contamination from privy
contents"; and only 32.88 percent of the houses were effectively
screened against flies. A very considerable improvement in farm
sanitation has resulted from the educational campaigns conducted during
the past decade, but effective rural sanitation awaits the employment of
public health officials who will convince the people of each local
community of their individual responsibility for the health conditions
on their own farms and of their common liability for the health of each
other.

With the above conditions in mind, let us now consider the agencies for
health conservation in rural communities. We have already seen that the
old-fashioned country doctor is rapidly disappearing. With better
transportation now available it seems probable that physicians will live
in the larger village centers, but with telephone communication and the
automobile it should be possible to secure as prompt medical attendance.
We may as well recognize that many a rural community is too small a unit
to support a resident physician and that if satisfactory medical
treatment is to be secured we shall have to have better hospital and
clinical facilities so that the time of the physician can be economized
and frequent attention can be given.

Most rural townships have a local board of health and health officer,
who is charged with reporting births and deaths and with the enforcement
of quarantines against contagious diseases, but it is notorious that
these local health officials are rarely efficient or take any leadership
in the betterment of public health. Ordinarily the health officer
receives little if any pay, and is a resident physician who is not
inclined to antagonize his own clients when the enforcement of health
regulations would meet their opposition. Students of rural health
problems are now fairly agreed that the only means of securing efficient
administration of public health regulations in rural communities is by
the employment of a full time county health officer, working under a
county board of health, who will have the same general duties as the
health officers in our cities. Local health officers would be retained,
but their work would be under the supervision of the county health
officer and would have the benefit not only of his support and
encouragement, but also of his superior technical training. If a county
superintendent is necessary for our schools, a county health officer is
equally necessar