WHAT IS SOCIAL HYGIENE?

All the agencies in the field were coördinated and, as a result of their team work, more than 130 red-light districts were closed, many hundreds of single houses of prostitution were abolished, more than 800 communities conducted local campaigns against venereal diseases, and more than 3,000,000 men in the army received definite information about venereal diseases. Millions of informational pamphlets were distributed among the civilian population and medical facilities were established in many communities and industries.

It is of note that there has been no let-up of activity on the part of social hygiene agencies since the war. They realize that venereal disease is a greater problem in time of peace than during war. In fact, the army records show that where one case of venereal disease was contracted after entering the army, five were brought in by the draft from the civilian population.

To meet this problem of civil life and to conserve the effective measures already in operation was the purpose of Congress in appropriating $4,100,000 for carrying on the venereal disease fight in the federal fiscal years 1919 and 1920, and $1,015,000 for the fiscal year 1921.

A large part of this appropriation went to aid the various states in establishing their machinery. By means of this federal assistance there has been established, in connection with the state departments of health in forty-seven states, divisions of venereal disease control, in charge of a commissioned officer of the United States Public Health Service, or some other person approved by the Service. Consequently, there is now in every state in the Union, save one, machinery for waging an aggressive warfare on the venereal menace. In a majority of states this is being done. The question now before the nation is "Shall the fight be continued?" With this answered in the affirmative comes the necessity for giving the fighting forces that support which will enable them to win a final victory.

Here is the situation: The federal government's appropriation for allotments to the states for the prevention, treatment, and control of venereal diseases in 1921 is $546,345.30. The states receive their allotments on a 50-50 basis. That is, every dollar that is paid by the federal government must be matched by a dollar paid by the state. The federal appropriation for this year constitutes a retrenchment of about 50% from the previous one. It will be

THE AMERICAN PLAN

seen, therefore, that the states must increase their appropriations in order to maintain even their present activities.

It will not be enough, however, merely to hold the ground already gained. A lasting victory can be achieved only through the continued and increased support of every.state. Additional legislation is needed; new appropriations are essential to.carry on activities already started and to provide for further progress. These responsibilities rest to a great extent upon the lawmakers.

To them is entrusted the protection of social and moral rights in their commonwealth. They should ask themselves, "Is it not the better part of wisdom to spend more for the prevention of disease, blindness, insanity, and wrecked homes than to relieve their results?" By supporting the clinic, the industrial home, and other social-hygiene activities a state can promote the health, welfare, and efficiency of all its citizens. It can protect the men, women, and children of this generation while at the same time providing a heritage for those of the future.

Happy, homes with healthy parents and children are the real wealth of a nation. Will you help to put your state on record as one believing in and supporting to the best of its ability this cam paign for healthy bodies and wholesome social standards?

"THE AMERICAN PLAN"

FOR COMBATING VENEREAL DISEASES

Of all programs ever devised for the prevention and control of the venereal diseases, the one inaugurated and put into effect by the United States Government is the most workable. This program, known internationally as the "American plan," consists of a fourfold method of combating syphilis and gonorrhea.

The four measures making up this plan are law enforcement, medical measures, recreation, and education. Each has an important place in the scheme and all are essential to its execution.

No better social laboratory could have been provided for a fair, comprehensive test of the value of this program than the American army cantonments, and its great success there, under the most trying and adverse circumstances, proved its definite value. Law enforcement prevented many exposures to venereal diseases by taking necessary legal steps to limit and repress the activities of

SOCIAL HYGIENE ORGANIZATIONS

the prostitute class. Medical measures prevented the spread of infections by curing or at least rendering non-infectious those who contracted syphilis or gonorrhea. Clean and wholesome recreation played its part by providing healthy and entertaining spare-time activities for the men, while education as to the prevalence and seriousness of these diseases, combined with an appeal to the inherent decency and chivalry of the men in service, had a strong influence on their conduct.

So valuable was this program in the army that Surgeon General Ireland said of it: "The great outstanding fact of importance for our future work is that the American plan of a coördinated attack on venereal disease from all sides is successful under any conditions where it has had a fair trial," and further, "any attack which omits either law enforcement, medical, recreational, or educational measures is not likely to be a complete success."

The problem of controlling venereal diseases in civil life involves most of the same elements with which the army had to deal, and the same many-sided type of attack is required. States and communities which have already put the American plan into effect will vouch for its value.

Legislative enactments providing laws and appropriations to back up this program must be forthcoming if progress is to be continued. Each individual state can establish the measures of the plan within its own borders if it will. Every commonwealth has the opportunity to utilize this decisive factor for solving what General Gorgas called "the most serious problem of public health confronting our nation at the present time."

SOCIAL HYGIENE ORGANIZATIONS

The agencies at work in the field of social hygiene are the United States Interdepartmental Social Hygiene Board, the United States Public Health Service, the American Social Hygiene Association, the state boards of health, and many local organizations.3 The League of Women Voters and the Woman's Christian Temper

8 The American Red Cross, Y. M. C. A., Y. W. C. A., Y. M. H. A., Rotary and Kiwanis Clubs, and Chambers of Commerce are among the noteworthy supporters of the nation-wide social-hygiene campaign.

SOCIAL HYGIENE ORGANIZATIONS

ance Union through their state and local committees have pledged the influence of thousands of women to the campaign.

By close coöperation in their activities, these agencies present a solid front in attacking any social-hygiene problem. They have inaugurated the most nearly complete program ever undertaken for the control, prevention, and eradication of venereal diseases and the advancement of social hygiene generally.

THE UNITED STATES INTERDEPARTMENTAL SOCIAL
HYGIENE BOARD

The United States Interdepartmental Social Hygiene Board was created by act of Congress on July 9, 1918, for the purpose of protecting the civil population of the United States against venereal diseases and for meeting the immediate emergencies of the war.

Its program (1) involves a search for additional accurate information concerning the causes, carriers, prevention, treatment, and control of venereal diseases; (2) includes measures for the appropriate distribution of this information; (3) provides for the development of sound and constructive methods of sex education; (4) acts as the distributor and auditor for those funds which the federal government has appropriated to each state on a dollar-for-dollar basis for the prevention and cure of venereal diseases in that state; and (5) supplies plans and resources for the employment of social measures for protection against and for the care of persons infected with these diseases.

Since the initiation of this comprehensive program, for the execution of which the government provided both the financial resources and the administrative machinery, something over $3,500,000 has been expended through the Board, and the expenditure of an even larger sum has been made by state and local governments and by volunteer agencies.

At present 39 colleges, universities, and normal schools are being aided in the establishment or enlargement of departments of hygiene. More than 100 men and women are at work in 22 institutions to perfect better medical treatment and preventive measures for gonorrhea, syphilis, and chancroid. In the field are 149 protective social workers and other agents engaged in establishing protective social measures throughout the United States.

SOCIAL HYGIENE ORGANIZATIONS

DIVISION OF VENEREAL DISEASES OF

THE UNITED STATES PUBLIC HEALTH SERVICE

The United States Public Health Service, "the country's first and last line of defense," as it has been termed, has general control of federal public-health activities throughout the nation. It came into being about the year 1798 as the Marine Hospital Service and has had its activities and responsibilities expanded by acts of Congress until now it is the recognized court of final resort in publichealth emergencies.

The Division of Venereal Diseases of the Public Health Service was created under the same act of Congress as was the United States Interdepartmental Social Hygiene Board. The purpose of this Division is first, to coöperate with state boards of health for the prevention and control of such diseases within the states; second, to prepare and distribute educational material concerning venereal diseases; and third, to control and prevent the spread of these diseases in interstate traffic. The experienced medical officers whom the Service has furnished to most states have proved of great value in building up the state's machinery for clinical, medical, law enforcement, and educational work.

The activities of the Division of Venereal Diseases during 1919 included campaigns to reach the nation's physicians, dentists, and druggists with educational material. Approximately 132,000

physicians and surgeons were communicated with, their attention being called to the prevalence of venereal diseases and the importance of adopting energetic measures for their control. In addition more than 50% of all druggists agreed to stop selling venerealdisease nostrums.

A special educational attack was made on the advertising quack specialists. The Division, recognizing the public danger resulting from this group, sent requests to 20,000 advertising mediums asking their coöperation against this class of advertising. The vast majority agreed to assist, many of them having already ceased to sell space for such purposes.

Other special campaigns were those to reach the members of fraternal organizations, the "Keeping Fit" campaign to reach boys between the ages of 15 and 21, and the industrial campaign in which approximately 57,000 employers of labor were reached and upward