HH62/1/DUNBAR/75

Transcription

[Page] 74

Condensing these tables, by taking the mean of the five years,
we get the following result:-

TABLE XIV.

Mean of the Annual Death-rates per 100,000 of Population, 1885-89.

[Table inserted]

It will be seen from these figures that in the Small Town
Districts Dunbarton has a total mortality slightly lower than that
of Scotland. From phthisis, however, the rate is considerably
higher, the difference amounting to 12 per cent. The zymotic
rate is lower than the average by nearly 5 per cent., and among
individual zymotics, enteric fever, measles, diarrhoea, and whoop-
ing-cough contribute to this result. On the other hand, scarlatina
and diphtheria have a high mortality, especially the former, which
is nearly 90 per cent. above the average.
The Rural Districts do not show so well. The total mortality
is 5 per cent. above the average, the phthisis mortality is 15 per
cent. above the average, and, worst of all, the zymotic mortality is
no less than 56 per cent. above the average. Looking at the

[Page] 75

individual zymotics, we find that measles has a death-rate nearly
threefold the average, and that in diphtheria and whooping-cough
there is a twofold rate. Indeed, of the diseases that I have
selected for comparison, enteric fever is the only one in which
Rural Dunbarton compares favourably with Rural Scotland.
I stated at p. 16 that there were better standards than the total
death-rate by which to measure the health of a community.
One of these is the zymotic death-rate, and its application to
the county goes to show that in the Small Town Districts the
health conditions compare favourably with the rest of Scotland,
while in the rural districts they compare very unfavourably.
Doubtless the inclusion of Helensburgh, Row, and Garelochhead*
has much to do with the lowness of the small town death-rate. In
partial explanation of the high death-rate of the rural districts, it
is to be borne in mind that a great part of the so-called "rural"
population of the county lives in villages of from 300 to 2000
inhabitants, and that such villages are likely to have a higher
mortality than smaller hamlets or isolated farm-steadings. On
p. 15 I give figures showing that the village population of the
county is much greater than the purely rural population, while in
Scotland as a whole the reverse is the case. This, however, will
not account for the whole facts, nor will it explain, still less explain
away, the high death rate from phthisis in the rural population.
Bad sanitation in general, and, in regard to phthisis, bad house
accommodation in particular, must be set down as at the bottom
of the unsatisfactory condition disclosed by these figures. The small
mortality from enteric fever - the one redeeming feature in these
statistics - is probably partly due to the fact that so great a pro-
portion of the population has its water supply derived from non-
local sources.
There is too much tendency in the public mind, and perhaps
even in the professional mind, to talk of sanitation as if it had
exactly the same meaning with relation to all infectious diseases.
This is not so. It is true indeed that, in its measure, dirt fosters
all diseases, whether zymotic or tubercular, or belonging to any
other of the Registrar-General's genera and species. But special

* As I have explained, Registration Districts are taken as a whole in
the Registrar-General's Reports and the District of Row contains Helens-
burgh, Row, and nearly the whole of Garelochhead.