THE TREND OF AMERICAN VITALITY 



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Table II 



Death-Rate per 100,000 op Population for Certain Causes of Death 



Male and Female Combined 



(Registration States as constituted in 1900) 



Cause of Death 



Cancer (all forms) 



Diabetes 



Cerebral hemorrhage and apoplexy, 



Organic diseases of the heart 



Diseases of arteries 



Cirrhosis of liver 



Bright's disease 



Total 



Per Cent. Increase 



30.6 

 60.0 

 18.8 

 39.3 

 396.2 

 14.3 

 18.1 



33.8 



It has, therefore, been assumed quite generally that the deteriora- 

 tion observed after age 40 is due to the increase in the incidence of 

 these so-called "degenerative" diseases. Indeed, much of the propa- 

 ganda for better personal hygiene at middle life has received its impetus 

 from the discussion of this tendency in American mortality. We must 

 not forget, however, that our returns for causes of death are still far 

 too inaccurate to warrant complete confidence. Only a small propor- 

 tion of our statements of cause are confirmed by autopsy. Yet, the 

 changes that have occurred in our medical practise with reference to 

 statements of cause of death have not been of such radical character 

 during the last ten years as to invalidate the conclusions drawn. The 

 figures are apparently confirmed by independent analyses made in a 

 number of specialized areas in which it appears that these degenerative 

 diseases have increased at about the same rate as in the registration 

 states. We are warranted in concluding, therefore, in spite of the lack 

 of absolutely accurate data, that the trend of our mortality in middle 

 life is at present unfavorable and that this condition is accompanied by 

 an increasing incidence of the degenerative diseases. 



The question we now desire to put squarely is this: What are the 

 forces at work in American life which have made for this increased 

 mortality at the adult ages ? In a recent paper entitled " The Possibili- 

 ties of Eeducing Mortality at the Higher Age Groups" the writer 

 pointed out some of the conditions of present-day life which he believed 

 tended to increase the death rates from the so-called "degenerative" 

 diseases. In this paper reference was made to the greater use of alcoholic 

 beverages and especially to the deleterious effects of modern conditions 

 of industry. It was assumed that the changing conditions of American 

 industrial life involved a greater strain on the organism, causing it to 

 break down at an earlier age than was formerly the case under the less 

 intense conditions of labor. In the present paper I wish to refer to 

 another element which is apparently at work in the causation of these 

 higher death rates from the diseases above mentioned. 



