The Health bulletin [serial] - University of North Carolina at Chapel Hill

July, 1951The Health Bulletinx-ray location. All of the tentativesights were visited by representativesfrom the State Board of Health, LocalHealth Department and Power Companiesbefore the final schedule, whichincluded thirty-eight separate x-raysites, was approved as final.At least one Public Health Nurse wasmade responsible for the successfuloperation of each x-ray location, andeach x-ray site was visited periodicallyduring each day to make certain thatthe x-ray take for the day was holdingup to expectations. When it was foundthat the x-ray total was falling considerablybelow the known x-ray populationfor a given area, special conferenceswere held and commando groups weresent into the field to visit the homes,churches and schools to make every effortpossible to start the people movingtoward the x-ray buses.For example, in one location it wasfoimd that the first day's x-ray take hadfallen considerably short of the expectedtotal; where-upon, six nurses were sentinto that area the following day to visitevery home to learn why the people werenot coming in. These nurses, visiting 714homes during the day, heard some veryinteresting excuses as to why peoplehad not responded. Here are a few ofthese reasons given the nurses duringtheir commando operations:"No man is smart enough to makesomething to see my lungs.""Don't want the home broken if T. B.is found in the family.""Anything free is half done.""It is for poor people who can't paytheir nrr.aie doctor."•The last time I took a picture on thex-ray imit, I got sick.""In case the wife or husband is foundto have T. B., he must go to the Sanatorivun.What God put together, let noman put asimder.""I heard that getting near the x-raymachine will make you sterUe.""I am too old to have T. B.""You just want to put me in the Sanatoriumand let me die.""My wife won't let me get an x-ray.""I am afraid the machine would electrocuteme.""I am a retired Veteran, they will giveme a check-up when I want it.""If I have tuberculosis, I don't wantto know it.""God didn't intend for anyone to bex-rayed or to take medicine.""No tuberculosis has ever been in myfamily and I know I don't have it."After learning the above reasons fornot reporting for x-rays, of course, wewere abie to convince many of thesepeople that these beliefs were withoutfoimdation and were able to motivatethem to be x-rayed; however, there werestill others who held steadfast to theirlife long beliefs and refused to be budged.This, I'm sure, highly pleased oiarcunning enemy, "T. B.," for surely theseare the people who constitute his dwindling"happy hunting grounds."Before presenting the provisional resultsof our second mass x-ray survey,perhaps it would be well to establish abase line with the present pertinentdata(2) relating to tuberculosis in thecoiuaty as compared with North Carolina.As present in Table 1, the residenttuberculosis morbidity rate for 1950 inHalifax County was 87.2 per hundredthousand population compared with 90.4for North Carolina as a whole, withthe white rate of Halifax County being59.4 compared with 71.4 for the Stateand with the negro rate being 108.4against 139.3 for North Carolina. Theofficial resident tuberculosis mortalityrates (Table 2) for Halifax County andNorth Carolina in 1949 revealed a rateof 34.3 per hundred thousand for HalifaxCounty with 23.9 for North Carolina,while the white mortality rate in thecounty was 19.8 compared with 13.1 forthe State and with the negro rate inthe county being 45.3 compared with 51.5for the State. The number of cases oftuberculosis reported per death (Table3) in 1950 in Halifax County was 2.7compared with 4.7 for the State. Thecounty rate was exactly double our ratefor the previous year, as a result of theepidemiological survey in Enfield. Perhapsthis small avalanche of new casesreported in 1050, as a result of the specialsurvey, is what took some of the"starch out of the sails" of the second