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Health--History  (under construction)

PictureLenni Lenape family depicted in print in nineteenth century book. Image: NewJerseyAlmanac.com
--The Colony
      The most severe impact of the European settlement of New Jersey was the devastation of the health of the Native Americans. The Lenni Lenapes and other tribes in New Jersey had lived isolated from the diseases prevalent in Europe, including smallpox, cholera, typhoid, scarlet fever, diphtheria, and whooping cough. 

         Soon after the arrival of the foreigners, the diseases brought by settlers ravaged the tribal populations, which lacked any natural immunity built up from prior exposures. The epidemics were beyond the skills of the native healers who used herbs, roots and other natural remedies, along with sweat lodges, to purge the diseases with which they had been most familiar. By 1640, according to one estimate, the Lenape population had been reduced by 90% as a result of different epidemics of European diseases, particularly smallpox.

         Settlers also would die in large numbers from disease, particularly the young and elderly. Medical knowledge remained rudimentary, with no understanding of the causes of disease or importance of contagion in its spread. During the early years of colonization, there were few physicians with formal training, and in most areas settlers with some education were looked to as the most qualified to treat those who were sick or injured. In some cases, local healers or tradesmen like barbers developed

        Often, ministers were called upon as learned men thought also to be able to serve in a medical role. Jonathan Dickinson, a Presbyterian minister who in 1746 founded and became the first president and sole teacher of classes held at at his home in Elizabethtown of the College of New Jersey (later Princeton University) was one of those ministers who supplemented his ministerial duties by treating the sick. (Dickinson himself died of smallpox soon after his new college began classes in 1747).  Other colonial ministers who on occasion practiced medicine were located, according to a later history, in Newark, Parsippany and Caldwell. 
       While New Jersey would not have its own medical school until the middle of the 20th century, some of the most prominent early physicians had strong roots in the state. Dr. Benjamin Rush graduated in 1760 from the College of New Jersey after its relocation to Princeton from Elizabethtown and then, after working as an apprentice to a prominent physician in Philadelphia, traveled to Scotland for his medical education at the University of Edinburgh. When he returned to America, in January 1776 he married Julia Stockton of Princeton, the daughter of Richard and Annis Boudinot Stockton; months after the wedding, both Rush and his father-in-law Richard Stockton would be signers, as representatives respectively of Pennsylvania and New Jersey, of the Declaration of Independence. During the Revolution, Rush would serve as surgeon general for Washington's army at the Battles of Trenton and Princeton. At the Army's winter encampments in Morristown, Rush supervised the establishment of field hospitals to treat injured or ill soldiers.  
PictureReconstruction of field hospital built at winter encampments of Washington's Army in Morristown in 1777 and 1778. Image: National Park Service
  

       Despite his prominence  as the "most famous American physician and medical teacher of his generation," Rush engaged in the accepted treatments of his time, employing bloodletting and high doses of mercury and other toxic chemicals as laxatives for a variety of ailments. During the Revolution, the hospitals under Rush's supervision would confine wounded or ill soldiers in smoke-filled cabins without chimneys, believing that the smoke would deter infection.

       Following independence, New Jersey medical care would remain rudimentary, primarily the province of the doctors who would set up practices after receiving their education and training as apprentices to physicians in New York and Philadelphia.  Dr. Jonathan Pitney, "the father of Atlantic City," was somewhat typical. Born in Morris County, he left the state to study medicine at Columbia College in New York, practiced for two years in the Staten Island hospital, and then in 1820 returned to New Jersey to practice on sparsely-settled Absecon Island. Pitney became, according to local historians, "the most influential physician of the county" for nearly the next fifty years. Apart from his medical practice, however, Pitney would become best-known by an active entrepreneurial and political career, organizing the company which received a charter from the state legislature to build a railroad crossing the state to connect Philadelphia workers and their families to the seaside "health resort" Pitney promoted providing visitors with respites from city factories and pollution. 

       As the industrial development of the country accelerated with resulting pollution in major cities, other shore areas of the state in addition to Atlantic City also benefited. Long Branch became the favored summer residence of seven presidents, commencing with Ulysses S. Grant in 1869 and continuing with Presidents Hayes, Garfield, Arthur, Harrison,  McKinley and Wilson. When Garfield was shot in the Washington railroad station in July 1881, his doctors had him taken by special train to his summer home on the Long Branch beachfront aided by rails newly laid from the station in town to the home to ease the president's arrival,  hoping that the sea air would help his recovery, but he died there in the following September.  
  
       The clean air of the pine forests of Ocean County also would be touted as a health tonic for those escaping the city. In the 1890s, hotels built in the village of  Lakewood attracted stays from some of the nation's wealthiest families, including the Astors and Vanderbilts. After their first stays, Glenn Gould and John D. Rockefeller would build their own grand estates, with Rockefeller buying the club house and golf course of the Lakewood Country Club (later to become the current Ocean County park). 

       The northern part of the state also would see developments promoted for their health benefits. The Watchung Mountains of Essex County, situated above the pollution from  Newark and the other industrial cities in the valley below, were the site of  the nation's first planned housing development; first built in the 1850s, Llewellyn Park in West Orange was an enclave of homes in a landscaped setting which later included the residences of Thomas Edison and those of the Merck and Colgate families.  

       Most of the early hospitals were founded to serve special ethnic or religious constituencies. In 1808, a group of proprietors in 1804 with the intention to purchase property at Paulus Hook. It was the idea of Alexander Hamilton of New York, the first US Secretary of the Treasury under President George Washington. Hamilton believed in the future of manufacturing for the American nation and looked over to New Jersey for a location suitable to fulfill that goalThe first hospitals founded in the 1850s and 1860s, included the German Hospital (later Clara Maas) and St. Barnabas in Newark and St. Mary's in Hoboken. In 1902, the first Jewish hospital--the precursor to Newark Beth Israel--was established with 28 beds in a crumbling Newark mansion, later expanding on the same site in 1908 to become a 110-bed, four-story facility. 

       Those who could not afford escaping the pollution and lack of sanitation in the cities, particularly recent immigrants often working in unhealthy conditions in factories and living close together in tenement housing, would remain exposed to swift spreads of illnesses. In 1887, the immigrant grandmother of future governor Brendan Byrne would see six of her nine children--ranging in age from an infant to a 14 year-old--die in a single week as diphtheria and typhus swept the factory city of Orange. Even into the 1920s, when the state was experiencing a surge in prosperity, the older cities continued to struggle with sanitation and outbreaks of disease.
New Jersey's wetlands, customarily called swamps well into the twentieth century, also were a breeding ground for insects, particularly mosquitoes that spread diseases like Yellow Fever, Dengue Fever and encephalitus. Mosquito born yellow fever was reported to have  struck Philadelphia in 1793, thus ending that city's supremacy in the young union. Appropriately, the disease was stamped out by an American doctor, Walter Reed an army surgeon who in 1900 with a team of heroic assistants traced its source to a virus carried by the Aedes aegypti mosquito. This eliminated, almost in a single blow one of the ancient scourges of mankind.Window screens, introduced in the 1880's, were called "the most humane contribution the 19th century made to the preservation of sanity and good temper."

Mosquito born yellow fever was known as the American plague since it had struck the bay colony in 1647. Yellow Fever also decimated Philadelphia in 1793, thus ending that city's supremacy in the young union. Appropriately, the disease was stamped out by an American doctor, Walter Reed an army surgeon who in 1900 with a team of heroic assistants traced its source to a virus carried by the Aedes aegypti mosquito. This eliminated, almost in a single blow one of the ancient scourges of mankind.

With many pieces of the puzzle of the mosquito's life cycle and disease transmission coming together at the turn of this century, organized, multi-disciplinary mosquito control became possible. New Jersey had many citizens and local governments interested in a crusade against the mosquito. Dr. J. B. Smith , New Jersey State Entomologist, did extensive research on the types of mosquitoes in the state and their life cycles.

Jersey City's first hospital began in 1808 in a building intended by the Associates of the Jersey Company, an investment group which included Alexander Hamilton, as a public market. Known as the "pest house," it treated patients affected by the cholera and small pox epidemic. It was located at the foot of Washington Street on Paulus Hook to isolate the patients from the rest of the community. After the epidemic, the pest house was used as a county poorhouse until the development of Laurel Hill in 1861. On December 15, 1868, the Board of Aldermen of Jersey City reclaimed the pest house as a medical facility and named it the Jersey City Charity Hospital. True to its name, it provided free medical care with physicians who contributed their services.
​
       Largely through the advocacy of Dorothea Dix, a social activist who previously had lobbied successfully in Massachusetts for reforms of its treatment of the mentally ill, the New Jersey legislature appropriated funds in 1845 to construct the first state facility to care for the insane. Dix submitted a report to the lawmakers detailing the harsh conditions she had found in county prisons and almshouses around the state, including describing the confinement of a former legislator and judge known to many in the legislature who in old age had been relegated to a county almshouse after he had become insane and impoverished. The new facility opened in 1848 as the New Jersey Lunatic Asylum, later renamed the Trenton Psychiatric Hospital. It soon became overcrowded, and a second hospital opened in 1876, originally the New Jersey Lunatic Asylum at Morristown and subsequently renamed as the Greystone Park Psychiatric Hospital. (After serving as head of nurses for the Union Army during the Civil War, toward the end of her life Dix returned to New Jersey to reside in an apartment at the Trenton Asylum at the invitation of its board, living there for six years until she died in 1887).



To the Honorable the Senate and General Assembly of the State of New Jersey.

Gentlemen:

I come to solicit your attention to the condition and necessities of Idiots, Epileptics, and the Insane Poor, in the State of New Jersey.
I ask your consideration of the claims of this large and much neglected class of sufferers, and such effective legislative action as shall check that tide of misery, the destroying force of which, each year witnesses the increase. I do not come here to quicken your generous impulses, and move you to emotion, by showing the existence of terrible abuses, revealing scenes of almost incredible sufferings. I come to ask justice of the Legislature of New Jersey, for those who,
in the providence of God, are incapable of pleading their own cause, and of claiming redress for their own grievances. Be patient with me—it is for your own citizens I plead; it is for helpless, friendless men and women, in your very midst, I ask succour—into whose broken minds hope and consolation find no entrance—the foul air of whose dreary cells still oppresses my breath—the clanking of whose heavy chains still sounds upon my ear. Have pity upon them! have pity upon them! "for their light is hid in darkness, and trouble is their portion;"—have pity upon them! their grievous, forlorn estate may be shared by yourselves or your children....

Dorothea Dix, Memorial soliciting a state hospital for the insane: submitted to the Legislature of New Jersey, January 23, 1845  >> US National Library of Medicine

        New Jersey lacked its own medical school until the Seton Hall College of Medicine and Dentistry was founded in 1954 and enrolled its first class in 1956 at the Jersey City Medical Center. In 1965, the college, which had been renamed the New Jersey Medical School,  was acquired by the state of New Jersey and renamed the New Jersey College of Medicine and Dentistry (NJCMD). Meanwhile, The Rutgers Medical School opened in 1966 as a two-year basic science institution offering the master of medical science (M.M.S.) degree. The College of Medicine and Dentistry of New Jersey (CMDNJ) was created by legislature in 1970 with the consolidation of the boards of trustees of Rutgers Medical School (now Robert Wood Johnson Medical School) and New Jersey College of Medicine and Dentistry. In 1981, the CMDNJ was renamed to the University of Medicine and Dentistry of New Jersey.[
       In the summer of 1916, a mysterious disease later given the term poliomyelitis, began to be tied to the deaths and crippling of children, with some of the first cases appearing in Italian sections of Brooklyn and soon spreading throughout New York City. Families with means sent their children out of the city, with one estimate that by July 5 some 50,000 children had left for places, including New Jersey, which their parents considered safer. In response, some towns attempted to bar outsiders. On July 14, the New York Times reported that by posting policemen at every entrance to the city to block the exodus from New York, "Hoboken led the way by isolating itself from the world, so far as new residents were concerned." But the efforts of Hoboken and other communities to set  themselves apart from the disease failed; Newark officials debated whether to close schools, order children to be quarantined in hospitals or allow families to care for them at home.  
​ 
Policemen were stationed at every entrance to the city—tube, train, ferry, road, and cowpath—with instructions to turn back every van, car, cart, and person laden with furniture and to instruct all comers that they would not be permitted under any circumstances to take up their residence in the city.
Report on Hoboken's effort to bar outsiders after polio outbreak in New York City
New York Times, July 14, 1916

       In 1918,  a rapidly-spreading influenza estimated to have killed 675,000 in the nation and many more around the world in " Great Pandemic" first appeared in New Jersey when a World War I soldier recently returned from Europe was diagnosed with flu at Camp Dix, the military training and discharge facility first established when the US entered the war. New Jersey first reported the presence of influenza on September 27th, but the disease was undoubtedly present in the state before that date. The disease then spread rapidly throughout the state. By the end of September, the state announced that 2,000 cases had been reported in the preceding three days; on October 17, state officials formally banned all public gatherings and closed all schools, churches, department stores, taverns, and movie houses.. The pandemic began to slow by November, but additional cases would appear until the summer of 1919. Over 150,000 cases were officially reported with nearly 5,000 deaths, numbers believed to be significantly below the actual cases and deaths.

       In Newark, the first cases were reported on September 25th. Under the guidance of the city's mayor, Newark's medical community met to discuss methods of dealing with the disease. The meeting led to a massive educational campaign, with pamphlets on prevention and treatment sent to every household in the city. Although launched with great fanfare, the campaign failed to contain the pandemic. Influenza rapidly spread throughout Newark. Dead bodies accumulated without being buried. City employees were recruited to dig graves and a hundred firemen volunteered to help bury the dead. Rather than individual graves, teams of horses dug trenches to bury the dead. Because public funerals were banned to prevent the spread of the disease, no one complained.

      City officials purchased a vacant furniture warehouse which they converted into an emergency hospital with four hundred beds. But with many of the city's nurses and physicians serving overseas, health care providers were in short supply across the state. One physician found himself treating over 3,000 patients within a month. Looking back on the experience, he said, “there was no need to make appointments. You waked out of your office in the morning and people grabbed you as you walked down the street. You just kept going from one patient to another until late in the evening.”

       An experimental vaccine was tested on Newark's residents. It proved ineffective, and people turned to whiskey and opiates for cures. One physician recommended that his patients eat red onions and drink coffee. He bragged that this treatment was quite effective as he had a low mortality rate among his patients. Guide’s Pepto-Manghan and Pope’s Cold Compound were also advertised as cures. Despite the boasts of physicians and drug manufacturers, none of these treatments were effective. While influenza rates declined after November, the disease remained prevalent throughout the state during the late fall, winter, and spring. By the summer,. influenza had begun to disappear from the state.

The Great Pandemic, The United States in 1918-1919, US Department of Health & Human Services 


The first came in 1916, when 26 states reported 27,000 cases of polio, with some 6,000 of them fatal. Fewer than 2,000 Newark children contracted the infection. The primary victims were Russians, Poles, and Polish Jews “in the most congested part of the city,” wrote Alan and Deborah Kraut in their book Covenant of Care: Newark Beth Israel and the Jewish Hospital in America.

A second epidemic hit its peak in 1952, killing 3,145 of its 58,000 young victims.

“In terms of why he made up the year 1944, I haven’t got a clue, but it sounds like he needed the polio outbreak to be during World War II,” said Alan Kraut, a history professor at American University in Washington, DC.

“That’s what historical novels do,” said Kraut, who said he was in the process of reading Nemesis. “Roth is a novelist, not a historian. He is a very honest person, a very honest intellectual, and he’s a novelist. He is entitled to play with the facts any which way he wants to. Only a fool would try to learn history from something that is so obviously a piece of fiction. He’s aiming at truth about the human condition.”

Undeniably real is the fear of polio captured in Roth’s novel. According to Covenant of Care, in the summer of 1916 guards were placed at quarantined homes, public libraries banned children, and the Harry Lukens Wild Animal Show was ordered out of town. Newark declared war on houseflies — a detail Roth borrows for his book.

        The clean air of the pine forests of Ocean County also was touted as a health tonic for those escaping the city. In the 1890s, hotels built in the village of  Lakewood attracted stays from some of the nation's wealthiest families, including the Astors and Vanderbilts. After their first stays, Glenn Gould and John D. Rockefeller would build their own grand estates, with Rockefeller buying the club house and golf course of the Lakewood Country Club. 

       The northern part of the state also saw developments promoted for their health benefits. The Watchung Mountains of Essex County, situated above the pollution from  Newark and the other  industrial cities in the valley below, were the site of  the first planned housing development of Llewellyn Park in West Orange, an enclave of homes first built in the 1850s which later included the residences of Thomas Edison and those of the Merck and Colgate families.  

Picture
History
    


       

       The scarcity of physicians in colonial New Jersey may also have been due to its lack of any formal medical college. Its first two colleges, the College of New Jersey and Queens College (later Rutgers) founded in 1766 did not offer medical training, and New Jersey would not have a medical school until midway into the twentieth century. 

       

      

       As industrial pollution became prevalent in the nineteenth century, other areas of the state also benefited from health concerns. Long Branch would become the favored summer residence of seven presidents, commencing with Ulysses S. Grant in 1869 and continuing with Presidents Hayes, Garfield, Arthur, Harrison,  McKinley and Wilson. When Garfield was shot in the Washington railroad station in July 1881, his doctors had him taken by special train to his summer home on the Long Branch beachfront hoping that the sea air would help his recovery, aided by rails newly laid from the station in town to the home to ease the president's arrival, but he died there in the following September.  
  
       The clean air of the pine forests of Ocean County also would be touted as a health tonic for those escaping the city. In the 1890s, hotels built in the village of  Lakewood attracted stays from some of the nation's wealthiest families, including the Astors and Vanderbilts. After their first stays, Glenn Gould and John D. Rockefeller would build their own grand estates, with Rockefeller buying the club house and golf course of the Lakewood Country Club. 

       The northern part of the state also would see developments promoted for their health benefits. The Watchung Mountains of Essex County, situated above the pollution from  Newark and the other  industrial cities in the valley below, were the site of  the first planned housing development of Llewellyn Park in West Orange, an enclave of homes first built in the 1850s which later included the residences of Thomas Edison and those of the Merck and Colgate families.  

       Most of the early hospitals were established to serve special ethnic or religious constituencies. The first hospitals founded in the 1850s and 1860s, included the German Hospital (later Clara Maas) and St. Barnabas in Newark and St. Mary's in Hoboken. In 1902, the first Jewish hospital--the precursor to Newark Beth Israel--was established with 28 beds in a crumbling Newark mansion, later expanding on the same site in 1908 to become a 110-bed, four-story facility. 

       Those who could not afford escaping the pollution and lack of sanitation in the cities, particularly recent immigrants often working in unhealthy conditions in factories and living close together in tenement housing, would remain exposed to swift spreads of illnesses. In 1887, the immigrant grandmother of future governor Brendan Byrne would see six of her nine children--ranging in age from an infant to a 14 year-old--die in a single week as diphtheria and typhus swept the factory city of Orange. 

Apart from man-made pollution
Even into the 1920s, when the state was experiencing a surge in prosperity, the older cities continued to struggle with sanitation and outbreaks of disease.\

Window screens, introduced in the 1880's, were called "the most humane contribution the 19th century made to the preservation of sanity and good temper."

Mosquito born yellow fever was known as the American plague since it had struck the bay colony in 1647. Yellow Fever also decimated Philadelphia in 1793, thus ending that city's supremacy in the young union. Appropriately, the disease was stamped out by an American doctor, Walter Reed an army surgeon who in 1900 with a team of heroic assistants traced its source to a virus carried by the Aedes aegypti mosquito. This eliminated, almost in a single blow one of the ancient scourges of mankind.

With many pieces of the puzzle of the mosquito's life cycle and disease transmission coming together at the turn of this century, organized, multi-disciplinary mosquito control became possible. New Jersey had many citizens and local governments interested in a crusade against the mosquito. Dr. J. B. Smith , New Jersey State Entomologist, did extensive research on the types of mosquitoes in the state and their life cycles.



      In the 1970s, the New Jersey state government strengthened its regulatory role over the health care industry. Legislation was enacted to authorize the Department of Health to review and approve proposed construction and expansion of hospital facilities, as well as the purchase of major equipment. In part, the state's hospitals welcomed the constraints on their traditional freedom of action, believing that the new system would deter major hospitals from outside the state in establishing satellite facilities in New Jersey. Stronger opposition resulted from the state's new authority to approve hospital rates for patient care, which hospitals claimed often failed to reflect their true operating costs. Joanne Finley, the state health commissioner under Governor Brendan Byrne, implemented an approach to rate-setting, “Diagnosis Related Groups,” that would gain national attention and subsequently be adopted by the federal Medicare program basing reimbursement on classes of diagnosis—thus paying for an admission for “appendicitis” with a fixed amount regardless of length of stay or special services needed due to complications. The system departed from the traditional reimbursement model of paying hospitals for each day of a patient’s stay and for individual treatment services, practices which critics claimed had contributed to excessive testing and extended hospital stays.

 
  • For decades, New Jersey’s infant mortality rate has been lower than

    that of the nation as a whole. The rate has steadily declined,

    decreasing 24% from 6.3 in 2000 to 4.8 deaths per 1,000 live births in

    2010. Meanwhile, the US rate only declined 12% from 6.9 to 6.1 (Figure

    6).

    • While the overall rates declined in the past decade, significant

  • differences in rates when comparing across racial/ethnic groups

    persist. Black infant mortality rates (12.1 per 1,000 live births) are

    significantly higher compared to Whites (3.5), and Hispanics (4.7)


    Heart disease deaths are significantly higher among Blacks (205.5

    per 100,000 population) compared to Whites (189.3), Hispanic

    (101.6) and Asians (87.6) statewide.

    • Homicide rates are 15 times higher among Blacks (16.1 PER

    100,000), and 4 times higher among Hispanics (4.0) compared to

    Whites (1.0) in New Jersey.

    • Mortality from kidney disease is significantly higher among Blacks

    (31.4 per 100,000) co

    Health issues related to environmental factors have been a special concern in New Jersey, particularly as a result of the state's history as center for industry, petroleum and chemical production and the disposal of toxic and solid waste.   ERSEY, PARTICULARLY AS A RESULT OF THE STATE'S It has been 34 years since a National Cancer Institute study determined that New Jersey had the highest incidence of cancer in the nation, with 19 of the state’s 21 counties ranking in the top 10 percent of all counties in the U.S. in cancer death rates.

    The study, which attributed the high rate of cancer to New Jersey’s then-$4 billion chemical industry, resulted in the state being labeled by the media as Cancer Alley.

    “If you know where the chemical industry is, you know where the cancer hotspots are,” Glenn Paulson, an assistant commissioner for the state Department of Environmental Protection, said at the time.

    Researchers later discredited the report, saying New Jersey was no worse off than other heavily industrialized states and discounting the notion that chemical plants and other environmental factors were largely to blame. The label has been largely forgotten and New Jersey’s cancer mortality rate is now close to the national average.

    Yet, in 2006, the last year for which complete data is available, New Jersey still had the fifth-highest incidence of cancers in the nation, according to the CDC, behind only Maine, Delaware, Vermont and Connecticut.

    Its rates for nine of the 10 most common types of cancer were above the national average — some well above the average, including urinary bladder (30 percent higher), ovarian (18.6 percent), melanoma skin cancers (17.9 percent) and prostate cancer (17.4 percent). The only major type of cancer in which New Jersey’s rate is lower than the national average is lung and bronchial.

    But there are some encouraging signs. Over the past 10 years, while the national cancer incidence rate in 2008 was up 1 percent, New Jersey’s average dipped 3.2 percent.

    There are hundreds of factors that contribute to the rise and fall of cancer incidence, scores of which doctors and researchers can’t even explain or define. But there are a few key factors they believe are playing a major role in the general decline across the Garden State.

    The area around the NJ Turnpike has long been called "Cancer Alley," the the US EPA is now going to investigate past dumping of cancer causing substances in the New Jersey Meadowlands near the Hackensack River.

    The U.S. Environmental Protection Agency today announced a legal agreement with


    Apogent Transition Corp., Beazer East, Inc., Cooper Industries, LLC and Occidental Chemical Corporation to conduct a study of the contamination at the Standard Chlorine Chemical Company, Inc. Superfund site in Kearny, New Jersey as part of the cleanup plan for the site. The site, which is in the New Jersey Meadowlands and is next to the Hackensack River, is contaminated with a number of hazardous chemicals including polychlorinated biphenyls (PCBs) and dioxin. The study of the nature and extent of the contamination and an evaluation of potential cleanup methods are essential steps in the cleanup process. The estimated value of the study work is $750,000. The companies will also pay for the EPA’s costs in overseeing the performance of the study.

    Fish consumption advisories have been issued for the Hackensack River due to the PCBs and dioxin contamination, originating in part from the Standard Chlorine site. PCBs are likely cancer causing chemicals and can have serious neurological effects. Exposure to dioxin can also result in serious health effects, including cancer.

    “This agreement marks an important step in the cleanup of the Standard Chlorine Chemical site,” said EPA Regional Administrator Judith A. Enck. “Today’s agreement illustrates how the Superfund law works to make polluters, not taxpayers, pay to clean up sites like this one.”

    The 25-acre site was formerly used for chemical manufacturing by various companies from the early 1900s to the 1990s. Operations at the site included the refinement of naphthalene for use in the production of certain industrial products, the processing of liquid petroleum naphthalene and the manufacturing of lead-acid batteries, drain-cleaner products and the packing of dichlorobenzene products. The soil, ground water and two lagoons were contaminated with dioxin, benzene, naphthalene, PCBs and volatile organic compounds. The site was originally littered with tanks and drums containing hazardous substances including dioxin and asbestos. Prior to placement on the Superfund list, the New Jersey Department of Environmental Protection sampled and studied the site and partially cleaned it up along with instituting measures to contain the pollution in the short-term. At the request of the NJDEP, the EPA added the site to the Superfund list in September 2007.

    Previous actions have been taken by parties responsible for the pollution with oversight by the NJDEP and the EPA to address the immediate risks to public. The dioxin and asbestos have been collected and disposed of at facilities licensed to receive the waste. Contaminated buildings on-site were demolished and removed. The two contaminated lagoons were emptied of water, filled with clean material and covered. A slurry wall was installed between the site and the Hackensack River to keep contamination from moving into the river. A system of pumps is being used to bring the polluted ground water to the surface where it can be cleaned. Fish consumption warnings have been issued for the Hackensack River. The study and evaluation of potential cleanup technologies will be conducted under the legal agreement announced today before the EPA issues a proposed cleanup plan for the remaining work at the site. 



     The Superfund program operates on the principle that polluters should pay for the cleanups, rather than passing the costs to taxpayers. After sites are placed on the Superfund list of the most contaminated waste sites, the EPA searches for parties responsible for the contamination and holds them accountable for the costs of investigations and cleanups. To date, the cleanup of the Standard Chlorine Chemical Company, Inc. Superfund site is being conducted and paid for by the responsible parties with oversight by



    New Jersey hospitals by contributing almost $21 billion to the Garden State economy in 2013, according to the 2014 N.J. Hospitals Economic Impact Report released t by the New Jersey Hospital Association.Even as the healthcare landscape continues to change, New Jersey hospitals supplied 144,000 full- and part-time jobs in 2013. Hospital activity in area such as goods and services purchased from other businesses and state income taxes paid by employees also increased.

    “Even as New Jersey hospitals are shouldering significant cuts in reimbursement under the Affordable Care Act, they continue to be a stable force in New Jersey’s economy by adding jobs while still giving back to their communities and providing $1.3 billion in charity care for our uninsured,” said NJHA President and CEO Betsy Ryan.

    The Economic Impact Report uses data gathered from 72 acute care hospitals in the Garden State and compiles their economic contributions statewide and across counties and individual hospitals. The 2014 edition uses data from year-end 2013. The full report is available at www.njha.com/2014economicimpactreport.

    Specific highlights include:

    • New Jersey hospitals purchased $2.8 billion in goods and services from other companies last year, an increase of $100 million over 2012. Key areas include contracted labor ($1.4 billion), pharmaceuticals ($962 million), utilities ($262 million), dietary, laundry and housekeeping ($138 million) and building supplies ($19 million).
    • New Jersey hospitals paid over $8.3 billion in employee salaries last year, compared with $7.9 billion in 2012.
    • Employees at New Jersey hospitals paid approximately $457 million in state income taxes last year, compared with $435 million in 2012.
  • There are 111 total hospitals in New Jersey, including specialty hospitals. There are 73 acute care hospitals in New Jersey.

  • NJHA’s membership includes 105 hospitals, plus affiliate members including nursing homes, home health agencies, long term care hospitals and other healthcare providers, bringing the total member count to nearly 400.

  • New Jersey hospitals employ about 140,000 individuals. Collectively, healthcare is the largest private sector employer in New Jersey and ranks second only to government as the state’s largest employment sector.

  • All told, New Jersey hospitals provide $19 billion in jobs, spending and other economic benefits to the Garden State economy.

  • New Jersey hospitals provided about $1.2 billion in charity care services to New Jersey’s uninsured residents in 2011. The state reimbursed hospitals for $675 million of that cost.

  • New Jersey hospitals care for more than 18 million patients each year.

  • N.J. hospital emergency departments provide care and comfort to 3.7 million individuals annually.

  • A November 2014 report from the state’s Department of Labor reinforces the positive

    outlook for healthcare jobs at the county level. Over a 10-year period ending in 2022, the

    Department projects that healthcare will be the top ranked sector for employment

    growth in 16 of New Jersey’s 21 counties, and ranked second in the remaining five

    counties.
  • Healthcare is the only industry that has added jobs in the state every year from 1990

    through 2013. According to the New Jersey Department of Labor, the outlook for

    healthcare employment in the Garden State is bright. From 2010 through 2020, it is

    projected that nearly 62,000 jobs will be added, accounting for more than 19 percent of

    net job growth in New Jersey.

    The pharmaceutical industry historically has been one of the strongest components of the state's economy, with several of the sector's largest companies maintaining their headquarters of major facilities in the state. Consolidation within the industry has reduced the number and total employment in pharmaceuticals, however,    


  • Resources

    New Jersey Department of Health
  • New Jersey State Summary, America's Health Rankings 2014 >> United Health Foundation
    New Jersey: Categories and Indicators, State Health Facts >> 
  • Henry J. Kaiser Family Foundation
  • State Indicator Reports >> Centers for Disease Control and Prevention
    New Jersey Hospital Association
  • New Jersey Hospitals 2014: Economic Impact Report >> New Jersey Hospital Association


  • Data for Leading Causes of Death: Counts and Percentages, New Jersey, 2010 You are Here: NJSHAD > Indicator Reports > current page Cause of DeathPercent of DeathsNumeratorHeart Disease26.9%18,642Cancer24.2%16,758Stroke4.9%3,389CLRD4.5%3,098Unintentional Injury3.5%2,454Diabetes3.0%2,090Alzheimer's Disease2.7%1,871Septicemia2.4%1,657Kidney Disease2.3%1,576Influenza and Pneumonia1.6%1,125All Other Causes24.0%16,591Record Count: 11Data SourcesDeath Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health;