Mortality table

“ If a mortality table of the usual form is deduced from these suppositions, out of 212 persons alive at the age of 3, 2 will die every year up to 53, 3 in each of the ten years from 53 to 63, 4 in each of the next ten years from 63 to 73, and 6 in each of the next seven years from 73 to 80, when all will be dead. ”

“ The outstanding fact which strikes one at once from this table is the high order of the correlation which exists between the explosiveness of the outbreak of epidemic mortality in these communities and the normal death rate from certain causes of death in the same communities. ”

“ From a table showing the ratio per thousand of mortality in the United States Army as compared with the mortality of males between twenty and forty years of age in civil life, it appears that the death-rate from disease among the soldiers is from twice to three times as great per thousand as among civilians. ”

“ Assuming that the death rates are uniform within the five-year periods, the decline in the proportion of institutional feeble-minded from 5-25 years of age as the result of excessive mortality is indicated by the last line in Table II, after allowing for the mortality in the general population. That this effect of excessive mortality upon the percentage of feeble-minded cannot be neglected between 5 and 25 years of age is apparent unless the mortality among institutional cases is much greater than it is among the deficient generally. ”

“ The probable mortality of that number of persons for the decade, supposing them to be good 'risks,' would be six. We may then suppose that 80 would enter the next decade. But our figures show that 922 of our entire group were between the ages of 30-39, inclusive, leaving the number 842 as representing the number of new names admitted during the decade. Of the total number for this age period (922) , the mortality tables lead us to suppose that 78 will die before its completion, giving us 844 as the number passing on to the next group—that for the age decade of 40-49 years. ”

“ A fearful truth for medical men has been established by the table of mortality by Dr. Casper, published in the British Review. Of 1000 members of the medical profession, 600 died before their sixty-second year; while of persons leading a quiet life—such as agriculturists or theologians—the mortality is only 347. ”

“ There is no reason to doubt that instead of every second man perishing miserably within a few weeks, the rate of mortality might have been as low as that exhibited in the South American Report, viz., one death annually by disease out of 150 men. ”

“ The rates, to be sure, vary considerably with the different nationalities; but taken as a group, the foreign born apparently show a lower resistance to the degenerative processes which these diseases imply. Is it to be wondered at, therefore, that the death rates for large cities and states in the registration area show increases in mortality at the higher age groups? In view of the marked changes that have occurred in the composition and characteristics of our population, it would indeed be surprising if these changes in mortality had not occurred. ”

“ When one reads the account of the condition of the densely crowded districts on the south side of the High Street, one is not surprised that the rate of mortality was 40 and over per thousand. That you now enjoy one of the lowest death rates in Europe—15.3 per thousand for last year—is due to the thoroughness with which measures of recognized efficiency have been carried out. ”

“ A detailed consideration of our sickness and mortality during the last year suggests to me a few other remarks, which may, I think, be of practical utility to your Hon. Court.
First, as regards the ages at which death occurs; the respective proportions of timely and untimely deaths may, generally speaking, be inferred from the local death-rates. In general terms, we know a high death-rate indicates that many die before their time—indicates that a proportion of the population, more or less considerable, instead of reaching old age, becomes prematurely blighted and extinguished. ”

“ From ten to fifteen, the average mortality is lower than at any other period. From fifteen to twenty the number of deaths increases again, especially among women. At this period, the influence of dangerous occupations begins to be seen in the death-rate. ”

“ This indicator is significantly affected by age distribution, and most countries will eventually show a rise in the overall death rate, in spite of continued decline in mortality at all ages, as declining fertility results in an aging population. ”

“ The expansion of medical services and improvement in the standard of health during the 1950s and 1960s resulted in a marked decline in the mortality rate, from 14 per 1,000 in 1950 to 8 per 1,000 in 1968. The age structure of the population, with a preponderance in the lower age brackets, provided the potential for a continuing low mortality rate. ”

“ While man's mortality, after falling off markedly up to forty-five years, begins after that period to increase distinctly, woman's death rate, on the other hand, continues to decrease until fifty-five years of age, beating man ten years ”

“ As the epidemic progressed the mortality-rate increased from day to day, until it reached the point of 5,000 deaths per day, and on several occasions ran up to as high as 10,000 deaths in the twenty four hours. ”

“ We have again to present to our friends the Report of the Annual Mortality in the Society of Friends, in Great Britain and Ireland. It has frequently been observed, how nearly the number of deaths in each year has approximated, but we have this year to notice a considerable diminution in the annual return. We are not disposed, however, to attribute the diminished numbers, chiefly to any special cause connected with health, but consider it rather as one of those fluctuations which are ever found to arise in a series of years, in the mortality of a small community. ”

“ In one favorable instance, that of between 600 and 700 persons of the working class in the metropolis, during a period of three years, the average rate of mortality has been reduced to between 13 and 14 in 1000. In another instance, for a shorter period, among 500 persons, the mortality has been reduced as low as even 7 in 1000. ”

“ For while we have been lengthening the average term of life and reducing the death rate in general, we have been shocked to find that the mortality above forty-five has been increasing rather than decreasing, so that men are being taken off just at the prime of life and at the height of their usefulness more than ever before, in spite of all our hygiene and the development of sanitary science. ”

“ And again, where, in fact, the proportion of death in one year may be represented as 1 death out of 20 of the population; the average existence enjoyed may be greater than when 1 in 40 died for the reason given in the former case. As for example, in the year when 1 in 20 died, it may have happened that the deaths were among the older lives, and that, taking one with another, the average age of all who died might be 50; while in the other case the mortality might have been amongst the infant population, when the average age might have been 20. ”

“ It will be a moderate computation with respect to these deaths, if we estimate that two-thirds of them might have been hindered.
And yet it is not only by acute disorders, that preventable death succeeds in ravaging the population. If we turn to the examination of chronic ailments producing death, we may quickly recognise many indications of their preventability, and may satisfy ourselves that here also the general mortality might be very largely reduced. ”

“ To ascertain whether a nation is long-lived, we must correct the crude death-rate by taking into account the average age of the population. When this correction has been made, a low death-rate, and the low birth-rate which necessarily accompanies it, is a sign that the doctors are doing their duty by keeping their patients alive. If our physicians desire more maternity cases, they must make more work for the undertaker. Large families almost always mean a high infant mortality; and it is significant that a twelfth child has a very much poorer chance of survival than a first or second. ”

“ It will be noticed that in 1849 the increase over the previous year was about 42,000, while in the following year, 1850, there was a falling off to 30,000 below the number of deaths in 1848. For the period of five years from 1848 to 1852 the annual average of 400,000 remained undisturbed. This would indicate that, when through a powerful influence an excessive death-rate prevails, a large proportion of the weak and sickly is carried off, so that by way of compensation the surviving, healthier population will for a time show a mortality below the average. ”

“ A curve is plotted from a careful study of the mortality statistics, thus giving a picture which accurately represents the variations of the death-rate in this disease during practically the last fifty years ”

“ First, by a high birth rate much in excess of the death rate. This is usually the rule in communities in a low state of culture, among agricultural classes, and also among the poorer and laboring classes in European and American industrial centers. The death rate, especially the infant mortality, is very high, but this is compensated by early marriages, and a substantial prolificacy. On the whole, the average duration of life is, in such communities, comparatively short; the population is being renewed at frequent intervals. ”

“ He estimates 5, 6, and 8 years interval, as a common rotine of irruption by some epidemical distemper, even in remote country parishes: and a few of them have been so fortunate as to escape any uncommon or remarkable mortality during 11, 12, or even 20 and 30 years. In all the seasons denominated sickly in the country parishes, the burials exceeded the christenings; and according to the nature of the epidemick, the morbid state of the seasons, the medical treatment, and many other circumstances, the gradations of mortality, even by the same disease, were extremely various. ”

“ For instance, if we suppose the standing number, on an average, of the London inhabitants at six hundred thousand; and the total inhabitants in Britain and Ireland at nine million; and if the same diseases and casualties were equally diffused and fatal to this whole community, then, in such case, the London bills would serve as a scale or index of mortality to both kingdoms: as many would die annually of every disease and casualty throughout nine million, as are cut off in fifteen years in London ”

“ The habits of order the system acquires in this period, continue to produce good health for many years afterwards; and hence bills of mortality prove that fewer persons die between forty and fifty-seven, than in any other seventeen years of human life. ”

“ Frost makes the important point that the relative mortality is determined more accurately by case fatality than by case incidence, and that without a full and exact knowledge of the variations in case fatality, statistics of mortality are by no means translatable to terms of relative morbidity. ”

“ Nor is there in Great Britain, as in this country, any evidence of a rising mortality among those in middle life and later who are chiefly affected by these degenerative maladies. The same may be said of Germany, where the death rate at every age period has steadily fallen during the past thirty years, notwithstanding a tremendous industrial progress. ”

“ This is no longer theory, but can be demonstrated by official mortality statistics. The death rate has declined more rapidly in cities than in rural communities because the cities have given more adequate support to public health organization. ”

“ The death-rate then gradually rises, slowly till 25, more rapidly later, when, from about 45 onward deterioration asserts itself more pronouncedly, and by three score years and ten the rate begins to exceed that of childhood. Thus, all other considerations being set aside, mortality tends to vary inversely with the proportion of the population at the healthy period 5 to 25. As the replenishment of this group depends upon the conditions prevailing at the earlier ages, it is to the mortality in childhood that most weight, from the standpoint of hygiene, must be attached. ”

“ The birth rate has shown a considerable increase whereas the death rate has decreased. Mortality rates from the ten leading causes of death have been re­duced. All of these facts indicate an improvement in the cleanliness and sanitation of our communities. ”

“ In the whole country, the marvellous results which have been produced can be seen. Thanks to these laws, the rate of mortality has been lowered, the mean duration of life increased, the amount of sickness decreased. ”

“ What are the forces at work in American life which have made for this increased mortality at the adult ages? In a recent paper entitled "The Possibilities of Reducing Mortality at the Higher Age Groups" the writer pointed out some of the conditions of present-day life which he believed tended to increase the death rates from the so-called "degenerative" diseases. ”

“ IT is quite generally believed by those who have studied American morbidity and mortality tendencies that there has been a marked increase in recent years in the death rate from chronic diseases of the important and hardest worked organs of the body. They also believe that this increase is reflected in the upward trend of the general mortality rate in middle life and old age. There are those, however, who assert—obviously without investigation or analysis of the public statistics bearing upon the subject—that neither of these increases has taken place. ”

“ That these movements of mortality are not beyond the control of man is shown by this lowering of the death-rate in the age-groups most affected by the communicable diseases which have recently yielded to the attacks of science. ”