Official proceedings of the annual meeting: 1923

HEALTH
SOCIAL WORK AND HEALTH PROGRAMS
Dr. Livingston Farrand, President, Cornell University, Ithaca, New York
I am glad Mr. Folks did not announce the topic printed on the program. After
a long experience I have learned that the chief reason for announcing a formal subject
is to permit a speaker to say what he pleases and, in the exercise of that privilege, I
certainly do not intend, at the close of a long and wearying day, to discuss in techincal
terms the situation which now exists in the campaign for health. I think my most
useful function must be briefly to sum up certain of the tendencies in the great health
movement now under way, and possibly to crystallize some of the results of today's
discussions.
Dr. Biggs has just given me all the text I could wish. It is a very wholesome thing
to have a conservative adviser like Dr. Biggs always at hand. If you follow him
in your tendencies to make predictions you will always be safe. He can combine
dramatic achievement with lugubrious prediction more consistently than any man I
know. I have sat at his feet in health work for nearly twenty years, and the conservative tone which he has taken tonight is very familiar to me. Of course the day must
come some time when Dr. Biggs will be right and the conservatism of his predictions
borne out by the facts; but up to date the decline in the mortality curve has annually
exceeded what he has been willing to forecast. Naturally this cannot go on forever,
and there is no doubt that some day that curve of his is going to flatten out.
One thing is clear, and that is that in the picture he has presented and by the means
he has outlined there is much yet to be achieved. You and I, associated as we are with
certain of these organized movements, are often in some danger of misconceiving our
task. Much is imputed to us from time to time in the way of claims of which we are
not guilty, but we must be very careful that, as members of any organization for the
fighting of any specific preventable disease, we do not lay claim to a reduction in the
death rate as being largely due to us or our efforts. What we are seeing is undoubtedly
the result of a vast accumulation of forces of improvement; but that result is also
undoubtedly greatly accelerated by the intelligent direct effort of specific organization.
We have seen these societies born and developed through various stages. Some
of their growth has been unconscious but most of it has been due to intelligent and wise
direction.
It is difficult to single out any one index of progress, but one of the most useful
and today most striking is the increased expectancy of life which has become so notable
in recent years. There has been, in a way, a certain correlation between the increase
in life expectancy during the centuries and the growing appreciation of social responsibility. There was a slow and gradual increase during the sixteenth, seventeenth, and
eighteenth centuries, when knowledge was slight, and then in the nineteenth century
came that enormous development of knowledge when new discoveries of science were
applied to human life and dramatic changes were the result. With the encouragement
lent by a picture which all could understand, and with the growing appreciation of the
significance of ill health and lack of vitality as an economic and social handicap, we
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