1938: Child Welfare

Births and Infant Mortality.

Provisional figures issued in 1938 by the U. S. Bureau of the Census showed 2,204,609 live births in 1937 and a birth rate of 17.0 per 1,000 population, a slight increase over the two preceding years. The provisional infant mortality figures for 1937 show 110,760 deaths of infants under one year, or a rate of 54 per 1,000 live births, the lowest infant mortality rate on record for the United States. (The latest available figures on maternal mortality are for 1936 and show a maternal mortality rate of 57 per 10,000 live births.)

Maternal and Child Health Services.

Under the Social Security Act, title V, part 1, administered by the Children's Bureau of the United States Department of Labor, all 48 states, Alaska, the District of Columbia, and Hawaii (51 jurisdictions) received Federal grants for maternal and child-health services during 1938. (Total Federal payments to the States for the fiscal year ended June 30, 1938, were $3,728,930.58.)

During the year, the state health agencies extended maternal and child-health services into an increasing number of rural communities largely through the employment of public-health nurses and an increase in the number of prenatal and child-health conferences conducted by local practicing physicians with the aid of the nurses. The quality of maternal and child-health services was improved through postgraduate courses for physicians, dentists, and nurses; through special training for maternal and child-health employees of state and local health departments; through demonstration services for groups in special need and areas of special need, and through the more widespread education of parents, particularly of mothers, in the care of children. During the year ended June 30, 1938, there were reported 281,210 visits of mothers to prenatal conferences, 939,031 children's visits to child-health conferences, 1,994,342 health examinations of school children, and more than 6,000,000 public-health nurses' home and office visits for maternal and child-health service.

Services for Crippled Children.

With the exception of Louisiana, all the states, the District of Columbia, Alaska, and Hawaii received Federal grants for services for crippled children under part 2 of title V of the Social Security Act administered by the Children's Bureau. (Total Federal payments to the states for fiscal year ended June 30, 1938, were $2,694,676.33.)

The state crippled children's agencies, with the aid of Federal grants and consultation service from the Children's Bureau, continued the program of locating crippled children and providing diagnostic, medical, surgical, hospital, and aftercare services. A total of 151,909 crippled children were on the state registers on June 30, 1938. Reports from the states show that 45,743 cases had been given care in hospitals during the preceding year. The recommendations of the Technical Committee on Medical Care (see below, New Proposals Related to Child Health) proposed increased funds for the care of children suffering from various types of physical handicaps who cannot be cared for with funds now available.

Child-welfare Services.

With the exception of Wyoming, all the states, the District of Columbia, Alaska, and Hawaii received Federal grants for child-welfare services under part 3 of title V of the Social Security Act administered by the Children's Bureau. (Total Federal payments to the states for the fiscal year ended June 30, 1938, were $1,351,638.44.)

The program for child-welfare services on the basis of plans jointly made by the state public-welfare agencies and the Children's Bureau had developed by June 30, 1938, to the point where child-welfare workers had been placed in 428 counties, and, in the New England states in 7 local areas, and some service was being given to individual children by state workers in more than 800 counties in the process of developing local child-welfare services. During the month of June 1938, more than 42,000 children — homeless, dependent, neglected, and in danger of delinquency — were given some service by child-welfare workers under this program.

Aid to Dependent Children.

In January 1938, 38 states, the District of Columbia, and Hawaii were receiving Federal grants for aid to dependent children under the Social Security Act, title IV, administered by the Social Security Board. By September 1938, 2 states had been added. The report for September showed 626,438 children in the 253,916 families to whom payments were made during the month. The average payment was $31,72 per family, ranging from $10.81 in Arkansas to $57,49 in Massachusetts.

New Proposals Related to Child Health.

In January 1938, the Conference on Better Care for Mothers and Babies called by the Children's Bureau was attended by 486 representatives of professional associations, national organizations, and health and welfare officials. The committee on findings of the conference reported the great and unnecessary loss of life of mothers and newborn babies from causes associated with pregnancy and childbirth and the meager resources for providing medical, nursing, and hospital care at delivery for mothers in families unable to provide such care unaided, and proposed various forms of action. In March, the National Council for Mothers and Babies was formed, consisting of representatives of 58 national organizations, to assist in the effort to increase public interest in better care for mothers and babies. In April at the request of the Conference of State and Provincial Health Authorities of North America, bills were introduced in both houses of Congress proposing an amendment to part 1 of title V of the Social Security Act to authorize increased appropriations for grants to the states to be used for improving maternal and infant care. No action was taken on these bills before Congress adjourned in June.

In February, the President's Interdepartmental Committee to Coordinate Health and Welfare Activities presented to the President a report of its Technical Committee on Medical Care on the need for a national health program. The Committee report containing recommendations for such a program was discussed at a National Health Conference called by the Interdepartmental Committee and held in Washington. July 18-20, 1938, and was to be transmitted to Congress, after it convened in January, with a special message from the President. One of the recommendations proposed expansion of maternal and child-health and crippled children's services carried under the Social Security Act. The extended program would include provisions for medical and nursing care of mothers and their newborn infants; medical care of children; services for crippled children; consultation services of specialists; and more adequate provisions for the postgraduate training of professional personnel.

Research.

The Children's Bureau research program during 1938 included studies of maternal and neonatal mortality, premature infants, physical fitness of school children, vitamin-C deficiency in children's diets, adoption laws and services, community supervision of mentally deficient children, institutional treatment of delinquent girls, community organization for the prevention and treatment of delinquency (St. Paul, Minn.), and the collecting of current statistics in various fields of child health and welfare.

Federal Laws.

In June 1938 a new Federal juvenile-delinquency act went into effect applying to persons 17 years of age or under who commit offenses under Federal law (not punishable by death or life imprisonment). The new act is intended to do away with long detention, to make possible prompt and private hearings, and to broaden the possibilities for disposition and treatment. The Congress also passed, and the President approved, in June 1938 a modern juvenile-court act for the District of Columbia. (See also CHILD LABOR.)

Other Events in the United States.

In February 1938, the Advisory Committee on Education in its report to the President recommended that among the major social objectives of the immediate future should be improved educational services for all children and that Federal aid to the states should be provided to supplement state and local treatment for schools to equalize the educational opportunities of children.

Events in Other Countries.

The Advisory Committee on Social Questions of the League of Nations met in Geneva, Switzerland, April 21 to May 5, to consider child welfare and problems of traffic in women and children. The committee considered reports of studies relating to the placement of children in families; children of illegitimate birth: traffic in women and children; recreational aspects of the cinema; and the protection and care of children in time of war. The Report on the work of the Committee in 1938 stated that there was general agreement that the problem of protection of children under conditions of modern warfare called for an urgent solution. In its report to the Assembly of the League of Nations in September 1938, the Committee raised the question of the enlargement of its scope of work to enable it to include in its studies the problem of the protection of children in time of war.

At the XVIth International Red Cross Conference held in London June 17 to 25, 1938, a resolution was passed affirming the importance of the problem of the protection of women and children against the suffering resulting from armed conflicts, requesting the International Red Cross Committee to study the problem in cooperation with the Save the Children International Union and recommending that National Red Cross Societies bring this question before their governments.

The Tenth Conference of the Pan-American Sanitary Bureau was held in Bogota, Colombia, from September 4 to 14, 1938. At this Conference resolutions were adopted relating to maternal and child health; a vote of confidence was given to the laws pertaining to child welfare adopted by the various Republics; a recommendation was made for the training of midwives; a recommendation that birth registration be made compulsory in all the countries; and a recommendation that the principle of compulsory reporting of pregnancy be generally adopted.

The Second Balkan Congress for the Protection of Children was held in Belgrade. Yugoslavia. October 6 to 10, under the auspices of the Yugoslav Union for the Protection of Children.