HEALTH Early adolescence under normal conditions sees the health problem almost solved, if the death-rate be taken as an index. Deaths from disease in the years between ten and fifteen are comparatively rare. In New York, for example, in 1910, one death occurred from all causes in every four hun dred of the population of that age, as against one in twenty under five years of age and one in thirty five in the twenty years from forty-five to sixty five. After fifteen tuberculosis begins to affect the death-rate more seriously. A large proportion of the comparatively small number of deaths be tween ten and fifteen, one-ninth or one-eighth of the whole, are due to drowning, injuries from fire arms, street and railway accidents, homicide, and other external causes.
But, of course, the death-rate at this age is not a complete index of the health problem. In adoles cence, as in infancy and childhood, normal, healthy living requires some conscious attention to physical defects and diseases. The teeth require frequent cleaning and prompt treatment of cavities. Free dental clinics have their champions, though I think inexpensive service would be better. Cer tainly decayed teeth are a neglected source of in fection, even in this country, in spite of the deserv edly high reputation of American dental surgery. We should not have to choose between the high prices charged by skilful dentists, a free dental clinic, or a fraudulent painless dental parlor. A dentist has suggested the advantage of opening, at many convenient places, tooth-cleaning establish ments, economically equipped but sanitary, in charge of properly instructed young women—there is no special merit perhaps in their being young— where, for twenty-five cents, or at most half a dollar, any customer, we would not have to call them patients, could drop in as he would for a shine or a shave or a haircut, and have the tartar removed and the harmless polish applied. In somewhat the same way for the fitting of glasses a trained re fractionist, even if not an optical surgeon, may per form a useful function. By standing out too stiffly for the principle that glasses can be fitted only by one who knows all about the diseases of the eye, or teeth cleaned only by a doctor of dental surgery, the medical profession might easily defeat its own ends and impose upon persons of limited means a disagreeable choice of prohibitive expense, charity, and charlatanism.
Adenoids may still be present to remove in the adolescent years, or may have come back after earlier treatment. Spinal curvatures and broken arches and organs which do not function properly may still require appropriate remedy. Such con ditions may be evidence of earlier neglect, or they may have developed after an apparently normal infancy and childhood. Eternal vigilance to de tect them promptly, efficient discipline to correct them definitely, and a not too penurious provision by parents, or, if necessary, by the community, for medical and surgical treatment are the price of normality in adolescence, as in childhood.
Faults of diet and of physical carriage and habits injurious to health and energy plant the seeds of disease from which the harvest is reaped in later life. Protection from such faults and habits, and persistent instructions in the laws and precepts of normal healthy living, are, therefore, as appropriate as in childhood—perhaps even more essential. For at this adolescent age the mind is capable of receiving and storing up dominant ideals, perma nent motives, which will color the whole subse quent life. Even childhood does this, but youth does it more consciously, more rationally, and more firmly. Our health ideal must be social, demo cratic, positive, associated with vigor and enjoy ment and fullness of life. To get such a dominant ideal in the back of the minds of the youth of Amer ica is the most stirring program of social reform.
Recreation in these years of character forming is essential, not primarily for health, but for more direct and more complex ends. Athletic sports, causing the young men and maidens to put forth their strength, to measure their utmost physical powers with one another or with an ideal bogey, giving them experience with team play in its most developed and subtle forms, guarding them by the varied attractions of the recreation fields from baser pleasures, have a social value far surpassing their mere health-giving function, though that of itself is not to be despised.