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~~ -. ~..~ ;. Other programs which the Sanitarians are involved with are: Inspection of residential care facilities. Training programs are being planned to educate workers in these facilities regarding food handling. Public Health will assist with problems with locations of green boxes, in the area of animal control, and also they are interested in housing standards for the County. He added that all housing should inezlude an approved water supply and sewage disposal. Tn response to a question asked by Chairman Whitted regarding migrant camps, Mr. Laws stated that migrant workers are the only laborers many tobacco farmers can get. The workers usually live in tenant houses or mobile homes located on the farm. There is an average of five workers to each camp. He stated that these workers are in transit and fxom time to time bring into the area various health problems. The North Carolina Employment Security Commission has the responsibility foz placing migrant workers in the County. The Health Director introduced to the Board Margaret McClintock, Supervisor of Nux'ses in the Health Department. Ms. McClintock stated that the County has a separate population in the Northern end of the County as compared to the Southern part. 1'he people in these two areas have different concerns and different health problems. The fact is not easily recognized, especially when one is looking at statistics, that the Chapel Hi11-Carrboro area distorts these figures and Orange County usually comes out looking good, which is not the case in the entire county. As far as indicators of health status go, classic indicators are the causes of illnesses and deaths. Ms. McClintock reviewed perinatal morta- - lity rates for Orange County, which are rates of children who die, including fetal deaths through the first year of life. The average range of 24.0 to 49.4 is for the years 1970 through 1974 for Orange County. The County's average, based against the State average is 29.6 out of 1000 children die during the perinatal stage. She stated that most of the problems existed in low income areas and in rural areas of the County. The Neonatal Mortality rate has to do with deaths which occur between birth through the first 28 days of life. The average range for Orange County is 11.7 through 19.0 out of 1000 children. The average mortality rate for the County is 13.3 out of 1000 children. In Infant Mortality, the range is 15.1 to 29.0. The County`s aver- age is 18.2 out of 1000 children. Causes of death in all children ages 1 through 4 are due 99 percent of the times to accidents. The mortality rate tends to drop as children grow. She informed the Board that the major cause of death in adults is due to heart diseases and hypertension, however, hypertension is usually not listed as a direct cause of death. Thirty-three thousand (33,000) people in Orange County have one dis- abling disease, and about half this number have two disabling diseases. She informed the Board that since 1968, lung cancer has increased by 345 percent in Orange County, cola-rectum cancer is up by 30 percent, breast cancer is up 44 percent and cancer of the prostate is up by 47 percent. She stated that Orange County tops all counties in this area in the in- cidents of sclerosis of the liver. Chairman Whitted asked that Ms. McClintock speak of Ways in which the mortality rate in infants can be lowered in the County. The Health Supervisor stated that good perinatal care at an early stage is of great value. The mother should receive good care and often. She .should have good nutrition, have social support, help in the home when the baby comes home, and that the baby should be a wanted baby. She stated that recent studies show that the amount of family planning in a community results in a decline in infant mortalities. Mothers who are considered high risks are mothers over the age of 35 and under the age of 18. The Health Director stated that an agressive approach Wi].1 make an impact on the infant mortality rate. He added the Family Planning Pro- gram was such an approach and is tailor to the needs of the County.