THE INFLUENCE OF URBAN AND RURAL ENVIRONMENT 353 



care of the sick in rural areas has yet been sacrificed to 

 any degree by the cityward trend of country folk and physi- 

 cians, although within the next twenty years, failure of 

 medical services, if determined exclusively on an individual 

 preference or competitive basis by physicians, is likely to 

 develop, especially where the clearing of the roads in winter 

 cannot be relied upon. The local county or crossroads 

 hospital available for all patients and for all physicians is 

 likely to prove a sufficient advantage to attract the young 

 physician again to enter rural practice. In the sparsely 

 settled mountain regions of the Carolinas, Kentucky and 

 Tennessee there never has been any self-supporting basis 

 upon which adequate medical services could be provided, 

 and a retrograde condition both physical and mental 

 has prevailed. 



The active public health movement, encouraged by funds 

 from private philanthropy, which has already resulted 

 in the provision of full-time health officers for more than 



Table i 



urban and rural death rates by principal causes per 100,000 of 



population in the united states registration area 



(u. s. census bureau, mortality rates, i918-i920) 



