ï~~ 48 ANNUAL REPORT [W. Va. MISCELLANEOUS ACTIVITIES. Thirty-five (35) advisory visits have been made to nurses in the field and eighty (80) visits to local towns and communities in the interest of health education and health promotion. In forty-eight (48) of these communities talks have been given to groups, ranging from eight (8) to approximately one thousand. (1,000) in number. The field workers have directed and assisted in the organization and conduction of eleven (11) pre-school conferences in which eight hun dred and eighty-six children (886) under school-age have been given a physical examination and personal or group conferences held with the mothers for the health promotion of their children and the correc tion of existing remedial physical defects. Thirty-three articles have been prepared for the press and our section of the Quarterly Bulletin of the Department maintained in each of the four issues. One thousand five hundred and thirty letters (1,530) have been writ ten, seven hundred and eighty-three (783) interviews held, and the various members of the staff have participated in one hundred and sixty-three (163) conferences pertaining directly or indirectly to our health work. LITERATURE. A large part of the health educational work of the Division has been carried on through the distribution of literature secured from the Children's Bureau, U. S. P. H. S., Federal Board of Education, National Tuberculosis Association, Child Health Organization, American Child Hygiene Association, American Playground & Recreation Association, and through material on rural sanitation prepared by our Division of Sanitary Engineering. All told, 61,625 pieces of literature from these various sources have been distributed throughout the State from this Division. Interest in the promotion of health has been stimulated to such an extent that every mail now brings requests for literature on health matters, and this is particularly true of teachers and pupils in the schools-the most effective avenue for health education. West Virginia has made only a start toward meeting the health needs of her children. Where school medical inspection is being done the physicians and nurses are finding from 35 to 90 percent of the children with remedial physical defects. Many of these might have been prevented; most of them can be corrected. Shall we not more thoroughly promote pre-school health work and send our children to school 100 percent fit; ready to receive the education, unhampered, that the schools are prepared to give them? Shall we not go one step farther and attempt to see that each prospective mother has adequate health education and care, so that the children may enter life with a fair start and a good physical foundation upon which to build an all-around development, which is necessary in the making of "good citizens?" "The race marches forward on the feet of little children." Respectfully submitted, Mrs. JEAN T. DILLON, Director. '_ r = r k. h } h,,; 0. b t:. e' '1 S. 0 R i. I 1921] STATE HEALTH DEPARTMENT 49 REPORT OF THE DIRECTOR OF THE DIVISION OF PREVENTABLE DISEASES Carl F. Raver, B. S., M. D., M. P. H. Epidemiologist Dr. W. T. Henshaw, Commissioner of Health, Charleston, West Virginia Dear Sir: It gives me great pleasure to submit the following report of the Division of Preventable Diseases of the State Department of Health for the period extending from July 1st, 1920, to June 30th, 1921. The work of this Division has not been carried on as vigorously as it should have been, because of the dividing of its activities between the regular work of epidemiology and that of vital statistics. For some years past, such vital statistics as were collected have been assembled under the supervision of this division and, when you remember that the office force consisted of the Director and two stenographers, you will appreciate that only by herculean efforts have we been able to keep our heads above water and make any progress whatsoever. As the Department wished to secure a Division of Vital Statistics worthy of the name, it became necessary to secure the enactment, at the approaching session of the Legislature, of a modern vital statistics law. This important work was assigned to the director of this Division and his staff. To secure this law, a public sentiment favoring its enactment had to be created. Some 25,000 circular letters and pamphlets were sent out to the people of our State, explaining the need of this law. During the legislative session, a great deal of time and energy were expended with the various members of the Legislature, and I am glad to report that the bill was passed. I offer the above explanation to show why certain activities, that should have been carried on in the line of epidemiology, were allowed to drop for a time. It is my earnest wish that these two divisions be divorced and that a director be appointed for each. During the past year we have had a great deal of sickness, as will be shown by a glance at the following summary. While it is true that the total number of cases is less than half of the number for the preceding year, it must be remembered that this falling off in the number of cases is due to the difference in Influenza reports, there being 38,852 less cases of that one disease alone. Two other important facts are disclosed: the large increase in the number of cases of measles and the large decrease in the number of cases of typhoid fever. There has been a general epidemic of measles throughout the state, which accounts for the large increase shown. The decrease in typhoid fever, I believe, has been brought about by the activities of the Sanitary Engineering Department. This Division has kept close watch on all water supplies with great apparent benefit to the citizens of our state. 0