Before Marine and Kimball1 published their report of the incidence and types of thyroid enlargement in school children of Akron, Ohio, in 1917, very little, or no work, had been done on the subject among school children in the United States.
Their report stimulated other investigators to estimate the thyroid incidence in school children in other sections of the country, the nongoitrous as well as the goitrous regions, and to outline methods for prevention and for cure. Reports of these surveys (Table 1) indicate that the so-called goiter belt was not limited to the Great Lakes region, but that it extended throughout the United States, in varying degrees of severity depending on geographic location. The incidence was higher in some places and lower in others, but the average is considerably higher than was thought to be the case before Marine's statistics were published.
GOITER SURVEYS: INCIDENCE AMONG SCHOOL CHILDREN
GOLDBERGER IH, ALDINGER AK. GOITER INCIDENCE IN SCHOOL GIRLS OF NEW YORK CITY. Am J Dis Child. 1925;29(6):780-798. doi:10.1001/archpedi.1925.04120300054008