10 <strong>The</strong> <strong>Health</strong> Bulletin April, 1951ing are necessary to prevent and minimizethe effect <strong>of</strong> the disease, the reportadded.Many p<strong>at</strong>ients with epilepsy can livea normal life and nearly all can bemade useful members <strong>of</strong> a communitythrough medical care and educ<strong>at</strong>ion <strong>of</strong>the p<strong>at</strong>ient, family and public, said areport <strong>of</strong> the American Chapter, Intern<strong>at</strong>ionalLeague Against Epilepsy."<strong>The</strong> psychologic handicaps <strong>of</strong> theepileptic are for the most part the results<strong>of</strong> social ostracism imposed by thepublic," said the report. "Preventioninvolves a change in the public <strong>at</strong>tituderegarding epilepsy."Preventive measures can reduce thenumber afiQicted by blindness, accordingto a report <strong>of</strong> the N<strong>at</strong>ional Society forthe Prevention <strong>of</strong> Blindness. <strong>The</strong> n<strong>at</strong>ion'safaicted were estim<strong>at</strong>ed <strong>at</strong> 260,000persons totally blind, 340,000 with visionbarely useful and 1,000,000 blind in oneeye.Screening tests among school childrenhave become important factors in theprevention <strong>of</strong> deafness, said a report<strong>of</strong> the American Hearing Society. Itadded:"<strong>The</strong>re is needed an awareness th<strong>at</strong> ahearing test is the only means <strong>of</strong> findinghearing loss in the early stages.Even though restor<strong>at</strong>ion to normalhearing may not be achieved, progression<strong>of</strong> the deafness may be arrested incases diagnosed early."Hereditary indic<strong>at</strong>ions were cited inconnection with cerebral palsy, epilepsy,diabetes, blindness and deafness. <strong>The</strong>reports recommended close observ<strong>at</strong>ion<strong>of</strong> persons with a family history <strong>of</strong> thosediseases, and more educ<strong>at</strong>ion as t<strong>of</strong>amily implic<strong>at</strong>ion <strong>of</strong> certain hereditarydiseases or those with an hereditarypredisposition.Obesity Reported as Chronic DiseaseFactorPoor e<strong>at</strong>ing habits th<strong>at</strong> cause childrenand adults to become excessively overweightor underweight are responsiblefor the development <strong>of</strong> many chronicdiseases, according to a report <strong>of</strong> theN<strong>at</strong>ional Conference on Chronic Disease:Preventive Aspects."An estim<strong>at</strong>ed 25 to 30 per cent <strong>of</strong>the adult popul<strong>at</strong>ion in the UnitedSt<strong>at</strong>es is overweight and the percentagemay reach as high as 60 per cent inwomen <strong>of</strong> the 50 to 70 year age group,"according to the Experimental Biologyand Medicine Institute <strong>of</strong> the N<strong>at</strong>ionalInstitute <strong>of</strong> <strong>Health</strong>.Deleg<strong>at</strong>es from 46 n<strong>at</strong>ional healthgroups <strong>at</strong>tending the three-day Conferenceon chronic disease prevention weretold th<strong>at</strong> programs to control obesitycould do much to prevent diabetes, gallbladder disturbances, heart and circul<strong>at</strong>oryabnormalities and hernias th<strong>at</strong> occurin hundreds <strong>of</strong> thousands <strong>of</strong> peopleeach year.Emphasizing the dangers <strong>of</strong> excessivedieting the report st<strong>at</strong>ed th<strong>at</strong> "weightcontrol is primarily a form <strong>of</strong> medicaltre<strong>at</strong>ment and should not be undertakenwithout medical supervision."<strong>The</strong> incidence <strong>of</strong> diabetes, increasing<strong>at</strong> the r<strong>at</strong>e <strong>of</strong> 50,000 cases each year, ismore than twice as gre<strong>at</strong> in obese adultsas in persons <strong>of</strong> average weight. Eightyper cent <strong>of</strong> diabetes in adults is associ<strong>at</strong>edwith obesity, according to a report<strong>of</strong> the American Diabetes Associ<strong>at</strong>ion.Programs to control obesity were suggestedas a means <strong>of</strong> reducing the incidence<strong>of</strong> this disease. Emphasis wasplaced on the need to find and tre<strong>at</strong>more cases <strong>of</strong> diabetes in the earlystages to prevent complic<strong>at</strong>ions. Waysand means <strong>of</strong> setting in motion theseand other programs for prevention <strong>of</strong>chronic disease were considered thisweek by conference deleg<strong>at</strong>es.Occup<strong>at</strong>ional HazardsOccup<strong>at</strong>ional hazards also play a rolein certain chronic diseases <strong>of</strong> the respir<strong>at</strong>orytract, heart and blood vessels,alimentary tract, liver, nervous system,muscle and boney structures, eyes, ears,and skin, according to a report by agroup <strong>of</strong> authorities in the industrialhealth field. <strong>The</strong> report called for anacceler<strong>at</strong>ed industrial health program.TuberculosisUndernourishment, f<strong>at</strong>igue, overcrowding,low economic st<strong>at</strong>us, poorpersonal hygiene and silicosis are among
April, 1951 <strong>The</strong> <strong>Health</strong> Bulletin 11the contributing causes <strong>of</strong> tuberculosis,the N<strong>at</strong>ional Tuberculosis Associ<strong>at</strong>ionreported. <strong>The</strong> disease is spread by contactwith tuberculosis persons and bythe use <strong>of</strong> unpasteurized milk from tuberculouscows. An estim<strong>at</strong>ed 500,000people in the United St<strong>at</strong>es now havethe disease.<strong>The</strong> report emphasized the importance<strong>of</strong> expanded mass chest x-raysurveys and wider use <strong>of</strong> tuberculintests to find cases in time for successfultre<strong>at</strong>ment <strong>of</strong> the individual and to protectother members <strong>of</strong> his family fromthe disease.Emotional Factors in Chronic DiseaseContinued emotional disturbancesplay a part in causing some chronic diseases,according to the American Psychi<strong>at</strong>ricAssoci<strong>at</strong>ion.Body structure or function may undergochanges imder prolonged emotionalstrains. <strong>The</strong>se physiologicalchanges can cause certain chronic diseases,the report said. Also, poor dietand accident proneness, possible results<strong>of</strong> a change in the individual's habits,may in turn produce chronic disease ordisability.Emotional factors were considered importantas causes contributing to hypertension,rheum<strong>at</strong>oid arthritis, epilepsy,colitis, ulcer, asthsma, and certain skindiseases.RAPID GROWTH OF VOLUNTARYHEALTH INSURANCE REPORTEDVoluntary health insurance is spreadingso rapidly th<strong>at</strong> a coverage <strong>of</strong> 90,000,-000 Americans against the major costs<strong>of</strong> illness should come within the nexttwo or three years, said Dr. Elmer L.Henderson <strong>of</strong> Louisville, president <strong>of</strong>the American Medical Associ<strong>at</strong>ion.Writing in the Journal <strong>of</strong> the A.M.A.,Dr. Henderson said th<strong>at</strong> between 70,-000,000 and 72,000,000 people now havesome form <strong>of</strong> voluntary health insurnance.Dr. Henderson, in reporting the rapidgrowth, said the second Blue Shieldmedical care plan, the United MedicalService, oper<strong>at</strong>ing in the New York metropolitanarea, has just passed its 2,-000,000 mark in enrolment. <strong>The</strong> firstplan to reach th<strong>at</strong> figure was the MichiganMedical Service. He said further:"Together, the achievements <strong>of</strong> thesetwo gre<strong>at</strong> medical care plans illustr<strong>at</strong>edram<strong>at</strong>ically the eternal truth whichsome <strong>of</strong> our detractors would denyth<strong>at</strong> voluntary health insurance is agrowing, successful, practical method <strong>of</strong>taking the economic shock out <strong>of</strong> illness."<strong>The</strong> United Medical Service, for instance,has reached its present size insix and one-half years. It oper<strong>at</strong>es inthe 17 southern counties <strong>of</strong> New YorkSt<strong>at</strong>e, with the active approval <strong>of</strong> theMedical Society <strong>of</strong> the St<strong>at</strong>e <strong>of</strong> NewYork and <strong>of</strong> the medical societies inthose 17 counties. Half a million memberswere gained during 1950 — onefourth <strong>of</strong> the total enrolment. <strong>The</strong> goalfor the next year or year and a half hasbeen set <strong>at</strong> further increase <strong>of</strong> 1,000,-000 members."It is pertinent here to cite some figuresshowing the remarkable growth <strong>of</strong>the nonpr<strong>of</strong>it medical care plans overthe n<strong>at</strong>ion. <strong>The</strong>re now are 72 BlueShield plans in 41 st<strong>at</strong>es. Particip<strong>at</strong>ingin their oper<strong>at</strong>ion are 113,000 out <strong>of</strong> the150,000 physicians who are in active,priv<strong>at</strong>e practice. Last year the BlueShield plans paid out $150,000,000 forsurgical and medical services renderedto member p<strong>at</strong>ients; this <strong>at</strong> the r<strong>at</strong>e <strong>of</strong>82 cents <strong>of</strong> every dollar paid in premiums."<strong>The</strong> Blue Shield plans are enrollingmembers <strong>at</strong> the r<strong>at</strong>e <strong>of</strong> 28,000 everyworking day, and they now protect approxim<strong>at</strong>ely12 per cent <strong>of</strong> the popul<strong>at</strong>ion—more than 17,000,000 persons.Other nonpr<strong>of</strong>it medical care plans notyet in the Blue Shield group cover anadditional 2,250,000 persons. During 1950the Blue Shield plans <strong>of</strong> the n<strong>at</strong>iongained 5,000,000 new members, an alltimerecord growth."<strong>The</strong> Blue Cross hospital plans keptpace. <strong>The</strong>y added more than 3,000,000new members in 1950, carrying them beyondthe 40,000,000 mark in total enrolment.Out <strong>of</strong> every premium dollar,Blue Cross plans are paying out closeto 88 cents in benefits for services totheir member p<strong>at</strong>ients.
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