Ages of Health Officers in Relation to Professional Training JOHN A. FERRELL, M.D., DR.P.H., F.A.P.H.A., AND PAULINE A. MEAD Rockefeller Foundation, New York, N. Y.

A LTHOUGH the age of a health officer is important for several reasons, the present discussion will be confined primarily to its influence on his taking university training in public health. The young physician who has been graduated at a grade A medical school within the past 10 years, as a rule is well grounded academically and medically. He is able to meet university admission requirements and to carry successfully its courses in public health. In view of his remaining years of usefulness, his investment of time and money in public health training should yield a real return. So much cannot be said for older physicians. Those who were graduated a score of years ago, for example, as a rule are not well grounded in the basic sciences and cannot satisfactorily take most of the university courses in public health. Moreover, there would be less incentive for them to invest time and money in courses of training when their expectancy for vigorous health would be for a comparatively brief period. Experience has shown that physicians not over 35 years of age are most satisfactorv as students of public health, but exceptional men up to the age of 40 do reasonably well. While occasionally men above this age may carry courses successfully, in general they find the work difficult and at times embarrassing. The physician who has grown old while serving as a full-time health officer has had opportunity to acquire a great deal of useful knowledge and practical experience, and even though he may be lacking in certain technical subjects, he may plav a very useful role in administrative and routine health measures. Until schools of public TABLE I CLASSIFICATION BY AGE GROUPS OF STATE AND PROVINCIAL HEALTH OFFICERS, 1932 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 48 State Health Officers 9 Provincial Health Officers.

1

5 1

[904]

4 1

1

8 3 1

14

11

4 1

2

AGES

AND

TRAINING

OF

HEALTH OFFICERS

905

TABLE II FULL-TIME COUNTY HEALTH OFFICERS GROUPED ACCORDING TO AGE, 1932 United States States Alabama Arizona Arkansas California Colorado Delaware Florida Georgia Idaho Iowa Kansas Kentucky Ketuk Louisiana

Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana New Mexico New York North Carolina Ohio Oklahoma Oregon

Pennsylvania South Carolina South Dakota Tennessee Texas Utah Virginia Washington West Virginia Total

Provinces Alberta British Columbia Quebec Saskatchewan Total

Number Total AverNum- age Age Under 35-40 41-50 ber 35 4 11 45 15 52 57 4 9 3 52 27 4 2 51 14 1 51 47 1 3 = 1 42 1 2 2 12 4 50 31 1

29

3 10 70 32 17 3 13 1 28 11 4 5 4 30 43 8 6 3 24 1 36 2

54 58 46

47 44 40 42 37 44 51 59

47 50 46 54 52

1

21 5 1

= 6A

.-4.13

7

4

5

3

1 3

6

4

8

1 1

7 3

= 1 2 3 3

43

57 44 44

4

3

45 38

7

4

2

62

13 8 15 527

48 62 47 47

3 93

11 4 2 2 12 10 3 2 1

12 1 17

=_=_ 2 2 1 2 4 54 152 Canada

15.6 12.5 40.6 31.3

10

8 6 4 2 1 9 27 5 1 2 5 8

1

1 2

Over Under 35-40 41-50 Over 50 50 35 7.7 21.2 42.322 28.8 100.0 4 15 11.1 33.3 55.6 14.3 28.6 57.1 8 100.0 1 2 33.3 66.7 50.0 50.0 6.5 38.7 41.9 12.9 13 l00.0 2 33.3 66.7 9 10.0 90.0 30.0 8.6 14.3 47.1 33

4

2 3

1

1 1 10

Percentage

I:

5.9 66.7 23.1

41.2

23.5

30.8 100.0 28.6 3.6 9.1

23.1

20.0

39.3 36.4

19.4 50.0

40.0 50.0 40.0 23.3 37.5 50.0 33.3 33.3 12.5 50.0 100.0 11.1 47.2 50.0

15.4

15.4

20.0

26.7 10.2

23.3 7.0

16.7

25.0 7.7 7.0

2

7 7 6 228

29.4 33.3 23.1

28.6 54.5 100.0 40.0 25.0 30.0 62.8 62.5 16.7 66.7 20.8 22.2 100.0

17.6

15.4 12.5 13.3 28.8

53.8 87.5 40.0 43.3

Percentage Number Total AverNum- age ber Age Under 35-40 41-50 Over Under 35-40 41-50 Over 50 50 35 35 1 3 24 1

29

57 42 39

1 11

1 5

35 40

12

7

1 1

5

3

5

5

1

100.0

33.3 20.8 100.0 41.4 24.1 33.3 45.8

20.8

33.3 12.5

17.2

17.2

906

AMERICAN JOURNAL OF PUBLIC HEALTH

health were established, training was obtainable only in the school of experience. As will be observed later, only a beginning has been made by health officers in taking professional training in public health. Table I presents the age distribution of 48 state health officers and 9 provincial health officers. The state health officers have an average age of 56 and the provincial health officers 52. One provincial health officer is 37 years old. With this exception, all of the state and provincial health officers are 40 or over. Of the 557 full-time county health officers in the United States in January, 1932, the available records did not give the ages of 30. The age distribution of the remaining 527 is given in Table II. In each of 2 states having 2 and 8 health officers respectively, or a total of 10, the average age is 62. In 10 other states there are 183 health officers with an average age of 45 or less. From Table II it will be noted also that in the group under 35 there are 93 county health officers in 20 states, and that in the 35-40 group there are 54, representing 18 states. These two groups, which may be regarded as including the potential students for schools of public health, have a total of 147. Among the county health officers in the states, 30 have had school of public health training-usually 1 year. As of January, 1932, Tennessee reported 5 county health officers who have had school of public health training, and Maryland 5, whereas 13 other states reported only 1 or 2 with such training. In Canada, there were 32 county health officers in January, 1932. Their age distribution by provinces is shown in Table II. The ages of 29 were available and averaged 40 years. Of these, 18 have had school of public health training. The record of Quebec is conspicuous, in that the average age of 24 of her 25 county health officers is 39 years, and 14 have had training in a school of public health. In the United States, of the 966 cities having 10,000 or more inhabitants only 407 have full-time health officers. Of 249 of these for which we have records, the average age is 52 years. Their age distribution will be found in Table III. Of the 158 full-time city health officers whose ages were not available, 150 are non-medical: 32 in Massachusetts, 51 in Pennsylvania, and 27 in New Jersey. SUMMARY

1. The age distribution of 862 full-time state, provincial. citv and county health officers is as shown in Table IV. 2. Of the 208 health officers under 41 years of age, 38 have attended schools of public health-a percentage of 18.2.

AGES

AND

TRAINING

OF

907

HEALTH OFFICERS

TABLE III FULL-TIME CITY HEALTH OFFICERS GROUPED ACCORDING TO AGE, 1932

States Alabama Arizona Arkansas California Colorado Connecticut Florida Georgia Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Vermont Virginia Washington West Virginia Wisconsin Total

Total

9 1 3 21 1 8 5 11 1 12 1 4 4 6 2 7 4 3 10 2 6 4 3 1 4 2 9 14 1 19 4 3

6 2 5 1 5 9 1

9 6 9 11

249

Number Percentage Average Age Under 35-40 41-50 Over Under 35-40 41-50 Over 35 50 35 50 54 39 50 51 60 52 52 53 56 52 47 51 44 52 65 55 52 54 52 58 42 61 59 57 58 49 56 49 53 53 43 49 53 63 43 44 43 47 82 49

1 1

2 1 1

1

1 1 1

6 1 5 1 2

2

1

2

2 2 3

3 1

2

1 1 3 6

1 2 1 1

1

1 13 1

7 1

2

6

6 2 1 3 1 4 1

33.3

_=_

1 3 5 1 4

1 1

1 4 2 4 2

1

3 1

2 1

1

2 4 1

1

2

2

4

1

3 1

2

2

5 6 6

19

22

79

129

66.7

100.0 4.8

9.5 12.5 20.0

9.1

66.7 23.8

33.3 61.9 100.0 75.0 12.5 20.0 60.0 45.5 45.5 100.0

8.3

25.0 16.7

58.3 100.0 50.0 25.0 25.0 16.7 14.3 50.0

28.6

66.7 30.0

1

5 2 1 3 3 1 3 1 6 7 1 11 1

1 3

58

49 53 52

3 = 2 5

20.0 33.3

50.0 25.0

33.3 50.0 25.0 66.7 100.0 57.1 50.0 33.3 50.0 100.0 16.7 75.0 100.0

25.0 50.0 33.3 42.9

7.1 10.5

31.6 50.0 33.3 33.3 50.0 50.0 20.0 80.0 100.0 20.0 40.0 33.3 11.1 11.1

25.0

11.1 33.3 9.1 7. 6

22.2 18.2 8. 8

100.0 75.0 50.0 66.7 50.0 100.0 57.9 25.0 33.3 50.0 50.0

40.0 44.4 100.0 22.2 44.4 16.7

83.3

18.2 31. 7

66.6 54.5 51.8

908

AMERICAN JOURNAL OF PUBLIC HEALTH TABLE IV AGES OF 862 FULL-TIME HEALTH OFFICERS

Kind of Health Officer

Under 35

41-50

Over 50

Total

9

39

48

1

2

6

9

35-40

State

Provincial County (U. S.)

93

54

152

228

527

County (Can.)

12

7

5

5

29

City (U. S.)

19

22

79

129

249

124

84

247

407

862

Total

3. In the age group under 35 there are 124 health officers, of whom only 25 have had university training in public health. 4. University courses should be supplemented by practical field training. As the age group 41-50 is at a decided disadvantage with respect to university courses, practical intensive courses should be offered for them. 5. Although the total number of health officers having diplomas in public health is still quite limited, the number taking the training and planning to take it is showing a yearly increase. NOTE: The Directory of the American Medical Association was the source of our information as to the ages of health officers, and the Public Health Reports were consulted to ascertain the city health officers who are physicians and those who are not.

Eye Defects in the Savage were about 200 savage African ltribesmen, especially imported from Africa by Hollywood. A group of eye specialists in California examined the eyes of every one of these men, with this interesting result: that the respective percentages of near-sightedness, far-sightedness, myopia, and other common eye defects were almost the same as the averages for men and women of America. Undoubtedly the abuse of our eyes is the cause of much defect in vision, yet this study of the savages' eyes shows that the human eye has a natural tendency to imperfection.

TN the recent film called " Trader Horn " there