Page:EB1911 - Volume 22.djvu/112

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the return comparable with those for communities differently constituted is somewhat complicated, but it is amply justified by its necessity in adapting the ngures to the important services they perform in actuarial and sanitary science. This subject can only be dealt with here in outline. In the first place, sex must be distinguished, because, from infancy upwards, except between the ages of IO and 20, the mortality amongst females is considerably less than amongst the other sex, and appears, too, to be declining more rapidly. So far as adult life is concerned this superior vitality is no doubt attributable to comparative immunity from the risks and hardships to which men are exposed, as, also, to the weaker inclination of women towards intemperance of different kinds. Thus, though the generally higher proportion of females in the community may seldom be enough to depress more than slightly the death-rate as a whole, it has a substantial effect upon it at the ages where women are in more marked numerical predominance, as in later life, and in places where the number of domestic servants is unusually great. Age is a factor still more important than sex in a return intended to serve as an index of mortality. The liability to death is extremely high amongst infants, decreasing with every month of life during the first year, but continuing above the mean rate until about the age of live. From the latter period until the fifteenth or sixteenth year vitality is at its best. The death-rate then gradually rises, slowly till 25, more rapidly later, when, from about 45 onward deterioration asserts itself more pronouncedly, and by three score years and ten the rate begins to exceed that of childhood. Thus, all other considerations being set aside, mortality tends to vary inversely with the proportion of the population at the healthy period 5 to 25. As the replenishment of this group depends upon the conditions prevailing at the earlier ages, it is to the mortality in childhood that most weight, from the standpoint of hygiene, must be attached. In most European countries not much less than half the annual deaths take place amongst children below five years of age, upon the total number of whom the incidence falls to the extent of from 40 to 120 per mille. The greater part of this is debit able, as just pointed out, to the first year, in which the mortality, calculated upon the number of births, ranged, in the decennium 1895-1904, between 70 per mille, in the exceptionally favourable circumstances of the Australasian States, to nearly 270 in European Russia. It should be remarked, in passing, that these rates are enormously higher amongst illegitimate children than amongst those born in wedlock, and that the proportion of still-born amongst the former is also in excess of that amongst the latter by some 50 %. Infantile mortality is higher, too, in urban tracts, especially those associated with manufacturing industries. In Table VII. below, in which the crude rate alone is dealt with, evidence will be found of the general decline which has taken place in the mortality, thus expressed in different countries.

The difference in the rates for the various countries must not be taken as a measure of difference in mortality, since, as according to the table, much of it is ascribable to difference in age constitution. At the same time, where the range is very wide, as between the rates in Scandinavia and Australia, and those in southern and eastern Europe, the variation, to a great extent, cannot be accounted for otherwise than by difference in hygienic conditions, more especially in the light thrown by the figures of infantile mortality in the second part of the table. The variations from period to period in the same country are more instructive. They show that in the 3 5 years covered the death rate has generally declined by over 2001). The exceptional cases are, first, Ireland and Norway, with their emigrating tendencies; then Spain, where the returns have probably to be discounted for improved registration, and France, where the population is all but stationary. In Finland the death-rate at the earlier period taken for the comparison was abnormally swollen by epidemic disease, and if it be set on one side the decline appears to have been in harmony with that in its Scandinavian neighbours. The decline in mortality has been much greater than that in the crude birth-rate everywhere except in France, Australia, and, of course, Ireland; and it is only in the two former that it has been exceeded by that in the fertility rate. The standard mortality of each community is deduced from a life-table, representing a “ generation ” of people assumed to be born at the same moment and followed throughout their hypothetical life, in the light of the distribution by age ascertained TABLE VII. 3


(C) Decline per cent.

(A) Death per 1000 of Total (B) Deaths under one *Probable 1 Country' Population. year per 1000 Births. 18614870 to Fertility Lifetime. 1895-1904. rate. Y

p 1 1841-1850. 1861-1870. 1895-1904. 1874-1883. 1895-1'904. 2313" § ;rf§ ' Ifgggfsgzfo Years. Sweden 20-6 20-2 15-8 128 98 21-7 15-0 8-2 52-3 N 0rway 18-2 18-0 15-1 104 90 10-5 3-9 3-5 52-2 Finland 23-5 32-6 18-7 164 134 42°62 7-2 - 42-8 Denmark 20-5 19-8 15-8 141 127 2O~6 4-2 9-3 47-8 England . 23-7 24-0 17-2 149 150 28-3 19-4 17-8 45-9 Scotland - 21-8 17-3 122 126 20-6 14-7 12-5 46-2 Ireland - 16-6 I8'0 96 103 +8-4 II'I +2-I-Holland 26-2 25-4 17-0 204 147 33-0 9-0 9-2 27-8

Belgium . 24-4 23-8 17-8 148 156 25-2 9-8 19-8 45-1 Germany 26-8 26-9 20-8 208 3 198 3 22-6 4-6 8-4 40-7 Austria (W) 29-8 29-1 24-0 255 224 17-5 4-2 — France 23-2 23-6 20-4 165 153 13-5 17-5 19-8 47-4 Italy - 30-9 22-7 208 170 26-5 10-7 2-5 43-0 Spam — 30-6 27-8 - 182 9-1 8-0 — Hungary

- 33-0 27-4 '- 216 7 I7~0 6-2 - 40-1

Galicia 33-5 27-8 - 17.0 3 .

Servxa - 30-9 23-6 - 154 23.6 9.9

1 Russia (Eur.) - 37-1 31-2 267 268 15-9 2-2 — N S. Wales - 16-2 11-7 - 108 27-7 32-2 30-7 51-2 Victoria - 16-7 13-3 - 105 20-4 37-2 24-1 New Zealand - 13-2 9-8 117 79 25-7 35-1 24-5 55-4 Mean after lifetime at birth. 2 Finland from 1850-1891, decrease 20-4. 3 Prussia only; Saxony, 284 and 272; Bavaria, 308 257.