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November 2, 1918


JAMA. 1918;71(18):1457-1458. doi:10.1001/jama.1918.02600440009003

The total estimated population of continental United States in 1916 was 102,017,312. Of this population, 41,752,530 was urban, that is, was in communities having more than 8,000 inhabitants. There were 770 such municipalities.1

In other words, 40.9 per cent, of all our people have their health looked after (or not looked after, as the case may be) by 770 local health departments. In this single consideration, we see the great importance of municipal health administration and also, it would seem, its relative simplicity compared with the problem of looking after the health of the 59.1 per cent. of the rural population. The latter population, which is scattered over the rest of the country and reached only by a bewilderingly large number of local organizations, can at best be coordinated only by efficient state departments of health.

To discuss municipal health administration as a whole would be obviously unprofitable. Dealing