Finland

Finland. General data. Area--388,483 km². Population on December 1, 1931--3,493,000, population density per 1 km²-10.8 (1931). Population movement in the current century is expressed by the following indicators (per 1,000 population): __

Table 1. Years Birth rate Death rate Natural increase 1901-1910...... 31.1 25.4 21.7 21.2 21.8 22.2 21.8 17.8 13.4 14.5 13.5 14.0 14.1 13.2 7.6 8.3 6.7 8.1 8.2 7.7 19.5% of the population lives in cities, 80.5% in rural areas. Healthcare organization. At the Ministry of Interior there is a Higher Health Council, which institutes for serum and vaccine production, the Pasteur Institute, municipal and district, as well as city physicians. At the governor of each province there is a municipal health council, under whose jurisdiction city physicians are placed. The provincial (municipal and district) physicians also ultimately depend on the governor. The healthcare organization is currently formulated by the law of July 1, 1927, which came into force on January 1, 1928. According to this law, in each city, settlement or volost there should be a health commission, part of whose members are elected by the population, while part enters by right without elections (physician, veterinarian and head of local police, and in communes-mayor). The functions of these commissions consist in supervising the sanitary condition of streets, garbage collection, etc., housing hygiene, water supply and sewerage, food products, as well as the application of sanitary rules. In fact, the rights of all these sanitary organizations are very small.-Acute infectious diseases due to the low population density are relatively weakly spread. Smallpox, typhus and relapsing fever are observed in individual cases, typhoid fever has little spread. Influenza is registered at a relatively high rate. The law of July 1, 1927 summarizes the rules for combating infectious diseases, their registration, disinfection, etc. Tuberculosis is extremely widespread and is the main cause of death. Table 2 presents the mortality figures from tbc in Finland (absolute): Table 2. Years Number of deaths > Pulmonary tbc Other Forms of tbc 7,659 7,289 7,843 7,521 7,013 1,269 1,234 1,240 1,250 1,176 1 These data, compiled on the basis of reports from district physicians, exceed official statistical data. Thus, the trend towards a decrease in tbc mortality is almost imperceptible. The fight is conducted on an insufficient scale. In 1925, the government allocated 14 million marks for the fight against tbc, including 4 million for the construction of a sanatorium. In 1926, only 12 million marks were allocated. Approximately the same amounts are allocated annually in subsequent years. By the law of November 11, 1927, rules for combating tbc were outlined. Thus, the physician of a dispensary or district must be notified within 8 days of any new case of tbc. The local hygiene bureau was given the right to prohibit tbc patients from producing and selling food products. The state covers /* expenses for the construction of sanatoriums and pays 16 marks per day for the maintenance of a patient. Most sanatoriums are private and pay. In 1926, there were only 31 sanatoriums with 270 beds in state, 262 in municipal and communal, and 1,127 in private. Most sanatoriums are small, up to 100 beds. In 12 cities and 115 communes there were dispensaries maintained by the commune, with a subsidy from the state and from the League against tbc. At the end of 1931, there were 2 state sanatoriums, 19 communal and 24 private, which admitted about 4,000 patients per year. In recent years, the organization of anti-tuberculosis centers in cities and rural areas has begun. At the end of 1928, there were 12 such centers serving 150 communes. In 15 cities there were also such centers. Venereal diseases are very widespread and do not show a tendency to decrease (Table 3, in absolute figures): Table 3. Name of _disease 1925 1926 1927 1928 Syphilis . . . Gonorrhea . . . Soft chancre 1,404 8,681 1,216 1,494 9,017 1,490 1,350 8,966 1,569 1,838 10,696 2,268 8,086 1 964 In 1928, per 10,000 population there were cases: syphilis-24.06, gonorrhea-128.5 and soft chancre-31.23. In 1931, there were 18 state venereal dispensaries, through which 6,121 patients passed. In addition, there were 7 central consultation offices and 19 different institutions for the treatment of venereal patients.-Trachoma was quite widespread, but in recent years the incidence has decreased significantly. In 1908, 1.75% of the population was affected by trachoma, in 1924 only 0.75%. The highest percentage of trachoma patients was observed among factory workers (1.9% in 1924), then in schools (1.6%).-Alcoholism is a major social scourge despite the long-standing prohibition of alcoholic beverages. Prohibition was circumvented by the smuggling of alcoholic beverages, the production of samogon in villages and the obtaining of alcohol by prescription from physicians. In 1924, 03,405 people were brought to justice for drunkenness, in 1920 -73,829, in 1928 -101,036 and in 1929 -101,500. In 1928, there was one sanatorium for alcoholics, through which only 20 patients passed. Besides police, no fight against alcoholism is conducted.-Psychiatric diseases are widespread. In 1931, there were 7 state hospitals for mental patients in cities, through which 1,857 patients passed, and 3 in rural areas, through which 1,457 patients passed, in addition there were 18 municipal hospitals admitting 7,153 patients and 2 private (403 patients). In 1931, there were 9,485 men and 8,797 women in psychiatric hospitals. Medical personnel. There is a medical faculty in Helsingfors, graduating 50 to 60 physicians per year. The number of physicians, medical students, midwives, etc. has grown rapidly in recent years. In 1931, there were 619 medical students, 1,033 physicians (in 1925 819), i.e. about 3 per 10,000 inhabitants, 517 dentists (in 1925 418), i.e. 1.4 per 10,000 inhabitants. The number of midwives rose from 908 in 1925 to 1,003 in 1929 (2.77 per 10,000 inhabitants). The figures above show that despite the growth, the number of medical personnel is insufficient, especially considering the dispersion of the population. Hospital care. The number of hospitals has increased significantly in recent years: in 1920 there were 300 hospitals in the country, in 1925-339, in 1930-403 and in 1931-415 (of which 86 state, 229 communal and 100 private). In 1928, these hospitals had 14,769 beds. On average, there were 4 beds per 1,000 inhabitants. - Pharmacy. According to the law of January 4, 1928, pharmacies can be opened only with the permission of the government by Finnish citizens possessing political civil rights and having a pharmacist's diploma. Pharmacies are taxed with a special large tax. In 1926, there were 338 pharmacies, in 1928-365. Protection of motherhood and childhood. Child mortality in F. is higher than in other Scandinavian countries. It is expressed by the following indicators (per 1,000 born, Table 4): Table 4. Mortality up to 1 year (per 1,000 born).

_______ Years Number Years Number Years Number 1901-1910 1911-1920 1921-1930 1922 . . . 1923 . . . 134.2 121.2 100.1 107.7 98.5 1924 . . . 1925 . . . 1926 . . . 1927 . . . 117.1 92.9 92.7 106.0 1928 . . . 1929 . . . 1930 . . . 1931 . . . 90.9 109.0 82.5 81.1 The network for the protection of motherhood and infancy is poorly developed. Besides a small number of children's consultations, the following institutions exist for orphans: state - 11 shelters for boys and 2 for girls, municipal - 7 shelters for boys and 2 for girls, as well as one shelter for boys. In addition, there are 6 private shelters for boys and girls. Besides school doctors, there are school nurses (several dozen). The protection of childhood and supervision of institutions lies with a special department of the ministry of social welfare. The protection of labor is very poorly developed and has changed little since the time of tsarist rule. Labor of children under 15 years is prohibited in most enterprises according to a special list of them. For adolescents working in enterprises, a 6-hour working day is established, and for adult workers - 8 hours, but the law permits 200 hours of overtime work per year, without special permission from the authorities. For women, there are neither maternity leaves nor mandatory rest for breastfeeding children during work. No social insurance. In 1927, a bill on social insurance was introduced to parliament (the Eduskunta), but rejected. In the same 1927, laws and decrees were issued on the introduction of inspection of industrial enterprises and on the protection of labor in various dangerous or harmful branches of industry. In 1929, the use of white lead was prohibited. All these measures are introduced unsystematically and actually do not protect labor. Only insurance of workers against accidents in industry is mandatory. By the law of 1/1 1926, this insurance was extended to all persons of hired labor, and it also included insurance against certain professional diseases, which are assimilated with accidents. Worker mutual aid funds are widely spread, which provide their members with benefits during illnesses, pay for medical care, funerals, as well as help in case of loss of working capacity. Employers subsidize these funds to some extent (not more than 15-20%), but in fact the main amounts are paid by the workers themselves. The number of funds grew from 132 in 1901 to 229 in 1920 (58,745 members), reached 258 (69,951 members) in 1927, and since then has been decreasing as the economic crisis deepens. In 1931, there were 248 funds with 64,045 members. Their income was distributed as follows (Table 5): T A b l e. 5. Years Worker contributions (in marks) Employer contributions (in marks) Other income 1901 . . . 1925. . . 1930 . . . 1931 . . . 321,877 7,882,951 7,618,655 6,790,955 1,625,643 2,123,470 1,645,986 168,374 1,319,630 2,716,470 2,236,286 Since the crisis, the already meager employer contributions have decreased disproportionately. Health budget. Expenditures on healthcare of central government institutions (ministry of interior and social welfare) in 1929 amounted to 94,000,000 marks, and in addition 45,200,000 marks for the construction of hospitals and 17,740,000 marks for the protection of childhood and improvement of schools.