HH62/2/LANARK/29

Transcription

[Page] 28

With a new Public Health Act, embodying and consoli-
dating the best features of the Scottish and English
Sanitary Acts, administered by a trained body of medical
officers and sanitary inspectors devoting the whole of their
time to the work, such as Scotland now possesses (in this
respect far in advance of England), under the control of
enlightened county councils, and guided by the central
authority, Scotland would speedily take a foremost place in
the march of sanitary progress among the nations of the
world.

VITAL STATISTICS.

In regard to that part of the report dealing with returns
of births and deaths a few explanatory remarks may be
serviceable.
In the first place, I would emphasize the fact that the
figures are only for the year 1891, and that too much
importance, especially in the case of small populations,
must not be attached to them as indicating the sanitary
condition of the various districts.They are important as
the beginning of a series of statistics which will undoubtedly
by-and-bye throw great light on the different circumstances
influencing the health of the people in the county.
It must also be borne in mind that, not being in posses-
sion of the full census report, I have been unable to make
the usual corrections for age and sex. In comparing one
population with another as regards mortality, and in
drawing inferences as to comparative healthiness from the
figures, it is essential to know in what respects the popula-
tions differ, and more especially as regards the number of
people living at various ages and of each sex. It is quite
obvious that a community with a relatively large propor-
tion of persons between 10 and 25 years of age would
have, even under the same sanitary conditions, a lower
death-rate than a community with a small proportion of
persons between these ages, and with a higher proportion
of infants and old people.

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So, too, with sex. Women on the average live longer
than men, and therefore a population with a large number
of females has - all other things being equal - a lower death-
rate than one with a smaller proportion.
In all reports on vital statistics the word "rate" is con-
tinually occurring, and in this first annual report it may
not be out of place to briefly describe what is meant by it.
The total number of deaths for the year 1891 in the Upper
Ward was 702; in the Middle, 2,908; and in the Lower,
539; but these figures, as they stand, give no indication
as to whether the mortality was highest in the Upper,
Middle, or Lower Wards. It is customary, therefore, for
purposes of comparison, to state the number of deaths that
occur in each thousand of the population: thus, in the
Upper Ward, with its population of 37,005, a total of 702
deaths is equal to 18·9 for every 1,000 people living in the
various parishes comprised in the Upper Ward District, or,
if decimals are to be avoided, 189 deaths for every 10,000
inhabitants. In dealing with small figures, as in the case
of the rates for scarlet fever and other zymotic diseases, it
is not unusual to give the rates per million instead of per
1,000, so as to avoid carrying the figures to three or four
decimal places; but I have preferred, for the sake of
uniformity, to give the rates per 1,000 in every instance.
One fallacy is so common that I think I may venture to
call attention to it, viz., that of expecting the rate for the
district as a whole to be the average of the rates for the
different parishes in the district. As an example, in Table
XVIII., p. 111, we find that the actual total death-rate in the
Lower Ward is 18·39, while the average of the rates of the
different parishes is only 17·29 - a considerable difference.
Were the populations of the parishes equal, then the
average rate would be that for the district as a whole, but
not otherwise, unless as a mere coincidence.

Births and Deaths in the County (Landward). - In the
portion of the county over which the County Council