y for the supervision of public health, and several
states have enacted legislation requiring or permitting the employment
of county health officers. The county is usually the best unit for rural
health administration.[56] The county health officer would have
laboratory facilities for the examination of drinking water, and samples
of blood, urine, or sputum for the detection of disease, and would give
direction for the taking of samples which might be sent to the
laboratories of the state department of health for the examination of
those specimens for which his laboratory was not equipped. He would
have general supervision of the medical examination of school children.
In numerous ways he would promote better means for health conservation,
as can be done by one who has had special training for such work and who
is giving his whole time and thought to its problems.

Although the county health officer is necessary for the administration
of the technical aspects of public health administration, the most
important gains in the health of the rural community will come through
the personal education of its people on matters of hygiene and
sanitation. This is the field of public health nurses, and I believe
that the records of their work in rural communities will show that they
have done more for health education than any other one agency. A decade
ago trained visiting nurses were practically unknown in rural
communities. In 1914 the American Red Cross first organized its Town and
Country Nursing Service and cooperated with a few rural communities in
supervising the work of trained public health nurses, but relatively few
places employed rural nurses prior to the war. The county tuberculosis
societies also employed visiting nurses who worked throughout a whole
county and whose work inevitably created a demand for visiting nurses
for a more general service. The shortage of physicians during the war
and the influenza epidemic of 1918 revealed the need for rural nurses
and since the war the local chapters of the American Red Cross, which is
devoting much of its attention to public health work, have employed
hundreds of rural public health nurses.

The success of school nurses in the cities has led to their employment
in the smaller towns, and now county school nurses are being employed in
individual counties in several states, and in other states school
nurses are employed by townships or jointly by several rural school
districts