Public Health: New Pattern of Disease

PUBLIC HEALTH

At first glance, Dr. Howard D. Chope’s new job as director of public health and welfare for California’s San Mateo County looked like a snap. Public health traditionally has been concerned mainly with vaccinations and microbes—small problems in San Mateo. The water was good; the war-exploded population, 95% white, consisted mainly of well-educated, well-paid business and professional people. The women kept spotless kitchens and conscientiously took their well-scrubbed children to the pediatrician for inoculations. What was there for a public health officer to do?

Sky-High & Going Up. Plenty, decided Dr. Chope. He knew that most of San Mateo’s residents were newcomers, lonely for home-town ties. They worked in highly competitive fields, and their budgets were strained by sky-high real estate prices and king-sized mortgages. Tension lived on every block, and Dr. Chope attacked it with his own updated concept of public health. He is not a psychiatrist, nevertheless he made his department unique in the nation by paying as much attention to mental as to microbial ills. “In our society today,” he said, “stress, frustration and anxiety are the triggering mechanisms for more diseases than all the bacteria in the microbiology books.”

Dr. Chope fought to have a broad new mental health program set up within his own department. He made it a rule that whenever a family or law officers applied to have a disturbed patient committed to a mental hospital, a psychiatrist visited the home before action was taken. Often, the psychiatrist found that the patient could be treated better (and more cheaply) outside a hospital. Dr. Chope also insisted on starting an “open door” psychiatric wing in the general hospital. Many psychiatrists, including some on his own staff, feared this would be a fatal error. If a violent patient committed an assault, the county would never forgive it. There has been no such incident, and the psychiatric wing is bursting its unlocked doors.

“If You Can Take It.” Sooner or later, many business and professional people come to need the services of Dr. Chope’s ultramodern public health department because they try to drown their tension in alcohol. Some, even among the highest paid, become welfare cases if they are too long between jobs, or have a catastrophic illness in the family. “San Mateo is a great place to live,” says Dr. Chope, “if you can meet its exacting standards. But it’s tough if you fall below the margin.”

In recognition of both Dr. Chope’s pioneering and the fact that the new pattern of disease so evident in San Mateo is also emerging in many another U.S. suburban community, the American Public Health Association last week gave Dr. Chope one of its annual $5,000 Bronfman awards, donated by associates of Samuel Bronfman, longtime head of Seagram’s liquors. Two other Bronfman awards went to Dr. Herman E. Hilleboe, longtime (1947-62) New York State Health Commissioner, and Marion B. Folsom, former (1955-58) Secretary of Health, Education and Welfare.