Additionally, some means should be found to pay for public transportation for the many elderly poor for whom the cost of 50 cents for a round trip D.C. Transit fares inhibits them from taking advantage of free clinics to which they have access at present. The pitifully meager income of substantial numbers of elderly persons is reflected in the fact that the average monthly payment for approximately 45,000 elderly social security beneficiaries is $72.67, putting the annual average (of about $872) at less than half the poverty index of $1,800 for a single person. Essentially, it may be persuasively argued, preventive health measures cannot be meaningful for those most in need, unless coupled with efforts to provide adequate subsistence income, proper housing and improvement of the shocking living conditions found by the medicare alert aids, whose report, referred to earlier, detailed lack of "proper bed or bedding on which rats, falling plaster, and the thoroughly dilapidated houses sheltering many of the elderly poor." to rest * * * 4. The effectiveness of the multiphasic health screening program which the Adult Health Protection Act would offer, it would seem to me, might be highly dependent upon the successful development of techniques to reach segments of the target population to educate them to the significance of availing themselves of the program. In the District of Columbia the higher death rates of nonwhites compared to whites in the upper age brackets may be in part attributable to lack of knowledge of availability of health services, as well as lack of education regarding proper health habits, which may have resulted from restricted amount of public school education received by inmigrants from rural areas of recent decades. In metropolitan centers such as this, therefore, it would be especially important to provide a means of informing and motivating the target population to utilize the facilities made available. 5. Should the Federal Government provide the multiphasic screening program described in your communication, the establishment of the centers would offer an opportunity for the Federal agencies to encourage the use of these facilities by vigorous promotion of health maintenance education for their employees who comprise a substantial proportion of the working population in this and some other metropolitan areas. In the District of Columbia, such cooperative activity by Federal agencies could be of great assistance in demonstrating for the total community the importance of a comprehensive health maintenance and protection program. I should like to express my appreciation to you and your committee for the attention and effort you are devoting to the needs of our aging and aged citizens. As Chairman of the District of Columbia Interdepartmental Committee on Aging, I am keenly aware of many urgent and unmet needs of these groups. You may be sure that the hearings you have scheduled, September 20 through 22, will be followed by me and my staff with great interest. Respectfully, DONALD D. BREWER, Director. Hon. MAURINE NEUBERGER, FLORIDA STATE BOARD OF HEALTH, Jacksonville, August 31, 1966. Chairman, Subcommittee on Health of the Elderly, Senate Office Building, Washington, D.C. DEAR SENATOR NEUBERGER: Thank you for your letter of August 24, 1966, in which you requested additional information pertaining to a community health profile screening program in Florida. A community screening program was established in the city of Monticello, Jefferson County, Fla., in February 1963. This program was implemented with the assistance of the local physicians and has furnished continuous health profile screening of the general public of that county since its inception. The purpose of the project is to screen the apparently healthy population and to refer the abnormal screenees to their physicians. Jefferson County was chosen due to the relatively small, stable population and the interest by local physicians, county health groups and the general population in conducting and participating in such a program. This county lies in rural, northern Florida with a population of 9,543 with a median age of 23.5. Other statistics of interest pertaining to Jefferson County are as follows: 10 percent of the popula tion is over 65 years of age; about 8 percent of the total population is on State welfare and over 50 percent of the residents over age 65 are receiving old-age assistance. As can be easily seen, this county has low economic indexes with a high indigent population. The Jefferson County program is currently being supported by funds from the Florida State Board of Health and the Jefferson County Health Department. The staff for this program consists of (1) a fulltime public health nurse who performs the screening examinations: (2) the county health officer who supervises the program; (3) parttime clerical assistance by the chief clerk of the county health department. Laboratory support is furnished by the Florida State Board of Health laboratory in Jacksonville This screening program has conducted, as of July 31, 1966, 60,131 tests on 3,818 persons. One thousand four hundred and six persons have been referred for 1,865 abnormal screening test results. The screenees are referred to their private physicians when abnormalities are found. Attached are the forms being used. (Enclosure 1), an informational brochure for the screenee; (enclosure 2), referral criteria standards; (enclosure 3), health profile screening form; (enclosure 4), the monthly reporting form used in the program; (enclosure 5), letter to persons with abnormal screening results, with copy to the private physician. 3: We are of the opinion that health profile screening of the general population is one way to provide early identification of those persons who may have insidious chronic diseases and bring them to treatment. Please notify us if we may provide you with further information. Sincerely yours, WILSON T. SOWDER, M.D., State Health Officer. [Enclosures] HEALTH PROFILE SCREENING UNIT, JEFFERSON COUNTY HEALTH ABOUT YOUR TRIP THROUGH THE HEALTH PROFILE SCREENING UNIT Most physicians prefer to treat diseases before they have become serious or chronic. Screening examinations such as you have just completed, are not diagnostic, but may point to conditions for which you need to consult your physician. Results of your screening examinations are reported only to your physician. However, you will be notified in writing within a few days if for any reason your tests are considered not to be within normal limits. Health profile screening examinations have been planned to best fit your needs, considering your sex and age. A check on your history, height, weight, blood pressure, eyes, X-ray of the chest, blood sugar and other screening examinations are given to provide your physician with valuable information, which may indicate your health profile index or health picture. In case you are advised to visit your physician for further study, you are urged to do so promptly as may be consistent with your convenience. Remember that these screening examinations do not replace a thorough physical examination which can only be done by your doctor of medicine. This Health Profile Screening Clinic is made possible by the physicians of your county, Healthyways Inc., Jefferson County Health Department and the Division of Chronic Diseases, Florida State Board of Health. 69-803 0-6628 Jefferson County health profile screening unit referral criteria, revised To be eligible the screenee must give the name and address of the physician to whom referral will be made, if indicated. 'Screening levels should be set up after consultation with the physician who will be receiving the referees NOTES Screening tests are for apparently healthy persons and those with known disease are eliminated from screening programs. Screening is not diagnostic but points to the people who should consult their own physician for further medical workup. Results of the selected abnormal screening findings are reported only to the physician, not to the screenee himself. Through screening, those people most likely to need medical attention are referred to their doctor. Thus, the physician's time can be better utilized for early diagnosis and treatment. |