Maternal mortality, which is the term used to include deaths assigned to pregnancy and childbirth per io,000 live births, also shows a significant decline in the U.S. In 1915, the rate was 61; in 192o it had been increased to 8o; in 1930, the rate was 67 and in 1937 it had declined to 49. In 1936 (the latest figures avail able), Belgium, Canada, Czechoslovakia, Denmark, England and Wales, Germany, Greece, Hungary, Ireland, Italy, Japan, The Netherlands, New Zealand, Norway, Sweden, and Switzerland, all had lower rates of maternal mortality than were reported in the U.S. for the same year. The figures for 1937 and 1938 will possi bly give a relatively better position to the U.S. owing to the marked decline in this rate in the U.S. from 1936 to 1937.
The services planned for crippled children under the Social Se curity Act opened an entirely new field. By June 3o, 1936, the provisions of this act to be used for this purpose had been in operation for only five months or less in a total of 38 States. The services to be included in State plans are: locating of crippled children and the provision for them of medical, surgical, and cor rective care and other services and facilities for diagnosis, hos pitalization, and of ter care. Under the amendment, $1,000,000 is available for grants to the States that do not have to be matched. The amounts under this authorization are to be allotted on the basis of the need of the State for financial aid in carrying out its State plan after taking into consideration the number of crippled children and the costs of care. This will make it possible for some of the poorer States that have not been able to match funds previously, to receive larger amounts and to go ahead actively on their programs. The number of crippled children on State registers on June 3o, 1939, was 224,289. It is estimated by
the children's bureau that there are in the continental U.S. about 365,000 children whose condition would bring them within the purposes of this act.
The child welfare services are also a new Federal activity. They include the care and protection of socially handicapped chil dren, the dependent and neglected child and those children who are in danger of becoming delinquent. It is the intent of the act to provide the services that will afford to these children the essen tial preventive and corrective care that will enable them to be come normal and useful citizens. This service is generally ad ministered in the States under State welfare departments in pre dominantly rural areas and in the areas of economic distress, after their plans for the work have been approved by the chil dren's bureau. As of June 3o, 1938, Federal funds were allocated in some degree in each of the 48 States.
While Federal funds given to aid efforts to reduce the maternal mortality rate and the infant mortality rate have been in effect since 1921, with the exception of the years 1929-35, the aid of the Federal Government for crippled and socially handicapped children is of such later development that an evaluation of its worth cannot be made at the present time. From the nature of this work, statistical data will probably always be difficult to present, but from the humanitarian standpoint such efforts are of great significance, reaching, as they do, a vast army of hitherto neglected children whose possible mental and physical soundness must always be of vital importance to the country as a whole. The provision of opportunities by which they may be benefited is of great social importance.