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V —M o r t a l i t y IN D E X TO P L A T E S . W HOOPING COUGH. DEATHS UNDER ONE AND UNDER FIVE YEARS.............................................................Plate 40 M EASLES................. Plate 45 R a t io o f D e a th s to A g g r e g a t e D e a th s. R a t io o f T o ta l to A g g r e g a t e D e a th s. RESPIRATORY SYSTEM. EXPECTATION OF LIFE. CONSUMPTION. Plate 41 A m o n g N a tiv e W h i t e M a le s , b y A g e s . R a t io o f D e a th s to A g g r e g a t e D e a th s . NERVOUS SYSTEM. DIARRHCEAL DIS EASES .............................................................Plate 42 LIFE INSURANCE EXPERIENCE (MALES). Plate 47 D e a th s fro m S e le c te d D is e a se s , b y S ta te s. R a t io o f D e a th s to A g g r e g a t e D e a th s . DIPHTHERIA. DIGESTIVE SYSTEM.............. Plate 43 LIFE INSURANCE EXPERIENCE (BOTH SEXES)................................................... Plates 48-49 R a tio o f D e a th s to A g g r e g a t e D e a th s . ENTERIC FEVER. SCARLET FEVER............Plate 44 P r in c ip a l C a u s e s o f D e a th , b y Y e a r s o f In s u ra n c e . A m e r ic a n a n d E n g lis h E x p e r ie n c e . R a t io o f D e a th s to A g g r e g a t e D e a th s. I l l G e n e r a l . — The total number of deaths In the states of New Jersey and Massa reported by the Tenth Census, as occurring in chusetts, in the District of Columbia, and in the country during the year 1880, was 756,893, the making the death rate 15.1 in 1,000. Chicago, In 1870 DEATH RATE. . . Plate 46 cities of Baltimore, Cincinnati, Bangor, Charleston, the death rate shown by the reported number Indianapolis, Louisville, of deaths was 12.8, and in i860 it was 12.5. Nashville, T h is apparent increase in the death rate is due delphia, simply to the fact that more effective measures St. Louis, Brooklyn, Cleveland, Milwaukee, Mobile, New Orleans, New York, Phila among colored infants, that of colored adults being only slightly in excess of the whites. The death rate among males was slightly greater than among females. female deaths there For every 1,000 occurred 1,074 male deaths; showing a male death rate of 15.35 Richmond, and a female death rate of 14.81 per thousand. San Francisco and Wilmington, This excess is probably .due, however, to the were taken for securing full returns than by registers of deaths are kept, which are pre greater number of unreported deaths of females. preceding censuses. sumably quite full and accurate. Pittsburgh, Providence, Comparing O f the total number of deaths among males According to these returns with those of the enumerators, whose ages were reported, those at less than the estimate of Dr. J. S. Billings, under whose Dr. Billings has arrived at the conclusion that one year of age formed 24.80 per cent., while direction the reports were compiled, not over the actual average death rate in this country, the deaths of females less than one year of 70 per cent, of the total number of deaths were in 1880, was certainly between 17 and age formed but 21.54 per cent, of the whole reported. The deficiencies are probably greatest per in the more sparsely settled regions, and in the 18.2 per thousand. H e contrasts this with deaths of males under five years of age were Southern states; they are doubtless greater the death England, 20.5, of 41.95 per cent, of all male deaths, while the among the colored race than among whites, Scotland, 21.3 per thousand. The reason for deaths of females under five years were but among females than among males, among the smaller annual death rate in this country foreigners than among infants may be found in the abundance, cheapness The returns for 1880 were, however, still far from complete. natives, and The statistics of mortality reported by this census are, of course, inadequate for such purposes as forming life-tables, in which the rate and of was probably nearly and number of female deaths. Similarly, the 38.19 per cent, of all female deaths. O f the whole number of deaths concerning everywhere which the age at death was reported, 8.76 per obtainable, and in the fact that the population cent, were between the ages of five and fifteen; is not overcrowded. 29.96 per cent, were between fifteen and sixty, and than adults. thousand, 19 excellent quality of food O f the whites, the death rate per thousand and 17.24 per cent, over sixty. For was 14.74, according to the census returns. comparative purposes, however, as illustrating That of the colored race was decidedly greater, T h e P lates .— The the relative proportions of deaths by different being not less than 17.28 per thousand. As 40 to 45, inclusive, have been constructed on a diseases, the relative prevalence of certain the omissions were, doubtless, much greater in plan different from that elsewhere employed in diseases in different sections of the country, the case of the colored than the white element, the charts. the relative mortality of the white and colored the actual death rate would show a still greater certain races, etc., they are of the greatest value, disparity between the two classes. one another in topography, climate and other although the results are affected, to a minor proportion of deaths among the colored race conditions affecting mortality. extent, by the omissions above mentioned. is accounted for mainly by the great mortality are sub-divided by state lines, and the divisions total number of deaths is required. The higher maps given on Plates The country has been divided into characteristic regions, differing from These regions SCRIBNER'S STA TISTICA L ATLAS. liv of the states, resulting therefrom, 111 in num most of which is yet unsettled, a Mississippi settled, have the largest proportion of urban ber, have been used as the units of the maps. river belt, a small area lying between the two population, and in this section the comforts and just mentioned, together with the prairie region refinements of civilization are most widely Massachusetts and Connecticut are each divided in the southwestern part of the state. diffused. into two parts: that adjacent to the Atlantic consists of narrow strips along the Mississippi of coast and the hilly or mountainous interior. and Missouri rivers, with a large interior of country, but this fact is sufficient to account Vermont lies entirely in the hilly region, while prairie. for only a very small part of the difference in Rhode Island is wholly in the region subjected strips bordering its two great rivers, a prairie the rate of infantile mortality. to direct oceanic influences. region in the northern part and a timbered, at hand corroborate the general law, that the New Y ork has five sub-divisions, as follows: broken country in the southern part of the state. higher the degree of civilization the less the A small area in the southeast corner, adjacent Dakota and Nebraska contain, together with birth rate, and the smaller the mortality among to the coast, the Catskill and the Adirondack the narrow strip along the Missouri, a prairie regions, the more or less hilly interior, and the region on the east, and a portion of the Great The greater mortality among the young in portion bordering Lakes Erie and Ontario. Plains on the west, while Kansas is divided the Southern states, is doubtless due in part to Pennsylvania has three sections: that of the between the last two named regions. the preponderance of the colored element in the Appalachians, in the middle of the state, with comprises a coast section, an interior largely population. the plateau and hill country on either side, covered with forests, and the western portion complete returns from this class, the number of forming the eastern and western divisions. of the state which corresponds to the western deaths is probably understated. New Jersey and Maryland have each a coast sections of Dakota, Nebraska and Kansas. The states of Maine, New Hampshire, and a mountainous section, while Delaware and the District of Columbia are entirely Iowa In Missouri there are, besides the Texas families is less than elsewhere in the A ll the facts the young. Owing to the difficulty of getting The high ratio of infantile mortality in The areas of Montana, W yoming, Colorado and It is true that here the average size New Mexico, are divided between the Utah is worthy of note, in connection with the practice of polygamy. In most of the other Great Plains and the Cordilleran mountain within the coast region. The states of Virginia, North and South territories and W estern states the proportion is region. low, manifestly because of the small proportion T o the latter belong also the entire which children bear to the total population. Carolina, Georgia and Alabama are each divided areas of Idaho, Utah, Nevada and Arizona, into three sections, comprising the low, and with the eastern parts of California, Oregon largely swampy coast, the hilly or mountainous and Washington Territory. portion, and the plain or plateau lying between region includes the western parts of the three D eaths fro m D ifferent Classes of Diseases.— O f the total number of deaths them. last named. reported by the Census, the cause of death was Florida as a whole belongs to the coast region. Mississippi and Louisiana also are These sections The Pacific coast having been outlined given in 733,840 cases. The following table divided into three sections: the coast, the allu without direct reference to the prevalence of gives vial lands of the Mississippi, and the upland particular diseases, may or may not coincide principal diseases, or groups of diseases, with plains. with areas of different shades of color. the proportion which each bears to the total Arkansas comprises the upland plains the number of deaths due to ten .! S . In Tennessee there are five areas, compris the series of maps on Plates 41 to 45 inclusive, ing the mountain region in the east, the central which treat of the relative prevalence of princi basin-like area, the plateau in the western part pal diseases, as shown by the census returns; of the state, and a narrow strip of alluvial land hence a given shade indicates on all these on the Mississippi. Kentucky has four sec maps the same proportion of the total deaths. tions : the mountain region in the east, the A deep shade, indicating a high proportion central region of rolling, hilly country, and the strips along the Ohio and Mississippi rivers. W est Virginia comprises two sections: that of number of deaths, of which the causes were—reported: N umber of D eaths . C auses . D is e a s e s o f th e r e s p ir a t o r y s y s t e m ............. 10 7 ,9 0 4 P ercentage of all D eaths . 1 4 .7 0 00 The scale of color is the same throughout M 10 and the alluvial lands bordering the Mississippi. C o n s u m p t io n .............................................................. 9 I ,5 5 I D is e a s e s o f th e n e r v o u s s y s t e m ..................... 8 3 ,6 70 1 1 .4 0 of deaths, does not, however, necessarily imply D ia r r h e a l d i s e a s e s .................................................. 6 5 ,5 6 5 8 .9 4 that a locality is especially favorable to the D i p h t h e r i a .................................................................... 3 8 ,3 9 8 5 -2 3 prevalence of the disease. D is e a s e s o f th e d ig e s t i v e s y s t e m .................. 3 4 ,0 9 4 4 .6 4 E n t e r i c f e v e r .............................................................. 22,905 3.12 It may indicate, on the mountains and that bordering the Ohio the contrary, that, on account of its real or S c a r le t f e v e r ............................................................... 1 6 ,4 1 6 2 . 24 river. fancied healthfulness, the region is one fre W h o o p in g c o u g h .................................................... 11,202 !- 5 3 quented by invalids beyond recovery, whose M e a s l e s ......................................................................... 8 ,7 7 2 00 M M Ohio and Indiana are sub-divided into three areas: that bordering on Lake Erie and deaths unduly swell the proportion. Lake Michigan, that of the Ohio valley, and a noticeably the case with the California coast Deaths from diseases of the respiratory middle region which is level or rolling, in the region, and parts of Minnesota, which have organs were much less prevalent along the latter state approaching the character of prairie. been much sought by consumptives. coast than in the interior of the country, This is Illinois is similarly divided into a lake region showing that the uniform climatical conditions, and a Mississippi river belt, with a larger cen M o r t a lit y o f In fa n ts .— The maps induced by the presence of large bodies of tral section of prairie. upon Plate 40, show the proportion which the water, are favorable to immunity from this Michigan contains two areas, one bordering deaths under the ages of one and of five years class of diseases, while the extremes of a on the lakes, and a heavily-timbered interior respectively bear to the total deaths. It appears continental climate are correspondingly un section. Wisconsin has, besides two areas that the proportion of deaths in the earlier years favorable. These affections were very prevalent corresponding to those of Michigan, a prairie is very much smaller in the northern than in in region in the southern part, and a narrow belt the southern Mississippi valley. along the Mississippi.* Minnesota has four sec decidedly the smallest in the North Atlantic Cordilleran region, in the Pacific states, and tions: the heavily-timbered northern portion, group of states. especially in the coast region of California, part of the country, and is These are the most densely the central and western parts of the In the higher parts of the M ORTALITY. the large distributed over the country with great uni least mortality was in Rhode Island, w h ere, troubles is doubtless due to the number of formity. only 0.02 per cent, of all deaths were chargeable invalids, suffering from such diseases, who to the total deaths reported, which was, in the have resorted to these sections in the vain country at large, 4.64 per cent., ranged among One very important practical point has been hope of recovery. the different states only from 2.8 per cent, in brought out forcibly by Dr. Billings’ discussion by Vermont, to 6.27 per cent, in South Carolina. of these statistics. The disease W ith scarcely an exception, it was greatest in due to blood poisoning, such as diphtheria and was also very prevalent in New York, southern the Southern states, owing to some extent to enteric and malarial fevers, the mortality is Ohio, Kentucky and Tennessee. The Southern the climate, and largely to disregard of proper decidedly less in the large, well-sewered cities, states, with the exception of the two above diet and the prevalence of rude cookery. which have general systems of water supply, The proportion of deaths from lung lv ^ region primarily most affected consumption was New England. The ratio of deaths from this cause to this disease. In the case of all diseases Typhoid fevers appear to have been least than in the rural districts and small towns prevalent in the North Atlantic states, showing where water is obtained from wells, and where Diseases of the nervous system were most that the attention given to drainage, sewerage, excreta are stored in cess-pools and vaults. prevalent in the North Atlantic states and in etc., offsets the ill-effects which follow the Thus, in the lake region, in the cities, 7.82 per Ohio, where they accompany the large urban condensation In the South cent, of all deaths were from diphtheria, while population, the close settlement, and the pre Atlantic region, and in the Mississippi valley, in the rural districts and small towns 8.41 per ponderance of professional employments and the disease was more prominent. cent, w e r' due to this disease. of manufactures. Under these conditions the speaking, it was less prevalent in the northern enteric fever, in the same region, the corre struggle for a livelihood is more intense than than in the southern parts of the country, a sponding proportions were 1.72 and 2.73; in in agricultural sections, and the result of the warm climate appearing to be more favorable the North Atlantic region, 1.63 and 2.00, and greater wear of the nervous system is plainly for its development than a cold one. in the Gulf coast region 0.77 and 3.00 per cent. mentioned, were comparatively exempt from this scourge. of population. Generally In the case of i shown. These diseases are prevalent in a Scarlet fever, so common and so fatal secondary degree in the central part of the among children, was confined in its range quite as striking. Mississippi valley, from the Gulf coast to the almost entirely to the Northern states, where, portions were 0.83 and 1.12; in the North great lakes, and along the South Atlantic as in the case of diphtheria, the facilities for Atlantic region, 0.30 and 0.54, and on the Gulf coast, as well as throughout California and spreading, consequent upon dense settlement coast 4.48 and 7.76 per cent. western Oregon. and more general intercommunication, are very The proportion is small in eastern Kentucky and Tennessee, in Alabama, and in the inland portions of North and South The results in the case of malarial fevers are In the lake region, the pro The exhibits on Plate 46 of the “ expecta tion of life” among native white males, at great. In the South the proportion of deaths from different ages from birth up to one hundred * Carolina and Georgia. It is still smaller in this disease was trifling, amounting in nearly years, an most of the Cordilleran region and upon the every state south of Mason and Dixon’s line of each 100,000 of the same class, are based on Great Plains. and the Ohio river, to less than one per cent. tables prepared by Levi W . Meech, actuary, Diarrheal diseases appear to be relatively The highest proportion in the country was in from the mortality statistics of the census of most prevalent in the prairie region and upon W yoming, where, owing to an epidemic during i860 and that of 1880. the South Atlantic plain, with a marked tend the census year, it was 19.57 per cent, of all ency also toward the Southern Central section. deaths. Next to W yom ing was the crowded increases up to the age of four years, the boy The proportion is smallest in the W est and in little state of Rhode Island, in which 11.48 per who has reached this age having an expecta northern New England. cent, of the deaths were due to this disease. tion greater by over ten years than at birth. The southern coast of the death rate in successive years The chart shows that the expectation of life region, with the exception of that of Louisiana, Deaths from whooping cough were rela does not appear to be especially subject to tively more abundant in the South than in advantage is gradually lost, and the youth of * diarrheal disease; indeed, the reverse is the the North, and least abundant in the North twenty has only about the same chances of life case. Atlantic states, although doubtless the disease as the new-born infant. Diphtheria is vastly more prevalent in the was quite as prevalent there as elsewhere. four and one hundred does the expectation North, and particularly so in the Northwest, W hile few children escape it, the proportion diminish in an equal ratio with the number of than in the South. of deaths is very small. years elapsed. This is mainly the result During the census Between the ages of four and twenty this A t no age between Between the ages of twenty of the severity of the climate, together with the year it caused only 1.53 of all and forty, for example, the expectation dimin facilities for spreading this contagious disease deaths, the ratio ranging in the different states ishes by about thirteen years, and a like amount offered by the denser population of the former 'from 0.26 per cent, in New Hampshire, to the between forty and sixty, while between sixty region. unusually large proportion of 7.30 per cent, in and eighty it decreases but 9.52, and between New Mexico. eighty and one hundred only 4.06 years, show In Utah nearly one-third of all deaths, in Dakota nearly one-fourth, and in Nebraska, Minnesota and Idaho, one-sixth, were caused by diphtheria. Passing to the other extreme, per cent, The distribution of deaths by measles was very similar to that of whooping cough. The ing a much smaller rate of decrease for the latter periods. the deaths from this cause were less than one- Southern states suffered the greatest mortality, half of one per cent, in the District of Columbia and the North Atlantic states the least. The than 16.2 per cent, die before reaching the age and in New Mexico, while in but one of the lines were not as closely drawn, however, as in of one year; of those who survive, 6.41 per cent, Southern states (W est Virginia) did the pro the case of whooping cough. The greatest die before reaching the age of two years, and portion reach five per cent. mortality was in New Mexico, Kansas, Colorado of the remainder, 3.59 per cent, die before the and Nebraska, while following them, in almost age of three. unbroken line, come the Southern states. between the ages of thirteen and fourteen. Deaths from diseases of the digestive system, as would naturally be expected, were The Out of 100,000 native white males, no less The smallest death-rate occurs SCRIBNER'S STATISTICAL ATLAS. lvi Not until the age of seventy-two does the These facts appear to disprove the oft- and injuries. For all diseases, the average death-rate equal that between the ages of repeated statement and popular belief that duration of the protective effect of examinations one and two, and not until eighty-four does Americans, especially those of mature years, is about two and one-half years, in the case of it exceed that of infants under one year of age. and those engaged in occupations which tax selected liv e s; while, if the rejected lives were the brain and nervous system, live too fast and included in the average death-rate for the L ife In su ran ce E x p e rie n c e —The wear out the vital energies early. whole insurance period, it would be seen to be Plates numbered from 47 to 49, inclusive, remembered that this is the very class which are thirty indulges in the luxury of life insurance, and this American life insurance companies, comprising comparison seems to indicate that, granting insured persons was, by the American tables, not far from 1,000,000 lives, as published in that Americans live at high pressure, then that for males, 10^ per thousand. “ Systems and Tables of Life Insurance,” 1881, condition is more favorable to longevity than was somewhat greater, being 1 1£ per thousand. by Levi W . Meech. the slower life of the mother-country. Am ong the causes of mortality, consumption based upon the experience of The statistics which they present are those, not of the mass of the population, but of selected lives, and are, It should be Another popular belief is dispelled by the above-mentioned concluding diagram upon For a generation American women much greater. The average mortality per year among For females it holds the first place among specific diseases, causing 1^ deaths per thousand among males, and 2^ among females. The following table therefore, much more favorable to longevity Plate 49. than the statistics of the census would be, were have been derided for their alleged physical shows the number of deaths per thousand they complete. inferiority to their English sisters, who have persons insured, caused by each of the princi The following table exhibits the expectation been held up as models of health and strength. pal diseases: of life, as given by seven different authorities. In consequence reformers have urged upon The first six columns, abstracted from the American women the adoption article on life insurance in the Encyclopaedia modes of life as a means of attaining, in a Britannica, ninth edition, are from English larger proportion, to the health and long life experience, while the seventh is taken from popularly ascribed Meech’s tabulation of the returns of the United W hether the fact be reassuring or not, life States census, mentioned D eath s. of English F em ale. to the Male. 1 .8 6 •78 English women. 4 8 .8 3 4 1 .4 6 4 1 .0 6 I n st it u t e of A c t u a r ie s . 1869. S e v en tee n O f fic e s E x p e r ie n c e . 1843. 4 8 .3 2 4 8 .3 6 5 0 .2 9 41-37 4 1 .4 9 4 2 .0 6 A m erican M ales. (M e e c h .) 4 8 .8 2 •63 .6 6 tables appear to indicate that, of the two, •45 .6 4 •52 •53 Od •49 A comparison of the diagrams on Plates E nglish N o. 3. M a l e s . 1864. I O ....................... 2 0 ....................... E q u it a b l e . (M o r g a n .) 1834. A ge. E q u it a b l e . (D a v ie s .) 1825. C a r l is l e . 1815. page; •77 American women are the longer lived. on the preceding •17 47-°5 4 8 .4 4 39-48 4 0 .8 7 .2 8 48 and 49, develops the fact that deaths from zymotic diseases, as well as from accidents •36 . 22 and injuries, present a striking exception to 34-53 34-43 3 4 .6 8 3 2 .7 6 34-51 4 ° ........................ 2 7 .6 1 5 ° ........................ 21 . I I 2 7 .4 0 2 7 .4 0 2 7 .2 8 2 7 .4 0 20.83 2 0 .3 6 6 N 6 0 ........................ 14 -3 4 15 .0 6 I 3-9 I 13-77 7 ° ........................ 9 .1 8 9 .8 4 8 .7 0 8-54 8 0 ........................ 5 -5 i 5-38 4-75 4 .7 8 9 ° ........................ 3 .2 8 2 .6 5 2 .5 6 2. I I 2 6 .0 6 2 7 .8 8 2 0 .3 1 19-54 2 1 .2 2 13 -8 3 13-53 14-93 C O Ca O 33-98 00 3 ° ........................ 34-34 8-45 9 -5 1 4 .7 2 4-93 5 -4 i 2 .3 6 2 .8 4 2 .7 6 .2 1 . 20 .1 9 the rule that, during the early years of insur .2 7 .1 8 ance, medical examination serves as a material .2 7 .1 8 protection to the companies. . 26 .1 8 C a n c e r ............................................................................................. Thus the death-rate from the class of con stitutional diseases is .63 for the first year of • 17 B r o n c h i t i s a n d p l e u r i s y ...................................................... . 16 •17 • !5 insurance, 1.53 for the second, and 2.25 for the .0 8 .I2 third year, per thousand males insured, as . 16 . 11 It will be seen that the American expecta against an average of 2.35 for the entire period •°5 . 11 tion of male life is greater at all ages, the of insurance, showing that for these diseases . 12 . IO excess in several cases being more than a year, medical examination is an effective protection although the American expectation is computed until after the third year. for all lives, while the English experience deaths from zymotic diseases average 2.37 for Aside from those causes of death peculiar covers only selected lives, as above stated. the first, 1.9 for the second, and 1.88 for the to women, it appears that females are more The comparison of selected lives in the two third year, all being in excess of the average of liable to diseases of the lungs and of the countries, given in the diagram at the foot of 1.83 for the entire period of insurance. There digestive organs, while males are more subject Plate 49, shows a still greater difference in is a similar contrast between zymotic diseases to accident, and more frequently victims to dis favor of American longevity. and all other causes of death, except accidents eases of the brain and the nervous system. I .0 4 D is e a s e s o f th e b r e a s t a n d u t e r u s ............................. •58 On the other hand,