From the title of this paper you will undoubtedly realize that it is quite difficult to lay out a plan of health work that will be suitable for all. The question thus arises, why should this task be difficult? Should not health work be the same in a city of 20,000 as it is in a city of 100,000 or more, only somewhat modified to meet local conditions?
You have undoubtedly tried to compare the work of various health departments from annual reports issued by them and found it next to impossible to do so. The greatest single need is probably standardization. In other words, there appears to be no standard of measurement. The public health official realizes that such standardization will promote a unification of thought and action, which will make it possible for him to devise ways and means of fairly competing in the field of public health
FURSTMAN M. PUBLIC HEALTH ADMINISTRATION IN CITIES OF FROM TWENTY THOUSAND TO ONE HUNDRED THOUSAND. JAMA. 1918;71(18):1463–1467. doi:10.1001/jama.1918.02600440015005