All communications relating to the publications of the Department of Health should be addressed to the Commissioner of Health, 149 Centre Street, New York Entered as second-class matter May 7, 1913, at the post office at New York, N. Y., NEW SERIES. VOL. II. NOVEMBER 22, 1913. No. 47 REORGANIZATION OF BUREAUS AND DIVISIONS OF THE DEPARTMENT OF HEALTH. At the meeting of the Board of Health held October 28, 1913, several resolutions were adopted effecting important changes in the organization of the bureaus and divisions of the Department of Health. The object of these changes is to rearrange the working forces of the Department of Health more in accordance with the needs and problems of the present time. The rapid expansion in the scope and functions of the Department of Health and the great increase in the number of employees which have come about in recent years have made necessary the creation from time to time of new divisions, several of which have grown from small beginnings until they are now of the first importance among the various lines of activity of the Department. The resolutions referred to have the effect of raising to the rank of bureaus several branches of the work formerly organized as divisions, making them co-ordinate with the Sanitary Bureau and the Bureau of Records, which latter have existed in the Department for many years. As a result of the action taken at the last meeting the Department of Health will now carry on its activities through the following bureaus: (1) Bureau of General Administration. (2) Sanitary Bureau. (3) Bureau of Infectious Diseases. (4) Bureau of Child Hygiene. (5) Bureau of Hospitals. (6) Bureau of Laboratories. (7) Bureau of Food Inspection. (8) Bureau of Records. By a second resolution the office titles indicated in the following schedule are given to the officials assigned to duty as chief executive officers of the several bureaus and they are required to report directly to the Commissioner of Health, to whom, as the chief executive officer of the department, they are responsible for the conduct of the work, and the efficiency of the employees under their jurisdiction: The Bureau of General Administration was originally created by the Board of Health on January 30, 1912, since which time it has been under the executive supervision of the secretary of the Board of Health, and has included the offices of the chief clerk and the assistant chief clerks in the several boroughs, the law clerk, and since July 2, 1912, the office of the filing clerk. By an additional resolution adopted October 28, 1913, there were established in the Bureau of General Administration two new divisions, to be known as the Division of Supplies and the Division of Audit and Accounts, to be developed under the direction of the secretary from the employees now under the supervision of the chief clerk, these new divisions to continue the work performed in the chief clerk's office. Mr. James McC. Miller, chief clerk, was assigned to duty as the head of the Division of Supplies, and charged with the duties of superintending the purchase of all supplies by the Department of Health, the supervision and care of all the buildings and offices of the Department of Health, with the exception of those belonging to the hospital service, the preparation of plans and extensions and repairs to the buildings, and the sale of laboratory products. Mr. Louis C. Connolly, examiner, was assigned to duty as the head of the Division of Audit and Accounts, and charged with the responsibility of the auditing and accounting work of the Department of Health and with the supervision of all bookkeepers, clerks and other employees detailed to duty in the Division of Audit and Accounts. Bureau of Infectious Diseases. The organization of the Bureau of Infectious Diseases was defined to include the following divisions: (1) Division of Contagious Diseases. (2) Division of Tuberculosis. (3) Division of Venereal and Veterinary Diseases. (4) Division of Institution Inspections. (5) Division of Typhoid Fever. (6) Division of Nurses. (7) Division of Diagnosis Laboratory. Bureau of Child Hygiene. The organization of the Bureau of Child Hygiene comprises the following divisions: (1) Division of Midwife and Foundling Inspection. (2) Division of Institutions and Day Nurseries. (3) Division of School Medical Inspection. (4) Division of Employment Certificates. (5) Division of Infants' Milk Stations. (6) Division of Children's Clinics. Bureau of Food Inspection. The organization of the Bureau of Food Inspection includes the following divisions: (1) Division of Meat, Fish, Vegetables, and Drug Inspection. (2) Division of Milk Inspection (City). (3) Division of Milk Inspection (Country). (4) Division of Milk Inspection (Pasteurizing plants). ROCHESTER'S INFANT MORTALITY, CORRECTION OF AN ERROR. Under the head "A Reduction of Infant Mortality," there appeared in the bulletin of August 2 a table in which the death rate and number of deaths occurring from all causes in infants under one year of age were given for a number of cities in New York State. The figures referring to the City of Rochester were starred and a footnote stated that deaths from prematurity were not included. For many years Rochester had not included deaths from prematurity in its report of deaths, but had published them in a separate table in its monthly as well as in its annual reports. In January, 1913, it began to include these deaths in its reports. We are informed by the Health Officer of Rochester that in the January issue of the Bulletin of the State Department of Health, from which our figures were taken, the figures given by Rochester were made to include all deaths from prematurity for the year 1912. The Commissioner of Health of New York State has informed us that the State Department did not see the certificates of deaths from premature birth occurring in the City of Rochester until after the close of the year, when it was called to their attention that these returns had been omitted. They were thereupon placed in Rochester's tabulation, and the death rate for Rochester as given in our chart should have been held to include all deaths from prematurity. Rochester's figures for 1912 per 1,000 births were as follows: Rate, 97.7; deaths, 539. PRENATAL WORK OF THE BUREAU OF CHILD HYGIENE. Another link has been added to the chain of effort in the reduction of infant mortality by extending the activities of the milk stations to include the care of pregnant women. Thirty-six per cent. of infant mortality occurs in the first month, and it is safe to infer that the majority of these children die either because the mothers were physically unfit to bear healthy children or because of their ignorance of the proper care of their offspring during the first weeks of life. The milk station at 2287 ist ave., Manhattan, has been selected as a centre for the instruction of nurses in prenatal work. When sufficiently familiar with its details, they will be assigned to other stations to carry it on. The nurses assigned to this work canvass the neighborhood and persuade expectant mothers to place themselves under medical care as early in pregnancy as possible; they communicate with the doctor of the hospital under whose care the patient may be, and explain the desire of the Department of Health to cooperate and the manner and degree in which it is prepared to do so; they instruct mothers in detail with regard to diet, fresh air, food, exercise, clothing, etc., and impress upon them the importance of nursing their infants. In normal cases visits are made every ten days ante-partum and every three days post-partum; in abnormal cases, as often as may be necessary. Visits are made for one month after labor. The mothers are then requested to enroll their children at the milk station, where they are cared for during their first and second years. To date one hundred and seventy-five mothers have been enrolled, of whom twenty-five have given birth to children. While it is too early to show by figures what can be accomplished, it is most gratifying to note the appreciation of the mothers and the enthusiasm of the nurses. DEATH RATE FOR THE WEEK. There were 1.388 deaths and a death rate of 13.48 per 1,000 of the population, as compared with 1,354 deaths and a rate of 13.65 for the corresponding week of 1912, an absolute increase of 34 deaths-corresponding to a decrease relatively of 18 deathsand a decrease of .17 of a point. The death rate from the following causes showed material decreases, scarlet fever. diphtheria and croup, diarrhoeal diseases under five years of age, bronchitis, lobar pneumonia and violence. Those causes showing increases were measles, whooping cough, typhoid fever, organic heart diseases, broncho pneumonia, pulmonary tuberculosis and Bright's disease and nephritis. Viewed from the point of age grouping, the mortality under one year of age represented 40 fewer deaths, and under five years of age 39 fewer deaths than in 1912 The increased mortality was based upon an increase in the diseases affecting adult hie such as pulmonary tuberculosis, organic heart diseases and Bright's disease and nephritis. There were 33 more deaths reported between the ages of five and sixtyfive and 40 more deaths at the ages of sixty-five years and over. The death rate for the first forty-seven weeks of this year was 13.71 per 1,000 of the population as against 14.07 for the corresponding period of 1912, a decrease of 35 point. VITAL STATISTICS Summary for Weck Ending Saturday, 12 M., November 22, 1913. Corrected according to borough of residence. ↑ The presence of several large institutions, the great majority of whose inmates are non-residents of the city, increases considerably the death-rate of this Borough. Deaths by Principal Causes, According to Locality and Age. rected, 1913. |