Chronic Disease and Gross Impairments in a Northern Industrial Community

The increasing importance of the problem of chronic disease challenges the best efforts of the medical and public health professions toward a broad program of control. Its social consequences masked in the larger problems of unemployment and dependency among young and old, chronic disease presses on the national scene today as an essential although undeveloped aspect of the broader program of social security. An effective program of control demands cooperation in broad policies and an appropriate division of labor: in the field of medicine, continued research on the etiology of certain chronic diseases and experimentation with promising therapeutic procedures ; in the field of public health, the prevention of predisposing acute diseases, community education to promote early diagnosis, and the provision of adequate facilities for the care of chronic cases in the low income groups. From the public health standpoint, the scope of a coordinated program must be determined with reference to exact knowledge of the magnitude of the problem in various local areas. With the purpose of extending this essential basic information, which now exists only for limited areas and special groups, the United States Public Health Service in 1935 conceived the plan for a comprehensive health survey 1 designed to define the problem of chronic disease on a national scale.