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Suggestions for Legislative Action
Pursuant to the provisions of section 12 of the Public Health Law, I have the honor to submit the following suggestions as to such legislative action as seems to me necessary for the better protection of life and health in this State:
Protection of Public Water Supplies
I would recommend that provision be made to enable this Department to exercise a constant supervision over the watersheds and the public water supplies of the State, the expenses incurred in supervision and inspection to be paid for by the municipalities or water companies owning or controlling such supplies.
I would also recommend legislation to simplify the present cumbersome procedure for the enforcement of the water rules made by this Department, and so to increase this Department’s authority that it may properly enforce these rules and require the installation of purification processes where such are necessary.
The Slaughter of Diseased Animals
The United States government regularly inspects all animals slaughtered which become the subject of interstate commerce. These furnish a very large proportion of all the meat consumed in this State, especially in the larger cities. There are, however, a large number of cattle in rural communities which are slaughtered and sold for food without inspection. Many slaughter-houses are operated in an insanitary manner, and many carcasses of diseased animals, whose meat is unfit for food, are sold without inspection for human consumption.
I would, therefore, recommend that suitable amendment of the Farms and Markets Law be made so that there be established a Veterinary Bureau in the Council of Farms and Markets which shall take cognizance of the prevalence of tuberculosis in cattle and which shall exercise a sanitary supervision over all slaughterhouses not subject to Federal or municipal inspection and shall inspect all animals slaughtered therein and have power to condemn therein all meat unfit for food.
Safeguarding of Meats and Foods
Article IV of the Public Health Law, enacted in 1881, charges the State Department of Health with the duty of “taking cognizance of the interests of the public health as affected by the sale or use of food and drugs and the adulterations thereof, and making all necessary inquiries and investigations relating thereto.”
In 1893, by an amendment to the Agricultural Law, many of these duties were also imposed on the Department of Agriculture. Article IV of the Public Health Law, however, has never been repealed, but in accordance with an original understanding between the two departments, no appropriation has been asked for its enforcement by the Department of Health, but an appropriation has been regularly asked for and received by the Department of Agriculture.
Most aspects of the general supervision of foods, other than milk and meats, are commercial, the purpose of such supervision being to prevent fraud rather than to protect health. There are, in my opinion, other activities which will bring larger returns in the Saving of life for the amount of money expended and consequently I have not asked for any appropriation for the enforcement of this article of the Public Health Law.
Inspection of Kitchens and Food Utensils in Public Places
There is another article in the Public Health Law which is not enforced for lack of appropriation.
Chapter 552 of the Laws of 1913, being Article 17a of the Public Health Law, deals with cleanliness in the preparation and service of food. The State Commissioner of Health is given power to inspect and supervise any hotel, public restaurant, public dining-room, dining-car or steamboat, and public, penal, or charitable institutions and all public places in which food is prepared, sold or served. His agents are authorized to enter the kitchens of these places to see that the dishes and other utensils used in the preparation of food have been properly cleansed, and the commissioner is given power to enact rules and regulations for the proper enforcement of this article. No appropriation has ever been made to this Department to enable the commissioner to carry out the duties thus imposed upon him.
Either a sufficient appropriation should be granted to enforce the provisions of this article or it should be repealed.
I have not asked for such an appropriation because of the necessary increases in the Department’s budget for other purposes and because I believe that there are other lines of public health work in which the money can be more profitably expended.
Medical Practice Act
Under the present law, whereby illegal practitioners of medicine are prosecuted by the county medical societies, it is well-nigh impossible to secure convictions. Medical societies are not unnaturally accused of prejudice, and juries, feeling as they frequently do, that actions are brought through motives of jealousy or pecuniary interest, rarely convict physicians of the illegality charged.
I would, therefore, recommend that the Public Health Law be so amended that the authority to initiate and maintain prosecutions for violation of the Medical Practice Act be vested exclusively in some State department, preferably a disinterested body, such as the State Board of Regents.
Centralization of Health Units
In many instances in smaller localities it is impossible to obtain efficient health officers. This is because there is no man really qualified for the position within the jurisdiction in some cases, while in others the sparsity of the population makes the salary so small that a competent man will not take the office. Furthermore, there is no centralization or coordination among the various health units existing in the county and work is duplicated and money wasted.
It would seem desirable to have the county organized as a health unit centering around a general or county hospital situated in a populous section of the county and having adequate provision for the care of the various communicable diseases, including wards or buildings for the care of the tuberculous and for acute venereal infections. Such a hospital should also make provision for a general dispensary, a tuberculosis, and a venereal disease dispensary. It should also house a child welfare station, a county laboratory and the offices of the county health officer, who would direct all
of the health activities in the county, including those of the deputies. By such an organization a tremendous step in advance will be taken in the interests of public health. I would, therefore, recommend that legislation be enacted giving boards of supervisors power to establish such a system.
Reports of Communicable Diseases by Laboratories
All physicians and other persons having knowledge of communicable diseases are now required to report the same to their health officer. This is a most important step in the prevention of the spread of such diseases. It seems to me that laboratories which examine specimens and find in such specimens evidence of communicable disease should be required to report the same at once to their local health officers.
On account of conditions incident to the war and the prevalence of venereal diseases in the local population as shown by reports from the Surgeon General’s office since the mobilization of our troops, the problem of the control and suppression of venereal disease becomes one demanding our immediate attention. It seems to me essential that there be established in the Department a bureau of venereal disease with a sufficient appropriation provided for the purpose of carrying on a campaign of education in regard to these diseases throughout the State, and to provide for instruction in modern methods of diagnosis and treatment for health officers and physicians, including the furnishing of salvarsan.
This has been strongly advocated by the Federal authorities.
Licensing of Pasteurizing Plants
During the past year the Department has conducted an inspection of various pasteurizing plants throughout the State, and such examination discloses that in many instances the plants are not up to standard. It seems to me that all pasteurizing plants should be licensed by the State Commissioner of Health and made subject to his control and supervision.
SUMMARY OF WORK OF DIVISIONS
Division of Administration
The Division of Administration, in addition to exercising general executive supervision of the work of the various divisions whose summarized reports are appended, is also called upon to undertake various other public health activities which do not come under the work of any one division. A brief outline of these activities follows:
Public Health Education
The cooperation of the public is essential to progress in hygiene and sanitation, but this cooperation can be secured only when the public is fully informed on these subjects. Health administrators, therefore, regard the education of the people in matters relating to the preservation of health and the prevention of disease as of vital importance. This Department, in common with other State Departments of Health, has put much time and thought into the preparation of instructive circulars and pamphlets, public lectures, exhibits and other methods of putting the facts before the people.
The Health News, containing articles of general interest on various phases of public health work, has been issued monthly to health officers and others whose duties or interests bring them in touch with this Department. The Official Bulletin, issued twice a month, is the channel by which official orders and announcements of a general character are brought to the attention of health officers and others officially engaged in public health work.
In addition to the regular publications, pamphlets and circulars on various subjects pertaining to the prevention of disease or the preservation of health have been issued from time to time throughout the year. When special conditions have arisen, such as outbreaks of disease or when a new activity is to be inaugurated, press notices have been issued to the papers of the State. In other cases, where it was desirable to obtain wide publicity on any particular subject in order to obtain the cooperation of the people,