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The George W. Comstock Center for Public Health Research and Prevention is located in the Washington County Health Department, Hagerstown, Maryland.
Established as a conjoint facility of the School of Hygiene
and Public Health and the Health Department, the Center continues
a long history of public health training and research in Washington
County.
When
the School was established in 1916, one of the desiderata
was that field training centers be set up in both an urban
and a rural setting. Washington County was selected as the
rural site, presumably because it was unique in having two
public health nurses supported by a voluntary association.
In 1921, the Washington County Health Demonstration opened
its doors. It operated as a health department that was remarkably
well-staffed for those days except that it had no legal powers.
In addition, a tripartite research program was initiated.
One was the famous series of Hagerstown Morbidity Surveys,
the first truly representative community health surveys, setting
the stage under Edgar Sydenstricker for the National Health
Interview Surveys of today. To provide tables of normal growth,
careful recording of heights and weights of school children
was carried out over a period of years. The third, unfortunately
not well known, was a comprehensive industrial hygiene survey
of a local cement plant, which elicited a number of facts
that have had to be rediscovered by subsequent studies.
Students
from the Department of Epidemiology and Public Health Administration
were initially required to spend three weeks observing the
Demonstration. These visits were continued for only a few
years, however, presumably being discontinued because the
local staff evinced no interest in teaching while the School
faculty showed little interest in the Demonstration except
for the research results. The Demonstration itself also ceased
when the County Commissioners failed to take over its financial
support.
Research
activities resumed in the mid 1930's and early 1940's when
Dr. Carroll Palmer came from his faculty position in the Department
of Biostatistics to direct research in the Bureau of Child
Hygiene, U. S. Public Health Service. The three major problems
he was charged to investigate were normal growth, dental caries,
and tuberculosis. Hagerstown became a major focus for all
three. Most famous was his pioneering work on dental caries
with Dr. Henry Klein, one of Pearl's graduate students. The
DMF (decayed, missing, filled) index was developed here for
the analysis of these studies.
In
1957, the National Cancer Institute established the Environmental
Cancer Field Research Project in a building adjacent to the
Health Department constructed specifically for this project
by local philanthropists Andrew and Gladys Coffman. The county
health officer, Dr. Ross Cameron, had noticed considerable
geographic variation in cancer deaths within the county, along
with suspicious concentrations in certain types of houses.
To establish the reality of these observations, surveys of
cancer among past and present residents were made each summer,
election district by election district. But when less than
half of the county had been surveyed by 1962, the project
was discontinued.
Stopping
the study was a fortunate event for the Comstock Center, since
a number of factors converged at that time to bring it into
being. The empty cancer research building was embarrassing
to the National Cancer Institute and the Health Department.
The Cancer Institute still wished to complete its study expeditiously.
The Bureau of State Services, U. S. Public Health Service,
was pushing public health involvement in chronic disease prevention,
and was sympathetic to the idea of field training. A field
center for the School was in the minds of Dr. John C. Hume,
Assistant Dean, and Dr. Philip E. Sartwell, Chairman of the
Department of Epidemiology. And in November, 1962, Dr. George
W. Comstock, with a long history of directing community projects
and a liking for Washington County, joined the faculty. In
a meeting on December 12, 1962 in the Alexander Hotel in Hagerstown
attended by Washington County Advisory Board of Health, the
Washington County Commissioners, and representatives of the
Maryland Department of Health and Mental Hygiene and the Johns
Hopkins School of Hygiene and Public Health, George W. Comstock Center for Public Health Research and Prevention, formerly The Training
Center for Public Health Research, was formally established,
with Dr. Comstock as Director.
To
support the new center, a training grant application was submitted;
on November 1, 1964, CD-1-01-1-T1 was awarded. In the interim,
the Cancer Institute donated furniture, the Health Department
made space available in the research building, the School
covered Dr. Comstock's salary and travel, and the Washington
County Tuberculosis Association paid for a secretary.
Early support also came from a contract with the National
Cancer Institute to conduct a private census of the county
to collect personal and housing information that would allow
the completion of the study of the geographic and residential
distribution of cancer cases. Dr. Frank E. Lundin, Jr., then
a doctoral candidate in the Department of Epidemiology, was
in charge of the small Cancer Institute staff that remained
in Hagerstown to maintain the cancer registry. He and Dr.
Comstock collaborated to conduct the 1963 private census,
which achieved a participation rate estimated to be greater
than 98 percent.
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