The advance in scientific discovery as to disease and health imposes new
considerations upon us. The Nation as a whole is vitally interested in the
health of all the people; in protection from spread of contagious disease;
in the relation of physical and mental disabilities to criminality; and in
the economic and moral advancement which is fundamentally associated with
sound body and mind. The organization of preventive measures and health
education in its personal application is the province of public health
service. Such organization should be as universal as public education. Its
support is a proper burden upon the taxpayer. It can not be organized with
success, either in its sanitary or educational phases, except under public
authority. It should be based upon local and State responsibility, but I
consider that the Federal Government has an obligation of contribution to
the establishment of such agencies.
In the practical working out of organization, exhaustive experiment and
trial have demonstrated that the base should be competent organization of
the municipality, county, or other local unit. Most of our municipalities
and some 400 rural counties out of 3,000 now have some such unit
organization. Where highly developed, a health unit comprises at least a
physician, sanitary engineer, and community nurse with the addition, in
some cases, of another nurse devoted to the problems of maternity and
children. Such organization gives at once a fundamental control of
preventive measures and assists in community instruction. The Federal
Government, through its interest in control of contagion, acting through
the United States Public Health Service and the State agencies, has in the
past and should in the future concern itself with this development,
particularly in the many rural sections which are unfortunately far behind
in progress. Some parts of the funds contributed under the Sheppard-Towner
Act through the Children's Bureau of the Department of Labor have also
found their way into these channels.
I recommend to the Congress that the purpose of the Sheppard-Towner Act
should be continued through the Children's Bureau for a limited period of
years; and that the Congress should consider the desirability of confining
the use of Federal funds by the States to the building up of such county or
other local units, and that such outlay should be positively coordinated
with the funds expended through the United States Public Health Service
directed to other phases of the same county or other local unit
organization. All funds appropriated should of course be applied through
the States, so that the public health program of the county or local unit
will be efficiently coordinated with that of the whole State.