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public, chiefly to the woman in the home who chooses the day's meals. Where such work has been undertaken, developments have shown that it has been, in many ways, productive of excellent and lasting results.

Assistance is given in conducting milk campaigns or programs at the request or upon the invitation of some local body. I shall not take time to outline the general plan which is followed, or to give details of the work or results, except to say that in one of the smaller places, where the work was more or less centralized, there was an average daily attendance of 350 adults. The aim of this undertaking is to bring to the attention of children and adults, school and civic authorities, and voluntary workers interested in advancement the value of a satisfactory diet and the advantages from an economical, nutritional, and national standpoint, of a clearer realization of the paramount place of milk in nutrition. Results of such campaigns have been encouraging, the most gratifying being that communities are undertaking follow-up work to sustain the interest which has been aroused in more and better milk.

There is need for a clearer realization of the importance of milk in nutrition, its economic importance, and the necessity for careful handling before and after delivery. The careful handling of milk can not be too strongly emphasized to the woman in the home, as well as to the man on the farm. By arousing interest in the importance of milk as a food there is instilled also a sense of responsibility as to the quality of milk which she demands and the care which she gives it upon receiving it.

The Dominion dairy branch, by its educational work to stimulate a greater consumption of dairy products, adds its quota to the work being done to assure the fine character and strong, sturdy physique of the Canadian child.

Chairmah STANLEY. Are there any questions you would like to ask Miss Campbell?

Mr. C. W. SCHMOLKE (Somerset West, South Africa). Madam chairman, I would like to ask what is being done to have milk introduced in the schools. Is it given out to the children?

Miss CAMPBELL. It is given out in many schools in several of our cities. This distribution has been undertaken in many of our cities and is increasing rapidly.

Chairman STANLEY. We are interested in the work inaugurated under the National Dairy Council and continued under the Child Health Demonstration, where a certain sum of money is set aside. We are going to have one of those demonstrators to describe his work. Dr. Walter H. Brown, who is director of Child Health Demonstration, Mansfield. Ohio, will speak to us about the health demonstration.

THE HEALTH DEMONSTRATION AND NUTRITION. WALTER H. BROWN, M. D., director, Child Health Demonstration, Mansfield, Ohio.

I am very much pleased with what has gone before, because it does not always happen that the ground is prepared for what you are going to say to your audience. I am interested as a public

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health worker in seeing that the accumulated experience of our scientific group is translated into actualities in the individual community. I am also interested to capitalize our campaigns for particular objects such as increased consumption of milk. In order to do this we must influence children and lay, as the real foundation for the fixing as habits in the lives of our future citizens, the proven results of the scientific investigations. I will briefly describe the demonstration which I have the honor of directing. One of our main objectives is to thoroughly fix certain health habits in the lives of the children in order that they may function permanently—to be specific, that the results of a milk campaign will stay.

Health demonstrations have become fashionable as a method of promoting various phases of health work. The Child Health Demonstration at Mansfield, Ohio, represents a distinct type. It is an effort to show what a typical rural county, containing a small industrial city (population 31,000), can and should do to assure all of its children an equal opportunity for a full measure of health.

The problem is being approached by means of an alliance between the people of Richland County and the American Child Health Association. The funds for this five-year venture in cooperation are being furnished by the American Red Cross.

The goal of the demonstration is to develop a child health program which will be economically practical for the community, rather than to conduct an intensive laboratory experiment. This does not preclude the possibility of scientific study or interfere with the trying out of new discoveries in the health field.

The policy of the demonstration is one of assisting to build up all of the local agencies, public and private, which are concerned with the health of children. Guided by this policy, we have devoted our time and funds to the cooperative establishment of certain services which are conceded to be essential for the prevention of disease and the promotion of the health of children.

One of the valuable instruments in establishing and guiding these services has been a series of national advisory committees which were organized by the child health council. These committees are made up of recognized leaders in their particular fields. Through the generous assistance of these leaders we have been able to profit by the experience of health workers in all parts of the United States.

After a careful survey of health resources and health conditions of the county certain services were established. The final disposition of these services will be dependent upon sound community relationships. We feel that we have established such relationships with the official and unofficial health and educational agencies. The foundations have been laid for them to take over the parts of the work which have passed the experimental stage. This has already begun to happen.

A brief description of each one of these services will form a background for making clear our relationship for nutrition as a whole, and the use of milk in particular.

MEDICAL SERVICE,

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This service is in charge of a full-time pediatrist. This physician has charge of all of the demonstration's supervision of well babies. In addition he furnishes consultation services for any physician in the county without fee.

The well-children supervision has been conducted through a series of health centers. The main center is located at Mansfield, with three branch centers in various parts of the county.

This service is assisting in establishing a system of medical supervision of schools through cooperation of county dental and medical professions. This year through this service 3,000 school children have been given a complete physical examination with careful nursing, follow-up work for the correction of defects and promotion of health.

NURSING SERVICE.

The nursing service is a cooperative undertaking between Mansfield Public Health Nursing Association, Richland County Chapter of American Red Cross, Shelby Public Health League, and the demonstration. By the coordination of these organizations with the demonstration there is being built up a well-rounded program of nursing for the entire county. The work is being conducted on the generalized plan. City and county have been divided into districts, with one nurse responsible for all forms of nursing in her district. At present we offer prenatal, obstetrical, infant and preschool care, and school nursing.

One of the major activities is health education in the schools. The director of health education of the demonstration has been officially made supervisor of health education both in the city and county schools. We are working out ways to make health habits attractive to children. We are bringing to the teachers of Richland County the benefit of the experiences of the best health workers in the field. At the same time we are stimulating them to develop new methods of teaching health.

The nutrition activities of the demonstration are of special interest to this group of workers. Our nutrition service is in charge of a fulltime trained nutrition worker. This gives ample opportunity for us to procure expert nutrition guidance for all divisions of our work.

I will not take the time to repeat the things which Miss Gillett placed before you. We are also covering them at Mansfield. They are taken up in the school instead of at the health centers. In the schools the work is correlated to the art department by means of the poster work. We have on exhibit in our health centers and county fairs and other places very admirable examples of the health projects which are being worked out by the children. We are bringing together all aspects of nutrition and placing it before the child all the way through his grades, to and including high school. We hope in this way to make this knowledge a part of the very life of the men and women who in the future will be responsibe for our dietary soundness.

It is the desire of the speaker to indicate the ways in which he believes the work at Mansfield is increasing the use of milk on a plane that will cause it to permanently occupy its rightful place among foods. In considering the topic from this point of view, it is necessary to remember that the demonstration is endeavoring to actually correlate all of its services in the solution of particular health problems. For instance, while nutrition projects are the

major responsibility of our nutrition service the other services reinforce and assist in its operation.

A brief description of some of the nutrition activities will serve to illustrate both the methods of operation and the way in which we are educating the public to the value of milk.

UNDERWEIGHT CHILDREN.

The problem of the underweight child is one of the starting points of our nutrition service. All children in the county are being weighed and measured by the teachers. This activity is being used both as a service and a teaching device. The health education and nursing service are assisting ii) methods and following up the children. We are serving milk tó all children 10 per cent or more underweight in the cities of Mansfield and Shelby and our six villages.

The 110 one-room schools are a different problem. By means of cooperation with the farm bureau and the extension service of the Ohio State University we are promoting proper school lunches. In this promotion we are making the rural child realize the wonderful value of milk, often no light task because familiarity has bred contempt with the rural child.

Through a carefully conducted propaganda and a series of demonstrations, it has been possible this year to secure the appointment of trained home economics teachers in the two cities and six villages of the county. By means of our intimate relationship with the estah. lishment of these departments, we are enabled to guide these courses in a way that will permit nutrition being taught from the public-school angle. The director of nutrition service of the demonstration has supervision of all of these courses; in a particular way we are including in the teaching of these young women a proper relative valuation of milk as a food. It is our belief that this will have one of the most permanent values in the future use of milk as a large factor in the food of the family.

HEALTH EDUCATION.

In close correlation with the health education divisions, great stress has been laid upon the classroom teaching of health habits. In this teaching milk has been constantly stressed to the children by ail sorts of teaching devices. A result of this is the direct testiniony of the milk dealers of the increase in the demand for milk.

MOTHERS' GROUPS.

On account of our all-around program for the health of children, there is beginning to be built up instruction groups for mothers. In these groups the nutrition service has had another opportunity to point out the value of milk and to encourage its use in various ways by means of special devices for the use of milk in the food of children.

I would like to reiterate what Miss Gillett has pointed out to yo'l, namely, that it is useless for us to go out and merely advocate a child drinking a quart of milk. If you have had experience with mothers in homes you will know that there is a mighty small percentage of them to-day who know anything about using milk except in its Auid

form. So we are devoting a great deal of time, both in school and in the home economics courses, and by means of literature and other instructions, to show how milk may be used in all sorts of ways.

PUBLICITY.

We are using all of the usual methods of publicity such as newspapers, posters, literature, slides, and lectures. In addition, at the county fair our exhibit illustrated in a graphic way the relative and

a actual value of milk, while in the health pageants, which are an annual event, episodes are always included on milk.

We have been calling this type of effort education; some of our educators say it is not education. Not being a pedagogue, I will not attempt to discuss the question. I do feel, however, that we must arouse attention and solicit interest in the subject. If we thus set up plans that include follow-up work we are surely getting educational value, whether the method is classified as education or propaganda.

If time permitted, I should like to discuss our use of pageantry. This year there were two health pageants produced in competition by the villages from the northern and southern parts of the county. One hundred and seventy-five dollars was given in prizes by the county fair board. Over 400 children participated. We believe that the effect was certainly helpful.

THE MILK SUPPLY.

One of the things in which we are particularly interested is the character of the milk supply. It is futile for the public health worker to educate the public to the value of milk unless a pure, safe supply of milk is obtainable at a reasonable cost. In this it seems that the time has come for the closest kind of cooperation between the health worker and the commercial distributor of milk. It is not always that the economical objectives and the health objectives travel over the same track. In the case of the production and sale of milk this is true, for I am quite sure anyone who is familiar with the production, distribution, and handling of milk knows that healthy cattle and clean milk are both commercial and social objectives. Therefore, we are working intimately to secure an adequate official control of the milk supply. This as you know is not always an easy task in the smaller communities of our country where there are no well-organized health departments. In addition, we are cooperating actively with the farm bureau in its attempt to eradicate bovine tuberculosis.

In conclusion, the point which I wish particularly to bring to the attention of this meeting is that while all of the specialized campaigns for increasing the consumption of milk are useful and desirable, unless we follow them up with consistent and constant processes of education they will not permanently increase the use of milk. Therefore, we deem it fundamental that in the education of the child there shall be a continuous process of education in the relative and actual value of milk as a food. We are convinced that if there is a proper correlation between our publicity campaigns and our educational efforts, milk will very soon assume and hold its proper place as our most valuable single food.

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