How to Live Part 27

SIGNS OF INCREASE OF THE DEGENERATIVE DISEASES

The fact that in the United States the general death rate has steadily fallen for the past several decades, a phenomenon common to all civilized countries, is accepted by many as evidence of a steady gain in National Vitality. That there has been a gain in vitality in the younger age groups is unquestionably true, but this gain has served to mask a loss in vitality at the older age periods.

This latter phenomenon, a rising mortality in elderly life, is something almost peculiar to the United States. It is not exhibited in the mortality statistics of the leading European countries. In those countries the fall in the death rate has not been due solely to a reduction of mortality in infancy and adult life through the conquest of diseases of children, tuberculosis and other communicable diseases.

England and Wales, Denmark, Norway, Sweden and Prussia show improved mortality at every age period.

The charts in this section show the trend of mortality in this country during 30 years at the various ages of life, and also the trend of mortality in the two great cla.s.ses of diseases: the communicable, which affect more emphatically the young lives, and the degenerative or regressive cla.s.s of diseases, which affect chiefly those in middle life and old age.

It seems evident that unless this increased mortality is due to some unknown biologic influence or to the amalgamation of the various races that const.i.tute our population, it must be ascribed, in a broad sense, to lack of adaptation to our rapidly developing civilization.

Whether or not there is one princ.i.p.al cause that determines the unfavorable trend of mortality in this country as compared to other civilized nations has not yet been conclusively shown.

[Ill.u.s.tration: INCREASES AND DECREASES IN DEATH RATE BY AGE PERIODS Ma.s.s. & N.J. 1880-1910 L.E.I. Inc.

ENGLAND & WALES IN BROKEN LINE]

This chart exhibits the trend of the death rate from all causes, by age periods. The decreases are below the center line and the increases above it.

It will be noted that the American decreases in the younger ages were not as great as in England and Wales, that they changed to _increases_ about age 45 and continued to increase in each age group thereafter, while in England and Wales the decline _occurred at all ages_.

NOTE.--Ma.s.sachusetts and New Jersey are used as a basis because they were the only States in 1880 where sufficiently reliable comparative statistics could be had. These records were accepted by the national government, and these States really const.i.tuted the registration area in that year. There were also fifteen cities outside these States where comparisons were possible.

[Ill.u.s.tration: DEATH RATE REGISTRATION AREA (PER 10,000 LIVING) ORGANIC DISEASES L.E.I. INC ENGLAND & WALES DOTTED LINES]

This chart shows that in the United States registration area, the mortality from diseases of the heart, blood vessels and kidneys increased 41 per cent. during the period 1890-1910, while in England and Wales (shown by the dotted lines) during the same period there was a decrease in the mortality from these maladies.

[Ill.u.s.tration: OCCUPIED MALES INCREASES-DECREASES FROM CERTAIN DISEASES]

This chart comparing 1900 with 1890 (1900-1910 not yet available) shows the sharp upward trend in the mortality from organic disease among males in gainful occupations, and the downward trend in the mortality from communicable disease in the same group. This heavy and increasing loss from chronic disease occurs among our most valuable lives--those of the breadwinners.

SECTION VIII

COMPARISON OF DEGENERATIVE TENDENCIES AMONG NATIONS

DEATH RATE PER 1,000 OF POPULATION BY AGE PERIODS IN THE UNITED STATES[N] AND IN VARIOUS EUROPEAN COUNTRIES.[O]

+-------+------+--------------+--------------+--------------+--------------+ U. S. PRUSSIA FRANCE ITALY SWEDEN Reg. 1900-01 1899-1902 1899-1902 1891-00 Ages Area 1900 P'sons --------------+------+-------+------+-------+------+-------+ Males Fem. Males Fem. Males Fem. Males Fem. +-------+------+------+-------+------+-------+------+-------+------+-------+ Under 1 165.4 221.8 189.4 ... ... 174.8 158.3 ... 101.6 1 46.6 ... ... ... ... ... ... ... ... 2 20.5 ... ... ... ... ... ... ... ... 3 13.2 ... ... ... ... ... ... ... ... 4 9.4 ... ... ... ... ... ... ... ... Under 5 52.1 24.3 23.4 56.9 48.5 38.4 39.8 ... 36.9 5-9 5.2 4.9 5.1 4.6 4.6 6.1 6.7 ... 5.9 10-14 3.3 2.7 3.0 2.9 3.5 3.2 3.8 ... 3.6 15-19 5.2 4.2 3.7 4.9 5.2 4.6 5.4 4.6 4.7 20-24 7.5 5.8 4.7 7.8 6.4 6.8 7.0 6.7 5.7 25-29 8.6 5.8 6.0 8.0 8.0 6.7 7.6 6.6 6.1 30-34 9.4 6.7 6.7 8.5 7.8 6.7 7.9 6.7 6.5 35-39 11.0 9.0 7.8 10.5 8.8 7.5 8.6 7.6 7.2 40-44 12.2 12.1 8.6 12.7 9.7 9.3 9.1 8.8 7.9 45-49 15.2 15.9 10.0 15.1 10.9 11.4 9.6 10.7 8.6 50-54 19.1 21.2 13.8 19.1 14.5 15.7 12.9 13.7 10.9 55-59 26.3 28.3 20.4 26.6 20.5 21.0 17.7 18.6 14.3 60-64 35.1 39.5 31.4 37.4 30.5 33.5 30.9 26.1 21.3 65-69 52.2 57.8 50.3 54.5 47.1 50.2 48.8 39.5 33.8 70-74 75.2 87.0 78.9 86.9 77.7 85.4 87.4 62.0 54.8 75-79 110.5 132.5 125.3 130.7 120.6 134.3 138.5 101.3 90.1 80-84 165.8 199.3 186.6 ... ... 214.5 215.6 ... ... 85-89 241.3 283.6 271.4 221.9 219.8 317.1 307.3 197.8 179.6 90-94 339.2 395.2 345.6 ... ... ... ... ... ... 95-over 418.9 404.8 402.1 ... ... 391.7 369.1 ... ... +-------+------+------+-------+------+-------+------+-------+------+-------+

NOTE: In 1900 or thereabouts, the death rates at the middle ages of life were heavier in the United States than in Prussia, France, Italy, and Sweden. Since then the death rates in the United States at these ages have grown even greater.

In the foreign countries the death rate by persons can be approximated by adding the rates for males and females of same age and dividing by two.

[N] 12th Census. U. S., 1900, iii. _Vital Statistics_, p. LXXIX.

[O] _F. Prinzing Medizinische Statistik_, Verlag von Gustav Fischer in Jena, 1906.

ENGLAND AND WALES

Annual Standardized Death Rates, Death Rates at Twelve Groups of Ages, and Infant Mortality, 1841-1910.[P]

-----+----+------------------------------------------------------------- All Ages (S DEATHS PER 1,000 PERSONS AT SUBJOINED AGES t a n d ----+----+----+----+----+----+----+----+----+----+-----+----- Year a 0- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85 r -5 -10 -15 -20 -25 -30 -45 -55 -65 -75 -85 and d up- i wards z e d) -----+----+----+----+----+----+----+----+----+----+----+----+-----+----- 1841- 20.6 63.7 8.7 5.0 7.2 8.8 9.7 12.1 16.1 28.7 62.0 137.1 295.3 45 1846- 22.4 68.7 9.4 5.6 7.7 9.8 10.9 13.6 18.1 31.4 65.9 145.8 306.6 50 1851- 21.7 68.9 8.6 5.2 7.4 9.0 10.1 12.7 17.2 29.6 62.9 143.2 299.5 55 1856- 20.7 66.9 8.3 4.7 6.7 8.3 9.4 12.0 16.1 28.4 60.9 136.6 293.4 60 1861- 21.4 69.1 8.4 4.7 6.6 8.4 9.8 12.6 17.1 30.2 62.4 139.1 298.8 65 1866- 21.2 68.1 7.6 4.3 6.2 8.0 9.9 12.9 17.6 30.6 63.2 141.7 294.3 70 1871- 20.9 64.9 6.9 4.0 5.8 7.7 9.6 13.1 18.0 31.6 65.3 141.6 305.2 75 1876- 19.8 61.9 6.1 3.5 4.9 6.5 8.4 12.3 17.5 31.6 64.7 142.9 311.5 80 1881- 18.7 56.6 5.7 3.2 4.6 6.0 8.0 11.8 17.2 31.0 63.5 136.1 277.7 85 1886- 18.5 56.9 4.9 2.8 4.1 5.3 7.2 11.1 17.1 31.8 66.3 139.0 290.3 90 1891- 18.5 57.8 4.6 2.6 4.0 5.0 6.8 11.0 17.3 32.5 67.3 140.8 274.1 95 1896- 17.6 57.6 4.1 2.4 3.5 4.5 6.0 10.1 16.2 30.5 64.1 133.6 267.5 1900 1901- 16.0 50.2 3.7 2.2 3.1 4.0 5.4 8.9 14.9 28.7 59.4 127.3 258.6 05 1906- 14.4 41.7 3.4 2.0 2.9 3.6 4.8 7.8 13.7 27.5 58.1 127.0 262.4 10 -----+----+----+----+----+----+----+----+----+----+----+----+-----+-----

-----------+-------------------- Year Deaths of Infants under 1 yr. of Age per 1,000 Births -----------+-------------------- 1841-45 148 1846-50 157 1851-55 156 1856-60 152 1861-65 151 1866-70 157 1871-75 153 1876-80 145 1881-85 139 1886-90 143 1891-95 151 1896-1900 156 1901-05 138 1906-10 117 -----------+--------------------

Note improvement since 1890 in death rate at every age period of life.

[P] Seventy-fifth Annual Report of the Registrar General of the Births, Deaths, and Marriages in England and Wales, 1912, p. 28.

DEATH RATES CLa.s.sIFIED BY s.e.x, AGE, AND GENERAL NATIVITY, NEW YORK STATE: 1900 AND 1910[Q]

MALE ----------+-------------------+-------------------+------------------- Native White. Foreign Colored.

Born White. +---------+---------+---------+---------+---------+--------- Age 1900 1910 1900 1910 1900 1910 Period. Death Death Death Death Death Death Rate. Rate. Rate. Rate. Rate. Rate.

----------+---------+---------+---------+---------+---------+--------- All ages 18.6 17.3 20.6 17.0 27.9 26.5 Under 1 180.3 154.9 166.6 104.6 410.5 313.2 1-4 23.0 17.5 31.6 21.7 57.0 46.6 5-9 5.0 4.0 5.3 3.4 11.0 7.4 10-14 3.0 2.3 2.5 2.5 8.1 7.1 15-19 4.6 3.9 4.9 4.3 10.2 11.3 20-24 7.4 5.9 6.8 5.2 13.8 11.2 25-29 9.4 7.5 7.9 5.6 14.0 11.8 30-34 11.3 9.6 9.3 6.9 15.5 19.6 35-39 12.4 12.3 12.2 9.8 15.1 19.8 40-44 13.6 13.7 15.0 13.2 19.3 23.9 45-49 14.7 16.6 19.8 17.7 30.9 28.7 50-54 17.2 19.6 26.0 23.6 32.0 32.4 55-59 22.3 27.0 34.3 35.4 43.8 45.3 60-64 31.0 37.4 43.4 46.9 40.5 57.4 65-69 46.3 53.5 61.9 65.6 72.4 76.5 70-74 67.5 72.3 82.2 85.2 90.2 77.5 75-79 109.4 118.1 119.4 115.7 125.0 130.6 80-84 156.1 163.9 182.4 190.7 163.1 163.5 85-89 243.8 246.0 239.0 243.3 122.8 183.7 90 & over 366.7 394.9 351.0 367.6 280.0 263.2 ----------+---------+---------+---------+---------+---------+---------

[Q] Willc.o.x, Walter F., Special Report on Vital Statistics, 33d annual report, State Department of Health, State of New York, 1912.

FEMALE ----------+-------------------+-------------------+------------------- Native White. Foreign Colored.

Born White. ----------+---------+---------+---------+---------+---------+--------- Age 1900 1910 1900 1910 1900 1910 Period. Death Death Death Death Death Death Rate. Rate. Rate. Rate. Rate. Rate.

----------+---------+---------+---------+---------+---------+--------- All ages 16.1 14.4 19.7 16.2 24.7 21.7 Under 1 149.7 128.7 160.1 92.0 335.6 265.0 1-4 21.0 16.3 30.5 18.6 49.6 40.1 5-9 4.8 3.8 5.0 3.9 10.1 8.6 10-14 2.9 2.3 2.7 2.4 12.3 7.2 15-19 4.5 3.2 3.6 3.2 8.8 9.7 20-24 6.8 4.9 5.8 4.0 8.8 10.9 25-29 8.1 6.1 7.6 5.3 10.1 10.4 30-34 8.9 7.0 9.3 6.6 12.4 11.4 35-39 9.3 7.7 11.0 7.9 15.1 14.3 40-44 10.1 9.6 13.3 9.9 19.7 20.2 45-49 12.4 11.3 16.9 13.5 19.1 20.8 50-54 14.9 15.0 22.2 19.1 25.4 29.8 55-59 19.4 19.8 31.3 28.8 39.3 36.4 60-64 25.4 27.5 41.7 41.0 52.2 49.8 65-69 38.2 42.7 57.0 59.4 62.0 69.6 70-74 58.7 64.5 83.1 85.2 86.3 49.7 75-79 93.4 96.0 117.5 115.0 110.7 96.0 80-84 148.7 152.7 167.5 170.2 136.8 131.7 85-89 224.2 223.9 246.9 242.1 117.6 175.8 90 & over 326.4 339.0 355.0 348.5 183.3 222.2 ----------+---------+---------+---------+---------+---------+---------

The tables on this and the opposite page show the same general trend of mortality in New York State that is exhibited in the Registration States generally and wherever reliable statistics are obtainable. It will be noted, however, that there is little change in the mortality rate among women until age sixty, when a decidedly increased mortality rate is shown comparing 1910 with 1900. It will also be noted that this unfavorable trend in mortality in later life is manifested among native whites, foreign born and colored citizens alike.

COMPARISON OF EXPECTATIONS OF LIFE, NEW YORK CITY, ENGLAND AND WALES, AND LONDON

---------+------------------------------------------------------------- New York City[R] England and London[S]

1909-1911. Wales[S] 1911-1912.

Ages 1910-1912. +---------+--------- ---------+--------- ---------+--------- Males Females Males Females Males Females ---------+---------+--------- ---------+--------- ---------+--------- At birth 44.55 48.8 51.50 55.35 ... ...

10 46.95 50.4 53.08 55.91 ... ...

20 38.26 41.7 44.21 47.10 42.35 46.71 30 30.34 33.6 35.81 38.54 33.87 37.94 40 23.34 26.2 27.74 30.30 26.03 29.67 50 17.11 19.1 20.29 22.51 19.09 22.17 60 11.71 12.9 13.78 15.48 13.09 15.39 70 7.66 8.2 8.53 9.58 8.17 9.57 80 4.66 4.9 4.90 5.49 4.79 5.39 90 2.24 2.8 2.87 3.16 2.75 3.10 ---------+---------+--------------------+--------------------+---------

The above tables show, both among males and females, that the expectation of life is greater at every ago period in England and Wales and in London than in New York.

[R] Annual Report, Department of Health, City of New York, 1912, pp. 176-177.

[S] Supplement to the Seventy-Fifth Annual Report of the Registrar-General of Births, Deaths and Marriages in England and Wales.

Part I--Life Tables, pp. 56-85.

DEATH RATE PER 1000 IN PRUSSIA BY AGE GROUPS 1875-80 TO 1901-1910 -----+-----------------+-----------------+-----------------+----------------- 1875-1880.[T] 1881-1890.[T] 1891-1900.[T] 1901-1910.[U]

Ages -------+---------+-------+---------+-------+---------+-------+--------- Males Females Males Females Males Females Males Females -----+-------+---------+-------+---------+-------+---------+-------+--------- 1-2 71.8 69.1 70.2 68.0 58.0 55.5 45.3 43.1 2-3 37.1 36.1 36.3 34.6 24.7 23.8 16.5 16.0 3-5 22.2 21.7 20.8 20.7 14.2 13.9 8.9 8.8 5-10 9.3 9.2 8.8 9.0 5.9 6.1 4.2 4.4 10-15 3.9 4.3 3.8 4.3 2.9 3.3 2.4 2.7 15-20 5.1 4.6 4.8 4.5 4.3 3.8 4.0 3.6 20-25 7.7 6.3 7.0 5.8 6.0 5.1 5.2 4.6 25-30 8.6 8.2 7.6 7.5 6.1 6.1 5.3 5.5 30-40 10.9 10.3 10.6 9.7 8.3 7.9 7.0 6.7 40-50 16.7 12.3 16.3 11.7 14.3 10.0 12.5 8.6 50-60 27.6 20.7 26.9 19.8 24.2 17.5 23.5 16.0 60-70 53.0 46.3 51.4 44.8 48.7 42.0 45.5 37.4 70-80 113.3 106.2 110.2 113.9 102.5 97.1 100.6 102.0 80 & over 236.4 227.2 238.2 229.0 233.1 223.3 214.4 202.6 -----+-------+---------+-------+---------+-------+---------+-------+---------

Note that in both s.e.xes there was a steady and substantial decline in the death rate at all age periods of life after 1875.