HH62/2/RENFRE/23

Transcription

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be 'understanded of the people' that the proximity of considerable
areas of putrefying filth of any sort - even if it be the excreta of
animals other than human - is inimical to health, and that but for
the great mitigating influence of the free sweep of the oxoniferous
country air, and the out-door life led by the people, the results of
living amidst such surroundings would be disastrous. - Phthisis in
the villages shows a mean death-rate of 2467, as compared with only
1534 in the country; and, still more striking, the death-rate in the
country districts from other tubercular (sometimes called 'scrofu-
lous') diseases was only 608, as compared with 1341 in the villages.
There is a diminution in the landward death-rates under each of the
headings cancer, diseases of the nervous system, heart diseases,
and respiratory (or lung) diseases; but, curiously enough, the death-
rate from 'violence' - generally speaking, accidents - in the country
is as high as 513, as compared with 459 in the villages; and, indeed,
the liability to fatal accidents in the country, so far as these figures
go, appears to be about as great as in the average busy industrial
town, with its thousand evident chances of misadventure. It may be
useful to give here, mainly for purposes of comparison with the vill-
atic death-rates, a summary of the mean death-rates, over the same
period, of a town with which I was formerly officially connected.*
The mean death-rate was 20·528, or, practically, 1·5 higher than the
mean of the Renfrewshire villages. The mean zymotic death-rate,
however, was only 2·345, as compared with 2·929 in the villages - a
very striking circumstance, considering the crowding together of the
population which exists in a town. The death-rate from diphtheria
in the town was - again abolishing decimals - 106 per million, as com-
pared with 280 in the villages. The death-rate from so very com-
municable a disease as scarlet fever was only 455 in the town, as
compared with 560 in the villages; from 'fever' (i.e., typhus and
enteric fevers) 198, as compared with 347; from measles, however,
it was 346, as compared with 300 in our villages; from whooping
cough, 440, as compared with 577. The mean death-rate in the
town from diarrhœa was 785, as compared with 862 in the country
villages. This last is a most pregnant fact - it speaks volumes in
favour of the establishment of a proper system of scavenging in our
rural communities. The death-rate from phthisis was 1·846 per
thousand, as compared with 2·467 in the villages. The death-rate

* South Shields.

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from septic diseases was at the rate of 120, as compared with 212 in
the villages. The death-rate from respiratory diseases, however,
was considerably higher in the town, being at the rate of 3·551 per
thousand, as compared with 2·940; and so, also, the death-rate from
heart disease, nervous diseases, and other diseases not generally re-
garded as susceptible to preventive treatment. - These figures alone
suffice to show how much remains to be done in order to place our
village populations in the position of healthfulness they ought to
occupy in virtue of their great natural advantages - of pure air,
more cloudless skies, comparative isolation from sources of infection,
less sedentary occupations, lessened wear and tear, and opportunities
of out-door exercise.

The relative healthfulness of the various villatic and land-
ward sections of the County, so far as deducible from the
vital statistics of the County over the decennium, 1881-90.* -
As I have already said, in the absence of a calculated 'infantile
mortality rate' too much stress may not be laid upon the percentage
of deaths under five, 'the gross death-rate,' nor, indeed, upon any
individual rate. Probably the most reliable individual test remaining
to us is the death-rate from zymotic, that is, infectious and filth-produced,
diseases. In this black list the village of Elderslie claims the worst
place with a deathrate of 6·3 per thousand of the population; coming
first, also, at the head of the list under the heading Diphtheria, with
·7; third in respect of Scarlet fever, with 1·5; Enteric fever, second,
with others. 1·5. This is a woful history, the more discouraging that
on comparing the second quinquennium of the decade with the first,
the mean zymotic death-rate shows no sign of decrease. Ϯ Blackstoun
and Clippens come next, with a zymotic death-rate of 5·5, and 5·3
respectively; these villages head the list under the heading Enteric
fever, and Blackstoun comes out highest under the heading Measles;
Blackstoun and Clippens share the discredit of second place in re-
spect of Diarrheal mortality, with Elderslie and Anniesland. To
summarize the results of the analysis of the zymotic death-rates: the
localities, all villages, having a death-rate of over 2·5 per thousand,
that is, having an excessively high zymotic death-rate, are in the

* See tables VI. and VII. of the Appendix.
Ϯ It is of good omen that of 12 cases of scarlet fever, occurring in the village
since the inauguration of the County Health Department, we have been able to
secure the removal to hospital of every one.