January, 1933 MOUNTAIN LINE AND
WORK Page S
resources, supporting public schools and other educative agencies, is coming great help. What is needed is a clear conception of the problems and the steps to be taken in their solution. It should be kept in mind that some in this great Highland region are able to care for themselves. Others are so stranded in unfavorable situations that permanent improvement can only come through securing their removal from inhospitable
surroundings. A large number, those considered in this article, are strong and capable but not able to solve their problems alone. They should remain where they are, and the best blood of the next generation should take the places left vacant as this generation passes on. With this type of mountain population is the great opportunity for service. To these we owe the greatest debt. May it be paid in full.
Child Health In Mining Camp And Village
Iva M. Miller
In April of this year the Save the Children Fund of America asked me to make a survey of the situation as regards children's health in Harlan County, Kentucky, one of the most populous of the Southern Appalachian coal mining counties, where unemployment has rendered a difficult hygienic and sanitary situation even more difficult. To study the problem of children's health meant that a general survey of the whole community's health and environment should be made. Beginning with reports of the Census Bureau and the State Board of Health, and aided by the various physicians in the county, city and county officials, educators, missionaries, pastors, business men, the State Health Officer and his colleagues, and the Harlan County Save the Children Fund Committee, with Rev. C. 1u. Vogel, pastor of the Harlan Methodist Church, as Chairman, I proceeded to study Harlan County
Among the significant facts which I discovered was this hint of the development of Harlan's coal mining activities, as seen in the growth of the county's population:
1890 1900 1910 1920 1930
6,197 9,838 10,566 31,546 64,557
The increase of 198 per cent in population between 1910 and 1920 is an index of the amazing -and as we see it now, the appalling-inflation of the coal industry during the World War. Some of the horde of new miners came from outside,
but many came from neighboring mountain counties. During the next ten years the population more than doubled again, partly due to incoming migration, but also in considerable degree to the high birth rate, which in 1931 was reduced to a few points above that of the state of Kentucky as a whole.
The rapid increase of population greatly complicated the problems of sanitation and health. When a community thus greatly enlarged was stricken by a decline in the prosperity of the coal industry, throwing thousands of men out of work, and necessarily making the living conditions of their families worse, the results were disastrous. The preponderance of mine employees in the county is shown by the population distribution in 1930, which is given as, urban 6,596; farm 4,623; and rural non-farm, mostly miners and their families in small camps, 52,968.
In every community, it is possible to obtain a few relevant facts which are indices of the health of the community. Among these is the rate of infant mortality. If this is higher than that of an adjacent community or state, one or more of several facts may bear part of the responsibility; either the drinking water is unsafe, sewage disposal is unsatisfactory, grade A milk is not available, or the child's food is not being selected, prepared or administered according to the best ideas of hygiene and sanitation.
The water supply of the city of Harlan was found to be excellent, but that of the rest of the county more or less questionable; mostly wells and springs, and except in a few mining camps, uncontrolled. The county, like many another in