HH62/2/RENFRE/17

Transcription

[Page] 16

Mearns landward, 114, possibly in connection with the bleach-fields;
at Kilmalcolm, 112, the excess beiug attributable to the same cause
as at Langbank. The only sections of the County in which there are
fewer females than males are - Anniesland, Scotstoun, Neilston
landward, Barrhead landward, Inchinnan, Clippens, and Busby land-
ward.

THE GENERAL SANITARY CONDITION OF THE COUNTY AS DEDUCIBLE
FROM THE VITAL STATISTICS OF THE PAST TEN YEARS.

When a physician is called upon to deal with a case of illness, his
first duty is, at whatever cost, to make a careful diagnosis of the
case - to ascertain the nature of the disease and its seat. Until
this is done, any attempt at treatment is mere empiricism. In
coming to deal with the sanitary ills of the body corporate of a
County, it appeared to me that I should have to act more or less
empirically, and consequently inefficiently, in the absence of any
attempt to diagnose, more especially in the sense of localizing, the
evils from which the district suffered. Furthermore, I was met at
the outset with statements as to the healthfulness of certain localities,
which it was difficult to reconcile with the marked sanitary disabilities
under which these localities lay. Under these circumstances it
appeared to me indispensable to the intelligent discharge of my duty
to the County Council and the District Committees, that I should
endeavour to collect and collate the vital statistics of the County, so
far as within my jurisdiction, over a considerable period, in order to
ascertain which sections had suffered most in the past, as the result
of insanitary conditions, to which sections the attention of the Health
Department ought in the first instance, to be principally directed,
and to obtain, if possible, from the nature of the prevalent diseases,
in the various localities, some indications of the sanitary conditions
which were in default. With this object in view I determined to
extract from the death-registers of the County, all the deaths which
had occurred over the ten years 1881-90, with localities, causes, ages,
etc., and to tabulate and analyse them so as to obtain, as far as
possible, the information desired. I hoped to have been able to
extract the births, over the same period, in order to place myself in
a position to calculate the 'infantile mortality rate' * for each

* the 'infantile mortality rate' is the proportion of babies (infants under
one year) who die within the first year of life: this is infinitely the most
sensitive and reliable individual test of the sanitary condition of a district.

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section, over the ten years; but I found that this would have
absorbed the time and energies of a person familiar with the district,
for a period of about five weeks. I had, therefore, to relinquish the
idea as impracticable. As it was, the labour involved in the
collection, collation, localization, tabulation, and analysis of the
figures has been very great.
There is nothing so deceptive as facts, except figures, says a cynical
critic. The phrase is more than an epigram. Figures must be care-
fully and intelligently handled, in a judicial spirit, and too large
deductions must not be drawn from them, if they are to be of any
practical service. I desire, therefore, to guard myself and my readers
from too hasty or too literal an interpretation of the figures which
follow, and which are set forth in detail in the tables of death-rates in
the Appendix.
In the first place, I remark that the death-rate alone, is a very
insufficient guide to the sanitary condition of a district - one ought
also to know what is called the 'age distribution' of the population.
One place, for instance, may have an excessive proportion of old men
and women, and only a small proportion of persons in the prime of
life; a high death-rate in this case does not necessarily imply an
insanitary condition of affairs. We have an excellent illustration of
this fallacy in the case of the village of Eaglesham, whose mean death-
rate over the ten years is given, in the tables which follow, as 22·7,
an abnormal death-rate for a village remote from towns; and one
which I could not accept nntil I had gone over the figures again and
again. I am unable to apply the necessary correction for the age-
and-sex-distribution of the population of the village, the material for
which will not be forthcoming until the further publication of census
results. But I find that, over the ten years, 47·9, or roughly,
50 per cent. of the deaths in the village were of persons over
sixty years of age; and I am led to understand that there
is in the village an abnormal proportion of aged persons.
As an illustration of the same fallacy acting in the reverse
way, I take the case of Scotstoun; there, as we have seen, the
population is more closely crowded together than anywhere else
in the County, yet the death-rate is only 16·0 per thousand. Here,
however, I observe that the percentage of deaths over sixty years of
age is only 8·4, the lowest, save one, in the County, while the per-
centage of deaths under five years of age is 69·4 - the highest in the
County. With these figures before me, and knowing that the local