problems presented in the Emergency Rooms. Drug overdose represented two cases: hypertension, three cases: choking, two cases: child poisoning, six cases: asthma, four cases: and dog bite, one case. Most other visits were related to respiratory problems, such as influenza, pneumonia, bronchitis, etc. The careless handling of birth control pills, bleach, linament, other medications and colorful chemicals in the home poses an obvious threat to infants. Most of those affected were less than three years of age. The problem of educating people, who have for years found the Emergency Room the only source of medical care in times of need, and convincing them of the advantage of using a clinic or group practice facility whenever
possible, represents a major undertaking. One cannot easily change habits of people. Educational levels and intellect often bear little or no relation to behavior, especially when that behavior by repetition has become a habit. Evidence of this is the number of intelligent people who smoke, and become addicted to alcohol, to amphetamines, and to sleeping pills despite the vast sums of money spent annually in an effort to educate them to the dangers of these practices. The marked difference between the cost of care rendered in a hospital Emergency Room compared to that rendered for the same condition in a group practice facility opens hospitals to suspicion for generating income through excessive use of laboratory
facilities. When two hospitals in the same community have fees which are basically 80 to 100 percent different from each other, the practices in one or the other may not be what they should be.
Conclusions There is strong evidence that considerable reduction in health care costs can be realized with modification of the current patterns of use of hospital Emergency Rooms in the ghetto. Acknowledgement This article was made possible by Grant #05 P000281 030-MO P31, Department of Health, Education, and Welfare to the Southside Community Health Plan. The author is grateful to Mr. Arthur Brown, Executive Director of the Southside Community Health Plan, for furnishing much of the basic data used in this study.
Mental Illness in Blacks: An Overview, and Treatment Approaches Elizabeth B. Davis, MD New York. New York Provisions for inner city mental health services must recognize the
association between poverty, discrimination, and related social and physical conditions and disproportionately high rates of severe mental disorder-a transcultural phenomenon. Program emphasis should therefore be on the prevention, early recognition, prompt and effective treatment and rehabilitative care of psychosis. The total spectrum of psychiatric services is required for this, and thus an opportunity is afforded for necessary training and research. Poverty has negative impact on general health and cognitive development as well as on self-esteem, self-care, and the ability to utilize medical and health services. This contributes to a vicious, intergenerational poverty cycle. Primary prevention of mental illness, where possible, depends at present on socioeconomic change. Secondary prevention, ie, timely, appropriate treatment, is effective, but requires patient access to and acceptance of all indicated modalities of care. In planning and providing mental health services for any area, it is important to know the general characteristics
Presented at the NMA Region Seminar, "Stress, Economics and the Mental Health of Blacks," May 1978, Cherry Hill, New Jersey. From the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York. Requests for reprints should be addressed to Dr. Elizabeth B. Davis, 353 E 17th Street, New York, NY 10003.
1022
of the population to be served. Foremost among characteristics of today's American inner city are that its population is largely black and large'ly poor. It has been well documented that being black in America vastly increases one's chances of being poor-irrespective of constitution, motivation, or even factors such as educational, vocational, or social status. The rules of social and economic
competition which have sooner or later applied at least roughly to members of most other ethnic groups in America have, until very recently, been systematically abrogated for blacks throughout their time in this country, in spite of the fact that after emancipation, conformity to the American ideal of equality of opportunity required that the continuing exclusion of blacks from the competitive system be denied, camouflaged, or rationalized. Aside from the complex effect of this arrangement on the motivation, attitudes, and values of inner city residents, there are very specific consequences of the poverty itself. It is to these that professional mental health services in the inner city must be specifically addressed.
Role of Poverty in the Epidemiology of Mental Disorder The work of Ho-llingshead and Redlich' and of Srole, et al2 (The Midtown Study) leave little doubt of the reality of the association between poverty and severe psychiatric illness, particularly schizophrenia, that is so strongly suggested by even casual examination of the correlation between hospital ad-
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 71, NO. 10, 1979
mission rates and poverty. This correlation can no longer be rationalized with the suggestion that the well-to-do obtain psychiatric care privately and therefore do not appear in public hospital admission rates. While this is true, it is also true that hospitalization for mental illness becomes more rare as the economic ladder is climbed, as does hospitalization for tuberculosis, cirrhosis, and cervical cancer. Langner and Michael3 have provided a most useful example of the way in which social data may be correlated with psychiatric data to give entry into the thorniest unsolved problems of psychiatric etiology. They examined "broken homes" and "family conflict" so often cited as causes of mental disorder, but to which there were so many exceptions that the concepts were useless except in the most gross epidemiological terms. With closer analysis, however, they found that specific aspects of family history were statistically significantly correlated with higher risk of developing mental illness. These were: early death or absence of a parent, quarrelsome parents, poor physical health in parent, and negative perception of parents' character. These correlations were found at all socioeconomic levels. Dohrenwend and Dohrenwend's classical work, "Social Class in Mental Illness"4 reviewed 60 studies of the prevalence of psychosis, personality disorders, and psychoneurosis in cultures and nations, developed and less developed, throughout the world. Almost all studies found a highly significant inverse correlation between prevalence of psychosis and social class. This important relationship is thus found to be a transcultural as well as an international phenomenon. Whether class membership is determined by downward drift, formal caste systems, or built-in discriminatory social patterns, people in the lower classes suffer from more severe psychiatric disorders than their more privileged counterparts. Among such severe chronic disorders are schizophrenia and the personality disorders. These considerations are perhaps especially pertinent since schizophrenia is the mental illness for which poverty constitutes the highest risk, and the primary defect in schizophrenia is a distorted perception of reality. It is also at the lower socioeconomic levels that parents are least able to provide
adequate parenting due to the frequency of early death or separation from the child, their high incidence of physical illness, and frequent parental conflict and/or personality disorder. Parents in this group are therefore at greatest risk of being negatively perceived by their children. Under such circumstances, there is greater need for a child to resort to denial as a defense against anxiety and helpless rage, thereby establishing at an early age a certain degree of alienation from reality, as well as laying the groundwork for failure to develop adequate methods of dealing with ambivalence in other relationships. Since there is no evidence that the genetic factor which makes individuals vulnerable to schizophrenia is by itself a sufficient cause for the development of schizophrenia, or that this genetic factor is differentially distributed among the various classes, it could well be concluded that nongenetically determined, socioeconomically mediated, intrapsychic factors contribute the additional stress which accounts for the worldwide disproportionate prevalence of schizophrenia among the poor. The implication -of these epidemiological data is that inner city mental health services must anticipate a higher proportion of schizophrenic psychoses in their patient populations than in areas with a more middle-class socioeconomic level.
Implications for Clinical Programs In the clinical program of a comprehensive mental health service for such an area, emphasis should be put on psychosis-its prevention, its early recognition, its prompt and effective treatment, and its rehabilitative care. If, in fact, all these aspects of care are adequately provided, the total spectrum of psychiatric activity is necessary. Such a service, therefore, is rich in the variety and scope of its programs and opportunities for training and research.
Effect of Poverty onXUtilization of Health and Educational Services Poverty appears to be perpetuated because people in poverty become trapped in a vicious circle and health care is involved in this unfortunate vicious circle for conscious and unconscious, external, and/or intrapsychic
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 71, NO. 10, 1979
reasons. Various studies have documented the association of poverty with poor nutrition and poor medical care. The everyday conditions of life for those in poverty also appear to mitigate against optimal development of the cognitive skills that seem essential to successful school performance, at the same time that the cognitive skills necessary for adaptation to the "street culture" may become very highly developed. But the current realities of living in a complex society demand development of adequate basic educational skills. Impaired cognitive functioning in school performance decreases the child's sense of mastery, and hence his self-esteem. Poverty has its impact also on patterns of utilization of health care services, as well as on the quantity and quality of services provided. Low cognitive skills and a poor sense of mastery lead to less care of the self, with insufficient practice of preventive health measures such as achievably adequate nutrition, and delayed or erratic usage of those medical facilities that are made available. Such patterns can amount to resistance to the use of primary preventive health measures by adults, which leads again, in their children, to pi7oblems of poor nutrition, poor health, and poor medical care, with their contributions to low cognitive skills. Identification with parental attitudes contributes to resistance in the young to health education and to the practice of preventive measures as taught in the schools and media. Povery-linked conditions thus produce continued and exacerbated poverty, in a tightening and truly vicious circle.
Implications for Health Care Providers Providers of health care serivces and health care educators must find techniques to interrupt this continuing cycle. The obstacles and resistances, whether realistic or psychological, must be clarified so that it becomes possible to reduce the distance between providers and consumers of health services. These observations are just as true of mental health care as they are of general health care.
Prevention Through Medical Services Primary prevention of mental illness, if at all possible, depends on 1023
changes in life-style which, in turn, are mainly dependent on socioeconomic factors and educational level. Preventive psychiatry, at the present time, is limited to secondary prevention, ie, early diagnosis and adequate treatment, since there is no known specific prevention for mental illness, as indeed there is no known prevention for most of the other disabling illnesses of postindustrial societies, eg, diabetes, hypertension, cancer, and cardiovascular disease. Effective treatment of mental illness requires that there be timely and continuous access to and ultimately acceptance of those modalities of care which are appropriate both to the illness and to the person with the illness. Below are briefly described the major treatment approaches for persons with mental illness. The main categories of treatment for mental illness are pharmacological therapy, psychotherapy, and milieu therapy. Psychiatric disorders which are believed to have specific neurophysiologic determinants or concomi-
tants respond most dramatically to the psychopharmacological approach, but effective therapy in these disorders usually also involves some degree of reliance on the other types of treatment during the course of the illness. The emphasis will vary significantly during different phases of illness and treatment. There has been an unfortunate tendency, since discovery of the efficacy of neuroleptic drugs in psychosis, to rely heavily or exclusively on these in caring for patients whose illnesses fall within the schizophrenia spectrum, particularly. While they are essential for providing access to the patient and for achieving patient acceptance for other aspects of care, neuroleptics, used alone, yield less than optimal results in most cases. Psychotherapy, in the form of individual therapy, group therapy, family therapy, or in combination with behavior therapy and milieu therapy is often necessary to assure adherence to medication regimens and other supportive measures, and is thus an essen-
tial ingredient of even the strictest pharmacological approach. Similarly, pharmacology, even when combined with psychotherapy, is often ineffective without specific changes in the social and emotional environment of the patient. Such changes are often essential aspects of any treatment program, whether it be crisis intervention or the long-term rehabilitation so important in any serious effort to return patients to premorbid status, and, as well, to improve on that status for individuals whose capacities have been grossly underdeveloped and/or underutilized because of economic and social disadvantage.
Literature Cited 1. Hollingshead A, Redlich FC: Social Class and Mental Illness. NewYork, John Wiley, 1958 2. Srole L, Langner TS, Michael ST, et al: Mental Health in the Metropolis. New York, McGraw-Hill, 1961 3. Langner T, Michael S: Life Stress and Mental Health. London, Collier-Macmillan, 1963 4. Dohrenwend BP, Dohrenwend BS: Social and cultural influences on psychopathology. Annu Rev Psychol 25: 417-52,1974
Allen Named to Commission on the Status of Women Dr. Gloria M. Allen (MD, Howard '51) of Queens, New York, was named to the Commission on the Status of Women by the Mayor of New York City, Edward Koch. The Commission, which includes 38 persons, was established in 1975 to assess the status of women in New York City; to advise the Mayor of evidence of discrimination against women; and to recommend to the Mayor steps to take toward the elimination of discrimination by execu-
tive or legislative actions. Dr. Allen was one of two blacks installed as members of the Commission. The second was Dr. Anne M. Briscoe of Manhattan who is assistant professor of medicine at the College of Physicians and Surgeons of Columbia University and the director of the biochemistry laboratory at Harlem Hospital Center. Dr. Allen is co-founder and practicing pediatrician at the George and Robert Carter Community Health Cen-
ter in southeast Queens. She is a member of the staff of Harlem, Long Island Jewish, Hillcrest, and Jamaica Hospitals. She serves on the boards of the Girl Scouts of America and the YWCA of New York City. Dr. Allen served as moderator at the Seminar on Nutrition at the NMA regional convention (Region 1) at the
Concord Hotel, Kiamesha Lake, NY, May 26-28, 1979. She is married and the mother of two children.
Charles 1. West, Sr, Anatomy Fund Established Dr. Wilbur H. Strickland (MD, Howard '31) and Mrs. Strickland, of Philadelphia, donated $5,000 to the Howard University College of Medicine to establish the Dr. Charles I. West, Sr, Anatomy Fund. The fund will be used to present an annual prize to a medical student who has excelled in anatomy. Mrs. Strickland is the daughter of 1024
Dr. West. Dr. West's two sons, the late Dr. John B. West and Dr. "tharles I. West, Jr, were also graduates of the College in the Classes of 1929 and 1933 respectively. Dr. West was a member of the Class of 1895, and served as head of the Department of anatomy from 1925-1930. According to Dr. W. Montague Cobb,
distinguished professor of anatomy emeritus and former head of the Department, "Dr. West was known as 'Pop' to hundreds of alumni and was the epitome of dignity, punctuality, and exactitude. He became the first Negro member of the American Association of Anatomists."
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 71, NO. 10, 1979
possible, represents a major undertaking. One cannot easily change habits of people. Educational levels and intellect often bear little or no relation to behavior, especially when that behavior by repetition has become a habit. Evidence of this is the number of intelligent people who smoke, and become addicted to alcohol, to amphetamines, and to sleeping pills despite the vast sums of money spent annually in an effort to educate them to the dangers of these practices. The marked difference between the cost of care rendered in a hospital Emergency Room compared to that rendered for the same condition in a group practice facility opens hospitals to suspicion for generating income through excessive use of laboratory
facilities. When two hospitals in the same community have fees which are basically 80 to 100 percent different from each other, the practices in one or the other may not be what they should be.
Conclusions There is strong evidence that considerable reduction in health care costs can be realized with modification of the current patterns of use of hospital Emergency Rooms in the ghetto. Acknowledgement This article was made possible by Grant #05 P000281 030-MO P31, Department of Health, Education, and Welfare to the Southside Community Health Plan. The author is grateful to Mr. Arthur Brown, Executive Director of the Southside Community Health Plan, for furnishing much of the basic data used in this study.
Mental Illness in Blacks: An Overview, and Treatment Approaches Elizabeth B. Davis, MD New York. New York Provisions for inner city mental health services must recognize the
association between poverty, discrimination, and related social and physical conditions and disproportionately high rates of severe mental disorder-a transcultural phenomenon. Program emphasis should therefore be on the prevention, early recognition, prompt and effective treatment and rehabilitative care of psychosis. The total spectrum of psychiatric services is required for this, and thus an opportunity is afforded for necessary training and research. Poverty has negative impact on general health and cognitive development as well as on self-esteem, self-care, and the ability to utilize medical and health services. This contributes to a vicious, intergenerational poverty cycle. Primary prevention of mental illness, where possible, depends at present on socioeconomic change. Secondary prevention, ie, timely, appropriate treatment, is effective, but requires patient access to and acceptance of all indicated modalities of care. In planning and providing mental health services for any area, it is important to know the general characteristics
Presented at the NMA Region Seminar, "Stress, Economics and the Mental Health of Blacks," May 1978, Cherry Hill, New Jersey. From the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York. Requests for reprints should be addressed to Dr. Elizabeth B. Davis, 353 E 17th Street, New York, NY 10003.
1022
of the population to be served. Foremost among characteristics of today's American inner city are that its population is largely black and large'ly poor. It has been well documented that being black in America vastly increases one's chances of being poor-irrespective of constitution, motivation, or even factors such as educational, vocational, or social status. The rules of social and economic
competition which have sooner or later applied at least roughly to members of most other ethnic groups in America have, until very recently, been systematically abrogated for blacks throughout their time in this country, in spite of the fact that after emancipation, conformity to the American ideal of equality of opportunity required that the continuing exclusion of blacks from the competitive system be denied, camouflaged, or rationalized. Aside from the complex effect of this arrangement on the motivation, attitudes, and values of inner city residents, there are very specific consequences of the poverty itself. It is to these that professional mental health services in the inner city must be specifically addressed.
Role of Poverty in the Epidemiology of Mental Disorder The work of Ho-llingshead and Redlich' and of Srole, et al2 (The Midtown Study) leave little doubt of the reality of the association between poverty and severe psychiatric illness, particularly schizophrenia, that is so strongly suggested by even casual examination of the correlation between hospital ad-
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 71, NO. 10, 1979
mission rates and poverty. This correlation can no longer be rationalized with the suggestion that the well-to-do obtain psychiatric care privately and therefore do not appear in public hospital admission rates. While this is true, it is also true that hospitalization for mental illness becomes more rare as the economic ladder is climbed, as does hospitalization for tuberculosis, cirrhosis, and cervical cancer. Langner and Michael3 have provided a most useful example of the way in which social data may be correlated with psychiatric data to give entry into the thorniest unsolved problems of psychiatric etiology. They examined "broken homes" and "family conflict" so often cited as causes of mental disorder, but to which there were so many exceptions that the concepts were useless except in the most gross epidemiological terms. With closer analysis, however, they found that specific aspects of family history were statistically significantly correlated with higher risk of developing mental illness. These were: early death or absence of a parent, quarrelsome parents, poor physical health in parent, and negative perception of parents' character. These correlations were found at all socioeconomic levels. Dohrenwend and Dohrenwend's classical work, "Social Class in Mental Illness"4 reviewed 60 studies of the prevalence of psychosis, personality disorders, and psychoneurosis in cultures and nations, developed and less developed, throughout the world. Almost all studies found a highly significant inverse correlation between prevalence of psychosis and social class. This important relationship is thus found to be a transcultural as well as an international phenomenon. Whether class membership is determined by downward drift, formal caste systems, or built-in discriminatory social patterns, people in the lower classes suffer from more severe psychiatric disorders than their more privileged counterparts. Among such severe chronic disorders are schizophrenia and the personality disorders. These considerations are perhaps especially pertinent since schizophrenia is the mental illness for which poverty constitutes the highest risk, and the primary defect in schizophrenia is a distorted perception of reality. It is also at the lower socioeconomic levels that parents are least able to provide
adequate parenting due to the frequency of early death or separation from the child, their high incidence of physical illness, and frequent parental conflict and/or personality disorder. Parents in this group are therefore at greatest risk of being negatively perceived by their children. Under such circumstances, there is greater need for a child to resort to denial as a defense against anxiety and helpless rage, thereby establishing at an early age a certain degree of alienation from reality, as well as laying the groundwork for failure to develop adequate methods of dealing with ambivalence in other relationships. Since there is no evidence that the genetic factor which makes individuals vulnerable to schizophrenia is by itself a sufficient cause for the development of schizophrenia, or that this genetic factor is differentially distributed among the various classes, it could well be concluded that nongenetically determined, socioeconomically mediated, intrapsychic factors contribute the additional stress which accounts for the worldwide disproportionate prevalence of schizophrenia among the poor. The implication -of these epidemiological data is that inner city mental health services must anticipate a higher proportion of schizophrenic psychoses in their patient populations than in areas with a more middle-class socioeconomic level.
Implications for Clinical Programs In the clinical program of a comprehensive mental health service for such an area, emphasis should be put on psychosis-its prevention, its early recognition, its prompt and effective treatment, and its rehabilitative care. If, in fact, all these aspects of care are adequately provided, the total spectrum of psychiatric activity is necessary. Such a service, therefore, is rich in the variety and scope of its programs and opportunities for training and research.
Effect of Poverty onXUtilization of Health and Educational Services Poverty appears to be perpetuated because people in poverty become trapped in a vicious circle and health care is involved in this unfortunate vicious circle for conscious and unconscious, external, and/or intrapsychic
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 71, NO. 10, 1979
reasons. Various studies have documented the association of poverty with poor nutrition and poor medical care. The everyday conditions of life for those in poverty also appear to mitigate against optimal development of the cognitive skills that seem essential to successful school performance, at the same time that the cognitive skills necessary for adaptation to the "street culture" may become very highly developed. But the current realities of living in a complex society demand development of adequate basic educational skills. Impaired cognitive functioning in school performance decreases the child's sense of mastery, and hence his self-esteem. Poverty has its impact also on patterns of utilization of health care services, as well as on the quantity and quality of services provided. Low cognitive skills and a poor sense of mastery lead to less care of the self, with insufficient practice of preventive health measures such as achievably adequate nutrition, and delayed or erratic usage of those medical facilities that are made available. Such patterns can amount to resistance to the use of primary preventive health measures by adults, which leads again, in their children, to pi7oblems of poor nutrition, poor health, and poor medical care, with their contributions to low cognitive skills. Identification with parental attitudes contributes to resistance in the young to health education and to the practice of preventive measures as taught in the schools and media. Povery-linked conditions thus produce continued and exacerbated poverty, in a tightening and truly vicious circle.
Implications for Health Care Providers Providers of health care serivces and health care educators must find techniques to interrupt this continuing cycle. The obstacles and resistances, whether realistic or psychological, must be clarified so that it becomes possible to reduce the distance between providers and consumers of health services. These observations are just as true of mental health care as they are of general health care.
Prevention Through Medical Services Primary prevention of mental illness, if at all possible, depends on 1023
changes in life-style which, in turn, are mainly dependent on socioeconomic factors and educational level. Preventive psychiatry, at the present time, is limited to secondary prevention, ie, early diagnosis and adequate treatment, since there is no known specific prevention for mental illness, as indeed there is no known prevention for most of the other disabling illnesses of postindustrial societies, eg, diabetes, hypertension, cancer, and cardiovascular disease. Effective treatment of mental illness requires that there be timely and continuous access to and ultimately acceptance of those modalities of care which are appropriate both to the illness and to the person with the illness. Below are briefly described the major treatment approaches for persons with mental illness. The main categories of treatment for mental illness are pharmacological therapy, psychotherapy, and milieu therapy. Psychiatric disorders which are believed to have specific neurophysiologic determinants or concomi-
tants respond most dramatically to the psychopharmacological approach, but effective therapy in these disorders usually also involves some degree of reliance on the other types of treatment during the course of the illness. The emphasis will vary significantly during different phases of illness and treatment. There has been an unfortunate tendency, since discovery of the efficacy of neuroleptic drugs in psychosis, to rely heavily or exclusively on these in caring for patients whose illnesses fall within the schizophrenia spectrum, particularly. While they are essential for providing access to the patient and for achieving patient acceptance for other aspects of care, neuroleptics, used alone, yield less than optimal results in most cases. Psychotherapy, in the form of individual therapy, group therapy, family therapy, or in combination with behavior therapy and milieu therapy is often necessary to assure adherence to medication regimens and other supportive measures, and is thus an essen-
tial ingredient of even the strictest pharmacological approach. Similarly, pharmacology, even when combined with psychotherapy, is often ineffective without specific changes in the social and emotional environment of the patient. Such changes are often essential aspects of any treatment program, whether it be crisis intervention or the long-term rehabilitation so important in any serious effort to return patients to premorbid status, and, as well, to improve on that status for individuals whose capacities have been grossly underdeveloped and/or underutilized because of economic and social disadvantage.
Literature Cited 1. Hollingshead A, Redlich FC: Social Class and Mental Illness. NewYork, John Wiley, 1958 2. Srole L, Langner TS, Michael ST, et al: Mental Health in the Metropolis. New York, McGraw-Hill, 1961 3. Langner T, Michael S: Life Stress and Mental Health. London, Collier-Macmillan, 1963 4. Dohrenwend BP, Dohrenwend BS: Social and cultural influences on psychopathology. Annu Rev Psychol 25: 417-52,1974
Allen Named to Commission on the Status of Women Dr. Gloria M. Allen (MD, Howard '51) of Queens, New York, was named to the Commission on the Status of Women by the Mayor of New York City, Edward Koch. The Commission, which includes 38 persons, was established in 1975 to assess the status of women in New York City; to advise the Mayor of evidence of discrimination against women; and to recommend to the Mayor steps to take toward the elimination of discrimination by execu-
tive or legislative actions. Dr. Allen was one of two blacks installed as members of the Commission. The second was Dr. Anne M. Briscoe of Manhattan who is assistant professor of medicine at the College of Physicians and Surgeons of Columbia University and the director of the biochemistry laboratory at Harlem Hospital Center. Dr. Allen is co-founder and practicing pediatrician at the George and Robert Carter Community Health Cen-
ter in southeast Queens. She is a member of the staff of Harlem, Long Island Jewish, Hillcrest, and Jamaica Hospitals. She serves on the boards of the Girl Scouts of America and the YWCA of New York City. Dr. Allen served as moderator at the Seminar on Nutrition at the NMA regional convention (Region 1) at the
Concord Hotel, Kiamesha Lake, NY, May 26-28, 1979. She is married and the mother of two children.
Charles 1. West, Sr, Anatomy Fund Established Dr. Wilbur H. Strickland (MD, Howard '31) and Mrs. Strickland, of Philadelphia, donated $5,000 to the Howard University College of Medicine to establish the Dr. Charles I. West, Sr, Anatomy Fund. The fund will be used to present an annual prize to a medical student who has excelled in anatomy. Mrs. Strickland is the daughter of 1024
Dr. West. Dr. West's two sons, the late Dr. John B. West and Dr. "tharles I. West, Jr, were also graduates of the College in the Classes of 1929 and 1933 respectively. Dr. West was a member of the Class of 1895, and served as head of the Department of anatomy from 1925-1930. According to Dr. W. Montague Cobb,
distinguished professor of anatomy emeritus and former head of the Department, "Dr. West was known as 'Pop' to hundreds of alumni and was the epitome of dignity, punctuality, and exactitude. He became the first Negro member of the American Association of Anatomists."
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 71, NO. 10, 1979
