City Manager

1 High Street

Portsmouth, Virginia 23704

Dear Sir:

August 1, 1973

Enclosed is my report for the fiscal year ending June 30, 1973.

The format of the report has been changed this year to reflect he relationship of expenditures to services and their value to the community. It is hoped that this report will become one part of a total human resource report demonstrating the inter-relationship of various services provided by city agencies working directly with people’s needs.

Our efforts occur within three major areas; Administration and Support, Environmental Services, Medical Services.

The initial part of the report will be a summary of where we stand now and what we need to do in the immediate future (a time span of five years). This will be followed by reports in the major activity areas.

Looking back over the past five years and previous reports, there is one outstanding deficit we have not yet been able to overcome, this is the absence of a meaningful information system relating our services to each other and other human resource services. There is a good possibility for overcoming this handicap in the next fiscal year. There are still needs for better utilization of staff and expansion of environmental programs in the area of food service. We also need to concentrate on improvement of the communicable disease programs.

This is the first full year of the rental activities. The combination of the rental and systematic code approach has allowed the inspection of over one fifth of the city’s dwelling units. There have been over 2000 rehabilitations of substandard units. The major defect in the housing program is the tracing of tenants who skip out leaving units vandalized. Additional emphasis will be placed on discouraging this during the next fiscal year. There is still a shortage of standard units to which tenants of substandard units can be referred, thus allowing more rapid removal of the seriously substandard units still remaining.

Most of the new homes being built have been in the Churchland area. Disposal of sewage remains a problem. Only limited connections are available to Hampton Roads Sanitation District due to excessive delays in approval by the State and Water Control Board. A number of lots are rejected as being unsuitable for septic tanks. The rejection is due to a combination of a high water table and inappropriate soils. We have had the advice of a State soil scientist on a number of lots to make sure we were not rejecting any lots, which might be used.

We also continue to have a problem in animal control with numerous dogs running at large soiling lots and biting people. Dogs have also been found to encourage rats in an area. This problem can only be managed with more staff for the dog wardens and strict control of the leash law.

Communicable diseases still are a problem, especially the venereal diseases. Additional staff, provided by the State, has increased the amount of Venereal Disease we are discovering. The control of disease, however, rests with proper education of both youth and parents, and with the development of a more mature attitude towards sexual responsibility. A youngster has a one in four chance of developing a Venereal Disease while growing from 15 to 19 years of age.

New active cases of Tuberculosis continue to appear. The present number of active cases is representative of health conditions as long as twenty years ago. This disease starts as an infection, usually lies dormant twenty or more years and later appears as disease in the lungs. Greater testing for infection, detection of active cases, their contacts and provision of prophylaxis when indicated will reduce the incidence of the disease several years from now. A major problem in Tuberculosis control today is that of alcoholics who also have Tuberculosis. They will not follow-up with visits to the doctor or take medicine prescribed. They wander from house to house, mainly in low income areas, spreading the disease to those they live with.

Birth rates continue to decline, but many people in low-income areas still need family planning services to allow them to choose when and how many children to have. The resistance of males towards taking any precautions to prevent pregnancy, the desire of young immature females to get pregnant and leave home increases the problem. We find increasing numbers of young females with illegitimate pregnancies who do not understand the mechanism of birth control. This ties into the behavior responsible for the high level of Venereal Diseases. Until a valid program of family life education is established in the school system, to reach adolescents before they become sexually active, the problem will get worse.

The quality of life for children is affected by lack of maternal health services for the mother, many of who are immature and pregnant. The mother and child can expect to have increased complications. Better referral services between the human service agencies are needed to provide prompt assistance without duplication.

During the year a local alcohol services program was initiated. This is coordinated by staff of the Bureau of Alcohol Services from the State Health Department and funded 10Oc~ at this time by the State. This is the fifteenth local program set up by the State. In the past it had been assumed that the Norfolk program would service Portsmouth, but this has not been possible. The initial objectives of the program are to assess the impact of alcohol abuse on the community, define needed services by priority, and work up methods to implement them. Objectives for the next fiscal year are to get the State to fund a program of basic services, develop a staff of counselors, establish a program for public inebriates and for drinking drivers, and provide an information program on the problem of alcohol for the community.

Sincerely Yours,

C.M. G, Buttery, M.D.

Director of Public Health