. . ...; - - A SURVIY Of CRIPPLED CHILD~EN IN , GEO~GIA ADMINISTRATIVE P~OJECT NO. 165 346015 WORKS PROGRESS ADMINISTRATION of GEORGIA WORKS PROGRESS GAY B. SHEPPERSON, Administrator ADMINISTRATION OE GEORGIA MILTON W. BLANTON, Coordinator of Research and Statistical Projects CRIPPLED CHILDREN IN GEORGIA Administrative Project Number 165-34-6015 1937 Supervised by Ben H. Askew, III Sponsored by the Georgia State Departments of Health, Education, and Public Welfare WORKS PROGRESS ADMINISTRATION OF GEORGIA Miss GAY B. SHEPPERSON AdminisuaioT Ten Forsyth Street Buildinq AnANTA, GEORGIA August 1, 1937 Miss Gay B. Shepperson, Administrator, Works Progress .Administration of Georgia, Ten Forsyth Street Bulding, Atlanta, Georgia. Dear Miss Shepperson: I am transmitting herewith the final report of a Survey of Crippled Children in Georgia. This report includes basic data which will be useful in establishing a coordinated program for the care and training of crippled children. It does not attempt to make a medical analysis or to recommend the adoption of a specific program. Instead, it is a statistical presentation showing the number of crippled children, the causes of their handicaps, the number of these children receiving treatment, and their educational status. It would have been impossible to have completed this project without the excellent assistance rendered by vari 'US organizations and individuals throughout the state. In several counties the project workers were furnished transportation by county officials, free newspaper publicity was given, and one radio station gave free broadcasts asking that interested persons report cases of crippled children to the survey workers. In the assistance rendered the field workers, the schools, county welfare agencies, and public health nurses were especially valuable. The project was conducted under the general direction of Milton W. Blanton; the original plans and procedure for the survey was prepared by Thelma R~ Wright; and the field work, statistical analysis, and preparation of the final report were under the supervision of Ben H. Askew, III. CIAftJ Yours very truly, (l;j~ Clifford A. Strickland, Administrative Assistant CONTENTS Introduction General summary. Causes of Crippling Conditions Treatment Education and Vocational Rehabilitation Conclusion Appendix A. Appendix B. Page 1 3 5 9 12 15 19 25 L1 ST OF TA&LES AND CHARTS Narrative Tables Page Table I Crippled Children Classified According to Race and Sex 3 Table II Residence of Crippled Children - By Race. 4 Table- III Age Group of Crippled Children 4 Table IV Doctor s Diagnosis of Crippled Children - BY Race- Total Cases 5 Table V Doctor s Diagnosis of Crippled Children - By Race - Total Diagnosed Cases 5 Table VI Doctor s Diagnosis of Crippled Children - By Sex-Total Cases 6 Table VII Doctor s Diagnosis of Crippled Children - By Relief Status - Total Cases 7 Table VIII ~ercentage Table Showing Doctor's Diagnosis of Crippled Children - By Age Group- Total Ca.s es 7 Table IX Medical Treatment ~ece1ved By Crippled Children - By Race and Residence 9 Table X Percentage Table Showing Medical Treatment Received by Crippled Children - By Race and Residence . . . . . . 9 Table XI Crippled Children Receiving Hospital C...re - By Relief Status, 10 Table XII Number of Local Crippled Children Tr!t&ted. in Georgia Hospitale 10 Table XIII Education of Crippled Children 12 Table XIV Median Grade 1n School for Fulton County Crippled Children - By Age Group. 12 Narrative Charts Chart I Location of Residence of Crippled Children 3 Chart II Causes of Crippling Condition - Per Cent of Diagnosed Cases 6 Chart III Per Cent of Crippled Children Receiving Hospital Care - By County of Residence S Chart IV Crippled Children Rece1v1ng Hosp1 tal Treatment - By Race and Residence 9 Chart V Crippled Children Receiving Hospital Treatment - By Relief Status 10 Cha.rt VI _Education of Crippled Children Attending School To Education of Total Crippled Children - Fulton County 13 Appendix Tables Table 1. Age Groups of Crippled Children - By Residence and Race 25 Table 2. Relief Status of Crippled Children - By Race 25 Table 3. Doctor's Diagnosis of Crippled Children - By Race and Sex 25 Table 4. Doctor's Diagnosis of Crippled Children - By Race and Age Groups. 26 Table 5. Doctor's Diagnosis of Crippled Children - By Relief Status and Race 26 Table 6. Doctor's Diagnosis of Crippled Children - By Parts of the Body Affected 27 Table 7. Relief Status of Crippled Children - Treatment By Race 2~ Table 8. Doctor's Diagnosis and Treatment of Crippled Children 28 Table 9. Type of Treatment Received By Crippled Children - By Doctor's Diagnosis (Percentage Table) 28 Table 10. Distribution of Crippled Children 29 Table 11. D1str1but1on of Hospital Cases 30 Table 12. The Grade 1n School for the Median Crippled Child 31 Srvpled child for a profession or a definite occupation may be the largest single factor in determining whether that child shall become a self-supporting citizen or a recipient of public relief. - 14 - CONCLUSION Seven thousand five hundred and fifty-seven cases were included in the Survey of Crippled Children in Georgia. Infantile paralysis was the cause of more of the disabilities than any other diagnosis. This disease was responsible for 21.S per cent of the total oases, and 36.0 per cent of the oases for which a dootors diagnosis was available. seventy and one-tenth per oent of the total crippled children were reported as having received medical treatment. Thirty-three and six-tenths per cent were treated in a hos- pital, and 36.5 per cent were treated by a private doctor outside of a hospital. Fifty-three and two-tenths per cent of the children living in urban counties received hospital treatment, whereas only 27.0 per cent of the children living in the remaining counties received hospital treatment. Fourteen and seven-tenths per cent of the white crippled children between 10 and 21 years of age had received no schooling. Seventeen and seven-tenths per cent of the Negro crippled children in the same age group were reported to be illiterate. Although this rate of illiteracy is higher than that of the normal child the findings of the survey indicate that crippled children made a steady rate of advancement in school. This fact is important since an education is so valuable to the physically handicapped. - 15 - APPENO\XES APPENDIX A SoCIAL SECUIUTY ACT, PUBLIC - NO. 271 74TH CONGRESS, H.R. 7260 TITLE V: GRANTS TO STATES FOR MATERNAL AND CHILD WELFARE PART 1 PART 2 - SERVICES FOR CIUPPLED CHILDRF.N APPROPRIATION Sec. 511. For the purpose of enabling each State to extend and improve (especially ln rural areas and ln areas suffering from severe economlc distress), as far as practicable under the conditions ln such State, servloes for locating crippled children, and for providing medical, surgical, corrective, and other services and care, and facllltles for diagnosis, hospltallzatlon, and aftercare, for children who are crippled or who are suffering from conditions which lead to crippling, there le hereby authorized to be appropriated for each fiscal year, beginning With the fiscal year ending June 30, 1936, the sum of $2,g50,ooo. The sums made available under thle section shall be used for !118.klng payments to States whloh have submitted, and had approved by the Chief of the Children's Bureau, State plane for euoh services. ALLOTMENTS TO STATES Seo. 512. (a) Out of the sums appropriated pursuant to eeotlon 511 for eaoh fiscal year the Secretary of Labor shall allot to each State $20,000, and the remainder to the States aooordlng to the need of each State as determined by him after taking into consideration the number or crippled children ln such State ln need of the services referred to in section 511 and the cost of furnishing such servloee to them. (b} The amount of any allotment to a State 1mder s11beeotlon (a) for any fiscal year remaining unpaid to such State at the end of euoh fiscal year shall be available for payment to such State under section 514 until the end of the seoond succeeding fiscal year. No payment to a State under section 514 shall be made out of lte allotment for any fiscal year until its allotment for the preceding fiscal year has been exhausted or has ceased to be available. APPROVAL OF STATE PLANS Seo. 513. (a) A State plan for services for crippled children must (1) provide for financial partiolpatlon by the State; (2) provide for the administration of the plan by a State agenoy or the supervision of the admlnlstratlon of the plan by a State agency; (3) provide such methods of admlnlstratlon (other than those relating to selection, tenure of office, and compensation or personnel) as are necessary for the efficient operation or the plan; (4) provide that the State agency will make such reports, ln such form and containing such information, as the Secretary of Labor may from ti~eto time require, and comply with such provisions as he may from time to time find necessary to assure the correctness and verification of such reports; (5) provide for carrying out the purposes specified in section 511; and (6) provide for cooperation with medical, health, nursing, and welfar~ groups and organizations and with any agency 1n such State charged with administering State la~ providing for vocational rehab1li tat1on of ph~ slcally handloapped ohlldren. (b) The Chief of the Children s Bur<"~u shall approve any plan which fulfills the oond1tlons specified in _subsection (a) and ehal 1 thereupon notify the Secretary of Labor and th"' State agenoy or hie approval. PAYMENT TO STATES Seo. 514. (a) From the sums appropriated therefor and the allotments available under sectlon 512, the Secretary of the Treasury shall pay to each State which has an approved plan for services for crippled ohildren,for each quarter, beginning with the quarter ccmmencing July 1, - 19 - 1935, an amount, which shall be used exclusively for carrying out the State plan, equal .to onehalf of the total sum expended during such quarter for carrying out such plan, (b) The method of computing and paying such amounts shall be as follows: (1) The Secretary of Labor shall, prior to the beginning of each quarter, estiate the amount to be paid to the State for sucn quarter under the provisions of subsection (a), such estimate to be based on (A) a report filed by the State containing its estimate of the total sum to be expended in such quarter in accordance with the previsions of such subsection and stating the amount appropriated or made available by the State and its political subdivisions fnr such expenditures in such quarter, and if such amount is less than one-half of the total sum of such estimated expenditures, the source or sources from which the difference is expected to be derived, and (B) such investigation as he may find necessary, (2) The Secretary of Labor shall then certify the amount so estimated by him to the Secretary of the Treasury, reduced or increased, as the case may be, by any sum by which the Secretary of Labor finds that his estimate for any prior quarter was greater or less than the amount which should have been_ paid to the State for such quarter, except to the extent that such sum has been applied to make the amount certified for any prior quarter greater or less than the amount estimated by the Secretary of Labor for such prior quarter. (3) The Secretary of the Treasury shall thereupon, through the Division of Disbursement of the Treasury Department and prior to audit or settlement by the General Accounting Office, pay to the State, at the time or times fixed by the Secretary of' Labor, the amount so certified. OPERATION OF STATE PlANS Seo. 515. In the case of' any State plan for services for crippled children which has been approved by the Chief of the Children's Bureau, if the Secretary of Labor, after reasonable notice and opportunity for hearing to the State agency administering or supervising the administration of such plan, finds that in the adminietration of the plan there is a failure to comply substantially with any provision required by section 513 to be included in the plan, he shall notify such State agency that further payments will not be made to the State until he is satisfied that there is no longer any such failure to comply, Until he is so satisfied he shall make no further certification to the Secretary of the Treasury with respect to such State. PART 3 PART 4 - VOCATIONAL REHABILITATION Sec. 531. (a) In order to enable the United States to cooperate with the States and Hawaii in extending and strengthening their programs of vocational rehabilitation of the physically disabled, and to continue to carry out the provisions and pu:'poses of the Act entitled "An Act to provide for the promotion of vocational rehabilitation of persons disabled in industry or otherwise and their return to civil employment", approved June 2, 1920, as amended (U. S. C., title 29, ch. 4; u.s. C., Supp. VII, title 29, secs. 31, 32, 34, 35, 37, 39, and 4o), there is hereby authorized to be appropriated for the fiscal years ending June 30, 1936, and June 30, 1937, the sum of' $S41,000 for each such fiscal year in addition to the amount of the existing authorization, and for each fiscal year there- after the sum of' $J.,93g,ooo. Of' the sums appro- priated pursuant to such authorization for each fiscal year, $5,000 shall be apportioned to the Territory of Hawaii and the remainder shall be' apportioned among the several States in the manner provided in such Act of June 2, 1920, as amended. (b) For the administration of such Act of June 2. 1920, as amended, by the Federal ageno7 20 - authoriz~ toadm1nister it, there is hereby authorized to be appropriated for ~ f1~cal 7ears ending June 30, 1936,and June 30, 1937, the sum of $22,000 for each such fiscal year in addition to the amount of the ex~sting authorization, and tor each fiscal year thereafter the sum of $102,000. STATE OF GEORGIA H.B. NO. 700 AN ACT To authorize and empower the State Department ot Public Welfare to cooperate with the Federal Government through its appropriate agency or instrumentality in supervising the administration of a program of services for children who are crippled or who are suffering from conditions which lead to crippling; to receive and expend grants of Federal or other money for the above purposes in accordance with such provisions and regulations made therefor; to deeignate the State Department of Public Welfare as the official agency of the State of Georgia (f) or the administration of the State program for services for crippled children; and for other purposes. BE IT ENACTED BY THE GENERAL ASSEHBLY OF THE STATE OF GEORGIA, and it is hereby enacted by authority of the same: Section 1. The State Department of Public Welfare is hereby designated as the agency of the State of Georgia to supervise the administration of a program of services for children who are crippled or who are suffering from conditions which lead to crippling. The purpose of such program shall be to develop, extend and improve services tor locating such children and for providing for medical, surgical, corrective and other services and care, and tor facilities tor diagnosing, ho1pitalization and after care. Section 2. The State Department ot Public Welfare is hereby authorized: (a) To formulate and administer a detailed plan or plane for the purposes specified in Section 1, and make such rules and regulations as may be necessary or desirable for the administration of such plane and the provision of this Act. (b) To receive and expend in accordance with such plans all funds made available to the Department by the Federal Government, the State or its political subdivisions or from other sources for such purposes. (c) To cooperate with the Federal Government through its appropriate agency or instrumentality in developing, extending and improving such se!'Vices and in the administration of such plans. (d) To delegate the authority provided tor in this Act as heretofore authorized to said Department in Section 6, subsection 15, of the Welfare Reorganization Act ot 1937. Section 3. All provisions of law in conflict with the provisions of this Act are hereby repealed. - 21 - Block 1. Child's Last Name EXHIBIT A CENSUS CAJ:ill ~_ Survey of Crippled ChiIdren In Georgia 1937 IDENTIFICATION OF CHILD White I Negro First Name I Race Male Female Sex Yee I No I Relief Name of Parent or Guardian Poet Office Address Countv Circle Age Last Birthday Age IJn~:rl 2 3 j 4 j 5 j 6 j 7 j 8 j 9 j 10 j 11 j 12 13 j 14 I 15 j 16 j 17 18 j 19 j 20 j 21 Educatio~s~~~~f I O j 1 Circle Highest Grade Reached 2 j 3 j 4 5 j 6 j 7 Js~~~~1 J 1 2 j 3 j 4 ]college 1 j 2 J 3 j 4 Has the crippling condition been treated? Yes No Hospital Private Doctor Block 2. Neck Snine RIL RIL RIL I I I Arm Shoul. Elbow RIL I Hand RIL I Chest PARTS AFFECTED RIL RIL RIL I I I Leg Hin Knee RIL RILi I II Ankle Foot Pelvis Other-snecifv Block 3 FUNCTION IMPAIRED-MARKED. Check j I I I I I I I Unable Walks wi thl Unable to Wheel Bed to Walk Apparatus Feed Self Chair Case Speech Defect I Sight 11-------------1 Defect I Other. - Snecifv Block 4. DOCTOR'S DIAGNOSIS - Check j Not I I I I I I .I Infant I Spastic I TB Bone \ Osteo- Club Ascert. ParalysislParalysi~ & Joint Myelitis Foot I I \ Arth- \ Trauritie matic Other Diagnosis Specify INSTRUCTIONS Prepare a Census Card for persons 21 years of age and under, having amputated, withered, paraly~ed, stiffened, shortened, distorted, or swollen members; or with continued dislocation of Joints or discharging bones. Block 1. IDENTIFICATION OF CHILD. Give child's last name and first name. Check correct race and sex ../. If child's family has received relief in 1935 or 1936 or has been transferred from relief to WPA, check relief, Yes ../; otherwise check Nov. Give name of parent or guardian of child, post office address, and county of residence. Circle age of child at last birthday. Circle highest grade reached in school. If the crippling condition.has been treated check Yes../; otherwise, No/. If treatment was given in a hospital or clinic, check ./after hospital; if treatment was given in a private office or home by a private physician, check /after Private Doctor. Block 2. PARTS AFFECTED. Check ../ to indicate parts affected. Block 3. FUNCTION IMPAIRED. Marked. If child has only a slight impairment, do not check; when impairment is marked or serious, check v'. Block 4. DOCTOR'S DIAGNOSIS. This block is designed only for a doctor's diagnosis. If this cannot be obtained, check space above Not Ascert.v'. Submitted by _ _ _ _ _ _ _ _ _~ Date~----~---- - 22 - EXHIBIT B 'f1CHEDULE OF-:f.UBLIC AND PRIVATE HOSPITAL EXPENDITURES SURVEY OF CRIPPLED CHILDREN IN GEORGIA 1937 Patient's Last Name First NamP I I 1'hite Negro Male Female Race Sex AIZe ~11nic Hosoital or Ins t i tut1on Homf! P. o. Add.ress Location County of Residence Last Date Admission Infant. Spastic TB Bone Osteo- Club ParalY. Paralv. & Joint rnye11 tis Foot D 1 a p: n " o l s Total Cost-Include Surgeon's Fee$ Number 'rimes Admitted Number Days in Hospital I I Arth- Traur1t1s mat1c Good I Fair I Poor Other Diagnos,Q-2nPc1fy Prognosis IPrivate Funds $ !Public Funds $ Source of Private Funds Source of Public: P:.mio: I NSTROCTIONS Submit Schedules on all cases admitted to clinics, hospitals, or ins ti t.itions, during January- June, 1936, inclusive, twenty-one years of age or under, which have a record showing amputation or treatment of withered, paralyzed, stiffened, stortened, distorted, or swollen m~mbers or treatment of dislocation of Joints or discharge frol!l bones or Joints or for treatment of severe burns. List patient's name in space indicated. Write the name of., the clinic, hospital, OT' institution from which the child received treatment above the words, "Clinic, Hosp1'tal, or Institution." List the name of the town or city in which the clinic, hospital,or institution is located above the word, "Location". Cheak Race and Sex, with mark./ in correct spaces. Above Age, give the child's age at the time of his last admission to the hospital during period January-June, 1936. Write the child's home post office address above the words, "Home Poet Office Address"; and the county of residence in the space prov1ded. G1ve the last date of the child's admission during period January-June, 1936, indicate the number ot times admitted during period and the total number days in hospital or institution in first six months of 1936 in the spaces provided, In the space following "Total Cost-Include Surgeon's Fee, give the total oost tor the period January-June, 1936. Show the amount of the total expenditure paid from private funds and the amount paid from public funds. Indicate source of private funds and source of public funds 1n the spaces provided. Private funds may be provided by an individual or from a general private fund such as Community Ches~, Red Cross, Scottish Rite fund, et cetera; while Public Funds refer only to public tax funds, either city tax or oounty tax or both, - 23 - Age Groups Under 4 Years 5 - 9 Years 10 - 14 Years 15 - 16 Years 17 - 21 Years Not Ascertainable TOTAL APPEMOIX B TABLE l AGE GROUPS OF CRIPPLED CHILDREN BY RESIDENCE AND RACE To t a l Total White GEORGIA - 1937 Negro Ur b a n Total White Negro 813 636 177 1,719 1,253 466 226 177 49 410 285 125 2,315 1,662 653 963 674 289 1, 714 1,206 508 33 31 2 617 451 166 232 161 71 388 261 127 24 22 2 2,095 l,897 l,357 54o Ru r a 1 Total White Negro 587 128 1,309 341 l,698 1,211 4$7 731 1,326 513 218 945 381 9 5,660 9 4,105 0 1,555 Rell et' Status Relief' Non-Relief TOTAL TABLE 2 RELIEF STATUS OF CRIPPLED CHILDREN - BY RACE GEORGIA - 1937 'l' o t a l Number Per Cent wh i t e Number Per Cent 1,838 24.3 l,375 5,719 75.7 4,087 7,557 100.0 5,462 100.0 N e gr o Number Per Cent 22.l 77.9 2,095 100.0 TABLE 3 DOCTOR'S DIAGNOSIS OF CRIPPLED CHILDREN - BY RACE AND SEX Doctor's Diagnosis GEORGIA - 1937 Gr a n d T o t a l Total Male Female wh i t e Total Male Female Ne g r o Total llale Female Infantile Paralysis 1,645 921 724 1,343 732 611 302 189 113 Spastic Paralysis 159 100 59 126 82 44 T.B. Bone and Joint 221 152 69 184 130 54 33 18 15 37 22 15 Osteomyelitis Arthritis 263 182 81 232 163 69 .169 90 79 106 64 42 31 19 12 63 26 37 Congenital Deformities 461 268 193 34o 209 131 121 59 62 Club Foot 277 188 89 226 155 71 Obstetrical Paralysis 89 59 30 81 53 28 51 33 18 g 6 2 Traumatic Deformities 820 589 231 526 384 142 294 205 g9 Burns 147 83 64. 94 57 53 26 27 Rickets 51 27 24 42 22 9 5 4 Other Two Diseases Not Ascertainable 203 67 2,985 126 35 1,700 77 32 1,285 142 53 l,967 88 29 1,136 61 38 23 14. 6 g 1,018 564 454 TOTAL 7,557 4,520 3,037 2,158 2,095 l,216 879 - 25 - TABLE 4 _DOCTOR'S DIAGNOSIS OF CRIPPLED CHILDREN BY RACE AND AGE GROUPS GEORGIA - 1937 R a c e a n d A g e Gro.JL:Q_e Doctor's iJiagnosis ----- W HI T E NEG R 0 Grand ana and Total Total N.A. Under 5 - 9 10-14 15-16 17-21 Total N.A. Under 5 - 9 10-14 15-16 17-21 Infan. Para. 1,645 1,343 4 13S 31g 420 161 302 302 o 35 6e 96 36 67 Spaet.Para. 159 126 0 20 33 4-0 9 24 33 0 1 6 11 3 12 T.B. Bone 221 1S4 o 10 26 71 19 5g 37 0 2 9 15 5 6 Osteomyli t. 263 232 0 6 4o gg 42 56 31 0 4 4 13 3 7 Arthri t1s 169 106 0 5 22 26 15 3g 63 0 3 8 16 10 26 Congen1 tal Deformi t1 es 461 34o 1 65 7g 107 36 53 121 0 12 27 45 11 26 Club Foot 277 226 0 eo 71 4o 15 20 51 1 12 11 10 6 11 Obstetrical Paralysis g9 81 0 16 34 19 5 7 g 0 0 2 3 2 1 Trauma tic Deformities S20 526 0 16 e6 147 107 170 294 0 9 56 101 50 7g Burns 147 94 1 15 28 26 11 13 53 0 0 14 20 11 g Rickets 51 42 0 19 11 10 1 1 9 0 4 2 3 0 0 Other 203 142 o 21 34 43 8 36 61 0 6 15 19 11 10 2 Diseases 67 53 0 5 13 17 8 10 14 0 1 1 7 2 3 N. A. 2,985 1,967 25 220 459 608 237 418 1,018 1 gg 243 294 139 253 TOTAL 7,557 5,462 31 636 1,253 1,662 674 1,206 2,092 2 177 466 622_ 282 5_08 TABLE 5 DOCTOR'S DIAGNOSIS OF CRIPPLED CHILDREN BY RELIEF STATUS AND RACE GEORGIA - 1937 Doctor's Diagnosis Infantile Paralysis Spastic Paralysis T.B. Bone and Joint Osteomye11 tis Arthritis Congenital Deformities Club Foot Obstetrical Paralysis Traumatic Deformities Burne Rickets Other Two Diseases Not Aecertainable TOTAL Grand Total Total White Negro 1,645 1,343 302 159 126 33 221 184 37 263 232 31 169 106 63 461 34-0 121 277 226 51 89 81 8 S20 526 294 147 94 53 51 42 9 203 142 61 67 53 14 2,985 1,967 l,OlS 7,557 5,462 2,095 Relief Total White 3gg 314 33 24 73 60 74 72 51 34 116 94 75 62 17 15 1S7 123 .. 42 31 21 19 58 45 22 20 690 462 1,847 1,375 Negro 74 9 13 2 17 22 13 2 64 11 2 13 2 228 472 - 26 - Non-Relief Tota1---wlilte Negro 1,257 1,029 22g 126 102 24 148 124 24 189 160 29 11e 72 46 345 246 99 202 164 3e 72 66 6 633 4o3 230 105 63 42 30 23 7 145 97 48 45 33 12 2,295 1,505 790 5,710 4,087 1,623 --- TABLE 6 DOCTOR'S DIAGNOSIS OF CRIPPLED CHILDREN BY PARTS OF THE BODY AFFECTED GEORGIA - 1937 Parts D o c t 0 r I 8 Diagnos i s of Infan, Spast. T.B. Osteo- Club Arth- Trau- Con- Obst. 2 Dis- Body Affected Paral. Paral. Bone 1'felitie Foot ritis matic genital Paral. Burns Rickets Other eases N,A. Total Total Cases 1,645 159 221 263 277 169 820 461 89 147 51 203 67 2,985 7,557 White Cases-No. 1,343 126 184 232 226 106 526 340 81 94 42 142 53 1,967 5,462 Neck Spine Arm Shoulder Elbow .39 17 4 3 l 3 li 34 6 9 3 15 3 118 266 213 36 34 5 6 7 40 70 26 l 7 39 12 393 889 387 47 8 29 6 13 171 87 30 23 6 29 11 452 1,299 179 33 8 13 1 6 33 43 6 4 3 14 6 211 560 iJ9 29 5 10 0 11 55 43 8 6 2 14 7 195 524 Hand Chest Leg Hip Knee 240 41 6 8 10 10 93 108 19 86 17 11 4 l 3 5 24 3 1,015 85 98 156 29 52 185 145 42 340 48 61 50 6 29 78 79 17 414 47 26 53 8 44 66 72 17 36 5 22 12 370 980 5 4 9 2 93 267 35 32 73 33 1,010 2,990 7 7 32 8 461 1,223 10 10 36 23 442 1,268 Ankle Foot Pelvis Other N.A. 433 48 17 27 53 26 559 55 13 28 212 24 50 6 2 0 0 0 28 13 2 l 0 2 12 l 1 2 1 l 53 85 18 74 127 28 3 8 1 7 16 8 0 7 1 12 2 38 16 452 1,280 18 15 46 19 637 1,855 0 1 7 0 57 135 16 l 21 7 99 221 0 0 4 0 39 69 Total Parts Affected 4,134 523 296 389 334 231 874 948 230 182 98 399 159 5,029 13,826 Negro Cases-No. 302 33 37 31 51 63 294 121 8 53 9 61 14 1,018 2,095 Neck Spine Arm Shoulder Elbow 7 4 0 l 0 2 3 2 0 1 0 6 0 49 75 36 5 7 1 0 6 13 13 l 3 2 6 1 127 221 124 18 4 2 0 9 39 29 2 15 l 16 4 222 485 58 8 l 1 0 5 11 12 0 4 3 7 2 109 221 56 9 0 0 0 7 11 14 0 7 0 5 1 81 191 Hand Chest Leg Hip Knee 83 12 0 0 1 7 39 47 2 17 0 7 3 193 411 18 5 2 0 0 1 3 5 0 5 0 1 l 50 q1 244 21 13 16 5 30 144 69 2 21 6 36 4 577 l, l.Sg 109 10 18 10 l 22 42 25 1 103 9 10 3 2 21 44 26 0 6 5 0 1 9 16 4 4 247 274 5Q1; 518 Ankle Foot Pelvis Other N.A. 101 10 10 3 13 11 26 28 0 137 13 7 6 49 11 44 53 3 11 0 0 0 0 0 3 2 0 60 02 0 0 9 0 0 40 00 0 0 l l 0 3 l 12 2 223 443 9 l 13 5 333 684 0 l 0 0 31 48 0 0 20 7 26 0 0 20 4 12 Total Parts Affected 1,097 124 72 45 71 132 432 236 11 96 16 138 31 2,527 5,ll!S Grand Total Parts Affected 5,231 647 36s 434 405 363 1,306 1,274 241 278 114 ;137 190 1.256 lB, 941+ In several cases where club foot is given as the cause of crippling conditions the children so classified were found to have other parts of the body affected. - 27 - Treatment Received Hospital Private Doctor None Not Asce.rtainable TOTAL 'l'AJIL& 7 :ULl:U S'l'J.TUS or CRIPJ'l.ID CHILIIRD 'l'm:.l'1'11111'1' BY R.lCI GIORGIA - 1937 Total 2,537 2, 755 1,878 387 7,557 Tot a 1 \'/hite 2,093 1,946 1,093 330 5,462 R e 1 i e f Status an d :a a c e Relief Non-Relief Negro Total White Negro Total White Negro 444 630 507 123 1,907 1,586 321 809 661 490 171 2,094 1,456 638 785 494 330 164 1,384 763 621 57 62 48 14 325 282 43 2,095 1,847 1,375 472 5, 710 4,087 1,623 TABLE 8 DOCTOR'S DIAGNOSIS AND TlillATMENT or CRIPPLED CHILDREN GEORGIA - 1937 Doctor's I:iagnosis Grand Total White Negro Total Hosp. Pr.Dr. None N.A. Total Hosp. Pr.Dr. None N.A. Total Hosp. -Pr.Dr. None N.A. Infant Para. 1,645 603 745 248 49 1,343 537 583 177 46 302 66 162 71 3 Spastic Para. 159 66 66 24 3 126 59 50 14 3 33 7 16 10 0 T.B. Bone 221 137 70 13 1 184 120 50 13 1 37 . 17 20 0 0 Osteoll\Yelitis 263 202 56 5 (} 232 181 47 4 0 31 21 9 l 0 Arthritis 169 56 84 22 7 106 37 54 10 5 63 19 30 12 2 Congenital Deformities 461 131 102 187 41 340 117 74 115 34 121 14 28 72 7 Club Foot 277 142 51 76 8 226 130 39 50 7 51 12 12 26 l Obstetrical Paralysis 89 27 32 27 3 81 27 30 21 3 8 0 2 6 0 Traumatic Deformities 820 370 326 99 25 526 254 207 44 21 294 116 119 55 4 Burns Rickets 147 49 68 26 4 94 39 40 11 4 53 10 28 i5 0 51 13 29 9 0 42 11 24 7 0 9 2 5 2 0 Other 203 67 100 31 5 142 51 69 17 5 61 16 31 14 0 Two Diseases 67 39 20 6 2 53 30 18 3 2 14 9 2 3 0 N, .l. 2,985 635 1,006 1,105 239 1,967 500 661 6o7 199 1,018 135 345 498 40 TOTAL 7,557 2,537 2,755 1,878 387 5,462 2,093 1,946 1,093 330 2,095 444 809 785 57 !DL& 9 PERCUTAGJ: 'l'AJILJ: SHOWUIG 'l'YPIS or 'l'Jlti'rlllJI' :UCJ:IVJ:D BY CRIPPLED CHILDREN BY DOC'l'OR18 lll.lGIOSIS IDORGI.l - 1937 Type of Treatment Doctor' Di.L.&nosis Infant Spastic 'l'B Bone Oeteo- Club .lrth- 'l'rau- Con- o. B. Two Total N.A. Parf_l. Para1. & JoJnt ~elitie root r1 tie tic genital Paral. Burns Rickets Other Diseases Hospital 33.6 21.3 36.6 41.5 62.0 76.8 51.3 33.1 45.1 28.4 30.3 33.3 25.5 33.0 58.2 Private Doctor 36.5 33,7 45.3 41,5 31.7 21.3 18,4 49.7 39,8 22.1 36,0 46.3 56.9 49.2 29.8 None N. A. 24.8 37.0 15,1 15.1 5.9 1.9 27.4 i3.o i2.1 4o,6 30,3 i7.7 17.6 15.3 9.0 5.1 8.0 3.0 1.9 .4 .o 2,9 4,2 3,0 8.9 3,4 2.7 .o 2.5 3.0 TOTAL 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 - 28 - COUNTY Appling Atkinson Bacon Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bryan Bullock Burke Butts Calhoun Camden Candl~r Carroll Catoosa Charlton Chatham Chattahoochee Chattooga Cherokee Clarke Clay Clayton Clinch Cobb Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene Gwinnett Habersham Hall Hancock Haralson Harrie Hart Heard Henry Hou aton Irwin Jackson Jasper Jeff D!RGIA - 1937 Per Cent COUNTY Total No. Cases 69 25 36.2 Jefferson 46 12 26.1 Jenkins 26 7 26.9 Johnson 32 9 2S.1 Jones 3\~64 27 3 ll.l Lamar 19 20 47 5 13 25.0 27.7 Lanier Laurene 15 g5 63 47 la 23.8 Lee s.5 Liberty 61 ll 18.0 Lincoln 25 32g7 131 77 5s.s Long 36 3g 12 31. 6 Lowndes 24 ~l 9 10 134..95 Lumpkin McDuffie 23 41.1 Mcintosh i~ 23 26 51 ~~ 31 13 14 lg.7 2 .9 Macon Mad1eon 2g9 45.3 Marlon 25.g Meriwether 5 3s.5 Miller 25 37 29 tt ~4 26 23 309 5 29.4 Mitchell g 9 37.5 30.s Monroe Montgomery g23 13.0 26.5 Morgan Murray 46 44 3225 33 6 0 .o Muscogee 90 4~ 22 56.4 Newton 17 36.2 Oconee 29 15 115 7 2~ 25.2 57.1 Oglethorpe Paulding 52 35 22 16 6 1- 2l..32 Peach Pickens 24 19 70 16 22.9 Pierce 46 29 97 3 31 10.3 32.0 Pike Polk 20 66 44 ll 2~.o Pulaski 22 55 38 23 9 l .4 Putnam lg 34.2 26.1 Quitman Rabun 30 16 25 45 7 15.6 Randolph 42 16 7 43.7 Richmond 244 19 l~l g 3 gg 15.s 10.4 56.4 Rockdale Schley Screven 57 5 s.s Seminole 20 ll ~ 29 g 27.6 Spalding 6g 52 32 20 g 3s.5 25.0 Stephens Stewart 31 17 lS 6 33.3 Sumter 21 7 4 57.1 Talbot ll 30 60 34 27 g 7 ll 23.3 13.4 32. Tal1af erro Tattnall Taylor 6 22.2 Telfair 15 50 4~ 6g 13 19.l Terrell 35 16 4 25.0 Thomae 63 134 70 52.2 T1f t 25 327g 967 10 27.0 Toombs 55~ 17.9 57.5 Towne Treutlen 68 22 20 42 16 3s.1 Troup 57 12 2 16.7 Tum er 27 ~ 22 37.9 Twiggs 35 as 22 15 54: Union Upson ~I lS 4 22.2 Walker 63 ~i 16 48.5 Walton 23 46.9 Ware 2g 36.S .Warren a 12 31 3 9.7 Washington 34 4o 10 25.0 Wayne 57 25 5 20.0 Webster 13 23 31 g 3 13.0 2~.8 Wheeler White 23 13 5 .5 Whitfield 21 g372 26 8 30.s Wilcox 29 33 51 16 9 1g5 2n9.4 50.0 W1lkee W1lk1nson worth 52 ~4 17 3 17.6 TOTAL Z1~~Z - 30 - Total No. Hospital Cases 12 7 9 5 7 3 2a 0 9 4 15 2 7 1 g l~ 11 8 19 10 l 5 47 7 8 14 9 6 6 6 2 21 12 0 5 14 13 16o 9 5 2 ll 34 6 3 5 0 1 16 6 9 5 22 4 ll 5 5 4o g 7 10 4 8 4 13 3 5 12 4 3 32 g l 5 2,5~ Per Cent 32.4 20.6 26.5 19.2 36.s 20.0 29.4 16.o .o 32.1 ll.l 2a.4 130. 4 3.8 32.0 51.4 124..84 17.8 41.3 22.7 20.0 27.3 15.1 52.2 24.1 52g.93 25.7 25.0 31.6 13.0 10.0 31.8 1564..1 .o 56.0 31.0 65.6 45.0 ~-.41 24.4 ;o.o 19.4 17.6 23.8 .o 6.7 32.0 15.4 21.4 14.3 34.9 16.o 16.2 22.7 25.0 70.2 29.6 20.0 2i.o 1 .7 "12. 7 21.1 24.1 2a.o 1 .7 21.0 23.1 19.0 8.1 39.0 27.6 l2g.51 20.8 ~~.li TABLE 12 THE GRADE IN SCHOOL FOR THE MEDIAN CRIPPLED CHILD BY AGE AND RACE FULTON COUNTY, GEORGIA 1937 WH I T E NEG R 0 'Normal Those Those Rate or Age Total in School Total in School Prosigornes*- 6 1 1 1 1 1 g 7 9 1 1 3 1 2 4 1 1 1 1 l 2 l 10 11 12 il i2 17 18 ~ 5 4 2 2 3 3 2 4 4 5 6 3 5 2 g 7 7 7 g 7 g 7 9 9 g 11 5 5 9 ~ 5 2 10 11 ~ 10 g Over 19 7 9 4 6 High 20 7 9 0 School 21 7 11 5 The normal rate of progression is defined as th~ advancement made by a child entering school at six years of age and progressing one grade each year. - 31 -