Fifteen years ago the Commonwealth Fund, together with local and state government agencies, established a demonstration of rural public health work in Rutherford County, Tenn. At about the same time other health demonstrations were begun in other areas. Many of these demonstrations have lapsed. Some of the communities in which they function are not noted for the present quality or completeness of their public health services. Not so with Rutherford County. The work there has been continuous though unspectacular. It has been supported by local funds, which at the peak in 1929 accounted for approximately 85 cents out of a total per capita cost of $1.20; in 1933, the lowest point since the peak, such funds accounted for approximately 55 cents out of an annual expenditure of 90 cents per capita. The remainder has come from state funds and other contributions, largely from the Commonwealth Fund.
A booklet1 now published by the Commonwealth Fund reviews fifteen years of public health work in Rutherford County. Syphilis has increased 100 per cent in cases reported in the five year period 1934-1938 as compared with the period 1924-1928; the increase in gonorrhea reported in the same length of time has been almost 700 per cent. The syphilis clinics are crowded. Of the persons under treatment 73.6 per cent have had at least twenty treatments of arsenic and twenty of a heavy metal in the last year. Although a considerable number of lapses in treatment occur, the health department nursing staff succeeds in returning a high percentage for further treatment.