Responsibility of Local Health Authorities in the War Emergency

Abstract

THE subject assigned to me for discussion, namely, The Responsibility of Local Health Authorities in the War Emergency, carries with it the implication that all areas in the United States are served by some form of local health organization capable of accepting responsibility and exercising authority. According to this interpretation, it is assumed that full-fledged staffs of local public health workers wait only to be told what to do before springing into action. This, I am sorry to say, is far from a true picture of the situation. In spite of considerable progress in recent years, no such comprehensive network of local health services exists. In extensive areas of the United States the exercise of local health functions is vested in political jurisdictions such as townships, boroughs, villages, and, in some instances, counties, in which the population consists of from a few hundred to a few thousand inhabitants. Such local subdivisions are in most instances nothing more than geographical fictions designed to fulfil the political requirements of the horse-and-buggy era. They bear no relationship to present community life, nor do they in any sense contain -institutions or administrative units which meet the economic and social needs of the population. Like the human vermiform appendix, evolution has rendered them obsolete and functionally sterile.