NATURAL DEATH, PUBLIC HEALTH 235 



death, and that, therefore, the decline is spurious. I have 

 not been able to find that there is any good evidence that 

 this is the fact ; that, in short, changes in reporting prac- 

 tice have affected the "non-controlled" group more than 

 the "controllable" group. But another kind of example 

 may be cited to illustrate the same general point. Suppose 

 we compare the course of mortality from certain well- 

 defined causes, about the reporting of which there can be 

 no controversy, in (a) a group of countries standing in an 

 advanced position in matters of public health, sanitation, 

 etc., and (b) a group of countries relatively backward and 

 undeveloped in these respects. Such a comparison is im- 

 possible to make over any long period of time because of 

 lack of comparable data. I have succeeded in getting com- 

 parable statistics on two diseases, namely typhoid fever 

 and diphtheria, for the period 1898 to 1912 inclusive, for 

 the following countries : 



A. Countries having (in period B. Countries having (in period 



covered) highly developed covered) less highly developed 



public health and sanitation. public health and sanitation 



Australia than those in group A. 



Austria Italy 



England and Wales Jamaica 



Germany Koumania 



Without going into detailed comparisons, which might 

 be thought invidious, it is evident on the face of the case, 

 I think, that the countries in the A group were, on the 

 average during the period covered, much more advanced 

 in all practical public health matters than were the coun- 

 tries in group B. 



In Figures 55 and 56 are shown the trends of the 

 weighted average death rates from typhoid fever and 

 diphtheria respectively in the two groups of countries. 



It is evident from these diagrams that the death rates 



