GENERAL DEATH EATE. Perhaps the highest death rate for ,:o-eat countries where records are kept occurs in Russia, with 33.5 per 1000 on the average for ISS4-(73; with 33,3; and with 32.4. The lowest death rates are found in Great Britain, the ::-.4enndinavian cowl tries, and those few American States for which information is obtainable. England having a death rate of 19.2 for the decade 1851-0:3, Norway 16.9, Massachusetts 0.6, and Rhode Island 20.2. The death rate is usually somewhat higher in cities than in rural districts, but with the in crease of sanitary precautions and the develop ment of preventive medicine the difference be tween city and country is steadily decreasing. Thus in the United States in 1890 the average death rate of the cities of the .egistratiun States was 22.1 and that in the rural districts 15.3. In 1000 the death rate of the cities had fallen to 18.6, while that of the rural districts had risen to 15.4, so that the apparent difference between the two was reduced one-half. Deaths are re corded with less completeness in the rural dis tricts. a fact which would tend to exaggerate the real difference between city and country, and it is probable that the foregoing figures for the rural districts understate the true death rate and that the slight increase during the decade testifies to an increase of accuracy rather than to an in crease in the number of deaths.
SEX. Wherever records exist the average death rate for males of all ages is higher than the death rate for females. Thus, in FAIL:land and Wales on the average of the ten years 18S1-00 the death rate of males was 20.2 and that of
females IS.0, and similarly in the registration cities of the United States in 1900 the death rate of males was 20.0 and that of females 17.2.
AGE. The first year of life and the years of extreme old age are those in which danger of death is greatest. Thus the death rate of male children in England during the first year of life was 161.0, a rate that is not equaled for any subsequent year of life until the age of eighty one is reached. The lowest death rate for each sex is reached at about eleven to thirteen years of age, when the death rate in healthy communi ties is from 4.0 to 5.0, not more than one-fourth of the average for all ages. The ages from three to fifty or slightly above fifty are the healthy years of life, or the years at which the death rate is below the average for all ages. The larger the proportion of the population belonging to these ages, the lower the death rate is likely to be. Cities usually contain a much smaller proportion of persons over fifty than do the country dis tricts about them and not much if any larger a proportion of children. They also contain a larger proportion of females than the country districts in their vicinity. These differences in age and sex composition of the population of cities, giving them a disproportionate number of the healthy ages and the healthier sex. tend to mask the real difference between the death rate of city and country districts.