Edward R. Schlesinger

Newburgh-Kingston Caries-Fluorine Study. II. Pediatric Aspects-Preliminary Report.

EXTENSIVE epidemiological investigation has led to general acceptance of the inhibitory effect of naturally occurring fluoride in drinking water on the development of dental caries.1 Acceptance of this concept has led to the planning and execution of long-term studies of the effect of artificial introduction of fluoride into communal water supplies. If the promise of such studies as the one at Newburgh and Kingston, reported upon at this session by Ast, Finn, and McCaffrey,2 is borne out on more prolonged investigation, use of fluoride in communal water supplies may become a routine public health procedure affecting large segments of the population. Before any public health procedure can be recommended for routine use, every effort should be made, within limits of available techniques, to ascertain the safety of the procedure in question. Although there is no acceptable evidence that naturally occurring fluoride in the concentration used in drinking water as a caries-deterrent, exerts any deleterious systemic effects, it is desirable to make carefully controlled observations of children receiving fluoride

Trends in Familial Susceptibility to Perinatal Loss.

upon epidemiologic studies which delineated the size and nature of the problem and suggested effective approaches and points of concentration. In recent years the present status of fetal and neonatal mortality has often been compared with that of later infant mortality when these first epidemiologic studies were performed. A standard epidemiologic approach to a public health problem is to determine which groups, if any, in the population show a higher prevalence of the condition and to study any changes that may have occurred in these

Infant, Perinatal, Maternal and Childhood Mortality in the United States.

3 of the 4 major sections of this monograph deal with infant and perinatal mortality maternal mortality and childhood mortality. Attention in each section is initially focused on the circumstances leading to the current situation and the extent to which some of the parameters of infants maternal and childhood mortality have changed over the years. Long- and short-term trends and the basic variables of cause of death sex of child race and geography are discussed. In the case of infant mortality consideration is given to addition risk factors such as age of mother birth order and prior pregnancy history of the mother. Other components of pregnancy loss and damage among the offspring are also discussed. Most of the information presented has been derived from national vital statistics. The 4th section of the monograph reviews health services medical and paramedical personnel facilities and medical care costs in the United States with particular focus on their relation to obstetrical and pediatric services.

NOTES ON TABLES

GDP Gross Domestic Product NNI Net National Income GDS Gross Domestic Savings NNP Net National Product GFCE Government Final Consumption Expenditure NPISH Non-profit Institutions Serving Households GFCF Gross Fixed Capital Formation NSDP Net State Domestic Product GNDI Gross National Domestic Income NSO National Statistical Office GNI Gross National Income NSVA Net State Value Added GNP Gross National Product NVA Net value Added GVA Gross Value Added PFCE Private Final Consumption Expenditure NDCF Net Domestic Capital Formation ROW Rest of the World NDP Net Domestic Product SNVA State Net Value Added NDS Net Domestic Savings UTI Unit Trust of India

Development of a State-Wide Program for the Care of Children with Long-Term Illness

THE medical rehabilitation program for persons under 21 years of age (or crippled childrens program) had its inception in New York State with the provision for rural patients of orthopedic consultation services in the severe 1916 poliomyelitis outbreak. While the intervening years have seen a steady development and expansion of the program, changes during the past two years (which are continuing) have radically altered the programs scope and methods of administration. The purpose of this paper is to describe the steps involved in implementation of the broadened program, and to derive some lessons from this experience which may be of general value and interest. Our medical rehabilitation program is a state-aid-to-county program. The State Department of Health establishes the standards and scope of services, and promotes the development of facilities for the provision of services throughout the state. The City of New York and the counties elsewhere in the state initiate the definitive diagnostic treatment and rehabilitation services, and the state reimburses the locality for 50 per cent of the costs in state aid. Determination of medical eligibility is the responsibility of the local full-time health officer, but financial eligibility presently is determined, outside New York City, by the family court judge. Even before its recent expansion, the medical rehabilitation program was broad in scope, including, for example, musculo-skeletal defects, speech and hearing disabilities, congenital malformations, such as those of the heart, gastrointestinal and genitourinary tracts, convulsive disorders, and other neurological defects. The total amount authorized for medical rehabilitation under the program rose from about

A new program for the rehabilitation of the handicapped.

4 million in 1950 to

Infant, perinatal, maternal, and childhood mortality in the United States.

12 million in 1963. At the same time, the amount for dental rehabilitation jumped from less than

Survivorship in Cerebral Palsy

200,000 to more than

Newburgh-Kingston caries-fluorine study X III. Pediatric findings after ten years

1,300,000 in the same 13-year-period.

The Conclusion of a Ten-Year Study of Water Fluoridation

EARLY IN 1961, a new rehabilitation program was instituted in New York State to promote and support a statewide network of comprehensive rehabilitation centers and to bring about more effective coordination of rehabilitation services for handicapped persons of all ages. The State Department of Health was assigned the immediate responsibility for carrying out this essentially interdepartmental program.