HH62/2/WIGTOW/35

Transcription

[Page] (34)

(b.) Analysis of Rates. - When the death-numbers are small it is
instructive to examine the ratios between deaths at different periods of
life. This gives an index to the general health of the area. Thus, in
the parish of Inch there were 47 births, but only 1 death of children
under 1 year. In Leswalt, on the other hand, there were 36 births, and
6 deaths of children under 1 year. Again in Inch the number of deaths
between 25 and 60 (adults) formed only one-third of the number of
deaths over 60 (post mature). In Leswalt the number of adult deaths
formed almost a half of the deaths over 60. Yet in Inch the total
deaths numbered only 22; in Leswalt, 23. In New Luce again, there
was only 1 death under 25. The area is too small to justify any con-
clusive inference; but in New Luce the average age at death this year
is high. In Portpatrick, though the death-rate is high, the proportion
of adult (between 25 and 60) to post-mature (over 60) deaths is very
small - only one-ninth; and only one-fifth of the deaths are under 25.
It is clear, therefore, that the high death-rate is not by itself a sufficient
reason for placing Portpatrick among the most unhealthy areas. On the
contrary, the large number of deaths over 60 gives ground for placing it
among the good areas. All these figures, however, require the check
and interpretation supplied, first, by the past records of the parishes;
second, by an inquiry into the social conditions of each main centre of
population; third, by a precise estimate of the part due to situation and
to climate. These will find their place in future reports.
So far as the figures before me go, the Upper District seems more
favourable to life than the Lower District, as the comparison with the
facts of the Lower District show. Whether this will be sustained when
the full returns are analyzed remains to see; at present a detailed com-
parison would only be misleading.

B. - SPECIAL RATES.

(a.) Zymotic Deaths. - The deaths from zymotic (or infectious)
diseases are not numerous. Four deaths are returned as due to
diphtheria, 4 to influenza, 1 to whooping cough, 1 to diarrhoea. These
give a rate of 1.01 per 1000, or 101 per 100,000 - a rate that is well
within the average for mainland-rural districts.
(b.) Tubercular Death-rate. - Phthisis (or consumption) and other
forms of tubercular disease show a record of 13 deaths. This gives a
rate of 1.313 per 1000, or 131 per 100,000. This, again, like the
zymotic rate, is well within the average for mainland-rural districts. Of
the 11 cases of phthisis, 5 occurred in Leswalt parish, 2 in New Luce,
2 in Portpatrick. To judge by previous investigation of the tubercular
deaths in the county, this rate for the Upper District must either be

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exceptionally low or my returns do not overtake the most tubercular
areas. The comparison with the Lower District is all in favour of the
Upper District.
(c.) The rates for nervous, circulatory, and respiratory diseases offer
no special feature remark.

C. - PREVENTION OR MITIGATION.

These facts are too few to justify any specific proposal in regard to
any one disease or class of diseases. Personal observation leads me to
place little reliance on such death-rates as an index of the amount of
disease. But my other sources of information are very limited. When
the Notification Act is in force, it will reveal not only to what extent
mild infectious diseases are debilitating the community, but many other
health conditions that are hardly otherwise to be got at. Thus in
Leswalt and Kirkcolm, where diphtheria has recently spread over a wide
area, one is not to suppose that diphtheria is more virulent or more
infectious here than elsewhere; rather the inference is that climate, or
housing, or life-habits, or personal histories predispose to the infection.
It is these preliminary conditions that the Notification Act makes better
known, and these it is that the Local Authority may help to change.
With this view, I would urge the District Committee to the systematic
inquiry recommended in the earlier part of this report. Such inquiry
will check and complete the figures now given, and prepare the way for
the gradual elimination of these unhealthy conditions that sanitation
may reasonably hope to remove or improve.

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