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

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examination of the general population,and such examinations are considered abasic part of any progressive tuberculosisprogram. However, the survey oflarge groups of people is of no valueunless there are facilities to re-examinethose persons who show evidence ofChest disease which are detected throughmeans of the X-ray made on the mobileunit. This Section emphasizes the reexaminationof all such persons, and in1950 our follow-up technicians were ableto re-examine, during and immediatelyafter commimity-wide siirveys, an averageof 92% of persons who requiredX-ray examination in order to establisha definite diagnosis. The re-examinationof persons with definite or suspecteddisease found during special surveys wasnot as successful as the re-examinationof those person detected with diseasein community- wide or mass surveys.This was due in a large measure to thefact that it was not practicable for usto assign a follow-up technician to thesespecial siurveys.It is our policy, in the case of community-wideor mass sui'veys, to conductthe so-called 14 x 17 X-ray clinicsfor a reasonable length of time afterthe survey has been completed. In somecases our personnel has remained in thearea for this purpose as long as twomonths after the completion of thesurvey. Generally, it is necessary for thetechnician or technicians to remain inthe area about one month. However,this is dependent on the wishes of thelocal health officer.b. EquipmentThe Tuberculosis Control Sectionowns 10 X-ray units. One of these is aportable 60 M. A. Westinghouse Machinewhich is used in the follow-up diagnosticclinics. One 70 mm. photoroentgenmachine is on loan at theDuke University Medical School Hospital,Durham and one of the sametype units is on loan at the BaptistHospital, Winston-Salem. Five 70 mm.photo-roentgen units are used for community-widesurveys and two of thesame type are used for special surveys.One of the units assigned for specialsurveys has been in use by the U. S.The Health Bulletin November, 1951Army Recruiting Service in Raleighsince September, 1950 for the examinationof Army Inductees. Other equipmentconsists of eight tractor trucks,one Chevrolet carry-all, one generator,and spare X-ray pai-ts. The Section hason loan X-ray equipment at the Wake,Mecklenburg, and Forsyth CountyHealth Departments.c. Method of AdministrationIn a community-wide survey four mobileX-ray units operate simultaneously,and a fifth unit is held in reserve to beused in case of break down. The centraloffice in Raleigh furnishes the localhealth officer a report of those personswho should be re-examined on accovmtof definite or suspected chest disease, aswell as a report of those who havenormal findings. X-ray pictures takenby the mobile imits are developed andinterpreted at the central office inRaleigh. The large picture, which isnecessary to confirm the diagnosis, isdeveloped at the site of the survey andforwarded to the Central Sanatorium,McCain, for interpretation.d. Community-wide (Mass) & SpecialSurveysCommunity-wide surveys have beenconducted in 75 counties. In one countya special survey was conducted in whichthe results were equivalent to a commimity-widesurvey and might properlybe considered a mass siu-vey. However,publicity and other measures incidentto a community-wide survey were notconducted in the county.One hundred twenty-six special surveyshave been carried out, and thenmnber of X-rays made ranged as highas 8,000. In these surveys one to twounits were used.It is our policy to schedule specialsurveys six months in advance. Community-widesurveys have been scheduledfor 1952 and 1953; and by thattime, providing there are no cancellations,one hundred counties will havebeen surveyed, eight of which will bere-surveys.e. PersonnelPersonnel totals twenty-three personswhich includes:(1) Two doctors
November, 1951The Health Bulletin(2) Eleven X-ray technicians(3) One part-time consultant nxirse(4) Seven clerks(5) Two health educators (one white,one negro).Personnel has been reduced by threetechnicians during the current year onaccount of a reduction in the budget.2. SURVEYS ACTIVITIESa. Planning activities prior to carryingout community-wide surveys consistof two pre-planning conferences. Theseare held at the local health departmentor a place designated by the local healthoflBcer. The first conference is held sixmonths prior to the survey, and thesecond conference two months prior tothe survey. Persons who are invited toattend these pre-planning conferencesare listed below:(1) The Health Officer and his staff(2) Representatives from:a. The local Medical Societyb. County Commissionersc. Board of Healthd. School Boarde. Local Tubercvilosis Associationf. Local Power Companyg. Coimty Demonstration Agentsh. County Welfare Representativesi. Ministers of the Gospelj. Members of Civic Organizationsk. Negro organizations and schools1. Any other persons interested inPublic HealthCases of tuberculosis found per 10,000persons x-rayed in Eastern and Westernareas of North Carolina by race.Area Total White Non-WhiteEastern N. O. 148.7 171.9 114.8Western N. C. 52.4 55.3 38.3b. White and Non-White Rates (practicallyall non-white limited to theNeg^o Race)It is of interest to note that of thetotal population examined by our mobileX-ray vmits there are more white personswho have tuberculosis than nonwhite.The non- white death rate is fourtimes the white death rate, and theexplanation for the low non- white morbidityis probably due to the fact thatthe non-white individuals x-rayed didnot ccmstitute a representative sampleof the population.Comparison of White and Non -WhiteTuberculosis'^ Mortality and MorbidityRates North Carolina, 1947-1949.MORBIDITY RATESWhite Rate Negro Rate Percent NecroYear Per 100,000 Per 100,000 Exceeds White1947 80.4 137.4 70.9%1948 71.0 124.4 75.2%1949 75.0 120.7 60.9%3. FIE
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MEMBERS OF THE NORTH CAROLINA STATE
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The Health Bulletin JantLary, 1951S
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^DSMBERS OF THE NORTH CAROLINA STAT
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