, "If it weren't
34
for our large Negro population the Florida disease
and mortality rate wouldn't be so high." Those dho
make this statement do not stop to think that other
states also have their underprivileged groups which,
in all probability are as much or more of a problem
than Florida's.
Disease and death do not recognize race or
social class. Therefore, public health cannot recog-
nize then. The health of the people is a common prob-
lan that must be net by all for all.
ORGANIZING- TIHE COWTNTY COMMITTEE
The first consideration in organizing
County Public Health Com.aittee should be that
of membership and selection of officers. Invita-
tions for membership should be extended to those
leaders in the county whose identification with
and interest in the Committee will create a favor-
able impression upon the public. Many tires such
persons are already established as civic leaders
but just as frequently the Committee will be the
means of discovering and developing new leaders.
This, of course, is a healthy condition for any
organization to promote because new blood acts as
a stimulant.
County Cammittees should consist of a mini-
mum membership of 25, divided as equally as possi-
ble among men and women. No limitation is placed
on membership, which varies according to population.
Counties with large populations may have as many as
200 or 300 members.
The largest community in the county is
usually Committee headquarters. This means
that the county seat may not always be Committee
headquarters.
As in the State Committee, so with the Coun-
ty, the organization must be planned on a basis
of (1) geographic representation (2) civic repre-
sentation. 'No area or group in the county should
be omitted.
Geographically The county may be divided into
arbitrary districts, making as many districts as deem-
ed necessary except in counties where there are Health
Units. In these counties, the districts laid out by
the Health Unit are accepted by the Committee.
In Hillsborough and Duval Counties, where the
County Health Unit does not operate within the cor-
porate city limits of Tmpa and Jacksonville, the Coun-
ty Public Health Committee should add a city district
or districts to its Com:ittee. Members of county dis-
trict committees located in cities where there are
full-time City Health Departments must remnn-
ber to utilize these official departments as
they do the County Unit.
It is helpful to black off the district bound-
aries on a large county map or blueprint. These
can usually be procured from the county engineer's
office.
In planning districts for counties without
Health Units, it is better to use the various can-
munities as a nucleus for each district. Thus, the
CoAiittee's pro-unit districts should be approximate-
ly the sane as those which will be set up by the Unit.
Each county district should have its own committee
headed by a chairman and co-chainman vho reside in the
district. The county district is represented on the
County Executive Board by the county district chair-
nan. These county district committees are the founda-
tion upon which the structure of the County Public
Health Conmittee rests. Their strength or weakness
38
determines the strength or weakness of the entire
county organization.
The county district committee can easily adapt
the organization plan of the County Public Health
Committee to its ovn use. The district organization
should be a replica in miniature of the county or-
ganization.
Civic Representation The County Public Health
Committee must be especially careful to secure repre-
sentation from every oivic organization. Among those
found in the majority of counties and which it is es-
pecially important to include, are American Legion
and American Legion Auxiliary, Parent-Teachers groups
and councils, Rotary, Lions, Kiranis, Civitan, Optimist,
Exchange, Junior Charber of Conmerce, Senior Chamber of
Commerce, County Federation of Women's Clubs and the
more active local woman's clubs, Business and Profes-
sional Women's Clubs, Pilot Club, and such voluntary
health organizations as Tuberculosis, Cancer, Heart,
Crippled Children and Social Hygiene.
39
The council of Social Agencies and organi*.-
zed labor should also be represented. There
should also be representation from various profes-
sional groups such as the County Medical Society,
Dental Society, etc. A more complete list is to be
found in the Suggested County Constitution in the Ap-
pendix.
Official Representation The following local
tax-supported agencies should be represented on the
County Public Health Counitteel County Cornission-
ers, district welfare board, the county budget con-
mission, school board, school superintendent.
As stated in an earlier chapter, the County
Health Officer, public health nurses, sanitary
engineers and other Health Unit staff members are
ex-officio nonbers. They do not hole office or
vote.
Fraternal and Religious No denoninaticn
should be overlooked. The Comnittee is a democra-
40
tic organization and some of the most important
work is done by pastors. They are the key persons
and carry the message behind the scenes to those
members of their congregation whom they feel best
qualified to assist in the health movement. Ladies'
Auxiliaries of such bodies should also be remembered.
Method of Inviting Representatives In seeking
representation from any organization, the proper pro-
cedure and the one that brings best results is that
of asking the president of the organization whose re-
presentation is sought, to appoint a representative.
It should be suggested that if he himself is too busy
to serve, he appoint a member interested in health
work.
Choice of representation for the organization
should be left with the president. If however, the
County Public Health Committee Chairman knows of some-
one whom it is thought would make an interested mem-
ber of the Committee, there is no reason why the in-
dividual's name cannot be suggested.
Health Councils Those counties that
have had active County Health Councils or lo-
cal community councils are affiliating with
the State-Wide Public Health Committee. This
is in accordance with an agreement between the
Bureau of Public ,Health Nursing, State Board of
Health, which organized these counsils three
years ago as adjuncts to the public health nurs-
ing service.
The merger in no way curtails the activ-
ities of the former councils. On the contrary,
it increases their scope, for they continue to
carry on nursing committee programs as a vital
and necessary function of the general program
of the Committee.
In a majority of counties where there are
Health Units, the merger has already been com-
pleted. Thoso are Pinellas, Hillsborough, (whose
Unit Auxiliary brought more than 250 members to
the State-Wide Public Health Conmiittee) Escanbia,
42
hosee Cormiittee merged with the Council and add-
ed some 120 new members to the State-Wide Comiittee
roster) Taylor, Jackson, Broward, Monroe, Orange,
Lake, Highlands, Gadsden. They are taking the name
of the Committee and in nost cases the Comaittee's
chairman. At this writing (January 1, 1940) only
Leon-Wakulla, Gulf-Franklin, Bay and Duval Coun-
ties have both a Council and a Connittee.
EXECUTIVE COIflITTEE
No matter how small the Lmenbership of the
County Public Health CoLuittee, an Executive
Board is needed to supervise the organization's
affairs. The Board acts as a clearing house for
all activities of the organization including those
of the County District Cor.nittees and sub-comnittees.
It is the duty of the Executive Board to plan
a general program for the County Committee on an
annual basis and turn it over for administration
to the various sub-comrmittees concerned. The Ex-
ecutive Board, however, is responsible to the gen-
eral maibership and should therefore maintain con-
tinuous supervision of all projects.requiring per-
iodic reports from sub-coiritteos.
It should not be possible for any sub-connittee
to start a project or release publicity without first
securing official approval from the Executive Board.
In counties with Health Units, the Executive Board of
the Committee should not approve any project without
44
first having discussed all phases of it with
the Health Unit director. Where there are
full-time City Health Departmeats, such as Tampa,
Miami, Jacksonville, the same holds true if the
projects affect the city.
Publicity Supervision The Board should
draw up rules governing release of publicity in
order to guide the Public Relations chairman and
protect the organization itself. The Suggested
Constitution for County Cci..ittees provides that
publicity releases such as health columns or any
stories or broadcasts relating to health shall
be approved by either the County Health Officer,
the State Board of Health, County Medical Socie-
ty or the Florida Medical Association. This is
considered a reasonable safeguard against inac-
curacy and should do much to promote the confi-
dence of the general public in the reliability of
information emanating froa the Connitteo.
Membership of County Executive Board The mem-
.45
bership of the Board should be kept as small as possi-
ble and still provide full representation of the whole
Coi:nittee.
There should be a minimum of 5 members and a maxi-
mum of 15. They should include the officers of the
County Comaittee, the chairman of each county district
committee, chairman of standing sub-conmittees of the
County Committee, and perhaps 2. or 3 members-at-large.
Meetings Since the County Executive Board is
responsible for the success of the County Cor.mittee,
and since the Comaittee usually neets only once or
twice a year, it is important that the Executive Board
hold frequent meetings. They should be held at least
every two months, and even more often if necessary.
For this reason, in drawing up the Cormittee's consti-
tution, care should be taken not to limit the Executive
Board meetings to specific dates.
MEETINGS
The degree of interest stimulated by fast mov-
ing, informative meetings will determine the degree
of success the County Public Health Conmittee enjoys.
It is possible for anyone to conduct interest-
ing meetings if he really wants to. All that is nec-
essary is a little preparatory planning and a firm
determination to start promptly and keep the meeting
lively after it gets under way.
If there is any secret to successful meetings
and successful leadership, it is probably that of
giving credit where credit is due, and bestowing re-
cognition in public so that the person commended
knows he is genuinely appreciated. Nothing makes
people work harder than pats on the back.
It is important that an agenda be written for
every meeting. There should be three copies, one for
the secretary, one for the shairnan-of-the-day.and
one for the Cormittee Chairman or presiding officer.
The chairman-of-the-day should be made con-
scious of the fact that accurate timing of the
progron is essential. Care must be taken that he or
she receives full credit for work done, both in the
meeting and in the publicity appearing in newspapers
in connection with the meeting.
Kind of Meeting Meetings need not be of the
same type throughout the year, sore can be luncheons,
others dinners. In fact, it night lend variety to
adopt an interchangeable policy, Local conditions,
however, determine the advisability or inadvisability
of instituting this policy. All meetings should be
well publicized in advance, not only to newspapers,
but also by written notices to each member. These
notices should be sent out well enough in advance
of the meeting to enable members to make a place for
it on their calender. If the Committee holds month-
ly meetings, a weeks notice should be sufficient. If
it meets only every two or three months, then two
weels notice is advisable. And if still less fre-
quent meetings are held, then the first notice should
48
go out a month in advance to be followed the week
before the meeting with another brief notice. If
possible, these should be followed by telephone call
reminders the day of the meeting.
We live in a busy world. Public-spirited people
who serve and work on committees are in great demand
and therefore, extremely busy. It is no reflection
on the County Public Health Committee and no indica-
tion of lack of interest if members need to be remind-
ed several times about a meeting in order to prevent
their unwittingly forgetting it.
Therefore, unless sane member asks that he or
she not receive a telephone reminder, it is the cour-
teous and wise thing to do. Usually, the membership
list is so large that it is too much of a burden for
one person to handle alone. In such cases a telephone
committee can be appointed to divide the responsibility
of calling.
Frequency of Meetings The frequency of general
49
meetings of the County Public Health CorAlittee
varies greatly in different counties. It de-
pends solely upon the wishes of the members.
Largo Ccnnittees usually meet in general
session only once or twice a year, the business
of the organization being carried on during the
interim by the County Executive Board. Smaller
Committees may hold general meetings either quar-
terly, every two months or even every month, as
directed by members.
First Meeting The first meeting is, of
course, the organization meeting and extremely
important. Special care should be taken in the
choice of time and date in order to assure the
very largest possible attendance.
The list of those to be invited should be
thoroughly assembled and as complete as it is
possible for the small group planning the meet-
ing to make it. The procedure for the organization
meeting should be planned as carefully as the list
of persons invited to attend. It is customary to
50
permit 10 or 15 minutes leeway at the first
meeting between the tine stated on the notice
and the tine it is actually called to order.
The constitution and by-laws will be pres-
ented for consideration and study. A sufficient
quantity should be on hcad at the first meeting
to permit thorough reading by all present. The
form of the Suggested Constitution is given in
the Appendix of this Manual. Copies for distri-
bution nay be obtained from state headquarters.
At scme point during the meeting it should
be made plain that the membership is not limited to
those present. They form a nucleus around which
the organization is to be built, and are, therefore,
privileged to suggest other candidates for membership.
The tueporary chairman for the meeting is ar-
ranged in several ways. A volunteer previously de-
cided upon usually the state-appointed County
Chairman may call the meeting to order and take
the chair. Or, saneane in the audience may be
51
"primed" to nominate a certain person as Chair-
nan inzuediately after the meeting is called to
order.
Still a third alternative is offered if a
representative of the state office happens to be
present. In this event, the representative could
open the meeting, state the purpose of the Connit-
tee to be organized,then at the conclusion of the
remarks call for a notion to organize, followed by
consideration of constitution and by-laws.
The main requirement for holding a successful
organization meeting is careful planning of details
in advance. Nothing should be left to chance, for
the difference between a strong and a weak organi-
zation is often determined by the strength or weak-
ness of the first meeting. A haphazard first meet-
ing may result in the election of the wrong people
as officers, and the Connittee's death before it is
born. A suggested order of business for a first
meeting would be as follows:
Call to order
Selection of meeting chairman
Selection of secretary
Purpose of mneting
Resolution to organize
Connittoe to draft constitution
and by-laws
Roll call, securing full name,
exact mailing address
and telephone number
of all present
Announce ciont of next ne eating
at which election of
officers will take place.
Or, if it is felt that it vill not be easy
to hold a second meeting v;ith as large an attendance
as secured at the first meeting, the constitution nay
be adopted and officers elected at the first meeting.
In the event consolidation of first and second
meetings is deemed advisable, the person planning
the organization meeting should have an unofficial
committee of three meet to draft a tentative consti-
tution, which will be as nearly in its final form as
it is possible to make it. Someone familiar with such
documents and with the purpose of a County Public
Health Committee should head this group.
53
Then at the general meeting, the three persons
can be officially appointed as the constitution
cornittee and thus be prepared to present the doc-
ument to the assembly for immediate consideration.
Order of Business, Regular Meetings The
order of business for regular meetings can be
varied greatly, giving precedence to important
items.
The County Public Health Connittee should
adopt an order of business best suited to its
needs.
Necessity for reading of the minutes nay be
eliminated by having then mimeographed and nail-
ed to all members irnnediately following each
meeting. When this is done the Chairman should
state, at the subsequent meeting, that the min-
utes were nailed to each neaber and ask if there
is any discussion or any corrections before of-
ficially incorporating them in the organization's
records.
The model order of business which follows is
subject to change to meet local needs:
1. Roll call
2. Reading of minutes
3. Reports of Executive Board and
Standing Comniittees
4. Reports of special Ccraittees
(this includes reports of
progress made or any action
taken at previous meeting)
5. Report of County Health Unit Direc-
tor and Supervising Nurse
6. Announcements (including health and
medical events of current interest
in the county, state and nation)
7. Unfinished business
8. New business
9. Special program
Annual Meeting In addition to the rou-
tine business and election of officers that al-
ways transpired at annual meetings, this would
also be a good time to feature an "Off the Chest"
ballot. By this is ncant that all present be per-
mitted to express their opinion and offer sugges-
tions as to what might profitably be included in
the Ccxaittoecs program for the coing year.
Ideas thus advanced could be presented on
55
signed ballots. The ballots could be serially
numbered with the author's naae on the stub and
his idea or suggestion an the other portion of
the ballet. Stubs containing the name should be
put in one box and the part of the ballot con-
taining the idea in a separate box.
The special sub-conr.ittee appointed to ana-
lyze the ideas should carefully consider each
suggestion. Any com.iendable ideas should be pres-
ented to the County Executive Beard (the author's
nane still unrevealed). In the event the Execu-
tive Board decides to incorporate any of the sug-
gosted ideas in the Cmnnittee's program, full rec-
ognition should be given the author of the idea.
He night receive a Special Achievement Award at
suitable ceremonies. No nmeaber of the health de-
partment staff should be eligible to receive the
award.
Preliininary Procedure --The Stato-W ie" Public
Health Ccr.-ittoo reoonnends that Robert's Rules of
56
Order Revised be used as the authority for all
decisions. If this recornuendation is accepted
by the County Public Health Committee it
should be incorporated in the constitution or
by-laws.
A copy of "Robert's Rules" should be in
the possession of every Cl..in.-.nr for ready ref-
erence. It is most helpful in planning details
of procedure for meetings and for general use
in directing the activities of the CoLnittee.
TOPICS FOR MEETINGS
No Chairman should ever be at a loss for
interesting subject material for study, discus-
sion or talks at Committee meetings. There is
probably a much larger number of subjects than
there are meetings.
In fact, in order to utilize even a fraction
of the available material the Conmittee undoubted-
ly will have to divert some of the subjects to
guest appearances before other organizations. For
this reason, the chairman of the Public Relations
committee is advised to devote sane tine to this
chapter.
After choosing the subject for the meeting,
the next step is choice of a speaker. For Coun-
ty Public Health Committee meetings the speaker
usually should be someone outside the Committee.
Although, by virtue of its size, diversity and
professional representation, the Comittee nen-
bership might offer an excellent supply
58
of speakers who could and should be put to work. In
this way the Conmittee meetings would serve as a
testing ground for the Speakers Division of the Pub-
lic Relations corrittee.
When a Conmittoe member is the guest speaker at
the Coranittee meeting, the County Chairman and chair-
nan of the Public Relations committee should nake a
special point of listening to the talk with the idea
of booking the speaker for appearances before other
organizations. The notes that follow, scratching on-
ly the surface of a vast supply of subjects, are in-
tended more to pique tho imagination than to pose as
a source of material:
1. Highlights of the American Public Health
Association survey of Florida health con-
ditions.
2. The County-vide Public Health Committee
(a) Organization
(b) Scope
(c) Value
(d) Purpose
(e) Functions
3. The importance of having a county survey of
health conditions made by State Board of
Health.
4. What is Public Health?
5. The Value of a County Health Unit to our
County.
6. How can local voluntary health agencies
be brought into the general health pro-
gram of the county?
7. Why health department personnel needs spe-
cial training in Public Health.
8. Highlights of Florida's new school health
program.
9. How to place publicity.
10. Demonstrations by the public health nurse
of communicable disease technique in the
home and many other phases of nursing ser-
vice.
11. Current trends in public health.
12. The State Board of Health, its organization
and functions.
13. The relationship of the State Board of
Health to the local Health Units.
14. The importance of early case finding and
hospitalization of cases of tuberculosis.
(This should be given by the County Health
Officer or someone from the State Sanitori-
un, or the Division of Tuberculosis, State
Board of Health.)
15. The State Hospital (Chattahoochee) by some-
one vho is a number of the staff.
16. The Crippled Children's program by someone
connected with the organization.
17. The contribution of the Industrial Home
for Boys to the State of Florida.
18. The contribution of the Girl's School of
Ocala.
19. The contribution of the Home for the Feeble
Minded, by someone employed by the institu-
tion.
20. The contribution of the Deaf and Blind Home,
St. Augustine, by member of the staff.
21. How the Red Cross can assist in the health
program of a county.
22. How service clubs can assist in the county
health program.
23. The achievements by other sections of the
country in public health work.
24. Program of the 4-H Club, given by the Home
Demonstration Agent.
25. Plans for National Negro Health Week, nonth
of April. Secure a good Negro speaker from
Tuskogee Institute, or from the A. and M.
College, Tallahassee.
26. Plans for annual May Day Child Health pro-
gram.
27. Maternal Mortality in Florida (Mother's
Day).
61
28. The state-wide and local midwife problem.
This should be given by a member of the
Public Health Nursing Bureau of the State
Board of Health or a County Health Unit
nurse assigned by the State Health Officer.
29. The value of a field nursing visit. By
public health nurses.
30. Program on annual Social Hygiene Day.
This is usually first of February.
31. The deficiency diseases and their rela-
tion to nutrition. This should be given
by the State Nutritionist from the Ex-
tension Department in Tallahassee.
32. The Malaria Control Project now being con-
ducted in Escambia County.
33. The Rockefeller Hookworm Survey by a mem-
ber of the State Board of Health staff.
34. Health insurance debates by members of
County Public Health Canmittee.
35. Health conditions in industrial plants
in your community.
Study Reference Material Suggested:
All books listed here can be borrowed from the
library of the State Board of Health. The li-
brary will also be glad to suggest additional
references on each subject:
Bassett, Clara: "Mental Hygiene in the Communi-
ty", N. Y. Macmillan, 1936.
Bauer, W. W.: "Health, Hygiene and Hooey".
Indianapolis, Bobbs-lIerrill, 1938.
62
Becker, S. W.: "Ten Million Americans Have it".
Philadelphia, Lippincott, 1937.
Bluemel, C. S.: "The Troubled Mind, A Study of
Nervous and Mental Illnesses", Baltimore,
WTms. & Watkins, 1938.
Burhoe, B. W.: "Social Adjustment of Tubercu-
losis", N. Y. Nat'l Tuberculcsis Associa-
tion, 1934.
Colcord, Joanna C.: "Your Community, Its Provi-
sion for Health, Education, Safety and Wel-
fare", N. Y., Russell Sage Foundation, 1939.
Educational Policies Commission: "Social Services
and the Schools", Wash. the Comnission, 1939.
Escambia County Health Department. Malaria De-
partment: Progress report activities
of the malaria department. 1937 to date.
Pensacola, the Department, 1937-
Finney, Roy P.: "Story of Motherhood", N. Y.
Liveright, 1937.
Galdston, Iago: "Maternal Deaths The Way to
Prevention", I. Y. Commonwealth Fund, 1937.
"Health Problems of Women in Industry", Wash.
Government Print. Off., 1931.
Heiser, Victor: "American Doctor's Odyssey",
N. Y. Norton, 1936.
Hill, Frank E: "Educating for Health", N. Y.
Anerican Association for Adult Education, 1939.
Hiscook, Ira V.: "Ways to Community Health Edu-
cation", N. Y. CommInwealth Fund, 1939.
Hodgscn, Viblet H. "Public Health Nursing in
Industry", N. Y. Macnillan, 1933.
Howard University, Bureau of Education Research:
"Health Status and Health Education of Negroes
in the United States". Wash. Howard Univer-
sity, 1937.
Interdepartmental Committee to Coordinate
Health and Welfare activities: "The Nation's
Health; Discussion of the National Health
Conference, 1938", Wash. also "Toward Better
National Health", Govt. Print. Off., 1939.
Mayer, Raymond C.: "How to do Publicity", N. Y.
Harper, 1938.
Milbank Mienorial Fund: "Modern Health Trends",
N. Y., the Fund, 1938.
Mustard, H. S., "Introduction to Public Health",
Coanonwealth, 1936.
Orr, D. W. and J. W.: "Health Insurance with
Medical Care" N. Y. Macmillan, 1938.
Parran, Thomas: "Shadow on the Land", N. YA
Reynal and Hitchcock, 1937.
Pratt, George K.: "Your Mind and You", N. Y.
Funk and Wagnals, 1937.
Reed, Louis S.: "Health Insurance", N. Y.
Harper, 1937.
Rose, M. S.: "Foundations of Nutrition", N. Y.
Macmillan, 1935.
Stimson, A. M.: "The Communicable Disease",
Wash. Govt. Print. Off., 1939 (Miscella-
neous Publication of U. S. Public Health
Service No. 30).
Tobey, J. A.: "Riders of the Plague", N. Y.
Scribner, 1930,
"Wcaon in Florida industries", Wash. Govt.
Print. Off., 1930.
"THE HEALTH SITUATION IN FLORIDA"
In order to derive the greatest benefit from
the American Public Health Association survey of
Florida, the County Public Health Committee should
give some thought to coordinating its program with
that of the state as a whole.
This report enumerates not only the problems
but also offers constructive suggestions for meet-
ing them. The suggestions are in the form of rec-
ommendations of which more than 20 are listed as
of major importance.
A special coinmittee might well be appointed
to study the report. In this way the County Pub-
lic Health Committee will be prepared to assist
the State-Wide Public Health Committee more effec-
tively when the time comes to inaugurate the var-
ious recommendations.
There should be no hesitancy about accepting
these recommendations when it is remembered that,
as stated in the first pages of this Manual, they
are so heartily approved by the U. S. Public
Health Service, the U. S. Children's Bureau
and the Florida State Board of Health. Or,
when it is further remembered that several rec-
ommendations have already been put into effect.
Briefly, the remaining recommendations of the
report are:
1) That the State Board of Health be increased to
five members appointed by the Governor for
long over-lapping terms of office.
2) That, subject to the approval of the Governor
and to the candidate's qualifications accord-
ing to law, the State Board of Health be made
responsible for the appointment of the State
Health Officer.
3) That the State Health Officer be privileged to
appoint personnel of the State Department of
Health with the consent of the Board and pro-
viding the candidate is fully qualified.
4) That the name of the State Board'of Health. be
changed to the State Department of Health and
the State Health Officer to the State Commis-
sioner of Health.
5) That Legislation be enacted authorizing the
State Department of Health to prepare rules
and regulations dealing with all sanitary and
health problems regarding the agency or agencies
responsible for their enforcement; it should
further provide that the enforcement shall be
a function of the duly constituted local health
authorities in those areas having full-time
health departments,
6) That the supervision and control of the fluid
milk supply be transferred from the Department
of Agriculture to the State Department of Health
and that a bureau of milk and food supervision
be established in the State Department of Health.
7) That all state health laws be intensively stud-
ied and rewritten to confonn with the modern
practice of public health.
8) That the state appropriation to the State De-
partment of Health be increased to provide state
funds more proportionately to public health
needs; to provide extension of syphilis and
gonorrhea control; assistance for development
of additional health units.
9) That a c.opetent public health administrator be
employed as deputy cormissioner and executive
officer.
10) That sufficient funds be allocated for the pro-
per training of personnel.
11) That,whore counties are financially able, they
should mebo a larger portion of the cost of
local health service.
12) That a capable epidemiologist be added to the
Epidemiology staff for field studies and to
act as advisor and consultant to full-time
local'health officers through the Section of
Io0all.Health Service.
l): That a pediatrician be added to the field
staff of the Maternal and Child Health Bureau.
14) That, through legislation, physicians and mid-
wives be required to put silver nitrate solution
in newborn infants' eyes.
15) That the number of public health nurses in full-
time health units be increased.
16) That an additional public health engineer be ad-
ded to the Bureau of Public Health Engineering,
and its program be broadened to include improve-
ment of community and rural sanitation.
17) That the housing conditions in Florida be in-
proved.
18) That a bureau of malaria and mosquito control
be set up vrith a qualified public health physi-
cian at its head.
19) That health courses be compulsory in all schools
and universities.
20) That teachers be required to have adequate health
teaching courses and that they be instructed in
health teaching methods.
SUB-COMMITTEES
Each County Public Health Committee should
have at least two standing sub-committees, Legis-
lative and Public Relations. Such other standing
sub-committees as may be necessary will be deter-
mined by local conditions.
The chapters that follow are devoted to the
duties of Legislative and Public Relations commit-
tees. For details concerning the possible typos
and activities of other sub-comnittees, see the Ap-
pendix, page 125.
In counties with full-time Health Units, all
sub-committees, like the County Conmittee itself,
work with and through the County Health Officer, who
is director of the Health Unit. Plans for all pro-
grams must be submitted to the Executive Board of
the County Public Health Committee, which in turn
discusses them with the Health Unit director before
they can be inaugurated. This procedure prevents
unnecessary confusion and duplication, and also pro-
toots the County Ccmmittee against onbarking upon
a progron that might not be in accordance with
modern public health practice.
In counties without full-tine Health Units,
the County Public Health Committee and its sub-
cormittees concentrate their efforts upon the es-
tablishment of a full-time Unit- If any other
activities are attempted they should be confined
to programs of health education vd~ich have been
authorized by the County Committee's Executive
Board.
PUBLIC RELATIONS COMMITTEE
(Publicity and Health Information)
If organizations expect to accomplish big
things these days they must have either unlimited
finances or unlimited publicity. Since the State-
Wide Public Health Committee has no money it must
have publicity.
What is true of the State Committee is equally
true of its county affiliates. For this reason the
Public Relations Comnittee occupies a key position
in the life of the County Public Health Committee.
The success or failure of the Public Relations Com-
mittee determines whether the door to a brilliant
future will be unlocked to the County Comiittee or
whether its program will fall on barren soil and
perish for lack of cultivation.
Nowhere is public relations more important
than in the administration of health organizations.
One of the greatest services public health can render
the public is in the amount of accurate health
information disseminated. Utilizing not only news-
paper publicity but also radio, exhibits, speakers,
notion pictures, posters, window cards and panphlots,
public relations becaoes the bulwark of every health
education program.
All publicity, and, in fact, the entire program
of the Public Relations Co nitteo nust be carefully
coordinated with the general program of the County
Public Health Conrittee. Releases, speeches, or
any other data for public dissemination should go
through such a systematic channel of checking and
double checking that there is no chance of a story
being released without official approval.
Most health topics are technical and untold ham
would result if the information released were inac-
curate. The County Public Health Cormittee cannot af-
ford, therefore, to release information that is not
accurate
That is why it is suggested in a previous
72
chapter that the organization's consti-
tution make it obligatory for technical ar-
ticles on public health and medicine to be
read and approved by eihfcr the County
Health Officer, the County medical Society,
the State Board of Health or the Florida
Medical Association, before being authorized for
release by the County Executive Board.
Public Relations Chairman The appointment
of a Public Relations Chainan is one of the iost
serious tasks facing the Chairman of the County
Conriittee. Although the person selected nay count
upon the state office of the State Conmitteo for
assistance and guidance in a publicity program,
the County Chairman should nake every effort tc
secure a Public Relations Chairman who has had
professional newspaper or publicity background.
In the event it is impossible to secure an
experienced person to act as chairman, perhaps
someone with newspaper or publicity experience
will agree to write the stories and radio scripts,
letting the chairman plan the general program
for the Public Relations Committee.
When confronted with the task of planning
the County Committee's publicity program, the
Public Relations Chairman should concentrate
upon utilizing every available channel in his
area. A few suggestions are given below in
the hope they will prove helpful.
Newspapers For details concerning prepara-
tion of copy the reader is referred to "A-B-C's
of preparing Newspaper Copy" in the Appendix.
Radio The scarcity of easily accessible
broadcasting stations makes radio a somewhat
difficult medium in certain areas. However, if
stations are accessible, their managers are us-
ually most generous with time. For that reason
it is important not to abuse their generosity
by either asking too much time, furnishing in-
adequately prepared scripts or booking speakers
who are either unrehearsed or do not have
74
pleasing voices*
A warr, personable voice is an absolute neces-
sity for a successful radio program, and is what
should be sought in scouting around for a speaker.
If he or she is pracinent in the community or active-
ly identified with public health or medical vork, so
much the better, for the name will add weight to the
message.
Talks and interviews are usually the easiest
form of radio broadcast for the amateur to present,
Unless, of course, it is th4 spot announcement,
which is no trouble at all to the amateur because
he does not make theo! The station staff is usual-
ly responsible for the delivery of "spots".
Dramatic sketches are better left undone un-
less it is possible to recruit the services of a
proficient drama group with radio experience. It
is frequently possible to have dramatizations pre-
sented by Little Theatre groups, WPA projects,
high school and college theatrical groups.
Speakers Division This is an inpor-
tant part of the Public Relations Committee and
should be painstakingly developed. No speaker
should be allowed to go before other groups as
a representative of the County Public Health
Committee until the County Chairman has made
certain that he or she is thoroughly familiar
with the subject. If the data needed for pre-
paration of the speech is not available from a
Health Unit, the State Ccnnittee will be glad
to assist in securing the necessary material.
When booking engagements for speakers, it
is only fair to make certain the audience will
be large enough to compensate the speakers for
time and money expended in preparing the speech
and making the trip. In presenting invitations
to out-of-tovn speakers it should always be
stated very clearly whether or not the organi-
zation can afford to pay an honorarium.
76
or expenses, or both.
The inability to pay either expenses or
an honorarium should not deter an organization
from inviting an out-of-town speaker, but he
should be made aware of this fact. To be inde-
finite shows lack of experience and may easily
lead to unpleasant difficulties.
The Public Relations Chairman should study
thn. chapter on Topics for Meetings, since it is
a source of material for both publicity and
speeches.
Health Motion Pictures These should be
shown as often as possible. Films may be bor-
rowed from the State Board of Health and from
the Florida Tuberculosis and Health Associa-
tion, headquarters of both of which are in Jack-
sonville. Someone should be present to discuss
the picture and answer questions.
House Organs Industries' house papers should
not be overlooked. They are usually happy to co-
operate with the promotion of good health, and'
should even be remembered for general releases
that do not necessarily pertain to a specific
campai gn.
Exhibits These should be carefully placed
in the nost populated districts if they are to
be effective. It is useless to have an elaborate
and attractive exhibit hidden in some remote un-
frequented place where there is no one to attract.
The problem of getting the exhibits can generally
be solved by schools, whose faculties are usually
glad to have ideas for exhibit subjects.
Posters Window cards nay be used in hotels,
banks and theatre lobbies, on counters at grooory
department and drug stores, bus and railroad sta-
tions, on bulletin boards of schools, churches and
club rooms.
Posters for billboards or space on painted
sign boards will usually be donated by some pub-
lic-spirited merchant in the community if he is
78
asked far enough in advance. Billboard companies
are also very generous about donating space
when their boards are vacant.
Trailers Short notion picture trailers are
very effective if the County Coi-ittee has a few
dollars to spend on them. Information on compan-
ies making movie trailers may be secured frno the
State Cocimittee office.
Newspaper Advertising Space In most in-
stances this can be utilized without cost if the
chairman solicits it correctly. .The space should
only be sought occasionally and then for specific
campaigns where it is possible to insert a few
words -- perhaps the slogan -- and thereby draw
the public's attention to the work. Most nor-
chants who use large amcunts of advertising space
are glad to insert a line or the can:aign insig-
nia in at least one of their ads, and often nore.
Handbills Those can be wrapped in packages
by merchants. In no case should h-ndbills be
distributed in such a way as to clutter up
streets, sidewalks or porches. Not only is
this undignified, but it produces a bad psy-
chological effect upon the person for whoc
the nmssage is intended. Being angered by the
untidiness of his premises he is in no frame
of nind to pay attention to the message, :iuch
less consider it favorably.
Contests This is a valuable aid in any
special campaign. There are many different
kinds of contests besides the old standby, the
essay. A little imagination should develop nov-
el and effective variations.
LEGISLATIVE COMMITTEE
Someone who has a special liking and apti-
tude for legislation should be selected as chair-
man of the County Legislative Cor.mittee. For un-
less this Committee can function efficiently, it
had better not be appointed at all.
/
The first thing the Legislative Committee
should do is conduct an investigation of all ex-
isting health laws. These nay be found on both
county and municipal books.
Laws should be studied and analyzed to de-
termine whether (1) they are up-to-date (2) they
are the best laws available for the purpose they
propose to serve.
Whether or not laws are being enforced is
also something to be considered by the Committee.
If they are not being enforced, the Legislative
Committee night make inquiries to determine the
reason. In the event the law is obsolete, the
Legislative Coranittee should gather data and make
tions to the County Executive Board. Such rec-
ommendations night state that the law should be
repealed, or they night advocate replacement with
a modern law.
Under no circumstances should any legisla-
tive changes affecting public health be under-
taken unless they have been. approved by either
the director of the Health Unit or the State
Health Officer.
It should be the duty of the Legislative
Committee to comb all county newspapers for re-
ports of any legislation that might affect pub-
lic health, such as water supply, boards of
health, sanitation, clinics for indigents, etc.
When such items are found, a copy of the
proposed legislation should be secured. It
should be carefully analyzed and compared with
standards set up by official health departments,
either city, county, state or national, to de-
termine whether it is good or bad legislation.
82
A report of the findings should be made imme-
diately to the County Chairman and referred to
the County Executive Board for action. This
will frequently result in a delegation from the
County Public Health Committee going before
councils and commissioners to voice their opin-
ion and wishes and thus give lawmakers the bene-
fit of their first-hand knowledge of public health.
In order to be a source of information to the
general membership of the County Public Health Com-
mittee, the Legislative Committee should familiar-
ize itself with the following laws: The U.S. Pub-
lic Health Service Standard Milk Ordinances*; Meat
Inspection ordinances*:laws governing licenses to
practice medicine which prohibit all but medical
doctors from administering narcotic drugs; the
County Health Unit law; County Board of Health law;
etc
The Committee should study local and state laws
Information available from State Board of Health
83
pertaining to public health administration, in-
cluding appropriations, and should carefully con-
sider the legislative recommendations outlined by
the American Public Health Association in "The
Health Situation in Florida".
Below are just a few additional questions the
Legislative Connittee could study to advantage:
How many communities in the county have milk
ordinances? Do they conform to the latest U. S.
Public Health standard ordinance which is consider-
ed the best municipal legislation available governing
rilk production and legislation? What ordinances
are there governing the production, distribution
and handling of food and food products?
KEEPING THE COMMITTEE ACTIVE
Whether or not a County Committee remains ac-
tive depends to a great extent upon its Chairman.
He, or she, should occupy a position of prestige in
the community, have a genuine interest in its wel-
fare and a firm conviction that that welfare can
best be promoted through proper health protection.
In addition, he must also possess that intangible
and illusive something called leadership. Reduced
to its essentials, leadership means an embodiment
in one person of an innate ability to get along
with other people, plus the driving force of em-
bition and accomplishment.
The Chairman must keep the organization busy
but must not overload those members who are unable
or unwilling to be active. The fact must be recog-
nized and accepted that only a few persons will do
the actual work in any organization.
The remainder of the membership will bask
85
in the reflected glory of a job well done. Never-
theless, they are just as important to the organ-
ization as the more active members. Much educa-
tional material of inestimable value flows through
than. They may influence many persons to vlno the
more active members have no access, thus counter-
balancing their non-participation in the routine
business of the Connittee.
There is so much to do that no Connittee
should beccno inactive for lack of an interest-
ing program. If the Conmittee has difficulty in
drawing up such a program, the state office will
be glad to offer suggestions either by nail or
through personal consultation.
To stimulate community interest and pride
in the Connittee, a Health Award might be given
annually to the citizen in the county (exclusive
of state or local health department personnel)
who has contributed the most to the advancement
of public health during the year, irrespective
86
of whether or not he is a member. Suitable cere-
monies should accompany the award presentation
in order to impress not only the recipient but
the public and the Committee members themselves.
This idea is enlarged upon in the chapter an Meet-
ings, under the sub-head "Annual Meeting".
Proper distribution of responsibility among Cam-
nuittee nmboers will also do much to keep them inter-
ested. The more the members can be made to feel per-
sonally responsible for the Co.mittee, the nore success-
ful the organization will be.
HOW ORGANIZATION IS FINANCED
The State-Wide Public Health Committee re-
quires no membership dues. However, nothing in the
constitution prohibits raising funds for a specific
purpose if it beccaes necessary. County affiliate
conmittees nay specify nominal dues to take care
of postage and other clerical necessities if they
so desire.
Quite a few County Public Health Cor7ittees
raise funds for purposes incidental to carrying on
their program. The Hillsborough County Health
Unit Auxiliary, affiliated with the State-Wide
Public Health Committee, recently raised $1,500
to purchase a mobile clinic for the Health Unit.
Since no dues are required of its 200-some-odd
members, the money was raised from contributions
solicited by members. They were assisted in the
drive by newspaper editors who became interested
in the project.
Cost of stationery, postage, publicity, re-
88
leases, bulletins and services of an Executive Se-
cretary for the State-Wide Public Health Committee
are borne by the State Board of Health. They also
supply two field workers in the persons of super-
vising nurses who serve the state at large. The Com-
rittee work done by both the Executive Secretary and
the field representatives is in addition to their
routine duties as State Board of Health staff members.
County Committees receive certain supplies and
services from the state office. A limited amount of
mimeographing service is obtainable in addition to
letterheads and membership cards for county committees.
Every member of every County Committee receives
a copy of "The Health Situation in Florida", and his
or her name is placed on the mailing list of Florida
Health Notes, official monthly publication of the
State Board of Health.
In counties with full-time Health Units a cer-
tain amount of clerical assistance is available
from the Unit. In unorganized counties, the Goun-
89
ty CoLraittee must look to the State Comiittee
headquarters for this assistance.
REPORTS
Quarterly activity reports are required of
all County Comnittees cn the first of January, April,
July and October. A brief annual report must also
be filed with the Ccanittee's state office. Forms
for these reports are available from State Committee
headquarters, P. 0. Box 210, Jacksonville.
These forms include such information as:
Number of meetings held
Total membership
Now members since last report
Program for next quarter
Funds raised and for what purpose
Conferences in which Health Unit was assisted.
(a) school
(b) home
(c) clinics
Sunmary of Committee's activities:
(a) Classes organized in Home Hy-
giene through State Board of
Health Nursing Bureau
(b) Equipnent secured for Units
of centers
(c) Rooms secured, etc.
Sub-Cormittee progrcns:
(a) Standing
(b) Special
As soon as the organization of the County
Public Health Ccmmittee is completed, a graphic
picture of the county should be furnished State
Committee headquarters. This is supplied on a
report form kowno as the County Health Question-
naire.
Tho Questionnaire dot' forth in brief-those
basic facts concerning phases of county life and
environment that may affect either directly or in-
directly the public's health. The forn is distri-
buted by state headquarters and will be revised
at intervals until a Health Unit is established.
In this way, an accurate check is maintained to
detenaine whether the county is progressing or
regressing.
Other than those three reports, the state
office does not burden county affiliates with the
making of tine-consuning records which are of
92
doubtful value. The State Cormittee prefers
that County committees spend their tine on
projects beneficial to the counties in which
they are located.
WHAT IS PUBLIC HEALTH?
Those who confuse public health with state
or socialized medicine are laboring under an en-
tirely erroneous conception.
Public health is strictly a preventative
science. Its purpose is to eradicate the con-
ditions that breed those diseases which medical
science has, through years of research and experi-
aent, rendered preventable and, therefore, un-
necessary. Its further purpose is to praocte
good health and encourage healthful living.
In the course of carrying on its progr-n,
public health finds many persons suffering froa
early stages of diseases they do not suspect
they have. Such persons, unless indigent*, are
promptly sent to their family physician for diag-
noses and treatment. Public health is responsi-
ble for sending to doctors many persons who
*Decision of what constitutes indigency is left to
the County Medical Society and County Welfare Board.
94
might never have sought medical attention had the
need not been discovered by the Health Officer.
Thus, the public health worker in the full-time
Health Unit becomes one of the strongest allies
of the private physician. Doctors' already over-
loaded charity burden is also lightened by a full-
time Health Unit.
Public health sees in preventable disease
not a condition to be cured, but a condition to be
eradicated. Public health looks at a person with
malaria and sees not a sick man alone, but also the
mosquito that transmitted the disease germ to the
man. It sees also the undrained land that bred the
mosquito that gave the man the germ. Public health
knows that this man ............ and thousands of
other men ......... can be neither permanently cured
nor safe until the land is drained and malaria mos-
quitoes no longer have a place to breed.
Public health sees in a child or adult suf-
|