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The Job Ahead

The Job Ahead

THOMAS PARRAN, M.D., Surgeon General, United States Public Health Service, An Article in Survey Graphic, July 1941Thomas Parran, M.D., Surgeon General 1936-1948[View Image]
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Thomas Parran, M.D., Surgeon General 1936-1948

All of us today are conscious of the grave task lying before us. The President has declared a state of unlimited national emergency. In the weeks and months to come, we shall need not only planes and munitions, a growing army and navy, but also rugged health and courage. All these defenses are within our reach. Given the national will to do it, we have the power to build here in America a nation of people more fit, more vigorous, more competent; a nation with better morale, a more united purpose, more toughness of body, and greater strength of mind than the world has ever seen.

This total result can be accomplished only by putting to work all the scientific knowledge we have for the nutrition of all our people. This country has the capacity for agricultural production, the soil fertility, the educational machinery, the food manufacturing and distribution facilities, with leaders keenly aware of their social responsibility. Throughout the nation there is a surging desire to join in the defense effort, to build better and more strongly the human bulwarks of democracy. These great assets can be canalized, through science, toward the goal of nutrition to lift our level of achievement. If we attain this goal, what will be the results ?

To find a parallel to the swift advance in nutritional knowledge in the last two decades one must go back to the epoch-making time of Pasteur, whose germ theory of disease made possible the last half-century’s progress against preventable infections. Without Pasteur and his co-workers, mankind still would be plague-ridden. They pushed forward the processes of civilization. Today we have within reach the key to a comparable advance if we put to work now, what we know now, about the nutrition of human beings.

In the past half-century we in this country have added twenty years to the average span of human life, largely by saving the lives of babies and of young people. But life expectancy for those beyond the age of forty has not increased since Pasteur’s time. On the contrary, many diseases have increased because more people grow old enough to acquire them. Deaths have increased from cancer, heart conditions, kidney diseases, mental illness—in fact, from all of the so-called degenerative causes. It is easy to say that this is due to the strain of modern life. Yet every disease, every malfunction of an organ, results from a derangement in the functioning of the individual body cell. The individual cell functions properly if it is properly fed; and if it is not killed by the invasion of bacterial, virus, or chemical poisons, or by endogenous toxins. The food available to each of the body cells probably determines to a large degree the health of that cell, its proper functioning, its reciprocal relations with other cells, which make up bodily organs and systems.

The science of nutrition is about as young as the science of aviation. We do not know all the answers in either field. But as much, relatively, is known about what nourishes a human body, as is known about what gets a heavy machine up in the air and safely to its destination. The difference is that far less of the nutritional knowlege is put to work.

The National Nutrition Conference brought together basic facts on nutrition today and drew blueprints for national action. The facts make clear that while nutrition is an individual and family problem, it is also a community and a national problem.

For the first time, experts have laid down the specifications for a diet adequate for good health—a “gold standard for nutrition.” The standard affords a wide choice of foods that can be purchased cheaply anywhere in the country yet which will provide for men, women, and children the nutritional essentials for life and buoyant health. It will have meaning only as it is translated into a wiser selection of what each one of the 130 million American eats every day.

While the full extent of the Nation’s nutritional problem is undetermined, we know that, as President Roosevelt stated to the Washington conference, “every survey of nutrition, by whatever method conducted, in whatever part of the country, shows malnutrition to be widespread and serious.” Studies of family diets by the Department of Agriculture in all income groups of nation show that one third of the people are getting food inadequate to maintain good health. Less than one fourth are getting a “good diet,” even when measured by the old standards which are lower than the “gold standard.” Some people cannot afford to buy food they need; others spend their food budget unwisely; still others have fixed and faulty food habits. Americans want good health to be the heritage of all, on as dramatic a basis as the suffrage itself. We want no property qualifications for health.

Here, we happen to have plenty of fertile land to supply every element of a full and adequate diet to the present population and any prospective increase. This is true, in spite of past exploitation of agricultural resources.

This country has been unwise on other fronts. Nature puts into the foods we eat the vital elements necessary for balanced health. Modern man has depleted many of them through zeal for overrefining, and through cooking methods of today.

One half of our fuel—the calories we eat—is in the form of bread and sugar. Add to this the refined fats, and two thirds of our energy intake is in the form of “inert calories,” which furnish fuel and nothing else. From the remaining third of our diet we must get the vitamin B complex and the minerals needed to burn up the inert calories. This is where we have been starving ourselves. Over the ages, bread has been the “staff of life.” In recent decades the bread of this nation has been a very frail and feeble reed because the wheat berry has been “scalped” of most of the vitamins and minerals which the good Lord put into it for our protection. Year by year, too, the national consumption of sugar has increased. White sugar is a source of fuel and of nothing else. It does not carry the vital elements necessary for its use in the body.

To restore bread to its traditional virtue, the millers and bakers of the country are revolutionizing their industries. The new standards assure the nation a stronger staff in the new “enriched flour.” This will be attained either by conserving the vital elements naturally present in wheat, through longer extraction—which means using more of the wheat berry; or, if the public continues to demand pallid bread, the most essential elements will be restored to highly milled white flour without changing its color. Whichever you choose, you get a more healthful food. But choose one of them.

A further deficiency in modern diets can be corrected only by a 50 percent increase in our national production of milk and milk products. One of the most valuable foods—dried skim milk—today is used largely for poultry stock feed. In fact, livestock now gets the best of many foods. We must see that our children have their fair share.

During the past decade, the United States has produced what we have called a “surplus” of agricultural products. Very wisely we have built up an “ever-normal granary” of corn and wheat on which to draw in the event of drought or other emergency. Wisely, also, we have conserved the soil and helped farmers to stay on the soil. Some of the neediest families have been able to improve their diet through the Food Stamp Plan. This plan has made good use of some of our surplus foods, as have the free school lunches, which assure about half the needy school children at least one good meal a day for five days a week during the school year.

But these important programs were designed primarily to take surplus foods off the market, not to meet nutritional needs. If full domestic food needs are met, we would have a surplus of only three farm products: wheat, cotton, and tobacco. If we add the urgent needs of Great Britain to our own requirements, we are faced not with a problem of surpluses, but of shortage—notably in animal proteins, milk and milk products, and the legumes. To meet the immediate need, and to prepare for the needs of the half-starved world after the war, means organized farm output. We cannot afford to grow unwanted cotton, wheat, and tobacco, on acres which can produce the concentrated protein foods needed both by ourselves and by the British.

In practical terms, we need every drop of milk, every egg, every legume, every pound of meat and of fish we can produce for Anglo-American nutrition, plus substantial quantities of animal and vegetable fats, fish liver oils, and certain vitamins. I believe that the program of the Department of Agriculture [see page 387] which will convert most of our ever-normal granary of feed into concentrated human protein foods represents a long step forward. We may have to go even further during this emergency.

The nine hundred experts to the Nutrition Conference were united in a common objective: To-build a stronger race through good food. Their recommendations to the President enlist the united efforts of agriculture, economics, public health, nutritional science, industry, and education to this end.

First of all, we must continue our search for knowledge, with greater support for scientific research in nutrition by government, by the universities and foundations, and by industry.

Through soil conservation this country can provide better nutrition—more food, richer in vital elements. Governmental aid to agriculture will discourage the planting of unnecessary crops, and stimulate the production of the goods needed for defense. Thus farmers will divert acres now planted to cotton, tobacco, and wheat to pasture for dairy herds; to growing home gardens, peanuts and soy beans, green vegetables, fruits, tomatoes; to increasing the numbers of pigs, chickens and eggs. To provide a good diet for all Americans means 35 to 40 million more acres producing foodstuffs. That, of course, means at the same time a higher farm income.

For the neediest people, certainly for all those on relief, I urge an extension of the Food Stamp Plan. Further, I suggest that the whole program be shaped toward better nutrition of human beings rather than getting rid of surpluses.

If war should make it necessary for us to conserve certain foods, the administrative machinery of the Food Stamp Plan could be put into reverse overnight in order to insure equitable consumption of such foods in proportion to need; not in proportion to buying power.

If food stamps or a comparable plan were in operation all over the country, it could be extended to more of the nutritionally needy families who now are without the foods essential to sound health. Well-planned school lunches, now available only to one half of our needy children, are a case in point. Milk and citrus fruits are such strategic foods that every family must have an opportunity to get enough of them.

Beyond today’s emergency, food offers a foundation stone in an after-war world economy. Food for defense involving, as it should, intimate coooperation between the United Kingdom, the British Commonwealth, the United States, and the other American Republics lay the basis for a world policy to meet effectively this elemental human need. Toward the realization of that hope for the future, immediate domestic responsibilities for food nutrition will point the way.

Plans are taking shape for State Nutrition Councils, to multiply the Washington conference by forty-eight, and to reach the 3,000 counties with the nutrition program.

Food manufacturers and distributors, as well as producers, have an important part in the nutrition programs. Their facilities and their influence will stimulate wider distribution and use of foods now deficient in the national dietary. Other food industries are planning to follow the lead of the millers and bakers in improving the nutritional value of their products.

The food and nutrition experts have the responsibility for spreading modern nutritional knowledge, and what a better diet will mean to every American, in terms of a strong body, a more alert mind, greater resistance to disease, longer life, greater vigor, and a better chance for happiness. Such education must go forward swiftly, not only among laymen, but also in the professions, particularly among doctors, dentists, social workers, and teachers.

These are great objectives. I hope that the President may see fit to make this task the sole responsibility of a competent body, acting through the Coordinator of Health, Welfare and Nutrition as an operating agency, for the immediate nationwide application of nutritional knowledge to human needs. Science, education, agriculture, industry and many government agencies should share the responsibility for the task ahead.

If this whole job ahead is done—and it will be done—it will constitute news of historic importance, greater on the constructive side than the capitulation of France or the over-running of Greece have been destructive to democratic hopes. The upbuilding of our own people to level of health and vigor never before attained, and scarcely dreamed of, the working out with the British Empire, the American Republics and other democracies, far-reaching cooperative plans for the pooling of food resources, all this may prove to be the one humane achievement of the war when we have done our share to win it.

But hopes for the future must not obscure the immediate task. Through public effort, and through joint personal efforts, we must begin now to put our food knowledge to work to build a stronger and more competent race. But the present effort is only the beginning of our historic task.

Today we are preparing to defend, not so much the square miles of land that represent the forty-eight states, our territories and possessions, nor an island here, or the bulge of a continent there—but the men, women, and children who are the United States. If necessary, we are ready to sacrifice comforts, convenience, money, even life itself, to insure our freedom and the freedom of our children to choose our own and their own way of life.

After this war, when cities and civilizations lie in ruins and the impulse toward human brotherhood is smothered with hate, all the strength and courage that America can muster will be needed for the rebuilding of a shattered world. As a people, we must be conscious of our destiny, for America is the last great hope on earth.

Source:  Parran, Thomas, M.D., “The Job Ahead,” Survey Graphic, Vol. 30, No. 7, p. 396 (July, 1941), The New Deal Network, (April 10, 2014)

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