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States: Those States ranking highest and lowest for each of the three types of administration of school health programs are here listed.

Board of Education: The 10 States reporting 80 percent or more of their cities with the school health program administered by the Board of Education are, in descending order: New York, Iowa, Nebraska, New Jersey, Minnesota, South Dakota, Arizona, Delaware, Vermont, and Texas. The 9 States reporting less than 20 percent are, in descending order: Alabama, Florida, New Hampshire, Mississippi, Georgia, Louisiana, Maryland, North Carolina, and Nevada.

Board of Health: Only one state (New Hampshire with 89 percent) reported more than 55 percent of its school health programs administered by the Board of Health. The District of Columbia is under Board of Health administration. Eight other States reporting between 54 and 30 percent are, in descending order: Alabama, Mississippi, Georgia, Ohio, Florida, Louisiana, Arkansas, and South Carolina. The 9 states having less than 5 percent are, in descending order: New Mexico, Minnesota, Utah, Colorado, Missouri, Pennsylvania, Indiana, New York, and Texas. The following 9 States reported "no" cities: Arizona, Delaware, Idaho, Iowa, Maine, Nebraska, Nevada, New Jersey, and Vermont.

Joint administration: The following 11 states reported that 40 percent or more of their cities had the school health program administered jointly by the Boards of Education and Health: Nevada, North Carolina, Maryland, Tennessee, Kentucky, Ohio, South Carolina, Florida, Virginia, West Virginia, and Montana. There were 9 States which indicated that 10 percent or less of their cities are so administered, as follows: Missouri, Vermont, New Jersey, Iowa, New Hampshire, South Dakota, Minnesota, New York, and Nebraska.

Financing

For all the 2,886 cities reporting, 54.9 percent were financed by the Board of Education; 10.5 percent by the Board of Health; 23.3 percent jointly by Boards of Education and Health; and 11.3 percent by

other methods.

In 1940, for all cities of 10,000 and above, 75.4 percent were financed by the Boards of Education; 12.1 percent by the Board of Health; 9.2 percent jointly; and 3.3 percent by other authorities. In 1950, the Board of Education financing for cities of 10,000 and above had dropped from 75.4 percent to 61.6 percent; Health Department financing had dropped from 12.1 to 10.0 percent; joint financing had increased from 9.2 to 21.3 percent; and other authority had increased from 3.3 to 7.1 percent.

Group I. Of the 93 cities in Group I, 56, or 60.2 percent, reported that the financing agency was the Board of Education; 15, or 16.1 percent, the Board of Health; 18, or 19.4 percent, jointly financed; and 4, or 4.3 percent, financed by other methods.

By regions, the percentages of cities in this group having their school health programs financed by Boards of Education range from 100.0 to 25.0 percent. It is highest in West North Central and Pacific and lowest in New England and South Atlantic.

Corresponding percentages for cities having the financing done by Boards of Health range from 50.0 percent for New England to 0.0 percent for four Western regions.

Joint financing ranged from 50.0 to 0.0 percent, being highest in Mountain and South Atlantic and lowest in West North Central and Middle Atlantic.

Group II. The financing agency in the second group is as follows: Board of Education, 63.3 percent; Board of Health, 13.5 percent; joint financing, 19.6 percent; and other methods, 3.6 percent.

By regions, the range for Board of Education financing is from 86.7 to 30 percent. It is highest in West North Central and Pacific and lowest in East South Central and New England.

The percentages for cities financed by Boards of Health are from 30.8 to 0.0 percent, with New England and East South Central highest and West North Central, West South Central, and Mountain reporting no financing by this plan.

Joint financing for cities in Group II ranges from 50.0 to 8.2 percent, being highest in East South Central and South Atlantic and lowest in Middle Atlantic and East North Central.

Group III.-In the third group, the financing agency is as follows: Board of Education, 61.1 percent; Board of Health 7.8 percent; joint financing, 22.3 percent; and other methods, 8.8 percent.

By regions, the percentages being financed by Board of Education range from 76.9 to 15.9 percent with West North Central and Middle Atlantic highest and South Atlantic and East South Central lowest.

The extent of financing by Boards of Health varies from 28.0 to 0.6

percent, being highest in East South Central and South Atlantic and lowest in Middle Atlantic and Pacific.

Joint financing ranges from 49.2 to 8.2 percent with South Atlantic and Mountain highest and Middle Atlantic and West North Central lowest.

Group IV.-The financing agency in Group IV is as follows: Board of Education, 51.2 percent; Board of Health, 10.8 percent; joint financing, 24.4 percent; and other methods, 13.6 percent.

By regions, the range for Board of Education financing is from 82.4 to 9.8 percent with West North Central and Middle Atlantic highest and South Atlantic and East South Central lowest.

Corresponding percentages for cities where the financing is done by the Board of Health range from 31.9 to 2.4 percent with East South Central and South Atlantic highest and West North Central and New England lowest.

Joint financing varies from 42.5 to 7.3 percent for the nine regions. It is highest in South Atlantic, East South Central and Pacific, and lowest in West North Central and Middle Atlantic.

Regions. By regions, the percentages for all cities having financing by Boards of Education are highest in West North Central, Middle Atlantic and Pacific and lowest in South Atlantic, East South Central and Mountain. The range is from 82.0 to 15.0 percent.

Corresponding percentages for cities having the financing by Boards of Health range from 30.6 to 2.4 percent, being highest in East South Central and South Atlantic and lowest in West North Central and Middle Atlantic.

Joint financing ranges from 43.3 to 8.2 percent for the nine regions. It is highest in South Atlantic and East South Central and lowest in West North Central and Middle Atlantic.

Personnel Available

for School Health Services

The extent to which school health service personnel, such as physicians, nurses, dentists, and dental hygienists, are available in the various school systems is indicated in table 8. More detailed information by regions and city groups is included in table 23. The percentages shown in these two tables are based on the total number (3,186) of school systems reporting. This number includes the 300 cities which have no school health services.

United States.-The number of school of school health personnel is as follows:

systems having various kinds physicians, 2,004 or 62.9 per

Table 8.-Percent of school systems reporting the availability of personnel for school health services, by type

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1 This column represents the school systems which reported that they had no school health service and consequently no personnel.

cent; nurses, 2,720 or 85.4 percent; dentists, 1,286 or 40.4 percent; dental hygienists, 506 or 15.9 percent; other school health personnel, 372 or 11.7 percent; and "no" personnel, cities with no school health services, 300 or 9.4 percent.

In general, such personnel was more available along the seaboard States and least available in the mountain and central States. The larger cities had the highest percentages of professional personnel employed, whereas the smaller communities had relatively less help. Nearly all the cities of 2,500 in population and above had nursing service or consultants available.

City population groups. The availability of professional personnel on the staffs of school health services for cities of varying size is here presented.

Group I. Of the 93 cities in Group I, 88, or 94.6 percent, have physicians; all have nurses; 75, or 80.6 percent, have dentists; 48, or 51.6 percent, have dental hygienists; and 37, or 39.8 percent, report other personnel available.

Group II.-Percentages for the 253 cities in the second group are: physicians, 81.8 percent; nurses, 97.6 percent; dentists, 59.7 percent; dental hygienists, 31.6 percent; other personnel, 18.2 percent; and "no" personnel, no school health service, 0.8 percent.

Group III.-Percentages for the 687 cities in the third group are: physicians, 71.9 percent; nurses, 94.6 percent; dentists, 47.0 percent; dental hygienists, 21.8 percent; other personnel, 11.2 percent; and "no" personnel, no school health service, 2.8 percent.

Group IV.-There were 2,153 cities reporting in Group IV. The percentage of cities having various personnel are: physicians, 56.4 percent; nurses, 80.4 percent; dentists, 34.2 percent; dental hygienists,

10.6 percent; other personnel, 9.8 percent; and "no" personnel, no school health service, 13.0 percent.

Availability by profession.-The relative availability of professional personnel by regions and city size follows.

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Physicians. The employment of physicians ranges from 97.3 percent for Middle Atlantic and 92.7 percent for New England to 34.6 percent for West South Central and 33.0 percent for West North Central. By city size, it ranges from 94.6 percent for Group I to 56.4 percent for Group IV.

Nurses. The extent to which nurses are employed varies, by regions, from 99.1 percent in New England and 97.6 percent in Middle Atlantic to 62.4 percent in West South Central and 72.3 percent in West North Central. By city size, the range is from 100 percent for Group I to 80.4 percent for Group IV.

In 1951 12 according to the Public Health Service, 6,088 nurses, including 139 supervising nurses, were employed by local Boards of Education. This figure indicates an increase of 51.8 percent over the number employed in 1941, as compared with a 24.6 percent increase in the total number of nurses in all fields for that period. This number of school nurses also represents 23.9 percent of the 25,461 nurses in all fields in that year as compared with 19.6 percent in 1941.

These data indicate that during the past decade there have been increases both in the total number of nurses employed by local Boards of Education as well as in the relative percentage of all nurses so employed.

Local official health agencies, by comparison, employed 12,556 nurses in 1951, which figure represents an increase of 31.4 percent over the figure for 1941. Local non-official agencies employed 4,774 nurses in 1951, which figure represents a 17.7 percent decrease from 1941.

Dentists. The availability of dentists ranges, by regions, from 70.6 percent for Middle Atlantic and 59.4 percent for New England to 19.0 percent for West South Central and 18.6 percent for Mountain. By city size, the range is from 80.6 percent for Group I to 34.2 percent for Group IV.

Dental Hygienists.-The extent to which dental hygienists are employed varies, by regions, from 32.9 percent in New England, 21.5 percent for Pacific, and 20.5 percent for Middle Atlantic to 4.1 for Mountain, 3.0 for West North Central, and 2.8 percent for West South Central.

The Medical Examination

The medical examinations can ordinarily be grouped under three classifications: the periodic examination required of all students, the

19 Total Number of Nurses Employed for Public Health Work in the United States, in the Territories of Alaska and Hawaii, Puerto Rico and the Virgin Islands on January first of 1937, 1941, 1946, 1951. Public Health Service, Federal Security Agency, Washington, D. C., 1951.

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