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POLITICAL ECONOMY OF HEALTH.

BY EDWARD JARVIS, M. D., OF DORCHESTER.

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POLITICAL ECONOMY

ECONOMY OF HEALTH.

“ HEALTH IS THE CAPITAL OF THE LABORING Man."-Latham.*

In estimating the power or the value of a state or nation, two factors are commonly used,

1. The number of the people. 2. The value of their property.

In the first the people are simply counted ; men, women and children,-all have equal share in this enumeration; the infant and the mature, the strong and the weak, the healthy and the sick, are all presumed to contribute an equal portion to the body politic.

Numbers have, in themselves, no power. They are merely representatives of things that may be nominally alike, but infinitely various in their degrees of value.

A community of children in the forming stages of life, or of invalids, or of patients in hospital, or lunatics, is very different from one that includes only persons in the mature and effective periods of life.

As the nation's wealth consists of the sums of all the estates within its borders, the great and the small, deducting all incumbrances, mortgages, debts, etc., so the strength of the state is the sum of all the effective people, deducting all the personal incumbrances, sicknesses, disabilities, and imperfections.

Thus, the state that has the largest proportion of its people in the years of maturity, from twenty to seventy, is stronger and wiser than one that has a larger proportion in the immature period of childhood and youth ; and one, all of whose members are in fulness of health and strength, is stronger than one, any of whose people are disabled with fever, consumption, lunacy, intemperance, etc.

* Sanitary Engineering.

Every increase of individual estate, every dollar earned, and every new value created, is so much addition to the common wealth, and every detraction from the wealth of individuals, every dollar that is expended without return, wasted or squandered, every extinguishment of any value, is so much taken from the public capital; and all incumbrances, debts, mortgages on property of persons, must be deducted from the sum total of the common wealth, in order to obtain a true estimate of its worth.

So all additions to the physical, moral or intellectual power of individuals, all strengthening of the arm and increased skilfulness of the hand, all culture of the brain, sharpening of the perceptive faculties, or discipline of the reflective and reasoning powers, in any individual, are, to that extent, additions to the energy and the productive force, the effectiveness and the wisdom of the state; and, on the contrary, all deductions from these forces, whether of mind or body, every sickness, any injury or disability, every impairment of energy, every clouding of the brain from intoxication, all waste of mental discipline, take so much from the mental force, the safe administration of the body politic. Collective personal gain is public gain, and aggregate personal loss is, to the same extent, the suffering of the community.

The State thus has an interest, not only in the prosperity, but also in the health and strength and effective power of each one of its members; and it has a claim upon all to develop their estates and themselves, bodily and mentally, to the greatest extent, and add each one to the aggregate wealth and power of the whole.

The period of development is from birth to the completion of the twentieth year. From twenty to seventy is the period of maturity and efficiency. From seventy and upwards is the period of old age, when men rest from their labors.

The years of growth, of old age, constitute the dependent periods. The years of maturity, from twenty to seventy, are the sustaining period.

The labors of these fifty years—twenty to seventy-create substance sufficient, not only for the support of the worker of that time, but for the early years of growth, and also the ordinary period of decrepitude, after seventy.*

The effective power of a nation is in the number of its people in the sustaining period, and in the proportion these bear to the dependent classes. In all the United States, among the whites, 49 per cent. are in the sustaining class, † and 51 per cent. in the dependent. Among the colored the proportions were 44.78 per cent. supporters, and 55.22 consumers. A wide difference in this respect is seen in comparison of the Northern States with those of the South. In Vermont the sustaiving classes are 53 per cent., and in Massachusetts, owing, in part, to immigration, 56.8 per cent., while the dependent classes in these States are, severally, 47 and 43 per cent. On the contrary, the sustaining classes in North and South Carolina are 46, and in Georgia 47 per cent., while the classes depending on others for support are 53 and 56 per cent.

A similar difference is found in analyzing the populations of Europe. The following table shows, at a glance, the proportions of the sustaining and dependent classes in various countries.

These are general averages, not applicable to every individual. Many earn snfficient for their support, under the direction of others, before they are twenty years old; but even these are not contributors beyond their consumption to the public capital. As a class, they do not mature until this period is passed. On the opposite extreme of life, some retain their strength and labor after passing their seventieth year; but more begin their rest in decrepitude before that age.

* This is due, in some measure, to foreign immigration, which brings a large proportion in the middle period of life,-twenty to forty years old.

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