COMMUNITY DEFENSE OF NATIONAL VITALITY 3 1 9 



personal and civic hygiene. This will involve very difficult problems of 

 education, but the results will prove as fruitful as those which have 

 been directed toward our better circumstanced classes. The problem 

 of the mortality at the higher age groups is a complex one and many 

 things will need to be done if we hope to accomplish our chief aim, 

 which should be to show a saving in life all along the line, both in our 

 native and foreign-born stocks, not only at the younger ages where 

 American medicine has made brilliant contributions, but more especially 

 after middle life. 



COMMUNITY DEFENSE OF NATIONAL VITALITY 



By C.-E. a. WINSLOW 



dieectoe, division op publicity and education, n. y. state depaetment 



of health 



THE shadow of the tragedy in Europe can not wholly be lifted from 

 our thoughts during the meetings of this Convocation Week. As 

 the representatives of science and of the applications of science to the 

 better ordering of the life of man, this barbarism shocks and amazes, as 

 much as it saddens us. As scientific men, however, we are accustomed 

 to recognize that slight constant factors may be as significant in their 

 effects as large and occasional ones. It is well, as we take counsel at 

 this time, to remember that peace, which has her victories as well as war, 

 has also her defeats, and her ranks on ranks of killed and wounded. 



It is tragic that a million or so of men should have perished in battle 

 during the last six months of 1914, and that many more should have 

 been wounded. It is also tragic that a million and a haK men, women 

 and children should have died in 1914 in the United States, and that 

 some three million people should be on the sick list all the time. The 

 most fearful thing about the war is that it seems to us at this dis- 

 tance so wantonly needless. Yet we are told on the good authority of 

 Professor Irving Fisher that over forty per cent, of our annual toll of 

 civil death and suffering is needless also. 



These facts and this comparison are trite and familiar. Yet as a 

 public health official, seeing close at hand the problems of preventable 

 disease and the meager efforts made to solve them, I often wonder 

 whether you and I really believe these things, and, if we do, why we do 

 not act upon our knowledge. Is it merely a rhetorical phrase that 

 600,000 people die needlessly in our midst — or is it really true ? 



Let me rehearse very briefly the disasters inflicted upon our country 

 during the past year, by foes whom we may conquer if we seriously will 

 to do so. First of all, a quarter of a million infants were carried off 

 before they had rounded out the first year of life. Try to get this out 

 of the realm of statistics and visualize it as a solid fact. Think of 



