"If Unemployment Grows. . ."

President Hoover and the president of their association optimized, but 300 members of the American Public Health Association listened carefully, fearfully, during their convention in Washington last week to a dread forecast of the nation's health made by their Field Director Carl Edward Buck of Manhattan. Warned he: "Let no one be lulled into a feeling of false security based upon the present low death rate. That is something to be thankful for, but it will constitute an added danger if any one is led to believe thereby that a very real danger does not now exist with even greater dangers in store.

"We can absorb and take care of 3,000,000 unemployed; even, after a fashion, 10,000,000. We have been doing it, so far. But if the number continues to grow and we are obliged to meet the increased demands upon us, with steadily decreasing appropriations, this depression is going to have a much more serious effect upon public health than has yet been reflected in sickness and mortality statistics.

"We have had to lop off many activities essential to health, and, unfortunately, those which have been most seriously affected are child welfare and public health nursing, which are the most vitally important of all. Results from these activities are not so immediate and dramatic as in the case, for instance, of immunization and other disease-control programs and the public generally has therefore had less appreciation of their value and importance."

Dr. Louis Israel Dublin of Manhattan, the Association's retiring president, perforce agreed with Dr. Buck--if present economic conditions continue. President Hoover, who later received the public health workers in the White House, recited: ''I am in favor, as a constructive measure of public economy, of a program to be carried out on such wise lines, to reduce contagious diseases with government encouragement." He reminded them that his first contact with their organization was 15 years ago, when "I had just come from observing at first hand in Belgium and other War areas, the acute problems of public health produced by violent dislocations in the normal economic processes of the life of nations." He advocated once more that every one of the nation's 5,000 counties "set up for itself, as its minimum health organization, a unit consisting of a doctor, a sanitary engineer, and a trained nurse."

Obviously the U. S. taxpayer is going to get less governmental protection of his health than he has enjoyed heretofore. What then may he expect? From various speeches and discussions at Washington last week it seemed certain that for the near future there will be no abatement of the public health officer's broadest functions--to protect his community's water, milk and food supply, to guarantee sure disposal of garbage and sewage. There probably will be a neglect of public health record-keeping throughout the land. The health officer will continue trying to prevent the spread of disease. But the private practitioner must expect to take up almost all the burden of curing the sick and, in more instances than ever before, do it for charity. Last week the American Medical Association suggested that its members keep track of their charity cases and note some years hence how many come back as paying patients.

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