Early in 1931, the Board of Health of
Meriden invited the Department of Public Health of the Yale School of Medicine
to undertake a health survey of the community. This invitation was gladly
accepted because the Department of Public Health considers as one of its
important functions the co-operation of its staff with local communities in the
State of Connecticut. At meetings of the Board of Health and of the Meriden
Hospital Medical Staff, Professor Ira V. Hiscock and Dr. Stanley H. Osborn,
Commissioner of Health of the State, outlined the purposes and scope of a
health survey and the opportunity for participation of the various agencies of
the community in the work.
The purpose of this survey has been to make
a careful, analysis of the present condition and of existing health machinery
in the city, as a basis of an outline of a comprehensive plan of organization
for the future. It is considered sound policy for a community occasionally to
take account of stock of its health equipment, for public health has become
recognized as the "foundation upon which rests the happiness of the people
and the welfare of the state."
It is with pleasure that we express our
appreciation of the helpful suggestions and co-operation received from the
local advisory committee and other representatives of the educational, dental,
medical and welfare organizations of the city, and from the State Department of
Health, the State Department of Education, the State Dairy and Food
Commissioner, the State Commissioner of Domestic Animals, and the State Water
Commission. Without their support, this survey would not have been possible.
We hope that this survey may form the basis
of future program planning and be of assistance in contemplated changes. In
view of the need for careful study and follow-up of the recommendations, we
suggest that the survey advisory committee be continued for this purpose.
The town of Meriden was set off from
Wallingford and incorporated 1806, 168 years after New Haven was settled and
136 years after Wallingford was set off from New Haven. The city of Meriden was
incorporated in 1867 and the city and town were consolidated in 1922. The city
government is vested in a Mayor and Common Council. There are 8 voting
districts.
The population of the town and city has
increased from 124 in 1810 and 7,426 in 1860 to 38,481 in 1930. The principal foreign
nativities are Polish (5.27%), Italian (4.39%), German (3.4%), Canadian English
(2.0%), and Irish (1.5%). A broad classification (2.6%) shows that 76.6 per
cent of the population are native white, 23.1 per cent foreign born, and 0.3
per cent colored.
The main developed portion of Meriden lies
between 41˚30' and 41˚35' north latitude and between 72˚45' and 72˚50',
west longitude. Meriden lies on the Quinnipiac River water shed and was
developed in the valley of a tributary, Harbor Brook. The elevation in the low
center of the city (near the railroad station) is about 135 feet above sea
level. The city is erected on hilly land, which rises to considerable heights
not far outside the old city limits. The striking appearance and beauty of the
"Hanging Hills of Meriden" are impressive. The summit of West Peak,
with an altitude of 1,007 feet, is the highest .point in New Haven County.
Taxation Districts.
On January 1, 1922, the city and town of
Meriden became a consolidated political unit. The former city line, possibly
with minor changes, constitutes a basis of division into two districts subject
to different taxation rates. The "First Taxation District" includes
the entire area of the unit, which covers 10,483 acres and has a current
population of about 38,500. Its gross total Grand List shows on the books of
the Tax Collector's office a valuation, as of October 1, 1930, of $64,362,155,
or $62,527,650 net total Grand List after exemptions have been deducted. The
current tax rate for the First Taxation District -- entire community -- is 17
mills.
Within the First Taxation District lies the
Second Taxation District. This is bounded by the former "city lines"
and includes the most built-up, most densely populated and most urbanized
territory. With an area less than 20 per cent of the total, it includes a
valuation of $55,374,475, or 86 per cent of the gross Grand List. For
additional metropolitan privileges (more fire protection, paving, water and
sewerage, and the like) the Second Taxation District pays an added tax
assessment of 8 mills, making its total tax rate 25 mills in 1930-31. The total
indebtedness as of January 1, 1929, was $1,508,000.
Industries and Other Resources.
Meriden is known as "the Silver
City". The industries are varied, including among others manufacture of
silverware granite, iron and pearl agate ware, cut glass ware, furniture
trimmings, hardware, gas, electric and kerosene cutlery, clocks, machinery,
machine guns, firearms, jewelry, hardware musical instruments, leather goods,
electric and automobile access and household utensils. Agriculture is the
principal industry outside of the city.
Meriden has three national banks, two
savings banks, and two Trust companies, besides two Building and Loan
Associations. A state school for boys, a state tuberculosis sanatorium
(Undercliff), and a general hospital, are among the institutions. The public
library, Curtis Memorial, was established in 1898 and contains over 35,000
volumes. There are 17 public and 6 parochial schools including a high school.
Two daily papers are published.
Streets.
About 50 miles of Meriden's 120 total miles
of streets lie in the inner, or second taxation district. Of these 50 miles,
approximately 19, or 40 per cent, are well paved with permanent surface. The
balance is mainly macadam and tar. There are few streets in the center
remaining with dirt or gravel surface.
Street mileage in the outer district
formerly "Town", numbers 70 miles of which 12 have been improved with
permanent or hard construction. Several additional miles are built of fairly
satisfactory trap rock and dirt material. This subject will be further
discussed in a later section. Meriden in 1927 adopted a modern Zoning ordinance
which has a direct bearing on the problem of housing and environment to be
subsequently reviewed.
Administration of Public Health.
Certain phases of public health work in
Meriden have been well developed, others are not correlated effectively, and
several important activities have not yet been undertaken to any extent if at
all. This condition may be partially explained by the nature of various
economic and political problems involved, and by the fact that the modern
public health program, has broadened somewhat rapidly in scope and emphasis in
recent years. However, it seems fair to state that Meriden has not kept pace
with several cities in the state and with many others of similar size and
resources in the country at large. It seems essential to consider the
organization, on a sound economic and administrative basis, of a continuing
public health program for the prevention of disease and the promotion of health
of the citizens of Meriden, remembering that human capital is the nation's
greatest asset. At the present time, the major responsibility for public health
work in the city is divided between the Board of Health, the Board of
Education, and the Visiting Nurse Association. The health department, is
administered by a medical officer, appointed by the Mayor for a two-year term,
on a part-time basis. The present health officer has had several years'
experience in this capacity. It is noted, however, that the appointment to this
position is influenced directly by the political affiliation of each incoming
Mayor. It is to be regretted that the salary provided has been insufficient,
and the policy of the city administration has not been such as to secure a
full-time, trained, health officer in accordance with charter provisions and
modern practice in cities of this size. The need for such provision deserves
early consideration by the Mayor, the City Council and the Board of Health.
The office duties of the Board of Health are
discharged by an able clerk on a full-time basis. There is one inspector, a
nurse for communicable disease work, a school nurse, and a part-time physician
for work in the parochial schools. In addition, the Board of Education employs
physicians on a part-time basis, and two nurses, for work in the public
schools. A dental hygienist was also formerly employed, but was discontinued in
1931. All other public health nursing work carried on in the city, except
industrial nursing, is performed by the Visiting Nurse Association. Four nurses
are employed, chiefly for first aid work, by the industries. It seems desirable
that several of these activities be correlated more closely and that increased
supervision be provided, in order that maximum efficiency and economy may
result. There is urgent need for the development
of additional public health services,
considered essential in a well rounded program, for the welfare of the public.
Several health services in Meriden may be improved without additional financial
outlay, but for the proper organization of others, a relatively small per
capita investment is necessary. Such an organization the citizens deserve.
Expenditures for Public Health.
The support of public health work in Meriden
is derived from the city governmental budget and from contributions to
community social service through the Community Chest. Many valuable services
are rendered by state departments, and certain of these, such as the laboratory
service, should be largely-handled locally by Meriden.
The governmental expenditures for the year
1930, classified by departments, give an idea of the distribution of funds.
Municipal Expenditures in Meriden, 1930
|
|
Total |
Per Capita |
|
General Government |
$99,796
|
$2.59
|
|
Police department |
97,274
|
2.52 |
|
Fire department |
131,025 |
3.40 |
|
All other protection of person and
property |
20,322 |
.53 |
|
Conservation of health |
13,499
|
1.35 |
|
Promotion of cleanliness |
49,859
|
1.30 |
|
Highways |
130,258 |
3.38 |
|
Charities, hospitals and corrections |
119,755*
|
3.11 |
|
Schools |
626,861
|
16.29
|
|
Libraries |
16,715
|
.43 |
|
Recreation |
32,662 |
.85 |
|
Miscellaneous |
22,764 |
.59
|
|
|
$1,360,790
|
$35.34
|
|
*
Includes $6,000 to V.N.A., $16,000 to Meriden Hospital, and $2,000 to
Community Welfare |
||
The items in the budget relating to the
Board of Health were as follows:
Board of Health Expenditures, Meriden, 1930
|
Health officer |
$1500.00
|
part time |
|
Clerk. |
$11500.00
|
full time |
|
Nurses |
|
|
|
Communicable
disease |
1,500.00
|
full time |
|
School
|
1,600.00
|
full time |
|
School physician |
1,000.00
|
part time |
|
Inspector |
1,500.00
|
part time |
|
Immunization |
424.80 |
|
|
Abbatoir |
1,200.00 |
|
|
Transportation |
600.00 |
|
|
Office |
527.52 |
|
|
Compensation (medical) |
37.57 |
|
|
Miscellaneous |
458.42 |
|
|
|
$11,848.31 |
|
|
|
|
|
|
Other items, health department |
|
|
|
Physicians'
and sexton's fees |
$351.25 |
|
|
Caretaker
at dump |
1,300.00 |
|
|
|
$13,499.56* |
|
|
*Expenditures
for the year 1931 amounted to $13,194 as compared with $13,512 in 1929,
$14,813 in 1928, $12,070 in 1927, and $9,150 in 1926. In 1930, fiscal year,
there was an unexpended balance of $273. |
||
In addition to the above items in the health
department budget, of which $1,651 are for services hardly related directly to public
health, an allocation of approximately $1,400 may be made from the city clerk's
office for vital statistics work. An average of $150 per year is received by
the city clerk for certified copies of birth and death certificates.
The official expenditures for strictly
public health services may be summarized as follows:
All Official Expenditures for Health Purposes, Meriden, 1930
|
Board of Health |
$11,848
|
|
City Clerk (vital statistics) |
1,400
|
|
City for Visiting Nurse Ass'n . |
6,000
|
|
Board if Education Physicians |
3,200
|
|
Nurses |
4,800 |
|
Dental Hygienist |
1,300
|
|
Supplies |
409
|
|
|
$28,957
|
The expenditures by the Meriden Public Health
and Visiting Nurse Association were $26,015, of which amount $6,000 were
received from the city, $5,656 from insurance company fees, $3,673 from the
Christmas Seal Sales, and $5,809 from the Community Fund. Hence the total
expenditures for public health work during the year 1930 amounted to $48,972 or
$1.27 per capita, of which 31 cents per capita were provided for the Board of
Health and 25 cents per capita were expended by the Board of Education.
It is to be noted that the expenditures for all
public health work in the city are relatively low and those of the Board of
Health are exceedingly low, in comparison with other cities of this size. The
time seems to have arrived when serious consideration should be given to the
provision of a more nearly adequate health department, with sufficient funds
for the full-time service of a trained health officer and a food and sanitary
inclusion will become necessary in addition to the present inspector. The
reasons for this conclusion will become apparent in the following sections
where the various health services are discussed.
Cost of Illness.
The amount of sickness is a factor which
causes interest in any program which had as its aim, health education and
disease prevention. This interest is present in any group of intelligent
individuals and transcends lines of race, color and political affiliation.
Sickness surveys show that under average
conditions, two per cent of the population is sick or disabled at any one time.
On this basis, there are, in the city of Meriden, between 700 and 800
individuals incapacitated every day, a large proportion of them being sick in
bed. On an average, each adult male is sick once a year and each adult female
between one and two times, while every school child averages two illnesses
every school year of 180 days, severe enough to cause absence from school.
The annual loss of wages incident to
sickness at a conservative estimate is over $200,000, and the cost of medical
care is considerably higher than this figure. A very large sum is, therefore,
directly chargeable to illness, a considerable amount of which is undoubtedly
preventable. Aside from this direct charge, there is an unmeasurable loss due
to resultant diminished productivity due to chronic illness and premature death.
There were 451 deaths during 1930, of which 32 occurred in infancy and many
others before or during the productive period of life.
On the other hand, 581 births were recorded,
an excess of 130 births over deaths. The progress made in the war against
disease during the past two decades has been encouraging on the whole, with
marked success in the instance of such diseases as diphtheria, typhoid fever,
tuberculosis and other communicable diseases.
In the battle against disease, there are two
main forces. First is that group whose main object is the treatment of disease
which includes the Meriden Hospital, 37 registered physicians, 21 dentists, and
102 registered hospital, private duty and public health nurses. Secondly, are
the agencies for the prevention of disease and the promotion of health, chief
of which are the health department, the board of education health staff and the
Visiting Nurse Association. The proper co-ordination of all these forces is
necessary if the issue is to be successful.
A community health program properly
organized yields dividends in the conservation of human resources commensurate
with the investment, and it has come to be considered sound policy for local
communities to invest much more liberally in a public health program than has
been the usual practice. Our human resources, in terms of men, women and
children, are conservatively valued at five times our material wealth in terms
of real estate, industries, and the like. Recognition of this fact challenges
our best thinking for the conservation of our human resources.
Subsequent sections will discuss in detail
the adequacy of present provisions for recognized public health activities and
the personnel needs. If these suggestions prove to be feasible, the additional
per capita outlays which seem most urgent will be relatively small. From the
standpoint of governmental agency expenditures it seems desirable to direct of
governmental agency expenditures, it seems desirable to direct attention to the
ultimate economies derived from preventive work. It is somewhat the fashion to
assume that the community is best governed which spends the least money. Surely
this is a short sighted viewpoint. We do not judge an individual or a business
corporation the most successful merely because of niggardly expenditure. We
honor in an individual or firm the thrift and the foresight which make possible
investment and expansion along lines which ensure greater profits in the
future. Surely this same principle applies to the business of a community.
Furthermore, during a period of economic depression, when the demands on the
public health and social service resources of a community are increased, it is
essential that there be no lessening, but rather a strengthening of these vital
forces.
It has been demonstrated that it pays large
dividends to give consideration to our human welfare as we do to our material
welfare. Public health is purchaseable; and progressive communities are fast
coming to realize the importance of finding funds for the purchase of this
profitable commodity.
Appraisal of Local Health Activities.
The standards by which the health services
in Meriden are measured are those set up in the Appraisal Form for City Health
Work, prepared by the Committee on Administrative Practice of the American
Public Health Association. These standards were arrived at as a result of very
careful and complete studies of public health activities in nearly 200 cities.
In each phase of public health service, the standard has been set so that 25
per cent of the cities studied, which were carrying on such a service, could
attain perfect rating. It is, therefore, not an idealistic and unobtainable
goal which is set, but one which may be closely approached by any city which
has a well planned and properly directed public health program and which enjoys
reasonably adequate financial support and reasonably complete community
co-operation. A city with adequate health services will score over 90 per cent.
Appraised on this basis, Meriden scores 542
points out of a possible 1,000, or 54.2 per cent. The details of the findings
are given in special sections of the report. In the accompanying table are
shown the points scored and the percentage of adequacy of each major public
health activiity, whether carried on wholly or in part by official or voluntary
agencies in the city.
Summary of Scores of the Public
Health Activities, Including Official and Non-Official Services Meriden
1930-1931
|
|
Total Allocated* |
Total Scored |
Percent |
|
Vital Statistics |
50 |
29 |
58 |
|
Communicable Disease Control |
160 |
100 |
62 |
|
Venereal Disease Control |
50 |
3 |
6 |
|
Tuberculosis Control |
90 |
55 |
61 |
|
Maternity Hygiene |
80 |
63 |
79 |
|
Infant Hygiene |
80 |
56 |
70 |
|
Pre-school Hygiene |
80 |
39 |
49 |
|
School Hygiene |
120 |
71 |
59 |
|
Food and Milk Control |
70 |
32 |
46 |
|
Sanitation |
80 |
47 |
59 |
|
Laboratory |
60 |
33 |
55 |
|
Popular Health |
40 |
6 |
15 |
|
Cancer Control |
20 |
4 |
20 |
|
Heart Disease Control |
20 |
4 |
20
|
|
|
1,000
|
542 |
54.2 |
This appraisal result means that the
combined effort of Meriden's official and non-official services measures only about
half the score of the best examples of such services in other cities of
comparable size. In studying this scoring, certain points, in addition to the
basis of above referred to, should be kept in mind. If it were not for scoring,
the work being done by private agencies, especially the Visiting Nurse
Association by the State Department of Health through its various bureaus,
particularly the bureau of laboratories, by the State Dairy and Food
Commissioner, and by the volunteer physicians serving the pre-natal, child
health and tuberculosis clinics, Meriden's score would be very much lower. In
addition to the major activities which are scored, there are other important
phases of public health work, including mental hygiene which have not been
developed.
Analysis of the organization of the public
health machinery indicates the striking need for adequate, full-time personnel
to direct certain phases of the work, the need for more comprehensive planning,
and co- ordination of child hygiene and tuberculosis control activities, and
for increased inspection services. Later sections will indicate that marked
deficiencies in the budget are closely correlated with marked weaknesses in the
corresponding services to the community. While at this time of depression it may
not be possible to carry out the recommendations which involve increased
expenditures, certain steps may be promptly taken to strengthen the vital
statistics, communicable disease, school health, inspection record keeping, to
provide for a co-ordinated tuberculosis control program, and to give a better
balanced community health program. As soon as possible, the greatest need of
all, the provision of a full-time health officer, on a permanent tenure of
office basis, should be met.
The sub-committee on model health ordinances
of the American Public Health Association, in its report of March 1, 1929,
indicated that it is desirable that the Board of Health be authorized to
appoint the health officer, and should have no executive functions or
appointive power except with regard to the health officer. The detailed powers
of the Board of Health are outlined. The qualifications of the health officer
are suggested as follows:
1. The Health Officer should possess at least one of the
three following qualifications: (1) a graduate of a recognized medical school,
who has had five years' experience in the practice of his profession, and in
addition to such practice has had at least one year's training in public health
work, or (2) a graduate of a recognized medical school who has had three years'
experience in public health work or at least one year's collegiate training in
the field, or (3) a graduate of not less than two years' work in public health
from some reputable institute of learning.
2. The Health Officer should not be dismissed from his
office except for inefficiency, neglect of duty, or misconduct in office upon
written charges of the Board of Health, after an opportunity of being publicly
heard in his defense.
3. The Health Officer should devote whole time to his duty.
4. The Health Officer's salary, which should be
determined by the Board of Health, should be in proportion to his
responsibility and the size of the community.
5. The Health Officer should appoint and prescribe the
duties of the staff of the Health Department.
Surely this is not too high an ideal for
Meriden to consider in the very near future.
Major Recommendations.
It is recognized that it will take several
years to develop a comprehensive health program in Meriden, and that new
developments must come gradually. For the purpose of future program planning,
the major recommendations of the survey may be here summarized. In subsequent
sections will be discussed the present activities and the reasons for these
recommendations.
Administration and Sanitation.
In a community of the size of Meriden, with
its complex problems, consideration should be given as early as possible to the
provision of an adequate health department staff, properly housed. It is
therefore recommended:
1. That early consideration be given to the provision of
a full-time, trained, medical health officer, secure in tenure of office, and
with an adequate health department staff.
2. That more adequate space be set aside in the Town
Hall for offices of the of the Board of Health.
3. (a) That additional use be made of the vital
statistics records by the health department, and that consideration be given to
the ultimate transfer of vital statistics work from the office of the town
clerk to that of the health officer; (b) That there be developed a more
complete record system for vital statistics and communicable- disease work,
including standard tabulations, graphs, and spot maps.
4. That there be appointed a full-time, trained, food
and sanitary inspector, that there be inaugurated a licensing system for food
handling establishments, and that systematic records of all inspection service
be maintained along lines suggested by the American Public Health Association.
5. That efforts be made to instruct the public regarding
the value of pasteurized milk and to stimulate the producers of raw milk to
safeguard still further their supplies by pasteurization.
6. That more frequent laboratory supervision be
exercised over milk and water supplies.
7. That as soon as possible, arrangements be made for
the provision of local public health laboratory service along lines suggested
for similar communities by the State Department of Health.
Medical, Clinic and Educational Services.
A. Considerable progress has been made in
tuberculosis control as it relates to nursing and sanatorium care. There is
definite lack of coordination of the work, however, in order that the extent of
the problem and the opportunity for development of needed services of
tuberculin testing, X-ray examinations, super-vision of contacts and detection
of cases in the early stages may be visualized. Excellent co-operation is
received from Undercliff Sanatorium in the handling of certain of these
problems. It is recommended:
8. That consideration be given to the possibility of
appointment by the Board of Health of the Medical Director of Undercliff
Sanatorium as the director of tuberculosis work for the city; that an active
register of all known tuberculosis cases and contacts among Meriden residents
be established and that a more adequate program of tuberculosis control, with
emphasis on childhood tuberculosis, be developed.
B. The reporting to the Board of Health of
cases of syphilis and gonorrhea is far from complete, and provision for
treatment of cases of gonorrhea unable to afford a private physician is
limited. It is recommended:
9. That efforts be made to secure more complete
reporting of cases of venereal diseases, and that facilities for
epidemiological study of these diseases and for more adequate clinic treatment
be provided.
C. The hospitalization of communicable
disease cases is a community responsibility of considerable importance. Present
local facilities are of an emergency character. The services of the hospital
would be strengthened by the services of a trained medical social service
worker and by tension of outpatient clinic services. Ambulance facilities are
far from satisfactory. It is recommended:
10. That as soon as possible, more adequate provision be
made locally for the hospitalization of cases of communicable diseases needing
this care.
11. That early provision be made for a more effective
ambulance service.
12. That a trained medical social service worker be added
to the hospital staff.
13. That consideration be given to the possibility and
desirability of extension of outpatient services at the hospital.
D. An excellent beginning has been made in
the establishment of pre-natal, well baby and pre-school conference service. In
the well baby and pre-school conferences, medical service is very limited and
on a volunteer basis. One conference has no physician in attendance. There is a
lack of correlation between the conference and home visitation service. It is
recommended:
14. That the child health conference services be
continued, but that efforts be made to establish the medical service on the
basis of payment to the physician for services rendered as is customary
elsewhere; that increased medical service be provided at all conferences; that
consideration be given to the desirability of establishment of another
conference at strategic point in town; that the educational opportunities of
the conferences be more widely utilized; and that the conference services be
more closely correlated with the home nursing services in behalf of registered
cases.
E. Considerable progress has been made in
school health supervision. There is need for more systematic record keeping and
for increased emphasis along certain lines. It is recommended:
15. That the order of medical examinations be slightly
altered to provide that examinations be made annually, in both public and
parochial schools, of children referred, those failing in grade, those
entering, those in the fifth and eighth grades, and high school pupils who
engage in competitive sports. At least five minutes, on the average, should be
allowed per child. A more complete physical examination than this should be
made of children returning after communicable disease and those in competitive
sports. (See Regulation 30, State Sanitary Code.)
16. That a more systematic program be developed for the
examination of children applying for working certificates.
17. That increased emphasis be given to the junior high
school and senior high school health supervision program for adolescents.
18. That a systematic study be made of each child contact
of tuberculosis with reference to: growth and development, overstrain, fatigue,
food, rest periods, proper use of open air facilities, tuberculin tests, X-ray
examinations, and clearance with other health agencies.
19. That closer supervision of open air classrooms be
given with emphasis on the election of contacts of tuberculosis, cardiacs,
positive tuberculin test, children with negative tuberculosis, as well as those
definitely below normal for other reasons.
20. That a more adequate system of school health records
be inaugurated along lines suggested by the American Public Health Association
and the American Child Health Association.
21. That a joint school health advisory committee be
organized with representatives from the Board of Education, the Board of Health,
and the Parent-Teacher Association.
F. The problem of mental hygiene is
exceedingly important from the standpoints of public health and social welfare.
The need for a mental hygiene program in Meriden is recognized by many who are
engaged in medical, social, and public health work. It is recommended:
22. That in co-operation with the Connecticut Society for
Mental Hygiene and the State Department of Health, a local Mental Hygiene
Committee be formed to study the problem and to develop such activities as seem
needed and practical.
Nursing.
Public health nursing is provided by nine
nurses employed by the Visiting Nurse Association, three by the Board of
Education, and two by the Board of Health. There should be close co-operation
between these three groups of nurses, and with the Board of Health. It is
recommended:
23. That a nurse qualified by training and experience to
serve as supervising nurse be added to the staff of the Visiting Nurse
Association as associate director.
24. That the visiting nurse staff be gradually increased
to meet more nearly the desirable ratio of 1 public health nurse to 2,000
population. The present nursing staffs of the Board of Health and of the Board
of Education are nearly adequate for the scope of nursing work for which these
organizations are now responsible.
25. That the three nursing groups, together with the
industrial and hospital nurses of the city, organize a Nursing Council to
confer periodically regarding problems of mutual interest and to stimulate
close cooperation in community nursing work.
These recommendations and other suggestions
of the survey have been framed with a view to a long-term program of gradual
development. It is anticipated that several of the recommendations may be
carried out in the near future. Certain of the recommendations direct attention
to present and future needs which for practical reasons must await the
provision of adequate funds or other means of support. The following table is
presented to indicate the ultimate cost of a reasonably adequate public health
program on the basis of the present population, provided the present programs
of the Board of Education and of the Visiting Nurse Association were not only
maintained at the present level, but were increased to the extent suggested in
the report.
Suggested Personnel and Budget,
Board of Health, Meriden, 1932
|
|
1930 Budget |
Suggested |
Additional
Needed |
|
Health officer |
$1500.00
|
$4,500-$5,500 |
$3,000-$4,000 |
|
Nurses |
|
|
|
|
Communicable
disease |
1,500.00
|
1,500-1,700 |
0-200 |
|
School
|
1,600.00
|
1,600-1,700 |
0-100 |
|
School medical service |
1,000.00
|
1,000-1,500 |
0-500 |
|
Tuberculosis medical service |
1,500.00
|
500-1,000 |
500-1,000 |
|
Bacteriologist |
0 |
1,800-
2,400 |
1,800-
2,400 |
|
Inspectors |
1,500.00 |
1,800-
2,400 |
300-900 |
|
Clerk |
1,500 |
1,500-
1,800 |
0-
300 |
|
Total
Personnel |
$8,600 |
$14,200-18,000 |
$5,600-
9,400 |
|
Transportation |
600 |
1,000-
1,200 |
400-
600 |
|
Abattoir |
1,200 |
1,200 |
0 |
|
Supplies
& contingencies |
1,448 |
2,000-2,500 |
552-1,052 |
|
Total |
$11,848.31 |
$18,400-22,900 |
$6,552-11,052 |
|
Per
capita from taxpayer |
31
cents |
47
cents-59 cents |
16-28
cents |
The chief need of personnel extension in the
Board of Education seems to be for the return of dental hygiene work which was
discontinued in 1931, and for minor expenditures to provide a more complete
record system in order to show more clearly the extent of services now
rendered, the results obtained, and future needs. The principal need in the
Visiting Nurse Association is for a-well trained supervisor at a salary of from
$2,200 to $2,500, and for gradual increase thereafter in staff nursing service.
The relatively small increases suggested for the Board of Health would have an
almost insignificant effect on the tax rate.
It should be emphasized that the survey attempts to present a plan for gradual adaptation to existing programs after consideration by community leaders of local problems, possibilities, and future policies. As the public health program develops, consideration must always be given to the relative values of different activities. Under present conditions, approximately the staff and approximately the budget changes indicated seem essential to the adequate protection of the health of the community and every dollar spent along the lines laid down should bring ample returns in the strengthening of the vital force and the economic resources of Meriden.
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