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Agenda.--

4

Participants

4

Statement of

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Andrus, Dr. E. Cowles, president-elect, American Heart Association. 34, 132

Berliner, Dr. Robert W., Chairman, Committee of Laboratory Chiefs,

National Heart Institute...

101

Betts, R. O., executive director, American Heart Association.-

103

Jones, Dr. T. Duckett, medical director, Helen Hay Whitney Founda-

tion, New York, N. Y.

10, 131

McCormick, Dr. Edward J., president, American Medical Association. 41

Perdue, Dr. Jean Jones, member, board of directors, Miami Heart

Institute and Miami Heart Association.--

105

Watt, Dr. James, Director, National Heart Institutes, National Insti-

tutes of Health, Public Health Service, Department of Health,

Education, and Welfare...

96

Wilkins, Dr. Robert W., vice president, American Heart Association. 23, 129

Wright, Dr. Irving S., past president, American Heart Association,

and professor of clinical medicine, Cornell University Medical

School.

7

Additional information submitted for the record by-

American Heart Association, Inc.:

Executive staff report to the assembly, 1952–53.

80

Fellowship and research grant awards, 1952–53.

72

History, policies, and program.-

89

To Live and To Work—1952 annual report.

106

Health, Education, and Welfare Department:

Heart Disease, prepared by National Heart Institute, National

Institutes of Health, Public Health Service..

51

Letter from Hon. Oveta Culp Hobby, Secretary -

6

National Heart Institute-Appropriations from inception of the

program (excluding contract authority), table.

National Heart Institute personnel

99

382

360

376

417

138

Statement of—Continued

Meader, Dr. Ralph G., Chief, Research Grants Branch, National

Cancer Institute..

318

Mider, Dr. G. Burroughs, Associate Director in Charge of Research,

National Cancer Institute.

304

Nathanson, Dr. Ira T., chairman, committee on cancer diagnosis and

therapy, National Research Council.

323

Runyon, Mefford R., executive vice president, American Cancer

Society ---

223

Teeter, John, Damon Runyon Foundation.-

337
Warren, Dr. Shields, director, cancer research institute, New England
Deaconess Hospital, Boston, Mass..

375, 410

Wermer, Dr. Paul L., secretary, committee on research, American

Medical Association..

282

Additional information submitted for the record by—

American Cancer Society:

Annual report, 1952-

225

Cancer funds, 1945–54, chart.

348

Cancer in the United States (including tables and charts) -

142

General funds raised and medical research funds allocated by

voluntary health agencies, interested in specific diseases,

table...

429

101 answers to your questions about cancer.

347

Sixth annual report, committee on growth-Trends in cancer

research.

179

Health, Education, and Welfare Department:

Cancer, prepared by National Cancer Institute, National Insti-
tutes of Health, Public Health Service-

304

Cost of medical care to cancer patients, prepared by National

Cancer Institute..

212

Lasker, Albert and Mary, Foundation, Inc.: Comparative figures on

control of one animal disease and agricultural research compared

to cost of cancer research..

223

National Research Council:

Principles and procedures for evaluatlon of proposals, July 1953. 324

Tentative criteria for cancer diagnosis and therapy --

329

Oak Ridge Institute of Nuclear Studies, report on European trip by

Dr. Marshall Brucer, chairman, medical division.

386

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HEALTH INQUIRY

(Heart Disease)

THURSDAY, OCTOBER 1, 1953

HOUSE OF REPRESENTATIVES,
COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

Washington, D.C. The committee met, pursuant to notice, at 10 a. m., in the committee room, 1334 New House Office Building, the Honorable Charles A. Wolverton (chairman) presiding.

The CHAIRMAN. The committee will come to order.

This morning, the Committee on Interstate and Foreign Commerce begins its inquiry into some important health problems. The hearings which have been scheduled so far cover a great deal of ground. It is appropriate for me, therefore, to outline briefly why we are making this inquiry and what the problems are which we expect to inquire into during these hearings.

Among the diversified legislative functions assigned to this committee, none appears to me more important than the committee's legislative jurisdiction with regard to health. None of the many other subjects with which this committee deals affects every family and individual in these United States more directly than the subject of health. Apart, however, from the human factors involved, I have become convinced from my study of health problems that the subject of health has more important economic implications for our Nation than many of the economic activities which are subject to Federal regulatory legislation. The following figures are evidence of the economic importance of ill health,

Recent surveys show that each day 134 million persons out of our civilian population between the ages of 14 to 64, estimated at 98 million, have been disabled from chronic diseases for more than a year. In the case of disabilities lasting 3 months, this figure increases to 2 million persons. The resulting economic loss each year has been estimated at 1 billion man-days.

The major diseases on which we have scheduled our hearings rank foremost among the diseases that cause this tremendous economic loss. Four major diseases alone-heart, cancer, tuberculosis, and rheumatism and arthritis—have resulted in an annual loss of 370 million man-days. This accounts for over one-third of the total man-days lost annually on account of chronic diseases.

The magnitude of the human suffering caused by these diseases and the enormous economic losses suffered both by the Nation as a whole and by individuals and family units raise two important questions:

(1) How can some of the suffering and some of the economic losses be prevented or mitigated; and

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(2) How can groups, individuals, and family units protect themselves against the unavoidable economic losses flowing from these diseases?

The first aspect of our inquiry is, therefore, directed primarily toward the public and private efforts that are being made into the causes, treatment, and control of some of these major diseases.

During the second series of our hearings beginning October 13, we will hear from insurance companies, Blue Cross, Blue Shield, cooperatives, employers, and unions with regard to some of the plans now in operation designed to protect individuals and members of groups and family units against the economic hazards of ill health.

Speaking of my own very personal feelings about these problems, I want to say that the thought of possible prolonged serious illness in my own family makes me feel very uneasy. I am confident that others must feel equally vulnerable to the possible impact of extended illness on themselves and their families resulting from extended illness. I am sure others as well as myself are asking the questions: What is being done? What can be done? What can I do?

The people of the United States are today enjoying standards of health as high as those of any Nation in the world. The expectancy at birth has risen by 21 years from 47 years in 1900 to 68 years today. During the last 15 years alone, the expected life span of an American at birth was increased by 8 years from 60 years to 68 years.

Credit for these spectacular achievements are due to many factors. However, our tremendous advances in discovering the origin and treatment of important diseases rank foremost among the factor which are responsible for this increase in our life span.

Many diseases that were highly prevalent only a few decades ago no longer present serious medical and economic problems for our Nation. For example, at the beginning of the century, 268 persons out of every million Americans could expect to contact typhoid fever and ultimately to die of this disease. Today, the death rate from this disease is one person out of every million.

Another example is that of influenza and pneumonia. At the turn of the century, 1,844 persons per million died of this cause. Today, this number has been reduced to 313 persons per 1 million inhabitants.

Childhood diseases, such as measles, scarlet fever, whooping cough, and diphtheria no longer present a serious threat to the children of our Nation. The death rate from these diseases has been reduced from 663 per million population at the beginning of the century to 15 per million in 1950. Even more spectacular are the figures with respect to appendicitis, maternal death, and tuberculosis where in 6 short years between 1944 and 1950 the death rate decreased between 50 and 57 percent.

Why, then, many including myself, will ask are we not equally successful with regard to cancer, heart diseases, polio, and the other major diseases that cause such great suffering and such stupendous economic losses? What is responsible for our inability to make similar progress with respect to these diseases? Is it lack of funds? Is it lack of trained personnel? Is it inadequate planning? Is it failure to maintain adequate communications among those active in the field of research? Are there, perhaps, missing in our knowledge of man some basic facts that might be discovered if a concerted effort in that direc

tion were made? These are some of the questions that occur to me as a layman in this field.

On the other hand, if we have to reconcile ourselves to living in the shadow of many of these major diseases for some time to come, the question that we would like to ask is how we can provide protection against the economic consequences of these diseases.

I could go on for quite some time giving you my thoughts on this subject of health on which I feel very strongly. However, time is short and we have arranged for a large number of witnesses to be heard.

The 15 days of hearings which we have scheduled so far are perhaps the equivalent of some 45 days of hearings while the Congress is in session. Now that the House is in recess, we will not be interrupted through floor calls or through conflicting committee meetings. Furthermore, we expect to hold hearings, mornings, afternoons, and if necessary during the evening. Therefore, we expect to do a great deal more work in 1 day than we would be able to do at times when the House is in session.

Before calling on the witnesses this morning, I want to express my appreciation for the splendid cooperation that we have received on the part of the men and women in the private and public organizations who have given so generously of their time in preparing for this inquiry and who are here today to participate in our hearings. Last but not least, I want to thank the members of this committee who have interrupted important duties in their own districts in order to attend our hearings this morning.

The hearing this morning relates to heart disease. The committee has set aside today to inquire just where we are, where we are going, and what additional measures must be taken, particularly in the way of research, that will hasten relief from the burden of heart disease.

As husbands and fathers, individuals ourselves, we members of the committee have a deep personal interest, for we have seen heart disease strike among our families and friends.

As members of the committee itself, we are gravely concerned with heart disease because of the staggering number of our people whom it kills or incapacitates and because of our committee's responsibilities in the field of health.

In the matter of especial knowledge of heart disease, we are laymen. But we are keenly conscious of our legislative responsibilities for the Nation's health, and we want to search out the important facts about heart disease.

What is its true significance? What about the gloomy statistics? What is being done today? What is not being done that could be done? What are the prospects, not for the far-off future, but for the, immediate years ahead? What are the resources? What has been accomplished in the past few years?

Heart disease is like an enemy loose within our country. It seems timely, when we are attacked by this disease as never before, to present to the American public the facts, to inform them about the current efforts to control heart disease, and to learn what can be done to improve these efforts.

If we can find ways to strengthen the research attack on heart disease, we must do so. If we can curtail the economic losses to

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