In using statistics of this character it is not'only desirable that they should be accurate but that they should be extended over as long a period of years as possible. This permits comparisons, the establislunent of averages and the drawing of conclusions which would not otherwise be possible. In making comparisons it must be remembered that data should be of the same class or kind, for only such admit of comparison.
Births.— Making a record of births is a custom which is at least as old as civilization. It was a standing custorn in the Roman Empire at the foundation of the Chrisdan era, to go back no further, and has been continued ever since by the town or parish clerk or notary, or by the clerk of the church. It is now one of the functions of the board of health and physicians, midwives and others are authorised or compelled by law to report all births within a given tune of their occurrence, usually within one or two days. These records are usually in accurate because those who should report them are frequently careless and negligent about it, or the authorities are careless m enforcing the law. Many births which are unattend by physicians or midwives are never recorded. A proper penalty, but not one which is too severe, ought to be inflicted when this law is disobeyed. This trouble could be remedied in part, at least, by having vital statistics returned by those who are engaged in public health nursing. However true it may be that physicians ought always to make birth returns, the very busy and the very careless will not do it accurately and promptly although there is a risk of losing their license to practice.
Bearing in mind the facts which have been mentioned and remembering also that in some of the States there is no law requiring the registration of births, deaths, marriages and sickness, the statement concerning- the imper fect character of our vital statistics and their consequent want of value will be found correct.
Crude birth-rate is estimated at so many per thousand of the population. The birth-rate must also be considered in preparing tables with reference to the number of women of child bearing age and with reference to legitimacy and illegitimacy, Still-births, as already stated, do not form an element in population, but they must be registered. They have been estimated at from
23 to 4 per c.ent of all births, and this estimate is probably too low. There should also be a record of abortions though this would undoubt edly be very difficult to obtain, particularly on account of the great number of criminal abor tions. If it were possible the entire number of pregnancies per year should be tabulated.
The birth rate of different countries or cities or States is often a matter of study and comparison. It is usually higher in the cities than in the country. The rate is higher when times are prosperous than when they are ad verse, as economists noted a century ago. It is higher in manufacturing communities than in those which are residential, higher among the ignorant than among the intelligent The birth rate of the countries which were engaged in war is of exceeding importance and will be increasingly so in the near future. Al ready the French government is offering prem iums to women who bear two or more children, whether legitimately or illegitimately, and other nations which have lost so heavily in men will probably do the same. The importance of accurate registry will be very great in all these countries.
A high birth rate often, but not necessarily, means a high death rate, for the mortality in infancy, as already stated, is higher than at any other period of life, but a high birth rate may also mean that the population is a vigorous one. A low birth rate may signify a low death rate but it may be followed by a high death rate.
For a number of years the birth rate in most of the civilized countries of the world has been declining, and in view of the increasing cost of living in all of them it will probably continue to decline. It is declining in England, it is de clining in die United States, while it has been declining in France for so many years that it causes persistent alarm to her government.
record of marriages is equally as important as that of births, and the custom of keeping it is almost equally ancient. It is the bond of the family and one of the most important props of civilization. Both Church and State have kept marriage records and con tinue to do so. It seems unnecessary that there shotsld be a double record.