A state held back by its ‘low-ebb vitality’

“In 1916 the [International] Health Board established its first county health unit in North Carolina…. Although directed primarily at hookworm, these units were educational in scope, awakening people to the importance of public health and hygiene.

“North Carolina was not a healthy place. Its population, 85 percent of which was rural, suffered from ‘low-ebb vitality’ brought about by chronic, devitalizing and crippling diseases such as malaria and hookworm, and by constipation, gum problems, childhood adenoids and bad teeth….And the state had an annual death rate exceeded only by that of Kentucky. As a typhoid pamphlet noted: ‘Thank the Lord for Kentucky.’ ”

–From “To Cast Out Disease: A History of the International Health Division of the Rockefeller Foundation (1913–1951)” by John Farley (2004)