Official proceedings of the annual meeting: 1923

COMMONWEALTH FUND HEALTH DEMONSTRATION-DINWIDDIE 45

for nutritional care. With children of this age class work is obviously impracticable.
The work must be done in 'the home. The workers visit the homes of the children,
weighing them on a portable scale and calling to the mother's attention errors in diet
and hygiene which are preventing the child from making the proper gain. At the end
of three months those children who have made good gains are brought to the doctor
for re-examination, to determine whether they are still below grade. If they pass the
doctor's examination, they are discharged but kept under observation for three months
to see if the health habits have been firmly established and the child has continued to
make good gains. Those who, during the first three months of care, have not responded in spite of the improvement of health habits are usually problem cases and
need further observation from the doctor.
The dental service for school children which we have been conducting for three and
a half years in this area can hardly be adequately described in this brief report. The
May number of "Mother and Child," however, gives a full account of this interesting
service. Our plan has been to concentrate our staff in the schools where no work has
been done and where work may go on from year to year without interruption. In
this way we are assured that the work is being done where it is most needed and where
the continuity of the service would enable us to secure tangible results.
One of the greatest contributions to be made by the health-center movement is the
better understanding of health problems presented in particular areas, which intimate
and intensive neighborhood work makes possible. A careful study of the defects
found in the pre-school age period clearly indicated that the outstanding defects of
this group were attributable to the high incidence of rickets among babies. This led
to our undertaking, in co-operation with the health department, an interesting campaign against this disease, which promises to be a most effective preventive measure.
An industrial and sickness census made by our staff last April has unearthed a wealth
of material both as to the economic resources of the neighborhood and the types of
illness which it encounters and the type of treatment afforded. A study of the vital
statistics of the area for a five-year period shows an alarming mortality among children
from pneumonia and among adults from tuberculosis, which calls for an intensive
drive against these diseases if appreciable savings of human life are to be made. Out
of the weighing and examining of children has come a study of the relation of height
and weight to undernutrition, which promises to be a real contribution to this pressing
national problem.
THE COMMONWEALTH FUND CHILD HEALTH DEMONSTRATION PROGRAM
Courtenay Dinwiddie, Executive Director, American Child Health Association, New York
The child-health demonstration program financed by the Commonwealth Fund
is a venture in co-operative relationships between three communities of the United
States and a national committee, in the interests of mothers and children of those communities and of the nation.
The demonstration program is based upon a fairly simple creed. No mother
should die or be injured in childbirth because of lack of knowledge on her part or of proper
medical and nursing attention. Every baby should be born under circumstances