RURAL HEALTH PHYSICAL 199 



of health to show the county its sanitary needs and how to meet 

 them. 



Rural sanitation must be developed on a smaller budget than 

 the budget for urban sanitation. The country is poor. What 

 the exact difference between the urban and rural per capita 

 wealth is in the United States, no one knows, but we do know 

 that rural per capita wealth is much less than the urban per 

 capita wealth. 



The influence of epidemicity is weaker in rural than in urban 

 life, and rural quarantine measures need not be as rigid as 

 urban quarantine measures. 



Rural sanitation will be influenced by the individualism of 

 the country. The ruralite (a term more expressive than 

 orthodox) is individualistic; the urbanite is communistic. The 

 errors of individualism are best treated by education ; the errors 

 of communism are best treated by legislation ; therefore, sanitary 

 education is relatively more important in rural sanitation than 

 in urban sanitation, while the reverse is true for sanitary legis- 

 lation. 



There are two general methods by which a county may have 

 sanitary measures carried out: First, the county may do its 

 own work; second, the county may have its work done by some 

 outside agency. The whole-time county health officer is usually 

 regarded as the best solution by the first method, while the unit 

 or contract system of county health work furnishes, probably, 

 the best solution by the second method. 



The unit system of county health work assumes, first, the 

 divisibility of county health problems into fairly independent 

 units of health work ; second, that a county may get better work 

 for less money by paying the State Board of Health just what it 

 costs to complete a certain piece of work than by attempting to 

 do the work itself. Several illustrations will make the practica- 

 bility of the unit system clear and perhaps better appreciated. 



Illustration No. 1. The North Carolina State Board of Health 

 proposed to and contracted with ten counties for a county ap- 

 propriation of $500 to administer free typhoid immunization to 

 those citizens of the ten counties who wished to be immunized. 

 In the first set of five counties we gave complete treatment to 

 26,537 people; when we completed the work in the next five 



