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dents, and in addition to this many of our students obtain work in other States. A certain percentage of our former students also fail to follow this occupation; some become farmers, others salesmen and inspectors, but most of them are connected in some way with the dairy industry.

While it is true that the majority of the students taking this short course of instruction have not had much school training, and only 14 per cent of them have had some college training, still the professors and the teachers of these classes are unanimous in expressing the pleasure they take in teaching students of this type. The fact that most of these students are depending on money which they have earned in some factory and, further, that they have already developed a liking for the work, helps a great deal in making this short course of instruction both pleasant and profitable to teacher and student.

SESSION 13. METHODS OF EDUCATING THE PUBLIC TO

THE VALUE OF MILK.

Honorary chairman, Dr. A. F. BARRERA, chief, Infant Hygiene Service of the

Republic of Cuba. Chairman, Dr. LOUISE STANLEY, chief, Bureau of Home Economics, United

States Department of Agriculture. Secretary, Miss FLORENCE L. Hall, specialist in milk utilization, Dairy Division, United States Department of Agriculture.

FIRST BAPTIST CHURCH ASSEMBLY HALL,

Syracuse, N. Y., Monday, October 8, 1923–9.30 a. m. Chairman STANLEY. The meeting will please come to order. The first paper this morning will be by Dr. Haven Emerson on “Per capita milk consumption from the point of view of the public health officer.” Doctor Emerson is director of the Institute of Public Health, College of Physicans and Surgeons, Columbia University. Doctor Emerson. [Applause.]

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PER CAPITA MILK CONSUMPTION FROM THE POINT OF VIEW OF

THE PUBLIC HEALTH OFFICER.

HAVEN EMERSON, A. M., M. D., professor of public health administration, College

of Physicians and Surgeons, Columbia University, New York City.

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“Food we can have in abundance if we devote our time to the conquest of the earth and to the utilization of nature, rather than to conquest of each other

*. There is good reason to believe that the available resources of the world are increasing quite as rapidly as the population, and that they will continue to do so for a number of generations if man devotes himself to science and industry rather than to war."

With such opinions expressed by eminent authority, it would be out of place for us to spend time just now in discussing the possibility of the production of milk sufficient to meet the reasonable needs of any or all people. We may assume that all the milk that is needed or that people can be taught to use for food, within the limits of economical and advantageous dietaries, can and will be produced through the natural response or adjustment of supply to demand. Nor shall I venture to enter the lists among the dietitians and the physiological chemists to dispute their conclusions as to the desirable use of milk for food. Rather shall I offer some considerations of the use of the public health office as a means of obtaining and distributing exact facts about the use of milk and the relation of this to the well-being of the community.

The health officer of to-day has traveled far and fast from his position in the public mind as a sort of glorified sanitary policeman,

* The World's Food Resources.

J. Russell Smith,

a

a

eagerly searching for smells and opportunities to prosecute the unwary for a defect of plumbing, or as the personification of a militant quarantine, enforcing the appearance of science to the great annoyance of blameless but suspected persons.

He is no longer concerned with communicable diseases alone, among the multitude of preventable afflictions for which education and public protection or service are required. He is by charter, or by the force of public opinion, obliged to take notice of all disabilities or handicaps to health, as well as of deaths and diseases, for which a proved or probable cause has been declared upon scientific evidence.

He must nowadays create a public opinion, interested and determined to be informed, on all elements within our control which affect unfavorably the development, growth, and duration of human life, and, furthermore, he is forbidden to be content with the more negative success displayed by an absence of sickness, but is called upon for leadership and public direction and training, in raising the level of living until an aggressive desire and competent knowledge of the ways and means to acquire vigorous health are prevalent throughout his community.

Thus it becomes the function of the health officer to learn the habits and customs of his people, their racial and religious prejudices, much of the intimate economies and household practices of the families, for in a knowledge of these lies the answer to the question which shocks and disturbs us all. Why in a nation of unparalleled wealth, with the machinery of distribution of supplies unequaled, with the facilities for elementary education in the main accessible to all, should we see deformity, physical impoverishment, bodily and mental stunting widespread among our childhood and apparently not decreasing materially?

Two possible and often powerful influences which we might expect to correct much of the prevalent inadequacy or inappropriateness of diets at all ages and throughout the country seem to be on the whole inoperative. I refer to thrift as applied by an intelligent economy in the purchase of foods, and devotion to childhood as practically expressed by provision of food to meet the requirements of growth, repair, and energy. To be explicit, we know that milk costs less almost everywhere in this country than any food, or rather foodstuffs, capable of providing equivalent value for the nourishment of child or parent.

The two facts contained in this statement, the cost fact and the value fact, are the essence of the argument and offer ample justification for the health officer's assuming a direct interest not only in the sanitary or bacteriological control of milk, but in the extent and manner of its use and in its cost.

May I propose such questions as many a health officer is asking himself to-day, and to some extent answer them, as they may be, more or less satisfactorily.

(a) What is the desirable per capita consumption of milk in a typical American community?

By typical I mean a mature permanent or stable group of persons of all ages with no unusual distribution of the important age groups, no specialization in a particular industry which might affect the age, the income, the standards of living, or the dietary needs of the people. Present information as to cost and value makes it quite clear that the entire community would save expense and serve their nutritional needs best if as much as 1 quart of whole milk were used as food for each member of the population daily. We can go further and say that it is indispensable for steady growth and development of children, at least until they reach school age, that a quart of milk should enter their daily dietary. We can add a third summary of the situation to the effect that unless at least a pint of milk a day per person is used in a community, waste of income and serious nutritional errors are certain to develop and affect the vitality, sturdiness, and capacity to resist disease, of a large number of both children and adults. Let me add further that none of these statements implies that these are measures of what each person in the community is supposed to drink daily in the form of whole fluid milk. I am not bringing this to your attention and saying that each person in the community must sit down to two or more large glasses of cold fluid milk, and if they don't take it in that form they have lost their right to live and keep healthy. The use of milk in all forms of foodstuffs, soups, sauces, puddings, ices, hot and cold drinks, etc., is included in the daily designated allowance.

This estimate of advantageous use of milk does not include the inilk from which the finished products, butter and cheese, are made, nor does it include the skim-milk powders or the condensed and evapcrated milk preparations.

The above statement of an optimum per capita use of milk of 1 quart per day for the entire population and a minimum safe allowance of 1 quart for each child under 6 years of age and not less than 1 pint for the remainder of the population is not based upon any single social, economic, chemical, or physiological test, study, or experiment, but represents the sum of observation in many relief agencies, budgetary studies of families under nursing and dietitian care, taken together with the experience of physicians and of medical services in hospitals, and the exact records of camps, institutions for children and adults, etc.

This general conclusion can be readily verified by anyone with a fancy for figures who will calculate the essential and accessory food qualities and contents of milk and its effect in causing and maintaining good nutrition, growth, and development when used as suggested.

The gist of the matter is briefly expressed, and in terms not likely to be subject of dispute, in a recent radio release issued September 22 by the commissioner of health of the State of New York, Dr. Matthias Nicoll, Jr.:

A quart of milk a day for children, but be sure that it is clean and pure milk. Milk is a very important food not only for infants and children but for arlults. It is an almost perfectly balanced food, containing practically all of the necessary elements for the growth, energy, and repair of the body in about the right proportions and in readily digestible form. The importance of milk as an article of diet for children is emphasized by the fact that it is the only food that provides sufficient lime for the proper development of the teeth without including an oversupply of other food elements. Children should have at least a quart of milk or its equivalent in milk products daily.

I know no good reason or valid argument against the opinions here expressed and shall proceed to the consideration of practical experience so far as the records can be relied upon.

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