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HEAL TH ^American Country 
Life ^Association Cjjural rHealth 
Proceedings of the 
Second National Countru 
Life Conference J 
Chicago, 1919 
American Country Life dissociation 
Charles J. Qalpin, Executive Secretary 
tPashington, D. C. \N„ FICHER ©OMPANY Contents 
PAGE 
President's Address 9 
President Kenyon L. Butterfield, Massachusetts Agricultural 
College, Amherst, Mass. 
Better Health For Rural Communities 13 
Dr. George E. Vincent, President Rockefeller Foundation 
Good Health; Its Relation to Human Progress 31 
Eugene Fisk, M. D., Medical Director, Life Extension In- 
stitute. 
Hospital Facilities for Rural People; the Need and Some Sug- 
gestions for 'Supplying 38 
Dr. J. J. Ross, Middleburg, Vermont. 
An Adventure in Rural Health Service 44 
Amalia M. Bengtson, Superintendent of Schools, Renville 
County, Minnesota. 
Health Problems in the State of Wisconsin; Methods of Ad- 
ministration and Management of 51 
Dr. H. E. Dearholt, Secretary of the Anti-Tuberculosis 
Association. 
Rural Nursing [Service in Cook County 59 
Harriet Fulmer, R. N„ Rural Nursing Service for Cook 
County, Illinois. 
Rural Public Health Nursing 67 
Elizabeth Fox, Bureau of Public Health Nursing, American 
Red Cross. 
Religion and Morals; Relation of Health To 78 
Rev. Wm. Covert, D. D., Pastor First Presbyterian Church, 
Chicago, Illinois. 
Farm Economy; The Human Side of 82 
Dr. C. J. Galpin, In Charge of Rural Life Studies, IT. S. 
Department of Agriculture. 
Rural Health and Sanitation; Report of the Committee on. . . 93 
Dr. W. S. Rankin, Secretary of the State Board of Health 
of the State of North Carolina. 
The Church's Responsibility for Rural Health 99 
Report of the Committee on Religion and Morals, Dr. War- 
ren H, Wilson, Chairman. 
Home-Making; Report of the Committee on 103 
Mrs. Harrietta W. Calvin, IT. S. Bureau of Education, Chair- 
man. 
Schools and Rural Health; The 107 
Miss Mabel Carney, Teacher's College, New York, Chairman 
of the Committee on Elementary Education and Junior 
Extension Work. 
Local Government and Legislation; Report of the Committee on 111 
Dr. E. C. Branson, University of North Carolina, Chairman. 
Recreation; Report of the Committee on 118 
Prof. E. C. Lindeman, Y. M. C. A. College, Chicago, Illinois, 
Chairman. 
Public Health Nursing; Report of Committee on 137 
Katherine M. Olmstead, Secretary National Organization for 
Public Health Nursing. 
Rural Charities and Corrections; Report of the Committee on. 138 
H. Ida Curry, New York State Charities Aid Association. PAGE 
National Organizations Engaged in Rural Social Work; Report 
of the Special Committee 143 
*C. W. Thompson, United States Department of Agriculture. 
Social Needs of Rural Communities and Means for Meet- 
ing Such Needs 151 
Principles Applicable to Rural Social Work 156 
Organization of Rural Social Work 157 
Programs of Work of National Organizations Engaged in 
Rural Social Work 160 
American Library Association 161 
American Red Cross 162 
Boy Scouts of America 165 
Federal Council of Churches 167 
National Catholic War Council 169 
Community Service (Incorporated) 171 
Young Men's Christian Association 174 
Young Women's Christian Association 17 6 
Proposed Manual of Suggestions for Rural Social Work. . 178 
Country Life Organization; Report of the Committee on 194 
E. L. Morgan, American Red Cross. 
Investigation of Rural Social Problems; Report of Commit- 
tee on 198 
C. J. Galpin, United States Department of Agriculture. 
An International Country Life Movement; Report of Commit- 
tee on 202 
President Kenyon L. Butterfield. 
Country Planning; Report of Committee on 207 
Prof. Frank A. Waugh, Massachusetts Agricultural College. 
The Teaching of Rural Social Problems; Report of the Com- 
mittee on 209 
Dean E. R. Groves, New Hampshire College. 
Road Building; Tendencies and Needs in 211 
Prof. John M. Gillette, University of North Dakota. 
Business Transacted at the Chicago Conference 214 
Secretary's Report 216 
Origin of the American Country Life Association 219 
Constitution 220 
Program of the Second Annual Conference 225 
Committees (Personnel of) 22'7 
Membership of the American Country Life Association (1919) . 233 
•Deceased. Oficials 
of the 
American Country Life dissociation 
1920 
Officers 
Kenyon L. Butterfield, president 
Amherst, Massachusetts 
Charles J. Galpin, executive secretary 
Washington, D. C. 
E. C. Lindeman, field secretary 
Greensboro, N. C. 
Clarence Sears Kates, treasurer 
Glen Loch, Pa. 
'Executive Committee 
Kenyon L. Butterfield 
Amherst, Massachusetts 
Warren H. Wilson 
New York City 
Edna N. White 
Detroit, Mich. 
Mabel Head 
New York City 
Albert B. Mann 
Ithaca, N. Y. 
P. P. Claxton 
Washington, D. C. 
E. C. Branson 
Chapel Hill, N. C. 
C. J. Galpin 
Washington, D. C. 
J. C. Ketcham 
Hastings, Mich. 
Clarence Sears Kates 
Glen Loch, Pa. President's Address 
Kenyon L. Butterfield, 
PRESIDENT MASSACHUSETTS AGRICULTURAL COLLEGE 
"'HERE is little need for a discussion of the value of the 
movement represented here. The proceedings of last 
year's conference are, in my judgment, the best compendium 
extant of definite programs in the Country Life field. This 
report is a remarkable document, not only in the breadth of 
interests which it covers, but in specific suggestions for action. 
The present program is, so far as I can discover, the first 
national conference in the United States on the fundamental 
subject of rural health. If one reads the list of the member- 
ship of the committees that are represented on this program, 
he will discover that it comprises a remarkable group of 
Country Life leaders. The general "findings" that were de- 
veloped at the meeting on co-operation last April form nothing 
short of a charter of Country Life interests. The mere fact 
that we bring together at these annual conferences official 
representatives of practically all the existing Country Life 
agencies is warrant enough for this Association. 
But, of course, all this is only a beginning. The main 
thing now is to "carry on." It is out of the question to 
prophesy all the lines of effort that may develop in the near 
future. I venture to suggest a few practical needs that I think 
might be considered. 
Undoubtedly these annual conferences should be kept up, 
and held in different parts of the country from time to time. 
They should cover the more fundamental and significant phases 
of the Country Life movement as it develops from year to year. 
In some way the committee reports should be given the 
widest distribution, and definitely placed before responsible 
9 10 
American Country Life Association 
bodies for discussion and action; it is highly desirable that we 
have the results brought back to us from year to year. We 
would soon have a comprehensve, clear-cut Country Life Pro- 
gram for America, not only agreed to by responsible agencies, 
but in actual, vital operation. 
To do all this, we need a much larger amount of public 
information. We have a strong committee on this subject. 
The only difficulty is lack of funds in order that the proper 
machinery may be set up. In spite of the interest in the Peace 
Treaty and in the industrial situation, people are ripe for the 
consideration of any large matter like that of the ultimate 
welfare of the people on the land. Never before could we get 
so good a hearing either in city or in country, on behalf of the 
interests of rural people. 
We need of course a much larger membership. The Asso- 
ciation ought to have a membership of thousands where it has 
hundreds. It needs also to encourage State conferences and 
State branches of the Association. 
All of these things cost money and need time. We need 
paid assistant secretaries who can give all their time to the 
work. At this point I want to pay my tribute to the remark- 
ably effective work of Professor Sanderson. The quality of 
this service is apparent in last year's conference and report and 
in this year's program. From every side I hear that the real 
success of the Baltimore meeting, which consisted in a fine 
spirit of co-operation and a genuine interest in all the dis- 
cussions, was due in large part to the skill, tact, and thought- 
fulness of Professor Sanderson. 
This Association needs a budget of at least $25,000 a year 
in order to perform the service which lies before it in the 
immediate future. 
With respect to the general subject of the present con- 
ference, may I comment briefly. We are just learning as a 
nation that the question of health is a public question of the 
first magnitude. The economic waste of preventable disease 
and accident and of weakened physical powers are almost 
beyond computation. Traditionally it has been supposed that 
the country is inherently healthy, and I, for one, am cautious American Country Life Association 
11 
about reaching conclusions to the contrary even when backed 
by official statistics. That, however, does not dispose of the 
question. It is perfectly evident that the maintenance of the 
health of the rural people is a real problem and one, moreover, 
that is likely to be neglected both in the public mind and by 
health authorities, so that this Association is rendering a real 
service to the rural people themselves, as well as to the nation 
at large, by concentrating its present program on this funda- 
mental issue. 
As I see it, there are three main lines of approach that 
should be followed up by organized programs and activities. 
1. Public health. 
2. Personal hygiene. 
3. Body building. 
There must be a vast deal of education before the rural 
public as a whole can accustom itself to co-operate heartily 
in the enforcement of public regulations relative to sanitation 
and disease. This one task alone is worthy of complete organi- 
zation and constant consideration. Perhaps even more diffi- 
cult in a way is the matter of personal hygiene. Lack of 
facilities is a factor, but the great element of difficulty lies in 
this same tradition concerning the healthfulness of the 
farmer's work and life. All this is also true of the problem of 
body building. It is supposed that the farm-bred boy needs 
nothing in the way of sports and games or gymnastic training 
in order to develop himself physically. On the whole, these 
items of rural public opinion have a background of fact to 
support them, but they are only partially true, and I think 
that our great difficulty is in convincing the rural people of 
the great necessity of a campaign along all of these three lines. 
To accomplish this we must not overdo the argument; we must 
stick to facts and prove our way. 
One important means of education in rural health has 
thus far not been utilized to a very great extent, and that is 
the widespread and increasingly efficient system of Extension 
Service fostered co-operatively by the United States Depart- 
ment of Agriculture, the various State agricultural colleges, 12 
American Country Life Association 
and the hundreds of county farm bureaus. There should be 
a "drive" to put rural health on the program of this Exten- 
sion work as one of the main topics. Indeed, I recommend that 
the Association press its whole program upon the attention of 
all agencies of Agricultural Education. 
I strongly recommend that the Executive Committee be 
asked to give special attention during the next year to the 
problem of unifying and nationalizing a movement for local 
community rural organization. There are several agencies 
already interested. Efforts in the direction of community 
integration are springing up spontaneously. The problem of 
proper guidance and co-operation is exceedingly important, 
especially in these early stages. I can not over-stress the 
necessity of wise, forward-looking, constructive leadership in 
this matter for the immediate future. 
We must remember that important and stimulating as we 
find a conference of this type, both in its program and in its 
personal contacts, the great objective and opportunity which 
lie before an association of this character are to be found in a 
statesmanlike and aggressive activity on the part of the co- 
operating group of thoughtful leaders whose main function, 
after all, is to endeavor to stimulate and encourage the farm- 
ing people themselves. Indeed, one of our objectives ought to 
be to endeavor to secure the active and constant support of 
the working farmers, to such an extent, in fact, that eventually 
they will have real leadership in the Country Life movement. better Health for Rural Communities 
George E. Vincent, 
PRESIDENT OF THE ROCKEFELLER FOUNDATION 
SIR Thomas Moore had a solution for the rural problem. 
In his Utopia there was no permanent distinction be- 
tween country and city people. At stated intervals the urban 
families moved out into country homes, while those who had 
been engaged in agriculture migrated to the towns. It was a 
game of stage coach on a national scale. At harvest time the 
city folk flocked into the rural areas, and in a sort of agricul- 
tural picnic lent a hand in gathering the crops. Thus a 
homogeneous population enjoyed equalized opportunities. One 
wonders how all this was brought about, but recognizes the 
essential value of the idea. At bottom the rural problem of 
today in the United States is that of making available for 
country people the satisfactions of life which in many ways 
have been more fully developed for city populations. 
Originally the negative side of the question was empha- 
sized. We used to hear a good deal about "keeping people on 
the farm." First it was the boys who were to be attached to 
the soil. It turned out that they had been reading the wrong 
sort of books, which always described the success of the country 
boy as a city merchant or blanker. The school curriculum, too, 
was permeated with urban ideas and suggestions. Then came 
the girls' turn. We were told that they looked askance at rural 
suitors; they wanted to be school teachers, stenographers, 
clerks, and get away from the country-side. Next it was 
evident that women must be kept on the farm. They were 
getting restless and discontented; they were refusing to carry 
water, and feed "hands" and bear children under the conditions 
of the average rural home. Finally it was urged that farm 
laborers must somehow be protected from the lure of the eight- 
hour day, high money wages, and the "white lights." 
Different methods of keeping these recalcitrant producers 
on the soil were suggested. A small group was sure that too 
13 14 
American Country Life Association 
much education was the real danger. If only in some way the 
simple rural mind could be kept innocent of knowledge about 
the deceptive fascinations of the city the problem would be 
solved. Other people proposed to hypnotize the rural recal- 
citrants by fine phrases which should expatiate upon the joys 
of life in the open country, the proximity to nature, compan- 
ionship with birds and flowers, a sense of honest duty nobly 
done, a consciousness of value to the nation. Still another 
group-the Roosevelt Commission took this view-insisted 
that a positive program must be adopted, that country life 
must, if possible, be made economically and socially satisfying 
to intelligent individuals, families and communities. Methods 
of production must be improved; communication and trans- 
portation facilitated, marketing conditions bettered; rural 
credits made more easily available on fairer terms; co-opera- 
tive enterprises encouraged; consolidated schools with modern 
equipment, trained teachers and ruralized curriculum estab- 
lished; housekeeping facilities provided: labor-saving devices 
for women employed; recreation organized; church and social 
life revitalized. Here was a program which aimed at the 
symmetrical development of the country-side into a kind of 
life from which it would be hard to tempt people away. 
This program has been realized fragmentarily throughout 
the land. In some communities much has been accomplished; 
in others there have been discouraging obstacles. Farmers 
seem to be by nature and environment individualistic. They 
are sensitive about outside initiative, or "interference," they 
tend to be suspicious of each other. The fact that about 37 
per cent of the farms of the United States are being worked 
by tenants, few of whom feel that they have a stake in the 
community, is a real handicap. These people are too generally 
non-conductors of the currents of community spirit. Then, too, 
differences of race and religion have prevented the rapid 
growth of local unity and co-operative efforts. Yet in spite of 
these handicaps, perceptible progress has been made in almost 
every phase of rural life. But it is characteristic that almost 
the last aspect to receive systematic attention is the most 
fundamental of all, namely health. There is some truth in the 
assertion that man in his desire for knowledge begins with the American Country Life Association 
15 
outskirts of the universe and gradually works back toward 
himself and the things that bear most directly upon his well- 
being. It is certainly true that until recently little persistent 
study has been given to the problems of health in the rural 
community 
During the last decade, however, significant facts about 
the health of country people have been coming to light. Al- 
though the j>ercentage of rejections among recently drafted 
soldiers was the same for both rural and urban recruits, 
namely 26.6, experience in army camps led the medical officers 
to believe that men from the country districts are a good deal 
less resistant to contagious diseases than are the city bred. 
The school population offers further evidence. Rural school 
children in the United States make a distinctly worse showing 
than urban pupils. The report of a joint committee of the 
American Public Health Association and of the Ameri- 
can Medical Association seems to leave no doubt on this 
point. Only last month in Louisiana a comparative study was 
made of the children of a town high school and the pupils in 
a rural school. Of the former 2% per cent give evidence of 
malnutrition; of the latter 52 per cent. Twenty per cent of 
the city children suffer from anaemia as compared with 51 
per cent of the country pupils. The percentage with respect 
to eye defects is 5 to 58 in favor of the city. While only 10 
per cent of the country boys and girls use tooth brushes, 89 
per cent of the city children give their teeth reasonable care. 
The rural sickness rate probably exceeds that of the city. 
It is believed that there is a lower ebb of vitality in the country 
because the rural population is more subject to crippling 
diseases like malaria, hookworm, constipation, adenoids, in- 
fected tonsils and defective teeth. However, it is still true that 
the rural death rate generally falls below the urban. Yet the 
significant fact is that during recent decades the city death 
rate has been steadily reduced, while the rural rate has only 
slightly declined. As a matter of fact, with respect to certain 
diseases like typhoid, the country often suffers more than the 
city. In Indiana for example, the typhoid death rate in cities 
is 27.5; in the country 31.5. The figures for Tennessee are 
29.1 and 40.1 respectively. Tuberculosis is a disease which in 16 
American Country Life Association 
spite of the fresh air of the open country is almost as prevalent 
there as in the crowded city. Infant mortality in many cases 
is higher in the rural than in the urban areas. A recent survey 
in Westchester county, New York, showed that the rate for 
cities was 82, for villages 80, while in the strictly rural regions 
it rose to 104. 
That the country is not inevitably less healthy than the 
city is suggested if not completely demonstrated by the experi- 
ence of other lands. Thus New Zealand, which is largely rural, 
has the lowest infant mortality rate in the world, a showing 
attributable in large measure to a government policy which 
subsidizes rural hospitals and doctors, maintains welfare 
clinics, carries on educational campaigns, makes grants to 
needy mothers, and provides an adequate public health nursing 
service. A comparison made in England a short time before 
the war throws instructive light upon the possibilities of rural 
sanitation and health. A study was made of the school chil- 
dren in fourteen industrial centers, in fifteen residential towns, 
and in eleven rural areas. With respect to every kind of 
disease and defect, the children from the country made a dis- 
tinctly better showing than those from the other groups. As 
one would expect, the residential towns surpassed the indus- 
trial. There is then ground for confidence that under proper 
conditions rural health can be safeguarded and fostered as 
well if not better than that of the city. 
Sanitary and health conditions in the open country have 
been frequently investigated during the last decade. In 1912 
four rural areas in Indiana were surveyed. A total of 9,753 
farms were visited and scored on a schedule which distributed 
100 points among the following items: House, cellar, ventila- 
tion, water supply, sewerage disposal, condition of barnyard, 
pigpen and hencoops, care of manure, health of the family. 
The average score was 45.4 per cent. The passing mark was 
set at 75 per cent. The highest score was 90, the lowest score 
24. In similar fashion twenty counties in West Virginia have 
recently been surveyed. Similarly unfavorable results are 
reported. The plan however has the value of arousing interest, 
stimulating rivalry, and setting on foot many projects for 
improvement. The U. S. Public Health Service has of late American Country Life Association 
17 
conducted a survey in three counties in Texas and Oklahoma. 
In Hill County, Texas, 10,441 homes, 127 churches, 123 schools 
and 502 stores were investigated. The results have not yet 
been published. A sanitary survey in Porter County, Indiana, 
also conducted by the U. S. Public Health Service, discloses 
serious defects in lighting, ventilation, sanitation of rural 
school houses, and reports a disquieting prevalence of defects 
and diseases and of mental retardation among school children. 
Accurate information then is available so that the question of 
sanitary and health conditions in the country is no longer a 
matter of speculation. There is ample evidence upon which 
to base a campaign for improved health in the open country. 
An important approach to education' and agitation in 
behalf of better health is through the public school. School 
medical inspection has stimulated public health progress in 
town and city. It is beginning to produce similar results in 
the country. The discovery of disease and defects in school 
children has led ito many activities on the part of public and 
private agencies. In North Carolina, for example, dental and 
medical inspection of school children is compulsory. In one 
year in that state 5,759 children received dental care; 600 
were operated upon for tonsilitis and adenoids. This service 
is extended to the remotest rural districts. Each county in 
North Carolina provides $500 annually for the medical treat- 
ment of children whose parents can not afford to pay doctors' 
bills. In Kansas free dental care is planned for rural school 
children. Inspection has become compulsory. A recent survey 
has been made in Nebraska as a basis for introducing a similar 
policy. In many other states measures of much the same kind 
have been adopted. The witty assertion that medical inspec- 
tion consists chiefly in making card catalogues of childrens' 
defects and in examining these records from time to time in 
order to identify the pupils by the continued presence of the 
diseased conditions, is beginning to lose its pungency. In- 
spection is coming to be the first step in treatment and not an 
end in itself. It is also pointing to prevention as the real aim. 
Whenever a new idea or doctrine or method of procedure 
is hit upon in the United States sooner or later the responsi- 
bility for inculcating the novelty is placed upon the overbur- 18 
American Country Life Association 
dened school teacher. Thus the pedagogue is compelled to teach 
various statutory forms of physiology and hygiene, kindness 
to animals, morality, respect for law. Of course the country 
teacher is called upon to play an important part in the im- 
provement of rural health. She is expected to be familiar with 
the principles of hygiene, to know the most effective methods 
for arousing an interest in children, to confer with doctors 
and public health nurses, to co-operate in health tournaments 
and to promote nutrition competitions. This does not mean so 
much an increase of responsibility, as a change in the methods 
employed. The old and dreary physiology gives way to charm- 
ing health literature, fascinating competitions and a satisfy- 
ing sense of co-operating with intelligent and enthusiastic 
persons who are promoting the interests of public health in the 
community. The normal schools are beginning to respond to 
the new demands and to provide modern instruction, but until 
rural teaching becomes a well-paid and satisfying career for 
both men and women too much must not be expected from the 
average rural school teacher. 
The rural school is also a valuable demonstration and 
educational center. The hot school lunch, which Is in many 
places being introduced, not only contributes to the nourish- 
ment of the children, but reacts upon the homes from which 
they come. Teachers of domestic science and rural nurses 
heartily support the undertaking 'and make it a part of the 
community program. The school playground and supervision 
of organized play are as much needed in the country as in the 
city, and have an immediate bearing upon the health, recrea- 
tion and social life of the country. Such rural school build- 
ings as are appearing in consolidated school districts, espe- 
cially in the middle west, are in themselves useful models for 
the whole community. Well lighted, admirably ventilated, 
equipped in modern fashion, provided with playgrounds, and 
supplied with approved toilet facilities, these new buildings 
are in themselves a means of education to both pupils and 
parents. 
As centers of health education, the rural schools offer 
significant possibilities. In them the best health literature 
may be distributed. The Louisiana State Board of Health, American Country Life Association 
19 
for example, send out monthly 200,000 bulletins to the schools 
of the state. These leaflets are attractively written and 
delightfully illustrated. The Child Health Organization has 
prepared most appealing types of health literature, notably an 
illustrated health alphabet. This literature is distributed at 
low cost through the Document Division of the Department of 
the Interior in Washington. The International Health Board 
of the Rockefeller Foundation in its campaign against tuber- 
culosis in France was successful in producing health primers, 
post-cards, placards, and games which were welcomed eagerly 
by children throughout France. Health and other social 
workers have learned that oftentimes the only approach to 
families is through children in the schools. 
All who are concerned in improving health conditions lay 
reiterated stress upon the absolute necessity of public educa- 
tion, by demonstrations, exhibits, press articles, posters, 
pamphlets, public meetings, study clubs, through rural schools, 
hospitals and public health centers. With the aid of Federal 
and State departments, agricultural colleges and voluntary 
agencies, campaigns have been organized and vigorously 
pushed in many country communities throughout the United 
States. In the South hookworm campaigns have called the 
attention of whole communities to the need of public health 
measures. Recently malaria control experiments have been 
undertaken, particularly in Arkansas and Mississippi, with 
results so convincing that counties have voted funds for anti- 
malaria campaigns more rapidly than the personnel to carry 
these on could be provided. In a number of states typhoid 
vaccination has also been used as a means of impressing rural 
people with the effectiveness of prophylactic measures. 
Motor truck and railway cars are being requisitioned for 
public health propaganda. The United States Department of 
Labor has recently put in the field a mobile children's clinic. 
This motor truck is in charge of a doctor and nurse who, going 
from place to place, hold baby clinics, give addresses, display 
motion pictures, and thus reach remote country districts with 
the gospel of hygiene and public health. In Louisiana, under 
the auspices of the State Department of Health, a negro lec- 
turer with a Ford car is rendering a similar service in negro 20 
American Country Life Association 
communities. The Health train in ithe same state has at- 
tracted wide attention. The New York State Department of 
Health has sent out what it calls a "Health-mobile/' which is 
at once a clinic and an educational unit. What the French 
called "medicinal tanks" were utilized by the Rockefeller 
Foundation and the American Red Cross in reaching rural 
parts of France with anti-tuberculosis and child welfare edu- 
cation. 
Exhibits, lectures, motion pictures dealing with health 
subjects, are now familiar features of County Fairs, Teachers' 
institutes, and agricultural and rural school meetings. Farm 
bureaus, university extension divisions, granges, farmers' 
clubs are co-operating with health authorities and societies to 
bring the effects of disease and the achievements of preventive 
medicine to the attention of rural people in communities 
throughout the country. In New York State health study 
clubs are being organized. The women leaders in a given 
community form a club and promise to attend ait least six 
study periods. These clubs are arranged in circuits so that 
trained speakers may reach one class each afternoon and an- 
other each evening. Printed or mimeographed syllabi are 
provided in advance. It is believed thlat this plan will arouse 
an intelligent interest in public health administration and will 
create a demand for full-time health officers and public nurses. 
Agricultural colleges are introducing courses of instruction in 
hygiene and preventive medicine in order that graduates may 
return to the country with intelligent ideas as to the im- 
portance of public health activity and the best methods of 
organization and administration. The rural hospital, as will 
be indicated a little later, is to be reckoned among the educa- 
tional influences at work in the interests of public health. 
A community, like an individual, "learns by doing." A 
campaign for improved sanitation and health is promoted by 
the creation of an official organization for the purpose. If 
aroused sentiment is to find permanent expression there must 
be some authoritative way of protecting water supplies, dis- 
posing of excrement, safeguarding milk, looking after refuse 
and manure, calling attention to health within the home, 
directing the public attitude toward health procedures, and American Country Life Association 
21 
enforcing the health laws. While private agencies may ac- 
complish significant results in agitation and in co-operating 
with the legally constituted authorities, only the latter can 
effectively administer the machinery of public health. More- 
over this machinery must be directed by an adequately trained 
official who devotes his full time to his public duties. This 
principle is fundamental and is receiving increasing recog- 
nition. 
The State of Vermont, for example, has been divided into 
ten health districts, each under the charge of a full-time health 
officer whose salary is paid by the State. City health officers 
are also appointed by the State Department of Public Health. 
Thus the entire Commonwealth is covered by a system of full- 
time health officials whose activities are directed from a single 
source of authority. Community health districts with full- 
time officers have been created in New York, Massachusetts 
and Illinois. Texas is conducting an experiment in the organi- 
zation of five counties under full-time officials. Twenty-three 
out of the one hundred counties in North Carolina are admin 
istered on the same basis. A new law in Ohio (House Bill 
211) calls for the thorough organization of the entire State 
upon a full-time basis. This statute authorizes the organiza- 
tion of district boards of health with full-time health officers 
and clerks. It requires the appointment of an adequate num- 
ber of public health nurses. It permits the establishment of 
welfare stations and detention hospitals. It prescribes medi- 
cal and dental supervision for schools, the free treatment of 
venereal diseases, and the establishment of district labora- 
tories. State funds to the amount of 50 per cent of the salary 
roll of a district board of health are made available with the 
stipulation that no one district shall in a given year receive 
more than $2,000 from the public treasury. The bill confers 
large powers upon the State Department of Health and district 
boards of health. It also authorizes annual conferences of 
health officers and special schools for the instruction of public 
health personnel. 
As ia test of the full-time system in a rural region, the U. 
S. Public Health Service has been conducting an experiment in 
Edgecombe County, North Carolina. An officer of the 22 
American Country Life Association 
Service has been detailed as a county health officer. All ex- 
penses other than this official's salary are borne by the local 
community. The program includes quarantine, child welfare, 
supervision of midwives, hygiene and sanitation, school in- 
spection, vaccination and an educational campaign. Under 
the auspices of the same Service an experiment has been car- 
ried on in Mason County, Kentucky, [the expenses of the 
administration being shared by the U. S. Government, the 
State and the County. 
As to the minimum cost of the full-time plan, authorities 
differ. Dr. J. T. Moore .regards the minimum unit as consisting 
of a full-time medical officer, a visiting nurse, an inspector and 
clerical assistance. He estimates the cost at $6,000 per year 
for a population of 30,000, or 20 cents per capita. Dr. K. E. 
Miller some time ago fixed the minimum at one officer, with 
a budget of $3,000. He expressly stipulated that the work 
under such conditions must be limited, explaining that many 
features could not be included, and that a laboratory would be 
quite out of the question. With the increased cost of living 
it is probable that the $3,000 estimate is now too low even for 
the simplest type of administration. The Ohio law seems to 
recognize a $6,000 norm, of which $4,000 will be supplied by 
the local community and $2,000 from the public treasury. 
It is agreed on all sides that the rural nurse is essential 
to the success of health programs in the open counitry. It was 
estimated that last July there were in the United States 
<8,180 public health nurses in active service. Of course the 
overwhelming majority of these were at work in large cities 
and towns. A considerable number, however, were serving 
rural constituencies. Some years ago the American Red Cross 
established a town and country nursing service. With the re- 
turn of peace the Red Cross is giving attention to rural nursing 
and has already 307 nurses in the field. The same organization 
has supplied scholarships to enable prospective nurses to fit 
themselves for public health service. At present there are about 
275 women pursuing courses of instruction with the aid of these 
scholarships. The National Organization for Public Health 
Nursing has rendered notable service in studying the problems 
of rural nursing, and in working out plans of organization. American Country Life Association 
23 
The movement for putting nurses in the field is nation- 
wide. Massachusetts has set the mark of one nurse to 2,000 
population. Connecticut aims at a ratio of one to 3,000. In 
Minnesota nurses are paid by counties as regular officials. 
Rural nurses are in the employ of consolidated school districts 
in Iowa. South Carolina has 22 nurses in service, some of 
them engaged in county work. Nurses are attached to the 
hookworm control units which are in the field in Tennessee. 
Towns in New England are combining to increase the efficiency 
of their public health nursing service. For example, three 
towns on Cape Cod, including seventeen villages and a popu- 
lation of 8,000, employ three nurses, each of whom is supplied 
with a motor car. Great Barrington, Mass., has extended its 
work to include outlying towns. 
The rural nurse is more than a bedside ministrant. She 
becomes a social service worker, sometimes a local leader in 
the organization of classes in home nursing, household man- 
agement, sewing, etc. She is a health propagandist working 
out from the town into the country. She is to be found as an 
attendant in the rest rooms which are being established in 
towns for the women who come in from the country for the day. 
She is the friend and counselor of the rural school teacher in 
solving her problems of education in hygiene. The program 
of the rural nurse includes prenatal work, maternity care, 
baby welfare, hygiene and sanitation, tuberculosis and other 
diseases. The supervision of midwives is being entrusted to 
her. The rural nurse is to be regarded not as a charity worker 
but, to use the phase of another, as a "community mother." 
Allusion has already been made to the educational value 
of the rural hospital. Until recent years hospitals have not 
been easily accessible for country patients. With the improve- 
ment of roads and the introduction of motor cars, hospitals in 
towns and cities have been brought within the reach of a large 
number of rural people. The local country hospital, however, 
can render a service to public health education as well as to 
the care of the sick which the remote city institution cannot 
provide. Rural hospitals are now being built in a number of 
places under public auspices. Permissive laws which enable 
county supervisors to lay a tax for the construction and 24 
American Country Life Association 
maintenance of county hospitals have been enacted in Michi- 
gan, New York, Indiana, Kansas, North Carolina, Iowa and 
Missouri. In Colorado, Idaho, Montana, Vermont and Mary- 
land communities are permitted (to combine in establishing 
local hospitals. In Texas the law compels all counties with a 
population of over 20,000 people to provide public hospitals; 
other counties with a smaller population are permitted two 
units in a hospital area. The province of Saskatchewan, in 
western Canada, under similar legislation, has already 20 rural 
hospitals in which free medical service for taxpayers is pro- 
vided. The tax for hospital purposes varies from $3.50 to $4 
annually for a quarter section. The Saskatchewan provincial 
government also appropriates 50 cents per day per capita to- 
ward the maintenance of these hospitals. Much the same 
policy has been adopted by Alberta. In New Zealand rural 
hospitals subsidized by the government provide a system of 
medical and surgical care for country people. The principle 
of collective responsibility for hospital maintenance in rural 
districts has been clearly recognized. 
Of country serving hospitals under voluntary auspices one 
of the most striking examples is afforded by the Greater Com- 
munity Hospital at Creston, Iowa. Largely as a result of the 
imaginative and inspiring leadership of Dr. R. F. Samson, an 
area in southwestern Iowa tributary to the town of Creston 
has been organized into what is known as the Greater Com- 
munity. Churches, farmers' clubs, benevolent orders and 
groups of many other kinds are co-operating in the under- 
taking. By contributions to the hospital or to a welfare fund, 
these groups provide for medical and hospital care for certain 
of their numbers. Social service work for the afflicted and 
indigent of the Greater Community is carried on through 
organizations and individuals. The central hospital is inti- 
mately associated with the Greater Community organization. 
A nurses' training school is maintained which gives an all- 
around education that is especially valuable for women who 
are called into country homes for service. They learn to be 
resourceful and to use the means at hand where city-trained 
and highly specialized nurses might find themselves helpless 
or seriously handicapped. The doctors of the Greater Com- American Country Life Association 
25 
munity as their contribution to the common undertaking give 
in the hospital free medical and surgical service to all patients 
who are being aided by any society or individual. The move- 
ment also consciously and systematically promotes education 
in hygiene and public health. Co-operation with public schools 
and the holding of clinics throughout the country districts are 
parts of the plan. From all accounts the experiment is not 
only thoroughly successful from the point of view of hospital 
care but has developed a community spirit and a habit of co- 
operation which react most favorably upon the whole life of 
southwestern Iowa. 
Experience seems to show that in spite of the accesssibility 
of city hospitals for surgical operations and acute diseases, 
there is a real need for the rural hospital. From a survey of 150 
small hospitals in Pennsylvania it appeared that 80 per cent 
of the cases in these hospitals were surgical. Of these surgical 
cases 75 per cent were emergency cases which called for imme- 
diate operation or attention. It is essential, too, that there 
should be hospital care for patients who suffer from typhoid, 
rheumatism, appendicitis, etc. It is highly desirable in 
maternity cases, especially such as present any serious diffi- 
culties, that there should be hospital attention. The value of a 
rural hospital to the community is obvious. Whether the 
institution is under public auspices or is maintained by a 
voluntary association, it fosters a community spirit and sense 
of collective responsibility. Its educational influence is 
marked. The patients who are cared for and the relatives who 
visit the institution cannot fail to get vivid and memorable 
impressions of the meaning of modern medical and surgical 
care. The rural hospital reduces the amount of sickness and 
lowers the death rate. It contributes directly and indirectly 
to the progress of public health sentiment and administration. 
A diagnostic laboratory, which should be a feature of even a 
small hospital, may be utilized by the public health administra- 
tion of the local area. So, too, the rural hospital is of service 
to the medical profession. It affords a meeting place for the 
doctors of the community. It favors the development of a pro- 
fessional esprit de corps. It stimulates doctors to study and 
to keep abreast of the times. It increases individual efficiency. 26 
American Country Life Association 
It helps to maintain ethical standards and is one means of de- 
tecting and driving out of the community ignorant and un- 
scrupulous practioners. 
Besides the school and the hospital, it is proposed to 
create in country as well as in town what has been called the 
Health Center. Tentative experiments in establishing such 
centers have been reported from different parts of the country. 
No single type or standard has yet been fixed upon. The idea 
is in the making. The most complete formulation of this new 
project has been made by the American Red Cross, which in 
outlining its peace program has given a conspicuous place to 
the Health Center. This is described as the "physical head- 
quarters for the public health work of the community." The 
essential features of the project are as follows: (1) Concen- 
tration in a single building of the offices of both public and 
private health agencies with a view to securing the maximum 
degree of co-operation; (2) provision of a public health dis- 
pensary, which in addition to the usual laboratory facilities 
shall provide a variety of special clinics-e. g., for tuberculosis, 
child hygiene, venereal diseases, industrial and mental hygiene; 
(3) a clearing house service for public health information, so 
that all inquiries may be promptly referred to the appropriate 
agencies; (4) a means of public health education for the distri- 
bution of (literature, the giving of lectures, holding of con- 
ferences, etc; (5) a rallying point for volunteer service in 
visiting the sick, rendering many forms of social aid, providing 
motor car transportation and in other ways supplementing and 
reinforcing the work of the trained personnel; (6) a, com- 
munity center with a rest room for mothers, a cheche for 
babies, an infant welfare clinic, work-rooms, etc.; (7) a head- 
quarters for a public health nursing service; (8) a point of 
contact with the public schools of the community. It is not 
the purpose of the Red Cross to attempt the imposition on any 
rural region of a. predetermined and inflexible plan of organi- 
zation. The desire is to act as a community agency in pro- 
moting efficient co-operation in the interests of public health 
and neighborhood spirit. The plan is full of fruitful possi- 
bilities and offers one of the most promising means of in- 
creasing the efficiency of health work in the country. American Country Life Association 
27 
No consideration of rural health programs is complete 
which fails to take into account the rural doctor. A move- 
ment to keep him in the country would not be unreasonable. 
In towns of over 2,500 population there is one doctor to every 
513 people. In the country districts there is one to every 991. 
Even when allowance has been made for the physicians who 
live in towns of over 2,500 and practice in the surrounding 
countryside, the disproportion between the medical services 
available in the city and in the country is striking. The success 
of public health work is so dependent upon the co-operation 
of intelligent and well-trained physicians that the problem of 
offering medical men an attractive career in the country is a 
very real one. Western Canada and New Zealand subsidize 
physicians who are willing to practice in the country. Under 
the health insurance act in Great Britain medical service is 
made available for rural districts. It is possible that for 
another decade or two part-time public health service will 
provide an inducement to medical men to undertake and con- 
tinue practice in the country. It is to be hoped that some 
solution will be found for the present disparity between the 
fee of the country doctor who diagnoses a case and that of 
the town or city surgeon to whom the country doctor refers 
the patient. So long as the one man receives $5 or $10 while 
the other is paid from $50 to $500 it will be difficult to do 
away with the evil of fee splitting and of secret subsidies. An 
effort to recognize the value of skillful diagnosis and to secure 
just remuneration for it ought to be made in the interests of 
the countryside if not of the individual practioner. 
Quite apart from the question of income, there are other 
inducements which influence men of right training and high 
ideals to devote themselves to country practice. The connec- 
tion with a rural hospital is a genuine attraction to growing 
and ambitious men. The development of an efficient public 
health service with visiting nurses cannot fail to increase the 
popular appreciation of medical service and thus offer larger 
opportunities and a more congenial environment to the rural 
practioner. As the public comes to understand better the 
nature of disease and the value of prevention, doctors may 
expect to find an increasing demand for examinations and for 28 
American Country Life Association 
advice about keeping well. The doctor, in short, will become 
more and more a trusted counsellor consulted before serious 
developments occur rather than a rescuer summoned when 
acute symptoms call for immediate relief. Moreover, the 
country doctors can be counted upon to co-operate in public 
health campaigns and thus to find satisfaction in working with 
others for a common cause. In short, the public health move- 
ment ought to increase the demand for doctors of the right 
sort in the country and to make country practice a more satis 
fying form of activity. 
The main proposals for improving health and happiness in 
the open country involve considerable expenditures. A certain 
amount of public health work can be supported by taxation or 
voluntary contributions in any area, but so soon as anything 
like a complete and well developed system of public health 
activity is developed the cost is likely to overtax local re- 
sources. Precisely this experience has been encountered in 
the improvement of rural education. Almost any locality 
can maintain some kind of a one-room, one-teacher, ungraded 
district school. When, however, consolidation with well-built 
and equipped schools, a specialized teaching staff and daily 
transportation is undertaken, the expense is greater than the 
average rural community feels able or willing to assume un- 
aided. Thus it has come about that county, state and federal 
subsidies for education have been increasingly provided. In 
education it is recognized that the intelligence and character 
of boys and girls is a concern not merely of the immediate 
locality but of the state and of the nation. So, too, the health 
of every individual and group affects the welfare of the whole 
people. 
Practically all the plans, therefore, for rural public health 
development call for contributions of some sort from outside 
the immediate area, concerned. For example, in the hook- 
worm campaign which has been carried on in the southern 
states largely upon the initiative of the International Health 
Board of the Rockefeller Foundation, a regular form of co- 
operation has been worked out by which the state, the county 
and the board contribute to a common budget. The same plan 
has been adopted in malaria projects in Arkansas and Missis- American Country Life Association 
29 
sippi. Mention has already been made of several projects in 
which the United States Public Health 'Service, the state and 
the county work 'together with a fund to which the treasuries 
of all three make a contribution. The new Ohio law which 
provides within certain limits of state subsidy amounting to 
50 per cent of the local salary roll, and the provincial sub- 
sidies to physicians and hospitals in Saskatchewan offer fur- 
ther examples of this principle. 
From this survey of the field of rural public health it is 
evident that the general movement for better and more satis- 
fying living conditions in the country will more and more 
include hygiene, sanitation and the promotion of health. This 
element of the problem cannot be isolated from all the others. 
It is a part of the common life and must 'be a part of the com- 
mon program. It is sheer blindness to be unduly optimistic 
about the difficulties to be overcome. The economic aspects of 
the situation are complex and baffling. The differences of 
race and religion are formidable. The tenancy factor is dis- 
couraging. It remains to be seen whether the countryside 
can be organized on the basis of the co-operation of inde- 
pendent, self-reliant individuals and families or whether the 
factory system will make its way into the open country and 
establish great plantations upon which a wage-earning 
peasantry will labor. The latter possibility is so repugnant 
to American ideas and so menacing to our fundamental insti- 
tutions that the very thought of it must arouse all friends of 
the countryside and of our native land to renewed efforts in 
behalf of country life. 
Yet it must be remembered that if it is to be improved 
and made satisfying, this must come about through local 
leadership working in democratic fashion, so that what 
progress is made is not imposed from without but is an 
organic and permanent growth from within. This does not 
mean that city people have not a duty and an opportunity, 
but it does mean that all activity must be in and with the rural 
communities. 
The many agencies then, public and private, in the field 
of public health are called upon to subordinate all their insti- 
tutional ambitions to a great common undertaking. The 30 
American Country Life Association 
American Red Cross in its new program has expressed a fine 
spirit of co-operation and declared itself ready to serve other 
organizations, if in this way the common welfare can best be 
promoted. It is in this spirit that the task should be under- 
taken with renewed vigor and unswerving enthusiasm. 
Scientific knowledge is available; the facts can be presented 
vividly; demonstrations have already shown that substantial 
results can be secured; funds are likely to be more generously 
appropriated by local and central governments and contributed 
in voluntary gifts. There are scores of organizations ready 
with their special knowledge and skill. A vast fund of good 
will and genuine desire to serve is available. It remains only 
to organize all these forces into a. persistent team-play in 
order that the people of the open country may live healthier, 
more vigorous, happier lives. Qood Health: Its Relation to Human Progress 
Eugene Fisk, M. D. 
MEDICAL DIRECTOR, LIFE EXTENTION INSTITUTE 
iaHAT is good health? What is this quality or composite 
(JJ of qualities, if you please, that you ask me to discuss in 
its relation to human progress? I believe that such a ques- 
tionnaire, simple as it sounds, would bring from the indi- 
viduals in this audience a surprising variety of answers. 
Far too many people believe that good health connotes a 
mere ability to keep out of a sick bed-a mere ability to re- 
main at some kind of work, regardless of the quality of the 
endeavor or its product. 
If I were asked to define good health, or rather thoroughly 
sound health, I should say that it is a state of mind and body 
representing the highest attainable degree of adjustment of 
the individual to his environment. In a physical sense, good 
health connotes absolute physical freedom. How many of us 
are actually free in this sense? We look upon this country as 
one where the largest degree of political and individual free- 
dom exists, as a place where men are free to do anything that 
is not injurious to their neighbors or to the state; yet, my 
friends, ask yourselves directly and honestly: "Am I indeed 
physically free? Can I call upon my body to do those things 
which a normal structure and a normal condition of the human 
organism should enable me to do? What are my physical 
reserves? Can I climb, run, work or play as a thoroughly 
sound human animal should reasonably be able to do?" 
At the present moment the problem of the political free- 
dom of nations and the right of their populations to the pur- 
suit of life, liberty and happiness has made a call on the 
wisest statesmen of our time for solution, yet tremendous and 
far reaching as are the political problems that confronted the 
Allied Council, they sink into insignificance as compared to 
the great fundamental problem underlying all human happi- 
ness and human achievement-'that of physical freedom. 
31 32 
American Country Life Association 
If you ask me what human progress is, I answer that it 
connotes a movement towards perfect adjustment of the indi- 
vidual to his environment, and since perfect adjustment is 
perfect health, human progress and better health are names 
for the same thing. I have asked you the question, "How 
many of you are physically free in an absolute sense?" and I 
will answer it for you as follows-"not one." 
No ' individual in this audience is absolutely free from 
physical defect or some fault in physical or mental adjust- 
ment limiting to some 'degree his capacity for getting the best 
out of life. About 50 per cent are in need of some form of 
medical, dental or surgical treatment; about 25 per cent are 
in need of medical supervision for important physical impair- 
ment or so-called disease, and about 5 per cent have serious 
physical impairments demanding immediate attention. I 
make these assertions on the authority of the statistics we have 
derived at the Life Extension Institute from the examination 
of about 150,000 people, from the examination of large groups 
of supposedly healthy people actively engaged in some form 
of occupation. If you are skeptical and believe that we are 
taking the extreme view of specialists in this health field, I 
refer you to the draft examinations, where it wa® found that 
35 per cent of the men between twenty-one and thirty-one 
years of age were found physically unfit, not for war but for 
the training camps, where many thousands were sent who 
were actually unfit for war, but were made fit by treatment 
and training. It may safely be said that practically none of 
our draft recruits were fit for war without some preliminary 
physical as well as military training. We called on civilized 
man to adjust himself to an uncivilized condition and we 
were startled to find that, in spite of our boasted civilization, 
we have lost some of the physical freedom that uncivilized 
man enjoyed. 
Under this superficial and apparent adjustment by which 
civilized man is able to dodge his physical .responsibilities and 
maintain himself after a fashion without adequate physical 
effort and in spite of physical deficiencies, there lurks this 
evidence of lack of adjustment, this undercurrent of physical 
deficiency, of chronic disease and premature ageing, the ex- American Country Life Association 
33 
tent of which can be dimly appreciated when we go over the 
census records and find that 130,000 people between the ages 
of thirty and sixty years die annually of diseases of the heart, 
blood vessels and kidneys. Comforted and reassured by the 
conquest of many communicable diseases, by the fall in the 
general death rate and especially by a fall in the death rate 
from typhoid, tuberculosis and other communicable diseases 
that affect early life, we have neglected to study the causes 
of chronic disease and substandard health that bear more 
heavily on the middle ages of life. It has been shown by a 
study of our census records that in contrast to other civilized 
countries there has not been an improvement at every age 
period of life, and there is good reason to believe that there 
has been deterioration at the middle and later periods during 
the past thirty years. We have not appreciated the pampering 
influence of the conveniences of civilization, some of which, it 
is true, protect us from acute and immediately menacing 
troubles, while others invite physical degeneration. 
We have gradually conquered the menace of epidemic 
disease, although the influenza epidemic was a warning that 
there is yet much to be done in that field, while our civilized 
habits of living, our neglect of bodily exercise, our self-in- 
dulgences have invited the attack of chronic maladies, of per- 
sistent and progressive tissue changes due to infection quite as 
malignant in their final effects as epidemic diseases, but they 
pass unnoticed because of their slow progress. 
In spite of the lower death rate in all civilized countries, 
chiefly due to saving of life at the early ages through sanita- 
tion and the reduction of communicable diseases, we find on 
close analysis that nowhere is there a race of organisms so 
diseased, imperfect, crippled, physically maimed, distorted and 
infected as this alleged god-like creature-man. Is there any 
other animal with such defective vision, with such distorted 
and crippled feet and badly balanced muscular system? Where 
in a state of nature will you find any other animal that shows 
at early maturity more than 50 per cent of individuals with 
decayed teeth, infected gums and nasal cavities-conditions 
that are of far more than local importance and fairly radiate 
disease, old age and death. What race or organisms can show 34 
American Country Life Association 
the widespread infection such as arises from the diseases of 
vice? Some people'with a lack of a sense of proportion have 
combated these views and statements with regard to the 
prevalence of physical defects and the menace of disease among 
our draft recruits, and have pointed out the wonderful 
achievements of our army in France. We may well be proud 
of that army, of its splendid physical condition, its superb 
morale. Our allies and the Germans themselves have conceded 
these facts, but our army formed 'but a small section of the 
population and it represented a very careful sifting of the 
most favorable age groups. It presented an inspiring contrast 
to the middle-aged war worn armies of Europe. It is folly 
to generalize from this fact that our population as a whole is 
not far below an attainable condition of sound health and 
physical freedom. We are entitled to expect a great deal of 
civilized man. We place him at the top of the scale of living 
organisms. It has been estimated that there have been more 
than ten million distinct species of which the world has 
record. There is good evidence that vast stretches of time 
represent the period during which the human organism has 
developed, and during that time civilizations have evolved, 
passed through decadent periods and died. Some races of 
men have even utterly disappeared from the face of the earth. 
We can gain nothing from national self-sufficiency. We 
can gain nothing in steering our country awrny from decadence 
by blunt-eyed optimism or by refusing to recognize underlying 
physical and social conditions that make for decay, by insist- 
ing that we are a chosen people. I firmly maintain that the 
recognition of this evidence of ill health, of faulty adjustment 
to which I have referred, marks the highest type of optimism. 
Combined with courageous resolve to correct these conditions if 
is the greatest individual and national safeguard against 
degeneration and decay. A genuine pessimist is the man who 
believes that everything that is, is right; that the life cycle 
of man is fixed; that it is beyond the power of science or of 
human intelligence to change that life cycle or to increase the 
capacity of the human organism to live a satisfying and happy 
existence. The fact that 50 per cent of the people are so 
physically defective as to require medical attention is to me American Country Life Association 
35 
almost a joyous message. I can safely say that, as I am not 
a practicing physician and am not seeking these people for 
patients, but I view them as people not inevitably doomed to 
a shortened and insufficient existence, but people who offer 
a reasonable hope of definite improvement, of a greatly 
broadened existence, if their co-operation can be gained. 
When I review the life tables of the United States census 
and find that at the age of twelve the death rate begins to rise 
until at forty it is approximately three times what it is at 
age twenty, I have no sense of discouragement, but one of 
elation, to find that here in this age period, when a man is sup- 
posed to be at his best, that this best is far below what it 
might be if application of the larger knowledge that we now 
have regarding the causation of physical decay may be made 
available, and we realize that there are definite reasons for 
the tissue changes which we have blindly ascribed to the 
operation of time. 
While this matter of the death rate and the life span is an 
index of the underlying conditions that involve our health, 
happiness and achievements, I wish to focus your minds on a 
more important problem which I term the health span. The 
health span is that period during which the individual enjoys 
exuberant and abounding vitality due to the hormones of 
health that circulate through his system, making him glad just 
to be alive. We see evidence occasionally of this in healthy 
young people. The expression of this delight in living seems 
almost to be a form of intoxication, yet without any sinister 
background. It is a condition that men seek to simulate by 
drug indulgence, by alcohol. The poisoned and jaded and in- 
fected individual lacking the hormones of health goes to an 
imitation hormone, a drug that does not really stimulate but 
simply masks his discontent with life. 
I think it is conservative to say that in few people does 
this state of abounding vitality continue for more than ten 
years. Until about the age of twenty-one the human animal 
goes through a period of growth and development. Below 
that age there is hesitation in taking men for military service 
as well as in taking men over thirty. When we closely scru- 
tinize men beyond thirty, we find that already they have 36 
American Country Life Association 
physical limitations; already they have accumulated physical 
disabilities, as the draft records will show. The rejection rate 
at age thirty-one was 30 per cent higher than the rejection 
rate for age twenty-nine. Now, ten years is a pitiably brief 
period of time if we fix the life cycle of man at three score 
years and ten. I am not aware of any scientific evidence that 
justifies the belief that these limitations are necessary. The 
question of the extension of human life is to me a negligible 
factor compared to this question of improving its quality, the 
lifting of handicaps that become so common and tend to nar- 
row our existence as age advances. It is surely a false.position 
when as the mental horizon widens thei physical horizon 
shrinks. There should be and there can be a better balance 
attained. We positively know that the life cycle of other 
organisms can be changed by comparatively simple methods. 
For example, an annual can be converted into a perennial by 
cutting the stem sufficiently early. The life cycle of the un- 
fertilized egg of the starfish can be profoundly modified by an 
extra, supply of oxygen; the cells of the chicken embryo, 
ordinarily short lived, have been made to survive for years 
by washing them of poisons, protecting them from infection 
and supplying proper nutriment. Man is such a complicated 
organism that this formula cannot be completely applied to 
him, yet it is a formula that offers a solution for most of the 
health problems presented in this paper. 
The campaign for community health is well under way; 
the protection of our food supply, our water supply, the guard- 
ing of our borders and our communities from epidemic dis- 
eases are recognized as commonplace social requirements. In- 
telligent people do not debate as to their necessity, though 
legislators may still be reluctant to vote appropriation in 
adequate amount for these elementary measures of protecting 
public health. In addition, there is need of education regard- 
ing the multiplicity of factors, apart from those ordinarily 
considered in public health work which make for physical 
decay, premature old age and death. There is need for the 
development of facilities for ascertaining the physical condi- 
tion of the individual and applying such knowledge as we have 
in improving it. American Country Life Association 
37 
The first great need is the periodic physical examination, 
the results of which are so emphatic in their testimony; next, 
is for medical, dental, surgical and hygienic facilities for cor- 
recting physical deficiencies; last, but not least, provisions for 
physical training, physical education and the extension of 
knowledge of the actual cause of physical decays, physical 
insufficiencies, premature old age and death. It will be nec- 
essary for scientific men as well as public to get rid of the 
dogma that senility and death are due to time. I maintain 
that disease, old age and death are due to the following causes, 
and if anybody can add another category to the list I should 
be glad to include it: Heredity, infection, poison, food excess, 
food deficiency, physical strain, mental strain, physical 
apathy mental apathy and accident. A knowledge of these 
causes clearly points the way either to definite and specific 
means of prevention or to the line of research that is neces- 
sary to discover some neutralizing factor. 
In conclusion, let me again emphasize the importance 
of going far beyond the mere prevention of disease. I think 
we are entitled to look upon man as he exists today as a mere 
adumbration of what he may become when he intelligently 
taps all his latent resources of mind and body and gives the 
same attention to improving his physical and mental type as 
he now does to improving the luxuries and self-indulgences 
that surround him. When he extends the same care to his 
own body that he now extends to his automobile or his busi- 
ness, we may hope for the day when, it is true, life will not 
be free from struggle, sorrow and disappointment, but it will 
be life on a higher plane, freed from the sordid miseries that 
indict our civilization as a failure, but not an unremediable 
failure up to the present time. QThe Need And Some Suggestions For 
Supplying Hospital Facilities To 
Rural People 
Dr. J. J. Ross, Middleburg, Vermont 
URING the last ten years, owing to the recent criticism 
and drastic recommendations to medical colleges, the 
number of men graduating from these institutions has been cut 
in half. At first there was little effect on the rural com- 
munities, but it was only for a short time. Very soon they 
were the ones to suffer most. Then came the war which has 
only tended to make the conditions worse, for in many cases 
it was the country that gave most freely of its doctors, and 
now with the close of war in many instances these men have 
gone to other fields. So as we are again approaching the 
normal there is still a great shortage which will even be more 
keenly felt as the older practioners retire from service. These 
men have grown up with the towns until they are a part of 
the community and will spend their last years of usefulness 
for the home folks. But we must soon face the fact that a 
man who has had to take a two-year course in college, a four- 
year course in medicine and a two-year hospital internship will 
be slow to locate in a community of 800 to 1,000 people; for 
many times he could receive more as intern than he could earn 
the first years of practice in a small town. 
The deans of our medical schools are constantly getting 
letters asking for men to locate in the small communities. One 
who is familiar with the subject knows full well that a country 
doctor has to spend far more for transportation and equipment 
than his city brother. His fees are smaller and he feels the 
isolation. All these factors are tending to turn away the 
physician from the rural districts and in some instances the 
situation is really acute. One has only to look a short way 
into the future to see the time when real estate will depreciate 
38 American Country Life Association 
39 
not have proper medical attention, at least in cases of acute 
illness and in times of accident. 
T quote from a recent editorial in a Vermont paper: "The 
town of Corinth would seem to be a fine place for a young 
physician to set himself up in practice, inasmuch as there is 
no physician in that town and none located nearer than 
Chelsea and Bradford, both of which communities are removed 
many miles. The need of a resident physician for Corinth is 
made more apparent when one is told that a newly born child's 
life was sacrificed because of the inability to get a physician 
to attend the case, although ten different calls were made for 
medical attendance. Aside from the desperate need of a 
physician located in Corinth, there is some incentive for a 
medical men to locate there, because Corinth is an attractive 
little village and the center of several smaller villages into 
which a doctor's practice might be extended. The location does 
not promise quick wealth for a doctor, but it does offer splen- 
did opportunity for service and for reasonable returns 
financially, it would seem." It then goes on to say: "This is 
one of the scores of similar instances reported from all direc- 
tions. It now behooves all people to encourage young men to 
engage in the study of medicine. We are to bear in mind not 
only that there is an excellent field for physicians, but also that 
this field offers a grand opportunity for service for humanity." 
Let us ask ourselves how many young men just starting a 
home would like to ask his bride to go to Corinth to live? 
Those of'you who were in France know how the medical 
problems were of necessity worked out there. The French 
people made their way to the base field hospital, advance 
dressing stations, or casual clearing stations of the British 
army, and cases that before the war would have felt they must 
have a personal visit by the physician were only too glad to 
have a hospital to go to. The scarcity of medical men was 
so great in the British army that I have had patients come for 
miles for treatment. One thing the war has taught us is that 
the hospital need not of necessity be constituted of brown 
stone or marble. I wish I could make the people of this 
country see and realize the great work done by our surgeons, 
in some cases in operating rooms constructed out of packing 40 
American Country Life Association 
boxes and under canvas. Cannot we give up the idea of 
spending so much for architecture and make the money go 
further by building a more simple structure? In a certain 
prosperous community the town rejoiced to know that a gift 
of $30,000 had been made for a hospital. Soon after, however, 
all building was stopped on account of the war. On the sign- 
ing of the armistice it was found that in price building 
materials had so soared that it was impossible to build with 
the money donated. A few days ago I was talking with the 
trustee of the funds and he told me they had stipulated in the 
gift that certain architects be employed. Now, to make the 
money go further they had decided to employ architects that 
would seek to make a practical building rather than one noted 
for its architecture. 
There, too, public sentiment needs to be aroused. If this 
same town had had some one to make known the needs of a 
hospital, there might be today a prosperous hospital in the 
place. The leading banker said to me only a few days ago: 
"Had I only thought to mention it to a wealthy man when 
he was making his will, he would have been only too glad to 
build a hosiptal." There are many people of wealth who are 
only waiting to have some one suggest to them such a need, 
and they will answer it. I recall one gift that built a hos- 
pital of fifty beds. However, it was a beginning, and today 
there is a hospital of 150 beds, together with a good en- 
dowment. 
Those who desire to study the workings out of the rural 
hospital will find a most interesting institution at White Rock. 
N. C. Miss Goodrich went into the mountains of this section 
to give an education to those who desired to avail themselves. 
She soon saw the possibilities of a hospital. For years she 
worked on, looking continually for the right man to carry on 
the medical work and to be the center around which the struc- 
ture should be reared. Finally, Dr. John Campbell, of the 
Russell Sage Foundation, persuaded his friend, Dr. George 
Packard, to take up the difficult task. He proved to be the 
man of the hour. Their first achievement is one that can well 
be emulated. They did not wait until sufficient funds were 
available. They got their plans well worked out and when the American Country Life Association 
41 
first money was given the foundation was laid. Later the 
frame was put up, and as money came in the building was 
completed bit by bit and furnished in the same way. Today, 
as a result of years of planning and working, there stands 
among these hills one of the most complete hospitals in the 
land. The country people are proud of it, for they feel it is 
their own and they show their confidence in it by preferring 
it to some well-known city institutions. 
Those of you familiar with city life know how easy of 
access are the numerous hospitals located in places like 
Chicago, and not an accident happens but that the victims, no 
matter how poor, are placed within a few minutes' time 
where they receive the best of care. How different in our 
rural communities. Unable to get to a hospital, cases have to 
remain at home, and anyone who has done country practice 
knows what that means. Accident cases and cases of severe 
illness often turn out fatally, when the outcome could have 
been different if proper treatment and nursing had been at 
hand. 
Is there not some way we as leaders in our rural sections 
may bring to the attention of men able to meet the need these 
appealing facts? It seems to me there has been no time in 
the world's history when, people were more ready to give. 
America has received a great lesson in giving and she can con- 
tinue for a long time with no ill effect, and surely there can 
be no more practical gifts than hospitals to minister to the 
needs of our rural people, and, as I have already shown, these 
need not be costly in structure, but unpretentious and at the 
same time equipped with all necessaries for good work. 
I have seen almost daily suggestions for appropriate 
memorials to our dead soldiers, but never have I seen the men- 
tion of a rural hospital. What more appropriate memorial 
could a county give than to erect a building where life might 
be saved and men and women made new ? Could we not in this 
way make good some of the lives recently sacrificed? 
I have had to break the news of the loss of sons in battle 
to parents, and in one case it was the only son and child. 
What more lasting monument could those parents erect than 42 
American Country Life Association 
a rural hospital in memory of their son, within whose walls 
the lives of multitudes might be saved? 
Another means of meeting these great needs, medically, 
especially if a hospital is available, is the hearty co-operation 
of the state authorities, as seen in the work of the North Caro- 
lina State Board of Health. This state is trying to give to 
each youngster a chance to make good by remedying some of 
the physical defects which so often hold back the youth of our 
land. I had opportunity to see first hand the working out of 
the plans of this state board the past summer in one of its 
public clinics. 
Owing to lack of medical inspection, many children of 
our rural schools and districts are suffering more today than 
those of our cities, and North Carolina is one of the states 
setting about to remedy this condition. It is arranging clinics 
where children may be operated upon at a minimum expense 
for such troubles as diseased tonsils and adenoids. In the 
case of this particular clinic which I attended, so remote did 
they live that it seemed as though doctors and nurses would 
have to give it up. Perseverance won out, however, and soon 
the workers were asking, "Can we accommodate all that want 
to come?" The first day of the clinic the new hospital had 
twenty-two operative cases and the second there were four- 
teen, and all this in a hospital located in a mere settlement 
eighteen miles from a town able to boost of one short street 
on which are a half dozen stores, court house, post office and 
bank. But this little settlement, really the central point of 
this mountainous section, is really the key to the medical 
situation and, rural in the extreme in its surroundings, the 
hospital placed there will be able to minister to the people 
living back in the mountains as it could not do if it were 
way down in the village on the railroad. 
One physician can do as much in two hours in a hospital 
as he could in driving ten hours. We must sooner or later 
conserve the time and strength of our country physicians. 
Good roads have helped, but the bulk of a doctor's work is 
during the time when roads are at the worst. 
In conclusion, I would suggest first that the vast amount 
of material collected by the war department on the construe- American Country Life Association 
43 
tion and equipment of hospitals be put to practical use. 
Reports will be made on the adapting of old structures to the 
use of hospitals. If this could all be worked over and put into 
available shape and placed in the hands of those responsible 
for building rural hospitals, it would be a great help. 
Second, that a set of plans be drawn that could be con- 
structed at a minimum cost and furnish the maximum of 
efficiency. Is this not quite as important as to furnish gov- 
ernment plans for cow barns and pigpens? 
Third, that each state be asked to pass public hospital 
laws, such as exist in the states of New York and Ohio. If a 
philanthropist knew such laws existed in his state he might 
more readily agree to leaving a gift for a community hospital, 
as he would know his funds would be wisely spent. 
Fourth, that an effort be made to educate our communities 
that the county should be willing to levy a tax for the erection 
and maintenance of a hospital. The per capita tax would be 
small, but the result would be great. 
I have tried to show briefly the great needs of rural hos- 
pitals and to give some suggestions for meeting the need. 
Surely we cannot expect the people of our rural communities 
to be much longer contented with their lot if they are not min- 
istered unto as well spiritually, intellectually, and physically 
as their brothers of the larger communities. Jin Adventure In Rural Health Service 
Amalia M. Bengtson 
SUPERINTENDENT OF SCHOOLS, RENVILLE COUNTY, MINNESOTA 
nHEN I first became superintendent of the Renville County 
schools I planned to do all in my power with the money 
allowed me for the betterment of these schools. I hoped to be 
able to persuade the people of the county that only the best 
in the line of school houses, equipment and teaching force 
should be thought of for the school children, and with this 
idea in mind I began visiting schools. 
I had made only a few visits, however, when one day I 
said to myself, "What is the use?" What is the use of asking 
the people of Renville County to spend money in bettering the 
schools for children who are physically unfit to get the full 
benefit of what is given them, or for children who are too sick 
to be in school at all? For as I went about visiting schools I 
saw 'children so badly affected with adenoids and tonsil trouble, 
children whose eyesight and hearing were so impaired, chil- 
dren who were such victims of malnutrition and nervous dis- 
order that they were unfit physically to do their school work 
as they should. The more I talked for better school houses and 
a better teaching force, the more convinced I became that I 
was hitching the cart before the horse, and I saw my duty 
toward those children in a new light, for I began to realize 
that an attempt must be made to have medical inspection 
and at least give the children an opportunity to be made fit 
for school as well as make the school fit for the children. 
I knew the visiting nurses had done much for the children 
of the city schools and I reasoned what was good for the city 
children ought to be good for rural children, were it suited 
to country conditions, and I began to plan for a county nurse. 
To get a nurse would take money, and as I planned to 
44 American Country Life Association 
45 
have the health work paid for by county money appropriated 
by the county board of commissiners I knew that I must work 
up some sentiment for our proposed health work among the 
taxpayers before the commissioners would feel justified in 
giving me an appropriation. My first move therefore was a 
campaign for public sentiment. 
At every meeting where I had an opportunity to speak, I 
took occasion to tell of health conditions among the school chil- 
dren as I had observed them. I pointed out what the cities 
had done for their school children for some years past and 
how conditions had been bettered. I argued that the people 
of prosperous Renville County ought to give this health ques- 
tion some consideration. Some one or two in every gathering 
would come to me at the close of such a meeting, say they were 
interested and ask what I proposed to do. To these I ex- 
plained my plan for a county nurse, and asked that those in- 
terested take occasion to speak to their county commis- 
sioners, asking them to give me at least thoughtful attention 
when I brought the subject up at a meeting of the bo>ard. When 
enough people seemed interested, I went before the county 
commissioners and asked for an appropriation for our health 
campaign; if nothing more, enough money so that we could 
"try out" our plan. 
The morning I went before the board I did receive the 
finest kind of attention, for all those men had been interviewed 
and were more or less ready to express their views and voice all 
their fears, one of these being the legality of the movement, 
for much to my surprise I found that medical inspection paid 
for out of public money could only be carried on legally in 
cities of the first and second class. We finally persuaded the 
commissioners to call the nurse assistant county superintendent 
(I should like to say here that Minnesota has since passed a 
mighty fine permissive public health law) and I was given an 
appropriation of $300, after I guaranteed her traveling ex- 
penses out of my own allowance <for traveling. The 
most convincing argument used was given by the chairman of 
the county board, when he said as it paid to have a campaign 
for better health among the hogs in this county, we might 
try a little something for the children. I might add that 46 
American Country Life Association 
during two years there was spent in Renville County $50,000 
to stamp out our epidemic of hog cholera, and the farmers all 
felt it was money well expended. 
It was the middle of November before our first nurse, 
Miss Mary Cornish, came to us and the work was begun; later, 
Miss Dorothy Motl. 
It was the middle of November before we began our work, 
but from then until Christmas we had good roads and weather, 
so with the use of my Ford we made a good start. We worked 
rapidly, examining as many as eighty-nine children a day and 
visiting four schools. We do not recommend such haste, but 
in our case it seemed absolutely necessary, for we wanted to 
cover as much of our county as possible in three months, and 
we have 140 schools. The children were examined for any 
symptom of eye, ear, nose, throat, tooth and skin trouble; in 
some cases we took temperatures and in others throat cul- 
ture. It was necessary to make many home calls to talk with 
mothers about their children. 
Yes, there was opposition to our health work and for the 
first few weeks we simply had to turn deaf ears to this and 
work on, trusting that the results would argue for the work. 
Whenever children refused to be examined, saying, "My 
mother said I did not need to be examined by the nurse," we 
did not argue with the children, but after we had finished our 
work in that particular school we made a "home visit," taking 
the children in question with us. In every case we found it 
was a matter of misunderstanding, and the mother consented 
to the examination when the work was explained to her. 
Sometimes children absented themselves from school when 
they expected the nurse, but they did not escape us, because 
we made it a point to make a home visit in every case, and 
soon it became noised about that there was no way of escap- 
ing the nurse. 
Some of my friends said that it was well enough to take 
a nurse about a county while the weather and roads were 
good, but when the snow began flying it would be an impos- 
sibility to carry on the work. Fate seemed to be with us, for 
had we set about to demonstrate what could be done under 
adverse climatic conditions, we could have chosen no better American Country Life Association 
47 
winter than we did; for weeks at a time the thermometer 
played around the 30 below mark, and the snow piled in ten 
and fifteen foot drifts, yet we traveled every day that it was 
at all possible for any human being to be on the roads. 
Renville County is prosperous; there are few poor people, 
no child is underfed and no one wilfully neglected, yet our 
tabulated report shows a nappalling amount of physical defec- 
tiveness. Out of our school population of six thousand we 
examined five thousand children, and found four thousand and 
ninety-five defective, testifying that 81 per cent of the children 
were defective. This seems almost unbelievable, and yet it does 
not tell the whole story, for I could take you to school after 
school where there was 100 per cent defectiveness, where we 
sent a notice to the parent of every child in that school. Yet, 
as 1 said before, Renville County is a prosperous county, and 
we have every reason to believe that conditions found in Ren- 
ville County today are the same as in other counties where a 
health survey has been taken. The percentages of the defec- 
tiveness found were: Teeth, 55 per cent; nose, 40 per cent; 
throat, 66 per cent; eyes, 22 per cent; ears, 17 per cent; mal- 
nutrition, 16 per cent; nervous disorder, 16 per cent; neck 
glands, 14 per cent; skin, 13 per cent, and general appearance, 
12 per cent. 
Think of 17 per cent of our school children being partially 
deaf, and many of these growing up to face stone deafness un- 
less something were done to correct the trouble while they 
are still children, and unless some sort of health inspection 
had been inaugurated nothing would have been done, for 
neither the children nor their parents realized that anything 
was wrong. We have on record children who were stone deaf 
in one ear and did not know it; children who had absolutely 
no sight in one eye and did not know it. Their parents had 
no realization of the state of affairs, and their teachers had 
not made the discovery. Who then was to come to the rescue 
if a nurse had not been employed? Out in our county we 
know we did not begin the work half soon enough. 
The 40 per cent of nose trouble represents the children 
who were mouth breathers from some cause of other-in a 
great many cases from adenoids. Children who are mouth 48 
American Country Life Association 
breathers, aside from having deformed faces, are a prey to 
many diseases, and almost invariably have throat trouble in 
addition to their nose trouble. I have here in my hand a 
plaster of paris mask taken of the face of a fourteen-year-old 
boy having adenoids (showing mask). Note his short upper 
lip, his protruding front teeth, the undeveloped nose and the 
dead expression under his eyes. To my certain knowledge this 
fact is typical of a large number of children in our schools. 
The boy in question had a skillful operation performed and 
his adenoids removed. He then w*ent to a dentist, a Dr. Miller, 
of Bird Island, in our county, and had his teeth straightened. 
Here he is eight months later (showing another cast). See 
what a well-shaped mouth he now has, how his nose developed, 
and how his whole face has changed. As I said before, he was 
only fourteen years old and was growing rapidly, hence the 
marked change in so short a time. 
Here is an impression of the mouth of a girl sixteen years 
old, who had adenoids. Note how the teeth fail to articulate. 
This girl, while keeping her mouth open in order that she 
might breathe, had deformed her jaw, and consequently her 
teeth had grown out of their natural places. 
Just a word about malnutrition. According to our report 
six hundred and eighty-nine children in Renville county were 
apparently underfed. Yet we know these children get all they 
need to eat, but the fact that they were physically unfit to 
assimilate properly this food, and consequently showed signs 
of malnutrition, had escaped the notice of their parents. 
Now to ask: "What of it? What good came of the health 
survey?" Our records show that about one thousand of the 
children examined were taken to see either a doctor or a 
dentist, or both, the first year. Parents who at first opposed 
the work are fully convinced that a county nurse should be a 
permanent worker among us when they see how much their 
children have been benefited by a little medical help. 
Besides examining the children, the nurse had been a great 
factor in bringing about a general education for better health. 
In our county today you are behind the times if you do 
not know what adenoids are and the havoc bad tonsils can 
bring; why eye strain is so prevalent and how to prevent it; American Country Life Association 
49 
why teeth should be taken care of; why we should drink 
plenty of water and eat the proper kind of food; what kind 
of clothing is best to wear, and why we should not wear too 
heavy and too much clothing while indoors (we have induced 
some little boys to remove one coat and three sweaters while 
in school) ; why we need to be clean, etc. 
Another great service the nurse rendered us was to bring 
about a veritable epidemic of schoolhouse improvement. She 
proved that the physical condition of the schoolhouse was 
reflected in the physical condition of the children. For ex- 
ample, a poorly lighted and badly ventilated schoolhouse 
always housed children with eye strain and nervous disorder, 
and in a schoolhouse having ill fitting desks were children of 
poor posture. 
During the summer of that first year the nurse was with 
us we conducted so-called "baby clinics" in the county, one in 
every township and one in each village. We urged the mothers 
to bring the children below school age to the clinics, and much 
the same kind of an examination was given them as was given 
to the children of school age. We found that 60 per cent of 
the children of pre-school age were defective. I am of the 
conviction that much of our health work should be done with 
these children of pre-school age so that the glad day will come 
when children are as physically fit as possible when they enter 
school. 
When the first year's work was completed the question 
came up as to the employment of a nurse for the second year. 
By this time there was so much public sentiment for the work 
that our county board felt justified in appropriating $2,000 for 
the next year, and now it is no longer a question as to whether 
or not a nurse should be employed, but merely a question as 
to how much money is to be appropriated. 
Once in a while some one voices the sentiment that taxes 
are going up every day and that expenses must be curtailed, 
and also once in a while the suggestion comes that the cur- 
tailment might be brought about by not employing a nurse: 
but, as happened one day, when we proved to one taxpayer 
that a $2,000 appropriation meant a tax of only 31 cents 
per quarter section, he is likely to shrug his shoulders and say, 50 
American Country Life Association 
"Oh well, I'd smoke that up in a day or two, and if its going 
to help the children any go ahead." 
In short, I believe we have had a new vision; that we are 
thinking less in terms of dollars and cents and more in terms 
of humanity. I believe we have prayed that prayer of Nellie 
McCurig's and heard its answer: 
"Lord, take us up to the heights and show us the glory; 
Show us a vision of empire. Tell us its story! 
Tell it plain, for our eyes and our ears have grown holden; 
We have forgotten that anything other than money is golden. 
Grubbing away in the valley somehow has darkened our eyes; 
Watching the ground and the crops, we've forgotten the skies. 
But, Lord, if Thou wilt, canst take us today. 
To the Mount of Decision 
And show us the land that we live in 
With glorified vision!" Hlethods of Administration and management 
of Health Problems in the State 
of IDisconsin 
Dr. H. E. Dearholt, 
SECRETARY OE THE ANTI-TUBERCULOSIS ASSOCIATION 
Q |A HEN I entered the private practice of medicine I waited 
(JJ for a long time for my first patient. As I recall it, it 
was exactly twenty-seven days. During these twenty-seven 
days I had a large number of visitors, drug retail men, book 
agents, furniture dealers and others of that sort, each one of 
whom I had treated with all of the courtesy due a prospective 
patient, only to be disappointed when they tried to sell me 
something instead of leaving any money with me. Finally, I 
got to a point where I was pretty well convinced that there 
wasn't a patient in the city waiting for me, when one day a 
man came into the office and said, "Is this Dr. Dearholt?" I 
said, "Yes." He said, "I would like to speak to you a moment 
if T may, doctor." I said, "All right, come on in, but I don't 
think it will do you any good." That was my first patient. 
Throughout the time that I treated him I had to keep up 
the bluff that I was a facetious kind of an individual and 
always said things that I didn't mean. 
Now my own approach to the rural health problem is 
through the Anti-Tuberculosis Association work. While I was 
born in a village and have some more or less intimate recol- 
lections of country life, at the same time I have spent far and 
away the vast majority of my life in the city. Wisconsin is 
rated as a rural state by the United States Census Bureau. 
More than 50 per cent of the total population live in rural 
districts or in communities of less than 5,000 population, so it 
seemed to be unescapable that we give some consideration to 
the rural problem. 
51 52 
American Country Life Association 
First, when we launched the work in Wisconsin (along 
about the time it was launched elsewhere) we started on 
tuberculosis statistics and findings of the large eastern com- 
munities-Philadelphia, Boston, New York and so forth, in 
which the anti-tuberculosis statistics were well compiled. We 
used to have a great deal of difficulty in our education work 
in convincing people of our larger communities, Milwaukee, 
Oshkosh, Racine and so forth, that they had a tuberculosis 
problem. You will all remember that when this educational 
health movement started people were very loath, and indeed 
they are still in many places, to admit that they have a health 
problem. We still find doctors who say, "I don't have any 
tuberculosis in my practice." We still find people saying, 
"Why, of course, they have tuberculosis elsewhere, but we 
don't have it in our beautiful home town or healthful rural 
community." Therefore we did not find the statistics of New 
York And Boston and Philadelphia and Baltimore, or of 
Chicago even, at all convincing to our public. And at that 
time we had almost no reliable vital statistics of our own. 
Wisconsin was not admitted to the registration area for 
deaths until 1908. We were of course far behind many of 
the eastern states in this respect, but we are far ahead of 
many of the largest and wealthiest states of this general 
region. If 1 am not mistaken, Illinois has only been entered 
as a registration state within the last year or two, and I do 
not think that Iowa has yet been entered. Therefore, it became 
necessary for us to collect facts in our own state with which to 
convince the public that something needed to be done, so we 
started with a series of surveys of our cities of the second 
class. Wisconsin has only one city of the first class, Mil- 
waukee, and then there is a sudden drop in urban population 
to cities of the second class of fifty to sixty thousand popula- 
tion, running from there down. We sent out expert sociologi- 
cal students (graduates from the University of Wisconsin 
Sociology Department) to look into the facts, run down such 
cases of tuberculosis as they could find, and we found this to 
be a very effective method of convincing the public of the nec- 
essity of doing something, because it was fundamentally right, 
in that we were putting out preachments upon a fact basis. American Country Life Association 
53 
But there remained the stubborn fact that we had still a large 
amount of tuberculosis in this more than 50 per cent rural 
state, which was not accounted for by the industrial conditions 
found in our own city of the first class and our cities of the 
second class, so we were induced to make a study of a typical 
rural county. We picked out Dunn County and made quite a 
comprehensive survey of the conditions in that county. This, 
so far as I know, was the first comprehensive rural survey on 
tuberculosis made anywhere, and when I say the first compre- 
hensive rural tuberculosis survey it pretty nearly means the 
first comprehensive health survey made on any subject, because 
we must not lose sight of the fact that it was the anti-tubercu- 
losis campaign which has pointed the way all through for the 
popular specialized health movements, venereal diseases, pre- 
vention of blindness, infants' welfare and the various other 
forms of specialized health compaigns. We found in Dunn 
County rural townships in which the death rate from tubercu- 
losis was as high or higher than those figures that we had been 
using from "Five Points," New York, and other congested 
industrial communities with their bad housing and tenement 
conditions. On this evidence we were able to go before the 
public generally and really arouse an interest and fighting 
spirit. 
Then we came to the question of: "What are we going to 
do about it?" and we were confronted at once with the in- 
adequacy of the health machinery as it has been built up in 
this country. First of all, you probably all know that our 
health departments in America have been built up after the 
English system, which is on the municipality basis. This 
answers very well in our large communities, and even some of 
our second-class communities have good health departments, 
but it is quite obvious that a metropolitan organization of 
health machinery is impossible in a rural township or in a 
small community. First, there is not a sufficient amount of 
work to inspire a real hygienist or health official to go into a 
community of that sort; and, secondly, of course, the people 
are utterly unprepared and unwilling to pay the cost of an 
adequate health department. So it seemed to us that nothing 
smaller than the county unit would be adequate for a health 54 
American Country Life Association 
machine. But even here we were faced with the difficulty that 
we could not launch a full-blown county health department 
with a health officer, bacteriologist and other assistants with- 
out some years of education. So we hit upon the idea of 
making the greatest possible use we could of the county nurse 
as being, in our judgment at least, the best qualified agent 
of the time to carry on a reasonably good quality of health 
educational work, health administration, health inspection of 
rural school children, and so forth. The employment of public 
health nurses in Wisconsin, both upon municipal health de- 
partment basis, school board basis, and as county nurses has 
prospered to an extent that is very satisfactory to us, and at 
the last legislature a law was passed making the employment 
of a county nurse or health instructor mandatory in each 
county by 1921. I am going to say a word a little later on 
concerning the ''health instructor." 
Then there was the difficulty in railroad transportation. 
These difficulties were also manifest in the work of 
the state board in the matter of laboratory diagnosis. 
While we had in the University of Wisconsin, which is situ- 
ated at the state capitol, a hygienic laboratory on a co-opera- 
tive basis with the State Board of Health, in which splendid 
work has been done for the physicians and health officers in 
the state in the early diagnosis of contagious disease, yet 
many of these diagnoses were not made or the result gotten 
back to the interested people (the vitally concerned people) 
until it was too late. This led our State Board of Health 
very wisely to set up a general chain of diagnostic labora- 
tories, which are run in co-operation with the local health 
departments of the larger cities of the second class, distributed 
on a good territorial basis over the state of Wisconsin. 
There has been going along coincidentally with the estab- 
lishment of the county nurses a splendid movement for the 
establishment of tuberculosis sanatoria, until something in the 
way of adequate sanatorium facilities are provided over the 
state. We iare unfortunate in Wisconsin in having almost no 
adequate hospital facilities in the smaller communities and in 
the rural districts outside of those that are provided by the 
sisterhoods and now and then by one and the other church American Country Life Association 
55 
organization or by the private initiative of some doctor or 
nurse. 
One of the enterprises, it seems to me, that we must very 
soon take up very seriously is the securing of adequate hos- 
pital provision throughout the state, because the public health 
nurse's chief function has been that of a mobile agency, a scout 
bringing in children with diseased tonsils or adenoids and 
other handicaps, and she has been bringing them in for what 
purpose, discovering them for what purpose? All too fre- 
quently for no purpose whatsoever, except possibly statistical 
interest, because there is no hospital, no clinic available in 
which the diagnosis can be made or in which the child may be 
successfully treated. Our sanatoria, we found, were not ade- 
quate alone, even with our public health nurses, because while 
the nurse is mobile the sanatoria are fixed, and many of the 
sanatorium superintendents were altogether fixed, more fixed 
than the brick buildings that housed them. To make (these 
institutions function adequately it has been found necessary 
to establish a chain of tuberculosis clinics. 
Now the question came up among the medical men, 
sociologists and nurses on our staff as to whether we should 
confine these clinics strictly to tuberculosis or try instead to 
have a general medical clinic or medical dispensary with a 
tuberculosis clinic as a part of it. We decided on the latter 
course, for two or three reasons. First, because, just as I have 
tried to point out in another connection, the tuberculosis prob- 
lem is so intimately mixed up with all of the other health 
problems that it is not profitable to spend too much time in 
an effort to tease out the tuberculosis thread from the other 
threads. It is not profitable certainly in small communities, 
where we cannot have highly specialized work in medical 
diagnosis or treatment. Second, our state, as have most other 
states, I believe, has gone in very vigorously upon the venereal 
disease campaign patronized by the federal government. Ob- 
viously it would be the rankest form of inexcusable extrav- 
agance to duplicate the overhead machinery of a series of 
tuberculosis clinics, venereal disease clinics, infant welfare 
clinics, child welfare clinics and so on. Good management 
alone and good business dictated that these various institu- 56 
American Country Life Association 
tions be brought together in one place and put upon a co- 
operative and co-ordinated basis. 
There is another reason, and that is this: It is a most 
ridiculously inexcusable thing, it seems to me, for physicians, 
health experts, nurses, social workers or any group of that 
sort to depend upon a patient with tuberculosis or cancer or 
any other obscure disease making his own diagnosis, and yet 
in effect that is what the attempt of these highly specialized 
clinics, each operating independently, amounts to. 
I said I was going to say a word about the "health in- 
structor." For a long time in Wisconsin the supply of public 
health nurses has been far less than the demand, as it has been 
in almost every other state in the union. We used to attempt 
to recruit our nurses from the more advanced states in the 
country. We did not succeed very well. I found other execu- 
tives in those days in much the same position that I am today. 
I prefer to keep our best nurses and pass along the poor ones. 
Again, we found through some rather unfortunate experiences 
that it was not good for us to import into our insular state 
workers who did not have the Wisconsin idea or the Wis- 
consin point of view. Therefore we preferred very much to 
have Wisconsin people working in Wisconsin, even though 
they were not at the beginning quite so expert as they might 
otherwise have been. Having then a demand far in excess of 
supply, it became necessary to put forth some effort in increas- 
ing the supply. This we attempted to do through the estab- 
lishment of a public health nursing course, the first course 
having been under the direction of Miss Olmstead. 
We went along turning out, I think, a fairly good 
grade of public health nurse, attempting to make each 
class better than the preceding class, until along came the 
w>ar. As you all know, no class of people were more prompt 
to "leave their plows in the field" and get into the Red Cross 
or army uniform than were the nurses. Our public health 
nurses' department was completely wiped out three or four 
times during the war. 
Stimulated by the increased shortage that the enlistment 
of the nurses for overseas duty occasioned, we started what 
we called our health instructors' course. Now, the health in- American Country Life Association 
57 
structor is not a nurse. We have been severely criticised in 
some quarters by some nurses because it was felt that we were 
lowering the nursing standards when we put a new medical 
social service worker into the field under the name health in- 
structor. That was not a just criticism. As I say, these 
workers are not and have never for one moment been called 
by us nurses or anything but health instructors. The idea, 
however, was not entirely one of expediency. While the imme- 
diate launching of this work was in the nature of an expedient, 
yet I know perfectly well we should sooner or later have done 
this thing anyway, because, whereas we find the nurse may 
have splendid technical training in the hospital, may be ever 
so competent as a health or disease worker, she is apt to be 
fundamentally lacking in pedagogical training. We realized 
that an increasing part of the public health nurse's work is, 
after all, teaching and not nursing; so it seemed to us that 
just as the public health had at first offered us, and still offers 
us, the very best promise in the way of furnishing the agency 
necessary to control disease, yet she is not enough, frequently, 
of a teacher. Therefore it occurred to us that by recruiting 
women from our school system-we were looking for the type 
of women who had become insurgent against the restrictions 
of our Prussianized common school system, women who found 
themselves unable to do for their pupils and for their com- 
munities things that they wanted to do, to realize the am- 
bitions, the ideals that had led them into the teaching pro- 
fession-we hoped to get these women to leave their school- 
rooms and come over and learn enough of the technical knowl- 
edge of medicine, disease and hygiene to go out and use their 
already possessed knowledge of teaching method, to put across 
the education which we felt to be fundamental. 
I wish to speak of just one other activity that 
has grown out of our study and experience, and that is 
our Health Instruction Bureau in the University Extension 
Division of the University of Wisconsin. This bureau was con- 
ceived on the thesis that, after all, as I have indicated before, 
great disease problems are not due to bad housing, to bad 
working conditions and to abject poverty nearly so much as 
they are due to the fact that people are failing to make the 58 
American Country Life Association 
best utilization of such facilities as they have for health; that 
ignorance, therefore, is the fundamental factor in the existence 
and spread of disease. If this be so, then knowledge is the 
fundamental factor in control of disease and in procuring 
health. The regents of the University of Wisconsin were in- 
duced to organize a health instruction bureau in the exten- 
sion division, because it was part of the dream of President 
Van Hise that the University of Wisconsin should reach out 
and serve men and women in the state of Wisconsin, where- 
ever they might live, who were unable to come to the uni- 
versity for such help and instruction as the university could 
give to them; "to take the university to those who could not 
come to the university." Through this bureau an effort has 
baen made to keep going the general teaching service concern- 
ing fundamental causes of diseases and fundamental ways of 
controlling disease. The service has been largely carried out 
through the newspapers, as constituting the largest forum that 
the instructor had access to. It is estimated that some three 
hundred thousand readers weekly get some form of health in- 
struction through the press service alone of the health instruc- 
tion bureau. 
We recognized also that the physician sooner or later 
must come to be considered one of the most fundamental fac- 
tors in our public health problem, and an effort has been 
made, as has also been made collaterally, independently one of 
the other, in North Carolina by Dr. Rankin, to carry the 
newer post-graduate instruction to the doctors who for one 
reason or another were unable to go to the medical centers. 
In conclusion, I wish to say that I have made a sketchy 
and hasty attempt to give you some idea of what seemed to us 
to be a more or less near approach to a working educational 
program for the control of health and disease. Throughout 
it has seemed to us that it is fully as important and proper a 
function for a university or school system to teach people how 
to live as how to make a living. Rural Nursing Service in Cook County 
Harriet Fulmer, R. N., 
OF THE RURAL NURSING SERVICE FOR COOK COUNTY, ILLINOIS 
zn T may be news to the middle west to know that the Cook 
QJ/ County Board of Commissioners four years ago voted a 
sum of money to put into the field a public health nursing 
service in the small town and rural sections of Cook County. 
Just offhand, one wonders why we need rural nurses in Cook 
County. Cook County is in the shadow of one of the great 
middle west universities; it is near the greatest hospital and 
medical center in the United States, and yet just across the 
boundary line from Chicago is a territory covering six hundred 
square miles, populated by a quarter of a million people, who 
need as much instruction as the most benighted region in the 
United States, as far as matters of health are concerned. 
The outlet belt area of Cook County contains huge truck 
gardens, greenhouses, vast celery trenches, enormous acres 
covered by industrial land. The population in this vast terri- 
tory has been so eager laying up its wealth that it has forgot- 
ten sanitation and hygiene and the care of its human beings. 
There are insanitary homes and schools, polluted water supply, 
and ancient toilet disposal, and this is the answer to the ques- 
tion, Why a public health nursing service for Cook County? 
Our standard for this nursing service is: First, the nurse 
must be of an accredited school; she must have been registered 
by the state in which she graduated; she must be a member 
of the national public health organization; she must be an 
enrolled Red Cross nurse; and these should be the minimum 
standards for such service in any rural community in the 
United States. We have no right to be using makeshift serv- 
ices to care for our children in the rural sections any more than 
59 60 
American Country Life Association 
we have in our Hull House district in Chicago. The 
very highest wage, the very highest standards of service 
only should be accepted by these communities, and one of the 
hardest jobs we have is to get the people to agree to these 
standards. They have been told that a six weeks' course in 
nursing is all you need to go out to nurse in the rural sections. 
I do not wish to minimize the work accomplished by other 
health agents-the Y. W. C. A.-the splendid work done by 
special teachers and physical directors-but they are not 
nurses, and that is the point we are discussing. There is no 
substitute for the public health nurse. We have now over 
fifteen thousand children under our supervision in Cook 
County, and you may see readily that with twenty-eight nurses 
we cannot do a very successful piece of work; but what we 
are trying to do is to make Cook County, with her rich tax- 
paying body, pay for this service, and the time is not far dis- 
tant when Cook County will not have twenty-eight workers, 
but we will have one hundred public health nurses paid for by 
the taxation bodies. I feel very strongly that we should sub- 
scribe to the very highest nursing standards in order to show 
to the people in the rural communities that the greatest need 
they have is this rural nursing service in our public schools. 
Scattered throughout Cook County today, behind the desks in 
one hundred and four one-room school houses, are the very 
greatest assets of our state, and it is poor policy not to provide 
for the health supervision of these children, and yet we say 
anything will do for them in the way of teachers and in the 
way of public health service. That is why we have had the 
very great shame cast upon this nation in the discovery that 
we are an illiterate nation, because we haven't paid enough 
to the teachers to get the best in the community, and we are 
down as a physically deficient nation because we did not 
send these health workers ten years ago to educate the people 
in matters of common health. I ask you men and women, as 
you go back to the states which you represent and the sections 
of the country from which you came, if you will not ask that 
the very highest standard of public health work be instituted 
in your states and in your communities, and if you only have 
one or two workers, have those one or two of the very highest American Country Life Association 
61 
type. The more you have the better, but don't say you will 
have ten workers of mediocre character. You want the very 
best your tax-paying bodies can pay for. 
DISCUSSION 
President Butterfield: It seems to me this is a splendid oppor- 
tunity to ask some concrete questions about a very concrete piece of 
work. I would like to ask Miss Fulmer if she will not re-state those 
minimum requirements for the public health nursing service? 
Miss Fulmer: We require first, that the nurse shall be a grad- 
uate from .an accredited school for nurses, and a minimum require- 
ment for the entrance to which is a graduate of a high school or a 
college if possible. Then, of course, her pedagogical training in 
addition is something to be looked for, just as Dr. Dearholt said, 
for not all nurses are teachers, but they should be. If they go 
through the right kind of training school for nurses every one of 
them should develop into health teachers. Then we ask that these 
nurses shall be registered nurses. I am sorry to acknowledge that 
there are many public health nurses and there are many graduate 
nurses in this country that have graduated from accredited schools 
who are not registered. These nurses ought to be members of the 
national public health organization. Why? Because this is a 
national group of nurses banded together to advance the standard 
and promote public health nursing, a specialized phase of nursing 
service. We ask that she shall be enrolled Red Cross nurse, because 
the very highest standard of nursing service that is acknowledged 
in America today is the nurse who can qualify for membership in 
the American Red Cross, and we hope the day is not far distant 
when every graduate nurse in this country shall be privileged and 
glad to wear the Red Cross nursing badge. We call these minimum 
requirements. 
President Butterfield: Are there adequate facilities for train- 
ing graduate nurses? Your first requirement called for a graduate 
nurse. Are there adequate training school facilities? 
Miss Fulmer: Yes, indeed, there are plenty of training schools 
in America today, if the nurses are only directed rightly toward 
those of high grade. 
The following questions were propounded to Miss Fulmer, and 
the following answers given: 
Question: Are these Cook County nurses apportioned terri- 
torially? 
Answer: Yes, they are. In Cook County we have as a basis 
of working divided the county into three divisions, and each 
division is divided into eight sections, and a nurse in charge of each 
of those sections. Sometimes it is only a village, and again one 
nurse may include several little villages with a population of three 
to four hundred each. When we first began the work three years 
ago, when the county board voted $13,000, we started with only foui 
nurses and we made what is generally known as a survey of the 
health conditions. We wanted to find just wliat the situation was. 
It was a great eye-opener to the entire county and the state of 
Illinois to find this nursing service was needed right here at our 
own doors. 
Question: Are these nurses supervised by the nursing depart- 
ment of the Red Cross? 62 
American Country Life Association 
Answer: No, they are not. The supervision is entirely under 
the Cook County service known as the Public Health Division of 
the Social Service Bureau. The four original nurses are under civil 
service. It was a great forward step when they placed public health 
nursing under civil service and under a governmental agency. 
Question: Is this service rendered directly to the homes or 
through the public school system? 
Answer: It is rendered directly to the homes. We have many 
schools, because we look upon the schools as the entering wedge, 
but the character of the work is this: We put at the top of the 
nurse's activities bedside care when needed. That does not mean 
we do nothing but bedside nursing. It is tenth in importance in 
our work. But we could not go into rural sections and find a case 
where nursing was needed and say we did not do bedlside nursing. 
But the entering wedge to the home is through the school, .and there 
is not one child that we take care of in the school, that we find 
physically deficient or defective in any way, that does not have 
a follow-up visit to the home. 
We need to visualize our work and one simple way is through 
the health center, where weighing and measuring of children and 
health conferences may be carried on; also it makes a center for a 
nurse's office, where she may be found at regular times. An empty 
storeroom or an abandoned house can be fitted up at very little 
expense. The picture shows a health center in Cook County. The 
room was previously occupied by an undertaking establishment. Six 
hundred and twenty-eight people passed1 through this center in 1918. 
Question: Does your work have any direction or supervision 
from the county school superintendent's office? 
Answer: Not any direction from the county superintendent 
of schools. We are the health agent in the community. If we were 
directly under the schools, we would curtail our usefulness to a 
large degree. There is much nursing service in the community 
which could never be related to the school-tiny babies and old 
people, insanitary conditions and what not, which could not be 
'•eached were the nurse directed by the school authorities. 
Question; You are responsible to whom? 
Answer: To the Public Health Division of Cook County, and 
not to the public schools, .although, of course, it goes without say- 
ing it would be impossible for us to have the co-operation and in- 
dorsement of the public at large if we did not work in close co-op- 
eration with the public school system. 
Question: How far do you have hospital appliances, such as 
beds or invalid chairs or other small appliances which are available 
for private homes? 
Answer: We have none of those things. Public health nurses 
simply go in and use the material at hand which is there to use. 
There are nurses who can turn an old broken-down bed with .a 
dirty mattress into a sanitary hospital bed with very little effort. 
Question: How is this service paid for? Is it paid for entirely 
by the county? 
Answer: The four public nurses that originally were voted by 
the county board are paid by the county. The first year they did 
a very good piece of work. They went up and down this entire 
section of Cook County and urged the people to ask for more nurses. 
Then .a private organization which heard we were in need of ad- 
ditional nurses went to the county board and said they would 
finance fifteen additional nurses if they were directed by the already American Country Life Association 
63 
organized Public Health Division of Cook County. That organiza- 
tion is the Tuberculosis Institute of Chicago. 
Question: What proportion of the budget is out of the public 
funds? 
Answer: About half. 
Question: Are there any fees paid by individual families? 
Answer: No, no more than they pay school teachers additional 
fees for additional service. 
Question: What additional requirement would be asked by the 
Red Cross on the part of a nurse graduated from an accredited 
school? Will the Red Cross require something more in order that 
they may become enrolled? 
Answer: No. If you are a graduate of an accredited school 
you may become, upon application, an enrolled Red Cross nurse. 
Question: Would you advise counties to wait for public health 
nursing until they had acquired a sufficient number of trained 
nurses of these minimum requirements ready to go into the work? 
Answer: Yes, I would. I will tell you why, because I have 
had experience in forty-seven counties in the state of Illinois and 
I think I know a little bit about what counties do. If you start 
in your county, and I have in mind five or six counties in Illinois, 
with very mediocre nursing service, you are not going to get much 
further. These counties I mention are just where they were when 
they started. The public is not behind the movement and it is dying 
because of that kind of a start. 
Question: What salaries do you pay? 
Answer: We have a minimum salary of $135 a month to be- 
gin on, with 10 per cent raises per year. 
Question: What is the maximum? 
Answer: The maximum pay will be $150 per month. 
Question: In these other counties are they paid as large 
salaries as that? 
Answer: The Red Cross has a minimum salary, which I think, 
is $125 a month and) a motor. Most of the rural Red Cross nursing 
service is done through the various divisions, and it is left to the 
local Red Cross chapter to decide upon the salary. 
Question: Are there some strictly rural counties in Illinois 
that employ nurses and pay them that amount of money? 
Answer: I cannot name those counties offhand. I have two 
or three in mind. Livingston is a strictly rural one and that county 
has a public health nurse. There are in Illinois today about forty- 
five county nurses in strictly rural counties. 
Question: You speak about the Cook County public funds 
from the taxing body of Cook County. It is possible to do in Cook 
County what you could do in some small rural county? 
Answer: That is true. I understand what you mean. But 
still a good many of the counties have voted this money for public 
health nurses and they are coming to do it more and more as time 
goes on. South Dakota is sending a cry throughout the United 
States today, .and wherever you go you see cards "Send us one 
hundred public health nurses at once," signed "South Dakota." 
South Dakota is ready to pay for one hundred nurses, and a goodly 
portion of those, perhaps 50 per cent of them, would be paid 
through the Red Cross, the others through public funds. 
Question: What provision is made for transportation in Cook 
County? Do they travel by auto or street car? 
Answer: Two nurses have automobiles, one nurse has a 
bicycle, but on the average we get about by walking. It is very 64 
American Country Life Association 
taxing and we hope to have before long, not more nurses, but four 
Fords. We call a Ford a nurse. When I have had the opportunity 
to have a machine to carry me about I know from my own experi- 
ence that I have done at least three women's work the day that I 
had the machine; so we are striking a happy medium by saying 
to the county board that one Fond equals one nurse. 
Question: After the nurse's examination, is a doctor's exam- 
ination required? 
Answer: Yes, indeed; every child is referred to the family 
physician. The nurse's examination is really a very superficial 
examination. We are taught scientifically to test a child's eyes, 
but we do not say what is the matter with the child's eyes. We 
have cards which we send home saying: "I have tested your child's 
eyes and find he does not see well. Will you please do something 
about it?" The probabilities are that somebody gets busy at once. 
A chart on the wall in the rear of the room is very significant to us. 
It represents 15 months of very hard work by four nurses. The 
examinations, tests, and observations were recorded, notes sent to 
parents and physicians, and with the backing of the teachers and a 
little urging on the part of the nurses it was most interesting and 
encouraging to find upon examination so many corrections had been 
made. It does not take very long when I have seen Johnny Jones 
with a curved spine to go along with him to his family doctor, and 
the doctor says: ''Why yes, we will take him to Chicago and put him 
in the Crippled Children's Home. The father and mother are per- 
fectly able to pay for his care and we will have a brace for him." 
But nobody had discovered that until our health supervision began. American Country Life Association 
65 
Physical Examination of School Children in the Rural Area of Cook County, Illinois 
FORM USED BY COOK COUNTY PUBLIC HEALTH 
NURSING SERVICE 
Cook County Public Health Nursing Service 
INSPECTION REPORT 
Report of physical inspection of pupils 19. . 
In School 
Town Township 
Total number of Pupils examined - - 
Total number of Pupils with defttces - 
Total number of Notices sent to Parents 
Total number of defects (Name defects: 
Number with 1 defect 
Number with 2 defects 
Number with 3 defects 
Number with 4 defects 
Condition of School Buildings: 
Sanitation 
Ventilation 
Lighting c 
Heating 
Drinking facilities 
Washing facilities 
Co-operation of Trustees and Teachers: 66 
American Country Life Association 
PARENTS' INFORMATION CARD 
To the Parents or Guardian of 
Will you please fill out the blank below, for in- 
formation and assistance of the Public Health Division 
of Cook County. This information will assist the 
authorities to keep contagious diseases out of the school, 
thus protecting your own child as well as others. It will 
also serve as a permanent record, which some day may 
be very valuable to your child for reference purposes. 
1. Child's name in full 
2. Year of birth 
3. Has (he or she) a Birth Certificate? 
4. Has (he or she) been vaccinated? 
Date of 
I know this child had: 
1. Mumps when years old 
2. Whooping cough when years old 
3. Scarlet fever when years old 
4. Measles when years oid 
5. Chickenpox when years old 
6. Diphtheria when years old 
7. Other severe illness when years old 
(Signed) 
Parent or Guardian of Pupil. 
Date Address 
Cook County Rural Nursing Service 
TO FREE THE HAIR FROM VERMIN 
Articles Needed 
Kerosene Oil, Olive Oil (Sweet Oil), Equal 
parts. (Half pint of each). 
Mix the kerosene and sweet oil and rub the mix- 
ture well into the scalp. Then with a piece of muslin 
cover the hair and fasten it above the head. Do not 
bring the head in contact with a lighted gas jet or flame 
of any kind. 
In the morning, wash the scalp well with soap and 
hot water, then wet the haid with hot vinegar; after 
which use a fine-'toothed comb, wet in hot vinegar, to 
remove "NITS." Dry the hair with a towel before going 
out. Repeat this two or three nights. 
Use Vinegar Daily Until "NITS" Are Gone Rural Public Health Nursing 
Elizabeth Fox, 
BUREAU OF PUBLIC HEALTH NURSING, AMERICAN RED CROSS 
/"] WANT to start this talk on rural public health nursing 
by giving you just a glimpse of the history of public 
health nursing, so that you will get a background for what is 
happening today. 
Like every kind of social movement, public health nursing 
had its genesis in the big city some twenty-five or thirty years 
ago, and it stayed in the big city for at least twenty years, be- 
cause it had a hard time getting started. It had a big new 
piece of work to develop, and it concerned itself in getting 
underway pretty much in the big city, and it was not until 
perhaps half a dozen years ago that it began to spread out into 
the country at all. So that what has been done in rural public 
health nursing is only a matter of some six years' growth. I 
think the credit for the first really effective work in that field 
ought to be given to the National Tuberculosis Association, for 
through their various state tuberculosis associations they be- 
gan to press public health nursing out of the city into the 
counties. They began to put a nurse here and a nurse there, 
and an idea about nursing here and a little more information 
off somewhere else and in some other county, until the country 
people began to realize that there was such a thing as a public 
health nurse, and some of the counties began to put public 
health nursing into their health plans. And because of the 
results of the work of the various s.tate tuberculosis associa- 
tions the state boards of health began to be interested, and 
after they became interested they began to think they might 
take hold of this proposition themselves, and first one state 
and then another state put on a state supervising nurse. And 
then pretty soon some of the legislatures took hold of this new 
activity and phase of public health and passed some laws, and 
67 68 
American Country Life Association 
some more states took notice and they began to pass some 
laws; so that at the present day we have two states, Ohio and 
Wisconsin, in which there is a mandatory law compelling every 
county out of its public funds to have a public health nurse, 
(or in Wisconsin the alternative of a public health nurse or 
a public health instructor), and in sixteen states we have 
permissive laws, enabling the counties to use county funds 
for public health nursing, but not making it compulsory, and 
in fifteen states we have state supervising nurses employed 
by the state department of health acting as directors of a 
bureau or division or subdivision of public health nursing, 
whose functions are to carry the state work of public health 
nursing through the counties and to get county officials and 
county funds and county interest back of a public program 
for public health nursing. 
In six years all of this has come about, which is, after all, 
pretty rapid progress. And yet when we look a little 
at the statistics we find that we are not as far as we 
think we are. There are four states-Massachusetts, 
Connecticutt, Rhode Island and New York-in which we have 
one public health nurse for every four or five thousand people. 
Dr. Winslow says the ideal is one to every two thousand, and 
those four states are as near it as any, with one to every four 
or five thousand, 50 per cent perfect. But then you go on 
down the scale until you strike Mississippi, with one nurse to 
every one hundred and eighty thousand, and you see we are 
not very far in some of the states. 
Taking another group of figures, you find New York state 
has about two thousand public health-nurses, at least half of 
those in the city of New York. Wyoming has two public 
health nurses, Nevada has three, Utah, outside of Salt Lake 
City, has none; so that during six years' work, while a good 
deal has been accomplished in some of our eastern states, and 
much has certainly been done to awaken our public officials 
and our philanthropic groups and our public at large to some 
idea of what public health nursing is, still we are a very, very 
long way from having accomplished anything like a complete 
organization of nursing service. 
But at the present moment we have a state of mind all American Country Life Association 
69 
over the country which probably is going to help us very much 
to obliterate any such figures as a state with only one nurse 
to one hundred and eighty thousand people. Everywhere you 
go, every program you pick up-and there is not a national 
organization or state organization or any individual, I think, 
that has not a program today-and every plan of work that you 
look over, you find well up towards the head written "Health." 
It may be a labor union program, it may be a school program or 
a church program, it may be any sort of organized group's 
program, but up towards the head of their topics you will 
always find "Health." That means our organized groups, our 
thinking groups, see very dictinctly that health is one of the 
most essential basic factors of the piece of work they want to 
accomplish. That does not necessarily signify that the public 
at large sees it. To be sure, we have learned many lessons out 
of the war. The draft, which everybody quotes, has 
been one of the means of driving home this lesson. 
The work of the Federal Children's Bureau is another 
way that the lesson was driven home. The example that was 
given us by the government in the medical care that it extended 
to the army and navy and the marine corps was a third lesson, 
and the influenza epidemic was the finishing touch; so that 
we have at large as well as in the organized groups an aware- 
ness of the menace of sickness and the significance of health, 
and I think we have a popular conviction that there are ways 
of taking care of health and ways of preventing sickness, but 
I don't think we have as yet a very clear conception on the 
part of the general public as to just what the tooys and the 
mechanics for inaugurating a health program really are. 
I would like to give you here some measure of what the es- 
sential activities of a public health nurse in a rural county are; 
not the things that are somewhat less essential, not the things 
that we might like to include but perhaps will have to wait for, 
but the very essential activities that she ought to be carrying 
on, so that you will know what her practical value is. 
Her duties begin with the conception of life-•that is, with 
the expectant mother. The Children's Bureau told us some 
year or two ago in one of its bulletins that the maternity 
death rate had not dropped in twenty years, although the 70 
American Country Life Association 
death rates from communicable diseases and from many other 
kinds of diseases had dropped decidedly, a fact which they took 
to mean that we have not extended to our maternity problem 
the thought and the attention that we should have. And we 
know that in the country especially have we neglected this 
maternity problem. You only have to read a few descriptions 
of what the country mother goes through during that period 
to realize that something very definite must be done for her 
immediately. She ought to have wise advice during the pre- 
natal period. She ought not to be dependent upon such instruc- 
tion as the neighbors and her mother may be able to give her, 
in this day and age when we have at our command scientific 
knowledge of what pre-natal care includes. Such knowledge 
and care should be extended to her just as well as to the city 
mother. So that the public nurse's work begins right here 
with the expectant mother, with visiting her, talking over her 
own health and her family and financial difficulties and her 
household tasks and her arrangements for confinement and all 
of those things which may affect the vitality of the new little 
life. Then comes the care during maternity, and in the country 
there is great need for such care. And then comes the infant 
welfare part of her program. Infant welfare has been talked 
about so much for the last ten years that I do not suppose it 
is necessary to dwell on that at all; the teaching of the mother 
of the simple hygienic care of the infant and the small child, 
the feeding, the clothing, the bathing, the amount of sleep the 
baby should have, the need of being outdoors, and all those 
simple hygienic principles and procedures which are very 
simple to us when we know them but which have never been 
taught to the average mother. And then the provision of a 
specialist when the baby requires the care of a specialist, and 
then the nurse's teaching the mother how to carry out the 
specialist's instructions. Then comes the pre-school period. 
Many a baby which has done very well until it has been 
weaned begins to lose through the second year and third year 
and fourth year, when it receives less care and attention. Its 
health habits are established during those years. The mother 
perhaps does not know what it ought to have in the way of 
food. She does not know how to start it out on the right American Country Life Association 
71 
road to health and how to train it in personal hygiene. The 
beginnings of the defects which we found in our young men 
creep in during those childhood years, the years that hereto- 
fore we have all neglected. The little child should be guarded 
and trained much more carefully during this period than it 
has been in the past. Then comes the school period. We have 
heard a great deal about medical school inspection and we 
know its very great importance. We know that if we had had 
it twenty years ago we would not have had so many draft 
rejections, because we would have found in those boys when 
they were little boys the wrong habit or wrong bodily struc- 
ture or organic weakness which later incapacitated them when 
they came to their physical examinations for the draft. So 
that the public health nurse includes in her functions the 
helping of the doctor, where there is one, in the examination of 
the school children, and the inspection of the children herself 
where there is no doctor, and then going home with the record 
to the mother and father, and explaining what is wrong, what 
it all means, what to do about it, why they should spend money 
to have the defects remedied which do not seem serious to 
them, in this way making the physical examination really 
result in improvement in the child's physique and habits. 
Then there is that whole realm of communicable diseases 
which takes such a heavy toll of child life and the lives of 
young men and young women every single year, and which are 
almost entirely preventable-scarlet fever and diphtheria; 
whooping cough, to which we pay so little attention, and 
measles which mothers are so likely not to consider at all 
serious; typhoid fever, which simply needs an intelligent and 
concerted campaign to wipe it out of the country district or 
city district; trachoma, hookworm, all of those parasitic and 
bacterial diseases which we only have to attack persistently 
and intelligently and all together to entirely remove. All of 
this is work which the nurse can help with because she goes 
into the homes and tells the mothers and fathers the simple 
facts about these diseases, the reason for fighting them and 
how to fight them. She finds early cases, undiagnosed cases, 
and she takes care of the sick, and in taking care of that one 
life she is protecting the whole neighborhood. 72 
American Country Life Association 
And then there is the actual care of the sick, which is part 
of any county program, part of any rural public health nurse's 
program. We know how many of our country people are 
remote from a hospital, for we have not yet many of those 
rural hospitals that Dr. Vincent described so very convincingly 
this afternoon. How many of our country people at long 
distances from 'a hospital have had any sort of trained care 
in their homes? The husband is a very busy farmer and can- 
not neglect his crops, and because of that he can only give a 
small part of his time to his wife, supposing she is the one 
who is sick, and even then he knows very little about it. Per- 
haps some woman comes in from a neighboring farm for so 
long as she can leave her own family, which is not very long. 
No other help is available and it is plain to be seen that this 
uncertain, untrained care is totally inadequate. So the actual 
care of our sick people in the country must be part of any 
public health nurse'® program. 
These are simply the most essential parts of a nurse's 
program. They do not include mental hygiene, social hygiene, 
industrial nursing or hospital social service work or many 
other branches which belong in a complete program, but for 
which we will have to wait for some time. Those things are 
needed right away and they must be part of the initial pro- 
gram that we are hoping to have undertaken at first. 
Now, if that is the program, we face two pretty big prob- 
lems in accomplishing it. The first problem is the question 
of personnel. Even one nurse in every county in the United 
States would mean three thousand more rural public health 
nurses. At present there are about nine thousand public 
health nurses in this country, but they are largely concen- 
trated in the big cities. They are not in the counties. And 
even, one nurse in a county is quite inadequate, I think you 
will realize, when you see what we are going to call upon her 
to do. Take a county, for instance, like one I think of in 
Nebraska, as large as the state of Connecticut, which has only 
six doctors in the whole county. One nurse might almost as 
well not go there; she is going to have such a hard time doing 
even a small part of what is needed. Even in the average sized 
county, where perhaps there are sixty rural schools, she is American Country Life Association 
73 
not going to have time to do much besides the work of a. school 
nurse. It will take almost her entire time to examine the 
school children and to see that their defects are corrected, and 
that they are taught something about health and hygiene. So 
we face the very difficult problem of getting anything like an 
adequate personnel, since such a personnel must be especially 
trained for its work. 
The question of what constitutes the sort of a 
worker we want is pertinent. The public health nurse 
does feel that she has certain attributes by virtue of 
her training which are necessary and exceedingly valuable to 
any rural health program and which she alone possesses. But 
she does not feel that she is the only person who knows any- 
thing about public health, or who can do anything about pub- 
lic health, or that she has a complete "corner" on that field She 
wants to use the rural school teachers very, very much indeed, 
because she realizes that she has no more valuable ally than the 
rural school teacher. She wants to use rural social workers, 
and use them to the 'limit of their intelligence. She wants 
to use these new workers that are not yet definitely named, 
health visitors, health instructors, whatever they may be, be- 
cause there is no doubt there is a certain part of the work that 
they can do. When we hear how big this whole program is, 
I don't thing any of us feel that we need to be afraid to invite 
every one who really knows something about public health into 
• it, because there is room for every one of us. And we want 
all the workers we can get. The only thing we do want is 
thorough-going work, based on real knowledge of the piece of 
work that the worker is undertaking to do, and if she has that 
knowledge we certainly welcome her into that' part of the 
public health field which she is prepared to enter. We are 
trying our level best to supply the demand for public health 
nurses, which has far outgrown our present supply. Probably 
there is a 2 or 200 per cent greater demand than supply, but 
the various courses which are training public health nurses 
are overcrowded, frightfully overcrowded. Many universities 
and state boards of health and other groups interested in 
public health nursing in the states are endeavoring to develop 
practice fields and thorough theoretical courses which can be 74 
American Country Life Association 
combined to provide a means of training and developing more 
public health nurses for their states. The time is not far 
off when we are going to have adequate training facilities and 
a sufficient supply of really well-prepared public health nurses 
graduating every year, but that at the present moment is one 
of our biggest problems in this question of personnel. 
The other question is that of cost. If we are going to 
have one nurse in a county (and we realize that one is in- 
sufficient and we ought to have one or two or three or four 
or five), where are we going to get the money to pay for them. 
Dr. Vincent said this afternoon that it was a recognized fact 
that the majority of rural communities could not out of their 
tax money meet the entire cost of any complete public health 
plan. And that plan only included one public health nurse 
to the county. So where are we going to get the money for 
the others that are necessary? That is a question to which 
we must give a good deal of thought. At the present 
moment the money is largely coming from philanthropic 
sources. Do we want it to come from philanthropy? Is that 
a democratic way of taking care of rural health? Or shall 
we find some other way? Shall we use the collective method 
Dr. Vincent spoke of today, every one paying a personal vol- 
untary contribution 'into the community fund? Shall we look 
to health insurance? Shall we have a fee system, or shall we 
remain in the stage where we are now, getting as much 
public funds as we can and relying upon private philan-. 
thropy to provide the rest? Until we find some practical 
democratic answer to this question of cost we are not going 
to be able to solve the problem of providing adequate public 
health nursing service to our rural districts. What is being 
done about the problem at the present moment? I have told 
you what our state boards of health are doing. Some of 
them are not doing anything at all, not having sufficient funds 
in their state coffers to be able to do anything; others are 
doing something, and some are doing splendid work. There 
is a state tuberculosis association in every state doing what 
it can. And now the Red Cross is taking hold of the prob- 
lem. I am not going to tell you what our policy is or what 
our plans are because you doubtless know them; but I American Country Life Association 
75 
shall tell you what we are actually doing at the present 
moment. The first thing we are doing is attempting 
to come to some form of agreement with the state 
boards of health and state tuberculosis associations 
whereby we may combine our efforts to develop public health 
nursing within each state. And in many states where there 
are no funds as yet to pay for a state supervising nurse the 
Red Cross and tuberculosis association together are going to 
pay for that nurse, or perhaps the Red Cross is going to pay 
entirely for her, so that the state may have this worker which 
the state needs but has no funds to provide. Furthermore, 
we are asking our chapters throughout the land to take an 
interest in public health nursing, and if there is a need for it 
in their communities which is not met and is not apparently 
about to be met by some other agency, for them to undertake 
that piece of work themselves. That means we are asking 
private philanthropy, which really is community philanthropy, 
to undertake this problem for the time being, with the hope 
that the day is not very far off when public funds will be 
available to provide this service which we know is a public 
service. 
And then the Red Cross has given a scholarship fund of 
$100,000 out of its national coffers, and many of its chapters 
are giving individual scholarships to prepare workers to enter 
this field. 
Then there is that other organization which has been doing 
such admirable work since 1912, the National Organization for 
Public Health Nursing. They, too, are tackling this problem 
with considerable aggressiveness. One of the things they are do- 
ing, which is going to bear fruit, is the developing of a legisla- 
tive campaign in those states where at present there are no 
signs of employing a state supervising nurse, or creating a 
state bureau to stimulate interest on the part of the state 
legislatures to provide such machinery. 
Another thing they are doing is (helping to establish 
these various courses to prepare public health nurses in many 
states of the union, and they are helping to secure teachers 
for these courses. They are carrying on propaganda work all 
over the United States with the hope of interesting our local 76 
American Country Life Association 
officials (our state officials do not need interesting very much, 
because they are aware of these problems now), but our 
local officials are not as yet fully 'aware of what public health 
nursing is, or why they should provide taxes for this kind of 
service, and the national organization and Red Cross together 
are doing a good deal toward helping those local health offi- 
cers and local county commissioners to understand what it is 
all about. 
These are the agencies that are working in the field. Now, 
how about your own contribution to this piece of work? Don't 
leave it entirely on the shoulders of the professional workers, 
because they probably will only see it from one angle, and they 
can only work from that angle. But all of you are interested 
in rural public health, or you would not be here today at this 
conference, and I take it you want to do your part, and it seems 
to me there are certain things you can do which will be of the 
greatest value. One of them is to break down the inertia that 
now exists in the minds of many of our county officials. They 
are lacking in understanding of what we are trying to do. 
They are lacking in appreciation of the value of this new type 
of public service, and they are unwilling to provide public 
funds for it. Then you all can get behind these campaigns 
for state legislation, so that we may in another five years have 
a state nursing bureau working on this problem in every state. 
Then there is another angle to it from which you can help 
very much, and that is you can get behind our difficulty in 
securing a sufficient supply of public health nurses by inter- 
esting young women with whom you come in contact in this 
particular field of work, getting them into training schools, 
and more than that, taking an interest in the training schools 
themselves to find out whether the training schools are giving 
the kind of educational training that you want your public 
health nurses to have. We all talk a good deal about the kind 
of education public health nurses ought to have, and we scold 
a good deal at the sort of training she is getting now, and we 
leave it there; we don't make it possible for the hospital to give 
her some other type of training, and the hospitals are probably 
not going to provide better training until the public demands 
it, and you are the public; so it is one of your responsibilities American Country Life Association 
77 
to take an interest in the sort of training provided for our 
nurses and see to it that your local hospitals are wide enough 
awake to include training in public health nursing. Combining 
your help with the efforts of the national and state agencies 
in the field, I hope that in another five or ten years we will 
be able to develop rural health nursing far .more extensively 
than at present. Without your help it is going to be a much 
longer period. ^The Relation of Health to Religion and Hlorality 
Rev Wm. Covert, d. d., 
PASTOR FIRST PRESBYTERIAN CHURCH, CHICAGO, ILL. 
ri AM greatly embarrassed at the fact that I am here to 
QJ speak in the presence of those that are expert, while I 
am utterly devoid of any special knowledge along the lines in 
which you are so proficient. There is also an incongruity in my 
coming to you to speak on rural questions, since my life's busi- 
ness is in the city. However, realizing that these are educa- 
tional leaders, whose business is to put things across, I feel we 
must share in certain emotional and spiritual requisites. One 
thing you men and women need as much as any class in the 
world is imagination, the thing that enables us to see that 
which does not appear. The man who has imagination to con- 
ceive the unrealized actuality ahead of him, while to others 
it is invisible, has the thing that helps put this theory into 
practice. 
You also need to have your sources of human sympathy 
constantly refreshed if your work is to continue vitally inter- 
esting and effective. I do not know the lines and varieties of 
labor to which you are committed, but I know they are not 
at their maximum value to society unless they meet human 
needs in the spirit of genuine sympathy. 
I have heard Mr. Herbert Hoover say again and again to 
various groups of food administration people, with that in- 
cisive vocabulary of his that I think has not been excelled by 
anyone: "Gentlemen, this food saving propaganda runs counter 
to the eating habits of a hundred and ten millions of people. 
Therefore, it will be opposed and misunderstood, and I know 
of nothing that is sufficient to put this thing across without 
the support of moral passion. I know no other word that I 
can use that would define the content of my mind upon this 
point. It is moral passion. Therefore, I ask you gentlemen 
78 American Country Life Association 
79 
Who have been accustomed to preach self-control and un- 
selfishness to come in here and get all the facts in the case and 
get behind this thing." And at the dinner given to Mr. Hoover 
not long ago, in New York City, it was made plain to him that 
this particular appeal to the American people was an effective 
appeal. I know this is a supreme need in making theoretical 
and academic plans effective. I am sure this is a requisite for 
complete equipment of you men and women as you go up 
against county problems and township problems and general 
rural problems. 
I was asked to answer this question: "Are dirt 'and dis- 
order in rural life causes of moral inertia?" What relation 
has disorder and ordinary dirt, carelessness and slovenliness 
in rural life to moral character? I would have some difficulty 
in trying to prove anything by concrete examples in this case, 
and yet I have a notion, and so have you, that the general 
principle ought to be accepted, that cleanliness is really a part 
of godliness. I have in my experience met a number of dis- 
orderly and dirty people who are not bad, which embarrasses 
me when I am trying to set up a theorem like this. In many 
of the old monastic orders dirt was a high token of piety, the 
more dirt the more piety. The ill-kept body and all that went 
with it indicated a state of high spirituality. I was very 
much interested this morning in turning to those portions of 
the book of Leviticus that deal with sanitation and rural life. 
I hope you ladies and gentlemen will especially read the 
eleventh, thirteenth, fifteenth and sixteenth chapters of Leviti- 
cus and remember the time, circumstances and stage of civili- 
zation in which these rules of sanitation and disinfection and 
everything else were promulgated. You will find there that 
the instruction Moses laid down in regard to sanitation was 
put upon a high ground. He placed it as a divine order in 
the organization of his society. The man that was found guilty 
of poor sanitation in and around his tent or camp by that 
sign proved to be wicked and was at once disfranchised from 
the synagogue or tabernacle. He had to get right with so- 
ciety as well as with Almighty God before he came back. The 
eleventh chapter is devoted almost entirely to the method of 
the disposal of carcasses in the community. This seems very 80 
American Country Life Association 
prosaic material to introduce into the Bible, but it was con- 
sidered so fundamental in the building of society that it is 
given conspicuous place, with some sixteen to twenty specific 
verses dealing with that one subject. A man who violated 
these regulations in the matter of removal of carcasses from 
the neighborhood thereby was proved immoral. The thirteenth 
chapter deals with the inspection for contagion. The priest, 
the educated man of the neighborhood at that time, made the 
inspection. Instructions are given as to the laws of health 
and the peril to welfare of a community by failure to submit 
to inspection in case of contagion like leprosy and various 
diseases of the skin that are mentioned in that chapter. I 
mention these references simply to show that in the old days 
if refuse was found in the particular neighborhood of a man's 
lent, or anything that contaminated, the man guilty of it 
was considered not merely a careless or neglectful member 
of society, but ungodly. He was wicked, according to the law, 
and had to bear the full pressure of the penalty for breaking 
a divine law of the community under the terms of theocracy. 
The result was a most substantial development along lines 
of health and sanitation and general society welfare in the 
crudest forms of civilization. 
Two years ago when in Egypt, accompanied by two friends, 
I went out into the desert. Coming to a little oasis, where 
there was a flowing well, I paused for rest. A Mohammedan 
traveller came up, and after greetings he went to where the 
water was pouring down through a little spot of green grass 
from the overflowing well and there he removed his sandals 
and his turban. He rolled up his big sleeves and with the 
greatest care washed his hands and arms to the elbows, also 
his face, feet and legs to the knees, with the greatest care. 
Having done this, he at once arose and bowed with his face 
toward Mecca and prayed. It is a fundamental law in Mo- 
hammedanism that no man ever worships until he washes. I 
don't know what would be the consequences if it were not for 
the custom. Every man that worships of all the millions must 
wash his hands and face and feet three to five times a day. 
Cleanliness goes with godliness among the Mohammedans. 
There has gradually grown up in the United States a American Country Life Association 
81 
feeling that old General Booth was about right in the three 
steps to sanctification that he laid down for the Salvation 
Army. First, it was soap; get a man clean. Then it was soup; 
fill him up; and then it was salvation, and if we could take 
time to discuss the value of that soap to salvation, I think 
we would find the connection very vital. So we have come to 
feel pretty generally in polite society that cleanliness is next 
to godliness. In a task so complex and difficult there is no 
possible success without motives that abide. We must locate 
in the work of rural sanitation motives strong enough to make 
everybody clean. An untidy, foul barnyard must be regarded 
as a violation of the Golden Rule and a contradiction of the 
divine law of brotherhood. I do not believe we are going to 
move people by simply telling them dirt and disorder violate 
good sanitation. I believe we must go a little deeper down 
and plead for that practical brotherhood that this thing con- 
tradicts. The health of the community is involved in the 
location of septic tanks and cesspools. Improperly located 
or constructed, these things contradict the laws of love in 
any man's neighborhood. An undrained swamp breeding 
mosquitoes and malaria violates the law of love. It violates 
both the laws of God and man. If you can root your appeal 
on behalf of sanitation, cleanliness and good order in rural 
life in the supreme law of mutual kindness, men will hear and 
heed. Humanity-that is to say the law of love-leads to 
cleanliness. Do I make my point? Does it sound like preach- 
ing? Morals spread good manners. The Golden Rule is simply 
the consideration of other people. Broad-minded religion is 
regard for the other fellow. These are the considerations under 
which we can appeal successfully everywhere to everybody on 
behalf of clean life. 
This is not an incongruous subject to introduce into a 
rural life convention. There is a very definite relationship be- 
tween! the behest of brotherhood and cleanliness in the 
community. QThe Human Side of Farm Economy* 
Dr. C. J. Galpin 
IN CHARGE OF RURAL LIFE STUDIES, U. S. DEPARTMENT 
OF AGRICULTURE 
OUR discussion this afternoon has two foci-farm economy 
and the human factor in that economy. To set forth 
the human side of the vast agricultural enterprise so that the 
three great parties to the enterprise-the economist, the public, 
and the farmer-may perceive how much the rural problems 
of each move about the focus of the purely human, is my 
principal aim. To suggest how meagre is scientific informa- 
tion about the human factor, especially on the non-economic, 
purely human side, is a secondary aim. And further to sug- 
gest that the economist, the public and the farmer will wel- 
come humanistic specialists and organized research through 
these specialists into the purely human aspects of the farm- 
ing enterprise, is a third aim ranking with the first. 
I 
Let us look first at the role of the purely human in the 
problems of the farm economist. Let us approach this role, 
moreover, through words of the economists themselves. 
Prof. Boss says: 
"Farm management is the application of business 
principles and the scientific principles of agriculture (as 
discovered by the chemist, the physicist, the agronomist, 
the animal husbandman and other specialists) to the busi- 
ness of farming." 
I am assuming that in the mind of Prof. Boss the "other 
specialistmentioned include specialists on certain non 
+ This paper was read at the joint session with the American 
Farm Economics Association. 
82 American Country Life Association 
83 
economic aspects of the human animal who appears as the 
chief factor in farm management; for Prof. Boss, implying 
the dependence of farming upon subtle non-economic human 
forces, goes on to say: 
"For the past several years it has been difficult to 
employ satisfactory farm help at seasons when it is most 
needed. 
"Few farmers market their products in the best pos- 
sible fashion. The reason for this state of affairs lies 
largely in the lack of community interest in the problem. 
"Upon the farmer quite as much as upon any other 
one factor depends the efficiency of the farm organization 
and the profits from farming." 
Dr. Carver has a great deal to say about waste labor, 
asknowledging the helplessness of the economist to increase 
production, unaided by humanistic agencies. He says: 
"Of waste labor there are four principal kinds-the 
unemployed, the improperly employed, the imperfectly 
employed and the voluntarily idle. In the elimination 
of these four forms of waste lie greater opportunities for 
the constructive economist than in any other direction." 
"The greatest source of waste labor power is vice and 
immorality. 
"To be a thoroughly scientific farmer probably re- 
quires a higher education than any of the learned pro- 
fessions, with the possible exception of medicine. 
"A progressive attitude of mind, a willingness to 
change, to learn a new method when it is once demon- 
strated to be better than the old one, is one of the first 
requisites to an efficient and economical employment of 
the labor power of a community. 
"However wise and efficient the government may be 
in its agricultural policy, if the farm managers are un- 
progressive, if they are under the power and domination 
of unscrupulous demagogues, the work of the legislator 
will be in vain." 
Dr. Nourse, implying that the human factor is susceptible 84 
American Country Life Association 
of being energized or de-vitalized by obscure forces not1 under 
economic control, says: 
"In agricultural economics it is the farmer who is 
in all cases the ultimate subject of our concern. 
"Labor in the economic sense means mental as well 
as physical effort, and the intellectual and spiritual qual- 
ities of individuals vary even more widely than their 
stature or their strength. 
"In 1901 and 1902 and 1903 the hookworm formed 
the nucleus of jest in talk and printed items; it was then 
the 'lazy worm.' But as time and experience confirmed 
and added to the earlier warnings, the real meaning of 
the insidious enemy to the district fastened itself in the 
public mind, and more than one paper earnestly urged the 
economic as well as purely pathological importance of 
the disease." 
Dr. H. C. Taylor, who is an optimist on ways and means 
of raising the farmer's output by increasing tdie farmer's 
personal quality and social status, says: 
"Human brawn and human brain are so important in 
giving direction to the other factors that man may easily 
be counted the most important of the three factors of 
production. Whatever affects man as an agent in agricul- 
tural production seriously affects the results of this basic 
industry. 
"The man with ill-health, who is often unable to work, 
has little hope of success on the farm. 
"When two farmers employ equal amounts of labor 
and capital goods upon equal areas of equally productive 
land, the one who possesses a relatively high degree of 
efficiency can produce a larger return than his competitor 
who is less efficient. 
"In the mind of the high-class young farmer, the life 
of himself and his family, in accordance with a high 
standard of comfort and right relations in the community, 
will give purpose and force to the primary economic 
motive and hold it in its right position as a means to an 
end, but not as an end in itself." American Country Life Association 
85 
Dr. Warren, opening our eyes to the complieated human 
qualifications for success in fanning, says: 
"More farmers fail because of poor farm manage- 
ment than because of poor production. 
"For success in farming, health, strength, and ability 
for the wife are almost as important as for the farmer. 
"Occasionally a man makes a fair success when he 
has no particular qualifications except muscle, but success 
under this condition is much more difficult than formerly. 
Good common sense which is another definition for busi- 
ness ability is" the most important trait, but the highest 
profits are made by those who combine this ability with 
experience, scientific knowledge of plant and animal pro- 
duction, manual and mechanical skill, and hard work." 
These quotations are sufficient, doubtless, to show how 
concerned the farmer economist is with the human factor in 
farm economy as appearing in farm labor problems and farm 
management problems. What stands out with startling clear- 
ness at this point in the development of agricultural scientific 
agencies is the general absence of specialists working on the 
particular human aspects of the human factor which are im- 
portant to farm economy. The farm economist, so far as I 
know, has never set up a claim to be a specialist on rural 
health, rural eugenics, rural psychology, rural education, or 
rural political science. The conclusion is forced upon us that 
the rural economists will welcome to the study of farm 
economy a staff of specialists on the non-economic, purely 
human phases of farm life. Think for a moment of the de- 
velopment of scientific data on the physical, chemical and 
biological side of the land factor in farm economy. Think of 
the scientific advance in our knowledge of the capital factor 
in plant breeding, plant disease, and in cattle breeding, cattle 
feeding and cattle disease. Think of the scientific staff at work 
in each line. Think of the amount of money expended in re- 
search in all these lines. Then note the creed of the fore- 
going economists that production and the farmer's profits 
hang upon the dynamic quality of the human agent; then 
recall that we have as yet in our agricultural research agencies 86 
American Country Life Association 
only an instance here and there, surely no widespread recog- 
nition of research, on the purely human side of farm economy, 
and the human situation in farm economy is fairly spread 
before you on the table in its broad outline for sober con- 
sideration. 
It would be a shock to many to learn how meagre is our 
trustworthy information about the life, labor, and happiness 
of our farm population. Rural sociology, a very recent social 
science, attempting to co-ordinate some of the basic human 
sciences and apply them to farm life, has made a few bare 
beginnings upon the problem. Perhaps the most serious gen- 
eral fact corrupting the value of the statistics of "rural 
population" is this, that we have never had as yet a classified 
census of farm population. Rural sociologists are especially 
handicapped by this glaring defect in population statistics. 
Not until the farm population is sifted and sorted out of the 
so-called rural population, and then classified with respect to 
dynamic characteristics, attainments, and shortcomings, can 
we expect national statistical information about the rural 
human animal for utilization in farm economy. 
Psychologists have not yet deigned to study the 
psychology of farming, as they have the psychology of some 
other occupational processes, like salesmanship, advertising 
and industrial management; nor have the political scientists, 
with small exception, attempted to tackle the problem of why 
farmers possess no modern local political instruments of the 
Character of the village or city municipality . 
The arena of country life, labor and struggle, where the 
farmer and his family achieve their primary habits of thought 
and action, is the farmstead-a miniature social and economic 
principality. A full knowledge of the human being who is 
sovereign over this little rural domain is one of the keys to 
understanding farm economy as well as rural society. 
The so-called efficiency movement of our time, which in the 
department of business goes under the name of scientific man- 
agement, is probably responsible for the application of prin- 
ciples of psychology to many practical situations arising in 
the course of industry and commerce. It was a far-reaching 
discovery when the administrative staff of commercial organ- American Country Life Association 
87 
ization, seeing that goods of quality did not automatically 
impress the consumer and produce sales, arrived at the con- 
clusion that buying and selling was a social operation depend- 
ing upon principles underlying the processes of the human 
mind. The psychology of salesmanship and advertising there- 
upon became a fixed part of business organization. 
Is it not quite possible that the promoters of scientific 
agriculture, in their eager and confident application of the 
fundamental physical sciences to the processes of agricultural 
production and distribution, have arrived at the point where 
the human factor must be taken more completely into con- 
sideration on the psychologic side? Agricultural extension 
method, recently introduced widely in the United States, is a 
partial answer to this question; "demonstration," which is 
visible explanation on the spot, is everywhere the vogue. But 
has not the deservedly popular extension method in agriculture 
arrived at the same point in its development where business 
organization stood when it was "demonstrating" its goods 
without a basic knowledge of the psychology of the buying 
operation ? 
Unless agricultural promotion, research, extension, educa- 
tion, in both its productive and marketing aspects, is to reach 
a point of diminishing returns at the stone wall of the rural 
social mind, it apparently must add to its method a broad 
recognition of the psychological and social aspects of rural life. 
The environmental influences surrounding human life, 
labor and intercourse on the farmstead furnish a set of pres- 
sures and strains upon farm life, the physiological, mental 
and social effects of which we may observe and judge. Here 
then is the beginning of a psychology of farm life which may, 
as time goes on, be elaborated by the psychologist and 
sociologist who happen to possess rural sympathy and farming 
imagination. 
If the light of scientific research can be widely turned 
upon the farm family and the farm population, it is not un- 
reasonable to suppose that methods of vitalizing and of ener- 
gizing the present motives of the farmer as a producer and 
profit-maker will be found. What is still more probable, more- 88 
American Country Life Association 
over, sources of brand new social dymanics through new farmer 
groupings will be made available to the farm population as 
a whole, which will add materially to our national farm 
economy. 
It may be fairly assumed that the farm economist would 
be highly interested in and would welcome, therefore, a series 
of studies carried on by specialists after something like the 
following program: 
A. The Farm Population In the United States. 
1. A numerical census by counties. 
2. A tabulation by counties of all the usual population 
items in the population schedule, such as age, sex, color, 
education, literacy martial conditions and the like. 
B. The Health of the Farm Population. 
1. State health maps. 
2. Regional maps showing areas of outstanding ailments. 
3. Health studies in areas of low production. 
4. Health studies in areas of tenancy. 
5. Studies of health of farm children and women. 
6. Health studies of farm populations engaged in the 
various types of agriculture. 
C. The Psychology of the Farm Population. 
1. Psychological studies of farm populations engaged in 
various types of agriculture. 
2. Psychological studies of farmer organizations. 
3. Psychological studies of farmers under various forms of 
land tenure. 
5. Psychological studies of various race elements in the 
farm population. 
6. Psychological studies of rural and urban inter-relations. 
7. Psychology of extension work among farmers. 
8. Psychology of backward and progressive communities. 
D. The Education of the Farm Population. 
1. Studies concerning the influence of elementary educa- 
tion of the farm population on farm economy. 
2. Studies concerning the influence of secondary education 
of the farm population on farm economy. American Country Life Association 
89 
3. Studies on the influence of technical argicul'tural educa- 
tion on farm economy. 
E. Municipal Privileges For the Farm Population. 
1. Studies of farm population groups, agricultural and 
social. 
2. Studies of the existing charters of local government 
among farm populations. 
3. Studies on the relation of urban municipalities to farm 
populafion groups. 
4. Studies on the adaptation of municipal instruments to 
the conditions of open country residence. 
The thorough going recognition by farm economists of the 
value to farm economy of some such program as the above 
would have a profound influence upon research agencies in 
each state of the union. Voiced recognition would supplement 
the silent welcome w4hidh I have assumed. 
II. 
The public is a decided party to all fundamental policies 
touching agriculture and the agricultural population. The 
public pays its share of the bills of agricultural experimenta- 
tion, extension, and technical education. This Tactl a|lone 
entitles the public to consideration. The public especially 
desires 'assurance, I take it, that the human factor in the farm 
enterprise-namely, the farmer and his family and the group 
of farm families associating together in 'community life-is 
reacting to the state and national expenditure in such a wlay 
that the benefits derived therefrom are relatively permanent, 
finding lodgment in the bed rock of rural community life, and 
not in constant danger of being washed off the lands into some 
urban stream. Nothing short of a systematic study of the 
farmer as a human being, a study holding out inducements 
of valuable discovery, ais does experimentation with swine, 
cattle, and sheep, can give to the public the solid assurance it 
needs for continuing 'the vast agricultural financial program. 
The public is interested, furthermore, in the farm popula- 
tion, not only as efficient producers of food, but as contributors 
of human balance to American citizenship. In all political 90 
American Country Life Association 
discussions the agrarian class is referred to, with more or 
less sincerity to be sure, as the backbone of the nation's in- 
tegrity, justice and democracy. From this point of view the 
problem of how to maintain a high standard of rural citizen- 
ship is a vital problem, but a very special one, depending on 
conditions which are as yet unknown only because unstudied. 
The structure of rural society has only recently challenged 
students of social life, and the sources of information are 
largely original observations yet to be made . 
The public will probably feel more comfortable about its 
budget for the improvement of farming in this country and 
easier in mind about the Americanism of its rural population 
if a study of rural human conditions is made the aim of a 
responsible research agency in every state. The following 
subjects will serve as a guide to what the public would pre- 
sumably like to know: 
I. The Farm Family as a Basic Institution. 
1. Influences at work upon the stability of the farm family. 
2. Influences which produce permanency in residence of 
the shifting families from rural community to rural 
community. 
3. The relation of the farm family to urban life and energy. 
II. The Religious Development of Farm Life. 
1. The influence of new methods of farming upon religious 
thought. 
2. The relation of church groups to agricultural groups. 
3. The influence of a larger contact with life upon the 
farmer's religious ideals. 
III. 
The farmer himself, in many ways the most deeply con- 
cerned, is the party to the agricultural program in America 
most intensely interested. He wants his share of the annual 
national dividend, and is coming to want this more and more 
insistently; but it should not be forgotten that he wants this 
dividend for the purpose of maintaining an American stand- 
ard of living. And right here is the rub, for how to maintain 
an American standard of living on the farm, as country life is 
now organized, is an enigma. The average farmer, from sheer American Country Life Association 
91 
perplexity of soul, solves the enigma by sidestepping the main 
issues. He either is resigned to a lower standard of living 
for his family, or as soon as his profits warrant, and sometimes 
sooner than they warrant, he leaves the agricultural enterprise, 
quits the farm and farming, turning it over to inferior farmers 
in many cases it must be conceded, and seeks the American 
standard of living for himself and family in an urban center 
where the social tools, instruments and machines of social 
power have been more fully developed. This result is plainly 
disastrous to the main agricultural enterprise of the nation 
and is a blow to the country life philosophy of many hard- 
headed people who hold that prosperity alone solves the 
country life problem. It all too frequently takes away from 
the land the persons possessing seasoned farm experience, pulls 
up usually from rural community life the most prosperous 
and spirited family groups and turns the human stream into an 
already congested town and city current, Where farm-bred 
persons seek more or less successfully to find their place in new 
life and work relations. The problem of maintaining a high 
standard of living for American farmers and keeping intact 
on the land the seasoned farm population itself is a rural 
problem of the greatest moment to the farmer, the public and 
the rural economist. But this is not exclusively an economic 
problem. Rather it is a very complicated social, human, 
psychological and political problem, having to do with a class 
of people whose cultural, esthetic and intellectual aspirations 
have hitherto been very largely postponed by one force or an- 
other, by one set of circumstances or another. 
The farmer himself will welcome, it may safely be assumed, 
scientific studies of the following nature: 
I. The American Standard of Living for the Farm Population. 
1. The social instruments of power. 
2. The political instruments of power. 
3. The relation of rural prosperity to standards of living. 
II. Social and Political Status of the Farm Population. 
1. Causes of social equality and social inferiority in the 
country. 92 
American Country Life Association 
2. Causes of political equality and political inferiority in 
the country. 
CONCLUSION 
From the point of view, therefore, of the farm economist, 
the public and the farmer, it would seem to be a strategic 
advance for the rural research agencies in the state and 
national life to include in the field of their legitimate activities 
the purely human side of farm economy along with the purely 
economic. This question will face especially the agricultural 
experiment stations in the different states. And the form in 
which it will come up to them will be this: Is the purely human 
side of farm economy susceptible of investigation by methods 
of a scientific character? Already some experiment stations 
have answered this question affirmatively, have incorporated 
rural social investigation into their program of research and 
have paved the way for other experiment stations by demon- 
stration of scientific method in this field. It is to be hoped 
that the director of every agricultural experiment station will 
speedily take this same stand and give, opportunity for the be- 
ginnings of a research staff in every state devoted to the purely 
human problems of the farm population. To know the farm 
people of the state in their relations to farming, to community 
life, to political life, seems an aim worthy of every state. The 
United States Department of Agriculture is already on record 
as intending to study the human side of farm economy, and 
welcomes co-operation in the states with responsible agencies 
of research. Report of the Committee on Rural Health 
and Sanitation 
Dr. W. S. Rankin, 
SECRETARY OF THE STATE BOARD OF HEALTH OF THE STATE OF 
NORTH CAROLINA 
/n SHALL try to be very brief in making, first, a report of 
the Committee on Rural Sanitation, and then in giving 
you very briefly just what is intended and provided for in the 
Lever bill for rural sanitation. 
First, the report of the Committee on Rural Sanitation. 
It is-the sense of that, committee that this conference should 
recognize the county as the ultimate unit in rural health ad- 
ministration. We realize in taking that position that in cer- 
tain states the district as the unit is sometimes desirable in 
the beginning. The district plan and the county plan are not in 
conflict, but fit one into the other. For example, if you take 
the county as 'your ultimate unit, as we do in my state, and 
start in with full-time county health officers, you will find 
after you have organized eight to ten or twelve county health 
departments that it is necessary to have another health officer, 
Whom you might call the district health officer, to supervise 
the eight, ten or twelve county health departments. There, 
for example, is the evolution of the district health officer from 
the county as the initial action. On the other hand in certain 
states, as in Vermont and in Illinois, the district idea is the 
one that the state has used with which to begin rural health 
work. For example, you start in the state of Vermont, we will 
say, with ten district health officers; as 'the state department 
of health gets more funds to use they will increase the ten 
district health officers to twenty, and finally they will have as 
many district health officers as they have counties, and so we 
have the county health officer as an evolution of the district 
93 94 
American Country Life Association 
officer. There is no conflict between the district plan and the 
county plan of rural health administration. You may go from 
the district to county health officer or you may begin in the 
county and work up to supervising officer of a number of 
counties-that is a district officer. But the point that the 
committee recommends first is that we keep in mind the fact 
that the county is the ultimate and logical unit of health 
administration. 
Second. It is the sense of your committee that the ap- 
pointment of county health officers should be by the local 
authorities, by the county authorities, but the county authori- 
ties should appoint health officers that are qualified and that 
are so certified to them by the state. The state should de- 
termine the qualifications of local health officers just as the 
state determines the qualifications of doctors and lawyers and 
of public health nurses. The state should determine the quali- 
fication of local officers, certify them to the local authorities, 
and they should appoint. 
Third. The plan of work both in scope and detail should 
be standardized and approved by both the local authorities 
and the state. Now, when we come to the standardization of 
a plan of county health work we immediately come in con- 
flict with the views of a number of local health officers to the 
effect that their initiative, that their individually, is destroyed 
whenever you standardize their work. 
At first sight there is some little conflict in this matter 
of retaining the initiative in the local health work and at the 
same time standardizing it, but it is only an apparent conflict. 
The matter can be handled so that there is no conflict. The 
local health officer does not want to have his work too closely 
outlined for him; he wants to do a little thinking himself, and, 
on the other hand, it is to the interest of the state, and it is 
to the interest of the local community, that the work of the 
local health officer be standardized, so that; the work of the 
county health officer may be compared with that of counties, 
A, B, C, D, E, F, and G. It is only by comparisons that the 
people employing the health officers, the county and state, may 
pass upon the efficiency or inefficiency of the officers employed. 
Standardization, a standard plan of local health work, is essen- American Country Life Association 
95 
tial. Without it no comparison can be made, and without com- 
parison no estimate of the value of one man's work as against 
another can be arrived at. 
How are we going to standardize? How are we going to 
have a 'standard plan of county health work and at the same 
time preserve and promote and encourage the initiative of 
the local health officer? We are going to do it this way: 
Every year or so we call in our local health officers for a con- 
ference; appoint a committee of them to revise the plan of 
work and to contribute all of the ideas and suggestions which 
they can gather from the group, all of the initiative they can 
collect from the entire group engaged in county health work, 
and put all of that in the new plan, and there you conserve the 
initiative of your local health officers. We have brought it 
together in the standardized plan of work, and at the same 
time we have a plan of work so that the health officers in a 
dozen counties doing practically the same thing can be com- 
pared every month through their reports, and the people em- 
ploying them can see what they are getting for the money 
spent. So much then for the plan of work and for the two 
principles that must be considered in opening local public 
health work, preserving the initiative of the local health offi- 
cers and at the same time bringing about a standardization 
of work, so that the work in one county can be compared with 
that in other counties. 
Fourth. Your committee believes that you should approve 
the participation of all governments, federal, state and local, 
in rural health work. The federal government has accepted 
for a num'iber of years, and it has established a precedent that 
will not be upset, that it has certain interests in large and 
fundamental public problems such as education, the 
promotion of agriculture and the development of good 
roads. Certainly the matter of health, as fundamental and 
of as general interest as any public problem can be, is a matter 
with which the federal government has a very real and vital 
interest. 
The federal government found in the war that it 
was very dependent upon the, average American citizen 
and found that 38 per cent of them were physically inefficient, 96 
American Country Life Association 
physically unqualified for purposes of national defense. A 
citizen of a county is not only a citizen of the county, but he 
is a citizen of the state of which the county is a part, and he 
is not only ;a citizen of the county and a citizen of the state, 
but he is an American citizen, and there he becomes a citizen 
of the federal government and a matter of direct interest to 
the federal government. The federal government, therefore, 
has an interest in the health of the average citizen, and it 
should provide for his health just as it has provided for his 
education and for his transportation. 
Tn making provision for taking care of and encouraging 
better rural sanitation, the federal government would 
naturally extend the principle that it has already adopted and 
tried out very successfully-that is, the federal aid extension 
principle. The federal aid extension principle is very simple. 
You can read these federal aid extension acts and you can 
forget all the legislative phraseology and boil them all down 
to this. There are just two things in them: The federal gov- 
ernment says to all the states and all the counties: "I recog- 
nize that this problem is a federal problem as well as a state 
problem and local problem. Therefore the federal government 
will participate in the plan for dealing with that problem." 
One feature of the federal aid extension is this: The federal 
government provides money to bear its share in dealing with a 
great national problem. The fund appropriated by the fed- 
eral government-and it does not make any difference hon 
much is appropriated, a million dollars or ten million dollars 
-is apportioned as it is in the Lever act to the states bn a 
population basis and on condition that the state receiving its 
apportionment shall appropriate a like amount. If, for ex- 
ample, the state of Illinois were to receive $100,000 for rural 
sanitation from the federal government, if that was the state 
of Illinois' portion, then Illinois, in order to get that, would 
have to provide another hundred thousand, which would give 
the state $200,000 for rural sanitation. Then that amount 
would be apportioned to the counties of Illinois on condition 
that the counties appropriate an amount equivalent to that 
apportioned from the state and federal fund to the county. It 
is simply a partnership arrangement. That is all there is to American Country Life Association 
97 
it. It is a stock company-the federal government, the state, 
and 'the local government. That is the first principle in 
federal aid extension acts. The federal appropriation is 
divided equitably among the states. The states put up a like 
amount, the amount being apportioned to the counties on 
condition that the counties put up their share. That is con- 
dition number one. The other thing about it is that the per- 
sonnel employed and the plan followed on which the combina- 
tion fund is expended shall be approved by the three parties- 
the federal government, the state and local government. That 
is to say, the federal, state and county funds in a certain 
county would be put at the disposal of the county health officer 
who was selected and approved by all three participating 
agents, and that eliminates politics absolutely in the county 
health administration. If any one government wanted to play 
politics it would be checked by the other two, or if the two 
attempted to play politics it would be checked by a third. 
The plan of work on which the fund is expended has to be 
approved likewise by all three participating agencies-county, 
state and the federal government. 
That idea brings about standardization and it makes of 
each state board of health, state health agency, a state clearing 
house for county health work. The state board of health can 
compare the work in all the counties. The plan is standardized 
and comparisons can be made, and if some particular experi- 
ment is carried out, some valuable method worked out. in one 
county, the state understands that and can pass it over to all 
the other counties. If some failure is made, the state knows 
that and can warn the other counties. 
Another thing, it makes out of the federal health agency a 
clearing house of information on health work for the entire 
country, as the state health agency is a clearing house for 
health work in the state. That is all there is in federal aid 
extension, an appropriation of so much money divided among 
the states on condition that the states put up a like amount; 
the combined state and federal fund is re-appprtioned to the 
counties on condition that they put up so much, one dollar for 
one dollar, sometimes one dollar for two. The second principle 
is the personnel employed, and plan followed must be approved 98 
American Country Life Association 
by all (three participating agencies. That brings about 
standardization and absolutely eliminates politics. 
I am very sorry that Mr. Lever could not be with us 
and go more fully into the provisions of his bill, but 
that is the sense of the Lever bill. It is one of the federal aid 
extension pieces of legislation, and that kind of legislation is 
fundamental to the solution of the rural health problem. If 
the Lever act would pass Congress, rural sanitation and county 
health work would develop within the next three years where it 
would otherwise require twenty years for 'a like development. 
It will mean the federal government taking the lead in this 
matter and, in fact, it will be the solution. 
DISCUSSION 
President Butterfield: As I understand it, the propositions 
advanced by the committee in regard! to the administration of rural 
health are: First, the county should be the unit of administration; 
second, the appointment of rural health officers should be made by 
local or county authority, but from a list which has been certified 
by state authority; third, there should be a standardized plan or 
program of county health work which is the combined result of 
local amd state judgment, and I assume federal judgment also; 
fourth, financial participation should arise from federal, state and 
local or county governments. ^The Church's Responsibility For Rural Health 
Submitted by Dr. Warren H. Wilson, Chairman 
✓-r-*HE conditions of rural health which affect morality and 
religious life of the nation are as follows: 
1. Soil pollution. 
2. Prostitution and venereal disease among rural popu- 
lations. 
3. Lack of professional care for women and children. 
4. Defectives uncared for among rural children. 
5. Presence of inferior types among country people. 
The measures to be taken at once to remedy these con- 
ditions of ill health are the following: 
First. There should be presented to the churches through- 
out the country full information concerning the work of those 
agencies now in the rural public health field. The work of the 
United States Public Health Service and of state departments 
of health, which are concerning themselves with the country 
populations, should be known to the churches, as well as the 
work of the Children's Bureau on behalf of mothers, babies 
and young children. This should be a health campaign as 
thorough and far-reaching as the war service drives were, 
having objective in the informing of the churches as to the 
need of better national health. 
Tn the work of information, denominational publications, 
including lesson papers, especially those designed for adults, 
should be asked to give more space to this matter. It concerns 
the city as well as the country, so that no objections need be 
made on the score of the city circulation. This report, for 
instance, should be published in such publications as widely 
as possible. The matter ought to be directly introduced into 
the lesson study material-e. g., a lesson on some one of Jesus' 
miracles of healing should be practically applied to the situa- 
tion revealed. 
99 100 
American Country Life Association 
A hand book, for use in study classes, would be most help- 
ful, making a practical course for Sunday school classes or 
young peoples' societies. Churches should co-operate with the 
State College of Agriculture for a campaign for more thorough 
house sanitation in the neighborhood, the church organizations 
should participate in neighborhood health and sanitation sur- 
veys and in other ways diflnitely express the Bible teachings 
in a demand for better health. 
Second. In all church bodies there should be organized 
groups of men and women presenting to their brethren the 
need of national public health service. Ministers should be 
urged by these groups and committees to preach on health 
topics and to treat the problem of health and disease in the 
spirit of the new socialized health-that is, of preventive 
medicine. Surely there will be Christian men and women 
found who will consecrate themselves to public health as 
zealously as others have to temperance reform or to missions. 
Third. To a limited degree, but adequately, the church 
boards and other religious societies should locate physicians 
and nurses in those fields in which they are rendering service, 
notably immigrant communities, isolated rural communities, 
mountain communities, negro and Indian and Mexican com- 
munities, and in Alaska and Porto Rico. In all these fields 
the churches are represented through preachers. They should 
be represented also by physicians and nurses. In some places 
the churches should maintain community hospitals. These 
communities are too small to have a divided supervision. There- 
fore, the church should undertake responsibility for all com- 
munity service. The purpose of this work is twofold: First, 
to render local service where it is acutely needed. This pur- 
pose must dominate in the extension of the service proposed. 
Second, to exemplify the needs of public health service in 
order that public officials and popular leaders may see what 
should be done. 
Fourth. The promotion of recreation in the country will 
do much to restore normal health. It will develop a sane view 
of life. It will stimulate bodily exercise. It will discover 
and support leadership and it will detect the weak and defec- 
tive individuals. A recreation program is perhaps as effective American Country Life Association 
101 
an initial effort toward health and moral improvement as any 
religious agency could without scientific guidance carry on in 
the country. 
The church should seek to inspire the community with the 
social and moral as well as the physical value of play. To 
this end she should lend her influence in creating public senti- 
ment in favor of supervised play in the schools, in playgrounds, 
at the noon hour in shops and factories, and wherever there 
is opportunity to bring people together, young and old, in play 
and wholesome recreation. Her principal- contribution will 
not be in actually supervising or controlling this work, but 
inspiring and encouraging the proper appropriation of public 
funds, as well as private voluntary contributions, for the pur- 
pose of training Christian leadership for community recrea- 
tional features. 
Too often the athletics and play life of the community 
have been left to 'leadership which is undesirable and some- 
times positively harmful. Community play and recreation 
under Christian leadership may have a significant relationship 
to community health and general welfare, and forces hitherto 
unused may be inspired by wise church encouragement to con- 
secrate leadership ability to the gospel of health through 
proper and wholesome play and recreation. The volunteer 
directors of play and recreation in a community, if inspired 
with Christian motive, may not only make their community a 
healthy place in which to live, but in so doing may teach the 
vital relationship between sound mind, strong bodies, alert 
mentality and spiritual vigor. 
Fifth. The message of the church, which is a teaching 
institution, should include the teaching of health. The preva- 
lence of Christian Science among intellectual people and the 
tendency -ro believe in Divine healing among ignorant men are 
reminders to the churches that the Christian tradition must 
not omit the teaching of health. Some of the /Christian 
communions are deliberately undertaking to organize the 
healing faith. We commend to the church the possible alliance 
at the present time between organized Christianity and 
organized health service, both governmental and private. Is it 
not possible for the pastor to co-operate with the public health 102 
American Country Life Association 
nurse and the salaried health officer? Through this co-opera- 
tion there could be accomplished a maximum of good by 
teaching. The health service societies could effectively organize 
the sentiment thus created. 
The ultimate service of health in rural communities must 
be in chief measure by the state. The physician and the nurse 
must be paid by the state to minister in the respects mentioned 
at the beginning of this paper, 'and in other respects in which 
the community needs care generally. It may be left for the 
individual to employ the specialist, but those pathological 
conditions which have 'a universal influence affecting the 
health, morality and spiritual force of every individual should 
be cared for by the state in the interest of the whole com- 
munity. Our concern with the duty of the churches of Jesus 
Christ, who was Himself called "The Great Physician," is 
justified by the close inter-relation between clean, wholesome 
living and spirituality. The state is guardian of the moral 
status of the people. The church has a duty to propagandize; 
the duty of the state is to organize and administer. The 
necessity by which either or both takes a hand in public 
health service is in the moral and religious bearing on health 
conditions. Report of the Committee on Home ^Making 
Mrs. Harrietta W. Calvin, Chairman 
-'HE Committee on the rural home begs to submit the 
I I / following report upon the health and housing in the 
rural home: ( 
1. There is no available exact knowledge in regard to 
rural housing conditions. It is not known what the average 
housing space per individual is, nor the sanitary conditions 
existing in the home. 
Many individuals know of existing conditions in certain 
homes in certain sections of 'the country. Studies have been 
made among the less fortunate families living in the country 
and there have been investigations, quite thorough investiga- 
tions, of rural life conditions in. comparatively small areas, 
but there is no evidence that conclusions drawn from these 
limited personal experiences or the work among groups of 
rural families partly dependent upon public aid or excellent 
studies covering restricted districts furnish adequate informa- 
tion upon which to found generalizations as to rural home life 
conditions on the majority of American farms. 
2. The rural homes differ greatly in different geographic 
divisions of this country as to economic status, labor con- 
ditions andthe customs affecting the demands placed upon the 
time and strength of the house mother. 
In each geographic division there are subdivisions into 
which rural homes must be grouped due to conditions affecting 
farm labor, tenancy and racial conditions. In the central 
west, where there are many wealthy land 'owners, many tenant 
farmers and a considerable number of hired farm laborers, it 
may be doubted if similar home conditions exist in all these 
classes. In the south, where the well-to-do prosperous farmer 
and the thriftless, illiterate white land owners live in close 
proximity and where great numbers of negro farm workers 
103 104 
American Country Life Association 
are on the same land, it is impossible to make any sweeping 
statements as to the healthful conditions of these farm homes. 
It is therefore deemed inadvisable to attempt such generaliza- 
tions until there is a greater volume of exact information. 
3. When accurate and full information has been secured 
there will yet remain a great task to be done in the organiza- 
tion and interpretation of the material and, later, in the 
formulation of a constructive program for the improvement 
of the rural home, 'that it may afford the maximum satisfaction 
to all the members of the rural family and that it may 
worthily contribute to the social and economic life of the 
community . 
4. That such information may be secured, organized and 
interpreted and that valuable suggestions may be offered to 
those interested in rural life betterment, it is here recom- 
mended that: When a country life commission Shall again be 
created there shall be a section of that commission for the 
study and investigation of the problems relating to the rural 
homes of the nation. 
5. It is the opinion of this committee that it is entirely 
needless to compare the conditions existing in the. rural 
homes with 'those of urban residences. Even with the more 
general information relating to urban living conditions few 
generalizations are possible and the issue will only be con- 
fused if efforts are constantly made to set the conditions exist- 
ing in one type of homes over against those of the other. They 
are of necessity different and in any discussion following no 
consideration will be given as to whether the difficulties of 
maintaining healthful living conditions are greater or less in 
rural than in urban homes. This much is agreed upon: The 
country dweller is in greater need of knowledge of sanitation 
and hygiene than the townsman, because he first must de- 
termine for himself the nature of his surroundings, while the 
other's environment will be largely determined for him by 
public authorities. 
6.' The health in the rural home is not so good as it 
should be. Many country-bred men failed to pass the 'army 
physical examinations in spite of the fact that 'they had been 
subjected to the danger of few occupational diseases and had, American Country Life Association 
105 
largely, led an outdoor life. Country school children, as proven 
by the public health service and children's bureau studies, are 
not exempt from physical handicaps. Rural women suffer 
needlessly at child birth and have many physical disabilities 
which could be prevented or cured. The work of the farm home 
is heavy, and, though the hours are not always longer than 
'is reasonable, not infrequently the muscle strain is greater 
than is desirable for women. There seems no reason to believe 
that participation in outdoor farm .activities is detrimental 'to 
the health of the women members of the family if not too heavy 
and if excessive hours of labor are not entailed. Since mind 
so largely affects physical well being, more varied interests, 
more profitable use of leisure time and more wholesome diver- 
sions would undoubtedly react upon the health of the members 
of the family. 
7. The following questions may be asked: 
a. Does not the average farm home usually provide 
ample housing space? 
b. Is the space afforded by the house used to the best 
advantage? 
c. Is the sanitation of the house itself well cared for? 
d. Is the standard of household cleanliness as high as 
it should be? 
e. Do rural people actually live as well as their means 
would justify? By this is meant are their beds 
as comfortable and well cared for, are their pro- 
visions for light and heat as adequate, is the 
quality and preparation of food as good, is read- 
ing matter as abundant as could be provided 
under the financial conditions of the family? 
8. It is the sense of this committee that the condition 
of Child labor on the farm should be carefully investigated. 
5o one will doubt that a reasonable amount of outdoor work 
is good for the health as well as the morality of the child, 
there seems to be divergent views as to whether farm children 
are exploited by their parents and their health thereby injured, 
there is no doubt that in sections where much hand labor is 
involved in the type of crop produced children do considerable 
field work. 106 
American Country Life Association 
9. One valuable agency now modifying rural home con- 
ditions, and one the effects of w'h'ich will be more thoroughly 
recognized when longer in existence, is that of the comely 
home demonstration agent employed by local, state and federal 
authorities. Because of her ultimate acquaintance with their 
problems and her opportunity for personal contact, she be- 
comes a source of help and encouragement to the woman in 
the rural home and to the other members of the rural family. 
Therefore this committee believes that this agency should be 
amply supported and extended and that all other community 
organizations should lend it their co-operation. ^The Schools and Rural Health 
Report Submitted by Mabel Carney of the Committee 
on Means of Education 
f/J- HE school is the most logical and practical agency for 
the introduction of all social reform, including health. 
The reasons for this are self-evident. 
1. In the first place all progress is a question of educa- 
tion, and the school is the local agency of education. 
2. The school educates the rising generation and through 
children their parents and other adults. This was particularly 
apparent during the war, when most of our important drives 
were organized through school forces. Professor C. J. Galpin 
emphasizes this fact in his recent book, ''Rural Life," where he 
devotes an entire chapter to the social role of the farm child, 
3. In the third place the school is universally accessible 
and available, at least to a far greater degree than any other 
social institution. 
4. It is the chief positive and compulsory force of de- 
mocracy, being the only one of the fundamental agencies of 
society operating under state support and control. 
5. It furnishes the most direct and effective entrance 
into the home-a fact especially notable in the matter of health 
instruction. 
With all these advantages the school has but partially 
realized its opportunity in health service or otherwise. This 
partial failure has been due to three chief causes, namely: 
1. Lack of insight and leadership on the part of educa- 
tional leaders. 
2. Lack of co-operation from health agencies. Unfortu- 
nate friction already exists in several states. Between the state 
board of health and the state department of education an in- 
creasing antagonism and jealousy is likely to occur unless more 
definite action is taken toward state programing and the fed- 
eration of social forces. 
107 108 
American Country Life Association 
3. A lack of adequate funds for school support which 
involves, also, a general lack of public recognition and appre- 
ciation of educational values. 
Aeeds of the Rural School for Health Service and Efficiency. 
Several inherent defects in the organization and admin- 
istration of the rural school must be corrected before it can 
function noticeably as a health agency. 
1. To begin with, the county must be made the unit for 
school administration-a poiicy which will do much to equalize 
educational opportunity and the burdens of taxation. With 
the county unit must come the county board of education and 
the elimination of politics from school affairs through the 
employment of a professionalized county superintendent and 
assistant supervisors under this board. 
2. In the second place, there must be 'a greater recog- 
nition of the office of the county superintendent and of school 
forces in rural health administration. This might be assured, 
perhaps, by making the county superintendent of schools a 
member of the county board of health. But, whatever the 
method, it is evident that the county superintendent, super- 
visors, and teachers of a county are responsible to the public 
for the education of children and that nothing can well be 
thrust into the schools without their co-operation and consent. 
3. To facilitate such co-operation certain school elements 
should be included in the preparation of public health nurses. 
These elements should include a general understanding of 
school organization and administration in state, county, fed- 
eral and local units, the general aims of education, and the 
simplest principles of curriculum-making and teaching 
method. Indeed, a rural public health nurse is frequently 
more of a health organizer and teacher than nurse, particularly 
when no county health officer is employed. 
4. Equally important and necessary is the health educa- 
tion of teachers. The country teacher, as commonly conceded, 
is the chief medium of advancement and growth in the average 
rural community. In health matters, as in other affairs, she 
often serves as a pioneer leader pointing the way and con- 
verting a reactionary community to progress. Some skill in American Country Life Association 
109 
plays and games, a general knowledge of health and sanitary 
laws, and the ability to detect the most common diseases of 
childhood and apply "first aid" remedies are now approved 
factor's in the preparation of the modern rural teacher. 
5. A much wider use of the school and its facilities for 
the advancement of public health is also essential. This exten- 
sion of 'the function of the school may be realized in several 
ways. In the first place, all school children, both public and 
private, should be subject to medical examination. The ne- 
cessity and desirability of this precaution are quite beyond 
argument, yet many cities and most rural counties are still 
Without adequate provision for this purpose. As conditions 
now exist nothing could add more to the welfare and happi- 
ness of the eleven million rural school children of the country 
than legislation providing a. county medical officer and rural 
nurses in every county of the United States. 
Regular class room instruction can also be made to yield 
large returns in rural public health propagandas Play and 
physical education, instruction in personal and community 
hygiene, and the development of health ideals, attitudes, and 
habits, as worked out in the best schools today, all constitute 
a fundamental background in the realization of national effi- 
ciency and safety in this line. 
The school may serve, furthermore, as a most practical 
and available public health center. Public health meetings 
and discussions, exhibits, and even clinics, are already estab- 
lished features in the administration of many public schools, 
both urban and consolidated. 
But our schools in general cannot fulfil the large oppor- 
tunities confronting them for public health service or any 
other development until education is more universally admin- 
istered under the principle of state and federal aid. Farmers 
have always been slow to appreciate the economy of good 
health, in fact. Some plan of inducing initial effort and of 
demonstrating the efficiency of public health service is there- 
fore necessary. In this connection the Smith-Towner bill 
now before the Congress of the United States deserves special 
study and consideration from this group. This bill calls for a 
federal appropriation of one hundred million dollars to be 110 
American Country Life Association 
made annually and distributed among the various states for 
the encouragement of education. Twenty million dollars of this 
sum are designated for the advancement of health instruction 
through the schools, and one has to exercise the imagination 
but slightly to picture what this great federal sum, when 
matched by an equal sum from the states, would mean to rural 
school children in the way of medical examination, nursing 
service, health standards, and physical and mental efficiency. 
In reply to questions from the floor, Miss Carney answered: 
Mr. Chairman, before .an organization of this type can work 
effectively, will it not be necessary to have a special agent or county 
community organizer whose duty it will be to help in the work of 
local organization? I have followed the counties which have at- 
tempted to organize somewhat closely and) it appears that even 
though the county superintendent of schools, the county farm agent 
and all the other special workers are doing all they can, each has 
a large task of his own and is unable to foster this work as it 
should be developed. There is needed a community worker in every 
county who can look after the local rural communities and come to 
their aid Whenever requested. I do not recall that in these reports 
there is mention of such a possible office as a county community 
organizer, but it seems to me it woulidl be well to consider the 
possibility. 
I did not mean to imply that the school was the only agency 
for this work. The school is but one agency working with others. 
If I made any statement indicating otherwise it was not intentional. 
I do, however, most emphatically advocate federal .aid to schools, 
on the same principles under which the Smith-Lever bill now 
operates. 
DISCUSSION Report of the Committee on Local Qovern^ 
ment and Legislation 
E. C. Branson, 
CHAIRMAN, UNIVERSITY OF NORTH CAROLINA, CHAPEL HILL 
I. Scope of the Report. 
x-r^HE fundings of your committee concern the govern- 
mental machinery of public health work (1) among 
forty-four million dwellers in the open country of the United 
States outside incorporated towns of every sort and size, and 
(2) among ten million village dwellers in towns of fewer than 
2,500 inhabitants. Here, all told, are fifty-four million people, 
or just about half our total population at present. These peo- 
ple are aside and apart from the centers of business activity 
and social enterprise. Remote and aloof, they were hard to 
reach down to the last household in our liberty bond, war 
stamp, and war benevolence drives. They are just as hard to 
reach with public health literature and to arouse to self-pro- 
tective activity in behalf of disease prevention and health pro- 
motion. 
The instinct of self-preservation is feeble in individuals, 
except on the lower levels and in dramatic situations of sudden 
peril to life and limb; it is even feebler in the collective per- 
sonalities called cities, as most of us have learned in the strug- 
gle to persuade boards of aidermen to invest in adequate public 
health machinery; it is almost non-existent, as a local civic 
asset, among the multitudes scattered throughout the vast 
open spaces of America. 
Your committee has been charged with considering the 
hard end of public health work, namely, the public health ma- 
chinery that will effectively reach and serve the rural multi- 
tudes who cannot or will not take individual or collective 
111 112 
American Country Life Association 
action in behalf of themselves, their homes or their home com- 
munities. Rural public health, like the rural public school, is 
a mired wheel at present in the United States. 
II. Committee Findings. 
Effective public health work in rural (areas seems to your 
committee to mean: 
1. A state department of public health with authority to 
determine general public health policies, to broadcast popular 
public health literature, to establish and maintain standards 
of public health service, to supervise and direct all state and 
local health activities, agencies and institutions whatsoever, 
and to serve within the state as a direct co-ordinating center 
for all extra-state public health organizations and agencies, 
federal health bureaus, as well as national public health 
philanthropies. 
2. Regional diagnosis centers, general clinics and dis- 
pensaries-enough to be within easy reach of the rural popu- 
lations of a state. 
3. Hygiene and sanitation as required subjects of in- 
struction in all grades and types of schools receiving state 
aid. These as a setting and support for: 
4. A county-unit organization of public health machinery 
under state board guidance. 
III. Explanation in Brief. 
1. The State Department of Public Health. It appears 
to your committee to be both possible and desirable that all 
local public health work, regional, county and municipal, be 
placed under the authoritative guidance of the state health 
board; and also that all outside public health agencies and 
organizations operating within a state function through the 
state board-this, in order to avoid, in Milton's phrase, "con- 
fusion worse confounded," which being translated means con- 
founded confusion. This finding presupposes the willingness 
of public health organizations, local, state and national, to 
federate their aims, to concentrate their funds and to operate 
through a single responsible state agency in comfortable com- 
radeship. If it cannot be so, it indicates a sad lack of self- 
effacingness among Good Samaritans along the road to Jericho. 
Pending such a federation, national organizations should place American Country Life Association 
113 
their public health work on a project basis and definitely an- 
nounce their projects to the public. 
2. Regional Diagnosis Centers, General Clinics and Dis- 
pensaries. Such centers ought to be established in steadily 
increasing number in every state, and their location determined 
by the necessities of remote rural regions. The investment and 
operating expense ought to be a charge upon the state treasury, 
supplemented by the funds of such federal bureaus and vol- 
unteer organizations as find these centers useful in reaching 
the disabled constituencies they are created to serve. The lack 
of such centers at present leaves our rural populations at the 
mercy of clogging inveterate superstitions, quack doctors and 
patent medicine venders. 
3. Schools of every grade and type receiving state aid 
in any measure should offer instruction in hygiene and sanita 
tion, with lessons in first aid, bedside nursing and sick-room 
dietetics, adapted to classes of various ages and degrees of 
preparedness. A measurable command of these matters ought 
to be required for a license to teach in the public schools of 
the United States; otherwise college, normal school and sum- 
mer school courses in these subjects are likely to be offered 
in vain for long years to come. Credit courses must be used 
to create civic and social mindedness. The school must hurry 
to capitalize popular interest in public health. Public health 
servants must be trained in wholesome numbers, and rural 
communities must be stripped into readiness for action, by 
intelligent local leaders in multiplied thousands. Public 
health instruction in the schools in foundational . 
4. The County Unit of Public Health Machinery. In 
forty-one states the county is the unit of. civil government. 
Just as we have slowly come to see that public education on a 
county-wide basis is the way of progress, so it begins to appear 
that the county as such is the proper territorial basis for 
local health organizations operating as mediate agencies of 
state health board effort, and that on no other basis are we 
ever likely to reach and serve our country populations in 
public health work. And this is probably just as true in 
regions where the town or township is the real unit of political 
life as it is in areas where the township is merely a geographic 114 
American Country Life Association 
term with little or no significance of economic, social or civic 
sort. Effective public health work is expensive-too expensive 
for rural taxpayers or for dwellers in fractional areas of rural 
counties. Our rural counties, it is well to remember, are four 
of every five on an average the country over; that is to say, 
in 2,350 of our 2,950 counties two-thirds or more of the people 
dwell in the open country and in small towns and villages 
The time has come to recognize this fundamental fact and to 
act upon it. The taxable wealth of an entire county is re- 
quired to support public health work that is organized to reach 
all the people. It is not too much to say that every dollar of 
taxiable wealth in every county ought to back health promotion 
and disease prevention in the richest town center and poorest 
country districts alike. Bear ye one another's burdens, and 
every man shall bear his own burden, are complementary bib- 
lical truths. They are also complementary democratic doc- 
trines. They mean local tax levies, reinforced by state and 
federal aid and by private benevolence, local and national. 
A state health board can function most effectively through 
county health machinery. It is hard to see how it can other- 
wise reach individual farmsteads in sparsely settled rural 
areas. In every detail-in health surveys, in case work, in 
advice, supervision, care and cure, public health bulks up too 
big for centralized authorities, agencies, and institutions, and 
this is true in urban and rural areas alike. Public health is 
fundamentally a local problem, and at last it must be in largest 
pail a local responsibility. Consider tuberculosis, for instance. 
The country over, the open pronounced tubercular cases of all 
sorts are around 15 per thousand inhabitants; which means 
38,000 cases in a state of two and a half million people. It is 
hardly thinkable that a state sanitarium with a few hundred 
beds can be either a diagnosis center or a curing station for 
such a host of stricken sufferers. On the other hand, the open 
cases in a little county of 16,000 inhabitants are some 240, 
and the deaths around thirty per year. Clearly the problem 
is too large for one big sanitarium in any state. Tuberculosis 
is a county problem and it calls for county or county group 
hospitals. Such hospitals are required by New Jersey, New American Country Lieb Association 
115 
York and Massachusetts, and other states are moving ahead 
in the same direction. 
County Public Health Machinery. Effective local public 
health work involves: 
1. A county public health board, elected preferably by 
the county board of finance and the county board of education 
in joint session and supported by a fund ait least one-third of 
which is locally derived, the balance coming from state, fed- 
eral and other outside agencies and organizations if possible. 
2. A county health department, headed by a whole-time 
county health officer, with clerical help, laboratories and 
assistants in the largest measure possible. He should be 
elected by the county board of health, the county board of 
finance and the county school board jointly from a certified list 
furnished by the state board of health. He Should be answer- 
able to the state health board and through it to the local health 
authorities. He should hold office without re-election during 
good behavior and effective service. He should have directive 
oversight of all local public health agents and institutions in 
the county. He should be quartered with the county school 
superintendent or alongside him with the veil between rent in 
twain. 
3. A county-paid public health nurse, one to start with 
and move just as rapidly as supporting funds can be found. 
She should be chosen by the county health officer from the 
certified list of the state board, to whom she is finally respon- 
sible through the county health officer. 
4. A county tuberculosis hospital in every county where 
the annual taxes, state and local, are $100,000 or more, under 
permissive legislation, by a majority vote of the voters voting. 
In short, a county health organization should develop a 
robust sense of local responsibility for local health problems. 
It should be removed as far as possible from local partisan 
politics and at the same time allow the largest possible measure 
of local democratic participation consistent with effectiveness. 
DISCUSSION 
Dr. John A. Fairlie, Urbana, Ill. 
(Submitted through Dr. Branson) 
As to proposals for local public health machinery, I doubit the 116 
American Country Life Association 
advisability of recommending both a county public health board 
and a health officer. In many places this seems to me an unceses- 
sary complication. Moreover, in a good many states there is no 
county board of education to take part in the proposed organization. 
I believe in full time public officers, but doubt whether this 
is practicable in many small rural counties. In Illinois there are 
some counties with only 7,000 population. For such places several 
counties should be united into .a larger district. The same will 
apply to public health nurses. A tuberculosis sanitarium in every 
county where state and local taxes amount to $100,000 also seems 
to me to propose too many small institutions. It would be better 
again for several counties to unite in maintaining an institution 
large enough to be really effective. 
Prof. Walter Burr, Manhattan, Kan. 
In certain states the board of finance is known as the board 
of county commissioners; also in some cases there is no county 
board of education. I speak of this because the report suggests that 
the one in charge of the county health work be chosen by the 
county board of finance, the county board of education and the 
county board of health. I suppose that it might be well to refer 
to states where this is not the organized plan, and suggest that in 
such states the leader should be elected by the board of county 
commissioners, the board of health and the county school superin- 
tendent. 
There is only one item in the report that personally I would like 
to see expanded a little, and1 that is with regard to the activities of 
health agencies working in the field, namely, that such agencies 
should put their work on a project basis, confine it to the work of 
health and sanitation, and announce the projects. 
Miss Fulmer, Illinois: I would like to ask the chairman how 
he is going to secure a county health board? Will iit be elective 
or appointive? We iare all. agreed in the middle west that it is 
the finest thing to have the county as a unit; but, just for instance, 
in the state of Illinois we have automatically elected by the people 
a township health board; every county has a certain number of 
townships and every township has its elective township health 
board. This township health board is made up automatically of 
the supervisor, the township clerk and the assessor. This seems a 
hit and miss way of doing it, because we sometimes draw very 
peculiar people for our health boards, and sometimes the health 
board itself doesn't know when it is a health board. In Cook 
County by the above process we have as health officers an under- 
taker, a barber, a saloon keeper and one man eighty-five years 
old who never goes any distance from his own fireside. They are 
never active excepting in dire distress during an epidemic of small- 
pox or the like. We couldn't change tradition or the law; we had 
no alternative but to work with these officers, whether they may 
or may not be up to our standard, but we have got to get them 
into our combine. So we called a meeting at the county courthouse 
of all public health workers. The first time only a few came, the 
second time we had a larger crowd, then we kept on asking them 
until, finally, we got our undertakers and barbers to come to 
these meetings and we put the responsibility upon them. And 
what db you think is happening in those rural sections now? When- 
ever there is an infectious disease in a house and a placard is 
needed such as a case of measles, for instance, the undertaker 
puts the placard upon the measles house. I do not want to min- 
imise the value of these people, but we must get somewhere away American Country Life Association 
117 
from the (political end of it and have the right people on our county 
health activities. 
In some of the towns in which we are working the president 
of the village board appoints his health officer. I believe we are 
on the right track in Illinois because we are going to use machin- 
ery that will help to educate the rank and file in health matters, 
and' when the election comes off in the springtime i assure you 
that in the twenty-nine townships in which we are working we are 
going to have a much higher grade of persons elected to those 
responsible positions than the respective communities have at the 
present time. 
Dr. Branson. Mr. Chairman, I am wondering whether or 
not-I am asking for information, Miss Fulmer-I am wondering 
wheltheir or not in Cook County you have a county public health 
secretary who heads up your county work? 
Miss Fulmer. No, we have not. The nurses are a part of a 
large bureau of social service. 
Dr. Branson. Then I can see the confusion that arises. In 
Cook County how can people get acquainted with your work, four 
millions or more? 
Miss Fulmer. Oh, no. We only try to reach the rural county 
outside of Chicago, some 250,000 in the towns and rural sections. 
No confusion arises, as we are the only health agents in this area. 
Dr. Branson. Outside of Chicago, in Cook County, you have 
250,000 people-; that is twenty-two times as many people as we 
have in the average county in my state. Cook County is a big-city 
county; it is a county of intricate and complicated civilization. Oui' 
idea was that the public health nurse or entire field agency in health 
promotion and -disease prevention should work under a county 
public health officer. There is the visiting and mediation officer. 
With such an officer in the rural communities of the United States 
-iand there are something like twenty-five hundred-you would be 
related to the township officials if you had them; you would be re- 
lated to them through the mediation officer or county superin- 
tendent of public health, who ought to be in the courthouse in the 
office of the school commissioner or alongside the school commis- 
sioner, with all the partitions thrown down. 
Dr. Wilson. I would like to ask, Mr. Chairman, if anyone 
present has any information as to these dealers in public health 
insurance, and what their relation would be to the proposals we are 
discussling? 
The President. Has anyone any suggestions on Dr. Wilson's 
question? Are you aware of anything yourself, Dr. Wilson? 
Dr. 'Wilson. I do not know. Report of Committee on Recreation 
Prof. E. C. Lindeman, Y. M. C. A. College, Chicago, Chairman 
ZT^ ECREATION is the positive phase of the health pro- 
v- L' gram. It is Nature's preventive medicine. While it is 
evident that all ill health is not due to a lack of recreation, 
it is equally evident that a proper regimen of play and recre- 
ation may prevent a large amount of physical degeneration. 
Any leisure time activity which is pursued without expectation 
of pecuniary reward may be called recreation. Play is a 
generic term, which embraces recreation but is much more 
comprehensive. Play is a positive, constructive term connoting 
zestful activity; it promotes not merely the prolonging of life, 
but the fullness of life. This introductory distinction is made 
because of the tendency to use these terms interchangeably. 
The task of this committee is to discover the relationship 
between recreation and health in so far as this relationship 
concerns the population of the open country. We have ap- 
proached this task from the constructive viewpoint. We are 
not unmindful of the vast amount of work which still remains 
to be done in eliminating those forms of recreation which are 
negative in their influence. The county fair, which has rural 
reasons for its existence, still affronts its rural patronage 
with cheap shows and gambling devices. The street carnival, 
with its "fakes" and its questionable exhibitions, still serves 
as the first introduction which many country boys and girls 
have to commercialized recreation. The dance hall operated 
in the nearby towns and cities and operated for "revenue 
only" receives its full quota of patronage from the ranks of 
country boys and girls. Motion pictures which cannot run the 
gauntlet of city censorship may be shown with impunity in 
small towns. These and other forms of recreation of a nega- 
tive sort have secured a powerful grip upon the life of the open 
country, and especially upon the life of its young men and 
118 American Country Life Association 
119 
young women; consequently, they impair the health of the 
rural population. For health implies more than physical 
efficiency. A healthy body is a worthy ideal, but without a 
discerning intellect it may become the enemy of real 
progress. One may even combine physical fitness with mental 
alertness and still produce a citizenship unworthy of the 
duties and privileges of a democracy. These attributes may 
become the sharpened tools of the one who uses them to more 
successfully exploit his fellowman. Social harmony and spir- 
itual idealism must accompany our health program if it is not 
to defeat its own ends. 
The committee has also approached its problem in the 
scientific spirit in spite of the fact that it found itself con- 
ffonted with innumerable questions for which the data of 
science offered no satisfactory answers. The questions which 
the committee has studied are as follows: 
1. What elements or phases of bodily growth, mental 
alertness or neuro-musclar co-ordination are neg- 
lected, receive least attention or are perverted in the 
ordinary regimen of country life? 
This is considered to be a primary question. As a part 
of the health program, recreation must be placed upon a sure 
knowledge of what it is to correct and prevent as well as 
what it is to create. This fundamental question raises the 
following corollary questions: 
1. Does farm work and farm life in general promote 
symmetrical bodily growth? 
2. Does farm work tend to over develop certai norgans, 
muscles or functions at the expense of others? 
3. Is mental alertness sacrificed through the demands of 
farm labor? 
4. Does farm work tend to neglect the development of 
those neuromuscular co-ordinations which make pos- 
sible decisive action, enthusiastic response, optimism? 
These questions and a score of others which are directly 
involved can be answered only by the specialists. This com 
mittee can do little more than suggest them, in the hope that 
after they are thrown into relief they will receive attention, 
interest and study. No conclusions upon which an adequate 120 
American Country Life Association 
and constructive recreation program may be built will have 
value or safety until these questions have been studied by the 
physiologist, the psychologist and the nerve specialist. The 
conclusions here offered are not based upon adequate statistics 
or research. They are offered as a starting point for a dis- 
cussion which it is hoped will be fruitful. 
CONCLUSIONS 
1. Notwithstanding the fact that farm work provides for 
an abundance of physical exercise in the open air, observa- 
tion seems to indicate that: 
(a) Farm boys and girls do not develop symmetrically. 
(b) The work of the farm seems to over develop the 
major or fundamental muscles, while the finer or 
accessory muscles are neglected. 
(c) Farm life in general does not produce a degree of 
mental alertness and neuro muscular co-ordination 
essential to an enthusiastic and optimistic outlook 
on life. 
(d) Observations with farm-reared young men seem to 
indicate that the above conclusions are at least 
partially correct because of the relatively more rapid 
approach of fatigue when placed on a comparative 
basis with young men of the cities . 
The above conclusions are based upon observations such 
as the following: 
(a) Farm-reared young men in the army camps were 
slower to respond to the stimuli of play. 
(b) Farm-reared young men reached the stage of fatigue 
sooner than city-reared young men in forms of 
activity requiring the action of the whole body. 
(c) City-reared young men usually excelled at games 
involving mental alertness. 
(d) Farm-reared girls lack the ability to execute prop- 
erly the actions necessary in such games as involve 
the free use of the whole body. 
2. The second conclusion, which is based upon the above, 
is this: Since non-symmetrical bodily development is one of 
the primary conditions of ill health, the entire question of American Country Life Association 
121 
rural recreation and its relation to health becomes pertinent 
at the point of determining the exact nature of the malforma- 
tion and of providing leisure-time correctives. 
II. What forms of recreation are best adapted for the 
purpose of acting as a corrective and a preventative 
for the non-symmetrical development tvhich appears 
to result from farm labor and farm life? 
Obviously this question has no validity unless it is ad- 
mitted that the conclusions above are in a measure correct. 
Because the committee does believe these conclusions to be, at 
least in part, correct, it raises the above question. If there 
is something inherent in the vocation of farming which tends 
toward unsymmetrical bodily growth, then it must be possible 
to supplement the ordinary regimen of farm life with recrea- 
tional activities which will offset this deficiency. In the 
absence of extended research and reliable data we must base 
our conclusions upon reasoning and observation. 
1. Since farm boys and girls do not appear to be lacking 
in size or in weight, and since the apparent malformations 
seem to be due to an overdevelopment of certain of the larger 
or major muscles at the expense of the finer muscles, it seems 
logical to conclude that the following types of recreation are 
needed: 
(a) Games which involve the free use of the entire body, 
(b) Games which require precision of action. 
(c) Games employing the expression of the rythmic 
instinct. 
2. From the psycho-physiological point of view it seems 
also logical that games of the following nature are needed: 
(a) Games which involve co-operative action. 
(b) Games which involve attention or the use of the 
higher nerve centers. 
(c) Games which are mentally exhilerating . 
The last conclusion deserves further emphasis. If the 
ordinary routine of farm life produces a certain mental som- 
breness, it is patent that the recreational life of the country 
should be active and not passive; it should be not only 
CONCLUSIONS 122 
American Country Life Association 
physically energizing but joy producing. In a very large 
sense the rural populations await in the interest of the satis- 
faction of their social natures just this type of recreative 
activity. Group games, organized athletics, folk dancing, 
community singing, these must be introduced into the life of 
the open country as a preliminary to an understanding of 
the distinction between exercise and play . 
III. Are there certain forms of highly specialized farm 
labor which are deleterious to health, and in what 
manner may recreation act as a corrective? 
This question is raised on behalf of such farm occupations 
as cotton picking, onion and sugar beet weeding and other 
forms of seasonal agricultural labor which require a difficult 
and unnatural posture and demand almost the same degree 
of monotonous attention as that of simple machine labor of 
industry. 
Tinis is in reality a question of farm labor rather than 
of recreation. It may also be argued that the number of 
persons affected by this type of labor is too small to receive 
national attention. However, if democracy is our goal, we 
dare not neglect any element of our population. If this type 
of occupation is inherently connected with the necessary crop, 
and if men and women and boys and girls must be utilized, 
there must be some manner in which the attendant evils may 
be overcome or minimized. If the crop is necessary, then the 
proper development of those who produce it is more important. 
This committee believes that in the sphere of recreation there 
is a distinct hope for ameliorating the results of this type of 
farm labor. 
The analogous evils of industry are combated with a 
program for shorter hours, more pay, better working con- 
ditions and a minimum working age. This is the negative 
phase of the problem. We must do more than recognize and 
minimize evils; we must correct them if ever we are to do 
more than lip homage to democracy. In the interest of 
national health we must act upon the faith that the persons 
who produce our goods are more important than the goods. 
Organized industry is approaching this problem with the intro- 
duction of rest rooms, recreation rooms, recreation directors, American Country Life Association 
123 
etc. Agriculture must also provide adequately for recrea- 
tional relief and physical correctives for its specialized occu- 
pations if we are to build and conserve the vigor of our rural 
population. It is the neglected elements of civilization which 
always wreck it. In this connection it may be pertinent to 
point ou't once more the fact thait the philosophy of the Indus- 
trial Workers of the World had its inception, in the United 
States at least, among the seasonal agricultural laborers. 
These men, in the very nature of their occupation, were forced 
to be wifeless .homeless, playless. As is always true in cases 
of social! pathology, this organisation is symptomatic of an- 
other disease which lies beneath the surface. Any population 
or element of a population in which the suppressed desires 
exceed the normal expressions is a dangerous element. And, 
play is one of the fundamental human desires or instincts. 
IV. What agencies are now at work in the field of rural 
recreation, and what agencies have proposed pro- 
grams of rural recreation with an avowed health 
motive? 
In seeking an answer to this question the investigator is 
impressed with two characteristics of the rural recreation 
movement. First, the relationship between recreation pro- 
grams and the health objective seems to be almost negligible. 
Second, most agencies dealing with recreation programs in 
rural fields use recreation as a superficial appeal or as an 
incidental part of a general institutional program. 
There are, however, a number of agencies of national 
character which either have definite health recreation pro- 
grams or are contemplating such programs. Those which have 
come to the attention of this committee are: 
1. The Bureau of the Public Health Service. (Office of 
the Surgeon General of the United States). 
This agency is conducting a nationwide campaign in the 
interest of sex education. Its "keeping fit" camapign has 
already reached a high degree of effectiveness. This cam- 
paign definitely implies a health motive. for recreational 
activities. Its illustrative charts are being widely used; a 
wider use of these charts in rural schools and churches is 
urged. 124 
American Country Life Association 
The Committee has been advised that this agency is now 
in search of a man who will be given the specific function of 
carrying this program to the rural districts. 
2. The National Child Labor Committee, which has ren- 
dered signal service through its research work in child labor, 
has definite plans for the future which will be of intense in- 
terest to the rural field. This agency is now planning studies 
which will reveal the relationship between farm labor and 
health; these studies will of necessity involve considerations 
of recreation. A letter from one of the officials of this agency 
clearly sets forth its purpose. We quote the following para- 
graph from a letter written by Mr. Raymond G. Fuller: 
"It is an astonishing fact that there exists no scien- 
tific data on the effect of child labor on health. We 
know that premature labor or too hard labor un(der bad 
conditions is physically harmful to the child, but the 
effects have never been measured. The modern studies of 
fatigue have had to do with adults and not with children. 
Our committee hopes to do something or to get something 
done that will give us the data we lack. I have been plan- 
ning to spend a large part of the winter in study and 
research in the subject of recreation, including a large 
amount of field investigation. Following up some psycho- 
logical studies made several years ago, 1 am seeking, 
among other things, to work out for publicity purposes 
as complete as possible a statement of the child labor evil 
in terms of the instincts and their expression or repres- 
sion. Of course, the psychological statement of the child 
labor evil involves the psychology of play." 
3. The Boy Scouts of America have always promoted 
physical activities as an integral part of their general pro- 
gram. The health objective is stressed in their manuals and 
in their educational programs. This agency is now con- 
templating a wide extension of its work in the rural field. 
4. The County Work Department of the Young Men's 
Christian Association has promoted health as a part of its 
fourfold program for the boy and the young man. Its organ- 
ized groups carry on recreational activities, study health prob- American Country Life Association 
125 
lems, invite speakers on sex education and in various other 
ways correlate recreation with health. 
5. The National Board of the Young Women's Christian 
Association includes health and recreation in its educational 
program. It is now carrying on a study of typical rural com- 
munities for the purpose of expanding this program through 
its Town and Country Department. It has already held suc- 
cessful health conferences and has distributed health literature 
which has reached the rural sections. The significant feature 
of the program of this agency is that it seeks to reach the 
farm woman and the farm girl-elements of the rural popula- 
tion which have been hitherto sorely neglected. 
6. Various boards of home missions are calling the 
churches to an awakening of their responsibilities toward the 
problem of rural health and recreation. In some cases pro- 
grams of study and activities covering an entire year are being 
urged. Notable in this connection is the nationwide confer- 
ence held during the past summer under the auspices of the 
Methodist Board of Home Missions. This conference was 
attended by more than one thousand rural ministers, who 
returned to their charges pledged to the execution of this 
enlarged community task which includes health and recreation. 
The opportunity of influencing the play life of the country 
is still open to the religious agencies. The erroneous attitude 
of inhibition and repression has already hampered the useful- 
ness of the church as a social agency. In so far as the labor- 
ing elements of the manufacturing centers are concerned, the 
church appears to have sacrificed this opportunity. It is 
urged that the encouraging steps now being taken by rural 
churches receive the endorsement and the support of all social 
workers interested in rural life. 
7. The Junior Department of the American Red Cross 
has plans for stimulating a positive health program for rural 
communities. In some cases this program will undoubtedly 
embrace recreation as well. 
8. The boys' and girls clubs organized and conducted 
under the direction of the United States Department of Agri- 
culture and the various state colleges of agriculture have 
always emphasized health as well as recreation. The 4-H 126 
American Country Life Association 
basis of their program includes education of the head, the 
hand, the heart and the health. 
9. The Community Councils, in their proposed extension 
to the rural field, are contemplating the promotion of health 
and recreation as distinct community functions. 
10. Community Service, Incorporated, has outlined a 
program of organization which contemplates the organizattion 
of rural counties. Since this organization is the direct out- 
growth of War Camp Community Service, which was in turn 
the War-time adaption of the Playground and Recreation Asso- 
ciation of America, it may be expected that its program will 
be specifically a recreational one. The Playground and Recre- 
ation Association of America had already laid plans and had 
conducted experimental demonstrations of both equipment 
and non-equipment types of recreation for small town and 
rural communities. 
11. The National Physical Education Service is a 
branch of the Playground and Recreation Association of 
America. It is a new service, which aims to promote state 
legislation for physical education in an aggressive manner. It 
has brought about a co-operative arrangement with such 
agencies as the following: 
The Athletic Research Society. 
The Society of Physical Directors of Colleges. 
The American Physical Education Association. 
The National College Athletic Association. 
The Society of Physical Directors of Normal Schools, etc. 
12. Official Agencies within the various states are at 
work on both the problems of rural recreation and rural 
health. Fourteen states now have statewide physical educa- 
tion laws, which in some cases carry compulsory sections for 
rural schools. The state departments of public health, the 
state departments of public instruction, the state normal 
schools, these official agencies await the creation of public 
sentiment for the completion of their task in this field. The 
regrettable fact of state legislation for physical education is 
the almost general neglect to make these enactments effective 
in the rural sections. American Country Life Association 
127 
The brief study which the committee has been able to make 
of the agencies listed above leads to the following conclusions: 
1. There are sufficient numbers of agencies at work on 
the problem. What is needed is effectiveness, correlation and 
extension. 
2. Before any of the agencies can perform their full task 
there is needed a large amount of research work. We must 
have accurate data upon which to build a permanent and 
constructive health-recreation program. 
3. The agencies should beware against the danger of 
jeopardizing the entire movement by duplication of effort. 
4. All of the private and semi-official agencies should 
co-operate in assisting the official agencies, which alone can 
produce general results on a permanent basis. 
5. The committee urges general support of those agencies 
which are making research studies. The real impetus of the 
movement awaits these preliminary studies. 
V. What constitutes a minimum standard requirement of 
play and recreation for country school children with 
the view of maintaining an efficient standard of 
mental and physical health? 
The committee does not presume to be able to give a 
satisfactory answer to this question. It does believe, however, 
that the question deserves an answer in order to facilitate the 
work of the interested agencies and in order to offset the 
occasional, the hit-or-miss, types of recreation which are all 
too prevalent in rural schools. No recreational authorities 
will agree on an exact minimum requirement, and, of course, 
the requirements must vary in different communities. What 
the committee is here attempting to do is to bring together 
the various standards which have been put forth with a view 
toward the promotion of discussion and experimentation. 
1. Every normal boy and girl in a rural school should be 
required to take a physical efficiency test; this test to be 
repeated at the various age periods. The result of this test 
should be tabulated in the office of the supervising agency of 
the county or district. In states where physical education 
laws are effective this information should also be on file in the 
CONCLUSIONS 128 
American Country Life Association 
office of the state supervising agency. Without this data we 
can never be sure of the progressive or retrogressive tendency 
of physical well-being. 
(a) The physical efficiency, test offers a splendid oppor- 
tunity for the correlation of health and recreation 
programs. 
(b) The physical efficiency test should be preceded or 
followed by a thorough medical examination. 
(c) In addition to the physical efficiency tests there 
should also be established certain physical stand- 
ards for the various ages of boys and girls; ideals 
toward which the individuals and the school groups 
strive. 
2. All normal boys and girls of every rural school should 
have fifteen minutes of organized and supervised play (out of 
doors if possible) every day. This implies that the teacher has 
been trained to supervise play and that she shall take part 
in these play periods. 
3. From the fourth grade and upward every pupil should 
have the opportunity of engaging in organized group games 
or athletics on a competitive basis. 
4. In schools where organized group games or athletics 
on the grade or class basis are impracticable due to the small 
attendance, such play opportunities should be arranged on an 
inter-class plan. 
5. There should be two periods each day devoted to 
"setting-up" exercises. This requirement is not urged on the 
basis of physical exercise but on the basis of relieving mental 
fatigue. Such exercises must be very simple and may even 
take the form of quiet games. Each period may be short, 
beginning with a one-minute period for the first graders and 
extending to ten minutes for the older pupils. This period 
should be used also for the purpose of securing a complete 
change of air for the schoolroom. 
VI. What are the requirements for a good game for the 
rural community? 
This question has been discussed from the broad stand- 
point of all forms of recreation under question II. It is here 
discussed from the standpoint of one phase of recreation, American Country Life Association 
129 
namely, games. To the casual observer this question will ap- 
pear to have but slight significance. It will be asked, Why 
should there be any distinction between games for city chil- 
dren and country children? Those who insist that there should 
be no such distinction base their philosophy of play on the in- 
flexible and erroneous interpretation of the human instincts. 
If modern psychology has taught anything at all of value 
it appears to be just this, namely, that instincts are not in- 
flexible; that they may secure expression in at least three or 
four ways instead of one, and, finally, that the expression 
which the instinct secures is almost entirely dependent upon 
the environment. One kind of environment permits the free 
expression of certain of the fundamental instincts, while an- 
other totally represses these same instincts. It is on the basis 
of environmental and vocational psychology that the follow- 
ing requirements for a good game for the open country are 
presented: 
1. A good game for the open country is ons which is safe 
to health. Some games Which may be played with impunity 
on the floor of a well-ventilated gymnasium where bathing 
facilities are also provided, are absolutely dangerous to health 
when played under conditions commonly prevalent in the 
country. 
2. A good game for the open country is one in which 
small as well as large numbers may participate. Under urban 
conditions it is comparatively easy to promote games which 
involve large numbers. The natural groups are larger. In the 
country the numbers are not always available. Children who 
must attend country schools with enrollments as low as ten 
to fifteen pupils have as much right to play as children who 
attend city schools or consolidated schools. When the chil- 
dren of the country gather for township or county play fes- 
tivals they should be prepared to play games which involve 
large numbers. A careful selection of games for the rural 
schools will reveal the fact that there are large numbers of 
games which comply with this requirement. More of such 
games-games which may be played enthusiastically by small 
and large groups-are needed, and it is hoped that the mere 
statement of this requirement will accelerate their origination. 130 
American Country Life Association 
3. A good game for the open country is one which may 
be played by both young and old. This requirement does not 
preclude such games as belong peculiarly to youth, but it aims 
to add to the repertoire a number of such games as may con- 
tinue in use beyond the period of youth. Rural recreation 
differs from urban recreation in that there are fewer oppor- 
tunities of "buying" one's recreation in the country. It differs 
also in the fact that the rural family is still homogeneously 
related in its recreational activities. A rural play day is a 
family affair. A country picnic is a family affair. The inter- 
est in community recreation will be greatly heightened when 
the school promotes forms of recreation which may be utilized 
by the entire family-old as well as young. 
4. A good game for the open country is one which may 
be played by both sexes. The reasons for this requirement 
have already been stated, namely, the scarcity of numbers in 
many rural schools and the family nature of rural recreation 
occasions. Altogether too many of our games make their 
appeal only to one-half of the population, the boys and the 
men. In rural communities, where recreation must be demo- 
cratic if it is to become an integral part of community ex- 
pression, it is essential that we provide a large number of 
games which are suitable for women and girls, as well as for 
men and boys. 
5. A good game for the open country is one which re- 
quires a minimum of equipment. The expensive and luxuriously 
equipped gymnasiums belong peculiarly to the city. Aside 
from the obvious fact that the country does not possess the 
surplus wealth to build and maintain such institutions, there 
is the psychological value of non-equipment games. The mind 
is brought into action in play in proportion as we diminish the 
use of paraphernalia and increase the use of the body, includ- 
ing the nervous system. 
6. A good game for the open country is one which em- 
phasizes the instinct of co-operation. So much of the ordinary 
life of the country is carried on on the basis of individual 
action that it is essential to provide recreational activities 
which promote the "team spirit." This requirement does not 
suggest the elimination of such games as are necessary to American Country Life Association 
131 
develop individual initiative and action; it merely urges that 
these forms of recreation be supplemented with those of a co- 
operative nature. 
7. A good game for the open country is one which grows 
out of the life of the people in conjunction with the community 
environment. Games, in order to have their fullest influence 
in the spheres of physical, mental and social health, should 
be more or less indigenous. The test of a good game is this: 
Will the community continue to play it after the outside 
stimulus is removed? Has it enough in common with the life 
of the community so that it may be incorporated into that 
common life? So much of attempted rural recreation is feeble 
and temporary because it is grafted on from the superficial 
recreation or amusement of the city; it has no Indigenous 
relationship to the rural community and its life. Rural recre- 
ation which is merely a cheap imitation of city recreation can- 
not grip the lives of rural people in a fundamental way. Curi- 
ously enough, when this viewpoint is put forth it is always 
combated by those who insist that the country and the city 
must be brought together and that this viewpoint hinders 
that process. There is no thought here of making it less con- 
venient for the rural populations to come into contact with 
the best in City life. But that best does not lie in the common 
forms of city recreation. What we are here presenting is the 
viewpoint that the country has within its own life the essen- 
tial resources for producing its own types of recreation. If 
this is n'ot true, then country life will continue to become 
more and more a mere supplement to city life. It is chiefly 
at two points that this process has received its most decided 
impetus-the points of economic supremacy and of apparent 
recreational superiority. A constructive program for making 
country life satisfying and representative may well begin at 
this simple point of creating an indigenous recreation. 
In addition to the suggestions and conclusions presented 
in the foregoing sections of this report, the committee desires 
to emphasize the following consderations: 
First. Recreation has physical, mental, social, ethical 
and spiritual implications. Those who use recreation as a 
mere part of an institutional program, or, worse still, as a 132 
American Country Life Association 
mere gateway to the attention of the rural community, should 
keep this always in mind. This does not mean that only those 
agencies which are dealing specifically with the recreational 
phases of life shall promote recreation. We may all promote 
recreation, but we must all be careful that the good which 
we do shall not be the enemy of the best. 
Second. Thus far recreation in so far as it concerns the 
rural population has been left almost entirely in the hands 
of non-official agencies. No worthy gains of a permanent 
nature will be made until all rural leaders and all rural 
agencies pool their efforts in the demand for officially recog- 
nized recreation as an essential to the public welfare. When 
this is accomplished there will still be room for the other 
agencies and there will still be needed the refreshing and the 
revivifying influence of agencies which are not subject to the 
stultifying effects which usually result from state-controlled 
activities. 
Third. We must become conscious of the full implications 
of play and we must make this consciousness general. Play 
is not merely a leisure-time activity; it is not merely an 
excrescence of modern civilization. In fact, spontaneous play 
and song disappeared when modern civilization came under 
the isway of machine industry. The rural populations have not 
yet felt the full deteriorating effects, the nervous disintegra- 
tion and the consequent reproductive limitations of the indus- 
trial revolution. The numerical preponderance of population 
is inevitably toward the city. The country is, however, still 
the seed-bed of our population which still must furnish the 
leadership for both country and city. We still have time to 
orient the life of the open country to those processes which 
promote straight thinking, wholesome living and social har- 
mony. We may still look forward hopefully to a countryside 
which shall be joyous as well as productive, socially co-oper- 
ative and optimistic as well as economically satisfying. With 
this vision, play and the playground become not merely the 
centers of training for physical perfection, but rather the 
nucleii for making habitual and natural those social virtues 
of team play, loyalty, obedience to the rules-virtues upon American Country Life Association 
133 
which our future depends. In this light the playground may 
become the veritable laboratory of democracy. 
DISCUSSION 
Dr. C. C. Taylor, Columfbia, Missouri. Mr. President, after 
the remarks by Mr. Lindeman, I should! like to ask one thing about 
the evil of initiating other rural programs on the platform of the 
recreational program. What is the evil? I see how you do not 
get as far with the recreational program as you otherwise might; 
but what is the evil? 
Mr. Lindeman. The evil is this: It gives the community the 
wrong conception of play. If you go into a community to promote 
some institution and you begin with a recreational appeal, and 
then when your institution is established diminish or stop its recre- 
ational function, you have given the community the notion that 
play is not fundamental. 
Dr. Taylor. The next question I want to ask is, How would 
you get your recreational program before the country people? 
How would you get it into these rural communities at the present 
time? There are two things rather clear to me: One is, as you 
say, you can initiate other programs easily upon the basis of the 
recreational program. The other is the difficulty of initiating an 
elaborate recreational program itself. How would you go about it 
to do the latter? 
Mr. Lindeman. I hope that this committee may be one of the 
agencies to render that service; for carrying on an educational 
campaign which will induce rural communities to recognize the 
fundamental significance of a community recreation program. 
Dr. Taylor. How do you expect to do it? I am interested in 
knowing how it is going to be put across. 
Mr. Lindeman. You are asking a question which it is difficult 
to answer, namely, how to bring about a change of attitude on the 
part of the rural population toward this matter of recreation. I 
wis'h that I knew the answer. I wish that this committee knew the 
best manner for approaching that problem. We do have some 
notions about how this approach may be made. One of them is by 
means of the community pageant, a recreational event in which the 
entire community takes part. In our report of last yelar we empha- 
sized this point, and we have been gratified to learn that our ap- 
pendix on pageantry and drama has been widely used by rural 
leaders. If 'we can secure a sulbsidy for this committee, we shall be 
able to conduct an aggressive educational campaign along this line. 
In the meantime all agencies interested must be urged to help along 
the lines suggested in the conclusions of this report. 
Dr. Taylor. The reason I asked the first question was because 
I felt there was no answer to the second question, and therefore 
in dealing with the rural community, which is against play, an 
attitude largely induced because of religious training, is it wise to 
expect that you will cause people to Change that attitude? That is 
the reason I feel that any sort of play initiation, even though it may 
not ultimately carry the idea but helps to make it clear, is worth 
while. It is one way of meeting this very difficulty of getting a 
play program started. 
Mr. Lindeman. I agree with you. My motto during eight 
years of rural work was: "Every rural gathering is a play oppor- 
tunity." But I still insist that agencies dealing with recreation in 
this manner make plain to the community that they do not propose 134 
American Country Life Association 
to carry on a permanent recreation program and that they db not 
supplant other agencies which may wish to do so. 
Miss Bengston, Olivia, Minn. Up where I come from we have 
long wanted a recreation leader and physical training supervisor 
and haven't the money to get one, so this summer, during my stay 
in 'Columbia University, I found a young lady who was much inter- 
ested and she was very anxious to help me get a leader of some 
rural experience. But having no money to pay anyone, I coaxed 
her to go out and teach a rural school, and she is doing so in the 
heart of a community fourteen miles from the county seat, and in 
that school she is doing some very fine work; she is linking it up 
as closely as possible with the curriculum work and she solved one 
problem. Up in Minnesota we have a very pernicious law that 
allows children of fourteen to sixteen to stay out of school until 
the first o'f November. In her particular part of the county those 
children come to school, because the report was that the children 
are having such a good time in school; they all wanted to come. 
Near her are six or seven very good teachers and they help her 
out, or we come down and relieve her once in a while. We also 
sendl cadets from the high school department, and that helps the 
work. She spends a good deal of her time visiting and supervising 
the schools in her immediate vicinity, and they are doing very 
effective work along these lines. She wrote recently and reported 
she was asked to go to a frontier school to get up some games 
for the older people, as well as the children, and she said they had 
a regular play program which was one of the best programs they 
had ever had. 
Mr. 0. H. Benson, Washington, D. C. During the past year 
or two we have been trying in many ways and places to get people 
to come out and help the boys and girls in playing. My observa- 
tion has been that there are a lot of people in every community 
who know how to play, but there are not many people who know 
how to lead in play, and especially lead play in the open country. 
I have called personally upon people in an effort to get them to 
come and lead in playing in the open country, people who were pro- 
fessional leaders of play, and I have ofentimes found people who 
would be an absolute misfit in that work, for they could only lead 
play in the open country by littering up a farm of forty acres or so 
with commercial toys, and it would be* impossible to get anything 
accomplished with that kind of work. And a thing I would like 
to say in support of the admirable paper just read, if we can 
incorporate in that, Mr. Lindem'an, a specific recommendation as 
to how we could get a line on the personnel of play leaders who 
know how to lead-people living in the open country-I should 
like to be one of the first to call for that last and make use of 
those leaders. We want people who know how to lead play in the 
open country without the artificial assistance of toys. 
Mr. Lindeman. I shall be glad, Mr. Benson, to incorporate a 
leadership clause in this report, although this matter was fully 
covered in last year's report of the committee. 
Prof. C. J. Galpin, Washington, D. C. Assuming every drop in 
the bucket will help, I would like to announce the publication of a 
little bulletin, coming out this month from the University of Wis- 
consin, on "Play Day at Country Schools,'' based on three years' 
experience in an ordinary country school by a teacher and leader 
who is supervising teacher in one. of the county schools. The 
article will deal with the use of the scheme, which was invented 
by her and carried out faithfully in the more open pants of the American Country Life Association 
135 
country. I think that anyone wishing that bulletin can get it on 
request. It outlines the plan and gives the actual names and 
description of the games used, together with photographs of the 
occasions when they were tried out. 
Prof. W. J. Camplbell, Springfieldi, Mass. I think the report 
has such unusual merit and comes in such unusual timeliness it 
would be a serious mistake not to make some provision for its 
widespread dissemination, something more effective than we would 
get by merely printing it in our proceedings, and I would like to 
make an amendment ito the resolution adopted providing that it be 
printed in some form of bulletin, in order that it be given wide dis- 
semination, because it carries -a message that we need. 
Dr. Warren H. Willson. It seems to me there is lacking a 
statement, although perhaps it is in the report, as to what the com- 
mittee contemplated as a unit oif service in providing leaders uni- 
versally experienced in play throughout the country. There was an 
attempt at it, as described by one of the speakers. Is that the 
committee's idea? Does the committee, on the other hand, think 
that the provision of recreation centers in villages, independent 
of any existing agencies, is feasible? My thought is to ask the 
question, or to move that the committee be asked to move a reso- 
lution that would precipitate opinion as to how these questions 
arising may be met. In particular, I thought of one: What is the 
committee's relation to dances? It looks to me as though they 
were describing dancing as the very best recreation to be had. I 
am not sure that it is. Wouldn't that be provided and made pos- 
sible if there was an agency that could be a demonstration unit 
that they believed in? Is it the country high school or the village 
unit house? 
Mr. Lindeman. I believe, Dr. Wilson, that any definite con- 
clusion in regard to the unit of training play leaders and the unit 
of organization for conducting a recreational program would be 
premature. If you will refer to our report of last year you will find 
that we studied the various agencies now at work in this field. 
Our conclusions are that the agencies which are training play 
leaders are sufficient in number, but are not far-reaching enough. 
We do not believe that the school as a unit for carrying a play 
program is comprehensive enough to meet the demands of the situ- 
ation. And, when we say that the community Shall be the unit of 
organization we are speaking in terms that are too broad. We 
welcome the utilization of the state and the county as units of 
supervision as steps toward a more intimate type of supervision. 
Mrs. May Elliot Hobbs, Englandl. I do not know, Mr. Chair- 
man, whether my not being a citizen of this country debars me 
from a part in the discussion, but I would like to say a word, as 
I think my idea would be of interest to you. I come from England, 
where we have 'been trying to sleep it off the last four or five years, 
and the first thing we thought o*f was to consider our material for 
recreation, and we found we had a wealth of material in our 
country, such as no other European country had, in our native 
songs and dances. By dance's I mean the action that co-ordinates 
the highest and best in mind and body. And when we had, through 
the devoted work of men and women, collected that material in 
England, we then considered means of disseminating it throughout 
the population, both in the country and city, and we realized at 
the outset that the problem was a difficult one in that it was a 
teaching problem. We must have teachers to teach. We, there- 
fore, formed a society, "The English Folk Song and Dance Associa- 136 
American Country Life Association 
tion," for the purpose of training people who would teach in what- 
ever part of the community he or she resided. We soon found it 
too large a problem for one body to d'eal with. However, large 
numbers of our elemental teachers have taken part in the courses 
we gave in the summer and winter schools and continued the lessons 
in large cities and country districts. They all agree that the bene- 
cial results in the schools, both physical and mental, are surprising, 
and particularly, perhaps, as regards discipline; they find it much 
easier to maintain discipline. 
With that record behind us, we approached1 the board of edu- 
cation and they have agreed that it should become an integral part 
of the training of every teacher in Great Britain. And last year, 
Mr. Fisher, minister of education, pronounced in favor of the idea. 
Country dancing has taken the same place. In the department 
of education we have had a man appointed who knows more about 
it than anybody in the country to supervise the systematic teach- 
ing of English folk songs and dances in teachers' schools through- 
out England and Wales. We hope by that means to give our chil- 
dren, our very young children, not only their healthful and stimu- 
lating exercises, but also to bring them back to healthy ideals of life. Report of The Rural Public Health Nursing 
Committee 
CREATED BY THE NATIONAL COUNTRY LIFE ASSOCIATION 
ON NOVEMBER 8, 1919, AT THE ANNUAL MEETING, 
CHICAGO, ILL. 
OLLOW1NG the afternoon session, the rural nurses at- 
J tending the conference held a round table. Active dis- 
cussion on the part of the nurses resulted in the following 
recommendations: 
First. That the National Country Life Association add 
to its present list a permanent committee or a subcommittee 
on rural public health nursing, the chairman of which shall 
be appointed by the president of the association, the rest of 
the committee to be selected by the committee chairman. 
Second. That this committee study and be prepared to 
report at the next annual meeting of the association recom- 
mendations on the following, with definite, concrete plans for 
their development: 
1. What is the legitimate scope of activities of public 
health nurses in rural counties where the services are 
maintained by public funds? 
2. What activities belong distinctly to a public 
health nurse and what health activities could well be 
delegated to other agencies, such as health instructors, 
volunteer aid, school teachers and social workers? 
3. How can funds be secured in the average rural county 
to finance an efficient, adequate public health nursing 
service? 
Respectfully Submitted, 
Katherine M. Olmstead, 
Temporary Chairman, Rural Public Heailth Nursing Committee. 
Submitted November 10, 1919. 
Katherine M. Olmstead, 
Secretary Western Office, National Organization ifor Public Health 
Nursing, 116 S. Michigan Avenue, Chicago 
137 Report of the Committee on Rural Charities 
and Corrections 
H. Ida Curry, Chairman. 
r a LTHOUGH the vast majority of our population requires 
neither charitable support nor correctional treatment, 
there is in every community both urban and rural a small but 
persistent minority needing such help which insistently de- 
mands consideration. As the health of the human body would 
be affected by the unsoundness of a tooth or the infection 
of a finger, so the body politic is affected by each single family 
or individual, who is socially unadjusted. 
The responsibility of the community for the poor coming 
down to us from the old English Poor Law has been modified 
and developed in the different states according to local con- 
ditions, but there is in every community of the United States 
some machinery for adminstering public charity in one form 
or another. Equally universal is the public machinery for 
the care of delinquent and criminal elements in the community. 
Public provision for charitable relief and for correctional 
care, is everywhere more or less inadequate, but never 
theless it does exist throughout the United States, yet how 
few even of our best informed citizens know what the ma- 
chine conists, how it operates, or how it should be modified 
or supplemented. Believing that improvement can only rest 
on knowledge, your committee would recommend that this con- 
ference endeavor to impress all citizens within the range of its 
influence with the necessity of becoming informed as to the 
charitable and correctional provisions made by their several 
communities. 
Along what lines should this citizen's inquiry be made? 
While to the present audience it may seem kindergarten ma- 
terial, your committee ventures to present suggestions not 
intended to be exhaustive, but in a form which may be useful, 
138 American Country Life Association 
139 
it is hoped, if distributed by members of the conference to lay 
citizens unfamiliar with the subject. 
What does the law provide in the way of charitable relief 
in any given community? What officials are delegated to 
administer this relief? How well do these officials do their 
work? What changes if any should be made in the law or in 
its administration? 
The good citizens will And that usually the law will pro- 
vide for the election or appointment of certain officers, county, 
township or city, to care for the poor. The law will recognize 
the need of two forms of public charity, known since ancient 
times as '''indoor" and "outdoor" relief. 
By indoor relief will be meant support within an institu- 
tion, while outdoor relief will indicate some contribution to- 
wards support outside of an institution, that is within the 
home. 
For indoor relief the state will provide at least alms 
houses, and in addition it may have established institutions 
for the care of the feeble-minded and epileptic, sometimes for 
children, and perhaps for other classes of poor people who 
need special care or training, such as the sick, Insane, the 
blind, the deaf, crippled children and the like. In considering 
the latter groups, however, care must be exercised, not to con- 
fuse charitable provisions for poor persons with educational 
and health provisions for those who are not necessarily poor. 
Every good citizen should know what charitable institutions 
are supported by tax money, where they are located, what 
service they render, who is responsible for seeing that needy 
persons are sent to them; what becomes of the people dis- 
charged from them, how adequately the institutions serve the 
community, and how efficiently and economically they are run. 
And especially should the good citizen know where and 
how the dependent children are cared for; who determines 
their need of public support, and how long such support shall 
continue. Where are they looked after and what is being done 
to bring about their early return to parents under suitable 
circumstances, and their permanent separation from parents 
who are improper guardians. What provision is made to in- 
sure that each poor child shall have that care and training 140 
American Country Life Association 
which will be most likely to make it, in its particular circum- 
stances and with its own particular characteristics, a self-re- 
specting and self-supporting citizen in time to come? 
Institutional charitable relief in most of the states has 
tended to improve more rapidly than has the so-called outdoor 
relief, which as almost universally administered is a doling out 
of small allowances which but faintly relate to the needs of the 
family, or the causes of such needs. 
In relief granted to widows or to mothers many states will 
be found to have started an improved form of home relief. 
The study of the outdoor relief system is particularly pertinent 
at present, when the American Red Cross through its home 
service, is extending its relief program to non-soldier families. 
May we not look forward to a reform of public outdoor relief 
administration throughout the country? 
The good citizen should learn what official administers 
outdoor relief, how he determines to whom it shall be given; 
what the character and amount of the relief shall be, and what 
steps shall be taken to make relief unnecessary. He should 
learn whether relief to mothers is given through a court, by 
Poor Law dfficials, or by child welfare boards. 
Of special interest to the good citizen will be the pro- 
vision made for the mentally defective and the measures pro- 
vided for training, controlling, or segregating them as may be 
necessary . 
Turning to the provision made for offenders against the 
law, the good citizen should know what officers in the com- 
munity are entrusted with law enforcement, what prosecuting 
officer and what judge deals with adult and juvenile offenders; 
how offenders are cared for pending a hearing, and whether 
children are kept from associating with adult offenders. What 
jails, lockups, penitentiaries and reformatories are provided; 
the condition and the usefulness of each. The line of inquiry 
suggested for charitable institutions is equally applicable to 
correctional institutions. The inquirer should learn what pro- 
bation and parole systems are provided, both for adult of- 
fenders and for juvenile delinquents; how the truancy prob- 
lem is handled, and also what legal aid is available to poor 
persons, so that their rights may be reasonably safeguarded. American Country Life Association 
141 
Public indoor and outdoor relief and correctional work in 
many cities and towns and in an increasing number of rural 
communities is supplemented and sometimes paralleled by 
private effort. The good citizen should ascertain what private 
organizations exist in his community. How their activities 
are related to each other and to public work of similar nature, 
and whether the service rendered by each is effective, and 
commensurate with the amount of money collected for its 
support. 
The welfare of families and individuals actually in need 
of charitable or correctional provision, depends upon the pro- 
vision made by the community for the care of the sick, for 
sanitary and housing control, for recreation, for dietary in- 
struction, etc. And although these suggested provisions are 
being made in an increasing number of communities, so far 
they have not been so universally recognized as a community 
obligation, as has the support of poor persons, and provision 
for delinquents. Happily, the public health movement is 
rapidly extending throughout the countrty, and we already 
are seeing clinics, some of them traveling, such as dental, 
infantile paralysis, tuberculosis and mental clinics, with an 
ever-extending nursing service-public health, pre-natal, and 
infant welfare; school and tubercular nursing, and other 
specialized health service are extending and emphasizing the 
principle that the community is responsible for the health of 
its people. 
The good citizens should learn which of these activities 
exist and especially what medical, dental and nursing service 
is open to the poor sick person in his community; who provides 
it, and how it is paid for; what hospital facilities are avail- 
able to the indigent sick; whether the medical service is as 
skilfull as the community affords? 
The good citizen, after even so superficial a study of the 
provisions made by his community for the care of its poor, its 
defective and delinquent will have a keener appreciation of the 
importance of wise consideration of the problems to be dealt 
with, for he will have discovered that his community, be it 
ever so rural, and ever so prosperous, has its problems of sick- 
ness, poverty and delinquency, of immorality, vice and de- 142 
American Country Life Association 
generacy. In all of these problems, he must as a good citizen 
be humanly interested, and as a taxpayer he will do well to 
give them some study. He will see that while the unadjusted 
are but a small group numerically, their care constitutes a 
severe drain on the revenues of the state and on the whole- 
some moral life of his community. He probably will find that 
while some of these destitute defective and delinquent, the 
truant and the criminal are cared for by his community in a 
commendable way, that others are being but poorly provided 
for, or are receiving no consideration at all. He almost surely 
will be led to favor a readjustment of the present machinery 
for their care, and inevitably he will be led to favor supple- 
menting the present expenditure for support with an even 
larger expenditure for prevention and for the elimination of 
causes. 
In closing, members of this committee would be glad to 
receive instructions from this conference as to lines of study 
to be followed by their successors in the coming year. Report of Special Committee 
of the 
National Country Life Conference 
Appointed to confer with 
National Organizations Engaged in Rural 
Social IPork 
Part I. 
Conclusions of Conference 
Part ll. 
Outlines of Programs of Dork of "National Organizations 
Engaged in Rural Social Dork 
Part 111. 
Report Regarding Proposed Manual of Suggestions 
Presented By 
C. 117. Thompson 
Chairman 
143 Part I. 
r a T the first National Country Life Conference held in 
Baltimore, January 6 and 7 the Committee on Morals 
and Religion, of which Dr. Warren H. Wilson was chairman, 
reported the following resolution which was adopted by the 
conference: 
"This committee recommends that the National Country 
Life Association appoint a committee 
(a) to draft a tentative program of the most immediate 
needs in the line of rural reconstruction in America, 
and, 
(b) to call within the next thirty days a conference with 
the representatives of the Council of National De- 
fense, the Red Cross, the Y. M. and Y. W. C. A.'s, the 
War Camp Community Service and such other volun- 
teer agencies as may be planning rural social work on 
a national scale, for the purpose of co-ordinating the 
the reconstruction programs of these various agencies 
in order that duplication and waste effort may be 
prevented." 
In carrying out the purposes of the resolution, the Execu- 
tive Committee of the National Country Life Association 
deemed it inexpedient to presume to attempt any definite co- 
ordination of the work of these agencies, but that much good 
might be accomplished by a conference between them for dis- 
cussing the most immediate needs of country life as suggested 
by the resolution and the principles and methods by which 
they could be met, which might be a>pproved by the organiza- 
tions concerned. After personal interviews with executives 
of several of these organizations, a conference was called at 
Washington on March 14. The arrangements for the confer- 
ence were in charge of a committee of the National Country 
Life Association, of which Mr. C. W. Thompson, of the United 
States Department of Agriculture, was chairman, and which 
144 American Country Life Association 
145 
included in its membership Miss Edna N. White, Ohio State 
University, President American Home Economics Associa- 
tion ; Dr. E. C. Branson, University of North Carolina; Dean 
A. R. Mann, New York State College of Agriculture at Cor- 
nell University; Prof. T. C. Atkeson, Chairman Executive Com- 
mittee, National Grange; Mr. W. T. Creasy, Chairman Execu- 
tive Committee, National Board of Farm Organizations; Prof. 
Alva Agee, Secretary New Jersey Board of Agriculture; Mrs. 
H. J. Patterson, College Park, Md.; Mr. E. Fred Eastman, 
Business Manager Red Cross Magazine; also Professor Dwight 
Sanderson, Cornell University, Secretary of the National 
Country Life Conference. Statements of the more important 
social needs of rural communities and mleans for meeting such 
needs, of principles applicable to rural social work and of 
methods of organization of rural social work, and resolutions 
covering the publication of reports, were formulated by special 
committees. These statements, as adopted by the conference, 
are presented in the following pages. Those in attendance 
at the conference, together with the organizations represented 
are also shown. 
ORGANIZATIONS REPRESENTED 
1. American Red Cross, Washington, D. C.-J. Byron 
Deacon, Dr. Jesse Steiner, James L. Fieser, Margaret F. By- 
ington, Elizabeth G. Fox. 
2. American Library Association, Chicago, Ill.-George 
B. Utley. 
3. Boy Scouts, New York City-John R. Boardman, 
Lorne W. Barclay, Edward D. Shaw. 
4. Federal Council of Churches, New York City-Dr. E. 
deS. Brunner, Dr. Paul L. Vogt, Elbert M. Conover. 
5. National Catholic War Council, Washington, D. C.- 
Rev. John O'Grady, John P. Bramer. 
6. War Camp Community Service, New York City-Dr. 
Frank A. Fetter, Prof. F. A. Starratt, Mr. Dickey. 146 
American Country Life Association 
7. Young Men's Christian Association, New York City- 
Henry Israel, J. A. Van Dis. 
8. Young Women's Christian Association, New York City 
-Miss Mabel Head, Miss Elizabeth B. Herring, Miss Elliott. 
The National Country Life Association was represented 
by the following: 
Prof. Alva Agee 
Prof. T. C. Atkeson 
Dr. E. C. Branson 
W. T. Creasy 
E. Fred Eastman 
Dean A. R. Mann 
Mrs. H. J. Patterson 
Prof. Dwight Sanderson 
C. W. Thompson 
Miss Edna N. White 
Members of the Council of National Defense and of vari- 
ous Governmental Departments were also in attendance, as 
follows: 
Council of National Defense 
Mrs. Ina J. N. Perkins Arthur Macmahon 
Miss Ruth Wilson 
Department of Agriculture, Bureau of Markets 
C. J. Brand, Chief 
O. B. Jesness 
W. C. Nason 
V. N. Valgren 
L. E. Truesdell 
C. W. Thompson 
(also a member of Country 
Life Conference) 
Office of Farm Management 
Dr. H. C. Taylor, Chief 
Asher Hobson 
E. K. Eyerly, Supervising 
Farm Help Spec. 
States Relations Service 
Dr. A. C. True, Director 
A. B. Graham 
Charles E. Gunnels 
E. Merritt 
Miss Emma Conley 
Miss Edith A. Roberts 
N. C. Wilson American Country Life Association 
147 
Department of the Interior, Bureau of Education 
Dr. Henry E. Jackson 
O. A. Neal 
E. J. Ward 
Department of Labor, Children's Bureau 
Mrs. Max West 
Commission on Living Conditions 
Miss Edith Rockwood 
Others present at the meeting were: 
William R. Camp 
Robert A. Woods 
Committee on S.ocial Needs of Pural Communities and Means 
for Meeting Such Needs 
Mrs. Max West 
Prof. Alva Agee 
Mr. Eugene Merritt 
Mr. E. Fred Eastman 
Miss Edna N. White, Chairman 
Mr. C. B. Smith 
Mr. Henry Israel 
Miss Mabel Head 
Prof F. A. Fetter 
Miss Margaret F. Byington 
Committee on Statement of Principles 
Dr. Paul A. Vogt, Chairman 
Mr. John R. Boardman 
Mr. A. O. Neal 
Rev. E. deS. Brunner 
Dr. John O'Grady 
Dean A. R. Mann 
Dr. Jesse Steiner 
Dr. A. 0. True 
Committee on Organization 
Prof. Dwight Sanderson, 
Chairman 
Miss Elizabeth Fox 
Mr. A. J. Van Dis 
Mrs. Elizabeth H. Patterson 
Prof. T. C. Atkeson 
Dr. Bradford Knapp 
Dr. Henry E. Jackson 148 
American Country Life Association 
General Committee on Co-ordination of Special Reports 
Dean A. R. Mann, Chairman 
Prof. T. C. Atkeson 
Dr. John O'Grady 
Dr. A. C. True 
Mr. J. B. Deacon 
Miss Mabel Head 
Committee on Publication of Final Reports 
Dr. E. C. Branson, Chairman 
Mr. J. Byron Deacon 
Prof. Dwight Sanderson 
?rof. F .A. Fetter 
Prof. E. deS. Brunner 
PREAMBLE 
1. Social work has developed in cities primarily to meet 
needs made evident by urban congestion among the poorer and 
immigrant classes. It has been supported by a relatively small 
number of men of means and administered by professionally 
trained workers. 
2. Social work in rural communities has had a dual 
origin: 
(a) The effort of farm people themselves to better the 
social conditions of the countryside. This movement 
has been promoted by institutions indigenous to 
rural communities, such as the grange, the country 
church, the country school, and the farm bureau. 
(b) The spread of urban social agencies to rural com- 
munities. 
3. The fundamental value of country life is in the ad- 
vantage of a superior family and home life. The home must 
be recognized as the outstanding social institution of the 
country. Any tendency toward multiplicity of organization in 
rural communities which will tend to disintegrate the home as 
a social factor should be opposed. 
4. Rural communities are usually coterminous with a 
local trade area, with a village or town center, but there are 
frequent exceptions to this rule and the existing community 
must be the recognized unit of social organization rather than 
any abstract or artificial community standard. American Country Life Association 
149 
5. There usually exists an apparent difference of inter- 
ests between the country, or farm people, and the town, or 
village people, of the community center. One effort of social 
organization should be to unify the community, and this may 
usually be best accomplished by developing leadership also in 
the country neighborhoods. 
G. The rural community should be regarded as a group 
of farms with a trading center, rather than as a center sur- 
rounded by farms. Although social and political leadership 
frequently resides in the town centers, farm people usually re- 
spond much more readily to their own leaders, and rural social 
work will not be on a permanent basis and really of the com- 
munity unit until it has genuine support of country people. 
For this reason the propagation of social work primarily 
through urban or town leadership frequently impresses farm 
people as "uplift" work and fails to secure their support. 
7. Heretofore rural communities have employed few paid 
executives for social work. The clergyman is found in almost 
every rural community but frequently his time is divided be- 
tween two or more parishes. The county agricultural agents 
and home demonstration agents are the most numerous social 
workers employed by counties but they are subsidized by 
county, state and national funds. Outside of social workers 
employed by county governments, public health or visiting 
nurses are possibly the next most numerous class of social 
workers employed by local voluntary associations. The Y. M. 
C. A. now bias rural secretaries in more than 200 counties and 
the Y. W. C. A. in nearly fifty counties. Generally speaking 
rural communities the country over have no social workers em- 
ployed by private organizations. 
8. Rural communities do not have the wealth of urban 
communities and the net cash income of farmers is relatively 
small. It is obvious, therefore, that the aggregate budget for 
social work in rural commlunities has certain definite limita- 
tions, particularly if it is to depend for its support upon local 
resources. 
9. The number of social workers which can be employed 
in rural communities, or by the several communities in a 
county either by private organizations or by county govern- 150 
American Country Life Association 
ment, is therefore limited by these considerations, and division 
of labor cannot be developed to the extent common in cities. 
10. Inasmuch as war conditions have demonstrated the 
need of social work in rural communities, and the value of 
technically-trained employed leaders, and inasmuch as na- 
tional organizations representing various social needs of ru- 
ral communities are now ready to give assistance in the pro- 
motion of their several lines of work, it seems desirable that 
these agencies should have a common understanding and 
method of procedure in the development of rural social work 
to meet the conditions above set forth. Social Needs of Rural Communities and 
Means for Meeting Such Needs 
This conference, interested in the social welfare of rural 
communities, recognizes that right economic and political con- 
ditions are essential to social betterment, but in accord with 
the purposes of the conference it addresses itself chiefly to 
social needs and methods of meeting them. 
A. In consideration of rural welfare the following are 
some of the problems needing attention: 
I. Education. 
1. Equalization of educational opportunity for all chil- 
dren. 
2. Adaptation of such education to special rural needs 
such as vocational, health, recreational, etc. 
3. Educational opportunity for adults. 
4. Development of social consciousness. 
5. Recognition of right of every child to full educational 
development. 
II. Health and Sanitation. 
1. Improved sanitation including sewage disposal, safe 
water and mil ksupply, better housing, etc. 
2. Better control of communicable diseases, including 
tuberculosis and venereal diseases. 
3. Better medical and nursing care. 
4. Provision for every child to have those conditions 
which produce a sound body. 
III. Recreation and Social Life. 
1. The development of organized and unorganized recre- 
ational opportunities peculiarly suitable to conditions 
in the rural districts to reduce the isolation of country 
life and to increase its attractiveness. 
2. Recognition by every individual of the need for recre- 
ation as a part of normal life. 
IV. Development of Normal Family Life. 
151 152 
American Country Life Association 
1. Organization of neighborhood forces to stimulate 
wholesome family life and to overcome the factors which 
tend to break it down. 
2. Special care for families and individuals who because 
of mental, moral, physical or economic handicaps are un- 
able to take part in the normal life of the community. 
V. Moral and Religious Life. 
1. Freeing the countryside of those forces and conditions 
that are inimical to sound morals. 
2. Stimulating growth of a finer spiritual life and 
strengthening the forces that develop righteousness in 
rural communities. 
VI. Better Understanding of Problems of Rural Social Life. 
In order to determine the most immediate needs of a 
given communlity and to devise means for meeting such needs 
it is necessary to have general and non-exclusive gatherings or 
conferences representing all local interests that may lead to 
further improvemient in the community. Only through such 
community conferences is it possible to take common counsel 
regarding matters of common need and to afford a proper 
agency for determining the distribution of functions in com- 
munity work. 
B. Among the specific means that may be employed to 
attain the respective aims above enumerated may be men- 
tioned the following: 
I. Education. 
1. Better trained and adequately paid teachers. 
2. Establishment of an adequate minimum standard for 
length of school term. 
3. Good school attendance laws properly enforced. 
4. Provision of adequate school buildings and equip- 
ment. 
5. Enlargement of provision for adequate training in 
physical education, agriculture, home economics, hy- 
giene and civics. 
6. Adequate provision for extension instruction. 
7. Provision for adult classes for foreigners and illit- 
erates. 
8. Provision for continuation classes. American Country Life Association 
153 
9. Free public libraries and school libraries. 
10. Lectures, concerts, pictures, etc. 
11. Special courses on rural life in higher institutions, 
including church-schools and seminaries. 
II. Health and Sanitation. 
1. Full time trained health officer. 
2. Public trained health nurse. 
3. Adequate medical and dental inspection and care 
of school children. 
4. Available inspection and expert advice regarding 
housing and other sanitary problems of homes and 
farms, and public buildings. 
5. Proper supervision of county housekeeping at county 
jails, almshouses and other county institutions. 
6. Sufficient hospital facilities and clinics. 
7. Instruction of mothers in prenatal and child care. 
8. Instruction in selection and preparation of food. 
9. Arousing public sentiment regarding public health 
laws and their enforcement with special attention to 
communicable diseases. 
10. Promotion of health education. 
III. Recreation and Social Life. 
1. Stimulation of community organization for social 
life. 
2. Adequate facilities and time for play and recreation. 
3. Trained leadership. 
4. Use of public buildings for community purposes. 
5. Community headquarters or center adapted to com- 
munity activities and open to all, which will accommo- 
date local civic organizations, provide rest room®, and 
afford facilities for public meetings, recreation, enter- 
tainments, dramatics, movies, clubs, classes, etc. Such 
a community house may well be made as a memorial 
to the community's soldiers and sailors, a memorial 
which will perpetuate their deeds in the life of the 
community. 
6. Cultivation of hospitality and social life of the 
family. 154 
American Country Life Association 
IV. Development of Normal Family Life. 
1. Community survey to show extent of destitution, de- 
linquency and defectiveness and other handicaps. 
2. Provision of trained social workers connected with 
local agencies such as welfare boards, probation or 
school attendance officers, societies, etc. 
3. The organization or use of local and state agencies 
and public institutions to provide for the removal and 
care of the disadvantaged. 
V. Moral and Religious Life. 
1. Recognition of all the foregoing as a basis for the de- 
velopment of higher standards of morality. 
2. To encourage strong churches with social vision and 
purpose, and to discourage burdensome rivalry result- 
ing from a multiplicity of church organizations. 
3. More general support of the agencies for religious 
education which will enable them to apply modern edu- 
cational methods to the promotion of religious life. 
4. Trained leadership. 
VI. Better Understanding of Problems of Rural Social Life. 
1. Special investigations of rural social problems con- 
nected with foreigners, negroes, illiterate whites, etc., 
as well as those needs indicated previously. 
2. Encouragement of discussion and study by the com- 
munity itself of its own problems. 
3. Fostering self-direction and self-help and develop- 
ment of leadership and the sense of responsibility in 
the community, affording opportunity to men and 
women who can earn the right to some degree of lead- 
ership. 
I. The Above Outline Presupposes the Proper Economical 
and Political Bases. 
EXPLANATORY STATEMENT 
Any statement on the social needs of country life pre- 
supposes the necessary economic basis for their relation. 
Among the more important needs are: American Country Life Association 
155 
1. Adequate Roads and Transport Facilities. 
2. Adequate Facilities for the Marketing of Farm Products 
and the Purchasing of Farm Supplies. 
In this connection should be mentioned the proper 
development of co-operative undertakings for the mar- 
keting of farm products and for the purchase of farm 
supplies. 
3. Adequate Credit Facilities. 
Federal Farm Loan Associations are important aids 
for long-time credit. Co-operative credit associations 
may be necessary in some localities for short-time credit 
improvement. 
4. Up-to-Date Information on Agriculture and Home 
Economics. 
Farm Bureaus or similar associations are needed for 
the promotion of extension work in agriculture and 
home economics, enabling farm people to secure the 
assistance of state and national agencies in the solution 
of their local problems through technically trained, paid 
county agents. 
An Adequate Labor Supply. 
Public employment bureaus assist as clearing houses 
for farm labor. 
6. Adequate Legal Provision to Safeguard Farm Ownership 
and to Regulate Farm Tenancy. 
Attention should be given to legislation aiming to 
encourage the ownership of the land by those operating 
it and to eliminate the evils of an increasing unregulated 
tenancy. 
II. In Most Instances Improvement in Local Political Organ- 
ization is Highly Desirable. 
(a) Uniform county accounting and reporting and a 
state system of auditing county accounts, with state 
manuals of instruction for county officers. 
(b) The salary plan of compensating county officials. 
(c) Further consideration to the problem of readapting 
the functions of county and local governmental 
agencies to the needs of the community. 156 
American Country Life Association 
PRINCIPLES APPLICABLE TO RURAL SOCIAL WORK 
1. The needs to be met by social work in any rural county 
or local community should be defined by the county or the com- 
munity itself with the aid of such external assistance as may 
be available and helpful. This aid in the first instance should 
generally take the form of educational effort. 
2. Social work in a county or local community should 
have the support of genuine public opinion and the active par- 
ticipation of farm people in its prosecution. Lt should have 
the financial support of the whole community rather than that 
of only a few persons of means. 
3. (a) Agencies for rural social work should be 
prompted to meet actual rural needs and not to establish or 
extend organizations or institutions as such. 
(b) In the choice of agencies for social work in a given 
county or local community the primary consideration should 
be what particular service or services may be most needed and 
will receive most general support in the given county or com- 
munity. The selected service or services should be considered 
in relation to the total welfare of the community. Full use 
should be made of existing public facilities. 
4. In rural organization it is recognized that the local 
community constitutes the functional unit and the county or 
district the supervisory unit. 
5. The important needs of the county or local community 
having been determined by conference, the necessary advisory 
and executive work for their accomplishment may well be 
entrusted to specialized organizations or agencies which give 
primary attention to the problems presented. 
6. (a) The leadership for the conduct of rural social 
work in the local community should in general be discovered 
or developed within the commlunity itself rather than be 
brought in from the outside. So far as possible it should be 
voluntary rather than paid service. 
(b) The activities of paid rural social workers should be 
limited primarily to educative, technical, advisory, and execu- 
tive functions in the broader sense and should seek to develop 
voluntary social work by the people themselves. American Country Life Association 
157 
REPORT OF COMMITTEE ON ORGANIZATION OF 
RURAL SOCIAL WORK 
The practical application of these principles will involve: 
A. The recognition by national and state organizations 
of the fact that social work in rural communities and counties 
must be administered upon principles essentially different 
from those now necessary in cities, and that correlation, co- 
ordination, and co-operation are essential. 
B. Organization or conferences for effecting such co- 
operation : 
1. Each local rural community should have an organiza- 
tion, community-wide in scope, of a form adapted to the local 
conditions, which should consider those community problems 
that demland action and which should encourage the co-opera- 
tion of all forces which may help in their solution. 
Where the community organization is not initiated spon- 
taneously by the people of the community, it should be pro- 
moted by agencies qualified for such work, but no specialized 
agency or organization with a distinctive program of work 
should attempt to be the co-ordinating body. In bringing 
about a common co-ordinating agency in a county or a local 
community, this should be accomplished either by the com- 
munity or county acting on its own initiative or by an inde- 
pendent agency representing all groups instead of by one in- 
terested group. National and state organizations should sug- 
gest to their county and local units that they encourage and 
co-oparte in such community organization. 
2. These commlunity organizations should be associated 
in a county conference composed of representatives of (1) the 
community organizations and of (2) county-wide organizations 
actively engaged in promting rural progress. This conference 
Should determine a program of work to meet the county needs 
and should appoint standing committees to study these needs 
and to make recommendations for action to the conference, and 
to carry out policies or programs adopted by the conference; 
and county or district organizations should in general aim to 
bring to the attention of the local communities the resources 
of county, state and national agencies, public and voluntary. 158 
American Country Life Association 
(The term "conference" js used above in the usual sense to 
imply a periodical assemblage for discussion and joint plan- 
ning of work, and which may authorize such officers and com- 
mittees, programs and statements, as the assemblage sees fit, 
but which is in no sense a controlling ,directing, or overhead 
organization for the communities and organizations repre- 
sented in it. The purpose of such conference is to afford op- 
portunity for the best organization of effective voluntary co- 
operation). 
In lieu of such county conferences, voluntary county social 
welfare committees, composed of citizens representative of all 
social interests and communities in the county, may well be 
inaugurated as a means of determining what social agencies 
are most needed in a county and of securing public support for 
an adequate but practical and well-correlated plan for the de- 
velopment of its social work. 
3. State conferences should be composed of representa- 
tives of the county conferences and of state-wide organizations 
engaged in rural work. 
The form of organization for community, county, and 
state referred to above should be determined by the local unit, 
in order that it may be adapted to local conditions. 
4. A national conference should be composed of repre- 
sentatives of national organizations engaged in rural social 
work. It should discuss the policies and methods of rural 
social work of national organizations, and should promote the 
co-operation of such organizations in a united effort for meet- 
ing the needs of country life. 
It is recommended that the National Country Life Asso- 
ciation continue to call together, when it may deem desirable, 
representatives of national organizations engaged in rural 
social work; and that the program for the next conference be 
determined by a committee to be appointed by the chair. 
REPORT OF COMMITTEE ON PUBLICATION OF 
FINAL REPORTS 
1. That the conclusions of this conference should be pub- 
lished and that, if feasible, they be published by the Rural American Country Life Association 
159 
Organization Division, United States Department of Agri- 
culture. 
That the editing of the above be entrusted to a comtmittee 
composed of C. W .Thompson, J. Byron Deacon, and Father 
O'Grady, and that the manuscript be submitted to the organi- 
zations concerned and be approved by them before publication. 
2. That a statement be made by those national organiza- 
tions engaged in Rural Social Work which are represented in 
this conference, of their programs of work, their policies and 
systems of organization, and that this be published in the 
same manner as the conclusions of the conference, so that there 
may be a common understanding of the service each is pre- 
pared to render and of their relations to each other and to 
local communities. 
3. That there be a joint effort on the part of the organi- 
zations here represented to stimulate the thinking of rural 
commfunities concerning their social needs; that this be pro- 
moted by the preparation of a manual of suggestions for study 
and discussion concerning the social needs of rural com- 
munities, with suggestions as to procedure in organizing 
communities and county conferences; that this manual be pre- 
pared by a committee of this conference composed of Miss M. 
F. Byington, chairman; E. L. Morgan, E. deS. Brunner, Father 
O'Grady, John Ketcham, (Lecturer, National Grange) ; W. T. 
Cross, (Secretary, National Conference 'Social Work), and C. 
W. Thompson; that this manual be published in the same 
manner as the conclusions of the conference, and that in so 
far as the work of individual organizations is concerned that 
it be referred to them for approval before publication. In- 
structions for its use should be given at national, state and 
county conferences and conventions and by written sugges- 
tions to field and local representatives. It is contemplated 
that such a manual should be ready for distribution in the 
fall of 1919. 
4. That in case the means of publication above contem- 
plated are not available, that the editing committee be author- 
ized to make such arrangements for publication as may seem 
practicable. Signed: E. C. Branson 
J. Byron Deacon F. A. Fetter E.deS. Brunner (part 11. 
Outlines of Programs of U?ork 
of 
National Organizations Engaged in 'Rural 
Social IPork 
I. ^American Library Association 
2. Jlmerican Red Cross 
3. Boy Scouts 
4. Federal Council of Churches 
5. National Catholic U?ar Council 
6. U?ar Camp Community Service 
7. Ijoung Men's Christian Association 
8. Ijoung Ulomen's Christian Association 
160 American Country Life Association 
161 
AMERICAN LIBRARY ASSOCIATION 
How and When Organized-1876. Incorporated 1879, under 
laws of Massachusetts. 
Purpose or Object-To promote the welfare of libraries in the 
United States and Canada. 
Nature of Specific Activities Engaged in or Service Rendered 
The American Library Association publishes an official 
"Bulletin" (bi-monthly), various books and pamphlets relat- 
ing to library work and bibliography, and "The Booklist," a 
monthly magazine of book selection, maintains a headquarters 
(78 E. Washington Street, Chicago, Illinois), as clearing house 
of library information to help keep library activities co-ordi 
nated; serves as free agency for libraries in search of positions, 
or for library trustees desiring librarians; has committees to 
conduct investigations on such subjects as library training; 
administration, work for the blind, rules for cataloging; helps 
to establish hospital and prison libraries, studies certification 
of libraries; salaries of librarians and library assistants; co- 
operates with other national educational associations, state 
library associations, state library commissions, etc.; through 
co-operation with state library commissions, etc., extends 
library services to rural districts; and for the past two years 
has, through its Library War Service, furnished books and 
libraries to the military and naval forces of the country. 
Method of Procedure in Connection with Such Activities 
or Service 
Library service is given to rural districts through co-oper- 
ation with state library commissions, by traveling libraries, 
book wagons, rural branches of county and township libraries, 
etc.; organization of various committees, standing and special, 
for the conduct of activities herewith mentioned; and through 
the activities of the headquarters office. 
Territory Covered at Present-The United States and Canada. 
How Individuals or Communities May Secure the 
Service Offered 
By applying to the headqufarters of the association, 78 E. 
Washington Street, Chicago, Illinois. 162 
American Country Life Association 
All publications sold at cost prices; no exhibits available. 
Some of the publications issued by the Association are: "Guide 
to Reference Books, " "A. L. A. Catalog," "A. L. A. Index to 
General Literature," and other publications as listed under 
"American Library Association Publishing Board," 78 E. 
Washington Street, Chicago, Illinois, in Publishers Trade List 
Annual. 
Publication or Exhibits Available for Distribution 
Present Officers 
President, Chalmers Hadley, 
Vice-President (1st) George H. Locke, 
Vice-President (2nd) Cornelia Marvin, 
Treasurer, C. B. Roden, 
Secretary, George B. Utley. 
AMERICAN RED CROSS 
How and, When Organized 
The American Red Cross, like Red Cross in other coun- 
tries, was formed in response to the recommendation of the 
International Conference of Geneva in 1863, "that there exist 
in every country a comimittee whose mission consists in co- 
operating in times of war with the hospital service of the 
armies by all means in its power." 
Purpose and Object 
As originally organized, the Red Cross Societies were de- 
signed to supplement the medical services of armies in time 
of war, but the great need of a thoroughly trained and efficient 
organization, national in scope and permanent in character, 
to render assistance after great disasters, has been so well 
established that many of the Red Cross Societies have extended 
their functions to include relief operations in time of peace. 
Recognizing this fact, the United States Congress, by the act 
approved January 5, 1905, to incorporate the American Red 
Cross and place it under government supervision, declared its 
purposes (in addition to its duties in time of war) to be: "To 
continue and carry on a system of national and international 
relief in time of peace and apply the same in mitigating the American Country Life Association 
163 
sufferings caused by pestilence, famine, fire, floods, and other 
great national calamities, and to devise and carry on measures 
for preventing same." The notable services rendered by the Red 
Cross of this and other countries during the World War has 
led, in this and other countries, to further expansion of pro- 
gram in response to public expectations. These expansions are 
in the fields of health and social service. 
Nature of Specific Activities Engaged in or Service Rendered 
(The following is a statement of the Peace Time activities 
of the Red Cross) : 
1. Public Health Nursing. 
2. Educational Classes in Dietetics, Home Care of 
the Sick and First Aid. 
3. Home Service to Civilian Families, Information 
Service and Community Projects., 
4. Children's Activities through the Junior Member- 
ship. 
5. Disaster Relief. 
6. Establishing Health centers for the preservation, 
promotion and improvement of the public health 
in the 
a. Conservation of child life. 
b. Promotion of rural hygiene. 
c. Prevention of mental diseases, industrial diseases, 
venereal diseases, and tuberculosis. 
d. Education of the people in matters of health and 
prevention of disease. 
Method of Procedure in Connection With Such Activities 
or Services 
The Red Cross is administered from. National Head- 
quarters in Washington, through fourteen division head- 
quarters, which, in turn, direct the activities of its 3,720 chap- 
ters. Through smaller operating units, known as branches and 
auxiliaries, of which there are many thousands, the chapter 
takes in all communities located within the territory assigned 
to it, and the members and workers in these communities do 164 
American Country Life Association 
their work solely under chapter direction. An outline for the 
guidance of communities in studying their social needs has 
been prepared, and division field representatives are 
trained to participate with chapter groups in making a careful 
study of local social needs and local social resources in de- 
termining their programs for peace time work. 
Territory Covered at Present 
These chapters, branches and auxiliaries cover the entire 
United States and its insular possessions. In peace time, op- 
erations are confined to American territory except in the case 
of disaster relief, when it extends its aid and assistance where- 
ever it may be needed. However, at the present time, the Red 
Cross is fulfilling its wartime commitments abroad, involving 
reconstruction work in at least the following countries: 
France, Poland, Czecho-Slovakia, Roumania, Serbia, Palestine 
and Russia. 
How Individuals of Communities May Secure the 
Service Offered 
Referring to the question of how services may be secured: 
Communities throughout the United States are now everywhere 
in position to secure Red Cross service through their local 
chapter or branch organization. Individuals receive services 
such as nursing, home service, class instruction, disaster relief, 
etc., by the simple process of application. 
The following among many pamphlets now available for 
general distribution may be obtained through National or 
Division Headquarters: 
Health Centers-A Field for Red Cross Activity. 
The Future of Red Cross Home Service. 
How 1 May Become a Nurse. 
Peace Program of the Junior Red Cross. 
Home Hygiene and Care of the Sick. 
Have You a Community Nurse in Your Town or County? 
Your Community Health Crusade. 
Manual of Disaster Relief. 
Publications or Exhibits Available for Distribution American Country Life Association 
165 
The Present Officers 
Woodrow Wilson, President. 
Robert W. deForest, Vice-President. 
William Howard Taft, Vice-President. 
John Skelton Williams, Treasurer. 
Alexander C. King, Counselor. 
Stockton Axon, Secretary. 
NATIONAL 
Franklin K. Lane 
Merritte W. Ireland 
Henry P. Davidson 
Executive Committee 
Eliot Wadsworth 
Cornelius N. Bliss, Jr. 
George E. Scott 
Livingston Farrand, Chairman. 
Willoughby G. Walling, Vice-Chairman. 
Frederick C. Munroe, General Manager. 
Clara D .Noyes, Director, Department of Nursing. 
J. Byron Deacon, Director General, Department of 
Civilian Relief. 
James N. Rule, Director, Department of Junior Member- 
ship. 
BOY SCOUTS OF AMERICA 
February 8, 1910, original incorporation; Federal charter 
by Congress, June 14, 1916. The Boy Scouts is a corporation 
formed by a group of men who are anxious to have the boys 
of America come under the influence of this movement. Affairs 
of organization managed by National Council. 
How and When Organized 
Purpose or Object 
To promote the ability of boys to do things for themselves 
and others, to train them in scoutcraft, and to teach them 
patriotism, courage, self-reliance and kindred virtues. 
Nature of Specific Activities Engaged in or Service Rendered 
Scouts hold themselves ready to co-operate in any move- 
ment undertaken for community welfare and betterment, as 
civic campaigns, i. e., "clean-up," "walk-rite," "anti-fly," etc.; 166 
American Country Life Association 
messenger, guide and usher service; co-operation with churches, 
schools, women's clubs; with police, park, fish and game com- 
missioners ; fire prevention, fire fighting, snow shoveling, char- 
itable work, visiting the sick, etc.; co-operation with national 
organizations, such as Y. M. C. A., Red Cross, etc.; in war 
work - assisted in sale of bonds and stamps; raising war gar- 
dens, elc. • conducting a census for black walnut timber for 
government use; collecting fruit pits and nuts for government. 
Method of Procedure in Connection With Such 
Activities or Service 
Troops are sponsored by an institution, organization, or 
group of citizens which applies for charter and appoints troop 
committees which supervises the scout leaders and troop and 
becomes responsible for seeing that the institution, organiza- 
tion or group provides opportunities for success of troop and 
that troop conducts itself in a manner appropriate to needs, pur- 
poses and policies of institution, etc. Standing committees are 
formed such as Finance, Camping, Scout, Supplies, etc.; or- 
ganization of departments, such as Field Education, Library, 
Camping, Publication and Supplies for the purpose of dis- 
tributing and fixing responsibility for the conduct of the work 
of the Boy Scouts. 
Territory Covered at Present 
Four hundred and eighty-one thousand eight hundred and 
fifty boys registered, covering the entire United States and 
Hawaii. 
How Individuals or Communities Secure the Service Offered 
By applying to National Headquarters, New York City, 
or local troop committees. 
Publications or Exhibits Available for Distribution 
Scouting. 
293,000 Boys Aid the Nation. 
The Scoutmaster. 
A Manual of Customs and 
Drills. 
Boy Scout Diary. 
Troop Record Book 
Handbook for Boys. 
The Troop Committee. 
General Information Bulletin 
Constitution and By-laws of 
the Boy Scouts of America. 
Scoutmaster's Handbook. 
Every Boy's Library. American Country Life Association 
167 
Hon. President, Woodrow Wilson. 
Hon. Vice-President, William Howard Taft. 
Hon. Vice-President, Daniel C. Beard. 
President, Colin H. Livingstone. 
Vice-President, Mortimer L. Schiff. 
Vice-President, Milton A. McRae. 
Vice-President, Benjamin L. Dulaney . 
Vice-President, Arthur Letts. 
Scout Commissioner, Daniel Carter Beard. 
Treasurer, George D. Pratt. 
Chief Scout Executive, James E. West. 
Present Officers 
FEDERAL COUNCIL OF CHURCHES 
How and When Organized 
Rural Work, 1910 
Purpose or Object 
To co-ordinate the work of the different Protestant bodies 
in the rural field to furnish a field for co-operative work of these 
bodies, to adjust inter-church relations so that the church can 
do its share in the provision of equipment for community serv- 
ice, to relate the church to other social agencies, and to develop 
the best life in our smaller communities. 
Nature of Specific Activities Engaged in or Service Rendered 
Purpose, as stated, is also a statement of procedure. At 
present the Commission on the Church and Country Life of 
the Federal Council has been taken over by the Inter-church 
World Movement and is co-operating with it in directing the 
National Rural Survey being conducted by that Movement. 
This survey will be budgeted in terms of men, methods, and 
money, and will promote programs of church efficiency dealing 
with methods, finance, religious education, boys' and girls' 
work, co-operation with government and social agencies, sur- 
veys, relief and community service. 168 
American Country Life Association 
Methods of Procedure in Connection with Such 
Activities or Service 
Method of procedure will be determined by this study. 
There is a salaried rural survey supervisor in each state, who 
is directing this work through county units. There are more 
than 12,000 volunteer or part-time workers. The machinery 
for conducting the survey is to be utilized for carrying out the 
program. 
Territory Covered at Present 
Whole United States. Seventy-six denominations with a 
constituency of 50 millions are co-operating. 
How Individuals or Communities May Secure the 
Service Offered 
Services may be secured by making application to the 
respective organizations, 894 Broadway, New York City. 
Publications or Exhibits Available for Distribution 
The Church and Country Life. 
Six Thousand Country Churches. 
The Country Church in the New World Order. 
Church Union and the Rural Church. 
The Church in the Community. 
A Reconstruction Program for Country Churches. 
The Country Church and the City Boy. 
A Rural Community House. 
The New Country Church Building and other books and 
pamphlets. 
PRESENT OFFICERS 
President, Rev. Frank Mason North. 
General Secretary, Rev. Charles S. Macfarland 
Treasurer, Alfred R. Kimball. 
Federal Council 
Chairman, Gifford Pinchot. 
Executive Secretary, Rev. Edmund deS. Brunner. 
Field Secretary, Rev. Charles O. Gill. 
Office Secretary, Helen T. Osborne. 
The Commission American Country Life Association 
169 
Chairman, John R. Mott. 
General Secretary, S. Earl Taylor. 
National Rural Survey Supervisor, Edmund deS. Brunnei; 
Associate, H. N .Morse. 
Office, Helen T. Odiorne. 
Inter-church World Movement 
NATIONAL CATHOLIC WAR COUNCIL 
Immediately after the declaration of war by President 
Wilson, the Catholic Hierarchy of the country assembled in 
Washington. It was presided over by His Excellency Cardinal 
Gibbons. At this meeting the Archbishops not only declared 
the loyalty of the entire Catholic body of the United States but 
pledged all the resources of the body for the aid and support of 
the government. On August 11 and 12, 1917, under the direc- 
tion and authority of Cardinals Gibbons, Farley and O'Con- 
nell, a general convention of Catholics was held in Washing- 
ton, D. C. To this convention came official delegates of all 
the dioceses of the United States and of the national organiza- 
tions of men and women and of the Catholic press. As a 
result the National Catholic War Council was formed. The 
members of the Council are the Archbishops of the United 
States who supervise through an administrative committee 
who manage and carry the practical field work. These com- 
mittees are: Committee on K. of C. War Activities and the 
Committee on Special War Activities. 
Purpose or Object 
The purpose of the Council is to bring the entire resources 
of the Catholic body of this country to the service of the 
immediate needs of the country, both during and after the war. 
Since the signing of the armistice, the Committee on Recon- 
struction, a subcommittee of the Special War Activities, has 
found its field growing more and more important. 
Nature of Specific Activities Engaged in or Service Rendered 
The Committee on Reconstruction will encourage the 
following in rural community organization: Community im- 
provement, community houses, forums, clubs, better schools, 170 
American Country Life Association 
roads, etc.; personal advancement, education, physical ability, 
etc.; health program, sanitation, visiting school nurses, medical 
inspection of schools, maternity work and child welfare move- 
ments; dissemination of knowledge among all classes; devel- 
opment of leadership and self-reliance. The committees have 
been subdivided for the various branches of this work. 
Method of Procedure in Connection With Such 
Activities or Services 
To carry out said activities, the following are recom- 
mended: Community houses, community forums, clubs, asso- 
ciations co-operating with county agents, physical training for 
adults as well a schildren, recreation centers in schools, visit- 
ing school nurses, medical inspection of school children, devel- 
opment of maternity work and of clinics for children, especially 
infant welfare clinics, development of leadership in groups, 
developing leadership for state and nation, co-operation with 
various agencies, etc., parish priests to aid in the development 
of clubs and social centers within the church. 
Territory Covered at Present 
The entire United States. 
How Individuals or Communities May Secure the 
Service Offered 
Through the National Headquarters at 1312 Massachusetts 
Avenue, N. W. Washington, D. C.; information will also be 
given by the diocesan councils. 
Publications or Exhibits Available for Distribution 
The following pamphlets are available for free distri- 
bution : 
Handbook of the National Catholic War Council. 
Pamphlet on Land Colonization. 
Pamphlet for Soldiers and Sailors and Those Dependent 
Upon Them. 
Pamphlet on Unemployment. 
Pamphlet-A Program for Citizenship. 
Pamphlet on The Fundamentals of Citizenship (Civics 
Text Book). American Country Life Association 
171 
Pamphlet-An Outline for a Social Service Program for 
Catholic Agencies. 
Pamphlet on Girl Welfare Work. 
Pamphlet on A Plan for Civic Education Through Motion 
Pictures. 
PRESENT OFFICERS 
Committee on Special War Activities. 
Chairman, Rev. John J. Burke. 
Secretary, Michael J. Slattery. 
Women's Activities. 
Chairman, Rev. William J. Kerby. 
Secretary, Rev. John Cooper. 
Men's Activities. 
Chairman, Michael J. Slattery. 
Historical Records. 
Reconstruction and After-War Activities. 
Chairman, Right Rev. Msgr. M. J. Splaine. 
Secretary, Rev. John O'Grady. 
COMMUNITY SERVICE (INCORPORATED) 
PLAYGROUND AND RECREATION ASSOCIATION OF 
AMERICA 
How and When Organized 
Playground and Recreation Association of America: In 
April, 1906, a small group of people from different parts of the 
country interested in recreation met in Washington, D. C., and 
organized the Playground Association of America, which later 
changed its name to the Playground and Recreation Associa- 
tion of America. 
War Camp Community Service, Inc. was established by 
the Playground and Recreation Association of America in May, 
1917, at the request of the War Department Commission on 
Training Camp Activities. 
Community Service, (Incorporated) : The outgrowth of 
War Camp Community Service, Inc., incorporated February 
27, 1919. 172 
American Country Life Association 
The Playground aud Recreation Association of America 
was organized to promote wholesome recreation for young and 
old, and to help cities and small communities establish year- 
round recreation systems on a municipal basis, supported by 
funds raised through taxation. 
War Camp Community Service, Inc., was established to 
organize the social and recreational life of the communities 
near the training camps for the benefit of the men in training. 
Community Service, (Incorporated), has been established 
to conserve the social values of War Camp Community Serv- 
ice, Inc.; and to bring about through the development of 
leisure-time activities a richer social and recreational life for 
the individual and for the community. 
Purpose or Object 
Nature of Specific Activities Engaged in or Service Rendered 
The Playground and Recreation Association of America 
acts as a clearing house for information on playgrounds, recre- 
ation centers and various phases of recreation in cities, small 
communities, and rural districts. It publishes a monthly mag- 
azine, "The Playground," and pamphlets and literature of 
various kinds. The Association helps communities through 
correspondence and personal conferences to develop their 
recreational facilities, maintains an employment department 
for recreation workers, and conducts the National Physical 
Education Service through which states are aided in securing 
state legislation for compulsory physical education. 
War Camp Community Service, Inc., during the war 
period aided cities in providing a wholesome recreational life 
for soldiers, sailors and marines. 
Community Service, (Incorporated), supplies field workers 
and conducts campaigns through which communities are aided 
to organize themselves for a broader community leisure-time 
program. It provides field representatives to act in an ad- 
visory capacity to communities wishing this help, publishes 
literature, trains workers for local communities and acts as a 
clearing house for information. Experiments in rural recre- 
ation through county organizations are being conducted and 
this phase of the work will be enlarged. American Country Life Association 
173 
Method of Procedure in Connection with Such Activities 
or Services 
The method of work consists of sending workers from 
National Headquarters to communities wishing their services 
to organize private groups and committees who will be respon- 
sible for carrying on the work, to initiate activities and to help, 
as in the case of the Playground and Recreation Association 
of America, in establishing a municipal recreation department. 
Further methods involve the publishing of literature, the 
furnishing of advice and help through district representatives 
and the conducting of local campaigns in the interest of recre- 
ation and Community Service. 
Territory Covered at Present 
The work is being conducted as far as resources permit in 
all parts of the United States. 
Row Individuals or Communities May Secure the 
Service Offered 
By making application to National Headquarters at One 
Madison Avenue, New York City. 
Publications or Exhibits Available for Distribution 
"The Playground," a monthly magazine, pamphlets, cir- 
culars, and folders of various kinds are available for dis- 
tribution. 
PRESENT OFFICERS 
Playground and Recreation Association of America 
President, Joseph Lee. 
Treasurer, Gustavus T. Kirby. 
Secretary, Howard S. Braucher. 
War Camp Community Service, Inc. 
President, Joseph Lee. 
Treasurer, Mortimer N. Buckner. 
Hecretary, Howard S. Braucher. 
Community Service, (Incorporated) 
President, Joseph Lee. 
Treasurer, Myron T. Herrick. 
Secretary, Howard S. Braucher. 174 
American Country Life Association 
YOUNG MEN'S CHRISTIAN ASSOCIATION 
How and When Organized 
Originated in London, when 12 young men organized on 
June 6, 1844, under the guidance of George Williams, for 
work of sacrifice and service for young men by young men to 
improve their environments and transform character through 
allegiance to the principles of genuine Christianity. The first 
city association formed in the United States was at -Boston, 
December 29, 1851. The first Rural Young Men's Christian 
Association was organized in Du Page Township, Will County, 
Illinois, in 1873. The first county convention of the Rural 
Young Men's Christian Association was held in 1875. The 
first county to be organized with an employed county secre- 
tary was Pawnee County, Nebraska, in 1889. 
Purpose or Object 
The associations "seek to unite those young men, who. 
regarding Jesus Christ as their God and Saviour, according to 
the Holy Scriptures desire to be His Disciples, in their doc- 
trine and in their life, and to associate their efforts for the 
extension of His Kingdom among young men." 
Nature of Specific Activities Engaged in or Service Rendered 
The association endeavors to meet needs of young men 
and boys in country communities, towns, etc.; works through 
the group plan of local organization, through the school, 
church, etc; enlists county comimittee of citizens to direct its 
work, which appoints secretary who is paid by volunteer gifts 
in the county; organizes local Y. M. C. A.'s; arranges programs 
and holds meetings for the study of religious, social, educa- 
tional and physical needs of boys, etc,; enlists local volunteer 
leaders for carrying on these activities; seeks to develop co- 
operation among people and institutions. It approaches its 
task from the standpoint of needs of young men; does not 
seek to do work of the community but rather seeks to discover, 
encourage, etc., these local forces in working out their own 
problems; promotes community surveys, conducts study clubs, 
etc.; encourages Y camps; develops leaders for work. American Country Life Association 
175 
Method of Procedure in Connection with Such 
Activities or Services 
International Committee of Y .M. C. A.'s provides staff of 
country life specialists; state committees provide state organ- 
izers for county work; district secretaries are provided for 
regional supervision of the county work in groups of ten coun- 
ties of a state. Each community maintains central organiza- 
tion of few leading Christian men who supervise whatever 
is attempted in local field. Groups in community are organized 
to carry on fourfold program of activities, social, physical, 
educational and spiritual, and to accomplish their objective 
through co-operation given to farmers' institutes, campaigns, 
and deputation work. There is an event each year to show 
people what the association is doing. The leader and his group 
keep in touch with activities such as Annual County Con- 
vention, County Boys' Conference, etc. 
Territory Covered at Present 
United States and Canada; rural area of India, South 
America, and Russia. 
How Individuals or Communities May Secure Service Offered 
The services of this department may be secured through 
state, district and county committees and secretaries. 
Publications or Exhibits Available for Distribution 
Publications and exhibits available for distribution in- 
clude: "Rural Manhood," "The County Work of the Y. M. 
C. A." 
Blue print charts available at International Office for 
small amount. County work chart at $2.50. Other material 
in form of booklets is available through International, State 
and County Committees. 
PRESENT OFFICERS 
International Committee 
Chairman, Alfred E. Marling. 
Treasurer, B. H. Fancher. 
General Secretary, John R. Mott. 176 
American Country Life Association 
Subcommittee on County Work 
Albert J. Nason. 
C. A. B. Pratt. 
John Penman. 
S. B. Thorne. 
A. A. Hyde 
Chairman, Dr. D. H. McAlpin 
Lyford A. Merrow. 
Clarence P. Dodge. 
E. W. Hazen. 
H. A. Colgate. 
E. E. Horner. 
YOUNG WOMEN'S CHRISTIAN ASSOCIATION 
The first Young Women's Christian Association was 
organized in Boston in 1866. In 1906 two National Young 
Women's Christian Association movements were united and 
became the present National Young Women's Christian Asso- 
ciation. Several attempts were made to organize rural asso- 
ciations in 1885. These associations lasted only as long as 
the leaders stayed in the respective communities. In 1909 
the county form of organization was recognized by the National 
Young Women's Christian Association. 
How and When Organized 
Purpose or Object 
To associate young women in personal loyalty to Jesus 
Christ, to promote growth in Christian character and service 
through physical, social, mental and spiritual training, to 
become a social force for the extension of the Kingdom of God, 
to meet the needs of girls by adapting the activities of the 
association to the psychology of the girl and the environment 
in which she lives. 
The activities are of four kinds: 
1. (Supervision of girls' clubs carried on by local leaders 
in towns and the open country. Promotion of summer clubs 
under the leadership of college girls at home for the summer 
holidays, called Eight Week Clubs. 
2. Uniting of communities and the county or district 
in recreational programs such as camps, pageants, field 
days, etc. 
Nature of Specific Activities Engaged in or Service Rendered American Country Life Association 
177 
Co-operation with all civic and social agencies affect- 
ing the welfare of girls and young wo nen. Co-operation with 
the church and other religious organizations in training lead- 
ership and sharing resources. 
3. Conduct of conferences for education and inspiration. 
Method of Procedure in Connection with Such 
Activities or Services 
The Town and County Department is directed by a Na- 
tional Committee and administered by a national executive 
and her staff. In each group of states there are field secre- 
taries who work with field committees of volunteers. The field 
secretary supervises the local associations and organizes new 
work. Every county or district association has a board of 
directors who plan for and direct the work. Activities and 
clubs are largely directed by local leaders and every organized 
county or district has a trained secretary or secretaries who 
supervise the work. When there are no county or district 
organizations the clubs are supervised from the field office. 
There is as little equipment as possible since available re- 
sources are used. Local leadership is trained to carry re- 
sponsibility. The association tries to co-operate rather than 
compete with already established organizations. Cpart 111. 
Report Regarding Proposed Manual of 
Suggestions for Rural Social IPork 
The Special Committee, appointed under Resolution No. 
3, after some correspondence, felt that this resolution did not 
sufficiently define the character of the pamphlet to be prepared, 
and the use to which it was to be put. Is it to be prepared 
for agencies such as the Grange, or Woman's Club, who desire 
to study their local social needs; for special committees or 
individuals interested in Community Study; or for local 
workers representing the national agencies participating in the 
conference ? 
The Chairman of the Committee, Miss M. F. Byington, 
prepared a tentative draft of two chapters, one on Education 
and one on Health, aimed to meet the needs of the first of 
these groups. These chapters, as shown in the following pages, 
have not been approved by experts in the respective fields nor 
have they been adopted by the Committee as an expression of 
its views as to the form which the manual should take. They 
were intended merely as a basis for discussion and are here 
submitted for that purpose. 
SCHOOLS 
Every citizen shares in the responsibility for the schools 
in his town. Good schools increase the number of good citi- 
zens; good schools draw to the community those people who 
want their children to have the right kind of education. 
Any community can have them if it is willing to work 
for them and to pay for them. Citizens, even those who have 
no children of their own, should therefore get together in an 
effort to bring the educational opportunities in their town up 
178 American Country Life Association 
179 
to the best standard. First it is necessary to know what kind 
of schools the children in your neighborhood go to, then to 
consider in what ways these schools might be improved. This 
chapter suggests some of the points to consider. 
What the School Should Teach 
Since a true education is one which really prepares a 
pupil for his future life, country schools should teach in terms 
of country life. There should, of course, be classes in agri- 
culture and in domestic science. The teacher may also from 
the start, use in her lessons facts drawn from the child's own 
experience so that he will think of school as having some rela- 
tion to his everyday life. 
In what ways do the teachers in your schools train chil- 
dren for the activities of country life? 
Are the children taught gardening or agriculture; cook- 
ing, canning and sewing, carpentry? 
Are boys' and girls' clubs conducted by the Farm Agent 
and Home Demonstration Agent? 
Does the teacher a/pply the facts thus gained in other 
classes such as arithmetic? 
Are the children taught anything about the geography 
or geology of their own part of the country or the govern- 
ment of their own town and state? The township and county, 
while often more important in our daily life than state and 
nation, are so close to us that we neglect considering their 
activities. 
In what way does your school teach hygiene to the chil- 
dren? Some teachers do not simply use a text book. They 
organize the children as ''Health Crusaders" with credits for 
sleeping with open windows, brushing teeth and eating the 
proper food. When taught these simple requirements for right 
living in school, the children will realize their importance. 
Equipment of the School 
The school must, of course, be planned to make such 
teaching possible with a garden, a room where cooking may 
be taught and simple utensils. It should be an example in 
matters of sanitation, having sanitary toilets, a pure water 180 
American Country Life Association 
supply, individual drinking cups or a fountain and places for 
washing the hands. The school house should be well built and 
well cared for, and surrounded by trees. 
In order to help the children acquire the habit of reading 
there should be a school library in addition to the text books. 
How many books are there in your library? 
Has the school a traveling library from the State Library 
Association? 
Are other people in town allowed to take books from it? 
The Teacher 
The teacher's skill and experience will of course largely 
determine the amount of education the children get. The 
person who trains the minds of growing boys and girls is a 
very important factor in our community life, yet in mlany 
places the teacher has had little preparation for her difficult 
task. In one rural state 20 per cent of the school teachers 
have only completed the grammar grades and h'ave had no 
special training to fit them to guide the development of 
another person's mind. Often indeed the pay is so small that 
no one of ability would be likely to seek the position. In Ken- 
tucky, for example, the average salary for a school teacher is 
$359.00 a year. The government pays day laborers three times 
as much! 
What salary do the teachers in your county receive? 
How does this compare with the wage of a skilled work- 
man in your town? 
How many of the teachers have had normal school 
training? 
How many years of experience have they had? 
Are you satisfied that these teachers can give your chil- 
dren the kind of training you wish them to have? 
If not, what are you going to do about it? 
Length of the School Year 
The average length of the school year in city schools is 36 
weeks, and in the country schools only 27 weeks. Thousands 
of country districts keep their schools open only three months. American Country Life Association 
181 
Is it fair that the city child should have so much more edu- 
cation than the country child? 
What is the length of the school term in your state as 
provided by law? 
How many weeks was your school open last year? 
If it is because the children are needed on the farm, can- 
not the farm agent help to work out some plan that will 
release the children of school age during the school year? For, 
of course, it is better economy for the community to have its 
children get a good schooling. Have you ever considered 
what the solution might be for your county? 
Of course neither a good teacher nor a long school year 
will count for much unless children are actually in school. 
School laws are not very well enforced in country districts; 
in fact, there are twice as many persons who cannot read and 
write in the country districts of America as there are in 
cities. In one rural state one-fourth of the people over ten 
years of age cannot read or write. That this is not necessary, 
however, is shown by the fact that in another state with an 
equally large rural population only one-fiftieth of the people 
are illiterate. Where does your county stand? The United 
States census will tell you how many people in your county 
over ten years cannot read or write. 
Any committee studying matters of local education should 
know how many children of school age there are in the county 
as given in the United States census or in the state school 
census. In one county the average daily attendance among 
white children was 70 per cent of the enrollment in incor- 
porated towns and only 55 per cent in rural districts. That 
is practically only half of the children enrolled were present 
any one day. This was partly because in one-third of the 
school districts in this county children are required to attend 
only three months though the schools are in session seven or 
eight months. 
How many children of school age in the county? 
How many are enrolled in schools? 
What is the average daily attendance? 
If a good many children are staying away from school 
find out what are the most frequent occasions for their ab- 182 
American Country Life Association 
sence; contagious diseases; other sickness; being kept at home 
to work; willful truancy. These facts will show what the 
community ought to do to decrease the truancy. 
Sometimes the country children stay away because there 
is no truant officer or because the teacher or truant officer 
finds it embarrassing to insist that the neighbors keep their 
children in school. Who is responsible in your county for 
the enforcement of the school attendance law? Perhaps a 
parents' association could be formed, if there is none, to help 
interest parents in keeping their children in school. 
Occasionally when children are growing up without any 
education and the parents continue indifferent, it may be 
necessary to bring them before the County Court. 
Is there a juvenile court law in your state? 
Is it possible under its provisions to bring parents into 
court for contributing to the delinquency of their children? 
Does your court or magistrate take advantage of this law? 
The failure of children to come to school regularly is often 
due to poor teaching or a wrong curriculum which makes both 
the children and the parents feel that school is of little value. 
The development of genuine enthusiasm for education through- 
out the town and the adaptation of the teaching to the future 
needs of the children will help to lessen truancy. 
A Wider Use of the Schools 
Schools nowadays are often a center for bringing to- 
gether all the people in the community. They offer oppor- 
tunities for extension courses from state universities on varied 
topics; they provide educational movies, lectures and concerts. 
In some communities, where there are many illiterate adults, 
night .classes in reading and writing are provided. The schools 
often serve as a center too for the recreational life of the com- 
munity as indicated in the following section. 
What special activities have been carried on in your school 
house this year outside of school hours? 
What people in the community would probably be inter- 
ested in having more such opportunities presented to them? 
How many of your schools have Parents' Associations or 
School Welfare Leagues? American Country Life Association 
183 
Have you carried on any educational campaigns, such as 
those for better health, in your school buildings? 
Does the teacher take part in the life of the community? 
Paying the Bills 
Good schools cost money. The teaching in your schools 
may be poor and the school year short because the funds are 
insufficient. Has your township ever really faced the ques- 
tion of whether it cannot or just will not pay for having its 
children well educated? The cost per day for educating a 
child varies all the way from about ten cents a day in North 
Carolina to almost fifty cents in Montana. 
How much are you spending in your county for the edu- 
cation of each child per day? 
Some of the states that have the best plans for rural edu- 
cation, spend thirty-five cents a day for each child. 
How much would it raise your school tax if you increase 
your expenditures to this level? 
Is there any reason why your county should not be taxed 
to this extent? 
Are you getting your full share of state aid ? 
If you are to provide this increased amount of money 
you must, of course, arouse public interest in schools. Here 
are some figures printed by Laurens County, N. C., when it 
was trying to secure a higher school tax. If everyone in your 
county had similar figures, would it not insure their asking 
for the expenditure necessary to secure first-rate teaching? 
"While some 15 or 20 of Dublin's most prominent citizens 
have shown you the needs of the city, only a few have taken 
into serious consideration the needs of a great county like 
Laurens. This article was contributed in support of the ef- 
forts of County School Commissioner Whitehurst for better 
education conditions. 
The greatest present need of Laurens County is undoubt- 
edly a better educational system. The only way to get it is 
through the levy of a small local tax. 
Often a subject may be presented more clearly and forci- 
bly by a series of questions. Listen: 184 
American Country Life Association 
Do you know that in every 100 children in Laurens County 
18 are illiterate? 
Do you know that although our white population at the 
last census increased 22 per cent, yet the average attendance 
upon the public schools dropped from 2,354 to 2,196? 
Do you know that 527 white children drop out of school 
every year after just one term of schooling? 
Do you know that in 1911 in the county schools only 72 
per cent of the white school population was enrolled and that 
the average attendance was only 42 per cent? 
Do you know that the present tax values of Laurens are 
so low that in 1910 this county received $5,512 more school 
and pension money from the State than she paid in? 
Do you know that although the cotton crop of Laurens 
led the State last year, only 50 per cent of the farms culti- 
vated by white farmers were free from mortgages or other 
debts ? 
Do you know that in 1910 Laurens County farmers spent 
$36,325 for feed alone? 
Do you know that there are 328 land-owners living in 
Dublin and 137 land-owners living outside of the county who 
own just 154,510 acres, or nearly one-third the farm acreage 
of Laurens County? 
Do you not realize that these land-owners will pay just 
one-third of this local tax? 
Do you know that, in 1911 school teachers had only tem- 
porary license to teach? 
Do you know that every other county in the State has a 
larger percentage of teachers possessing first-grade or life 
licenses? 
Do you know that the city of Dublin spends about $12.12 
per year upon the schooling of each child, while Laurens 
County spends only $3.56? 
Hasn't the country child just as much right to the benefits 
of an education as the city child? 
Do you know that the County School board owns only 15 
of the 113 schoolhouses in Laurens? American Country Life Association 
185 
Do you know that 93 of the houses in which schools are 
taught are owned by private individuals? 
Don't you know that proper schooling educates the bad 
things out of your children as well as educates in the good 
things ? 
Do you think that $1.50 on every $500 of your property is 
too much to put into the future of your children ? 
With the above facts in your mind, try to construct a 
sensible argument against a local tax for schools, and you will 
find you have given yourself a difficult task. Laurens County 
is one of the greatest in the State. Its possibilities are still 
greater. Proper education, and that alone, will bring them out 
as they should be?" 
Co-operation on Behalf of the Schools 
Any community group which intends to undertake any 
activity in behalf of the schools should, at the start, talk 
things over with the school teachers, school trustees, and the 
county superintendent of schools in order to find out in a 
sympathetic spirit the problems which are troubling them. 
The superintendent or trustees may, for instance, need public 
support in their efforts to secure money enough to provide 
thoroughly equipped, well taught schools. 
If you feel that your schools are not fully living up to 
their possibilities, you might suggest that the authorities 
ask the State Board of Education to send an expert to study 
your local schools and see how they may be improved. 
When it is clear what problems your community is facing, 
you will wish to interest the citizens and taxpayers, many of 
whom probably have never thought about the needs and 
opportunities of their own schools. Sometimes her fellow 
townsmen would be glad to help the individual teacher in her 
efforts to improve her school; to plan an Arbor Day celebra- 
tion for planting trees and shrubs around the schoolhouse 
or a Pie Supper to raise money for a sanitary drinking foun- 
tain or for playground equipment. Such activities will en- 
courage the teacher and the pupils and will make more people 
interested in the welfare of the schools. 
The organization of a parents' association as has been 186 
American Country Life Association 
suggested will create a closer relationship between home and 
school, helping parents to understand the needs and problems 
of the teacher. Such a group might also help to organize 
recreation for the grown-ups out of school hours. 
Finally, of course, the whole comjmunity must be made to 
realize the importance of generous financial support of the 
schools and an intelligent understanding of their adminis- 
trative problems. 
If we are to have good schools therefore, 
1. We must know what good schools are and how nearly 
ours measure up to these standards. 
2. We must bring together those in our community who 
have a special interest in the schools (to make plans 
for improving them)-parents, teachers, taxpayers, 
school trustees, county superintendent of schools, 
State Board of Education. 
3. We must arouse the interest of the whole community 
in carrying out plans thus made. 
HEALTH 
Any community can buy health. It can up to a certain 
point determine how many of its citizens shall die each year. 
How is this possible? 
New York City cut its death rate in two in the course of 
fifty years. During 1860 thirty people died out of every one 
thousand of population. In 1913 only fourteen our of every 
one thousand died. The city had increased in population and 
had carried on extensive campaigns of education about the 
prevention of disease. The death rate of cities is being low- 
ered faster than that of the country as shown by a careful 
study of the death rates in New York State. 
How many people died last year in your county? 
What is your population? 
How does your death rate (number of deaths per thousand 
population) compare with that of New York City? 
Can your county health officer or State Board of Health American Country Life Association 
187 
tell you what the death rate of your county was in 1900, 
1905, 1910, 1919? 
Think of the suffering that would have been saved if 
only half as many people had died in your town last year. 
What are you doing to make the death rate go down? A 
community can help to decrease the number of deaths by see- 
ing that the conditions under which people live and work make 
for health and efficiency; by seeing that people know how to 
keep well and have medical care when they are sick; by 
stamping out contagious diseases. 
Save Babies' Lives 
Three hundred thousand babies die every year from causes 
that might have been prevented, is the statement made by the 
Children's Bureau. How mtany can be saved by providing 
pure milk and by giving every mother the opportunity to secure 
good advice about the care of her baby, is shown in'this little 
picture of the way the death rate among children under five 
has fallen off in New York in fifty years. 
At what point in this line does your county stand? 
How many babies were born in your county last year? 
How many babies under one died last year? 
The Children's Bureau found that in one county in Kansas 
only fifty children under one died for every thousand that 
were born, while in a mountain county it was as high as 
eighty deaths per thousand'births. Sometimes these babies 
die because they do not have proper medical attention, some- 
times mothers themselves do not realize how important it is 
that babies should have plenty of sleep and fresh air and do 
not know just how to plan their food for the first two years. 
The community should see to it that babies do not die because 
their mothers lack simple knowledge like this. ''Saving a baby 
costs the public so little; losing a baby costs the mother so 
much." What can you do to save the lives of the babies in 
your town? 
Take Care of the Mother 
The community ought also to be interested in seeing that 
the mothers have proper advice before the babies are born and 188 
American Country Life Association 
the right kind of care during confinement. Sometimes the 
mothers do too much hard work before the baby is born and 
get up too soon afterward. Sometimes the doctor is so far 
away that the mother cannot have his services. In one county 
in Montana only one-third of the mothers were attended by a 
doctor. In that county for every thousand babies that were 
born, thirteen mothers died, a rate twice as great as for the 
United States as a whole and five times the rate of Italy. 
An American has not much reason to be proud of that record. 
Many mothers also become chronic invalids or do not recover 
their strength because of lack of medical skill at childbirth. 
Health for the Children 
It is also important to watch the general health of chil- 
dren for they often suffer from physical defects which in- 
fluence their whole lives. If their eyesight and hearing are 
poor they may fail to get on in school. Bad tonsils and de- 
cayed teeth may cause rheumatism later. These troubles can 
usually be overcome and the child's health greatly improved. 
Every community ought to see to it that no child because of 
poverty or of the remoteness of the doctor, starts out life 
with such an unnecessary handicap. 
Are all the children in your schools examined at regular 
intervals by a doctor to find out whether they have any such 
removable defects? 
Does the nurse help parents arrange for the needed treat- 
ment? 
In one study made of country school children it was found 
that nearly half of them had something the matter with their 
teeth. Poor eyesight, adenoids, enlarged tonsils and other 
throat troubles were each found to be present in about one- 
fourth of the cases. About one-sixth of the children were 
undernourished, twice as many as in a corresponding group 
of city children. Three-fourths of the children were suffering 
from more than one of these defects. If all of these children 
had had the right care, think how many more of them would 
have had a good start in life. American Country Life Association 
189 
Children's Diseases 
We are also learning how important it is to prevent the 
spread of contagious diseases. Even the so-called "children's 
diseases," measles, scarlet fever, whooping cough, chicken pox, 
that we used to expect every child to have we now know often 
have serious complications and bad after-effects. 
How many cases were there Qf each of these diseases in 
your county last year? How many deaths from each? 
Is there a law requiring doctors to report such cases; do 
they ? 
Can you trace any group of cases to the failure to isolate 
one case properly? 
What does the teacher do when a child shows symptoms 
of one of these diseases? 
What action does the health officer take when a case of 
contagious disease is reported? 
Tuberculosis 
Probably more people die from tuberculosis every year 
than from any other one cause and yet it is a disease which 
can be prevented and arrested. In order to stamp out this 
disease the community must see to it that there is some place 
where people suffering from a slight cough, loss of weight 
and similar symptoms, can be properly examined by a 
specialist; that every patient suffering from the disease has 
adequate medical care; that there are sanatoria for those who 
have the disease both in an early stage and in an advanced 
stage; that there is a nurse to teach patients at home how 
to avoid giving the disease to others; that the law requiring 
the doctor to report every case of tuberculosis to the health 
officer is properly enforced. 
The number of deaths from tuberculosis in Massachusetts, 
Rhode Island and Connecticut dropped from nearly four hun- 
dred per one thousand population in 1870 to less than two 
hundred in 1910. 
How many deaths from tuberculosis were there in your 
county last year; how many cases were reported? 
Have you a State Tuberculosis Association; a State Sana- 
torium for incipient cases? 190 
American Country Life Association 
How are advanced cases cared for? 
Is there any nurse to help take care of patients who must 
stay at home? 
Have you ever had an exhibit or any other kind of cam- 
paign to explain the importance of early treatment of this 
disease and how to prevent contagion. 
Getting a Doctor 
Of course one difficulty in caring for the health of people 
in country districts is the fact that they sometimes have not 
enough doctors to provide adequate medical care. Moreover 
country doctors must usually be general practitioners and can- 
not be expected to have the knowledge of specialists. People 
suffering from serious diseases cannot therefore always get as 
expert advice as can people in the city. Every community 
ought to consider whether it has a good medical service as it 
might have and if not how it can be improved. Some states 
send medical specialists in mental troubles for example, tuber- 
culosis, diseases of the eye, etc., from town to town to conduct 
clinics so that even people in the remote sections may have 
the benefit of their skill. Probably any state in which there 
was sufficient demand on the part of the people could organize 
such clinics through the State Board of Health or the State 
University. 
How many miles from a doctor is the average family in 
your county? 
Are state or private hospitals or clinics available for the 
care of tuberculosis, surgical and obstetrical cases, mental 
troubles, diseases of the eyes and ears and contagious dis- 
eases, etc. 
Have you any local clinics where mothers can get advice 
about their babies? 
If you feed that your medical care is inadequate, consult 
the State Board of Health or the State Medical Association. 
The Visiting Nurse 
Many counties have now procured a nurse to help people 
keep well. Sometimes the nurse is paid by the State Board of 
Health and the county together, sometimes by the local Red American Country Life Association 
191 
Cross chapter. If you have no nurse take up the matter with 
your State Board of Health or with the Department of Nurs- 
ing of the Red Cross, in your division. 
"The community nurse cares for the sick, protects the 
well, and teaches the principles of good health to all." She 
will advise mothers about the care of their babies, individually 
or through the establishment of an infant welfare clinic. She 
will make regular examinations of all school children to dis- 
cover any faults of physical development and to check the 
spread of contagious diseases. She will visit the parents and 
help them to arrange for the removal of the defects thus 
revealed. She will find out those in the community who are 
suffering from incipient tuberculosis and help them secure 
medical care. She will assist in nursing the sick. She will 
also help to increase an understanding throughout the com- 
munity of the methods of curing and preventing sickness. 
The nurse's work everywhere proves of so much value that 
she quickly becomes an accepted and important part of the 
community life. 
H ealth-Sanitation 
Sanitation. To keep people from getting sick is one of 
the greatest services we can render them. Healthful as country 
life is in most respects, a great many people suffer because 
they have not yet learned the elements of sanitation. It seems, 
for instance, as if anyone could have pure water to drink in 
the country. As a matter of fact in a great many country dis- 
tricts people drink water from contaminated wells and get 
sick as a result. Sometimes such a well has not been prop- 
erly constructed and unclean surface water drains in; some- 
times the well is close to and lower than the barn and privy 
so that the water which seeps into the well brings poison 
with it. 
Again many homes have toilets which are not properly 
constructed. Since some diseases, such as typhoid and dis- 
entary are carried by flies, a flyjproof privy is an important 
means of keeping people from getting sick. For the same 
reason houses should be carefully screened. This can be done 
with simple netting if wire is too expensive. The U. S. 192 
American Country Life Association 
Public Health Service prints pamphlets for free distribution 
which tell how to build wells and privies properly and how to 
screen houses. 
Has your community ever studied these problems? If 
not you might undertake a general campaign to arouse public 
interest in them. The State Board of Health will test the 
water from all the wells in town so that you can know just 
which ones it is safe to drink from. You might have an ex- 
hibit, perhaps at the schoolhouse; perhaps in connection with 
the county fair showing models of good wells, sanitary privies, 
etc. You could also have charts showing how many deaths 
there had been in your community over a period of years from 
typhoid, disentary and malaria. You may find that bad san- 
itation is responsible for more sickness than you realize. In 
one county where the U. S. Public Health Service made a sani- 
tary survey twenty-five people had died from typhoid the pre- 
vious year. As a result of the survey many people were per- 
suaded to build sanitary privies and the community secured 
the services of a full-time health officer. Two years later 
there were no deaths from typhoid at all. Was it worth while? 
A poor milk supply is another removable cause of disease 
especially among little children. Find out from the state 
board what the regulations are about producing milk; whether 
the cows in your district have been tuberculin tested and 
whether they are milked in a cleanly manner. If the people 
in your town take milk from a milk route do you know 
whether the milk is safe. The State Board of Health will 
test it for you and tell you whether it contains enough butter 
fat and whether it is free enough from germs to be good for 
children. 
Milk Supply 
These suggestions about how to prevent needless deaths 
in your community shows what an important and difficult 
problem it is. It is evident that it would be hard for the citi- 
zens as individuals to do everything necessary to keep them- 
selves and the other people in their town well. Health is a 
A County Health Officer American Country Life Association 
193 
community asset and can only be secured by community action. 
Every county should therefore have a paid expert county 
health officer who can give all his time to helping raise the 
standards of health throughout the county. He would see 
that the water and milk are tested, he would correct unsani- 
tary conditions, he would help to stamp out contagious dis- 
eases, he would plan for exhibits and other educational cam- 
paigns, with the help of the nurse he would provide for the 
medical inspection of school children and the teaching of 
mothers in the care of babies. The doctor with a practice of 
his own would not have sufficient time to do all this work. 
The salary of a full-time health officer and one or more 
nurses may seem a heavy charge on the county tax fund but 
if after all they prevented a number of deaths from typhoid, 
or lessened the number of babies who died or stamped out 
an epidemic of diphtheria, you would surely feel that the 
money for their salaries was well spent. 
Get from your state board an analysis of the deaths in 
your county; learn from it w'hich of these diseases are pre- 
ventable and what the conditions are in your community which 
are probably breaking down the physical well-being of your 
citizens. Then with the help of the State Board of Health, 
county health officer and the local doctors plan an exhibit 
to cover the points raised in this study and others which have 
equal significance. Through movies, lantern slides, charts and 
popular talks you can help to make all this reach the people in 
your town. You want your community to be a healthy com- 
munity. It will be so to a much greater extent if every single 
person understands how important health is and how disease 
can be prevented and cured. Report of the Committee on Country Life 
Organization 
presented by Prof. E. L. Morgan, Chairman 
The Relation Between the Village Center and the 
Surrounding Farm Area. The Field. 
iaITHIN the last few years there has been a growing recog- 
nition among students of country life of the faict that 
the rural problem has two very definite aspects-that of the 
village or town and that of the open country. A part of the 
problem, therefore, has to do with the relationships between 
these two elements of the rural population. With this in 
mind, the executive committee of the Association requested 
your committee on Country Life Organization to make this 
the subject of its report. 
Since relationships are expressed in terms of concrete 
groups of people the field considered in this report may then 
be defined as the village or small city dependent upon agricul- 
ture for its well-being and that surrounding farm area which 
comprises the community basin. 
About one-half of our population is to be found in the 
125,000 communities of 50 to 2,000 inhabitants and in the 
farm area surrounding them. Intercourse between such towns 
and country at present extends all the way from a very few 
relations besides trade to many complex relations of a real 
community nature. There appears to be in very many locali- 
ties a lack of appreciation of the social and economic inter- 
dependence of these two parts of the same whole. Possibly it 
may be said that here is a social unit or organism that is out 
of adjustment. 
There are certain definite expressions of this lack of 
The Nature of the Problem 
194 American Country Life Association 
195 
working harmony. The following do not exist in every instance 
but are typical: 
The town often sees the country as a thing that exists 
that the town may live, when in fact the reverse may be 
fundamentally true. Business interests think farm trade be- 
longs to them regardless of how they treat it. The town is 
often intent on the time in the future when it will become a 
large commercial center and apes the city wherever possible, 
all of which estranges the farmer. 
Farmers feel they have been exploited and disregarded in 
legislation. The farmer does not express loyalty to his com- 
munity but buys where he can buy the cheapest, regardless 
of the fact that he and his family may be the constant recipi- 
ents of numerous improvements maintained by the village- 
all of which tends to make the local merchant's price slightly 
higher than that of the mail order house, which does not par- 
ticipate in similar things of a community progress nature. 
The problem arises, then, because of a lack of adjustment. 
The groups fail to see that they are bound in the bundle of 
community life together and that neither can attain its best 
without the other. 
The Goal to Be Attained 
1. A recognition of this social basin as the community, 
embracing as it does both village and country. 
2. The fullest development of the unique and legitimate 
life of both village and country, with such an adjustment 
between the two as will enable both village and country to 
make its maximum contribution to united planning and con- 
scious development of those things by which both live-agri- 
culture, education, civic affairs, recreation, religion and 
morals, transportation and communication, family life, politi- 
cal life, etc. Each of these needs represents a definite task, 
for the achievement of which there will have to be some local 
medium through which individuals and agencies can function 
in the larger development of the community. Let there be an 
increase in these integrating forces. 
Some Significant Movements 
During the past few years various developments have 196 
American Country Life Association 
taken place which are significant in the contribution they are 
making in this welding together process. They are centripetal 
.forces. 
The community house and community center movement. 
The Farm Bureau, Rural Y. M. C. A. and Y. W. C. A., 
Red Cross and others, which are uniting all for specific tasks 
common to both. 
Community fairs. 
The community club movement in Iowa. 
The public market. 
'The Co-operative Leagues of Virginia. 
The community council plan in Kentucky, Indiana, Ohio, 
Massachusetts, Kansas and Virginia. 
Community church. 
Centralized schools. 
Development of transportation and communication, and 
many others. 
Some Principles Involved 
1. While the county may be recognized as the admin- 
istrative or supervisory unit for many lines of work, still the 
local community, embracing both village and country, must 
be recognized and used as the functional unit. 
2. All movements should be based on the democracy of 
the whole community, i. e., thoroughly representative of all 
groups. 
3. The only forces which can permanently and ade- 
quately lead in community progress are the local forces 
developed and trained, i. e., organized self help. 
4. Unity cannot thrive in the midst of undue competition 
and rivalry. The bargaining factor in trade between village 
and country cannot be eliminated, but the extent to which it 
becomes unreasonable and bitter is the limiting factor in 
in ter-group development. 
5. A correlation of the forces and agencies working 
within the community, such as will afford opportunity for 
exchange of plans and projects and for participation in the 
larger gradual progressive development of the community, is 
indispensable. American Country Life Association 
197 
6. The deciding factor in the constructive solution of 
problems resides in the enlightened judgment of the entire 
community, i. e., projects that comprise programs of work 
must be developed from within, and represent the conscious, 
enlightenment and deliberate choice of the community, and 
not be superimposed from without. 
Your committee recommends as follows: 
1. That there be a further coming together of national 
agencies interested in country life to determine principles 
and procedure in approaching the county and community 
problem . 
2. That this get-together idea be immediately extended 
to states, in order that there may arise a thorough under- 
standing among the agencies concerning the plans and pro- 
jects of each, and that a beginning be made at state-wide 
planning in rural affairs. 
3. That especial attention be given by all country life 
agencies to the subject of local community organization. Many 
communities have, out of self-defense, insulated themselves 
against panaceas, jars and thrills, which have been put over 
in their localities by the outside opportunist. There is a 
genuine desire on the part of rural communities for practical, 
comprehensive, long-term planning which will produce sub- 
stantial development over a period of years. The agencies 
involved have it in their power to meet the get-together chal- 
lenge and eliminate overlapping and duplication in a fair 
and statesmanlike manner. If this is not done the people 
will achieve the same result by their own methods in one 
locality with another. 
4. That this association address its 1920 conference pro- 
gram to the general subject of the relation of the village or 
population center to the surrounding farm area; and that the 
various committees be asked to construct their reports so 
that principles and methods of development in their various 
lines necessary for this type of community may be presented. 
This should include the question often referred to in our 
present session of the relation between tax supported and 
voluntary agencies. 
Some Recommendations Report of the Committee on Investigation of 
Rural Social Problems 
C. J. Galpin, Chairman 
ri T is with considerable satisfaction that the committee 
QJ/ notes the present nation-wide interest in scientific 
studies of country life problems. Certain problems are emerg- 
ing from the general blur with clear-cut outlines. Some stand- 
ard methods of study are slowly developing. Responsible 
agencies in some states are venturing small budgets for study 
of the human side of farm life. The Inter-Church Survey is 
the outstanding instance of rural investigation this year. Its 
influence on succeeding studies should be powerful and far- 
reaching. 
The recent adoption by the U. S. Census Bureau of a 
classification of "farm population" in the census of 1920 will 
go far toward making future rural study scientific. The favor- 
able attitude of the Department of Agriculture toward Farm 
Life Studies will reinforce state agencies of research, and 
encourage them to include the human side of agriculture in 
research programs. 
The committee wishes to renew its proposal of selected 
problems of study made last year, namely: 
1. A Directory of Rural Organization in each state. 
2. A Study of Farm Tenancy after the Community 
Method. 
3. An analysis of a Rural Community of the Village 
Center Type. 
4. A Codification of the Rural Social Laws of each State. 
These are basic problems, and each one studied will lead 
to the solution of others. 
This year the committee desires to make two main sug- 
gestions: First, a suggestion on the choice of a problem of 
198 American Country Life Association 
199 
study together with a word on method; second, a suggestion 
on the study of rural health. 
1. Choice of a Rural Study Problem. 
Too much emphasis can scarcely be laid on the fruitfulness 
of a very simple study problem. A directory of rural organiza- 
tions is an example of a simple study of a fertile character. 
All that is required, unit by unit, is the name of a going rural 
organization; like a farmers' club, its location, a list of its 
officers with addresses. The directory may be long, it may take 
considerable inquiry and correspondence; but it has no mys- 
terious complications. It is a perfectly plain piece of work 
requiring only faithful clerical skill. The fruitfulness of a 
completed directory, however, is beyond question. 
In some of the middle west states there has been in the 
last year a widespread transfer of farms. This situation is 
well worth inquiry on the human side, and makes a very simple 
investigative problem. The problem would be, what farms in 
a county have been sold during the past year? Who sold? 
Who bought? Why did he sell? What is he going to do now 
or what is he doing? Why did he buy? What is he going to 
do with the farm or is doing with it The problem may take 
time to run down but its units are all plain and simple. The 
outcome, moreover, would throw light on one of the dark spots 
in rural economy. 
Probably the all-embracing type of schedule containing an 
intangible complex of situations, should almost never be at- 
tempted. 
As to method of investigation of a simple problem, the 
most important thing is to ask a few significant questions, 
the answers to which are concrete objective facts. 
II. Rural Health Study 
The committee has a few proposals to offer making up a 
modest first year program, on the subject of rural health study. 
First of all, the committee wishes to go on record as 
being in favor of health studies through the investigations of 
health specialists. The place in health study for the non- 
specialist, whether social worker or not, is limited to such 200 
American Country Life Association 
questions as the nature and extent of health inspection in rural 
schools; to what degree records of births and deaths are made 
among our farm population. Fertile study of health situations 
probably depends on background information of a very special 
sort which the non-specialist does not possess. An ideal team 
would be a health specialist and a social specialist. If the 
two were combined in one person, so much the better. 
The following limited program of study is offered for the 
oming year in the hope that its very limited character may be 
'n inducement. 
A. Public Health Administration in Rural Areas 
1. The law governing such administration. 
2. The public health officials and duties. 
3. The public health institutions. 
4. Health instruction in rural schools. 
5. Health inspection in rural schools. 
Semi-Public Health Agencies Among the Rural Population 
1. Semi-public health institutions; hospitals, general and 
maternity; clinics. 
2. !Semi-public health officials and duties. 
3. Co-operation with public health agencies. 
The proposed program for the coming year fastens at- 
tention upon the present machinery, of a public and semi- 
public or private nature, which is already available for rural 
health promotion. 
State maps showing the present hospitals which are open 
to rural patients and showing the area covered by each, would 
be illuminating. County spot maps showing either general 
or maternity hospital cases among the rural population would 
open the way to appreciating the problem of supplying the 
rural people with modern medical care. 
Somebody surely could trace out the rural patients in 
the history of each hospital or clinic in the United States 
and reduce this study to a graph for publicity in the com- 
munity and county and state. 
One simple thorough-going study of a special health 
feature has the power of arousing public notice to the whole .American Country Life Association 
201 
health situation, and may be more influential than a hasty 
aggregation of many diverse health facts. 
It should be mentioned that the InterjChurch Survey will 
make an outline health study of each county in the United 
States. Much basic information on the present agencies or 
rural health will therefore be in the hands of the Inter-Church 
investigators and will doubtless be available for local use at 
some period during the year. 
The health of the farm population from now on will be 
scrutinized more closely than ever from the point of view of 
the farm economist, the public, and the farm family. National 
agencies such as the United States Health Service, the United 
States Children's Bureau, the American Red Cross will, it may 
be assumed, give an increasing share of time to the health of 
the rural population, and it is important that correlation 
and co-ordination of all the forces at work, on rural health, 
should be attained. Report of the Committee on an International 
Country Life Movement 
President K. L. Butterfield, Chairman 
£AST year the Association recommended that the Chair- 
man of this commlittee, while in Europe, should be 
empowered to "convey the greetings of this Association to the 
leaders of country life on the other side, and to confer in- 
formally with them as to their attitude toward an unofficial 
international conference at a date sufficiently removed to pre- 
vent any embarrassment of official international relations." 
This resolution was presented in writing to a number of in- 
dividuals and organizations in Great Britain, France, Bel- 
gium, and in a few other countries. There was no opportunity 
for formal conference or discussion with the leaders, but it be- 
came evident that a number of organizations which are al- 
ready in the field in some of these countries are more than 
ready and anxious to co-operate in an international country 
life movement. 
The Educational Corps Commission of the Ameri- 
can Expeditionary Forces, in connection with the work of its 
University in Beaune, France, during the first week of June, 
1919, held a conference on World Agriculture, with six repre- 
sentatives each from Great Britain and France, and two from 
Belgium. The teachers and administrators of the agricultural 
work of the American Expeditionary Forces were also in at- 
tendance. A program of lectures was presented to the stu- 
dents of the College of Agriculture, of the Farm School, and 
to others who might care to attend. It was a very significant 
and suggestive gathering. Resolutions were passed at the end 
of a series of evening conferences of delegates, from which 
we quote these paragraphs, referring particularly to country 
life affairs: 
202 American Country Life Association 
203 
"That by reason of the significance of the social or country 
life interests, and their most intimate contact with the family, 
the home, means of intercourse, health, recreation, and gen- 
eral welfare, it is most desirable that all agencies for im- 
provement of rural life should be correlated on a world basis." 
"That the key to agricultural improvements in securing 
better farm life, is the betterment of family life by the appli- 
cation of better methods in home training of children; and by 
the organization and maintenance of local rural groups, each 
capable of planning its own development, but co-operating 
with other communities for the larger welfare of all. This 
principle should, therefore, be recognized in all activities as 
the one all-embracing method of rural advancement." 
The Committee believes that the time will soon be 
ripe for a conference on international relations in country 
life affairs. The Massachusetts Agricultural College, through 
this committee, extends an invitation to this Association to 
hold such a conference at Amherst sometime during the col- 
legiate year of 1920-21. Your committee recommends that 
the Association go on record as favoring such a conference, 
that it indicate its appreciation of the invitation, and that 
the matter be referred to the executive committee with power. 
The Committee also recommends that the Associ- 
ation authorize the executive committee to take steps to ar- 
range for a temporary country life committee thoroughly 
international in character-a committee distinct from any 
committee of the Association, and intended to develop interest 
in country life affairs in the different countries and in inter- 
national country life relationships. 
DISCUSSION 
In reply to inquiries regarding the Conference on world agri- 
culture and the work of the E. L. L. A. E. F., President Butter- 
field gave the following information: 
The President: The conference that is referred to was a four- 
day meeting and proved to be exceedingly interesting and I think 
very valuable, but it was only what was left of a much larger 
scheme. It was our hope, and indeed we had ouv plans already 
under way, to have a four-weeks' conference on world agriculture, 
to have quite a large number of American country life leaders and 
agricultural authorities over to join with those who belonged to 
the educational corps, and then to secure quite large delegations 204 
American Country Life Association 
from just as many countries as possible, and to have a thorough- 
going conference. But the educational work was stopped early in 
June, because the men were being sent home so fast that we had 
to take what we could get. We succeeded in securing from Great 
Britain, from France, from Belgium and from Canada typical 
leaders in agricultural work. There was no special effort made to 
bring over people who were primarily interested in country life as 
such. Our conference was not a country life conference; it was a 
conference on agriculture and country life, with the emphasis upon 
the technical and economic problems that we thought might be dis- 
cussed from an international point of view. It is significant, how- 
ever, that when the committee on resolutions, which was thor- 
oughly international, formulated the resolutions, it came out strong- 
ly in favor of the social aspect of agriculture. And you will notice 
also-and this was something that was clearly the opinion of the 
delegates from the different countries, without any pressure or 
propaganda among them-that the local community unit is empha- 
sized as the key to the rural situation. Now that perhaps might 
be expected from the fact that in Great Britain and in nearly all 
the European countries the country village is the dominant factor 
in country life. But it is obvious that we are already on a common 
platform with the people across the sea on what I think we are 
all regarding as the key-work, that is, the local community. 
Also a word in regard to the recommendation for a committee 
on international agriculture. We simply thought that under the 
circumstances it would not be out of place for this Association, 
through its executive committee, to take the leadership in trying 
to pull together a typical international committee on country life. 
I might say that I discovered on the other side many people 
interested in country life affairs and many organizations doing 
something. I was impressed by the fact that up to date the great 
emphasis in rural matters has been upon the technical and economic 
problems. I do not mean that the others have been neglected, but 
they have not been specialized; and I felt very sure that from the 
correspondence I had, and particularly from this conference, that the 
time is ripe there also, just as here, for the segregation of country 
life interests and I feel sure that .any advances we may make will 
not only be received with courtesy and politeness, but with en- 
thusiasm. 
We have the satisfaction of having with us one of the dele- 
gates to that conference from Great Britain, Mrs Hobbs, who came 
over, representing the British Board of Agriculture. She has been 
the prime mover in the development of women's institutes in Great 
Britain. Mr. Hobbs came over this time to judge tne Shorthorns, 
at the famous Eastern States Exposition, and Mrs. Hobbs came 
with him, and through the good offices of the Women's Land Army 
and the co-operation of some of the agricultural colleges, Mrs. 
Hobbs has been going to some of the agricultural colleges and to 
other points. I have asked her to say a word at this time. I take 
great pleasure in presenting Mrs. Mary Elliot Hobbs, of Gloucester- 
shire, England. 
Mrs. Hobbs. President Butterfield and Ladies and Gentle- 
men: I feel, first of all, extremely nervous, because I had expected 
to come here as a listener, and not intending to speak, and I also 
feel very deeply the honor conferred upon me by allowing me to 
say just a few words about this question of international co-op- 
eration, as one might call it, in our agricultural problems, both 
economic and social. American Country Life Association 
205 
In the short time I have been in this country I have been much 
struck with the basic similarity of your problems and ours in the 
rural districts; they are different in detail, but it seems to me that 
the basis is the same, and I have been learning a very great deal 
since I have been here. I came for the purpose of studying your 
rural extension work. Now, our difficulty in England, and it seems 
to me from what I have heard today, your difficulty here, too, is 
how we can best co-operate in, and co-ordinate all the work, the 
research and expert work, that is being done in this field in the 
same way that we wish to co-ordinate the expert work that is done 
in any technical field, and how we can bring that knowledge to 
those who wish to use it in a practical way. It is a matter that 
daunts the bravest heart in England to try to find out what has 
been done in any given department or field of work; you proceed 
from one government department to another, from one private 
agency to another, and; you have to be a very determined person 
indeed if you are going to get your information at the end. This 
should not be; that is where we want to get national co-ordination. 
That, I think, is the first problem we must tackle in our own 
nation; we must know what is being done and what is the best 
way of tackling international problems. 
During the war, we had in England, amongst our numerous 
new ministries we set up one which was called the Ministry of 
Information. Eveiybody laughed at first, but we all finally came 
to the conclusion that it was a very useful body. It was used, as 
far as we were concerned, to develop all information about any kind 
of work that was going on in connection with the war, and it was 
used to spread information among us and the allied nations as to 
what we were doing and what the allied nations were doing. It 
seems to me that something of that kind ought to be in every 
country, where not only information about what government agen- 
cies were doing would be accessible, but all voluntary agencies as 
well. It could have different departments and bureaus of the gov- 
ernment and they could be linked up into an international organi- 
zation in some way. That was just one of the ideas I had in mind 
while President Butterfield was speaking. But we have already 
a great deal of international communication going on, and action 
and reaction, as has always been the case in our history, are taking 
place. We have had1 several quite significant things happen since 
the war. Dr. Butterfield referred to the women's movement in 
England. Well, that was a reaction from Canada, one of our self- 
governing dominions, upon the mother country; we adopted this 
movement, practically in its entirety, from the Dominion of Canada 
through the agency of two or three Canadian women who were at 
that time in England, and it has fitted into our rather more com- 
plex rural organization in the most extraordinary way, and will, I 
hope, prove to be the basis of a work which will accomplish much 
the same thing as your home bureau in this country. 
Then, I think, one of the most striking international relations 
was the way in which the Union of South Africa, when it was 
creating its department of agriculture, came to this country-not 
to ours-to find a model. I was reading the other day about Dr. 
McDonald's visit to Cornell and its results. You have shown the 
right spirit in the way you are helping France in her extension 
work by sending workers over there to arouse the training of 
teachers. All this shows, I think, that this is really the psychologi- 
cal moment to try to formulate some kind of international organi- 
zation, however provision it may be, in order that-we may get to- 206 
American Country Life Association 
gether, as it were, to have some basis for future work, because as is 
our habit in England, we generally find that it is the voluntary 
agency which sets the pace, the agency that voluntarily takes up 
some specific form of work; .and then our government departments, 
working through the local government, absorbs that work, or gives 
it official support in some way. That is our method of work. 
And, I think, nothing is such a striking sign of the time than in 
our new developments that are taking place, particularly in the 
rural areas in England, where we had nothing that we could in 
very truth call civilization at all, we are following that old and 
tried plan-we find this women's institute movement being sup- 
ported in an educational way by our Board of Agriculture; we find 
organizations of farmers for definite, technical purposes being sup- 
ported in some way, and we are linking those up very closely with 
our councils, which are our units of local government. 
Now, the French are striving in the same way to do rural re- 
construction work; the Belgians in the same way; and one result, 
President Butterfield, I think you will be interested to know of 
the international conference held at Beaune was that a deputation 
of the Women's Institute from England went over to Belgium and 
conferred with the Belgian people there as to how they could best 
keep in touch with each other and help. In that and other ways 
the work is being extended. So it seems to me that everything 
points to this, that the moment has now come when we can have 
some definite international relation, and one about which there can 
be no dispute on the ground that it would interfere m any way 
with nationalism. Relation of Country Planning to Rural Health 
REPORT OF THE COUNTRY PLANNING COMMITTEE 
submitted by Frank A. Waugh, Chairman 
zq F country planning is to be understood in any broad 
QJ/ sense, as covering provisions for the entire physical 
equipment of the rural community, then certainly it must 
have a direct relation to rural health. Whatever elements of 
the physical plan may have any bearing on health conditions 
such elements may be studied and improved for the sanitary 
benefit of the entire community. 
Such a definition of country planning is obviously neces- 
sary, since any merely esthetic design, having regard to 
beautification without reference to practical utilities has sel- 
dom any value whatever. All art takes its due place in life 
only when it is understood to give dignity and beauty and 
organized design to necessary utilities. 
It is therefore a quite proper interpretation of country 
planning which includes the design of the farm home. It is 
well understiod that the character of the farm house, its heat- 
ing, water supply, and ventilation, have a direct and important 
bearing on the health of the family. This matter need not 
be taken up in detail at the present time, but it should be 
pointed out that much remains to be learned regarding the 
practicable designing of farm houses and other farm buildings. 
Along with the design of the farm house and other farm 
buildings come the various problems of their grouping. These 
buildings may be connected in series, according to the accient 
fashion in New England, or they may be scattered all over 
a twenty-acre lot according to the custom in the middle west. 
On the other hand they may be organized into a definite, com- 
pact and logical group, thus economizing land and much more 
economizing labor. 
207 208 
American Country Life Association 
It is plain, however, that the location of farm buildings, 
especially stables, pigpens and wells, with reference to one 
another and with reference to the farm home will have an 
important relation to sanitary conditions within the home. 
A suitable water supply should be a first concern of 
country planning. Every farm house and every country vil- 
lage should have an adequate and unquestionably safe supply 
of water. It is sometimes said that typhoid fever is a rural 
disease, and typhoid fever is frequently transmitted through 
drinking water. Obviously one of the leading problems in 
country planning ought to be to provide the necessary water 
supply. 
The disposal of sewerage is also a serious problem in 
reference to health, and one which has had too little atten- 
tion in country affairs thus far. Perfectly simple and effective 
sewage disposal systems are available for use in the country, 
however, and every project in country planning ought to at- 
tempt to secure their adoption. 
Another essential item in any country planning program 
lies, in the provision of adequate recreation facilities, includ- 
ing playgrounds, opportunities for swimming, boating, fish- 
ing, hunting, etc. While the bearing of these utilities upon 
health is not so direct and obvious it is not altogether 
negligible. 
While country planning has many other objects in view 
besides the conservation of health, it is sufficiently plain that 
any efforts in this field which overlook questions of sanitation 
and health are not worthy to be considered as country 
planning at all. Report of the Committee on the Teaching of 
Rural Social Problems 
Dean E. R. Groves, Chairman 
J. General Recommendations Concerning Teaching of Rural 
Social Problems 
It is the opinion of your committee that the teaching of 
rural sociology may be advanced by: 
1. Greater emphasis upon the fact that the student needs 
most of all to be trained through his courses to think socially 
and to make first-hand use of source-material of social sig- 
nificance. 
2. Greater co-operation between members of the teach- 
ing staff and extension and research specialists in the rural 
field at the institutions where teaching, extension service and 
research work are separately maintained. 
II. Specific Recommendations Regarding the Teaching of 
Rural Health 
The committee recommends the following as means by 
which rural health conservation may be influenced by the 
teaching of rural sociology. 
1. That emphasis be given the social significance of 
physical and mental health conditions of rural people and the 
present need of bringing to the rural population in the 
greatest degree possible the advantages of modern science 
along lines of preventive medicine, mental hygiene and public 
sanitation. Public health programs need to be neither urban 
nor rural but national in scope. 
2. That the students be assigned investigations of local, 
rural and urban death and illness rates and be given practice 
209 210 
American Country Life Association 
in the use of public health and sanitation reports and surveys 
of physical and mental health conditions. 
3. That the student be required to make an original 
report on the sanitation and health conditions of the com- 
munity best known by him. 
4. That the student be introduced to the activities of 
the American Red Cross with special emphasis upon its work 
for village and country communities along lines of health 
conservation. 
5. That there be given before classes in rbral sociology 
occasional lectures by rural social workers experienced in the 
problems of public health among rural people. 
6. That the students be given a clear and detailed under- 
standing of the duties and opportunities of local and state 
Boards of Health and of the public laws that influence the 
health of rural people. 
7. That so far as possible charts and other illustrative 
material regarding rural health conditions be used to bring 
to the student a vivid sense of the health problems of the 
rural sections. 
III. Material for Rural Sociology. 
The committee desires to call to the attention of the editor 
of the Experiment Station Record published by the United 
States Department of Agriculture its belief that a section in 
the Record devoted to rural sociology will prove a useful 
assistance to the teacher and student of rural sociology and 
also further the interests of rural social life. ^Tendencies and Needs in Road Building 
REFORT OF THE COMMITTEE ON MEANS OF COMMUNICATION 
John M. Gillette, Chairman 
r a FEW significant facts may serve to denote some of the 
tendencies and needs in road building at the present 
time. First, to make the 2,500,000 miles of roads in the nation 
serviceable will require a classification and adaptation of con- 
struction to the use demanded. Roads in districts with large 
motor truck traffic require the equivalent of city pavements; 
either concrete of vitrified brick; those under heavy automo- 
bile usage demand a macadam or equivalent surfaces; gravel 
or sand-clay surfaces may serve for wagon and light auto 
traffic; and well constructed and kept dirt roads for unim- 
portant neighborhood highways. 
Second, the Federal Aid to Highways is proving a mighty 
stimulus to the much needed establishment of state highway 
departments, as is seen in the fact that when the plan was 
enacted the funds could not be distributed because so few 
states had such departments but that the apportionment could 
take place in 1917 since practically all of the states had con- 
formed and passed other needed enabling laws. 
Third, road construction and improvement is attaining 
great impetus as the bonding of states for these purposes for 
huge sums indicate: California in 1910 for $18,000,000 to 
build a state system of turnpikes; New York in 1912 for 
$100,000,000 to construct 12,000 miles of highways, county and 
state; Illinois in 1918 for $660,000,000 to establish a system of 
state-wide roads to the extent of 4,800 miles; and Pennsyl- 
vania the same year for $50,000,000 to undertake highway 
construction. Many other states have bonded for lesser 
amounts. 
Fourth, the beginning of the value of concentrating Fed- 
211 212 
American Country Life Association 
eral Aid on the building of a connected system of through 
routes is observed in the case of practically only one state: 
Illinois. Between 600 and 700 miles of such highways, con- 
necting the larger points in the state and articulating with 
main roads from other states, are embraced in the plan, on 
some 500 miles of which system contracts have been let. 
Fifth, the perception is growing that good roads, besides 
being a general economic and social asset are closely related 
in particular to the health conditions of rural sections. In 
many sections of the nation the proper construction of high- 
ways affords a drainage system which carries off much of 
the stagnant water on which mosquitoes breed. A system of 
lateral connections will go far to rid certain regions of malaria 
promoting conditions. That it is desirable is indexed in the 
case of twelve southern states for which the estimate is made 
that malaria entails an annual loss of $190,000,000 on account 
of illness and impeded work. 
Again the establishment of good highways will place a 
large portion of rural populations within reach of medical 
attention, whereas now such attention is unavailable by reason 
of impassable roads, except in the most critical cases. It is 
found that a large proportion of southern rural women are 
without medical attention before, during, and subsequent to 
childbirth for this reason, chiefly, and that the maternal death 
rate is exceptionally high, as a consequence, especially among 
colored women. 
A Fen) Rerefences on Roads 
Public Road Systems of Foreign Countries and of the 
United States, Washington Printing Office; prepared under the 
direction of Hon. Jonathan Bourne, Jr. 
Economies of Road Construction, W. S. Gillette, En- 
gineer News Publishing Co., New York, 1918. 
The Design of Public Roads, C. H. Moorfield, Good Roads 
Year Book, 1917. 
Good Roads, An Outline of State Road Systems, Svein- 
bjorn Johnson, Legislative Reference Library Department, 
Bismarck, N. D. American Country Life Association 
213 
How Small Communities May Have Good Roads, L. W. 
Page, Scientific American, January 2, 1915. 
Federal Aid to Highways, J. E. Pennybacker and L. E. 
Boykin, Year Book, Department Agriculture, 1917: 127-138. 
Benefits of Improved Roads, Farmers' Bulletin, 505. 
Operating a Co-operative Motor Truck Route, H. S. Yohe, 
Farmers' Bulletin, 1032. 
Motor Transportation for Rural Districts, J. H. Collins, 
Farmers' Bulletin, 770. business of the American Country Life 
Association Transacted at the 
Chicago Conference 
Items of business were brought to the attention of the Con- 
ference at various times. It has been deemed advisable to con- 
dense all of these transactions and to compile them in such form 
as will render them readily accessible and readable. The exact 
wordings of motions, resolutions and remarks are on record and may 
be utilized by members of the Association if desired. 
The executive committee requested the appointment of tem- 
porary committees on audit and nominations, and a permanent com- 
mittee on finance. These committees were duly appointed by the 
president. 
APPOINTMENT OF COMMITTEES 
REPORTS OF COMMITTEES 
Auditing Committee 
We have exJamined the books and accounts of the secretary- 
treasurer of the National Country Life Association for the year 
ending November 1919, and we have found them to be correct. 
Signed: 
ALBERT E. ROBERTS 
WALTER BURR 
C. W. PUGSLEY 
The report was accepted. 
The committee on nominations presents the following report: 
For President-Kenyon L. Butterfield, President Massachusetts 
Agricultural College. 
For First Vice-President-Warren H. Wilson, Professor of Ru- 
ral Education, Teachers College, New York. 
For Second Vice-President-Edna N. White, Professor of Home 
Economics, Ohio State University. 
For Executive Committee-For one year: Mabel Head, Asso- 
ciate Executive, Department of Research and Method, National 
Board of Y. W. C. A.; A. R. Mann, Dean New York State College of 
Agriculture, Cornell University. For two years: P. P. Claxton, 
United States Commissioner of Education; E. C. Branson, Kenan 
Professor of Rural Social Science, University of North Carolina. 
For three years: C. J. Galpin, Office of Farm Management, United 
States Department of Agriculture; J. C. Ketcham, Hastings, Mich., 
Master Michigan State Grange and Lecturer National Grange. 
Signed W. J. CAMPBELL, Chairman. 
Nominating Committee 
214 American Country Life Association 
215 
The report was accepted and the secretary was instructed to 
cast the ballot of the Association for the nominees presented. 
Constitution 
Dean A. R. Mann submitted the report of the committee on 
constitution. The constitution was read and discussed by sections. 
It was voted that the constitution be referred to the executive com- 
mittee for revision with power of final adoption. 
GENERAL MOTIONS 
The following general motions were passed by the Conference: 
It was voted that the executive committee be empowered to 
publish separately the report of the committee on recreation and 
any part of the report of that committee given at the Baltimore 
Conference which it may find desiralble to include in such publi- 
cation. 
It was voted that the recommendations contained in the re- 
ports of the committees on Rural Organization and the special com- 
mittee on Conference of National Organizations engagedl in Rural 
Social Work, and the recommendations made by members of these 
committees on the floor of the Conference be referred to the execu- 
tive committee. These recommendations were: 
1. Extension of the work of the special committee on Confer- 
ence of National Organizations engaged in Rural Social 
Work. 
2. Extension of the work of this committee to state organi- 
zations. 
3. Emphasis upon local community organization. 
4. (Construction of the 1920 program of the Association 
around the idea of the "relation of the village or popula- 
tion center to the surrounding farm area." 
All reports of standing committees were adopted by a vote of 
the Conference after discussion. 
RESOLUTIONS 
The following resolutions were presented andl adopted by the 
Association: 
Rural Clinics 
Moved that this Conference take cognizance of the great need 
of clinical facilities available to rural communities in the depart- 
ment of rural health program, and that the committee on Health 
and Sanitation investigate the question and report at our next meet- 
ing definite recommendations for projecting, financing and main- 
taining rural clinics. 
Signed: 
AMALIA BENGTSON 
MABEL CARNEY 
EARL R. RODMAN 
B. F. BROWN 
Recreation 
The committee on recreation presented the following resolu- 
tion, which was voted by the Conference: 216 
American Country Life Association 
Whereas, The examinations under the dlraft law have re- 
vealed the fact that more than one-third of the young men ex- 
amined were physically unfit for full military service, and, 
Whereas, Statistics of the Life Extension Institute and the 
Life Insurance Companies show this to be only one evidence of a 
progressive physical degeneration, and, 
Whereas, The strenuous requirements of modern life have an 
irresistible influence away from natural health-giving habits and 
vitalizing physical activities, and, 
Whereas, These natural tendencies can be offset only by the 
provision of specially planned and1 directed programs of physical 
training and wholesome recreation, for both children and adults, 
therefore be it 
Resolved, That this organization shall exert its full influence 
toward securing state and federal legislation for establishing in 
the schools a universal system of physical education, including in- 
struction in the principles of health, periodic physical examinations 
and health-giving activities, and1 that this organization shall sup- 
port every practical effort to enlist in such activities adults and 
young people not enrolled in the schools. 
SECRETARY'S REPORT 
The first National Country Life Conference, held at Baltimore 
January 6, 7, 1919, registered about 175 persons, of which number 
30 immediately paid their dues in the National Country Life Asso- 
ciation which it established. The secretary at once commenced 
an active campaign for membership among country life leaders 
throughout the country. Letters were sent to all persons attend- 
ing the conference; to a list of about 1,000 select names of persons 
recommended to us by state leaders; to all state and county agri- 
cultural extension workers; to all county superintendients of 
schools and to all public libraries-in all some 12,000 were cir- 
cularized. As a result the Association on November 1st had 420 
members and had sold 143 copies of its proceedingts. From the 
interest evinced it is safe to say that the membership can be 
doubled during the coming year. 
Considerable delay was experienced in publishing the pro- 
ceedlings, due to inadequate reporting and the consequent neces- 
sity of asking some of the speakers to .write their papers and on 
account of a considerable amount of correspondence necessary in 
summarizing the report of the committee on the objectives of 
country life. The proceedings were distributed early in July and 
have been commended by many active in the country life move- 
ment. In many instances, classes in rural sociology are finding the 
proceedings most useful for a reference text. 
The expenses of the Association during the year have been met 
through the receipts for memberships and the sale of the proceed- 
ings. The financial statement below shows total receipts of 
$1,2 61.60, with an unpaid account for printing the proceedings of 
$250, which is covered by bills payable. The four hundred copies 
of the proceedings will undoubtedly be sold and may be consid- 
ered an asset of $800. The expenses of the present meeting will 
be paid from dues for the coming year. American Country Life Association 
217 
NATIONAL COUNTRY LIFE ASSOCIATION 
To Dwight Sanderson: 
Dr.-356 memberships at $3 $1,068.10 
121 copies proceedings 197.00 
$1,265.10 
Less two badi checks - 3.50 
$1,261.60 
Cr.-To bills paid $1,232.27 
To balance in bank 29.33 
$1,261.60 
Accounts Receivable: 
64 memberships at $3 $ 192.00 
12 copies proceedings at $2 24.00 
10 copies proceedings at $1.50 15.00 
• $ 231.00 
Assets: 
Cash in bank $ 29.33 
Accounts receivable 231.00 
$ 260.33 
Also 400 proceedings at $2 $ 800.00 
Accounts Payable to October 31, 1919: 
W. F. Humphrey, printer, $250 and 3 months' interest $ 253.75 
Accounts Payable Year Commencing November 1, 1919: 
Atkinson Press $ 81.75 
Andrus and Church 37.47 
Louise Williams 13.75 
Dwight Sanderson, expenses (estimated) 50.00 
Louise E. Smith (convention reported, estimated) .... 50.00 
Expenses local committee (estimated) 25.00 
Badges (estimated) 25.00 
$ 282.97 
The secretary has carried on a large correspondence in ar- 
ranging the personnel of the various committees of the conference 
and in advising with leaders in the various states as to the most 
desirable persons for state directors. The secretary has also un- 
dertaken to ascertain how many states have country life associa- 
tions or conferences or similar organizations. So far as cor- 
respondence shows, nine states and one province have such organi- 
zations. This list includes: 
Colorado Rural Life Association; Iowa Rural Life Confer- 
ence; Rural Organization Section of the Farm and Home Week, 
Kansas State Agricultural College; Massachusetts Federation for 
Rural Progress; Missouri Rural Life Conference; Ohio Rural Life 
Association; Rural Progress Association of Pennsylvania; Rural 
Welfare League of Texas; The Co-operative Educational Associa- 
tion of Virginia ;Rural Community Life Movement of Ontario. 
In a number of states there are federations of farmers' or- 
ganizations which often cover the country life field, though in 
some cases their emphasis is chiefly upon the technique of pro- 
duction and distribution. Such organizations occur in the fol- 
lowing states: 218 
American Country Life Association 
Idaho Federation of Farmers' Organizations; Maine Feder- 
ation of Agricultural Associations; Maryland Agricultural Society; 
Nebraska Organized Agriculture; State Farm Congress of Okla- 
homa; Federation of Farmers' Organizations of Washington. 
In a number of other states I am adivised that the State Farm 
Bureau is the chief organization concerned with country life in- 
terests. In several states the State Grange or the State Farmers' 
Union is the only organization nearly related to this field of ac- 
tivity. In several states rural life conferences or programs are 
held in connection with Farmers' Week and several state uni- 
versity summer schools, notably Virginia and North Carolina, have 
held country life conferences. Some of the agricultural colleges 
are holding rural conferences for ministers. It has been indicated 
in this correspondence that it is not the purpose of the National 
Country Life Association to form branches in any of the states, but 
that we do wish to promote the idea of some state-wide conference 
or informal organization which will bring together all of the 
organizations andl forces working for the betterment of country 
life within the various states. 
The executive committee held two meetings at Washington, 
D. C., on March 13 and 14 and on April 10, in connection with the 
meeting of the special committee in charge of the conference of 
national organizations engaged in rural social work, which has 
been reported by Dr. Thompson. As authorized by the confer- 
ence, the executive committee undertook the selection of a treasurer 
and was fortunate in enlisting the interest of Mr. Clarence Sears 
Kates, secretary of the Rural Progress Association of Pennsylvania, 
who has been active in promoting the country life movement in 
Pennsylvania for many years and who is heartily in sympathy with 
our purposes. Mrs. Virginia C. Meredith was compelled to resign 
as a member of the executive committee and we were fortunate 
in securing in her place Mrs. Dora Stockman, lecturer of the Michi- 
gan State Grange and recently elected a member of the Michigan 
State Board1 of Agriculture. A considerable correspondence has 
been carried on between members of the executive committee upon 
various matters throughout the year, and much time and thought 
have been given by them to the work and policies of this Asso- 
ciation. 
The secretary has had several requests to make addresses at 
various state conferences and to furnish speakers for state and local 
funds has prevented their acceptance, but it is clear mat the Asso- 
ciation should make some provision for meeting these demands in 
the future. It seems to me quite clear from the correspondence 
(vith our membership and with various national organizations car- 
rying on work in rural communities that this Association should 
publish a monthly or bi-monthly journal, which should be a clear- 
ing house of information for country life leadters throughout the 
country, calling to their attention the work undertaken and pro- 
jected by different national and state organizations, so that workers 
in every field may be informed as to what is being undertaken. 
There is also need for such a journal for the publication of ad- 
dresses and discussions which occur at various state conferences, 
farmers' week, etc., for which there is now no place tor publication. 
I have no question that such a journal can do more for advancing 
the country life movement in America than anything else this asso- 
ciation might undertake at the present time. Obviously, such an 
undertaking would require an employed editor and extensive cor- 
respondence. American Country Life Association 
219 
The program of the present conference would have been im- 
possible except for the efforts of Dr. W. S. Rankin, chairman of 
our committee on Rural Health and Sanitation, who has had gen- 
eral charge of the organization of the problem, and of Dr. Warren 
H. Wilson, who organized the Sunday program. The association is 
deeply indebted to Prof. E. C. Lindeman, of the Chicago Y. M. C. 
A. College, and to his local committee for effective and untiring 
work in local arrangements for the success of this conference. 
Respectfully submitted, 
DWIGHT SANDERSON, 
Executive Secretary. 
Statement of the Origin of the American Countri] 
Life Association 
The First National Country Life Conference held at Baltimore 
last January was attended by 175 persons from 30 states, who repre- 
sented 25 national organizations and five federal bureaus engaged 
in country life work. The conference was such a distinct success 
that the National Country Life Association was formed and a com- 
mittee on a permanent constitution was authorized to report at the 
next conference. The association now has nearly 5 00 members. 
The work .already accomplished by the association, which will be 
reported at the coming conference, demonstrates its usefulness for 
bringing together the various niational and state organizations and 
agencies engaged in the improvement of country life. The war 
and the social situation ensuing, has given a new vision of the 
importance and needs of country life. Many organizations and 
agencies are extending their work to rural communities. At such 
a time the conference of all these forces to consider their common 
problems and responsibilities is peculiarly valuable. The National 
Country Life Association has no administrative program of work. 
It aims "to facilitate discussion of the problems and objectives 
of country life and the means of their solution and attainment; to 
further the efforts and increase the efficiency of agencies and insti- 
tutions engaged in this field; to disseminate information calcu- 
lated to promote a better understanding of country life, and to aid 
in rural improvement." Constitution 
Preamble 
The American Country Life Association is maintained to facili- 
tate discussion of the problems and objectives in country life and the 
means of their solution and attainment; to further the efforts and 
increase the efficiency of persons, agencies, and institutions engaged 
in this field; and to disseminate information calculated to promote 
a better understandiing of country life and to aid in rural improve- 
ment. 
I. The Field 
The field of this Association is broadly that of rural social im- 
provement, embracing among others the following country life in- 
terests: 
1. The Rural Home: 
a. Physical, material, ethical, and spiritual aspects. 
b. Child training. 
c. Economics of the home. 
d. Home and community. 
e. Housing. 
f. Farm ownership and tenancy. 
2. Rural Education: 
a. The rural school. 
b. Agricultural schools and colleges. 
c. Educational extension; public libraries, continuation 
schools, agricultural and home economics extension, 
junior extension, Americanization. 
3. Morals andl Religion: 
a. ideals of personal and community life. 
b. The country church, allied religious organizations and 
societies promoting moral welfare. 
4. Rural Government: 
a. Local government: Efficiency, honesty, enlargement of 
function. 
b. Legislation, state and national, as affecting rural 
affairs. 
5. Communication, including such sociological problems as 
rural isolation. 
6. Rural Health and Sanitation: 
a. Personal hygiene. 
b. Public hygiene. 
8. Rural Recreation. 
a. Play life of the young. 
'b. Sociable life of adults. 
8. Rural Charities and Corrections. 
9. Country Planning; planning roads, buildings, parks and 
other public areas, etc. 
220 American Country Life Association 
221 
The Association exists to assemble and integrate the active 
workers andi forces in the country life field for the accomplishment 
of the purposes stated in the preamble. It invites executives and 
other representatives of national, state and local organizations 
working in any part of its field. Any person interested in its pro- 
gram may become a member on the payment of the membership 
fee. National, state, district and local associations or conferences 
may become affiliated with the American Country Life Association 
by vote of the Association on the recommendation of its executive 
committee. 
II. Membership 
III. Officers 
1. The officers of the Association shall be a President, a 
First and a Second Vice-President, a Treasurer, an Executive Secre- 
tary and such Assistant 'Secretaries as may be needed; also a 
Director from each state and territory in the United States and one 
from the District olf Columbia. 
2. The President and the Vice-Presidents shall be elected 
annually by the Association. The Executive Committee shall ap- 
point the Treasurer and the Secretaries. In each state having a 
state-wide affiliated organization the State Director shall be chosen 
by the Executive Committee of such affiliated body. In other 
states the respective directors shall be elected by the membership 
in those states on the nomination of the Executive Committee of 
the Association, except that any person who is nominated by seven 
members in a state shall also be placed on the ballot. In case any 
state fails to designate a director, the Executive Committee of the 
Association may, at its discretion, appoint such director provision- 
ally. The term of the State Director shall be one year. 
IV. Committees 
1. The Executive Committee shall consist of the President, 
the Vice-Presidents and six additional members elected by the 
Association, two each year for a period1 of three years, vacancies to 
be filled in the same manner. The Treasurer and the Executive 
Secretary shall sit with the Executive Committee. In the interval 
between meetings olf the Association the Executive Committee shall 
possess the full powers of the Association unless otherwise dele- 
gated or reserved. The President .shall ibe ex-officio Chairman of 
the Committee. 
2. There shall be such standing and special committees as 
the By-Laws provide or as may 'be voted by the Association. 
V. Meetings 
The American Country Life Association shall convene an- 
nually at a time and place to be chosen by the Executive Committee. 
Additional meetings may be ordered! by the Association or called 
by the Executive Committee. The Executive Committee shall be 
responsible for the program for meetings. 222 
American Country Life Association 
The Constitution and the By-Laws may be amended ^y a two- 
thirds vote of the members present at any regularly called meet- 
ing of the Association, provided that any proposed amendment 
shall have been presented to the Executive Committee for con- 
sideration and report prior to action thereon by the Association. 
VI. Amendments 
BY-LAWS 
I. Membership Fees 
1. The annual membership fees shall be as follows: In- 
dividual memberships; regular, $3; contributing, $10; supporting, 
$25-$100; institutional co-operating membership, $100, $250, 
$500, $1,000. Membership entitles the holder to receive all of- 
ficial publications of the Association, including a copy of the pro- 
ceedings of the Association. 
2. The Executive Committee may accept donations for the 
purposes oif the Association. 
H. Responsibilities of Officers 
1. The President shall be Chairman ex-officio of the Execu- 
tive Committee. Unless otherwise provided' by the Association or 
the Executive Committee, he shall appoint all standing and 
special committees. 
2. The First Vice-President shall discharge the duties of the 
President in the absence of the latter or in the event of his inability 
to function. 
3. 'The Executive Secretary shall be executive officer of the 
Association. He shall conduct the business of the Association as 
authorized by the Association or its Executive Committee, arrange 
for the annual meeting and such special meetings as may be called, 
edit the publications of the Association, develop the membership, 
and otherwise promote the interests and the 'work of the Associa- 
tion. He shall be responsible to the Executive Committee, by whom 
he is chosen, and he may receive such compensation and be pro- 
vided with such clerical and other assistance as the Executive Com- 
mittee shall authorize. 
4. The Treasurer shall he responsible for the finances of 
the Association and shall disburse funds on the authorization of 
the Executive Committee. The Executive Committee may, at its 
discretion, designate the bank in which the Treasurer shall deposit 
the funds oif the Association, and it may require him to give bond 
sufficient to cover the deposits of the Association, the expense of 
the bond being a charge against the funds of the Association. 
1. The following standing committees are provided: 
a. Committee on the Rural Home. 
b. Committee on Rural Education. 
c. Committee on 'Morals and Religion. 
d. Committee on Rural Government. 
e. Committee on Communication. 
f. Committee on Rural Health and Sanitation. 
g. Committee on Rural Recreation. 
m. Committees American Country Life Association 
223 
h. Committee on Rural Charities and Corrections. 
i. Committee on Country Planning. 
j. Committee on the Teaching of Rural Sociology in 
Schools and Colleges. 
k. Committee on Investigation of Rural School Problems. 
1. Committee on the Enlistment and Training of Coun- 
try Life Leaders. 
m. Committee on Public Information. 
n. Committee on Country Life Organization. 
o. Committee on International Relations of the Country 
Life Movement. 
p. Committee on the Economic Relations of Country Life 
Affairs. 
The membership of each of the foregoing committees shall be 
not less than five persons. 
2. The Auditing Committee shall be elected at the annual 
business session. 
3. The Executive Committee shall be the Committee on Reso- 
lutions. All resolutions introduced at meetings of the Association 
shall first be referred to this Committee for consideration and 
recommendation before being diebated. 
4. The Executive Committee may appoint a local Committee 
on Arrangements for the meetings of the Association. 
IV. Election of Officers 
A Committee on Nominations, consisting of not less than five 
persons, shall be appointed by the President not later than six 
months after the adjournment -of the annual meeting. No officer 
of the conference or member of the Executive Committee shall be 
eligible to appointment to this Committee. This Committee shall 
prepare a list of nominations-one or more for each office-for the 
officers and members of the Executive Committee to be elected by 
the Association. It shall include in the list of nominations any 
names proposed by at least 20 members of the Association, the 
latter nominations being so designated. This Committee shall sub- 
mit its nominations to the Association on the first day of the annual 
meeting. Election shall be by ballot at the business session. A 
majority vote for any candidate shall constitute election. 
V. Relations with Kindred Bodies 
The Executive Committee is empowered to invite other societies 
having similar or related aims and interests to meet at the same 
time and place as the American Country iLife Association, and may 
arrange joint sessions as desired. Any proposal for formal affilia- 
tion with other bodies shall be by vote of the Association after 
consideration by the Executive Committee. 
VI. Business Meeting 
There shall be at least one business session at every regular 
meeting. The time of this session shall be announced in the call 
for the annual meeting. Election of officers shall take place at the 
announced business session. In matters of business a majority 
vote shall prevail. 224 
American Country Life Association 
Members whose dues have been paid for the current year are 
entitled) to vote. 
VH. Voting 
VIII. Quorum 
Twenty-five voting members shall constitute a quorum at any 
regularly called business session. Program of the Second Annual Conference of the 
American Country Life Association 
All Sessions of the Conference Were Held in the Red Room of the 
La Salle Hotel, Chicago, Illinois, November 8-11, 1919 
SATURDAY, NOVEMBER 8 
9 a. m.-Committee Meetings. 
10 a. m. 
1. The Nature of the More Important Rural Physical Handicaps. 
Dr. Oscar Dowling, (President Louisiana State Board of Health, 
New Orleans. 
2. A Successful Experience with County Health Departments. 
Dr. K. E. Miller, U. S. Public Health Service, Washington. 
3. The School and Rural Health. Mrs. Josephine Corliss Preston, 
President National Education Association and Superintendent 
of Public Instruction, State of Washington. 
2 p. m First Steps Toward the Improvement of Rural Health. 
1. Public Health in Rural Communities. Dr. Geo. E. Vincent, 
President Rockefeller Foundation. 
2. Participation and Co-operation of Governments on the Federal 
Aid Extension Principle in the Improvement of Rural Health. 
Hon. A. F. Lever, Member of U. S. Congress from South Caro- 
lina, Washington, D. C. 
8 p. m. 
1. President's Address. President K. L. Butterfield, Amherst, 
Mass. 
2. Relation of Health to Human Progress. Dr. Eugene L. Fis-k, 
Director Life Extension Institute, New York City. 
3. Rural Public Health Nursing. Miss Elizabeth Fox, Bureau 
of Public Health Nursing, American Red Cross, Washington. 
4. The Need and Some Suggestions for Supplying Hospital 
Facilities for Rural People. Dr. J. J. Ross, Middlebury, Vt. 
SUNDAY, NOVEMBER 9 
3 p. m.-General Session. Theme: "The Church and Rural Health. 
1. The Church's Responsibility for Rural Health. Report of 
the Committee on Morals and Religion. Dr. Warren H. Wil- 
son, Chairman. 
2. The Relation of Rural Health to Religion and Morality. Rev. 
William C. Covert, D. D., First Presbyterian Church, Chicago. 
3. An Adventure in Rural Health Service in Minnesota. Miss 
Amalia M. Bengtson, County Superintendent of Schools, 
Olivia, Minn. 
4. The Red Cross and Rural Health. Miss Elizabeth Fox, Bu- 
reau of Public Health Nursing, American Red Cross, Wash- 
ington, D. C. 
225 226 
American Country Life Association 
Members of the conference are urged to attend! the services 
of Chicago churches. A number of these churches have arranged 
to present the general theme of Health and its relationship to the 
Church. The following churches have made definite plans for the 
Sunday evening service: 
Pres. K. L. Butterfield, Hyde Park Baptist Church, 5 600 Wood- 
land Avenue. 
Dr. J. J. Ross, First Presbyterian Church 53rd and Black- 
stone Avenue. 
Prof. C. C. Taylor, Hyde Park Christian Church, 57th and 
University Avenue. 
Hon. A. F. Lever, St. James M. E. Church, 46th and Ellis 
Avenue. 
Dean A. R. Mann, Normal Park M. E. Church, 71st and Union 
Avenue. 
Dr. John Timothy Stone, Fourth Presbyterian Church, East 
Chestnut and N. Michigan Avenue. 
Prof. E. C. Branson, Arlington Heights Presbyterian Chruch. 
SUNDAY EVENING 
MONDAY, NOVEMBER 10 
8 a. m.-Executive Committee Breakfast. 
9 a. m.-Committee Meetings. 
10 a. m.-Committee Reports (15 minutes each) : 
1. Housing and Rural Health, Committee on Homemaking. Mrs. 
H. W. Calvin. 
2. Education and Rural Health, Committee on Education. Presi- 
dent H. W. Foght. 
3. Local Government and Rural Health, Committee on Local 
Government. Dr. E. C. Branson. 
4. Recreation and Rural Health, Committee on Recreation. Prof. 
E. C. Lindeman. 
5. Relations of Social Welfare Work to Rural Health, Committee 
on Charities and' Corrections. Miss H. Id'a Curry. 
6. The Administration of Rural Health Work, Committee on 
Rural Health and Sanitation. Dr. W. S. Rankin. 
2 p. m. 
Problems of Rural Organization 
1. Report o!f Committee on Country Life Organization. Prof. 
E. L. Morgan. 
2. Report of Special Committee in Charge of the Conference of 
National Organizations Engaged in Rural Social Work. Dr. 
C. W. Thompson, Washington. D. C. 
3. Discussion of above reports and general discussion of methods 
and agencies for rural community organization. 
4. Report of Committee on International Country Life Move- 
ment. President K. L. Butterfield. 
6 p. m.-Conference Dinner. The conference dinner was one of 
the features of the Baltimore meeting. Every member is urged 
to attend. Dinner will be served promptly at 6:00 p. m., in the 
Red Room of the La Salle Hotel. Toastmaster: Dean Shailer 
Mathews, University of Chicago. The business session of the 
association will follow the conference dinner program. Tickets: 
$2.00. Reservations should be made on Saturday. 
8 p. m.-Business Session. 
Secretary's Report. 
Report of Committee on Constitution. Dean A. R. Mann. 
Report of Committee on Finance. 
Report of Committee on Nominations and Election of Officers. American Country Life Association 
227 
TUESDAY, NOVEMBER 11 
2 p. m.-Joint meeting with American Farm Economic Associa- 
tion at Auditorium Hotel. 
Address by Dr. Clarence Poe, Editor of the "Progressive 
Farmer," Raleigh, N. C. 
Address, "The Human Side of Farm, Economy," Prof. C. J. 
Galpin. In charge Rural Life Studies, Office of Farm Man- 
agement, U. S. Department of Agriculture. 
Informal discussion. 
Committee in Charge of Local Arrangements 
CONFERENCE COMMITTEES 
E. J. Tobin, Superintendent of Schools, Cook County. 
P. G. Holden, International Harvester Company. 
J. M. Artman, University of Chicago. 
C. V. Gregory, Prairie Farmer, Chicago. 
Leverett Thompson, Chicago. 
R. E. Hieronymous, University of Illinois, Urbana. 
E. C. Lindeman, Y. M. C. A. College, Chicago. 
1. Committee on Health and Sanitation. 
Chairman-Dr. W. S. Rankin, Secretary State Board of Health, 
Raleigh, N. C. 
Dr. S. J. Crumlbine, Secretary State Board of Health, Topeka, 
Kansas. 
Dr. Taliaferro Clark, U. S. Public Health Service, Washing- 
ton, D. C. 
Dr. John A. Ferrell, International Health Board, New York 
City. 
Dr. Clarence Poe, Editor "Progressive Farmer," Raleigh, N. C. 
Hon. A. F. Lever, Federal Farm Loan Board, Washington, D. C. 
Miss Ella Phillips Crandall, Secretary Public Health Nursing 
Association, New York City. 
Harry E. Gardner, Lecturer Massachusetts State Grange, 
Blackstone, Mass. 
2. Committee on Homemaking. 
Chairman-Mrs. Henrietta W. Calvin, U. S. Bureau of Educa- 
tion, Washington, D. C. 
Dr. Georgia L. White, Adviser of Women, Cornell University, 
Ithaca, N. Y. 
Dr. D. B. Johnson, President Winthrop Normal College, Rock 
* Hill, S. C. 
Miss Florence E. Ward, States Relations Service, U. S. Depart- 
ment of Agriculture, Washington, D. C. 
Miss Mary Sweeney, Lexington, Ky. 
Miss Mary E. Creswell, Athens, Ga. 
Mrs. Nellie Kedzie Jones, Madison, Wis. 
Miss Harriet Mason, Cleveland, Ohio. 
Miss Mary Garing, National Y. W. C. A., New York City. 
Mrs. Hannah Mackay Lyons, Oxford, Pa. 
3. Committee on Means of Rural Education. 
Chairman-H. W. Foght, President Normal and Industrial 
School, Aberdeen, S. D. 228 
American Country Life Association 
A. Rural Elementary Education and Junior Extension 
Chairman-Miss Mahe! Carney, Teachers College, Columbia 
University, New York City. 
Mr. L. B. Sipple, Head Department of Rural Education, State 
Normal School, Kearney, Neb. 
Mrs. Marie Turner Harvey, Director Porter School, Kirks- 
ville, Mo. 
Mr. O. H. Benson, States Relations Service, U. S. Department 
of Agriculture, Washington, D. C. 
Mr. W. J. Thompson, Master Maine State Grange, South 
China, Me. 
Mrs. Hence Orme, President Indiana Parent-Teachers' Associa- 
tion, R. F. D., Indianapolis, Ind. 
B. Rural High Schools. 
Chairman-Dr. Milo H. Hillegas, Commissioner of Education, 
for Vermont. 
Mr. E. C. Higby, Lawrenceville, N. J. 
Miss Minnie Jean Nielson, State Superintendent of Education, 
Bismarck, N. D. 
Mr. Mosiah Hall, State High School Inspector, Salt Lake City. 
Utah. 
Mr. M. S. Pittman, Head Rural School Department, State Nor 
mal School, Monmouth, Ore. 
C. Agricultural Education. 
Chairman-George A. Works, Professor Rural Education, Cor- 
nell University, Ithaca, N. Y. 
C. D. Jarvis, U. IS. Bureau of Education, Washington, D. C. 
Prof. W. S. Taylor, State College, Pa. 
Prof. C. J. Sargent, Port Collins, Colo. 
Dr. G. W. Wilson, Department of Agricultural Education, 
Iowa State College, Ames, Iowa. 
Prof. H. C. Price, Newark, Ohio. 
D. Education in Homemaking. 
Chairman-Miss Edna N. White, Head Department of Home 
Economics, Ohio State University, Columbus, Ohio. 
Miss Carrie A. Lyford, Department of Home Economics, Hamp- 
ton Institute, Virginia. 
Miss Nell Spensley, Head Department of Home Economics, 
Northern Normal and Industrial School, Aberdeen, S. D. 
Miss Ellen C. Lombard, Division of Home Education, Bureau 
of Education, Washington, D. C. 
Miss Lillian Johnson, Memphis, Tenn. 
E. Adult Education. 
Mr. M. M. Guhin, State Director of Americanization, Pierre, 
South Dakota. 
Mrs. Cora Wilson Stewart, President Kentucky Illiteracy Com- 
mission, Frankfort, Ky. 
Mr. John Conway, Assistant State Superintendent of Schools, 
Sante Fe, N. M. 
F. Extension Education. 
Chairman-Prof. A. B. Graham, States Relations Service, U. S. 
Department of Agriculture, Washington, D. C, American Country Life Association 
229 
Mr. W. D. Hurd, Soil Improvement Committee, National Ferti- 
lizer Association, Postal Telegraph Building, Chicago, Ill. 
Miss Marion Hepworth, State Leader Home Demonstration 
Agents, Morgantown, W. Va. 
Chester H. Gray, President Missouri Federation of Farm Bu- 
reaus, Nevada, Mo. 
Miss Neale S. Knowles, Ames, Iowa. 
G. Library Education. 
Chairman-Dr. John D. Wolcott, Librarian U. S. Bureau of 
Education, Washington, D. C. 
Miss Mary L. Titcomb, Librarian, Washington Free Library, 
Hagerstown, Md. 
Mrs. Edward R. Blanton, Secretary North Carolina Library 
Commission, Raleigh, N. C. 
Morton J. Ferguson, State Librarian, Sacramento, California. 
Harriet C. Long, Brumback Library, Van Wert, Ohio. 
Sara Askew, State Library, Trenton, N. J. 
4. Committee on Rural Government and Legislation. 
Chairman-Dr. E. C. Branson, Kenan Professor of Rural Social 
Science, University of North Carolina, Chapel Hill, N. C. 
Dr. W. O. Scroggs, Louisiana State University, Baton Rouge, La. 
Dr. John A. Fairlie, University of Illinois, Urbana, Ill. 
W. T. Creasy, Secretary National Dairy Union, Catawissa, Pa. 
B. Needham, Master Kansas State Grange, Lane, Kansas. 
Mrs. Josephine Corliss Preston, Superintendent Public Instruc- 
tion, Olympia, Wash. 
H. W. Jeffers, Plainsboro, N. J. 
L. J. Taber, Master Ohio State Grange, Barnsville, Ohio. 
Prof. C. J. Galpin, Office of Farm Movement, U. S. Depart- 
ment of Agriculture, Washington, D. C. 
5- Committee on Rural Charities and Corrections^ 
Chairman-Miss H. Ida Curry, State Charities Aid Association, 
New York City. 
C. C. Carstens, General Secretary Massachusetts S. P. C. C., 
Boston, Mass. 
Wm. W. Hobson, Director Children's Bureau, State Board of 
Control, St. Paul, Minn. 
W. C. Crosby, Executive Secretary Bureau of Community Serv- 
ice, Raleigh, N. C. 
J. Byron Deacon, Director General Department of Civilian Re- 
lief, American Red Cross, Washington, D. C. 
Judge Samuel D. Murphy, Juvenile Court, Mobile, Alabama. 
Miss Mabel Brown Ellis, National Child Labor Committee, 
New York City. 
Miss Sarah A. Howell, Extension Division, University of Iowa, 
Iowa City, Iowa. 
6. Committee on Recreation and Sociable Life. 
Chairman-'Prof. E. C. Lindeman, Y. M. C. A. College, Chicago, 
Illinois. 
Geo. E. Farrell, Hamden County Improvement League, Spring- 
field, Mass. 
Miss Ruth Sherburne, Recreation Association of America, New 
York City. 230 
American Country Life Association 
Prof. Geo. E. Johnson, Harvard University, Cambridge, Mass. 
Dr. Wm. Burdick, American Physical Education Association, 
McCoy Hall, Baltimore, Md. 
J. Sterling Moran, Community Motion Picture Bureau, At- 
lanta, Ga. 
Miss Constance D. MacKay, Community Service, Inc., New 
York City. 
Prof. A. G. Arvold, Agricultural College, N. D. 
Miss Leonarda Goss, Editor "Farmers' Wife," St. Paul, Minn. 
Prof. Peter Dykema, University of Wisconsin, Madison, Wis. 
Miss Clarinda Richards, National Y. W. C. A., New York City. 
Mrs. J. H. Patterson, College Park, Md. 
C. Samuel Langdon, Hulbbardston, Mich. 
Dwight Drew, County Work Department, International Com- 
mittee Y. M. C. A., New York City. 
Geo. W. Oakley, Boy Scouts of America, New York City. 
Chas. E. Gibbons, National Child Labor Committee, New York 
City. 
7. Committee on Country Planning. 
Chairman-Prof. Frank A. Waugh, Massachusetts Agricul- 
tural College. 
Prof. Phillip H. Elwood, Jr., Ohio State University, Colum- 
bus, Ohio. 
Prof. John W. Gregg, University of California, Berkeley, Cal. 
Prof. Arthur W. Cowe'll, State College, Pa. 
Prof. Frank H. Culley, Iowa State College, Ames, Iowa. 
Dr. Wilhelm Miller, Stevens Building, Detroit, Mich. 
Geo. B. Dealey, Manager "Dallas News," Dallas, Texas. 
Dr. Elwood Mead, University of California, Berkeley, Cal. 
8. Committee on Morals and Religion. 
Chairman-Dr. Warren H. Wilson, Presbyterian Board of Home 
Missions, 15 6 Fifth Ave., New York City. 
A. Co-operation of Churches. 
Rev. Edmund de S. Brunner, Secretary Rural Section, Inter- 
church World Movement, 894 Broadway, New York City. 
Rev. Roy B. Guild, Federal Council of Churches, 105 East 
22nd street, New York City. 
Rev. Edwin Earp, Drew Theological Seminary, Madison, N. J. 
Rew. Alfred Williams Anthony, 15 6 Fifth Ave., New York City. 
Rev. Rolvix Harlan, Secretary Rural Life Work, Am. Baptist 
Publication Society, 1701 Chestnut St., Philadelphia, Pa. 
B. Moral and Religious Education. 
Dr. Warren H. Wilson, 156 Fifth Ave., New York City. 
Prof. Allaa Hoben, Carleton College, Northfield, Minn. 
Miss Martha E. Robison, Bloomsberg, Pa. 
Rev. Chas. M. McConnell, Lakeville, Ohio. 
Miss Lavina Tailman, Teachers College, New York City. 
C. J. Tyson, Floradale, Pa. 
C. Allies of the Church. 
Dr. A. E. Roberts, County Work Secretary, International Com- 
mittee, Y. M. C. A., 3 47 Madison Ave., New York City. 
Alva Agee, Secretary State Board of Agriculture, Trenton, N. J. American Country Life Association 
231 
Wm. H. Kendrick, Agricultural Extension Department, West 
Virginia University, Morgantown, W. Va. 
John Engel, Secretary Kansas Sunday School Association, 
Abilene, Kansas. 
Miss Kate Logan, Secretary Town and County Work, Y. W. 
C. A., 600 Lexington, Ave., New York City. 
Lorne W. Barclay, Educational Director, Boy Scouts of 
America, 200 Fifth Ave., New York City. 
9. Committee on Means of Communication. 
Chairman-Dr. John M. Gillette, University of North Dakota, 
Grand Forks, N. D. 
Dr. L. L. Barnard, University of Minnesota, Minneapolis, Minn. 
Prof. E. S. Bogardus, University of Southern California, Los 
Angeles, Cal. 
Prof. W. O. Hedrick, East Lansing, Mich. 
Prof. Scott E. W. Bedford, University of Chicago, Chicago, Ill. 
Prof. T. R. Agg, Iowa State College, Ames, Iowa. 
10. Committee on Investigation of Rural Social Problems. 
Chairman-Prof. C. J. Galpin, Office of Farm Management, 
U. S. Department of Agriculture, Washington, D. C. 
Dr. Paul L. Vogt, Methodist Episcopal Board of Home Mis- 
sions, Philadelphia, Pa. 
Prof. W. J. Campbell, Y. M. C. A. College, Springfield, Mass. 
H. N. Morse, Interchurch Worldl Movement, 89 4 Broadway, 
New York City. 
Miss M. F. Byington, American Red Cross, Washington, D. C. 
Dr. Anna R. Rude, Division of Hygiene, Children's Bureau, 
Washington, D. C. 
Dr. L. L. Lumsden, Office of Rural Sanitation, Bureau of Public 
Health Service, Washington, D. C. 
11. Committee on Teaching of Rural Sociology. 
Chairman-Dean Ernest R. Groves, New Hampshire College, 
Durham, N. H. 
Dean Howard W. Odum, Emory University, Atlanta, Ga. 
Prof. John Phelan, Massachusetts Agricultural College, Am- 
herst, Mass. 
Prof. Mark Burrows, sState Normal School, Kirksville, Mo. 
Henry Israel, Editor "Rural Manhood," International Com- 
mittee, Y. M. C. A., New York City. 
Prof. C. C. Taylor, University of Missouri, Columbia, Mo. 
Prof. Geo. H. Von Tungeln, Iowa State College, Ames, Iowa. 
12. Committee on International Country Life Movement. 
Chairman-'President Kenyon L. Butterfield, Massachusetts 
Agricultural College, Amherst, Mass. 
Dr. IL. H. Bailey, Ithaca, N. Y. 
Dean Thomas F. Hunt, College of Agriculture, University of 
California, Berkeley, Cal. 
Dean A. R. Mann, New York State College of Agriculture, 
Ithaca, N. Y. 
Dr. Geo. E. Vincent, President Rockefeller Foundation, 61 
Broadway, New York City. 
Oliver Wilson, Master' National Grange, Peoria, Illinois. 
C. W. Barrett, President National Farmers' Educational and 
Co-operative Union, Union City, Ga. 232 
American Country Life Association 
13. Committee on Rural Leadership Training. 
Chairman--Prof. W. J. Campbell, Y. M. C. A. College, Spring- 
field, Mass. 
Prof. Paul L. Vogt, Rural Work Dept., Methodist Episcopal 
Church, 1701 Arch St., Philadelphia, Pa. 
Prof. John Phelan, Massachusetts Agricultural College, Am- 
herst, Mass. 
Prof. Ernest Burham, State Normal College, Kalamazoo, Mich. 
John Sherley, Eastern States Agricultural and Industrial Ex- 
position, Box 1482, Springfield, Mass. 
Prof. G. Walter Fiske, Oberlin College, Oberlin, Ohio. 
Miss Anna M. Clark, National Y. W. C. A., New York City. 
Prof. L. O. Lantis, Ohio State University, Columbus, Ohio. 
14. Committee on Country Life Organization. 
Chairman--Prof. E. L. Morgan, Director Bureau of Rural Or- 
ganization, Department of Civilian Relief, American Red 
Cross, Washington, D. C. ' 
Prof. Walter Burr, Kansas Agricultural College, Manhattan, 
Kansas. 
Miss Ida H. Curry, State Aid Association, New York City. 
Prof. T. C. Atkeson, Chairman Executive Committee, National 
Grange, Washington, D. C. 
O. E. Bradfute, President Ohio Federation of Farm Bureaus, 
Xenia, Ohio. 
Nat T. Frame, Director Agricultural Extension, Morgantown, 
W. Va. 
C. W. Lyman, Secretary National Boardi of Farm Organizations, 
Washington, D. C. 
John R. Boardman, Boy Scouts of America, New York City. 
Dr. Henry E. Jackson, U. iS. Bureau of Education, Washing- 
ton, D. C. 
Dr. Bradford Knapp, States Relations Service, U. iS. Depart- 
ment of Agriculture, Washington, D. C. 
W. A. Lloyd, States Relations Service, U. S. Department of 
Agriculture, Washington, D. C. 
Mrs. H. J. Patterson, College Park, Md. 
15. Committee on Public Information. 
Chairman-Dr. L. H. Bailey, Ithaca, N. Y. 
Ray iStannard Baker, Amherst, Mass. 
Dean Eugene Davenport, College of Agriculture, University of 
Illinois, Urbana, Ill. 
C. V. Gregory, Editor "The Prairie Farmer," 223 W. Jackson 
Building, Chicago, Ill. 
C. P. J. Mooney, Editor "Commercial Appeal," Memphis, Tenn. 
Dr. Clarence Poe, Editor "Progressive Farmer," Raleigh, N. C. 
C. W. Pugsley, Editor, "The Nebraska Farmer," Lincoln, Neb. 
C. R. Titlow, Secretary Federal Land Bank, Baltimore, Md. 
Prof. Dwight Sanderson, New York State College of Agricul- 
ture, Ithaca, N. Y. National Country Life Association 
1919 Membership 
Alabama 
Duncan, L. N.-Auburn. 
Arkansas 
Barnett, John C.-iSouthern Trust Building, Little Rock. 
Bonslagel, Connie J.-324 ISouthern Trust Building, Little Rock. 
Critz, Hugh-Russellville. 
Mendenhall, Ruby-Home Demonstration Agent, Hamburg. 
California 
Bogardus, E. S.-1133 West 41st St., Los Angeles. 
Cassidy, Lysander-Federal Land Bank, Berkeley. 
Ellis, Willard D.-Federal Land Bank, Berkeley. 
Griffin, F. L.-College of Agriculture, University of California, Los 
Angeles. 
Mead', Elwood-University of California, Berkeley. 
Peixotto, Jessica B.--Cloyne Court, Berkeley. 
Powell, Grace -Sutton-800 California-Pacific Bldn., San Francisco. 
Robson, Mrs. Frederick T.-Hotel Shattuck, Berkeley. 
Roeding, Geo. C.-Fresno. 
Tribby, IM. A.-Home Demonstration Agent, Stockton. 
Bowei', Clark-iClilfton. 
Coen, B. F.,-Fort Collins. 
Douglas, Julia B.-Evergreen Pu'blic Library, Evergreen. 
French, H. T.-Extension Service, Fort Collins. 
Kirkpatrick, E. L.-Fort Lewis School, Hesperus. 
Sargent, C. G.-Fort Collins. 
Lewis, Geo. B.-Otis. 
Colorado 
Connecticut 
Baker, Heribert J.-Connecticut Agricultural College, Storrs. 
Keller, Roy E.-312 Thayei' Building, Norwich. 
Olmstead, Miss E. I.-P. O. Building, Danlbury. 
Russell, Mrs. Samuel, Jr.-Ridewood Farm, Middleton. 
Thienes, Elmer T.-b Haynes Street, Hartford. 
Delaware 
Grantham, A. E.-Delaware College Experiment Station, Newark 
Webb, Wesley-State Board of Agriculture, Dover. 
233 234 
American Country Life Association 
District of Columbia 
Benson, 0. H.-States Relations Service, U. S. Department of Agri- 
culture, Washington. 
Calvin, Mrs. Henrietta W.-Bureau of Education, Washington. 
Clark, Taliaferro-U. S. Public Health Service, Washington. 
Claxton, P. P.-U. S. Commissioner of Education, Washington. 
Dunn, A. W.-The Oakland Apartment, Washington. 
Fieser, James L.-1319 Floral St., N. W., Washington. 
Galpin, C. J.-Office of Farm Management, U. S. Department of 
Agriculture, Washington. 
Graham, A. B.-Office of Extension Work, N. & W., U. S. Depart- 
ment of Agriculture, Washingto.n. 
Jarvis, C. D.-U. S. Bureau of Education, Washington. 
Lathrop, C. D.-U. S. Bureau of Education, Washington. 
Lundberg, Emma O.-Apartment 703, The Woodward, Washington. 
Morgan, E. L.-American Red Cross, Washington. 
Peck, F. W.-Office of Farm Management, U. S. Department of 
Agriculture, Washington. 
Roberts, Edith A.-Office of Extension Work, N. & W., P. S. De- 
partment of Agriculture, Washington. 
Smith, C. B.-Office of Extension Work, N. & W., U. S. Depart- 
ment of Agriculture, Washington. 
Smith, Oliver-Forage Crops Investigations, U. S. Department of 
Agriculture, Washington. 
Steiner, Jesise Frederick-American Red Cross, Washington. 
Thompson, C. W.-Bureau of Markets, U. S. Department of Agri- 
culture, Washington. 
True, A. C.-States Relations Service, U. S. Department of Agri- 
culture, Washington. 
Ward, Florence E.-Office of Extension Work, N. & W., U. S. De- 
partment of Agriculture, Washington. 
Florida 
Harris, Agnes Ellen-Tallahassee. 
Layton, Harriette B.---Tallahassee. 
Sims, Newell L.-Gainesville. 
Georgia 
Garnett, Wm. E.-Athens. 
Hammond, Henry C.-82 5 Greene St., Augusta. 
Hubbell, Howard-1610 Candler Building, Atlanta. 
Moran, J. Sterling-146 Marietta St., Atlanta. 
Odum, H. W.-Emory University. 
Parry, Mrs. H. L.-43 College St., Decatur. 
Idaho 
Spencer, S. H.-Paris. 
Illinois 
Bane, Juliet Lita-University of Illinois, Urbana. 
Bill, Arthur J.-Bloomington. 
Davis, Julia A.-Suite 1404, 17 N. State St., Chicago. 
Dunlap, Mrs. H. M.--Savoy. American Country Life Association 
235 
Gillin, John Lewis-American Red Cross, 18 0 N. Wabash Ave., 
Chicago. 
Hieronymus, Robert E.-University of Illinois, Urbana. 
Kohl, F.-Centralia. 
Meebold, Louise-519 Scott St., Wheaton. 
Nolan, A. W.-University of Illinois, Urbana. 
Swan, Florence-Sterry Block, Pontiac. 
Wilson, Willis Ray-Prophetstown. 
Y. W. C. A., Town and Country Department-Suite 1404, 17 N. 
State St., Chicago. 
Lindeman, E. C.-Y. M. C. A. College, 5315 Drexel Ave., Chicago. 
Indiana 
Christie, G. I.-Purdue University, Lafayette. 
Clarke, V. V.-Plymouth. 
Cole, Orpha-Tipton. 
Coleman, T. A.-'Purdue University, Lafayette. 
Frier, G. M.-Purdue University, Lafayette. 
Johns, W. A.-College of Agriculture, University of Notre Dame 
Notre Dame. 
Kershner, Clarke B.-Franklin. 
Meredith, Mrs. Virginia C.-35 6 State St., West Lafayette. 
Orme, Mrs. Hence-Route D, Box 313, Indianapolis. 
Purdue University Library-Lafayette. 
Reed, G. L.-Box 213, Brookline. 
Sollenberger, J. J.-9 05 N. Wayne St., North Manchester. 
Y. M. C. A. College Library-5 315 Drexel Ave., Chicago. 
Iowa 
Baker, Rev. W. N.-iRembrandt. 
Chalice, Gilbert J.-West Branch. 
Cram, Fred D.-'Mason City. 
Howell, Sarah A.-State University o£ Iowa, Iowa City. 
Roberts, Jane E.-State University of Iowa, Iowa City. 
Reed, Ralph J.-518 Century Building, Des Moines. 
Samuelson, Agnes-Clarinda. 
Secor, Alson-"Successful Farming," Des Moines. 
Von Tungeln, Geo. H.-Iowa State College, Ames. 
Knowles, Neale S.-Ames. 
Kansas 
Burr, Walter-Hural Service Department, Kansas Agricultural Col 
lege, Manhattan. 
McCoy, Etta Joe-Girls' Industrial School, Beloit. 
Kentucky 
Crenshaw, John S.-County Board of Agriculture, Cadiz. 
Frost, W. G.-Berea College, Berea. 
Graham, Thomas Jackson-Lincoln Bank Building, Louisville. 
Hines, Edward W.-Intersouthern Building, Louisville. 
Stone, May-Hindman Settlement School, Hindman. 
Wolcott, Mrs. Helen Brown-3 38 Grosvenor Ave., Lexington. 
Louisiana 
Wyckoff, G. P.-Washington Artillery Hall, New Orleans. 236 
American Country Life Association 
Maine 
Adams, Frank S.--State Department of Agriculture, Augusta. 
Allan, H. A.-State House, Augusta. 
Platts, Catherine N.-University Inn, Orono. 
Webber, Elmer H.-Mt. Vernon. 
Berry, Mrs. Chas. M.-Landlover. 
Bomberger, F. B.-College Park. • 
Broome, E. W.-Rockville. 
Brown, Mrs. Edgar-'Lanham. 
Durdick, Wm.-Public Athletic League, McCoy Hall, Baltimore. 
Burroughs, E. S.-Clinton. 
Cooper, Clarence G.-Glencoe. 
Glenn, William Lindsay-Emmorton. 
Kellar, Venia M.-'State Home Demonstration Agent, College Park. 
Patterson, Mrs. H. J.-College Park. 
Schmidt, Margaret-College Park. 
Staley, Raymond E.-Hagerstown. 
Titlow, C. R.-Federal Land Bank, Baltimore. 
Van Hoesen, Fred J.-Rockville. 
Woods, A. F.-Maryland Agricultural College, College Park. 
Maryland 
Massachusetts 
Butterfield, K. L.-Amherst. 
Campbell, W. J.-Y. M. C. A. College, Springfield. 
Carstens, C. C.r-43 Mt. Vernon St., Boston. 
Comstock, Laura-84 N. Pleasant St., Amherst. 
Ladd, Mrs. Geo. S.-Sturbridge. 
Massachusetts Agricultural College Library-Amherst. 
Middlesex County Bureau of Agriculture and Home Economics-7 
Moody St., Waltham. 
Phelan, John-3 Mt. Pleasant, Amherst. 
Sherley, John-Eastern States Agricultural and Industrial Expo* 
sition, Springfield. 
Stimson, Rufus W.-State Board of Education, State House, Boston. 
Upton, R. M.-North Attleboro. 
Wheeler, Homer J.-92 State St., Boston. 
Willard, John D.-Massachusetts Agricultural College, Amherst. 
Michigan 
Burnham, Ernest-1532 Grand Ave., Kalamazoo. 
Cowles, Anna B.-East Lansing. 
Davis, Leslie M.-East Lansing. 
English, Mabel-Y. W. 0. A., Cadillac. 
Ford, Clifford M.-Centreville. 
Hadley, Theodosia-Western State Normal, Kalamazoo. 
Kelley, John-Mt. Pleasant. 
Kies, Glenn S.-Board of Education, Lansing. 
McGraw, Mrs. Wm. A.-Hotel Ponchartrain, Detroit. 
Mumford, Eben-East Lansing. 
Person, May M.- East Lansing. 
Sayles, Marie-1123 E. Kearsley St., Flint. 
Smith, Edna V.-Box 72 6, East Lansing . 
Stewart, Glen 0.-Town Hall, Dearborn. 
Turner, R. A.-East Lansing. American Country Life Association 
237 
Minnesota 
Bernard, L. L.-508 S. E. 7th St., Minneapolis. 
Black, John D.-University Farm, St. Paul. 
Foster, Rhoda-425 Northwestern National Life Bldg., Minneapolis. 
Hoben, Allan-Carleton College, Northfield. 
James, J. O.-Blue Earth. 
Jewel, D. B.-Grand Rapids. 
Munford, Edna-Y. W. C. A., Red Wing. 
Storm, A. V.-University Farm, St. Paul. 
Gaines, F. P.-Agricultural College. 
Rice, Nannie H.-Agricultural College. 
Wilson, R. A. N.-Batesville. 
Mississippi 
Missouri 
Blackburn, L. F.-Independence. 
Crow, Robert W.-Salem. 
Fidler, Thurba-511 E. Scott St., Kirksville. 
Gillum, W. W.-Barnett. 
Graham, Mrs. Clara E.-110 S. Virginia Ave., Charleston. 
Harvey, Mrs. Marie T.-Forter School, Kirksville. 
Johnson, F. L.-1413 Brockell Ave., Columbia. 
Kruse, Samuel Andrew-Cape Girardeau. 
Meyer, A. J.--College of Agriculture, Columbia. 
Root, Rosamond-First District Normal School, Kirksville. 
Ross, P. H.-Agricultural Building, Columbia. 
Taylor, A. W.-Bible College, Columbia. 
Taylor, C. C.-University of Missouri, Columbia. 
Cooley, F. S.-Bozeman. 
Cummings, F. L.-1007 W. Boulevard, Lewiston. 
Mendenhall, D. W.-City Hall, Glendive. 
Taylor, J. C.-723 South 6th Ave., Bozeman. 
Wilson, M. L.-Montana Agricultural College, Bozeman. 
Montana 
Nebraska 
Gilkeson, L. J.-Clay Center. 
Housel, N. A.--11th and Lake Sts., Madison. 
Nebraska Agricultural College-University Farm, Lincoln. 
Percival, Geo. A.-Box 93, Clay Center. 
Pugsley, C. W.-care "Nebraska Farmer," Lincolnton. 
Ream, J. D.-Broken Bow. 
Ruyle, W. L.-(Malcolm. 
Sipple, L. B.-State Normal School, Kearney. 
Smith, Hervey F.-954 Omaha National Bank Building, Omaha. 
Watson, H. D.-Kearney. 
New Hampshire 
Bushnell, A. W.-Gorham. 
Groves, Ernest R.-Durham. 238 
American Country Life Association 
Kendall, J. C.-Durham. 
Lorentz, D. E.-Y. M. C. A., Keene. 
Robinson, Earl P.-'County Agent Leader, Durham. 
New Jersey 
Agee, Alva-State Board of Agriculture, Trenton. 
Douglass, Ellwood-County Agricultural Agent, Freehold. 
Free Public Library-Newark. 
Hartnett, Margaret H.-448 Van Houten St., Paterson. 
Helyar, Frank G.-New Jersey State Agricultural College, New 
Brunswick. 
Higbie, Edgar C.-Lawrenceville. 
Hill, Raymond W.-Room 804, Broad Street Bank, Trenton. 
James, Lauretta P.-Court House, Trenton. 
Judd, E. T.-P. O. Bldg., Freehold. 
Reimer, R.-Palmyra. 
Sheppard, Elizabeth P.-3 41 Bellevue Ave., Trenton. 
Straw, Eunice-Freehold. 
Townsend, Wm. Porter-South Plainsfield. 
New Mexico 
Hollinger, E. C.-Clayton. 
New Mexico College of Agriculture and Mechanic Arts, Extension 
Service-State College. 
Yeaw, Fred F.-Roswell. 
New York 
Anthony, Alfred Williams-156 Fifth Ave., New York. 
Babcock, H. E.-College o,f Agriculture, Ithaca. 
Bailey, L. H.-Ithaca. 
Barclay, Lorne W.-200 Fifth Ave., New York. 
Barnes, L. C.-23 East 26th St., New York. 
Belden. S. B. D.-Franklin. 
Beckwith, Franklin H.-Ilion. 
Board, Samuel S.-69 Greenwich St., Hempstead, L. I. 
Boardman, John R.-200 Fifth Ave., New York. 
Bowman, LeRoy E.-War Camp Community Service, 1 Madison 
Ave., New York. 
Boynton, Anna D.-Fredonia. 
Braucher, H. S.-1 Madison Ave., New York. 
Bruner, Edlmund de S.-Interchurch World Movement, 894 Broad- 
way, New York. 
Burritt, M. C.-College of Agriculture. Ithaca. 
Cady, Mary L.-600 Lexington Ave., New York. 
Carney, Mabel-Teachers' College, Columbia University, New York. 
Chase, Daniel-603 Hudson Ave., Albany. 
Clark, Anna M.-600 Lexington Ave., New York. 
Columbia University Library-New York. 
Crosby, Dick J.-College of Agriculture. Ithaca. 
Curry, H. Ida-State Charities Aid Association, 105 East 22nd St., 
New York. 
Drew, Dwight C.-347 Madison Avenue. New York. 
Dunn, Fannie W.-Box 166, Teachers' College, New York. 
Eastman, E. Fred-Roslyn. 
Ellis, Mabel Brown-National Child Labor Committee, 105 East 
22nd St., New York. American Country Life Association 
239 
Elwood, Everett S.-'State Hospital Commission, Albany. 
Freer, Florence H.-College of Agriculture, Ithaca. 
Genung, Elizabeth F.-600 Lexington Avenue, New York. 
Guild, Roy B.-105 East 22nd St., New York. 
Harlan, Rolvix-23 East 26th St., New York. 
Head, Mabel-600 Lexington Ave., New York. 
Herring, Elizabeth-600 Lexington Ave., New York. 
Israel, Henry-347 Madison Ave., New York. 
Jones, Jennie C.-Paris. 
Lauman, G. N.-College of Agriculture, Ithaca. 
Logan, Kate-600 Lexington Ave., New York. 
Mann, A. R.-College of Agriculture, Ithaca. 
Mitchell, Mrs. Willis G.-Hudlson Falls. 
Morse, Hermann N.-156 Fifth Ave., New York. 
Oakley, Geo. W., Jr.-200 Fifth Ave., New York. 
Peabody, Elizabeth G.-Holland Patent. 
Penfield, Lida S.-Oswego State Normal, Oswego. 
Pincus, J. W.-care Alexander Hincuk & Co., 5 Beekman St., New 
York. 
Powlison, Chas. F.-70 Fifth Ave., New York. 
Richards, Clarinda-600 Lexington Ave., New York. 
Roberts, Albert E.-347 Madison Ave., New York. 
Sanderson, Dwight-College of Agriculture, Ithaca. 
Shenton, Herbert N.-'Columbia University, New York. 
Sherburne, Ruth-1 Madison Ave., New York. 
Speers, Mrs. James M.-600 Lexington Ave., New York. 
Strivings, S. L.-Castile. 
Thompson, Warren S.-College of Agriculture, Ithaca. 
Tucker, Gilbert M., Jr.-Rockhill Farm, Glenmont. 
Wallace, Mrs. Helen P.-1000 Park Ave., New York. 
Wells, Geo. Frederick-Poughquag. 
White, C. R.-Department of Farms and Markets, Albany 
White, George L.-1 Suage Ave., New York. 
Wilson, Warren H.-156 Fifth Ave., New York. 
Wilson, Mrs. Warren H.-416 West 122nd St., New York. 
Zimmer, E. R.-373 Front St., Oswego. 
North Carolina 
Akers, A. E.-Roanoke Rapids. 
Branson, E. C.-'Chapel Hill. 
Camp, W. R.-West Raleigh. 
Holman, Lydia-Altapass. 
Johnson, A. M.-Smithfield. 
Kilgore, B. W.-Raleigh. 
Mask, Homer H. B.-Raleigh. 
University of North Carolina, Rural Economics, Chapel Hill. 
Poe, Clarence-care "Progressive Farmer," Raleigh. 
Rankin, W. S.-State Boardi of Health, Raleigh. 
Rubinow, S. G.-Raleigh. 
Steward, Florence M.-Salisbury. 
North Dakota 
Arvold, Alfred G.-Agricultural College. 
Curtiss, Blaine-1106 8th St., N., Fargo. 
Dickey, J. G.-254 5th St., W., Dickinson. 
Ford, E. C.-1017 7th St., N., Fargo. 
Gillette, John M.-University. 
Piche, J. Edward-La Moure. 240 
American Country Life Association 
Biery, C. J.-State Normal College, Bowling Green. 
Borror, P. M.-102 West 5th St., Marysville. 
Condon, Katherine E.-905 First National Bank Bldg., Cincinnati, 
Croxton, Fred C.-1010 Hartman Bldg., Columbus. 
Falconer, J. L-College of Agriculture, Columbus. 
Fiske, G. Walter-Oberlin. 
Gibbons, C. E.-272 9 Willard! Ave., Cincinnati. 
Green, John D.-R. F. D. No. 5, Mt. Gilead. 
Harris, Thomas L.--Miami University, Oxford. 
Jones, Laura M.-9 05 First National Bank Bldg., Cincinnati. 
Lantis, L. O.-College of Agriculture, Ohio State University, 
Columbus. 
McGuire, Olive-36 South Third St., Columbus. 
McNutt, Matthew B.-Wooster. 
Sellers, D. H.-Court House, Marysville. 
Shambaugh, Frances A.-Y. W. C. A., Van Wert. 
Thompson, W. O.-Ohio State University, Columbus. 
Vivian, Alfred-College of Agriculture, Ohio State University, 
Columbus. 
White, Edna N.-Home Economics Department, Ohio State College 
Columbus. 
Ohio 
Blocker, R. C.-Coalgate. 
Dickerson, E.-Box 177, Pryor. 
McCuistion, S. M.-Pawhuska. 
Manchester, Mrs. R. D.-Cold Springs. 
Shotwell, E. B.-(Stillwater. 
Talley, O. W.-Hobart. 
Oklahoma 
Fitts, Edward B.-Oregon Agricultural College, Corvallis. 
Hurd, C. J.-Federal Bldg., Rosebury. 
Maris, Paul V.-135 North 26t'h St., Corvallis. 
Powell, P. O.-Monmouth. 
Rudd, John H.-Room 305 Y. M. C. A., Portland. 
Oregon 
Pennsylvania 
Bressler, Raymond G.-State College. 
Creasy, William T.-'Catawissa. 
Essick, Frank C.-Jerseytown. 
Foresman, Carolina-630 Witherspoon Bldg., PhiladeTpnia. 
Holcomb, Geo. N.-509 Collingdale Ave., Collingdale. 
Horst, Miles, R. F. D. No. 1, Lebanon. 
McConaughy, James---1816 Chestnut St., Philadelphia. 
McKee, C. L.-147 LeMayne Ave., Washington. 
Moravian College Library-Bethlehem. 
Robison, Martha E.-Bloomsburg. 
Vogt, Paul L.-1701 Arch St., Philadelphia. 
Watts, R. L.-215 E. Foster Ave., State College. 
Rhode Island 
Edwards, Howard-Kingston, American Country Life Association 
241 
South Carolina 
Brock, J. A. J.-904 National Loan and Exchange Bank Bldg., 
Columbia. 
Coker, David R.-Hartsville. 
Gee, Wilson-Clemson College. 
Hubert, Benjamin F.-State A. and M. College, Orangeburg. 
Johnson, D. B.-'Rock Hill. 
Johnson, Henry S.-Aiken. 
Lanham, T. B.-Y. M. C. A., Columbia. 
South Dakota 
The Bushnell Co., Aberdeen. 
Foght, H. W.-Aberdeen. 
Yankton College Library-Yankton. 
Tennessee 
Frost, Norman-Peabody College for Teachers, Nashville. 
Morgan, H. A.-College of Agriculture, Knoxville. 
Shelley, Flora D.-1220 18th St., Nashville. 
Texas 
Blanto, Annie Webb-.State Department of Education, Austin 
Clark, F. B.-Texas A. and M. College, College Station. 
Goddard, C. W.-State Health Department, Austin. 
Gruss, E. W.-811 24th St., Galveston. 
Hathorn, William E.-Mt. Pleasant. 
McKnight, H. L.-Texas A. and M. College, College Station. 
Neale, Laura F.-College Station. 
Parsons, Mary R.-307 Scollard Bldg., Dallas. 
Smith, R. L.-109 Bridge St., Waco. 
Vadien, Mrs. Bertha L.-R. F. D. No. 5, Sherman. 
Utah 
Caine, John T.,111-Agricultural College, Logan. 
Harris, F. S.--Logan. 
Hendricks, Geo. B.-10 8 West 1st St., North, Logan. 
Peterhon, E. G.-College Hill, Logan. 
Farrar, H. A.-Main St., Vergennes. 
Gary, Marion-Rutland. 
Vermont 
Agnew, Ella G.-Blacksburg. 
Buford, Mrs. Mary E. W.-Route No. 3, Box 13, Pulaski. 
Burruss, Julian A.-Harrisonburg. 
Davis, Jackson-Chamber of Commerce Bldg., Richmond. 
Davis, Mrs. M. M.-Extension Division, Blacksburg. 
Eason, Thomas D.-Richmond. 
Harrison, Mrs. H. F.-The Plains. 
Jones, J. M.-Blacksburg. 
Koiner, G. W.-Richmond. 
McConnell, J. P.-East Radford. 
Virginia 242 
American Country Life Association 
Montgomery, J. H.-Richmond. 
Mumford, Mrs. B. B.-503 E. Grace St., Richmond. 
Quisenberfy, James H.-Frederick Hall. 
School of Social Work and Public Health-1112 Capitol St., Rich- 
mond. 
Starnes, A. M.-Blacksburg. 
Stubbs, Florence H.-500 High St., Farmville. 
Wayland, John W.-State Normal School, Harrisonburg. 
Wright, Arthur D.-Box 15, Richmond. 
Washington 
Beach, W. G.-Pullman. 
Bever, James--614 Ivy St., Bellingham. 
Diehl, Lois-312 6 Arcade Bldg., Seattle. 
Holland, E. 0.--Pullman. 
Hupp, E. E.-Newport. 
Keeler, Delia L.-2101 H Street, Bellingham. 
Klemme, E. J.-601 Garden St., Bellingham. 
Thornber, W. S.-301 Colorado St., Pullman. 
State College of Washington, Experiment Station-Pullman. 
West Virginia 
Anderson, C. Claude-13 Naomi St., Morgantown. 
Bristol, L. M.-Morgantown. 
Frame, Nat T.-Morgantown. 
Gore, Howard M.-Clarksburg. 
Hartley, Chas. H.-Morgantown. 
Hepworth, Marion-Morgantown. 
Marsh, J. F.-Charleston. 
Arnot, J. K.-815 Hyatt St., St. Janesville. 
Artman, O .C.-Y. M. C. A., Madison. 
Babcock, W. H.-321 Babcock St., Eau Claire. 
Bickel, Mrs. E. F.-6'5 Otter St., Oshkosh. 
Cooley, O. H.-Waukesha. 
Crothers, Geo. E.-Neillsville. 
Jones, S. Paul-2 07 Washington Ave., Mad'ison. 
Neale, Oscar W.-541 Main St., Stevens Point. 
Wisconsin Anti-Tuberculosis Association-417 Van Buren St., 
Milwaukee. 
Wisconsin 
Wyoming 
Elby, Harvey L.-University of Wyoming, Laramie. 
Walker, R. B.-care First Congregational Church, Sheridan. 
Canada 
Arnot, S. J.-Y. M. C. A., Halifax, Nova Scotia. 
Howard, Lester-205-232 Portage Ave., Winnipeg, Man. 
Knapp, F. P.-12 0 Bay St., Toronto, Ont. 
McIntosh, D. H.-West Summerland, B. C. 
Moore, Albert-299 Queen St., W., Toronto, Ont. 
Stotesbury, F. G.-Corbetton, Ont. 
Thornton, C. D.-7 08 Board of Trade, Vancouver, B. C. 
Yates, Mary-Box 277, Port Credit, Ont.