The Disabling Diseases of Childhood: Their Characteristics and Medical Care as Observed in 500,000 Children in 83 Cities Canvassed in the National Health Survey, 1935-1936. 1. Characteristics and Leading Causes

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Abstract
In a canvass- of 83 representative urban communities conducted by the U. S. Public Health Service in 1935-36, records of disabling illness in a 12-mo. period were obtained for 518,767 white children under 15 yrs. of age. The records of sickness were limited to disabling illnesses, i.e., those which had prevented the usual activities of the preschool child, or school attendance of the school child, for at least 7 consecutive days in the 12-mo. survey period. Disabling illnesses occurred with greater frequency among children under 10 yrs. of age than in any subsequent period except old age. The duration of the average disabling illness was lowest among children; as a result, childhood illnesses, although frequent in occurrence, gave rise to a relatively small volume of disability. The amt. of disability accruing from illnesses disabling for 7 consecutive days or longer among children of preschool age (1-4 yrs.) amounted to 7 days per capita; at ages 5-9, the rate was 8 days per capita. The lowest disability rate observed in childhood, 5 days per capita, was among children of 10-14 yrs. Except in infancy, the rate of recovery from illness was notably higher among children than among adults. 4 in every 5 disabling illnesses occurring among children under 15 yrs. of age were due to acute communicable or respiratory diseases; these diseases accounted for over half of the disability experienced by the av. child in the 12-mo. period. Broadly considered, the control of the acute communicable and respiratory diseases represents the major problem in the field of child health, since many of these diseases are preventable. Permanent orthopedic impairments incapacitated 12 in every 10,000 children under 15 yrs. of age for at least a week during the survey year; the av. duration of disability per case was almost 8 mos. On the date of the survey, permanent orthopedic impairments (including all cases without reference to the resultant incapacity) were found in 49.5 per 10,000 children under 15 yrs. Congenital defects, accidental injury, and poliomyelitis were reported most frequently as causes of impairments in this age period.

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