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REGISTRATION OF VITAL STATISTICS. The registration of the births, marriages and deaths of the State is intrusted by law to the secretary of State, under whose charge this important department has been conducted for nearly fifty years. The work of editing the official report has been committed to the secretary of the State Board of Health for the past five years.

Since a considerable portion of the report has a definite relation to public hygiene, a condensed summary of the statistics of 1890 is herewith presented :

The births registered in Massachusetts in 1890 were 57,777, the marriages 20,838, and the deaths 43,528. The excess of living births over deaths was 14,249.

These numbers, as compared with the living population of 2,238,943 (Cnited States Census of 1890), indicated a birth rate of 25.81 per 1,000, a marriage rate of 18.62 per 1,000, and a death rate of 19.44 per 1,000, and the excess rate of births over deaths was 6.37 per 1,000.

The births, 57,777 in number, were more than those of any previous year, and the birth rate, which had diminished with irregularity from 1850 to 1878, has again slightly increased. The number of still-births was 2,099.

The largest number of births, 5,338, occurred in December. The birth rate of the twenty-eight cities was 28.4, the largest being that of Holyoke, 42.7, and the least that of Newton, 21.2. The birth rate of the rest of the State was 21.7.

The whole number of marriages was 20,838 and the rate 18.62 ; the greatest number occurred in November, 2,505, and the least number in March, 817.

The cities having the highest marriage rate were New Bedford and Chicopee, each having a ratio of 12.5, and the city having the lowest was Pittsfield, 6.7.

The number of deaths was 43,528, which indicated a death rate of 19.44 per 1,000. The deaths of infants under one year were 9,625. The death rates have varied but little during the past forty years, the highest being 22.8 in 1864 and in 1872, and the lowest 16.9 in 1867. For the past ten years the death rate has not varied more than 1 per 1,000 from 19.5.

By counties, the highest death rate in 1891 was in Dukes and Nantucket, 25.4 and 24.5, and the lowest, 15.8, in Franklin. The greatest number of deaths, 5,300, occurred in January, and the least,

2,840, in June. Twenty-five persons died at the age of one hundred and over. By cities, the highest death rate was in Lawrence, 26.5, and in Lowell, 25.2, and the lowest, 13.7, in Newton.

The causes of death were distributed as follows by general classes : 8,079, or 18.6 per cent., were from zymotic diseases ; 9,211, or 21.2 per cent., were from constitutional diseases; 19,509, or 44.8 per cent., were from local diseases ; 4,396, or 10.1 per cent., were from developmental diseases; 1,814, or 4.2 per cent., were by violence, and 519, or 1.2 per cent., were from unknown or unspecified causes.

The deaths from dysentery were 220 in number, which was the least number from this cause for ten years. Those from typhoid fever were 835, which was also less than the average of the past ten years. Those from whooping-cough were 363. Those from croup were 387, from diphtheria 1,239, from measles 114, from scarlet-fever 196, which was very much less than the average of the ten years past. Those from cholera infantum were 2,491, which was in excess of the average. From small-pox, but one death was reported.

The deaths from consumption were 5,791, which indicated a slightly diminishing ratio.

From diseases of the nervous system, classified under apoplesy, paralysis, insanity and convulsions, there were 3,613 deaths.

The deaths recorded as due to heart diseases were 3,579, which was much greater than the average of the past ten years.

Special prominence is given in this report of 1890 to the vital statistics of cities, the birth, marriage and death rates being presented for the census years 1870, 1875, 1880, 1885 and 1890.

THE PROTECTION OF THE SEA-COAST FROM FLOATING NUISANCES.

The Board has received communications from two different sources during the past year relative to the existence of floating garbage of various kinds which comes ashore at certain stages of the tide and with favorable winds, causing thereby considerable nuisance in the neighborhood of such deposits. In one of these instances the nuisance consisted of floating garbage supposed to have been discharged from fishing schooners ; it came ashore at Amesbury and created a nuisance there. The other complaint came from the authorities of Swampscott, the nuisance being caused by the dumping of the garbage of Boston at the outer part of the harbor; the decomposing material was driven ashore at Swampscott.

In neither of these cases did the State Board have any legal jurisdiction. It was therefore deemed best to advise the parties to seek some remedy by legislation.

With reference to the dumping of the offal and garbage of Boston at sea, there has been much improvement since the complaint above alluded to was made, as appears from the following extract from the report of the superintendent of streets of Boston for 1891:

On investigation it was found that the complaints were well founded, since the refuse picked up on the beaches at Swampscott and its vicinity came from the Boston dumping-scow. The location of the dumping-place was therefore changed, and instead of using a single dump, as had been the custom in former years, a number of dumps were arranged, so that advantage might be taken of the wind to keep the refuse from floating ashore. These dumping-stations are shown on a chart, and are from two to eight miles farther out to sea than the old dumping-place. Since this change has been made, no complaint from any source has been received, as it is possible to choose a station from which the garbage cannot be blown ashore.

FOOD AND DRUG INSPECTION. This department of the work of the Board has now been in existence nearly ten years, and has proved to be a protection against danger and against fraud.

The routine work of the Board in this direction has progressed as usual during the year. Before the close of the year it was deemed advisable by the Board that so much of the work of food and drug examination as is done in eastern Massachusetts should be under the supervision of one chemist, who should have charge of this work. Accordingly, at the annual meeting in June, 1891, Dr. Charles P. Worcester was appointed as the analyst in charge of this department of work.

An important question which came up during the year was that of the presence of copper as an adulterant in certain sorts of canned vegetables imported from France. A complaint was entered in the lower courts with reference to this form of adulteration. The defendant was convicted and appealed, but the trial in the superior court did not take place until after the close of the year embraced in this report. Hence a further account of the same will be presented in the next annual report (1892).

MUNICIPAL HEALTH ORGANIZATION. Every year the State Board is called upon to give advice to local boards of health with reference to the proper management of sanitary matters in cities and towns, but chiefly in the smaller towns, since the cities have in most instances well-organized boards of health. The present unsatisfactory law allows any town to neglect the public welfare by intrusting the important duties pertaining to the public health of the town to a board of selectmen who are not elected in consequence of their fitness to fulfil the duties of a board of health. As a natural consequence instances of the evil results of this glaring defect are of frequent occurrence. The Board has repeatedly called attention to the need of legislation to remedy this evil, but thus far without avail.

THE WEEKLY MORTALITY REPORTS. The Board has maintained during nearly the whole period of its existence a weekly report of the deaths in such cities and towns of the State as have voluntarily made returns to the State Board of such deaths as occur during each week in these cities and towns. This report is compiled at the office of the Board each week, and a copy is sent to the town clerk or registrar of each city and town.

In the present report a summary is given for the year 1891, together with an abstract of the reports of the preceding eight years.

THE GEOGRAPHICAL DISTRIBUTION OF CERTAIN DISEASES

IN MASSACHUSETTS. In this paper is presented a demographic study of eight diseases or causes of death, most of which are recognized as infectious, and preventable in a greater or less degree. The method of treating the subject is mainly statistical, and a degree of uniformity is maintained in the tabulations and groupings of counties. In the discussion of each disease the death rates from the given disease are first presented for each of the twenty years included in the period selected for observation (1871-1890). Next the death rates by counties. In addition to geographical position, the important condition of density of population receives consideration, and finally the entire list of cities and towns in the State is presented with its general death rate per thousand of the population, and its death rate from each disease for the twenty years.

As a matter of convenience and uniformity the mortality of the State from each disease is taken as an average or standard of comparison, and is assumed to be 100.

Other special conditions receive due consideration, such as the influence of railway communication; the relation of paper mills to small-pox mortality; of employment of married women away from home to the death rate from cholera infantum ; of elevation above sea level and distance from the sea to the death rate from phthisis and pneumonia.

HEALTH OF Towns. Under this title a digest has been prepared from such reports of local boards of health as have been forwarded to the office of the State Board of Health for the year 1891. In addition to the usual matter presented, a tabular statement is given containing the number of cases of infectious disease reported to the local boards of health during the year, and the number of deaths from each of the diseases specified in the statutes so far as they were known at the time of making up the table. It would add very much to the efficiency as well as interest of this part of the report if all of the large towns were required by law to publish an annual health report.

ROUTINE WORK OF THE BOARD. During the year ending Sept. 30, 1891, the Board held thirteen regular meetings, besides many meetings of standing committees, and five public hearings relative to questions which arose under the provisions of chapter 375 of the Acts of 1888, and certain special acts.

The mortality statistics of the cities and towns which have been voluntarily forwarded by the proper officials to the office of the Board each week have been compiled at the office and published weekly. A summary of them is presented in this report.

Much advice has been given to local boards of health relative to sanitary matters, and also to individuals who have requested

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