Labour Law

Increase in the Average Length of Life.

The health of the people of the United States has been improving consistently for the past 5o years as is revealed by the official morbidity and mortality rates and estimates of life expectancy. Even as late as 188o the average length of life in the New England States and New York city probably did not exceed 4o years. By the begin Decrease in Death Rate.—In 187o there were 3o deaths from all causes for each 1,000 of the total population of New York city; in 1937 there were 11.4. Similar changes have occurred in other large cities and in the rural populations, although the city rates ning of the present century this had increased to 49 years for the original Registration States and in 1920 to 56 years for at least the 85% of the population in the registration area. Latest studies (1940) show the average duration of life for the white population is beyond 6o years. It is entirely possible, without any additions to the present knowledge of the causes and means of prevention of disease, that an average duration of life of 7o years may be attained by 197o.

were higher in the beginning and have fallen at a more rapid rate than have those of rural communities. In some instances the city rates have been, for recent years, lower than the rural. Since 1900 the general death rate for the registration area of the United States has fallen from 17 to 11.4 per 1,000 of the population.

The past quarter century-191o-35---during which an increas ing shift of the population took place from rural to urban resi dence (55% urban in 1927), was characterized by a greater im provement in general health conditions in both city and rural re gions than in any previous similar period of time.

The advantage of the rural dweller over the city dweller is found in each decade of life, at least up to the age of 50, and this applies to both sexes.

Changes in Specific Death Rates.

More indicative than are general death rates, of the success of sanitation, personal hygiene and the application of administrative government and social re sources for disease prevention, are the changes in the death rates from tuberculosis, typhoid fever, diarrhoea and enteritis among children, diphtheria and the infant mortality. All of these have fallen without exception in those States and cities where reliable records are available.

Typical experience is expressed in the following: The greatest reduction in the death rate from tuberculosis has been in children under ten. The highest tuberculosis death rates for the country as a whole are those of women from 20 to 3o years of age and for men from 45 to 6o.

communities, a reversal of the conditions so or even 25 years ago.

Increasing Death Rates.

The saving of life in the early years of childhood, particularly from diseases peculiar to infancy and from communicable diseases affecting chiefly children under five, and from tuberculosis in persons from 15 to 3o years of age, since about 1900, has, together with the limitation of immigra tion altered the age composition of the population to a degree affecting the rates from such causes of death as affect persons over 45 years of age. Of these the most important are heart diseases, cancer and diabetes.

The increases in the death rates from heart diseases, cancer and diabetes are in part due to the higher age grouping of the popula tion as a whole, but in addition to this, the death rates for each decade over 45 show increases for each of these diseases.

Deaths from violence and accidents, particularly those due to automobiles, and from appendicitis have increased sharply in recent years. Deaths from causes connected with childbirth have not declined greatly, and those in the United States are above those of other countries with reliable records.

While in 1866 in New York city one death out of every 2,400 was due to diabetes, now (1940) one in 4o is from this cause. The increase, while greater in the cities, is found also in rural popula tions and among the coloured as among the white races, but everywhere especially among women over 3 5 years of age.

Typhoid fever, from being an endemic disease of cities, chiefly due to polluted water, is now characterized by its epidemic char acter resulting from carriers, milk products, oysters and accidental occasional failures of water purification. The endemic typhoid areas are now the small towns and villages of rural States where unprotected water and unpasteurized milk are used.

Diarrhoea and enteritis, from being the leading cause of death in children under five, and particularly among city children and especially in the summer months, now plays a minor role, is less prevalent in cities than in rural areas and is hardly more frequent in summer than in winter.

Diphtheria. Now that means of permanent and universal pro tection of children against diphtheria by active immunization are available, in addition to the resources for specific therapy and determination of susceptibility, the practical disappearance of diphtheria as a frequent cause of death in children under five years of age is within sight.